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Infections with COVID-19 can induce thrombophilia and increase the risk of thrombotic events. We describe a case of a 64- years-old male who presents with intermediate-risk pulmonary embolism and brachial artery thrombosis secondary to an undiagnosed patent foramen ovale and COVID-19 infection. The patient was successfully treated with thrombolysis and heparin infusions and was discharged home with long-term anticoagulation. Managing patients with multiple pathologies occurring concurrently requires effective inter-speciality working in order to take a holistic approach to managing the patient opposed to managing the conditions in isolation. This case report highlights how clinical guidelines can support decision making of the individual pathologies but working as a team will enable the best care.

Background & Aim: Self-efficacy disruption poses a significant challenge for patients with a stoma, affecting their ability to engage in community life and carry out daily activities. Utilizing remote training methods for patients presents an opportunity to maximize the use of these resources. This study aims to determine the effect of a telenursing-based training program on the self-efficacy of patients with a stoma. Methods & Materials: This quasi-experimental study involved a convenient sample of 80 patients with a stoma in Zahedan in 2023, who were randomly assigned to two groups: intervention and control, each comprising 40 participants. The intervention group received the telenursing-based program application. Self-efficacy was assessed using the self-efficacy of stoma patients questionnaire before the intervention, as well as one and three months after the intervention. Data were analyzed using Chi-square test and a two-way repeated measures analysis of variance through SPSS software version 26. Results: The intervention group exhibited a mean (SD) age of 42.84±12.98 years, while the control group had a mean (SD) age of 46.26±11.89 years (P=0.320). The self-efficacy total scores in the intervention group showed values of 69.75±8.05 before the intervention, 77.28±7.57 at one month, and 92.72±6.43 at three months post-intervention, suggesting a significant effect of the telenursing-based training on self-efficacy levels (P

Mechanistic, constraint-based models of microbial isolates or communities are a staple in the metabolic analysis toolbox, but predictions about microbe-microbe and microbe-environment interactions are only as good as the accuracy of transporter annotations. A number of hurdles stand in the way of comprehensive functional assignments for membrane transporters. These include general or non-specific substrate assignments, ambiguity in the localization, directionality and reversibility of a transporter, and the many-to-many mapping of substrates, transporters and genes. In this perspective, we summarize progress in both experimental and computational approaches used to determine the function of transporters and consider paths forward that integrate both. Investment in accurate, high-throughput functional characterization is needed to train the next-generation of predictive tools toward genome-scale metabolic network reconstructions that better predict phenotypes and interactions. More reliable predictions in this domain will benefit fields ranging from personalized medicine to metabolic engineering to microbial ecology.

Background & Aim: A large number of drug users make attempts to cease drug use; however, a relapse tendency often emerges subsequent to the cessation period. The present study aimed to examine the effect of emotion regulation skill training on self-control and psychological distress among opioid-dependent people hospitalized at Zahedan Psychiatric Hospital. Methods & Materials: This quasi-experimental study was conducted over the fourth quarter of the year 2022, focusing on 80 drug users who underwent treatment at Baharan Psychiatric Hospital in Zahedan. The participants were selected using convenience sampling and subsequently assigned to either the intervention group or the control group. The intervention group received a total of 10 sessions of training in emotion regulation skills. The self-control and psychological distress questionnaires were used to collect the data. The data were analyzed using both descriptive and inferential statistical tests through SPSS software version 22. Results: The mean and standard deviation of the psychological distress score among opioid addicts in both the intervention group (P

Background & aim: The fear of being affected by COVID-19 has significantly reduced perinatal care. The current study aimed to evaluate the impact of smartphone-based self-care education on awareness, perceived severity, and self-care of pregnant women at risk of preterm birth during a covid-19 pandemic.Methods: This quasi-experimental study was conducted on 115 pregnant women at risk of preterm birth that was assigned into intervention (N=58) and control (N=57) groups. The research tools included the demographic and preterm delivery screening checklist, awareness, perceived severity, and self-care questionnaires. The intervention group received training files using WhatsApp software within two weeks. The control group received no intervention. The questionnaires were completed before (T1), 8 (T2) and 12 (T3) weeks after the implementation of the intervention in two groups. ANOVA, ANCOVA, independent t-test, chi-square, and Fisher's exact test were used to analyze the data using SPSS software (version 24) Results: No significant difference was found between baseline data (T1) before the intervention in two groups (p>0.05); while after the intervention, a significant increase was observed in the mean score of awareness at T2 and T3 compared to T1 (P

Background & Aim: The utilization of emotional expression methods, including narrative counseling and written emotional expression, has been shown to be efficacious in mitigating the intensity of diverse psychological issues such as depression and acute stress, particularly following traumatic events. Additionally, emergency cesarean section is commonly acknowledged as a traumatic event that may lead to psychological challenges for the mother. The purpose of this research was to compare the effectiveness of emotional expression through writing and narration in reducing post-traumatic stress and postpartum depression among women undergoing emergency cesarean section. Methods & Materials: This quasi-experimental study was conducted in Zahedan, involving a total of 120 women who underwent emergency cesarean section and were admitted to Ali Ibn Abi Talib (AS) hospital during the period of 2021-2022. The participants were selected using convenience sampling and were randomly divided into three groups: written emotional expression, narration and control, with each group consisting of 40 participants. The intervention consisted of one face-to-face session and two non-face-to-face sessions. Data collection involved the use of the Edinburgh Depression Questionnaire and PTSD assessments, administered before and six weeks after the intervention across all three groups. The data were analyzed using SPSS version 24, employing descriptive and inferential tests such as ANOVA and Tukey's post hoc analysis. Results: The results showed a significant decrease in the average scores of post-traumatic stress and postpartum depression in the written emotional expression and narration groups, compared to the control group, after the intervention (P0.05). Furthermore, a higher mean difference was observed in both post-traumatic stress and postpartum depression scores before and after the intervention in the written emotional expression group, compared to the narration group, indicating a greater effect of written emotional expression (P

BACKGROUND: Premature infant hospitalization in the neonatal intensive care unit (NICU) is considered a traumatic event for mothers. It is critical to provide instructions and support to couples to help them emotionally adapt and reduce posttraumatic stress. The aim of the present study was to determine the effect of family-centered education on posttraumatic stress in mothers of premature infants hospitalized in the NICU. MATERIALS AND METHODS: The present study was a quasiexperimental study. The parents of 80 premature infants admitted to the NICU ward of a hospital in southeastern of Iran in 2020 were divided into two groups of 40 intervention and control. The intervention group received five sessions of family-centered program on daily basis with an average of 60 minutes per session; sessions were held in the presence of both couples and for each couple separately. The control group received only training and usual care. Six weeks after intervention, information was collected using the posttraumatic stress disorder checklist. Data were analyzed using the paired t-test, independent t-test, Chi-square test, and covariance analysis. RESULTS: The intervention and control groups’ mean posttraumatic stress scores before family-centered care were 49.65 ± 8.73 and 55.45 ± 10.39, respectively. Six weeks after the intervention the score decreased significantly to 32.75 ± 6.05 and 44.82 ± 6.53. Also, the mean score changes in the intervention group (-16.90 ± 7.69) were significantly higher than those in the control group (-10.63 ± 6.12). CONCLUSIONS: Family-centered education has a positive effect on reducing the severity of posttraumatic stress in mothers of premature infants admitted to NICU.

Whole-cell modeling is “the ultimate goal” of computational systems biology and “a grand challenge for 21st century” (Tomita, Trends in Biotechnology, 2001, 19(6), 205–10). These complex, highly detailed models account for the activity of every molecule in a cell and serve as comprehensive knowledgebases for the modeled system. Their scope and utility far surpass those of other systems models. In fact, whole-cell models (WCMs) are an amalgam of several types of “system” models. The models are simulated using a hybrid modeling method where the appropriate mathematical methods for each biological process are used to simulate their behavior. Given the complexity of the models, the process of developing and curating these models is labor-intensive and to date only a handful of these models have been developed. While whole-cell models provide valuable and novel biological insights, and to date have identified some novel biological phenomena, their most important contribution has been to highlight the discrepancy between available data and observations that are used for the parametrization and validation of complex biological models. Another realization has been that current whole-cell modeling simulators are slow and to run models that mimic more complex (e.g., multi-cellular) biosystems, those need to be executed in an accelerated fashion on high-performance computing platforms. In this manuscript, we review the progress of whole-cell modeling to date and discuss some of the ways that they can be improved.

Background: The quality of marital relationships can impact couples’ cardiovascular health directly and indirectly. Given that communication is essential for a happy marriage and plays an important role in health, this study aimed to explain the positive interactions of couples after myocardial infarction.Methods: The current study was conducted qualitatively with the participation of seven couples (patient and his or her spouse) in teaching hospitals affiliated with Zahedan University of Medical Sciences. Purposive sampling was used to select participants. Then, unstructured in-depth interviews were conducted after obtaining informed consent. The interviews were immediately transcribed and analyzed. MAXQDA 2020 was used to categorize the data, and the method proposed by Elo and Kingas was used for data analysis.Results: The analysis of the data revealed that myocardial infarction could affect the way couples interact through two main themes including empathetic union (acceptance of each other’s true selves, mutual understanding, adjusting expectations, increase in cooperation and joint activities) and optimizing couples’ interactions (mutual care and attention, increase in intimacy, mutual reliance).Conclusion: This study indicated that positive couple interactions affected not only marital relationships but also health status, both directly and indirectly. Therefore, the findings of this study can be used to improve nursing student education and nursing care, and would help to develop educational and supportive interventions for patients and their spouses.

Background: Childbirth self-efficacy is one of the most important factors affecting pregnant women's decision about the type of delivery. Low childbirth self-efficacy can lead to unnecessary cesarean sections (CS). Objective: This study aimed to examine the effectiveness of motivational interviewing (MI) on self-efficacy and the decision about the type of delivery in primigravid women requesting elective CS. Methods: A randomized controlled trial was conducted on 120 primigravid women at 28–31 weeks of gestation. The participants were selected through multistage sampling and randomly assigned into an intervention and a control group, each 60. The intervention group received four 90-min sessions of MI, whereas the control group received routine prenatal care. The Childbirth Self-Efficacy Inventory, and the Decision-Making Checklist were used to collect data before and 4 weeks after the intervention. Chi-square, independent-samples t-test, and paired t-test were used for data analysis. Results: The mean baseline childbirth self-efficacy score was 63.68 ± 18.91 in the intervention group and 71.58 ± 25.66 in the control group (P = 0.57). The mean score increased significantly in the intervention group at the end of the study (P = 0.001), whereas it decreased significantly in the control group (P = 0.003). Although all women preferred CS at baseline, 91.7% of the intervention group and 28.3% of the control group applied for normal delivery at the end of the study (P < 0.001). Conclusions: MI can increase childbirth self-efficacy and can be used by midwives and other health-care providers to encourage pregnant women to choose normal delivery.

Background: The painful procedure of drawing blood from the heel (heel lance) in the neonatal intensive care unit (NICU) is necessary for some diagnostic tests. However, it can have negative effects on the physiological criteria of preterm neonates. This study aimed to compare the effect of lullaby and kangaroo care on the physiological criteria of preterm neonates admitted to the NICU during heel lance. Methods: This clinical trial study was conducted with a crossover design on 60 preterm newborns (30-36 weeks of gestation) admitted to the NICU at Ali ibn Abi Taleb Hospital, Zahedan, Iran, 2019. The neonates were randomly divided into two groups of lullaby and kangaroo care (n=30 each). In the former group, a lullaby was played for the neonates through headphones for 30 min, and in the latter group, the naked neonate was placed in the mother's arms for the same duration. Physiological criteria were recorded before (0 min), during (15 min), and after the procedure (30 min). The collected data were analyzed in SPSS software (version 22) using independent t-tests and Chi-square test. Results: There was no statistically significant difference between the mean scores of gestation age of neonates in the lullaby (32.63±1.92) and kangaroo care (32.69±1.92) group (P=1.000). The results of the independent sample t-test showed that during the intervention, there was a difference between the mean pulse rate (P=0.015), respiration rate (P=0.003), and arterial oxygen saturation percentage (P

Background & Aim: Pre-hospital emergencies are one of the most stressful medical professions. Stressful jobs affect employees’ resilience and their ability to control anger. The aim of this study is to determine the effect of psycho-education on the level of anger and resilience among pre-hospital emergency staff. Methods & Materials: In this quasi-experimental study, 120 people employed in urban and road centers in Zahedan were included through the convenience sampling method. To determine the intervention and control group, out of 24 available centers, 12 centers were randomly assigned to the intervention group and 12 centers to the control group. First, a demographic information form and the self-reported anger and resilience questionnaires were completed by both groups. Then, the intervention group participated in five sessions of psycho-education in groups of 8-12 people. The questionnaires were completed again by both groups two months after the intervention. Data was analyzed by the SPSS software version 16 using descriptive (mean and standard deviation) and inferential statistics (Chi-square test, independent t-test and paired t-test). Results: The results of independent t-test showed no significant difference in the mean and standard deviation of resilience score among pre-hospital emergency staff between the intervention and control groups before the intervention (P=0.492), but after the intervention the difference was significant (P=0.009). Also, the results of independent t-test showed no significant difference in the mean and standard deviation of anger control score among pre-hospital emergency staff between the intervention and control groups before the intervention (P=0.672), but after the intervention, mean and standard deviation of anger control score in the intervention group were significantly higher than those of in the control group (P

Secondary metabolites are not essential for the growth of microorganisms, but they play a critical role in how microbes interact with their surroundings. In addition to this important ecological role, secondary metabolites also have a variety of agricultural, medicinal, and industrial uses, and thus the examination of secondary metabolism of plants and microbes is a growing scientific field. While the chemical production of certain secondary metabolites is possible, industrial-scale microbial production is a green and economically attractive alternative. This is even more true, given the advances in bioengineering that allow us to alter the workings of microbes in order to increase their production of compounds of interest. This type of engineering requires detailed knowledge of the “chassis” organism’s metabolism. Since the resources and the catalytic capacity of enzymes in microbes is finite, it is important to examine the tradeoffs between various bioprocesses in an engineered system and alter its working in a manner that minimally perturbs the robustness of the system while allowing for the maximum production of a product of interest. The in silico multi-objective analysis of metabolism using genome-scale models is an ideal method for such examinations.

The ancient cemetery of Khorram Abad is located 7 km away from Meshgin Shahr in Ardabil province. During the excavations, relics of Iron Age I, II and III and also tombs (1500 to 550 BC) have been found. Iron Age I and II tombs are of the type of Megalithic cemetries. The Scythians were a nomadic tribe that spread over a wide geographical area, from the Black Sea in the west to the borders of China. The most important relics of these tribes were their barrows, which can help us understand their political, economic, artistic and worldview. Therefore, for studying tombs, various factors such as the way of distribution of tombs, the shape and form of tombs, burial in tombs, objects and gifts placed in tombs can be very closely related to the culture of people or a region. According to the conducted excavations, this article has pursued three important goals: 1- Typologically, in how many categories can the tombs of this cemetery be classified? 2- What was the relationship between these tombs and the sites of the surrounding settlements, if any, and can the existence of a community with a ruling structure be deduced from the structure and contents of the tombs? 3- What are the analytical comparison and typology of these tombs with their similar types in Iran and abroad? The remains of these barrows have been excavated outside the geographical territory of Iran in the south of Caucasus and around the Black Sea, Russia and Kazakhstan, the most important of which are Pazyryk, Arrajan (Russia) and Kostromskaya. It seems that Khorram Abad’s cemetery had an important religious context used over a wide period of time.

Objective (s): Family caregivers of patients with severe mental disorders experience a great deal of psychological burden. Various interventions have been performed to reduce the psychological problems and psychological burden of caregivers. The aim of this study was to compare the effect of a psychoeducational intervention and quality of life therapy on the psychological burden of family caregivers of patients with severe mental illness. Methods: This quasi-experimental study was performed on 150 family caregivers of severely mentally ill patients admitted to a psychiatric hospital in Zahedan, Iran, in 2020. Caregivers randomly were allocated in three groups: quality of life therapy intervention (50 people), psycho-education intervention (50 people) and control group (50 people). The quality of life therapy intervention group received 8 sessions and psycho-education group received four sessions training during two weeks each lasting for 90 minutes. The psychological burden of caregivers was assessed before and 4 weeks after the training through using the Zarit burden questionnaire. Data were analyzed by SPSS software version 22 using paired t-test, independent t-test, chi-square and ANOVA. Results: The mean score of psychological burden of caregivers was significantly different between the three groups after the intervention (P = 0.002). Post hoc analysis showed that the mean score of psychological burden of caregivers in quality of life therapy group and psychological education was significantly different from the control group (P = 0.001). Also, the mean score of psychological burden of caregivers in quality of life therapy was significantly less than the score in psychological educational intervention group (P = 0.001). Conclusion: Quality of life therapy was more effective in reducing the psychological burden of family caregivers of patients with severe mental disorders compared to psychological educational intervention.

Background: Major thalassemia has a significant impact on the personal performance and life of the affected person and leads to reduced quality of life (QoL) of the patient. One of the ways to improve quality of life is to use the Continuous Care Model (CCM). Aim: This study aimed to determine the impact of CCM on the QoL of patients with thalassemia major. Method: A clinical trial was performed with 60 thalassemia patients referring to Aliasghar Hospital in Zahedan, Iran. Eligible candidates were selected by convenience sampling method and randomly assigned to the intervention and control groups (n=30 each). Data collection tools included a demographic form, the quality of life questionnaire the brief version of the World Health Organization's QoL, and a self-control checklist. The intervention was performed in six training sessions three times a week in the presence of the patient and a family member; however, the control group received no intervention. Data analysis was performed in SPSS software (version 21). Results: The mean scores of QoL and its dimensions showed no significant difference between the intervention and control groups before the intervention (P>0.05); nevertheless, a significant difference was observed one and three months after the implementation of the model regarding (P

Introduction: Psychological factors including depression and anxiety are the most critical risk factors in the treatment and prognosis of heart failure which should be addressed in treatment and care programs. The purpose of this study was to examine the effect of cognitive-behavioral training (CBT) on depression severity and self-care ability of patients with heart failure. Methods: This study was a randomized clinical trial that carried out on 80 patients with heart failure who had been hospitalized in 2018. The participants were divided into the CBT group (n= 40) and the conventional training (CT) group (n= 40), randomly. Data were collected using Beck Depression Inventory (BDI) and the Self-Care of Heart Failure Index (SCHFI) version 6.2 before and 8 weeks after the educational interventions. Data were analyzed in SPSS 21 using paired t-test, independent t-test, chi-square test, and covariance analysis. Results: The mean score of self-care in the CBT group turned out to be significantly higher than the CT group after receiving the intervention. Also, the mean depression score of the CBT group 26.95 (5.53) after intervention was significantly lower than the CT group 36.04 (8.45). Conclusion: Cognitive-behavioral intervention, compared with conventional training, had a greater positive impact on improving self-care and alleviating the severity of depression symptoms. Therefore, it is recommended that the principles of cognitive-behavioral therapy be integrated into routine educational programs.

Background & Aim: Addiction as a crisis and a chronic long-term disorder can lead to mental health symptoms in the users and their family members, the most common of which are stress, anxiety and depression. The aim of the study was to determine the effect of a quality of life intervention on the psychological reactions in family caregivers of addicts. Methods & Materials: This study is a clinical trial. The research population included the family caregivers of addicts admitted to Baharan psychiatric hospital in 2018. The sample consisted of 80 subjects who were randomly divided into intervention and control groups. The caregivers in the intervention group received eight sessions of group counseling based on quality of life therapy and based on specified content, every other day. Eight weeks after the intervention, the data were collected using the DASS-21, and were analyzed by the SPSS software version 21 using paired t test, independent t test, Chi-square and Covariance. Results: After the quality of life intervention, the mean scores of stress, anxiety and depression in family caregivers in the intervention group (11.50±4.36, 11.05±3.49, 10.57±4.67) were significantly lower than those of in the control group (14.67±4.93, 14.02±4.33, 13.40±4.77) (P

Introduction: Depression is one of the most common psychological disorders in the world. Many depressed patients are being hospitalized in psychiatric centers every year, which can lead to hopelessness and indifference. Considering the role of family as a support system in caring for depressed patients, the goal of the present study is to assess the effects of regular family appointments on the hope of hospitalized depressed patients. Methods: This was a randomized clinical trial on 70 hospitalized depressed patients in the Baharan psychiatric hospital of Zahedan. Block Randomization was used to categorize the participants continuously into two groups intervention (n=35) and control groups (n=35). The data collection tools were demographic characteristics questionnaire and Schneider hope scale. The patients in the interventions group received 6 sessions of regular family appointments with first- degree relatives. The control group received freely and without any planning appointments. Hope level was measured and compared before and after the intervention for two groups. The data were analyzed by SPSS using the chi-square test, the independent t-test and the paired ttest. Results: The results showed that both groups were homogeneous in terms of sociodemographic differences. The hope scores of patients in the intervention group significantly increased compared to those of the control group. Conclusion: Encouraging family cooperation and using patient's choice in selecting visitors is recommended.

Background & aim: Reproductive health has been documented as international human rights. In this respect, residing in slums can lead to poor reproductive health status due to reduced access to healthcare services. Therefore, the present study was conducted to determine women’s reproductive health status in urban slums in southeast Iran. Methods: In this cross-sectional study, a total number of 400 married slum-dwelling women in southeastern Iran were selected through random sampling in 2017. The inclusion criteria were marriage, residence in slum areas, and age group of 15-49 years. To collect the data, the Reproductive Health Needs Assessment questionnaire was completed using face-to-face interviews. Descriptive statistics were employed to analyze the data using SPSS software (version 19). Results: 67.8% of sample were women who were married before the age of 18. Also 36% of the subjects had more than four children, and 79.9% of them experienced an inter-pregnancy interval of less than 3 years. Moreover, 96.8% of the participants received prenatal care services, and 81% of the individuals used family planning methods. Unintended pregnancies experienced by 26% of the subjects, and 59% of them suffered from reproductive tract infections within the last year. The prevalence rate of sexual and physical violence were 40% and 20.5%, respectively. Conclusion: Although the coverage of prenatal, childbirth, and family planning services was appropriate in this region, the domains of family planning, physical and sexual violence, as well as marriage age in women living in urban slums, were undesirable and required more efforts to be improved by reproductive health professionals.

Background & Aim: Substance use as a crisis and a long-term chronic disorder can lead to psychological burden and reduce the quality of life of family caregivers. The aim of this study was to determine the effect of the quality of life therapy intervention on the burden of the family caregivers of addicts. Methods & Materials: This is a clinical trial. The research population included all the family caregivers of the recovering addicts, admitted to Baharan psychiatric hospital in Zahedan in 2018. The samples were 80 people who were randomly divided into either intervention or control group. Caregivers in the intervention group received eight sessions of group counseling based on the quality of life therapy and on the basis of the determined content, every other day. Before the intervention and eight weeks after the intervention, the data were collected using the Zarit burden questionnaire and were analyzed by statistical tests through the SPSS software version 21. Results: Before the intervention, there was no significant difference in the mean score of burden between the two groups (P=0.25). After the intervention, the mean score of family caregiver burden in the intervention group (40.10±12.92) was significantly lower than in the control group (46.80±13.58) (P

Background: Stress and burnout are among the challenges that nurses face, and the proper use of time can lead to its reduction. The purpose of this study was to identify the effect of time management training on stress and job burnout among nurses in hospitals affiliated to Zahedan University of Medical Sciences. Methods: This was a quasi-experimental study which were conducted sampling 120 nurses, using a convenience sampling method. Intervention group samples were selected from Imam Ali hospital and the control group from Khatam al-Anbia hospital in Zahedan. Data were collected through demographic, ENSS job stress, and Maslach burnout questionnaires. In the interventional group, after completing the questionnaires, time management training was conducted in four sessions by two groups of 30 people per week for 90 minutes. This intervention included lectures using educational aids and PowerPoint for eight weeks. After the final time management training session, the burnout and stress questionnaires were again completed in the intervention group and the control group. Data were analyzed through Independent and paired t-test, and chi-square. Results: Findings showed that there was a significant difference between the mean scores of job stress scores after time management training in the intervention and control groups (P> 0.001). Mean changes in emotional exhaustion and depersonalization scores and personal achievement of burnout after time management training were significantly different between the intervention and control groups (P < 0. 001). Conclusion: Given the importance of time management in nursing, nurse managers should hold in service time management training courses for their employees, nurses.

Background. The design of an orthodontic mini-implant is a significant factor in determining its primary stability and its clinical success. The aim of this study was to measure the relative effect of mini-implant design factors on primary stability of orthodontic mini-implants. Methods. Thirty-two 3-dimensional assemblies of mini-implant models with their surrounding bone were generated using finite element analysis software. The maximum displacement of each mini-implant model was measured as they were loaded with a 2-N horizontal force. Employing Taguchi’s design of experiments as a statistical method, the contribution of each design factor to primary stability was calculated. As a result of the great effect of the upper diameter and length, to better detect the impact of the remaining design factors, another set of 25 models with a fixed amount of length and diameter was generated and evaluated. Results. The diameter and length showed a great impact on the primary stability in the first set of experiments (P

Background & Aim: The experience of domestic violence has negative consequences on the mental health of pregnant women, and interventions must be designed to reduce these negative consequences. Therefore, the aim of this study was to determine the effect of supportive-educational intervention on psychological distress among pregnant women subjected to domestic violence. Methods & Materials: This clinical trial was conducted on 100 pregnant women subjected to domestic violence, referred to comprehensive health centers of Zahedan for receiving prenatal care in 2018. Eligible women were selected by the convenience sampling method and randomly assigned into two groups of intervention and control. The intervention group received four supportive-educational individual sessions during two weeks. The control group received routine care during this period. Data were collected in two groups by the Kessler Psychological Distress Scale (K10) and Hurts, Insults, Threaten, Screams (HITS), before the intervention and four weeks after the intervention. The data were analyzed by statistical tests using the SPSS software version 21. Results: The results showed that the mean score of psychological distress of pregnant women dropped from 30.9±4.58 to 22.18±3.81 (mean change score -8.72±3.93) in the intervention group and from 25.22±4.15 to 24.06±4.16 (mean change score -1.16±1.48) in the control group. Analysis of covariance demonstrated that there was a statistically significant difference in the mean score of psychological distress of pregnant women exposed to violence between the two groups after the supportive-educational intervention (P

Background & Aim: Menopause has been recognized as a critical stage in women’s life. Menopausal symptoms and problems can affect women’s health and well-being. Health promoting behaviors may be useful in alleviating these symptoms. The purpose of this study was to determine the effect of couple counseling on severity of menopausal symptoms in women. Methods & Materials: In a quasi-experimental study, 80 women with their husbands were selected by the convenience sampling method from health care centers in Zahedan in 2017, and were assigned to either experimental or control group. The data gathering tool included a demographic questionnaire and Menopuse Rating Scale questionnaire. Couple counseling for the intervention group was conducted in four 60-minute sessions. Data were collected before and 12 weeks after the intervention, and analyzed by independent and paired t-test, analysis of covariance and χ2 using the SPSS software version 21. Results: There was no significant difference between the two groups in terms of demographic variables, but the mean of score changes for menopausal symptoms in the intervention group was -1.42±1.95 and in the control group was -0.10±1.10. The independent t-test showed a significant difference in the mean of score changes for menopausal symptoms in the two groups (P

Background and Aim: Self-care behaviors are one of the effective factors in preventing symptoms and recurrence of the disease. Continuous Care Model has been introduced as a regular process for effective communication between patient and nurse. considering the feature of this model in the continuity of communication in patient care that is appropriate to the patient's condition, This study aimed to determine the effect of Continued Care Model (CCM) on self-care behaviors in patients with myocardial infarction. Materials and Methods: A randomized controlled clinical trial study was performed on patients admitted to coronary care unit (CCU) wards of the Zahedan-based teaching hospitals in 2017. Sixty patients were selected by convenience sampling method and assigned randomly into intervention and control groups (N=30 per group). The CCM in five group sessions, they performed 45-30 minutes and were followed up by telephone. Data were collected by using a demographics form and questionnaire of standard scale Self-Care Miller in a Data were collected from using a demographics form and questionnaire of standard scale Self-Care Miller in three periods of time. data were analyzed in SPSS software (Version 20) and with the help Independent t-test, Chi-square and repeated measures ANOVA with Bonferroni post hoc test, at the significant level of P

Abstract Background Living organisms need to allocate their limited resources in a manner that optimizes their overall fitness by simultaneously achieving several different biological objectives. Examination of these biological trade-offs can provide invaluable information regarding the biophysical and biochemical bases behind observed cellular phenotypes. A quantitative knowledge of a cell system’s critical objectives is also needed for engineering of cellular metabolism, where there is interest in mitigating the fitness costs that may result from human manipulation. Results To study metabolism in photoheterotrophs, we developed and validated a genome-scale model of metabolism in Rhodopseudomonas palustris, a metabolically versatile gram-negative purple non-sulfur bacterium capable of growing phototrophically on various carbon sources, including inorganic carbon and aromatic compounds. To quantitatively assess trade-offs among a set of important biological objectives during different metabolic growth modes, we used our new model to conduct an 8-dimensional multi-objective flux analysis of metabolism in R. palustris. Our results revealed that phototrophic metabolism in R. palustris is light-limited under anaerobic conditions, regardless of the available carbon source. Under photoheterotrophic conditions, R. palustris prioritizes the optimization of carbon efficiency, followed by ATP production and biomass production rate, in a Pareto-optimal manner. To achieve maximum carbon fixation, cells appear to divert limited energy resources away from growth and toward CO2 fixation, even in the presence of excess reduced carbon. We also found that to achieve the theoretical maximum rate of biomass production, anaerobic metabolism requires import of additional compounds (such as protons) to serve as electron acceptors. Finally, we found that production of hydrogen gas, of potential interest as a candidate biofuel, lowers the cellular growth rates under all circumstances. Conclusions Photoheterotrophic metabolism of R. palustris is primarily regulated by the amount of light it can absorb and not the availability of carbon. However, despite carbon’s secondary role as a regulating factor, R. palustris’ metabolism strives for maximum carbon efficiency, even when this increased efficiency leads to slightly lower growth rates.

Abstract Background Genome-scale metabolic modeling is a cornerstone of systems biology analysis of microbial organisms and communities, yet these genome-scale modeling efforts are invariably based on incomplete functional annotations. Annotated genomes typically contain 30–50% of genes without functional annotation, severely limiting our knowledge of the “parts lists” that the organisms have at their disposal. These incomplete annotations may be sufficient to derive a model of a core set of well-studied metabolic pathways that support growth in pure culture. However, pathways important for growth on unusual metabolites exchanged in complex microbial communities are often less understood, resulting in missing functional annotations in newly sequenced genomes. Results Here, we present results on a comprehensive reannotation of 27 bacterial reference genomes, focusing on enzymes with EC numbers annotated by KEGG, RAST, EFICAz, and the BRENDA enzyme database, and on membrane transport annotations by TransportDB, KEGG and RAST. Our analysis shows that annotation using multiple tools can result in a drastically larger metabolic network reconstruction, adding on average 40% more EC numbers, 3–8 times more substrate-specific transporters, and 37% more metabolic genes. These results are even more pronounced for bacterial species that are phylogenetically distant from well-studied model organisms such as E. coli. Conclusions Metabolic annotations are often incomplete and inconsistent. Combining multiple functional annotation tools can greatly improve genome coverage and metabolic network size, especially for non-model organisms and non-core pathways.

BACKGROUND: Improving self-care in adolescent pregnancy leads to improved maternal and neonatal outcomes of pregnancy. However, self-care in adolescent pregnancy is less than other women. The aim of this study was to compare the effect of face-to-face training and telemedicine on self-care in adolescent pregnant women. MATERIALS AND METHODS: The present study is a quasi-experimental study that was conducted in Zahedan in 2021 and 120 adolescent pregnant women with a gestational age of 15–20 weeks participated in it. The sampling was done in multistage, and the samples were divided into three groups: Face-to-face training, telemedicine, and control. Face-to-face training was presented in five sessions and the telemedicine group received the similar educational content through the mobile applications. The samples completed a researcher-made self-care questionnaire before the intervention and at 28 weeks of gestation. SPSS software version 21 was used for the analysis, and data were analyzed by ANOVA, Tukey post hoc, Kruskal–Wallis, and Mann–Whitney tests. RESULTS: There was no significant difference in face-to-face and telemedicine training in improving the scores of nutritional performance, smoking and narcotics use, personal hygiene, and routine pregnancy care (P > 0.05), but face-to-face training caused more improvement in the scores of sports and physical activity as compared to telemedicine group (P = 0.04). Face-to-face training and telemedicine training in all domains led to a significant improvement in scores as compared to the control group (P < 0.05). CONCLUSION: The results of this study showed that the face-to-face training and telemedicine methods were proper methods for self-care education in pregnant adolescent women. It is recommended to use these methods in promoting self-care in pregnant adolescent women.

Abstract Background Lactobacilli, as normal vaginal flora, have a central role in controlling body environment and preventing the growth of pathogens. Sucrose, by promoting the growth of Lactobacilli, accelerates the suppression of pathogenic bacteria. The aim of this research was to compare the effects of sucrose gel with those of metronidazole gel in treating women with bacterial vaginosis (BV). Methods This triple-blind clinical trial (IRCT2016112631105N1) was conducted with 70 sexually active, premenopausal women diagnosed with bacterial vaginosis through meeting at least three out of four Amsel criteria. The subjects were randomly divided into two groups of 35 patients, one group treated with sucrose vaginal gel, and the other with metronidazole vaginal gel. The treatment period was 14 days for each group. At the end of the treatment period, the status of each woman’s improvement was determined by elimination at least three out of four Amsel criteria (homogeneous vaginal discharge, presence of clue cells > 20%, positive whiff test and vaginal pH value > 4.5), and clinical complaints and reported side effects of medication were recorded for the patients. Data were analyzed using the t test, chi-squared test and McNemar’s test). Results The sucrose vaginal gel and metronidazole vaginal gel were not significantly different in reducing patients’ clinical complaints or in elimination at least three out of four of the Amsel criteria that were positive before treatment. With an 85.7% improvement rate with sucrose gel and an 88.5% improvement rate with metronidazole gel, the differences in therapeutic response were not significant, and neither was statistically different in improving the disease (p = 0.389). Conclusion It seems that sucrose vaginal gel might be considered a possible alternative to metronidazole vaginal gel in the treatment of bacterial vaginosis. Trial registration Iranian Registry of Clinical Trials, IRCT2016112631105N1. Registered on 27 December 2016.

Imagine that, in order to build a city, murders were always necessary. If grief counts then someone has the task to mourn for the victim, to plan the celebration of the recurrence and to come to term with the murderer. The territory where the city exists is certainly that which has been violated at first. When we stare at the on-going overbuilding of our contemporary cities we are often reminded of all that which has been and must be irreparably lost because of the desire and the necessity to build. Responsible architects want to express a profound and sincere sense of grief for that loss. We could name it: “radical grief”. The well-educated architects indulge diligently in front of their weeping walls before “driving” irresistibly toward their shopping malls. The overexposed sacrificial victim appears as that which has been irreparably lost and cannot be revived: a recurring martyrdom (victimage mechanism). Are we still asked to sacrifice the most precious thing for the glory of our city, and, if so, what is it and who has the task to mourn it?

Background & Aim: In pregnancy following stillbirth, the parental relationship and attachment to the dead child are denied, and this can impair the mother’s attachment to the new child. The present study aimed to determine the effect of cognitive behavioral training on maternal-fetal attachment in subsequent pregnancy following stillbirth. Methods & Materials: This quasi-experimental study was performed on 100 pregnant women with the history of stillbirth, referred to health centers in Zahedan in 2017. Mothers were selected using convenience sampling and assigned into two groups of 50 each. Data were collected by a demographic questionnaire and the Cranley maternal-fetal attachment scale. After pre-test, the intervention group received 4 sessions of cognitive behavioral training during 4 weeks. After 8 weeks, the post-test was performed for two groups and data were analyzed using independent t-test, chi-square, Fisherchr('39')s exact and ANCOVA tests through the SPSS software version 21. Results: The mean score for maternal-fetal attachment was not significantly different in the baseline but was significantly higher in the intervention group (92.36±11.89) than in the control group (80.90±16.36) after the intervention (P

Background & Aim: Waterpipe smoking during pregnancy is a health problem, and interventions must be designed for its cessation. The present study was conducted to examine the effect of motivational interviewing (MI) on self-efficacy to quit hookah smoking in pregnant women. Methods & Materials: The randomized clinical trial was conducted on 140 pregnant women who smoked hookah and lived in the marginal settlements in Zahedan in 2017. The convenience samples were randomly assigned to intervention and control groups. Data were collected using demographic characteristics and self-efficacy to quit hookah smoking questionnaires. Participants in the intervention received four group sessions of MI, while those in the control only received usual recommendations for quitting hookah smoking. The post-test was performed eight weeks after the completion of the intervention. Independent t-test, paired t-test, Chi-square, and Analysis of Covariance (ANCOVA) were used for data analysis through the SPSS software version 21. Results: The demographic characteristics and gestational age of women were comparable between two groups, but the duration of hookah consumption in the intervention was more than the control (P=0.008). While the mean score of self-efficacy of two groups in pre-test was alike, in the post-test the score of self-efficacy in the intervention (60.85±7.25) was higher than the control (22.77±3.79) (P

Objective (s): Chronic Renal Failure (CRF) is one of the major public health problems, and since in most patients with chronic disease, quality of life is lower than the general population, and improving and maintaining quality of life in these patients requires serious family support, this study was to determine the effect of a family-centered empowerment model on quality of life in dialysis patients referring to a teaching hospital in Zahedan, Iran. Methods: This quasi-experimental study was performed on 100 hemodialysis patients referring to the dialysis department of a teaching hospital. Patients were randomly allocated to intervention and control groups. The intervention group received the family-centered empowerment model in four steps: perceive threat, self-efficacy through problem solving, self-esteem through educational participation and evaluation in four sessions. The data collected by Kidney Disease Quality of Life -Short Form questionnaire at baseline and one and two months after intervention by both groups. Data were analyzed by SPSS version 22 using Chi-square, independent t-test, ANOVA with repeated measures. Results: There was a significant difference between intervention group and control group in the mean score of specific dimensions (P = 0.01) and total quality of life (P = 0.005) in one and two months after the intervention and the mean score of the general dimensions of quality of life in two months after the intervention (P = 0.006). The repeated measures analysis of quality of life showed that changes in quality of life score in the two groups were not the same and this indicated that the increase in the quality of life score in the intervention group was significantly higher than the control group (P

Education and support based on family’s needs may reduce anxiety and increase satisfaction of family members of hospitalized patients in Intensive Care Unit (ICU). This study was conducted to determine the effect of educational-supportive intervention on satisfaction of family members. In this quasi-experimental study, 154 participants of family members of hospitalized patients in ICU in Zahedan (Iran) were studied. The participants were allocated to intervention and control groups. Family Satisfaction-ICU (FS-ICU) was used as data collection tool. The validity and reliability of questionnaire was confirmed in Iran. The questionnaires were completed by both groups before and after one- week intervention. The mean change in the score of satisfaction with performance, comfort and participation in decision-making of family members of patients after educational-supportive intervention were 76.62±14.34, 73.86±4.15, and 31.61±19.323 respectively in the intervention group. These scores were significantly higher than those of control group (43.5±3.62, 22.63±5.83 and 18.12±13.84). Analysis of covariance through control of covariate showed that the mean score of satisfaction of family members concerning the three sub-scales were significantly different in two groups after intervention. According to the effect of educational-supportive intervention on the increase of family satisfaction, it is essential to apply these interventions in educational programs and family-centered care. This action reduces the family’s concern as well as increases their motivation and power in caring after patient’s discharge.