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Abstract Background Regarding the psychosocial aspect of treating those with substance use, it is crucial for them to exhibit a capacity for personal transformation, fully utilize their remaining capabilities, and eradicate societal discrimination. We aimed to assess the efficacy of educational instruction grounded in the theory of planned behavior (TPB) in enhancing adherence to medication regimens, fostering hope, and improving marital quality among people with substance use disorders. Methods This study was conducted at the Rapid Addiction Closure Center in Fasa city, Iran, involving a sample of 140 patients undergoing addiction treatment with methadone and buprenorphine in 2021–2022. Subjects were randomly allocated to intervention and control groups. The intervention group participated in 15 weekly educational sessions, each lasting 50 to 55 min, covering topics such as quitting strategies, social support, problem solving, communication skills, and coping mechanisms. Data were collected using demographic questionnaires, TPB construct questionnaires, Miller’s Hope Survey, and the Revised Dyadic Adjustment Scale. Results The study included 140 individuals receiving treatment for addiction. No differences were seen among the two groups in education, occupation, marital status, and living conditions before the intervention. However, six months later, the intervention group showed improvements in attitude, subjective norms, perceived behavioral control, behavioral intention, medication regimen adherence, hope, and marital quality compared to controls. Conclusion The results indicate that family-based educational interventions grounded in TPB are effective in improving medication regimen adherence, hope, and marital quality among patients with substance use disorders. Significant increases in attitude, subjective norms, perceived behavioral control, and behavioral intention positively impacted medication regimen adherence in these patients.

Extended Abstract Background: The plant biodiversity of any ecosystem is directly affected by its vegetative characteristics and diversity of plant species, which always guarantees the ecosystem’s stability against variable environmental and biological factors. Biodiversity indices are measured to compare the biodiversity of different masses and estimate the changes in biodiversity over time at the mass level. The Hyrcanian forests of northern Iran are a legacy left from the third geological period, and today a large part of them has been destroyed in the plains due to destructive human activities. These forests have a special importance for the protection and management in the south of the Caspian Sea. Hyrcanian boxwood (Buxus hyrcana Pojark.), which belongs to the Buxaceae family, is the only species of boxwood in the Hyrcanian forests of Iran. It has unique values from various aspects, including economics, tourism, preservation of biodiversity, etc. This valuable species has been threatened by human and natural factors for a long time and its area has decreased in the country. The present research investigates the floristic-physiognomic status of boxwood habitats in Cheshme Bulbul, Sangdeh, Si-Sangan, and Shafarood regions. Methods: In this research, the important habitats of Hyrkanian boxwood were sampled from the protected area of Cheshme Bulbul, Bandar Gaz, Golestan province, as the easternmost distribution area of this species in Hyrkanian forests to Shafarood forests in Gilan province. In total, 125 sample plots of 400 m2 (20 × 20 m) were planted in the four identified areas (35, 30, 40, and 20 sample plots in Bandar Gaz (Cheshme Bulbul), Frame (Sangdeh), Si Sangan, and Shafarood, respectively). To measure the herbaceous cover of the forest floor in each sample plot, five small plots of four m2 (2 × 2 m) were walked in the center and four corners of each sample plot to harvest their herbaceous cover. Biodiversity indices, including Shannon, Simpson, and Fisher diversity, Margalf and Menhinik richness, and Pilou, Simpson, and Shannon uniformity, were measured for each of the sample plots. The plants were identified very carefully using the Persian Flora of Iran, the Flora of Iranica, the Flora of Türkiye, and the Flora of Europe. The biological form of any plant was determined and recorded based on the Rankier method. The range of geographical distribution was determined according to the mentioned flora. Then, the belonging of each species to the existing phytochorions was determined and the geographical distribution diagram of the regional plants was drawn using floristic data in the division of the vegetative regions of the earth's surface. Species diversity between habitats was compared with the one-way analysis of variance. Means were compared using the Tukey-HSD test in SPSS software. Graphs were drawn using Excel software (2013). Results: In total, 186 plant species belonging to 68 plant genera were identified in the studied regions. The hemi-cryptophytes (65 species, 34.94%), phanerophytes (40 species, 21.5%), geophytes (37 species, 19.90%), trophytes (36 species, 19.35%), and cryptophytes (5 species, 69.2%) dominated the vegetation composition of Hyrkanian boxwood habitats. Kamephytes were the rarest biological form in the region with a percentage (3 species). The results of the geographical distribution of plant species in the region showed that the entire flora was mainly of European Siberian (55 species) and multi-regional (38 species) elements, which accounted for more than 50% of the species (93 species). This was followed by Europe-Siberian/Turanian Iran/Mediterranean vegetation areas (25 species, 13.44%), Europe-Siberian/Turanian Iran (25 species, 13.44%), Turanian Iran (16 species, 60.8%), Europe-Siberian/Mediterranean (13 species, 6.70%), and cosmopolitan (8 species, 4.3%) species. The lowest presence in the region was observed for the vegetation areas of Mediterranean/Turanian Iran (5 species, 2.70%), considering that the northern forests are geographically located in the Auxin-Hyrcania state of the Pontic sub-region, which is a large vegetation area belonging to Europe-Siberia. The presence of species belonging to this geographical spectrum in the flora of these regions is not far from expected. Moreover, the presence of species in other geographical areas is a result of the natural patterns of the accidental presence of plant elements from other vegetation areas of the world. Conclusion: The results of this research show higher indices of diversity, uniformity, and species richness in Shamshad Frame and Shafarood habitats, which have a higher average height above sea level than Cheshme Bulbul and Sisangan habitats. The review of the sources shows that physiographic factors play an important role in the indicators of species richness and diversity. Changes in altitude above sea level often lead to changes in environmental conditions, such as temperature, precipitation, and soil characteristics. This diversity in habitat conditions increases its heterogeneity and allows a wider range of species to coexist. As a result, more habitat heterogeneity leads to higher species diversity, which is also reflected in the biodiversity index.

Abstract Objective The present study was investigate parents’ experiences of children with Epidermolysis bullosa. So, this descriptive phenomenological qualitative study was conducted on 17 parents of children with EB from five hospitals affiliated with the University of Medical Sciences, west of Iran. Data was collected through semi-structured interviews. COLAIZZI’s method was also used to analyze the data. Results Three main themes were extracted in this study: invasion of psychological crisis, alive but no living, and comprehensive support, including 10 categories. The parents of these children are the target of psychological crises that severely reduce their quality of life. In this regard, they need extensive support to improve their living conditions. Therefore, it is suggested to provide cultural and institutional contexts in which all components of the children’s dignity are emphasized.

Abstract Background Regarding the prevalence and pervasiveness of psychiatric disorders, which significantly affect not only the patients themselves, but also their families, family therapy has emerged as a promising intervention. This research examined the effects of Acceptance and Commitment Therapy (ACT) on stigma and family functioning in family members of patients with psychiatric illnesses, demonstrating effectiveness in improving family functioning and coping strategies in the face of mental illness. Methods This randomized controlled clinical trial without blinding. Forty family members of patients with psychiatric disorders were randomly assigned to an intervention group (N = 20) or a control group (N = 20). The intervention group received ACT in eight weekly sessions, each lasting 90 min, while control group remained on a waiting list. Both groups were assessed at three time points: pre-intervention, post-intervention, and at a one-month follow-up. Data collection instruments included a demographic information questionnaire, a stigma assessment, and a family functioning measure. Data were analyzed using SPSS software version 23. Results A statistically significant difference was observed between the mean post-test and follow-up stigma scores of the intervention and control groups (P

Abstract Background Type 2 diabetes being a chronic condition that requires long-term care. This study examined the impact of an educational program using King’s goal attainment model on health behaviors and life satisfaction in type 2 diabetes patients. Methods This is a randomized controlled clinical trial with no blinding in which we tested two groups of intervention control. 70 patients with type 2 diabetes were allocated to an intervention (N = 35) and a control group randomly (N = 35). The nursing process stages included examination, diagnosis, goal determination, transaction based on patient preferences, and evaluation based on King’s theory. Data was gathered using the Walker Health-Promoting Lifestyle Profile (HPLP) and Satisfaction with Life Scale (SWLS, before, after, and 3 months, post-intervention. Data were analyzed in SPSS25 through descriptive statistics, Chi-square Test, Independent and paired sample T-test, two-way ANOVA, and multivariate repeated measures ANCOVA. P-values

Abstract Objective Effective time management is crucial for the survival of all patients, particularly those with cardiovascular conditions. This is especially true in the context of pre-hospital emergency services, where prompt intervention can significantly impact outcomes. This study delves into the timeliness of emergency services and the subsequent outcomes for hospitalized cardiovascular patients in EMS center in Fasa University of Medical Sciences, southern Iran. Results A total of 4972 emergency calls related to cardiac diagnoses were received between 2020 and 2023. The transport time was significantly correlated with age, location of the mission, and type of mission. Of the total, 86 underwent angioplasty within the standard time of less than 90 min, of which 81 were discharged and 5 died. 51 patients underwent angioplasty after more than 90 min, of which 47 were discharged and 4 died. In addition, 124 of these patients experienced cardiopulmonary resuscitation, of which 63 were successful and 61 were unsuccessful.

Purpose: Many environmental problems are due to the unfavorable environmental intentions and cultural-behavioral weaknesses in the relationship between man and nature. This study aims to adopt an environmental psychological perspective to green intention (GI) and green behavior (GB) of agricultural students; to this end, protection motivation theory (PMT) was used as the core of the theoretical base. Design/methodology/approach: This research method was based on descriptive-correlational and causal-relational analyses. The statistical population included agricultural students of Iranian universities with green university standards (N = 5,582). Out of the total population, 384 students were selected as the study sample. The research instrument was a questionnaire whose validity was confirmed using a panel of experts and the average variance extracted. Also, its reliability was verified by Cronbach's alpha coefficients (0.61 = a = 0.92), principal component analysis and composite reliability index. Findings: The results of structural equation modeling showed that the obtained model is able to explain 36.3% and 5.56% of GB and GI variance changes, respectively. In addition, the results revealed that GI has the greatest effect on GB ([beta] = 0.362). Research limitations/implications: It is worth to mention that according to the results, most of the independent variables, besides the direct effects they have on students' GB, also indirectly affect this variable. This effect was performed through the key variable - GI. In other words, it can be concluded that the GI variable successfully mediates the effects of variables such as response efficacy (RE), self-efficacy (SE) and environmental norms (EN). Therefore, it is suggested that in the behavioral changes interventions in GB of agricultural studies, it should be considered that the presence or absence of GI can affect the actual behavior of individuals. In other words, it is recommended that to accelerate actual behavioral changes, behavioral interventionists should first focus on encouraging people's GI. Practical implications: It can be said that the conclusion of this research can provide a basis for the successful encouragement of students to GB. First, GI, as a key element, can mediate the impacts of variables such as RE, SE and EN on students' GB. Second, PS only directly affects students' GB. Third, RE has no significant impact on GB, but its effect on GI is significant. Fourth, RC affects students' GI directly, without mediation. Fifth, SE and EN constructs affect students both directly and indirectly GB of students through GI. Knowing the location of the effect of these variables on each other and the role they have in explaining GI and GB of agricultural students presented some suggestions that can prepare the ground for further development of GB. Hence, managers, students, agricultural educators and other users can use these results to accelerate GB changes. Originality/value: The conclusion of this research might provide a basis for the successful encouragement of students to GB. In interventions to change GB, it would be essential to pay enough attention to the fact that the presence or absence of GI might affect the actual behavior. It is suggested that behavioral interventionists focus on encouraging people's GI so as to be able to accelerate the actual behavioral changes.

Abstract Background Early diagnosis and control of risk factors affecting frailty syndrome (FS) in older adults may lead to changes in the health/disease process, prevention of disability and dependency in the older adults, and reduction of health care costs and mortality rates. The aim of this study was to determine the predictive role of CVD risk factors and FS in community-dwelling older adults of Amirkola city in Iran. Methods This descriptive-analytic cross-sectional study is part of the second phase of the Amirkola Health and Aging Project (AHAP) cohort study conducted since 2011 on all individuals ≥ 60 years in the city of Amirkola in northern Iran. Totally, 1000 older adults were included in the study and divided into three groups: frail (n = 299), pre-frail (n = 455), and non-frail (n = 246) older adults. In the present study, age ≥ 60 years, female sex, fasting blood sugar (FBS) ≥ 126 mg/dl, affected diabetes mellitus (DM), body mass index (BMI) ≥ 27 kg/m², waist circumference (WC) or abdominal obesity > 102 cm in men and > 88 cm in women, low-density lipoprotein (LDL) > 100 mg/dl, triglyceride > 150 mg/dl, cholesterol > 200 mg/dl, high-density lipoprotein (HDL) 90/140 mmHg, uric acid > 7 mg/dl and a positive smoking history were considered CVD risk factors. Results The results showed that with each centimeter increase in WC, the odds of frailty compared with non-frailty was 79% higher, and the odds of frailty compared with pre-frailty was 1.43 times higher in older adults. In addition, the prevalence of pre-frailty compared with non-frailty, pre-frailty, and non-frailty was 10.59 times, 6.08 times, and 73.83 times higher in older individuals > 84 years old, respectively. The results of the present study indicated that the prevalence of pre-frailty compared with non-frailty, frailty compared with pre-frailty, and frailty compared with non-frailty was 2.86 times, 3.01 times, and 14.83 times higher in older adults women, respectively. The comparison between frail and non-frail groups represented that in DM older adults, the prevalence of frailty compared with non-frailty was 1.84 times higher and that of frailty compared with pre-frailty was 98% higher. The older adults with an FBS ≥ 126 mg/dl were 53% more likely to become frail, and with each unit increase in uric acid, the odds of becoming frail increased 2.05 times compared with non-frail older adults, and pre-frail compared with non-frail increased 99%. Conclusion The results demonstrated that CVD risk factors predictive of FS included central obesity, age > 84 years, female sex, DM, FBS ≥ 126, and uric acid > 7. This problem highlights the need for preventive strategies in the older adults who are simultaneously vulnerable to CVD and frailty.

Background and purpose: Cardiovascular diseases are the most important diseases of the elderly, and recently the effect of triglyceride glucose (TYG) index as one of the indicators of insulin resistance in type 2 diabetes and coronary artery disease has attracted the attention of researchers. Previous research has shown a link between insulin resistance and coronary artery calcification. Since triglyceride glucose index (TyG) is an index that is easily available, this study aimed to investigate the relationship between triglyceride index and fasting blood sugar and coronary heart disease and diabetes in the elderly of Amirkola. Materials and methods: This cross-sectional study was conducted on the elderly participating in the second phase of the Amirkola Health and Aging Cohort Study (AHAP). The elderly were divided into two groups of 200 people, the first group was diabetics with cardiovascular disease and the second group was diabetic elderly without cardiovascular disease. Patient information including age, sex, body mass index, diabetes, coronary artery disease, history of dyslipidemia, medications, triglycerides, fasting blood sugar, smoking habits, systolic and diastolic blood pressure, cholesterol, creatinine, physical activity, and HbA1c were collected in a checklist. The TYG index was calculated based on the LN formula [fasting triglycerides (mg/dl) × fasting glucose (mg/dl)/2]. Ultimately, SPSS version 25 software was utilized to describe the data using mean, standard deviation, and percentage. The qualitative variables were compared with the coronary artery disease using the chi-square test, while the quantitative variables were compared using the independent t-test in univariate analysis. Furthermore, the process of adjusting for confounding variables was carried out by using multivariate logistic regression. Results: In this study, 400 diabetic elderly participants were examined based on the relationship between triglyceride glucose index and coronary artery disease. The average age of the elderly with coronary artery disease was 70.46±6.10 and the elderly without coronary artery disease was 70.50±6.49 years. Triglyceride glucose index in diabetic elderly with and without coronary artery disease was 9.3±0.68 and 9.30±0.65, respectively, which was not statistically significant (P=0.92). Mean creatinine (P=0.004), number of comorbidities (P

Abstract Background Infectious keratitis is a serious ocular condition, which can lead to corneal scarring, vision loss, and even blindness. Pediatric infectious keratitis accounts for about 13% of all cases, although there is a lack of comprehensive data regarding keratitis in less than two years of age population group. This study was aimed to determine predisposing factors, clinical characteristics, microbial profile, and management of infectious keratitis in a population of children aged less than two years. Materials and methods A retrospective study was carried out in a tertiary eye institute over a period of 18 years from July 2005 to December 2022. Collected data was analyzed for demographics, predisposing factors, clinical features, and treatment methods. Results Fifty-seven cases of keratitis were identified. Age of the patients ranged from 1 to 24 months (Median: 6, interquartile range: 2–10). Thirty cases were male (52.6%). Predisposing factors were identified in 39 cases (68.4%): consisting of prior ocular trauma (n = 15), previous intraocular surgery (n = 11), ocular surface disease (n = 10), nasolacrimal duct obstruction (n = 4), prematurity (n = 3), developmental delay (n = 2), TORCH infection (n = 1), and contact lens (n = 1). Corneal thinning was observed in 29 eyes (50.9%), which progressed to perforation in 13 eyes (22.8%). Three patients developed endophthalmitis (95% CI, 1.5–13.4%). Most eyes had negative smear (60.4%) and culture (59.6%) results. Pseudomonas aeruginosa was the most common microorganism (11 of 21). Candida albicans was isolated in one case. In vitro susceptibility results showed good coverage of the combined ceftazidime and vancomycin regimen (100%). Surgical procedures were carried out in 35 eyes (61.4%) and 15 eyes required tectonic procedures (26.3%). Conclusion Despite good coverage of medical treatment over cultured isolates, surgical tectonic intervention was required in nearly a quarter of cases to resolve the corneal infection. This finding indicates the necessity of prompt patient referring, corneal sampling and initiation of the treatment.

Statment of the Problem: Podoplanin can indicate the lymphangiogenesis. On the other hand, lymphangiogenesis affects the biological behavior of lesions. The clinical behavior of odontogenic keratocysts (OKC) and dentigerous cysts (DC) is different.Purpose: This study aimed to evaluate the immunohistochemical expression of podoplanin and to investigate lymphangiogenesis in OKCs as compared to DCs.Materials and Method: In this experimental laboratory study, sixty paraffined blocks, including 30 OKC and 30 DC samples, were examined in this study, all of which were histopathologically non-inflamed. To evaluate lymphangiogenesis, the immunohistochemi­cal reaction of D2-40 was evaluated via cytoplasmic and membrane staining of lymphatic endothelial cells. The expression of podoplanin in the epithelial cells of two cyst groups was also examined. To analyze the collected data and compare the results between the two groups of cysts, independent samples t-test, Mann-Whitney U test, and Chi-square test were performed in SPSS version 22. The significance level was set at 0.05.Results: The mean lymph node count and podoplanin expression were significantly higher in the OKC epithelium as compared to DC (P

Abstract Background Moral courage and team work are the most important aspects of professional competence in clinical nurses; nurses with moral courage and team work are thought to be able to deliver safe nursing care to patients. The present study aimed to investigate whether moral courage and teamwork correlate with safe nursing care among clinical nurses. Methods This descriptive cross-sectional multicenter study was carried out from December 2023 to February 2024. A total of 375 nurses who were practicing in four hospitals in the south of Iran were enrolled in this study using convenience sampling. The data collection tools used consisted of a demographics survey, Moral Courage Questionnaire (MCQ), Team STEPPS Team Perception Questionnaire (T-TPQ), and the Assessment of Safe Nursing Care Questionnaire (ASNCQ). The data were analyzed using descriptive statistics, t-test, chi-square, multiple regression analysis, and Pearson’s correlation coefficient. SPSS version 22 was used to analyze the data. Results The participants’ mean age was 32.66 ± 6.63 years, and their work experience was 8.56 ± 6.22 years. The total mean scores for moral courage, teamwork, and safe care were 422.37 ± 52.92, 144.09 ± 18.43, 315.84 ± 41.95, respectively. A statistically significant positive correlation was found between teamwork and safe care (r = 0.57, p

This study is intended to explore an applicable and effective model of simulated situation for English as a Foreign Language (EFL) learners and also investigate the effects of the simulated environment on Willingness to Communicate (WTC) of the learners. To carry out this study, 300 elementary level EFL learners were chosen. A Key English Test (KET) was administered to ensure homogeneity on the learners. They were divided into two groups of experimental and control. A WTC questionnaire developed by Macintyre, Baker, Clement, and Conrod (2001) was used, after validation through Exploratory Factor Analysis (EFA), Confirmatory Factor Analysis (CFA) and Modeling, as an instrument to obtain primary data. The results of Mann-Whitney U test revealed that simulated environment had positive effects on the participants' WTC. The findings of this study suggest that understanding how a simulated environment affects EFL learners' success in speaking proficiency can help institutes to provide such environments for EFL learners and instructors. This method can be presented at different levels of English proficiency. The focus of this study was mainly on speaking skill; therefore, similar studies can be conducted regarding other language skills, e.g., writing, listening and reading.

Abstract Objective The demand for esthetics has increased in today's world and most parents prefer to preserve their children's primary anterior teeth until their natural exfoliation. However, an intracanal post is required to provide retention for reconstruction of severely damaged anterior teeth due to caries or trauma. Various materials and methods may be used for the fabrication of intracanal posts. This study assessed the fracture strength and fracture mode of primary canine teeth reconstructed with prefabricated and customized polyethylene and glass fiber posts. Materials and Methods This in vitro study evaluated 60 extracted primary canine teeth in four groups (n = 15). After pulpectomy and post space preparation with 4 mm depth, composite resin post, prefabricated glass fiber post (Whitepost), customized glass fiber post (Interlig), or customized polyethylene fiber post (Ribbond) were placed in the root canals to provide retention, and the tooth crown was restored with bulk‐fill composite resin. The fracture strength was then measured in a universal testing machine. The fracture mode was also evaluated visually. Results The mean fracture strength was 22.45 ± 5.06, 33.10 ± 8.5, 30.20 ± 7.33, and 32.61 ± 5.73 N/mm2 in the composite resin post, Whitepost, Interlig, and Ribbond groups, respectively. The fracture strength was significantly lower in the composite group than in the remaining three groups (p = 0.000). No other significant differences were found (p > 0.05). Also, no significant difference was observed among the study groups in the fracture mode (p = 0.241). Conclusion The composite resin post yielded a significantly lower fracture strength than the prefabricated and customized glass and polyethylene fiber posts, but the fracture mode was not significantly different among the four groups.

Electronic learning (E-learning) is a method of acquiring knowledge by using information technology. In this regard, faculty members of medical schools play an important role in the design, development and institutionalization of electronic content education and face many challenges. Hence, the present study was performed to explore the challenges to the development and institutionalization of e-learning content as perceived by faculty members of medical schools in southern Iran. The present study is a descriptive qualitative study. Purposeful sampling was performed. Based on this, 23 individual and in-depth semi-structured interviews were conducted with 23 faculty members of medical schools. Granheim and Lundman's approach was used for data analysis. Three themes and eleven subthemes were extracted based on the qualitative data analysis results. Three main themes included individual challenges, organizational management challenges, and course design challenges. Based on the results of the present study, we should keep in mind that electronic teaching methods and preparation of e-learning content by professors are different from traditional educational methods. Hence, the senior managers of educational system should make necessary arrangements and plans for methodological support, technological and technical support, and all kinds of organizational support and create continuous professional development opportunities for professors to minimize the negative effects caused by the rapid changes of electronics era and educational environments on professors, and consequently on the quality of educational contents and processes.

Deforestation in the form of forest land use change (FLUC) increases the emission of greenhouse gases, disrupts the water cycle, dries the soil, and reduces the growth of plant products. This has a direct effect on the well-being of local communities whose livelihoods depend on the forest and threatens biodiversity. The systematic review aimed to analyze the studies conducted on the effects of FLUC on biodiversity ecosystem services (BECS) and human well-being (HWB) of local communities. The study utilized a qualitative content analysis (QCA) based on a deductive approach, which reviewed 114 scientific documents, particularly research articles, selected by searching keywords through a purposeful sampling method. The FLUC indicators in the two groups of dominant morphology (intensity, scale, pattern, and usage) and recessive morphology (function, property rights, and management mode) had 172 repetitions in the articles. Moreover, the BECS criteria (regulating, provisioning, supportive, and cultural services) and HWB (items related to Maslow's hierarchy of needs, subjective well-being, objective well-being, and preferences) had 125 and 148 repetitions, respectively. Results confirm the relationship and effects of FLUC on BECS and HWB, which emphasizes the mutual role of these variables in social, economic, and environmental studies in future research programs. An increase in FLUC can decline the performance and structure of BECS and have a negative impact on the HWB of those communities who depend on forest. Findings are presented in the form of a model that provides a comprehensive understanding of the relationships between FLUC, BECS, and HWB for relevant decision makers.

Agricultural insurance plays a crucial role in managing and mitigating damages from natural disasters, while also providing support to farmers through equitable risk distribution. This study focuses on identifying vulnerabilities of the Agricultural Insurance Fund (AIF) in Iran during natural disasters and proposing solutions for maintaining preparedness and adapting to new circumstances. Utilizing a qualitative approach, the research involved a three-stage classic Delphi technique with 24 experts in agricultural insurance which purposefully selected using snowball sampling. Three open-ended questions on AIF vulnerabilities in facing natural disasters, AIF's adaptive capacity, and forecasting strategic measures for the future, were provided in the first research round. After refining in subsequent rounds, a consensus was reached on 19 vulnerability points, 7 adaptive capacity factors, and 20 strategic actions. Key indicator of vulnerabilities includes the “weak financial capacity of the insurance fund”. “Designing an integrated agricultural insurance system” was the most crucial factor in enhancing AIF's adaptive capacity. Finally, the study proposes strategies like ''strengthening financial capacity and ensuring sustainable credit resources,'' ''developing capacities of the insurance system with location-based technologies,'' and ''differentiating catastrophic damages in the insurance tariffing system'' to address vulnerabilities and enhance agricultural insurance resilience.

Background: Coronary heart disease (CHD) is an underlying cardiac condition contributing to increased COVID-19 mortality and morbidity which can be assessed by several diagnosis methods including coronary artery calcification (CAC). The goal of this study was to find out if there were potential links between CAC, clinical findings, severity of COVID-19, and in-hospital outcomes. Methods: This retrospective study evaluated 551 suspected patients admitted to teaching hospitals of the Babol University of Medical Sciences, Babol, Iran, from March to October 2021. Data included previous diseases, comorbidities, clinical examinations, routine laboratory tests, demographic characteristics, duration of hospitalization, and number of days under ventilation were recorded in a checklist. Results: Findings of current study provide evidence of a significant relationship between coronary artery calcification (CAC) and in-hospital mortality. Additionally, we observed significant correlations between CAC and several clinical parameters including age, duration of hospitalization, pulse rate, maximum blood pressure, erythrocyte sedimentation rate (ESR), blood urea nitrogen (BUN), neutrophil count, white blood cell (WBC) count, and oxygen saturation. However, we did not observe a significant association between CAC and the severity index of COVID-19. In addition, logistic regression tests did not find a significant value of CAC to predict in-hospital mortality. Conclusion: Our findings showed a significant relationship between CAC and in-hospital mortality.

Background: Vitamin D is a modifiable risk factor in cancer and prostate diseases. In this study, we investigate the relationship between vitamin D and serum PSA in elderly men of Amirkola City. Methods: The current cross-sectional descriptive study was conducted on elderly men participating in the cohort study in Amirkola. Demographic information including age, sex, marital status and occupation were recorded and blood samples (5 cc of blood) were taken to measure PSA and vitamin D. A p -value less than 0.05 is statistically significant. Results: After applying the inclusion and exclusion criteria, 837 elderly men with mean age of 69.99 ± 7.72 years were included in the study. In terms of marital status, 779 (93.1%) were married and 59 (6.9%) were single. In the study of employment status, 476 (56.9%) self-employed, 331 (439.5%) retired, 8 (1.0 %) housewives, 14 (1.7%) unemployed and 8 (1.0 %) They were in an unknown situation. The mean level of vitamin D was 31.94 ± 28.57 ng / mL and the mean level of PSA was 1.94 ± 3.28 ng / dL. No significant relationship was found between vitamin D level and serum PSA in Pearson Correlation test (P = 0.16). Among the other variables studied, only age was related to PSA levels and PSA level increased with age (P = 0.001). Conclusion: No significant relationship was found between PSA serum level and vitamin D level, but the existence of vitamin D deficiency in most of the elderly studied needs attention.

Background: Dialysis cuffed catheter dysfunction results in inadequate dialysis, increased sepsis risk, and a shortened catheter life. It may be possible to prolong catheter function by identifying the causes of cuffed catheter dysfunction. Methods: This study was a cross-sectional descriptive study conducted in 2021-2022 on hemodialysis patients with jugular cuff catheters. The catheterizations were performed using the Seldinger technique and were confirmed by fluoroscopy. A 12-month follow-up was conducted with respect to the performance of the cuffed catheter. Results: A total of 123 patients underwent hemodialysis over 2 years via a cuffed catheter. Catheters were most commonly inserted into the right internal jugular vein, with lengths of 19 cm (tip to cuff). The rate of dysfunction of cuffed catheters was 27.6%. Catheter-related thrombosis was the most common cause in 10 cases (29.4%), followed by catheter tip fibrin sheath in 8 cases (23.5%) and catheter tip malposition in 8 cases (23.5%). Furthermore, 18 patients (52.94%) of cuffed catheter dysfunction occurred within 3 months of catheter placement, based on our study. The dysfunction of cuffed catheters on the left side 23 (67.64%) is more prevalent than the right side 11 (32.35%) (P=0.043); the malposition of catheter tips is more prevalent on the left side (P=0.023). Conclusion: Most commonly, cuffed catheter dysfunction is caused by thrombosis, fibrin sheath formation, and catheter tip malposition. Cuffed catheter failure can be reduced by carefully monitoring the catheter's path and tip position, searching for fibrin sheaths when investigating cuffed catheter failure, and preventing thrombotic events.

Abstract Background Ethical decision-making in end-of-life care is one of the most challenging aspects of healthcare: providing ethical care to the society is one of the most important responsibilities of healthcare professionals. In order to assess nurses’ ethical decision-making in end-of-life care, researchers need a specialized and comprehensive instrument which is sufficiently valid and reliable. The present study was conducted to translate and test the psychometric properties of the Persian version of Nurses’ Ethical Decision-Making in End-of-Life Care Scale (NEDM-EOLCS). Methods This is a cross-sectional, multi-centric study with a methodological design The participants were selected via convenience sampling from five hospitals located in Iran. In total, 1320 nurses (660 for exploratory factor analysis and 660 for confirmatory factor analysis) participated in the study. The original NEDM-EOLCS was translated into Persian and subsequently the psychometric properties of the scale were assessed according to COSMIN criteria. Results Exploratory factor analysis (EFA) showed the factor loading of the 55 items to be between 0.62 and 0.88, all of which were significant. Also, exploratory factor analysis showed that 3 factors (perceived professional accountability, moral reasoning/moral agency and moral practice) explained 74.51% of the variance. Confirmatory factor analysis (CFA) results verified the good fit of the data (a chi-square of 21.74, df = 7, P = 0.001) RMSEA = 0.01, CFI = 0.96, NFI = 0.95, and TLI = 0.97). The reliability of the scale was measured in terms of its internal consistency and the Cronbach’s alpha of the whole instrument was found to be 0.98. Conclusion The Persian version of NEDM-EOLCS for nurses is sufficiently valid and reliable. Thus, this instrument can be used to measure nurses’ ethical decision-making in end-of-life care and identify the most effective strategies, e.g. educational interventions, to improve ethical decision-making skills in end-of-life care in these healthcare professionals as necessary.

The study assessed the Farmer Field Schools (FFS) activities as a strategy to enhance capacity building of rural smallholder cocoa farmers in Kwara State, Nigeria. A descriptive survey to enhance the capacity to conduct the research. A purposive sampling procedure was used to select 160 smallholder rural cocoa farmers who participated in the FFS activities in Kwara State. A structured interview schedule was used to collect the data from the respondents. Data were gathered on the socio-economic characteristics of smallholder cocoa farmers and the skills provided by FFS to smallholder cocoa farmers. Data was analyzed using mean, frequency counts, percentages, and chi-square at 0.05 level of significance. The result revealed that 91.3% were male, while 8.7% were female. The result showed that all the skills needed were provided by FFS. The results showed that FFS activities had a significant relationship with the FFS skills provided and the training needs of the rural smallholder cocoa farmers with a p-value of 0.001 being < 0.05. The findings concluded that farmer field school activities had a positive relationship between the skills provided and the training needs of cocoa farmers and this is because the skills provided by FFS are in line with the training needs of cocoa farmers. The study recommends that the Kwara State Ministry of Agriculture through the FFS should continue to serve as a training base that involves more farmers in the program and encourage extension service delivery to encourage capacity building and increase productivity.

Recently, machine learning (ML) has been considered a powerful technological element of different society areas. To transform the computer into a decision maker, several sophisticated methods and algorithms are constantly created and analyzed. In geophysics, both supervised and unsupervised ML methods have dramatically contributed to the development of seismic and well-log data interpretation. In well-logging, ML algorithms are well-suited for lithologic reconstruction problems, once there is no analytical expressions for computing well-log data produced by a particular rock unit. Additionally, supervised ML methods are strongly dependent on a accurate-labeled training data-set, which is not a simple task to achieve, due to data absences or corruption. Once an adequate supervision is performed, the classification outputs tend to be more accurate than unsupervised methods. This work presents a supervised version of a Self-Organizing Map, named as SSOM, to solve a lithologic reconstruction problem from well-log data. Firstly, we go for a more controlled problem and simulate well-log data directly from an interpreted geologic cross-section. We then define two specific training data-sets composed by density (RHOB), sonic (DT), spontaneous potential (SP) and gamma-ray (GR) logs, all simulated through a Gaussian distribution function per lithology. Once the training data-set is created, we simulate a particular pseudo-well, referred to as classification well, for defining controlled tests. First one comprises a training data-set with no labeled log data of the simulated fault zone. In the second test, we intentionally improve the training data-set with the fault. To bespeak the obtained results for each test, we analyze confusion matrices, logplots, accuracy and precision. Apart from very thin layer misclassifications, the SSOM provides reasonable lithologic reconstructions, especially when the improved training data-set is considered for supervision. The set of numerical experiments shows that our SSOM is extremely well-suited for a supervised lithologic reconstruction, especially to recover lithotypes that are weakly-sampled in the training log-data. On the other hand, some misclassifications are also observed when the cortex could not group the slightly different lithologies.

ABSTRACT1,2,3-triazole is a five-member nitrogen-containing heterocyclic compound with diverse biological activities. A number of 1,2,3-triazole-containing FDA-approved drugs are available on the market, and many other pharmaceutically significant potential molecules are under clinical investigation. Therefore, it is fairly reasonable to anticipate that there will be an increase in demand for new triazole-containing drugs in the coming future. Because of its broad pharmacological applications, it has recently attracted the attention of scientists worldwide. This review provides a concise summary of the synthetic techniques for triazole compounds from various strategies and their medical importance as a lead structure for the enhancement of therapeutic molecules.

Introduction Knee osteoarthritis (KOA) is one of the most common and prevalent debilitating chronic diseases across the world with various adverse effects such as pain and movement limitations which impact the health status and quality of life of the patients in the long run. Objectives This study aimed to investigate the effects of self-care education on pain, quality of life, and consequences of disease in patients with KOA in Southern Iran. Methods This is a randomized controlled clinical trial using a pretest–posttest design. Eighty patients with KOA were enrolled in this study and randomly allocated to a control and an intervention group. The data collection instruments included VAS: Visual Analog Scale, the SF-36 quality of life scale, and the Knee Injury and Osteoarthritis Outcome Score. The collected data were analyzed through SPSS v. 22, using descriptive tests, paired t -tests, independent t -tests, Chi-square, and ANOVA. A P level of

Abstract Background Eimeria is a protozoan parasite that affects poultry, particularly chickens, causing a disease known as coccidiosis. This disease imposes substantial significant economic challenges to the poultry sector. Objectives The current study aimed to estimate the global prevalence and associated risk factors of Eimeria in domestic chickens. Methods Multiple databases (Scopus, PubMed, ProQuest, Web of Science and Google Scholar) were searched for articles published until June 2023. The pooled prevalence was estimated using a random‐effects model with a 95% confidence interval. The statistical analysis was conducted using meta packages in R version (3.6.1). Results In total, 41 articles fulfilled the eligibility criteria. The global pooled prevalence was 44.3% (36.9%–51.8%) with Eimeria tenella (38.7%, 30.1%–47.7%) as the most prevalent species. The highest pooled prevalence was related to the Western Pacific Region (80.5%, 72.6%–87.3%) and urban areas (44.4%, 36.5%–52.6%). Moreover, areas with humid subtropical climates represent the highest overall prevalence (75.8%, 46.6%–95.9%). Conclusion The necessity for robust and innovative strategies for preventing and managing this disease cannot be overstated. Addressing Eimeria impact is crucial not only for safeguarding poultry health but also for sustaining the economic viability of the poultry industry.