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Abstract The pulp and paper industry generates vast quantities of paper sludge, posing significant environmental challenges due to its disposal in landfills or incineration. This study explores the potential of valorizing paper sludge by incorporating it into particleboard production. It aims to optimize sludge content and particle size to enhance board properties—a novel approach to waste management in the wood composites industry. Through systematic variation of sludge content (0–25%) and particle size ( 2 mm), we assessed the mechanical and physical properties such as internal bond strength (IB), modulus of rupture (MOR), modulus of elasticity (MOE), water absorption (WA), and thickness swelling (TS). The findings indicate that incorporating paper sludge at moderate levels (5–15%) with optimized particle sizes (

Abstract In this study, a spatiotemporal disaggregated simulation model was developed based on water–food–energy (WFE) nexus approach to assess water and food supply security considering ecosystem provisioning services. The main components of the developed model in this study (SD-WFE model) are population, water, agriculture, and energy modules. The model, which was developed using system dynamics (SD) approach, was utilized to simulate effectiveness of sectoral municipal, industrial, and agricultural water and energy consumption management and environmental protection policies in improving ecosystem provisioning services during a 20-year period. Through sensitivity analysis utilizing the Monte Carlo model, the study addresses the formulation of sustainable water resource policies across four main categories: water demand management, water supply management, food resource management, and energy resource demand management. Additionally, it explores the integration of policies within an optimal framework. The simulation of proposed solutions revealed that a combination of water demand management and food resource management yielded the most promising outcome. Specifically, the recommended solution entails enhancing water irrigation efficiency by 18% through the expansion of pressurized irrigation network coverage, adjusting cropping patterns by 14%, reducing agricultural product losses by 8% via improved food supply management, minimizing food demand by 9% due to reduced food consumption losses, and achieving an annual 10% increase in crop performance. These selected policies form the foundation for sustainable water resource management strategies.

Abstract In this paper we investigate the influence of cold plasma as novel method on the external otitis treatment which is a frequent cause of earache. 24 infected external auditory canals in 24 rats were categorized in four experimental groups including control, plasma exposed, ciprofloxacin drug and mixed of plasma-ciprofloxacin groups. In plasma group, dielectric barrier discharge was employed as the source of cold plasma in 5 days. All rats were observed with otoscope daily and a scoring system was used to evaluate swelling and effusion of the ear canal. Number of colonies in microbiological culture were counted in each group during the first 5 days after treatment. For the multiple group comparisons of swelling and effusion measured in the external auditory canal, Kruskal–Wallis analysis was applied and one-way anova and Kruskal–Wallis analysis was used for the statistical analysis of the results of the cultures in different days. Also, Tukey and Mann–Whitney tests was applied for multiple comparisons. Our findings show that swelling and effusion were obviously reduced in plasma group compared to control group (P

Objectives: COVID-19 was triggered by the severe acute respiratory syndrome coronavirus-2, leading to a pandemic. The risk of developing dysphonia and dysphagia amongst COVID-19 patients is considered to be high. Methods: In this prospective study, 150 patients affected by COVID-19 admitted to the intensive care unit (ICU) and the ward of Firoozgar Hospital in Tehran, Iran, were analyzed. Dysphagia and dysphonia were evaluated according to the swallowing impairment score and the consensus auditory-perceptual evaluation of voice (CAPE-V). Also, the quality of life (QoL) was measured using the Persian version of the voice handicap index, the swallowing QoL and the Persian version of the dysphagia handicap index (DHI). Results: A total of 150 COVID-19 patients (mean age: 59.64±17.87 years and 54.3% male; 75 admitted patients to the ICU and 75 patients admitted to the ward) were evaluated. A total of 115(77%) patients with COVID-19 were experiencing dysphagia, and the prevalence of dysphagia did not vary meaningfully between the two sets. According to the swallowing QoL, the QoL of the two groups was meaningly different (P

Background: Patients with foot drop may need compensatory mechanisms to improve their gait. Although several gait analysis parameters have been studied in these individuals, no prior research has examined their joint contact force. Thus, this study investigated multiple gait analysis parameters and the joint contact force in patients with foot drop.Methods: This experimental study recruited twenty individuals aged 15 to 60 (mean value 56.4 ± 3.68) with foot drop disorders. A control group was also matched with the first group based on age, height, and gender. The participants were instructed to walk along a 12-meter path. A motion analysis system with eight high-speed cameras and a Kistler force plate was used. During gait analysis, various parameters were measured, such as spatiotemporal, peak forces applied on the leg, range of motions, moments applied on the lower limbs, and joint contact forces.Results: The mean values of stride length and speed for normal subjects were 1.32±0.2 m and 1.24 ± 0.177 m/s, respectively, compared to 0.961±0.24 m and 0.686 ± 0.25 m/s for foot drop subjects (p-value = 0.00). The joint contact force components of the ankle joint increased significantly in foot drop subjects compared to normal subjects.Conclusion: The joint contact forces of the ankle joint increased significantly in foot drop patients, which should be considered in the rehabilitation treatment of these patients.

Risk and uncertainty are crucial factors in decision-making processes, especially when integrating emerging technologies into essential systems like supply chains. Failing to adequately consider significant risks can disrupt supply chain operations, leading to a loss of competitive edge and causing financial and reputational damage. On the other hand, the complex nature of new technology environments, differing viewpoints among stakeholders, and the challenges of interpreting data introduce a variety of uncertainties in decision-making. In this study, we conduct a thorough examination of how blockchain strategies can be applied within supply chain frameworks. Our analysis utilizes data-driven network decision-making models that are refined to effectively manage uncertainty and risk. These models take into account aspects such as supply chain dynamics and technological factors. Importantly, we meld risk considerations with our models to tackle efficiency shortfalls, while also accounting for uncertainty caused by ambiguous and stochastic data environments. By applying and assessing these models in a real-world case study of the oil and gas industry, our research uncovers insightful observations. Specifically, we find that adopting a localization strategy presents specific risks, while a single-use strategy yields significant efficiency improvements.

Background and purpose: Experimental and clinical studies have shown the potential role of progesterone in relieving neural injury. In addition, emerging data on vitamin D, a steroid hormone, have shown its neuroprotective properties. This study was designed to evaluate the mutual effect of vitamin D and progesterone on neuropathic pain (NP) in male rats. Experimental approach: Chronic constriction injury (CCI) was induced by inserting four ligatures around the sciatic nerve. Hyperalgesia and allodynia (cold and mechanical) were considered positive behavioral scores of NP. After surgery, Sprague Dawley male rats (weighing 200-250 g) were assigned into 7 groups. Vitamin D (250 and 500 units/kg/day, i.p.) and progesterone (4 and 6 mg/kg/day, i.p.) were injected from the 1st day after CCI which continued for 21 days. Moreover, one group received the co-administration of vitamin D (500 units/kg/day, i.p.) and progesterone (6 mg/kg/day, i.p.) from the 1st day until the 21st post-CCI day. Behavioral tests were performed on the 7th, 14th, and 21st days. Findings/Results: Daily supplementation with vitamin D (250 and 500 units/kg) did not alter nociception. Progesterone (4 and 6 mg/kg/day) was ineffective on thermal hyperalgesia. In the allodynia test, progesterone significantly decreased pain-related behaviors. The co-administration of vitamin D (500 units/kg/day) with progesterone (6 mg/kg/day) significantly relieved thermal hyperalgesia. Finally, the combination significantly decreased cold and mechanical allodynia. Conclusion and implications: This study showed the mutual effect of progesterone and vitamin D on NP for the first time. Hyperalgesia and allodynia were significantly relieved following co-administration of vitamin D and progesterone.

Abstract Handgrip strength (HGS) is a non-invasive and reliable biomarker of overall health, physical function, mobility, and mortality. This study aimed to investigate the possible relationship between HGS and mortality in older adult patients hospitalized with COVID-19 in the intensive care unit (ICU) by Alpha (B.1.1.7) and Delta (B.1.617.2) variants. This retrospective cohort study was conducted on 472 COVID-19 patients (222 female and 250 male) aged 60–85 years admitted to the ICU. Demographic data, underlying comorbidities, COVID-19-related symptoms, as well as laboratory and computed tomography (CT) findings were obtained from the patient’s medical records. Using a JAMAR® hydraulic dynamometer, the average grip strength value (kg) after three measurements on the dominant side was recorded for subsequent analysis. Low grip strength (LGS) was defined as an arbitrary cut-off of two standard deviations below the gender-specific peak mean value of normative HGS in Iranian healthy population, i.e.

Abstract Background Dengue fever (DF) is one of the most prevalent arboviral infections worldwide. In Iran, the dengue-positive serological cases as well as the presence of the dengue vector Aedes aegypti have raised health concerns, highlighting the need to enhance the dengue surveillance system. This study aims to assess the knowledge, attitudes, and practices (KAP) of healthcare professionals (HCPs) regarding dengue fever in a large and high-risk region of southeastern Iran. Methods A total of 492 HCPs were recruited using a multi-stage sampling method from May 2022 to July 2023. Data were collected using a self-administered questionnaire. Data analysis was done using independent t-tests, one-way analysis of variance (ANOVA), one-factor and multi-factor general linear models, and simple and multiple regression models. Results About two-thirds (71%) of the participants did not receive any training on DF. A small percentage of participants were familiar with ovitrap (32.6%) and only 21.7% knew that destroying larval breeding sites could not eliminate the dengue vector. The knowledge of disease symptoms among HCPs was found to be lower in border areas compared to non-border areas (P = 0.018). However, the practice situation in HCPs working in border areas was better than in non-borders (P = 0.003). According to the multiple regression model, the most influential factors associated with knowledge, attitude, and practice were the type of healthcare facility and passing the DF training course. Additionally, education level, work experience, and gender were identified as other factors associated with it, respectively. Significant correlations were found between knowledge and practice (P

Abstract Background To investigate the safety (adverse events [AEs] and post-vaccination multiple sclerosis [MS] activity within 6 weeks), clinical efficacy (protection against coronavirus disease 2019 [COVID-19]), and vaccine-induced humoral immunogenicity (SARS-CoV-2 neutralizing antibody, anti-nucleocapsid IgG, and anti-spike IgG) of the Sinopharm (BBIBP-CorV) vaccine among people with MS (PwMS) receiving different disease-modifying therapies (DMTs). Methods This prospective cohort study was conducted between November 2021 and May 2022. PwMS were followed for six months after the 2nd dose of vaccination. Antibody responses were measured 2–16 weeks after the 2nd dose injection. Multivariate logistic regression was employed to assess the impact of each DMT on dichotomous antibody responses, adjusting for age, sex, MS phenotype, expanded disability status scale, disease duration, and vaccination-antibody titration interval. Results Among the 261 screened PwMS, 209 (aged 38.23 ± 9.73 years, female: 70.8%; relapsing-remitting MS: 80.4%) were included. The frequencies of experiencing non-serious AEs and post-vaccination MS activity were 66.0% and 4.8%, respectively. Breakthrough COVID-19 infection was observed in 14.8% of the PwMS. A subcohort of 125 PwMS was assessed for antibody responses. Positive neutralizing antibodies, anti-nucleocapsid IgG, and anti-spike IgG were detected in 36.8%, 35.2%, and 52.0% of the PwMS, respectively. Multivariate regression indicated a 96% (OR: 0.04 [95% CI: 0.00, 0.51], P = 0.013), 93% (OR: 0.07 [0.01, 0.64], P = 0.019), and 89% (OR: 0.11 [0.01, 0.96], P = 0.045) reduced odds of positive neutralizing antibody, anti-nucleocapsid IgG, and anti-spike IgG, respectively, among fingolimod-receivers. Additionally, anti-CD20s-receivers had 88% (OR: 0.12 [0.02, 0.85], P = 0.034) lower odds of being positive for anti-nucleocapsid IgG. Conclusions BBIBP-CorV appeared to be well tolerated in PwMS, with promising clinical efficacy. However, a suboptimal humoral response was observed in PwMS receiving fingolimod and anti-CD20s. Future research should investigate the relationship between humoral responses and the frequency and severity of COVID-19 infection across various DMTs.

Abstract Myocarditis is a significant public health concern because of its potential to cause heart failure and sudden death. The standard invasive diagnostic method, endomyocardial biopsy, is typically reserved for cases with severe complications, limiting its widespread use. Conversely, non‐invasive cardiac magnetic resonance (CMR) imaging presents a promising alternative for detecting and monitoring myocarditis, because of its high signal contrast that reveals myocardial involvement. To assist medical professionals via artificial intelligence, the authors introduce generative adversarial networks ‐ multi discriminator (GAN‐MD), a deep learning model that uses binary classification to diagnose myocarditis from CMR images. Their approach employs a series of convolutional neural networks (CNNs) that extract and combine feature vectors for accurate diagnosis. The authors suggest a novel technique for improving the classification precision of CNNs. Using generative adversarial networks (GANs) to create synthetic images for data augmentation, the authors address challenges such as mode collapse and unstable training. Incorporating a reconstruction loss into the GAN loss function requires the generator to produce images reflecting the discriminator features, thus enhancing the generated images' quality to more accurately replicate authentic data patterns. Moreover, combining this loss function with other regularisation methods, such as gradient penalty, has proven to further improve the performance of diverse GAN models. A significant challenge in myocarditis diagnosis is the imbalance of classification, where one class dominates over the other. To mitigate this, the authors introduce a focal loss‐based training method that effectively trains the model on the minority class samples. The GAN‐MD approach, evaluated on the Z‐Alizadeh Sani myocarditis dataset, achieves superior results (F‐measure 86.2%; geometric mean 91.0%) compared with other deep learning models and traditional machine learning methods.

Abstract Trial design This study is a pilot randomized clinical trial aimed to investigate the effect of using Hip Exoskeleton Assistive (HEXA) robot compared to conventional physiotherapy on the quality of walking, disability, and quality of life of stroke patients with hemiplegia. Methods In this study, 24 patients were randomly assigned to the intervention group (robotic physiotherapy with HEXA robot), or control group (conventional physiotherapy). In each session, both groups received 30 min of conventional physiotherapy including electrotherapy and conventional exercises, and then the intervention group did gait training for 30 min with the HEXA robot and the control group for 30 min without the HEXA robot. The treatment program was 12 sessions, 3 times a week. Before the 1st and after the 12th sessions, both groups were evaluated for walking quality, disability, and quality of life. Results The results showed that the main effect of time was significant (P

Abstract Background New-onset postoperative atrial fibrillation (POAF) is a common complication after coronary artery bypass grafting (CABG) surgery, increasing the risk of embolism and stroke. There is a lack of information on the use of anticoagulants in this context. The choice between Warfarin and Direct oral anticoagulants (DOACs) also is not well-established. This randomized study aimed to compare the feasibility and safety of Warfarin and Rivaroxaban in preventing thrombotic events in POAF patients after isolated CABG. Methods A total of 66 patients were randomized parallelly with 1:1 allocation to receive either Rivaroxaban (n = 34) or Warfarin (n = 32). Major bleeding events within 30 days after discharge were the primary outcome. Secondary outcomes included minor bleeding events and thrombotic episodes. Clinical characteristics, medication regimens, and left atrial diameter were assessed. Statistical analyses were performed using appropriate tests. Results No thrombotic episodes were observed in either treatment arm. No major bleeding events occurred in either group. Four minor bleeding events were reported, with no significant difference between the treatment groups (P = 0.6). Patients with atrial fibrillation had significantly larger left atrial diameters compared to those with normal sinus rhythm (40.5 vs. 37.8 mm, P = 0.01). Conclusions This pilot study suggests that Warfarin and Rivaroxaban are both safe and effective for preventing thrombotic episodes in POAF patients after isolated CABG. No significant differences in major bleeding events were observed between the two anticoagulants. These findings may support the preference for DOACs like Rivaroxaban due to their convenience and easier maintenance. Trial registration Number IRCT20200304046696N1, Date 18/03/2020 https//irct.behdasht.gov.ir/ .

Aims: The aim of this meta-analysis was to determine the pooled incidence of postoperative urinary retention (POUR) following total hip and knee arthroplasty (total joint replacement (TJR)) and to evaluate the risk factors and complications associated with POUR. Methods: Two authors conducted searches in PubMed, Embase, Web of Science, and Scopus on TJR and urinary retention. Eligible studies that reported the rate of POUR and associated risk factors for patients undergoing TJR were included in the analysis. Patient demographic details, medical comorbidities, and postoperative outcomes and complications were separately analyzed. The effect estimates for continuous and categorical data were reported as standardized mean differences (SMDs) and odds ratios (ORs) with 95% CIs, respectively. Results: A total of 31 studies were included in the systematic review. Of these, 29 studies entered our meta-analysis, which included 3,273 patients diagnosed with POUR and 11,583 patients without POUR following TJR. The pooled incidence of POUR was 28.06%. Demographic risk factors included male sex (OR 1.81, 95% CI 1.26 to 2.59), increasing age (SMD 0.16, 95% CI 0.04 to 0.27), and American Society of Anesthesiologists grade 3 to 4 (OR 1.39, 95% CI 1.10 to 1.77). Patients with a history of benign prostatic hyperplasia (OR 1.99, 95% CI 1.41 to 2.83) and retention (OR 3.10, 95% CI 1.58 to 6.06) were more likely to develop POUR. Surgery-related risk factors included spinal anaesthesia (OR 1.44, 95% CI 1.19 to 1.74) and postoperative epidural analgesia (OR 2.82, 95% CI 1.65 to 4.82). Total hip arthroplasty was associated with higher odds of POUR compared to total knee arthroplasty (OR 1.10, 95% CI 1.02 to 1.20). Postoperatively, POUR was associated with a longer length of stay (SMD 0.21, 95% CI 0.02 to 0.39). Conclusion: Our meta-analysis demonstrated key risk variables for POUR following TJR, which may assist in identifying at-risk patients and direct patient-centered pathways to minimize this postoperative complication. Cite this article: Bone Jt Open 2024;5(7):601–611.

Background: According to the cholinergic hypothesis for Alzheimer’s disease, potentiation of cholinergic neurotransmission is one of the best strategies for combating dementia. Methods: A new series of benzamide derivatives bearing 1,3,4-thiadiazole nucleus were synthesized and subsequently, their anticholinesterase activity was evaluated. Molecular docking was carried out to explore the likely binding mode and interactions. Results: Fortunately, some of the tested compounds exhibited more activity than donepezil as a reference drug (IC50 = 0.6 ± 0.05 µM). Some of the evaluated derivatives displayed potency in the nanomolar range. Compound 7e with fluorine atom on the meta position of the phenyl ring was the most active compound in this series (IC50 = 1.82 ± 0.6 nM). Conclusion: The 1,3,4-thiadiazole derivatives that were synthesized and tested in the current manuscript demonstrated remarkable anticholinesterase activity. Therefore, these compounds could be suggested as potential anti-Alzheimer agents.

Abstract The shift of focus from a cognitive to social view has drawn the attention of second language assessment researchers to delve into interactional competence as an intriguing topic in paired oral tests. To fill the gap on how interactional patterns compare across L1 and L2 interactions this study was specifically set to explore and compare 45 paired interactions of L1 English speakers, L1 Persian speakers, and L2 English learners. While the findings indicated that the collaborative pattern was the most common pattern in the three groups less than half of the interactions in total were collaborative. Furthermore, not all the interactional patterns were found in all the groups. The frequency and prominence of the common patterns also varied. The findings could be explained by cultural norms of speech (e.g., in taking turns) and interlocutor effects (e.g., dominating the conversation or adopting a passive role). The findings imply challenges for fair assessment when using paired tasks as assessment tools. Furthermore, the findings call for rubric development and rater training programs to include description and discussion of interactional patterns to help raters improve their understanding and rating of paired interactions.

Abstract The absorption of acidic gases in the oil and gas industries is important due to their toxicity and corrosive effects. Recently, the application of nanofluids based on aqueous or organic solvents as absorbents has been examined by a variety of researchers. In this study, a single bubble column was exploited to study the effect of water-based nanofluids on the absorption processes of SO2 and CO2 using response surface methodology (RSM) based on Box-Behnken three-level experiment design. With this in mind, CO2 and SO2 are separately injected at the bottom of a bubble column filled with one of the nanofluids: Al2O3-water, SiO2-water, or ZnO-water for each experiment. Then, the rate of SO2 or CO2 absorption in the nanofluids has been elucidated. The effect of important parameters including the weight fraction of the nanoparticles (NPs) (0.01, 0.055, and 0.1 wt.%), gas–liquid contact time (150, 300, and 450 s), and the diameter of nozzle for gas injection (0.46, 0.57, and 0.68 mm) have been studied. Results revealed that the maximum molar flux of both gases was observed in the ZnO-water nanofluid, followed by the SiO2-water nanofluid. In addition, increasing the nanoparticle mass fraction and the bubble size causes the molar flux to rise. However, increasing the gas–liquid contact time causes the molar flux of the mentioned gases to decrease. Finally, a set of the accurate equations has been proposed to predict the molar flux of SO2 and CO2 in the various nanofluids assessed in this work.

Abstract There are two major forms of solar energy that are typically utilized: photovoltaic and concentrated applications. The application of fractal glass texture to photovoltaic solar panels is a cutting-edge technique in the field of solar panels that generate electricity from exposure to light. When it comes to studying the environmental implications of a product during its development and commercialization, the life cycle assessment (LCA) approach is an excellent technique that can be utilized. The purpose of this study is to offer a thorough understanding of the product’s effects on the environment by taking into consideration a wide range of criteria, including environmental, economic, and other evaluations. Through the utilization of the life cycle assessment (LCA) methodology and the SimaPro software, this paper presents a comparative analysis of conventional solar panels and fractal glass texture panels. During the course of this research, 18 midpoint indicators and three endpoint indices were investigated. In addition, a sensitivity analysis has been carried out on the fractal property of the panel in order to evaluate the impact that it has on environmental impacts and damages. For the purpose of this study, three distinct levels of fractal coating were applied to the panel surface: one percent, three percent, and five percent. As a result of the data, it was determined that the “Photovoltaic cell single-Si wafer” and the “Transport, freight, sea, transoceanic tanker” had the most significant impact on the midpoint and endpoint indices for both panels, respectively. Furthermore, there is a direct association between the rise in fractal coating on panels and the reduction in environmental repercussions, approximately. This correlation exists because of several factors.

Abstract Background Atrial fibrillation and flutter (AFF) are the most common cardiac arrhythmias globally, contributing to substantial morbidity and mortality. The Middle East and North Africa (MENA) region face unique challenges in managing cardiovascular diseases, including AFF, due to diverse sociodemographic factors and healthcare infrastructure variability. This study aims to comprehensively evaluate the burden of AFF in MENA from 1990 to 2019. Methods Data were obtained from the Global Burden of Diseases Study 2019, a comprehensive source incorporating diverse data inputs. The study collected global, regional, and national Age-Standardized Incidence Rate (ASIR), Age-Standardized Mortality Rate (ASMR), and Age-Standardized Disability-Adjusted Rate (ASDR), Mortality across sex, age groups, and years. LOESS regression was employed to determine the relationship between age-standardized rates attributed to AFF and Socio-Demographic Index (SDI). Results The study found minimal change in ASIR of AFF in MENA from 1990 to 2019, with a slight increase observed in ASMR and ASDR during the same period. Notably, AFF burden was consistently higher in females compared to males, with age showing a direct positive relationship with AFF burden. Iraq, Iran, and Turkey exhibited the highest ASIR, while Qatar, Bahrain, and Oman had the highest ASMR and ASDR in 2019. Conversely, Kuwait, Libya, and Turkey displayed the lowest ASMR and ASDR rates. Conclusion This study underscores the persistent burden of AFF in MENA and identifies significant disparities across countries. High systolic blood pressure emerged as a prominent risk factor for mortality in AFF patients. Findings provide crucial insights for policy-making efforts, resource allocation, and intervention strategies aimed at reducing the burden of cardiovascular diseases in the MENA region.

Abstract Background All orthopaedic procedures, comprising foot and ankle surgeries, seemed to show a positive trend, recently. Bone grafts are commonly employed to fix bone abnormalities resulting from trauma, disease, or other medical conditions. This study specifically focuses on reviewing the safety and efficacy of various bone substitutes used exclusively in foot and ankle surgeries, comparing them to autologous bone grafts. Methods The systematic search involved scanning electronic databases including PubMed, Scopus, Cochrane online library, and Web of Science, employing terms like 'Bone substitute,' 'synthetic bone graft,' 'Autograft,' and 'Ankle joint.' Inclusion criteria encompassed RCTs, case-control studies, and prospective/retrospective cohorts exploring different bone substitutes in foot and ankle surgeries. Meta-analysis was performed using R software, integrating odds ratios and 95% confidence intervals (CI). Cochrane's Q test assessed heterogeneity. Results This systematic review analyzed 8 articles involving a total of 894 patients. Out of these, 497 patients received synthetic bone grafts, while 397 patients received autologous bone grafts. Arthrodesis surgery was performed in five studies, and three studies used open reduction techniques. Among the synthetic bone grafts, three studies utilized a combination of recombinant human platelet-derived growth factor BB homodimer (rhPDGF-BB) and beta-tricalcium phosphate (β-TCP) collagen, while four studies used hydroxyapatite compounds. One study did not provide details in this regard. The meta-analysis revealed similar findings in the occurrence of complications, as well as in both radiological and clinical evaluations, when contrasting autografts with synthetic bone grafts. Conclusion Synthetic bone grafts show promise in achieving comparable outcomes in radiological, clinical, and quality-of-life aspects with fewer complications. However, additional research is necessary to identify the best scenarios for their use and to thoroughly confirm their effectiveness. Levels of evidence Level II.

Abstract The main focus of this study is the transmission of SARS-CoV-2 through virus-laden aerosols in enclosed spaces that utilize ceiling fans. The impact of an air circulation of ceiling fans on virus transmission is not clear. Computational modeling is employed to investigate aerosol transmission within an enclosed space that features ceiling fans. The aerosol concentration is modeled using a transport equation, and the probability of infection distribution across individuals’ breathing zones is assessed. The particle removal efficiency for two ceiling fan speeds of 10 and 35 rad/s is calculated to evaluate the effect of the ceiling fan’s shear flows on the spread of breathing aerosols. The simulated breathing aerosol considers various environmental situations, including thermal gradients, thermally active surface interaction, and deformability. The results indicate that increasing the ceiling fan speed within an enclosed space causes the aerosol cloud to circulate within the room rather than exiting it. Therefore, ceiling fans may not effectively suppress breathing aerosols and could increase transmissibility. Understanding aerosol behavior is essential in reducing the risk of SARS-CoV-2 transmission in enclosed spaces.

Abstract Developing environmentally friendly and highly efficient inverted perovskite solar cells (PSCs) encounters significant challenges, specifically the potential toxicity and degradation of thin films in hybrid organic-inorganic photovoltaics (PV). We employed theoretical design strategies that produce hysteresis-reduced, efficient, and stable PSCs based on composition and interface engineering. The devices include a mixed-organic-cation perovskite formamidinium methylammonium tin iodide ( $${\text {FAMASnI}}_{3}$$ FAMASnI 3 ) as an absorber layer and zinc oxide (ZnO) together with a passivation film phenyl-C61-butyric acid methyl ester ( $${\text {PC}}_{61}\text {BM}$$ PC 61 BM ) as a double-electron transport layer (DETL). Furthermore, a nickel oxide (NiO) layer and a trap-free junction copper iodide (CuI) are used as a double-hole transport layer (DHTL). The optoelectronic characterization measurements were carried out to understand the physical mechanisms that govern the operation of the devices. The high power conversion efficiencies (PCEs) of 24.27% and 23.50% were achieved in 1D and 2D simulations, respectively. This study illustrates that composition and interface engineering enable eco-friendly perovskite solar cells, improving performance and advancing clean energy.

Background: Prenatal and postnatal depression (PND) is associated with adverse outcomes for mother, fetus, andchild. The aim of study was to examine the prevalence and risk factors of prenatal and postnatal depressive symptoms.Materials and Methods: This was a cross-sectional and hospital-based survey of 2305 pregnant women and post-partumwomen (18-48 years) that was registered in the Babol Pregnancy Mental Health Registry (BPMHR) database from June2020 to March 2021. Two questionnaires, including demographics and depression, were analyzed in this study. Also, theEdinburg Postnatal Depression Scale (EPDS) was used to assess the depressive symptoms. Independent t test and theanalysis of variance were used to compare the means. Multiple logistic regressions were used to determine risk factors fordepressive symptoms.Results: According to the EPDS scale, the prevalence of depressive symptoms was 19.8% in the pregnant womangroup in comparison with the postpartum period (11.6%). Risk factors for antenatal depressive symptoms were parity(women with parity ≥ 4 vs. 1 parity, ß=1.808, P=0.020), two groups of gestational age (gestational age ≤12 weeks vs.28 weeks, ß=1.562 P=0.030) as well as (gestational age 21-27 weeks vs. 28 weeks (ß=1.586, P=0.033), and high-riskpregnancy (high-risk vs. low-risk pregnancy, ß=1.457, P=0.003). For postnatal depressive symptoms, none of the factorswere a significant risk.Conclusion: Prenatal and postnatal depressive symptoms should be screened, particularly for women in the first andsecond trimesters, with high parity, and those with a high-risk pregnancy, as recommended by the present study.

This research aims to optimize the utilization of long-term sea level data from the TOPEX/Poseidon, Jason1, Jason2, and Jason3 altimetry missions for tidal modeling. We generate a time series of along-track observations and apply a developed method to produce tidal models with specific tidal constituents for each location. Our tidal modeling methodology follows an iterative process: partitioning sea surface height (SSH) observations into analysis/training and prediction/validation parts and ultimately identifying the set of tidal constituents that provide the best predictions at each time series location. The study focuses on developing 1256 time series along the altimetry tracks over the Baltic Sea, each with its own set of tidal constituents. Verification of the developed tidal models against the SSH observations within the prediction/validation part reveals mean absolute error (MAE) values ranging from 0.0334 m to 0.1349 m, with an average MAE of 0.089 m. The same validation process is conducted on the FES2014 and EOT20 global tidal models, demonstrating that our tidal model, referred to as BT23 (short for Baltic Tide 2023), outperforms both models with an average MAE improvement of 0.0417 m and 0.0346 m, respectively. In addition to providing details on the development of the time series and the tidal modeling procedure, we offer the 1256 along-track time series and their associated tidal models as supplementary materials. We encourage the satellite altimetry community to utilize these resources for further research and applications.

Abstract The Persian Eye Cohort Study, a population-based cross-sectional study from 2015 to 2020, examined refractive error prevalence among 48,618 Iranian adults aged 31 to 70. The study encompassed six centers in Iran, employing random cluster sampling for demographic, medical, and socioeconomic data collection through interviews. Ophthalmic exams included visual acuity, automated and manual objective refraction, subjective refraction, slit lamp, and fundus examinations. Using the spherical equivalent definition, the sample population was categorized into groups. Results indicated a mean age of 49.52 ± 9.31 and a mean refractive error of 0.26 diopters (D) ± 1.6 SD (95% CI − 0.27 to -0.24), ranging from -26.1 to + 18.5 SD. Prevalence of myopia ( + 0.5D) was 22.6% (95% CI 22.2–23%) and 12.5% (95% CI 12.1–12.8%), respectively. Regarding different age groups, the prevalence of hyperopia and astigmatism exhibited a steady and significant rise with increasing age (p-value 1D) was prevalent in 25.5% of participants (95% CI 25.1–25.9%) and correlated with male gender, aging, urban residency, illiteracy, and higher income (p-value

Abstract Purpose This present study aimed to assess the impact of treadmill running on distal femoral cartilage thickness. Methods Professional athletes aged 20 to 40 years with a history of treadmill running (minimum 75 min per week for the past three months or more) and age-, sex-, and body mass index (BMI)-matched healthy controls were recruited. Demographics and clinical features of participants were recorded. Athletes were divided into subgroup 1 with less than 12 months of treadmill running and subgroup 2 with 12 months or more of treadmill running. Distal femoral cartilage thicknesses were measured at the midpoints of the right medial condyle (RMC), right intercondylar area (RIA), right lateral condyle (RLC), left medial condyle (LMC), left intercondylar area (LIA), and left lateral condyle (LLC) via ultrasonography. Result A total of 72 athletes (mean age: 29.6 ± 6.6 years) and 72 controls (mean age: 31.9 ± 6.7 years) were enrolled. Athletes had significantly thinner cartilages in the RLC (2.21 ± 0.38 vs. 2.39 ± 0.31 cm, p = 0.002), LLC (2.28 ± 0.37 vs. 2.46 ± 0.35 cm, p = 0.004), and LMC (2.28 ± 0.42 vs. 2.42 ± 0.36 cm, p = 0.039) compared with the control group. Furthermore, cartilage thickness was significantly thinner in subgroup 2 athletes compared with the control group in the RLC (2.13 ± 0.34 vs. 2.39 ± 0.31 cm, p = 0.001), LLC (2.22 ± 0.31 vs. 2.46 ± 0.35 cm, p = 0.005), and LMC (2.21 ± 0.46 vs. 2.42 ± 0.36 cm, p = 0.027); however, subgroup 1 athletes did not have such differences. There was a weak negative correlation between total months of treadmill running and cartilage thickness in the RLC (r = − 0.0236, p = 0.046) and LLC (r = − 0.0233, p = 0.049). No significant correlation was found between the distal femoral cartilage thickness at different sites and the patients’ demographic features, including age, BMI, speed and incline of treadmill running, and minutes of running per session and week (p > 0.05). Conclusion Compared with healthy controls, professional athletes with a history of long-term high-intensity treadmill running had thinner femoral cartilages. The duration (months) of treadmill running was weakly negatively correlated with distal femoral cartilage thickness. Longitudinal studies with prolonged follow-ups are needed to clarify how treadmill running affects femoral cartilage thickness in athletes.

One of the special topics in the aeroelastic field is the flutter of the airplane wing at an index speed called the flutter speed, which, if this phenomenon is not controlled, there will be a possibility of destroying the structure (airplane wing). Various methods for wing control have been proposed in the last two decades. In the current research, two-way forced jet momentum embedded on the wing is used to control a pseudo three-dimensional wing with a simplified unsteady flow regime. The jet activation signal at the flutter speed is provided by the pulse width-pulse frequency modulator. The advantages of this modulator include its quasi-linear performance, high precision with the presence of fluctuations and flexibility. In this research, the double aeroelastic, non-reversible and rectangular (Hancock) wing model is considered, and the strip theory is used to develop the lift force during spinball. In the speed of the flutter ball, the swing of the wing is driven to damping by the jet activity, and according to the obtained aeroelastic graphs, satisfactory results have followed.

Background: Chronic Kidney Disease (CKD) as a leading cause of death is a major health problem. One of the major contributor of CKD is diabetes. On the other hand, anemia as a common complication of CKD among diabetics increases risk of morbidity and mortality. Then, this meta-analysis identified the prevalence of kidney failure in the diabetic individuals with and without anemia. Methods: We searched electronic databases such as PubMed, MEDLINE, Web of Science, Google Scholar, and Scopus from 2010 to 2023 to find out related reports. Data were extracted by two reviewers independently. The random-effect model used to calculate pooled estimates. Heterogeneity of studies assessed using Q statistic. Data were analyzed using Stata software version 17. Results: This study included a total of 8348 participants with an age range of 45–63 years. The combined prevalence of kidney disease in anemic patients was 28.29 % [31.28 % in diabetic anemic patients compared to 15.08 % in those without anemia (P for heterogeneity

This case series explores three patients who underwent percutaneous coronary intervention (PCI) and experienced prolonged QT intervals under treatment with Ticagrelor. The first case was a female who presented with chest pain and received a Xience stent. The second case involved a male patient who received two Xience stents. The third case was that of a male patient with LAD stenosis. All three patients received Ticagrelor and exhibited prolonged QTc intervals on their electrocardiograms (ECGs), which was resolved after switching to Clopidogrel. Thus far, the potential impact of Ticagrelor on QT prolongation has not been adequately addressed in the literature. It is hypothesized that Ticagrelor can block adenosine uptake by red blood cells, which may explain QTc prolongation. The results of this case series indicate that Ticagrelor may prolong QTc intervals. Consequently, it is imperative that clinicians are aware of this previously unlisted side effect and that patients are closely monitored while seeking alternative medications to manage the condition.

The selection of a sustainable supplier is a multi-criteria decision-making issue that covers a range of criteria (quantitative-qualitative). Selecting the most eco-friendly suppliers requires balancing tangible and intangible elements that may be out of sync. The problem gets more complicated when volume discounts are taken into account, as the buyer needs to decide between two issues: 1) What are the best sustainable suppliers? 2) Which amount needs to be bought from each of the selected eco-friendly suppliers? In current study a combined attitude of best-worst method (BWM) ameliorated via multi-objective mixed integer programming (MOMIP) and rough sets theory is developed. The aim of this work is to contemporaneously ascertain the order quantity allocated to these suppliers in the case of multiple sourcing, multiple products with multiple criteria and with capacity constraints of suppliers and the number of suppliers to employ. In this situation, price reductions are offered by suppliers based on add up commerce volume, not on the amount or assortment of items acquired from them. Finally, a solution approach is proposed to solve the multi-objective model, and the model is demonstrated using a case study in Iran Khodro Company (IKCO). The results indicate that ISACO is the most sustainable supplier and the most orders are assigned to this supplier.

Abstract Background Scorpion envenomation, a prevalent medical emergency in rural areas, demands immediate attention due to its potential severity. While ocular manifestations are uncommon, they can lead to significant complications such as corneal ulceration. We present a unique case of corneal ulceration subsequent to a yellow scorpion (Hemiscorpius lepturus) sting near the eye, a scenario not previously documented. Case presentation A 34-year-old male sought medical care following a scorpion sting despite prior anti-venom treatment. Clinical examination revealed pronounced ocular inflammation, corneal stromal melting, and anterior chamber inflammation, with microbiological confirmation of Pseudomonas spp infection. Treatment comprised fortified ceftazidime and vancomycin eye drops, alongside topical corticosteroids, leading to visual and corneal healing. Conclusion This case highlights the urgency of addressing scorpion envenomation and its potential for severe ocular complications, including corneal ulceration. Prompt diagnosis and targeted therapy with antibiotics and corticosteroids are crucial for favorable outcomes. A comprehensive understanding and timely intervention in scorpion sting-induced ocular manifestations are essential for optimal patient management and outcomes in such cases.

Abstract Total knee arthroplasty (TKA) improves patients’ Health-related quality of life (HRQoL) compared to before surgery. However, based on our knowledge, the improvement in HRQoL after TKA, which depends on various factors, has yet to be investigated compared to healthy people. This study aimed to evaluate the HRQoL of patients compared to healthy people and the factors affecting the HRQoL after TKA. In this matched case–control study (1002 participants), HRQoL in 501 patients who underwent TKA between 2015 and 2022 at Shafa Yahyainan Hospital affiliated with Iran University of Medical Sciences were compared with 501 healthy controls. HRQoL was evaluated in two parts (before compared to 12 months after TKA and 12 months after TKA compared to the healthy population). The 36-item short-form health survey (SF-36) was used to evaluate HRQoL 12 months after surgery. The influencing factors on HRQoL were evaluated by multivariate logistic regression analysis. No significant difference was observed in the demographic characteristics of the participants in the two groups. The mean overall SF-36 score, 12 months after surgery, significantly improved compared to before surgery (64.21 ± 22.2 vs. 37.55 ± 15.13, p:0.001). The mean total score of SF-36 was statistically similar between the case and control groups (64.21 ± 22.2 VS 72.53 ± 25.3). The multivariate analysis showed that sex, BMI, number of comorbidities, postoperative compliance, and complications were significantly related to the decrease in patients’ HRQoL (P

Abstract Background Cherubism is known as a very rare autosomal dominant familial disorder of childhood caused by a mutation in the SH3BP2 gene on 4p16.3. It has not yet been observed at birth and is usually diagnosed in children aged 2–7. Here, we present a non-hereditary case of cherubism at a very early age. Case presentation A 6-month-old girl presented with bilateral progressive jaw enlargement. On physical examination, bilateral asymmetrical jaw enlargement, predominantly on the left side, and some enlarged, non-tender, mobile submandibular lymph nodes were detected. No other abnormality was observed. Further investigations with radiology suggested cherubism and Burkitt’s lymphoma as differential diagnoses. Later on, histopathologic evaluations were suggestive of cherubism. No surgical interventions were indicated, and the child is on regular follow-ups. Conclusion Non-hereditary Cherubism, despite scarcity, can present in children below two years of age, even as early as the beginning of primary dentition. Accurate and swift diagnosis is essential to avert physical and psychological complications. Our case report shows the importance of keeping cherubism in mind as a differential diagnosis of bone disease, even in children under a year old, and the value of interdisciplinary collaboration in dealing with rare genetic disorders.

Abstract The purpose of this research is to present the knowledge sharing model in Maskan Bank of Iran. The research method is applicable in term of its purpose, and mixed in terms of implementation. The statistical population in the qualitative part includes 15 experts, professors, and all people who have had practical or research activities in the field of knowledge sharing, using a purposive sampling method; and in the quantitative part, it includes 344 employees of the headquarters of Maskan Bank of Tehran, using a simple random sampling method. Data collection was done in the qualitative part by using semi-structured interviews; and in the quantitative part by a researcher-made questionnaire. The data-based method was used in the analysis of the data of the qualitative part, and PLS software in the quantitative. The results in the qualitative part showed that 6 structures include: causal conditions (with 3 dimensions of universality and inevitability, the need to change the attitude towards branding, urban brand identity), contextual conditions (with 3 dimensions of brand structural coherence, urban branding, strategic location of city), intervening conditions (with 3 dimensions of tourist behavior pattern, investment/financing, environmental factors), dimensions of the phenomenon (with 3 dimensions of creating a platform for smart tourism, attention to stakeholders, integrated urban brand management), strategies (with 3 dimensions of urban advertising system improvement, smart urban branding design, urban brand culture), and consequences (with 3 dimensions of social capital development, development of quality of life, competitive power of urban brand). Based on the results of quantitative analysis, the relationships between significant research variables and the model have a good fit. Extended Abstract Introduction During many years and working in organizations, human resources acquire sets of ideas, thoughts, skills, experiences and applicable sciences. The collection of such reserves is considered the knowledge of each person, which is recorded in the person's mind over time. As long as this knowledge exists in a person's mind, other people do not have the ability to access and benefit from it. There are many organizations that have such people (Park & Gabbard, 2018). Leibovitz believes that knowledge management is a combination of acquisition and storage of obvious knowledge, along with intellectual capital management. In other words, knowledge management is the process through which organizations use their collected information. Approaches to knowledge management depend on the management perspective. Differences can be caused by information-based, technology-based, and culture-based perspectives (Asgharneghad & Haghdoust, 2022). Therefore, one of the most important means of continuous creation of knowledge is sharing it among all units and members of the organization with an emphasis on technology and social interaction, attention to which has an important role in the survival of the organization in the spaces facing the competitive organization (Gholipour domyeh, 2023). Knowledge sharing is the axis of development and transformation in different societies and it is considered the main focus of training specialized and trained human resources in any society. Realization of knowledge management, sharing and documenting it in financial and banking organizations is one of the basic needs of today's knowledge-oriented society. In the current age, which is called the age of knowledge, organizations are witnessing environments that are becoming more dynamic and challenging day by day, and consider intangible and spiritual capital, called knowledge, as an important and vital factor (Firouzi & Feyzi, 2017). Based on the said material, the researcher is trying to answer the question: what is the model of knowledge sharing in Iran Maskan Bank? Theoretical Framework Sharing knowledge Researchers state that one of the key assets of organizations is the knowledge they have access to (Hao et al, 2019). Knowledge sharing is the voluntary and enthusiastic transfer of acquired skills and experiences to other people and departments of the organization (Gupta et al, 2019). Knowledge sharing is also defined as informational behavior that requires effort and preparation to be responsive and understand information knowledge sharing (Kurmiawan at al, 2020). Knowledge sharing takes place voluntarily to share their expertise and knowledge with others with the intention of creating an interested learning process (Oyemomi et al, 2019). Hemti Nooddoost Gilani & Bagherzadeh (2023) investigated the relationship between intellectual capital and creativity with the mediating role of knowledge sharing perception in Sanat and Ma'dan Bank. The findings of the research indicated the existence of a positive and significant relationship between intellectual capital and creativity of employees in Sanat and Ma'dan Bank. Also, the mediating role of the perception variable of knowledge sharing in the relationship between the components of intellectual capital and creativity was confirmed. These findings mean that the emphasis on knowledge sharing by employees can have a positive effect on the creativity of employees in a way that significantly influences the effectiveness of intellectual capital on the creativity of employees. Gholipour domyeh (2023) investigated the simultaneous optimization of knowledge sharing and customer loyalty in social networks under the digital marketing approach. The results of the integrated approach on a company active in the field of digital marketing in Tehran showed that there is a significant positive effect of 6.47% between customer loyalty and knowledge sharing at a significance level of 1%. The results of the regression analysis also showed that there is a positive and significant relationship between knowledge sharing and customer loyalty under the digital marketing approach by 1.53%. AHP analysis showed that protestive behavior and purchase intention are the most important components of customer loyalty. Coding and implementation of the proposed bi-objective mathematical model in Games software provided a level of optimization in which maximum shared knowledge with maximum customer loyalty was achieved. Research methodology The research method is applicable in term of its purpose, and mixed in terms of implementation. The statistical population in the qualitative part includes 15 experts, professors, and all people who have had practical or research activities in the field of knowledge sharing, using a purposive sampling method; and in the quantitative part, it includes 344 employees of the headquarters of Maskan Bank of Tehran, using a simple random sampling method. Data collection was done in the qualitative part by using semi-structured interviews; and in the quantitative part by a researcher-made questionnaire. Research findings The data-based method was used in the analysis of the data of the qualitative part, and PLS software in the quantitative. The results in the qualitative part showed that 6 structures include: causal conditions (with 3 dimensions of universality and inevitability, the need to change the attitude towards branding, urban brand identity), contextual conditions (with 3 dimensions of brand structural coherence, urban branding, strategic location of city), intervening conditions (with 3 dimensions of tourist behavior pattern, investment/financing, environmental factors), dimensions of the phenomenon (with 3 dimensions of creating a platform for smart tourism, attention to stakeholders, integrated urban brand management), strategies (with 3 dimensions of urban advertising system improvement, smart urban branding design, urban brand culture), and consequences (with 3 dimensions of social capital development, development of quality of life, competitive power of urban brand). Conclusion The current research was conducted with the aim of presenting a knowledge sharing model in Iran Housing Bank. The results of this research are in agreement with the results of Hemti Nooddoost Gilani & Bagherzadeh (2023), Gholipour domyeh (2023), Azeem et al, (2021), Bayati et al, (2021), Ghanbari & Ahmadi (2022), Tabatabaei et al, (2020), Katlijn et al, (2021), Daphna et al, (2020), and Lee et al, (2020). Katlijn et al, (2021) in their study showed that people believe that their knowledge is an important part of their identity; sharing it is costly, but facilitates greater trust that the recipients of this knowledge have with future reciprocal rewards. According to the results of this research, the following suggestions are presented: Create a culture of knowledge sharing: managers should create a culture that encourages employees to share their knowledge and experiences. This can be through team meetings, internal publications, online systems, or collaboration platforms. Creating an atmosphere of cooperation: encouraging employees to cooperate and interact with each other is important. Banks can promote co-working spaces, hybrid teams, and joint projects so that employees can directly communicate with each other and share their knowledge. Internal training platforms: creating an internal training platform where employees can easily access training resources, recorded trainings, and online courses will help companies to share their knowledge with bank employees.

Background and Objective: Three-Stage Theory explains development of suicidal ideation and suicidal attempt. According to Three-Stage Theory, high levels of pain and high levels of hopelessness lead to suicidal ideation. Belongingness plays a protective role against suicidal ideation and individual's suicide capacity predicts suicidal attempt. The purpose of this research was to investigate the relationship between pain, hopelessness, belongingness with suicidal ideation and attempt. Materials and Methods: In this cross-sectional study, 224 patients hospitalized in psychiatric department of Shahid Yahya Nejad Hospital with suicidal ideation were selected through convenience sampling between March to August 2021. All participants completed suicidal attempt question of Self-Injurious Thoughts and Behaviors Interview, Beck Scale for Suicide Ideation, Scale of Psychache, Beck Hopelessness Scale, Interpersonal Need Questionnaire and Suicidal Capacity Scale-3. Pearson's correlation, t-tests, hierarchical regression, analysis of variance and logistic regression were used to analyze the data and data were analyzed using SPSS software version 27. Results: There was a significant interactive effect between pain and hopelessness in predicting suicidal ideation (P< 0.01, t = 5.01). Additionally, belongingness and burdensomeness had significant interactive effects in predicting suicidal ideation (P< 0.01, t = 2.16). Pain and hopelessness accounted for 63.6% of the variance of suicidal ideation, while belongingness and burdensomeness explained 49.8% of variance in suicidal ideation. According to logistic regression, psychological pain (P

Abstract Lewy body (LB) diseases, characterized by the aggregation of misfolded α-synuclein proteins, exhibit notable clinical heterogeneity. This may be due to variations in accumulation patterns of LB neuropathology. Here we apply a data-driven disease progression model to regional neuropathological LB density scores from 814 brain donors with Lewy pathology. We describe three inferred trajectories of LB pathology that are characterized by differing clinicopathological presentation and longitudinal antemortem clinical progression. Most donors (81.9%) show earliest pathology in the olfactory bulb, followed by accumulation in either limbic (60.8%) or brainstem (21.1%) regions. The remaining donors (18.1%) initially exhibit abnormalities in brainstem regions. Early limbic pathology is associated with Alzheimer’s disease-associated characteristics while early brainstem pathology is associated with progressive motor impairment and substantial LB pathology outside of the brain. Our data provides evidence for heterogeneity in the temporal spread of LB pathology, possibly explaining some of the clinical disparities observed in Lewy body disease.

Abstract As a major component of innate immunity and a positive regulator of interferons, the Stimulator of interferon gene (STING) has an immunotherapy potential to govern a variety of infectious diseases. Despite the recent advances regarding vaccines against COVID-19, nontoxic novel adjuvants with the potential to enhance vaccine efficacy are urgently desired. In this connection, it has been well-documented that STING agonists are applied to combat COVID-19. This approach is of major significance for boosting immune responses most likely through an autophagy-dependent manner in susceptible individuals against infection induced by severe acute respiratory syndrome Coronavirus (SARS‑CoV‑2). Given that STING agonists exert substantial immunomodulatory impacts under a wide array of pathologic conditions, these agents could be considered novel adjuvants for enhancing immunogenicity against the SARS-related coronavirus. Here, we intend to discuss the recent advances in STING agonists’ recruitment to boost innate immune responses upon vaccination against SARS-related coronavirus infections. In light of the primordial role of autophagy modulation, the potential of being an antiviral vaccine adjuvant was also explored.

Abstract Background Cervical spondylotic myelopathy (CSM) is a prevalent degenerative condition resulting from spinal cord compression and injury. Laminectomy with posterior spinal fusion (LPSF) is a commonly employed treatment approach for CSM patients. This study aimed to assess the effectiveness of machine learning models (MLMs) in predicting clinical outcomes in CSM patients undergoing LPSF. Methods A retrospective analysis was conducted on 329 CSM patients who underwent LPSF at our institution from Jul 2017 to Jul 2023. Neurological outcomes were evaluated using the modified Japanese Orthopaedic Association (mJOA) scale preoperatively and at the final follow-up. Patients were categorized into two groups based on clinical outcomes: the favorable group (recovery rates ≥ 52.8%) and the unfavorable group (recovery rates

Background and aims: Ongoing methadone intoxication parallels the generalization of the implemented addiction cession programs, as well as the necessity to sustain an effectively durable addiction treatment course. This study aimed to investigate the predisposing factors and clinical features of methadone intoxication. Methods: During a one-year period (March 2018 to March 2019), patients admitted for methadone intoxication were investigated retrospectively. Demographic data, the consumed methadone dose, electrocardiogram findings, and the level of creatinine phosphokinase (CPK) at admission were collected and entered into a statistical analyzing platform (SPSS version 22) for further statistical testing. Results: Seventy-five eligible patients were investigated. The mean age was 23.63±16.66, 66.7% were male, and 15 patients were children. The unemployment status led to an increased methadone poisoning (MP) incidence (P

Introduction: One of the main complications of multiple sclerosis (MS) is imbalance and walking problems that can lead to falls. This study investigated the association between a fall measurement scale called the Hopkins Falls Grading Scale (HFGS) and motor function tests in patients with MS. Material and Methods: This cross sectional study was conducted using convenience sampling on 85 patients referred to the MS Association of Mashhad, Iran, in 2023. The HFGS examined falls during the past year and divided them into 4 degrees, and the function test included the timed 25 foot walk (T25FW) test and the timed up and go (TUG) test. Kruskal–Wallis test and Spearman’s correlation coefficient were used for data analysis. Results: A statistically significant association was obtained between HFGS and functional tests (T25FW and TUG) (for both P < 0.0001). A significant association was observed between the variables of age (P = 0.006), duration of the disease (P = 0.03), the use of mobility devices (P = 0.05), and HFGS. Conclusion: Considering the association between HFGS and motor function tests in MS patients, clinical experts should pay attention to patients who have slower movement and evaluate them in terms of falling status when performing motor function tests.

Background: Evaluations have shown that the severity of pulmonary involvement is very important in the mortality rate of patients with coronavirus disease 2019 (COVID-19). The purpose of this study was to evaluate the value of chest CT severity score in assessment of COVID-19 severity and short-term prognosis. Materials and Methods: This study was a cross-sectional study with a sample size of 197 patients, including all patients admitted to Rasoul Akram Hospital, with positive polymerase chain reaction, to investigate the relationship between computed tomography (CT) severity score and mortality. The demographic data and CT scan findings (including the pattern, side, and distribution of involvement), co-morbidities, and lab data were collected. Finally, gathered data were analyzed by SPSS-26. Results: 119 (60.4%) patients were male, and 78 (39.6%) were female. The mean age was 58.58 ± 17.3 years. Totally, 61 patients died; of those, 41 (67.2%) were admitted to the intensive care unit (ICU), so there was a significant relation between death and ICU admission (P value = 0.000). Diabetes was the most common co-morbidity, followed by hypertension and IHD. There was no significant relation between co-morbidities and death (P value = 0.13). The most common patterns of CTs were interlobular septal thickening and ground glass opacities, and a higher CT severity score was in the second week from the onset of symptoms, which was associated with more mortality (P value < 0.05). Conclusion: Our study showed that a patient with a higher CT severity score of the second week had a higher risk of mortality. Also, association of the CT severity score, laboratory data, and symptoms could be applicable in predicting the patient’s condition.

Background: Melatonin, mainly regulating the body's circadian rhythm, may have protective effects against type 2 diabetes mellitus (DM2)-induced depression due to its antioxidant and regulatory impact in the pathogenesis of both DM2 and depression. This study aimed to find the association of serum melatonin levels with depression in DM2 patients. Methods: A total of 50 DM2 patients were recruited in this retrospective cross-sectional study and divided into 25 patients with depression (DM2-DP) and 25 without depression symptoms (DM2-NDP). Depression was diagnosed using the Hospital Anxiety and Depression Scale (HADS) assessment. Fasting blood samples were collected and examined for the level of serum melatonin and other biomarkers. All statistical analysis was performed by SPSS software Version 22, and a p-value less than 0.05 was considered statistically significant for all tests. Results: The depression score was significantly lower in DM2-NDP than DM2-DP (p< 0.001). The mean weight was significantly lower in the DM2-DP group (P= 0.021). Total cholesterol, triglyceride, and anxiety scores were higher, and the melatonin level was lower in DM2-DP. The correlation of melatonin levels was positive with age, DBP, HbA1C, FBS, and TG. In contrast, it was negative with male gender, BMI, diabetes duration, SBP, TC, family history of DM, depression score, and anxiety score. However, no significant differences were seen. Conclusion: Lower melatonin may be associated with depression and anxiety in patients with DM2. The serum melatonin level might be a strong predictor of depression in DM2 patients.

Background: Modifying and enhancing treatment methods is essential to meet effluent standards for treating landfill leachate. This study investigated the treatment of municipal solid waste leachate (MSWL) using coagulation, flocculation, advanced oxidation, and extended aeration processes. Methods: The effects of different coagulant doses and pH values on coagulation processes were compared. The treatment procedure was analyzed to determine the impact of varying concentrations of potassium persulfate (K2S2O8) and hydrogen peroxide (H2O2) on the results after coagulation with FeCl3. The extended aeration process’s biological stages were studied using a sludge retention time (SRT) of 23 days and the effects of hydraulic retention time (HRT) of 18 and 36 hours. Results: The experimental results show that in the pH range of 5–8, the lower the pH value, the higher the treatment efficiency. The addition of 0.8 g L1− FeCl3 can achieve a 57% removal of chemical oxygen demand (COD). The addition of 2.5 g L1− K2S2O8 and 1.5 g L1− H2O2 with UV-C (15 W) for 70 minutes at pH 7 can effectively remove 86% of COD. Activated sludge extended aeration can attain an 88% removal of COD under optimal operating conditions (HRT = 36 hours, SRT = 23 days, and aeration = 36 hours). The studied hybrid process with the efficiency of 99%, 98%, 95%, 87%, and 83% removal of COD, biochemical oxygen demand (BOD), total suspended solids (TSS), turbidity, and total Kjeldahl nitrogen (TKN), respectively, is suitable for leachate treatment. Conclusion: This study showed that flocculation-coagulation followed by the advanced oxidation process (AOP) and extended aeration can be an efficient and promising treatment method for MSWL.

Abstract Background Previous researches conducted in both developed and developing countries have demonstrated a rising trend in the utilization of complementary and alternative medicine. The World Health Organization has underscored the importance of studying the prevalence and determinants of such alternative practices. This study delves into the knowledge, attitudes, and practices of Iranian adults towards Persian medicine, a distinct form of complementary and alternative medicine, through a national survey for the first time. Methods A total of 2882 Iranian adults (aged ≥ 15 years) were randomly chosen from all regions. Data were gathered through structured door-to-door interviews using a survey questionnaire, wherein cases were selected randomly based on postal codes, and interviewers completed the forms at the participants’ residences. Results Approximately 46% of the subjects exhibited familiarity with Persian Medicine. The study revealed that the primary sources of knowledge about Persian Medicine were family, relatives, and friends, with only 2.9% indicating medical staff as their source of information. Furthermore, the study indicated that 21% of participants expressed a strong interest in using Persian Medicine, while 30.3% did not. When comparing Persian medicine to modern medicine, respondents indicated that Persian medicine is more cost-effective and has fewer side effects, yet modern medicine is more widely used globally; although, the majority responded “I don’t know” to other questions. The results also demonstrated that approximately 37% of the participants had a history of Persian Medicine utilization in their lifetime. Conclusion This study revealed that Iranian adults have low reliable knowledge (from medical staff, Persian medicine books and other publications) and limited familiarity with Persian medicine, with about one third of the participants expressing disinterest (attitude) and over half of them having not utilized this form of medicine (practice).

Abstract Despite advancements in vital pulp therapy (VPT), a subset of cases fails to achieve desired outcomes. This study based on a previous large-scale cohort study involving 1257 VPT-treated teeth, aiming to describe the demographic data and clinical characteristics of all failed cases and their management protocols. Clinical records/images of 105 failed cases treated by a single endodontist (2011–2022) were examined, including 10 extracted teeth. Asymptomatic cases with PDL widening received no intervention, while others underwent management protocols, including (selective) RCT and (tampon) re-VPT. These retreatments were assessed for success (defined as radiographic evidence of healing) and survival (characterized by the retention/function of the treated tooth) using Kaplan–Meier analysis. While 51.4% of all initial failures were diagnosed due to symptoms, 48.6% were symptom-free. Notably, failed cases with symptomatic irreversible pulpitis, and apical periodontitis/widened PDL before initial treatment significantly outnumbered asymptomatic cases and normal PDL, respectively (P = 0.001). Moreover, most of the initial failures were observed in teeth with composite resin rather than amalgam restorations (P = 0.002). The success and survival rates for the management protocols were 91.78% and 95.79%, respectively, over an average follow-up period of 36.94 (± 23.30) months. RCT and re-VPT procedures provide successful outcomes for managing unsuccessful VPTs.

Abstract The challenge of providing water, energy, and managing the environment is widely recognized as a significant barrier to global advancement in light of the increasing population. Based on projections, it is anticipated that the global community will encounter crises pertaining to water, energy and the environment in the foreseeable future. In this research, the application of the hybrid renewable system in a thermal power plant has been assessed based on the approach of analyzing the link between energy, water, and environment. The design of the solar system and the assessment of carbon balance during the power plant lifetime have been conducted in PVsyst application in 2022. Moreover, ReCipe environmental model has been used for assessing the effect of decrease in carbon emission on the ecosystem. The findings of the research indicate that the replacement of at least 2% of the nominal capacity of the fossil fuel power plant with the renewable one, prevents the emission of 1340.37 tons of carbon dioxide yearly. This amount equals to 371.25 m3 of reserve in fossil fuel consumption and 382.64 tons of crude oil. The results also showed that in addition to preserving natural resources, the hybrid cycle design leads to significant water demand reduction which equals to 3751 m3 with the capacity to supply underground water sources. Due to the interests of preserving water and energy resources and decreasing carbon emission in power plant industry, within the framework of nexus approach, management of energy supply by replacing resources and using water and heat recovery technologies and application of energy demand management policies based on energy efficiency and environmental implications is recommended.

Abstract Background The chicken body louse is an obligate ectoparasite of domestic chickens. Chicken body lice feed on feathers, and infestation with this louse is linked to decreases in egg production, hen weight, and feed conversion efficiency. However, it is unknown how chicken body lice impact egg-laying chickens in cage-free environments. Welfare and behavior metrics were collected from flocks of egg-laying chickens either infested with chicken body lice or left uninfested. Methods In two trials, two flocks of cage-free commercial egg-laying chickens were infested with chicken body lice or maintained as uninfested controls. At three timepoints, behavior and welfare of all chickens was measured. On-animal sensors were used to quantify pecking, preening, and dustbathing behavior. Other animal-based welfare metrics included recording comb wounds and skin lesions. Results Birds infested with chicken body lice exhibited significantly more preening behaviors than uninfested birds, even at low louse levels. Moderate or severe skin lesions were detected on birds that were moderately infested with chicken body lice while skin lesions were never detected on uninfested birds. Conclusions The welfare of chickens was impacted by the chicken body louse, a chewing louse that primarily feather feeds. Evidence of skin lesions on infested birds suggests that lice may cause more damage to birds than previously thought, and further evaluation of louse economic damage is necessary. Graphical Abstract

Abstract Purpose The classification of trauma patients in emergency settings is a constant challenge for physicians. However, the Injury Severity Score (ISS) is widely used in developed countries, it may be difficult to perform it in low- and middle-income countries (LMIC). As a result, the ISS was calculated using an estimated methodology that has been described and validated in a high-income country previously. In addition, a simple scoring tool called the Kampala Trauma Score (KTS) was developed recently. The aim of this study was to compare the diagnostic accuracy of KTS and estimated ISS (eISS) in order to achieve a valid and efficient scoring system in our resource-limited setting. Methods We conducted a cross-sectional study between December 2020 and March 2021 among the multi-trauma patients who presented at the emergency department of Imam Reza hospital, Tabriz, Iran. After obtaining informed consent, all data including age, sex, mechanism of injury, GCS, KTS, eISS, final outcome (including death, morbidity, or discharge), and length of hospital stay were collected and entered into SPSS version 27.0 and analyzed. Results 381 multi-trauma patients participated in the study. The area under the curve for prediction of mortality (AUC) for KTS was 0.923 (95%CI: 0.888–0.958) and for eISS was 0.910 (95% CI: 0.877–0.944). For the mortality, comparing the AUCs by the Delong test, the difference between areas was not statistically significant (p value = 0.356). The diagnostic odds ratio (DOR) for the prediction of mortality KTS and eISS were 28.27 and 32.00, respectively. Conclusion In our study population, the KTS has similar accuracy in predicting the mortality of multi-trauma patients compared to the eISS.

Introduction: Vital pulp therapy includes is differnt methods that are used to preserve pulp vitality and root development in immature permanent teeth with thin dentin wall and open apical foramen which have been damaged or inflamed due to dental caries, trauma, or during the restoration. This study was conducted to assess the knowledge of Yazd general dentists toward Vital pulp therapy in immature permanent teeth in 2022. Methods: In this descriptive-cross-sectional study, a valid and reliable questionnaire, including demographic information and 15 questions related to the knowledge of vital pulp therapy was distributed among 150 general dentists in Yazd City, Iran. Data were analyzed using SPSS-22 software, T-test and ANOVA. Results: The participants in this study, included 55.3% men and 44.7% women with an average age of 34.25 (±7.32) years old and an average years of job experience of 8.32 (±7.04). Among them, 35.3% had participated in dentistry retraining courses. The average knowledge score of the participants in this study was 9.2 out of 15. The average score in different groups did not show any significant difference in terms of age, sex, job experience, work place and participation in retraining courses. (P-value >0.05) Conclusion: Yazd general dentists had intermediate level of knowledge about the vital pulp therapy of immature permanent teeth. It seems that the need for retraining courses to improve the level of knowledge about vital pulp therapy to help choosing the best treatment plan for young permanent teeth is evident.

Abstract Background Coronavirus disease 2019 (COVID-19) has various sequelae, one of which might be hypertension. We aimed to evaluate COVID-19’s impact on blood pressure (BP) in non-hospitalized patients at one-year follow-up. Method A total of 7,950 consecutive COVID-19 patients regularly visiting our cardiology clinic were retrospectively screened. Patients’ electronic medical records including demographics, comorbidities, vital signs, treatments, and outcomes, were reviewed by two physicians. Individuals with at least one BP measurement in the three months preceding COVID-19 and one measurement in 12 months or more following recovery were included. BP levels before and after COVID-19 were compared using the paired t-test. Results 5,355 confirmed COVID-19 patients (mean age 55.51 ± 15.38 years) were included. Hypertension (56.9%) and diabetes mellitus (34%) were the predominant comorbidities, and 44.3% had prior major adverse cardiovascular events. Both systolic (126.90 ± 20.91 vs. 139.99 ± 23.94 mmHg, P