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BackgroundIndividuals who are newly diagnosed with clinically isolated syndrome (CIS) or relapsing–remitting multiple sclerosis (RRMS) may choose not to undergo disease-modifying therapies (DMTs) due to concerns about expenses or potential adverse effects. Thus, many individuals will opt for alternative therapies, such as dietary modifications. Among these dietary approaches, the modified Paleolithic elimination diet has shown promise for improving MS-related symptoms; however, restriction of certain food groups can lead to inadequate intake of nutrients.MethodsThree-day self-reported 24-h dietary recalls using the Automated Self-Administered 24-h (ASA24) Dietary Assessment Tool were assessed during a 12-month quasi-experimental (i.e., non-randomized) trial among individuals who either voluntarily declined DMTs and received health behavior (HB) intervention, (n = 29) or included DMTs and opted for the standard of care (SOC; n = 15). Participants in the HB group received a multimodal intervention that included dietary modifications, a walking program, and breathing exercises. Usual intake of each micronutrient was estimated and then evaluated with the estimated average requirement (EAR)-cut point method.ResultsAt 12 months, >80% of both HB and SOC groups completed 3 days of the self-reported 24-h recalls, indicating the potential feasibility of ASA24. From baseline to 12 months, the HB group had a decreased mean ratio in total grains (0.64; 95% CI 0.43–0.93; p = 0.02) and added sugars (0.52; 95% CI 0.35–0.75; p ≤ 0.001), and an increased mean ratio intake of cured meats (1.74; 95% CI 1.05–2.90; p = 0.04); whereas, the SOC group had a decreased mean ratio intake for beef, veal, pork, lamb, and game meat (0.60; 95% CI 0.40–0.90; p = 0.01). At baseline, both groups had high proportions with inadequate intake of vitamin E and calcium. The SOC group also had a high proportion with inadequate intake of vitamin D. By 12-months, the HB group exhibited severe proportions of nutrient inadequacies (>20% of the group) for vitamin D (43.5%), vitamin E (29.1%), calcium (69.9%), and copper (27.8%). The SOC group, following their own diet, had inadequacies for all the same micronutrients, except for copper, as the HB group. The SOC group also had additional inadequacies: vitamin A (21.3%), thiamin (26.3%), riboflavin (24.2%), folate (24.8%), vitamin B12 (27.8%), and zinc (28.2%).ConclusionCompared to the usual diet, adhering to the modified Paleolithic elimination diet, as a component of a 12-month multimodal intervention, may lead to reduced consumption of specific food groups, such as added sugars, as well as decreased risk of severe proportions of inadequacy for certain nutrients. The utilization of the ASA24 for acquiring dietary recalls from participants with MS may be feasible for future studies.Clinical trial registrationclinicaltrials.gov identifier NCT04009005.

School systems have increasingly turned to continuous improvement (CI) processes because traditional school improvement plans (SIPs) have resulted in neither reaching set goals nor maintaining performance in challenging times. Improvement science is one way of enacting CI that combines CI with networked improvement to encourage educational equity and build organizational resilience. This study examines the efforts of a school district in the United States to use improvement science to transition their static SIPs to a dynamic process in their underperforming schools. Using a case study design with observations and interviews, we find several sensemaking mechanisms acted as mediators between organizational learning and authentic improvement science implementation. The complexity of improvement science often inhibited sensemaking given time and resource constraints before and during the COVID-19 pandemic, leading to participants often reporting improvement science as too inefficient for their needs. Schools that more successfully integrated improvement science into SIPs saw the value of a systematic approach to SIPs, had interest in distributed leadership, and saw improvement science as advancing equity. This study provides insight into the utility of improvement science as a tool to build organizational resilience as part of school improvement while documenting the many difficulties school improvement teams have in shifting away from static school improvement practices.

Objective The aim of this study was to investigate the effect of neuromuscular training on balance, motor function, and knee and ankle proprioception in female taekwondo athletes aged 15 to 18 years. Methods In this study, 30 taekwondo athletes aged 15 to 18 were selected and randomly divided into two groups: control and experimental. To assess the training program's efficacy, tests related to static and dynamic balance were conducted using the stork and wow tests, while functional movements were evaluated with the screening test (FMS). Results The results of this study demonstrated a significant improvement in static balance following the implementation of the exercise program (p < 0.05). Conclusion In summary, the findings of this study indicate the efficacy of neuromuscular exercises in enhancing both static and dynamic balance, motor function, knee and ankle proprioception in female taekwondo athletes. Consequently, the adoption of this training program is recommended for coaches and athletes in this sport to mitigate injury risk and enhance sports performance.

Abstract Background The shortage of skilled nurses is a major concern for health systems worldwide. This may be partly due to the hesitancy of some nurses to enter or remain in the nursing career. This shortage consequently reduces the quality of standard patient care, increases patients’ length of stay in a hospital, increases medical costs, and results in patients’ dissatisfaction. This study aimed to explore hesitancy among senior undergraduate nursing students to pursue a career in nursing. Methods This qualitative study adopted a thematic analysis approach. The population comprised senior undergraduate nursing students at Isfahan University of Medical Sciences, Iran, who indicated that they were hesitant to pursue a career in nursing. The study sampling was performed from May 2021 till February 2022 and continued until data saturation. Twenty-four interviews were conducted with the selected students. The attributes related to hesitancy among senior undergraduate nursing students to pursue a career in nursing were extracted as themes and sub-themes. Results Four themes were identified: academic idiosyncrasies, individual characteristics, poor nursing market regulations (sub-themes: nursing as a tough and intense career, and unfavorable employment contracts), and the peculiarities of the workplace (sub-themes: conflict within work environment, and barriers to professional nursing practice). Conclusions The findings of this study showed that senior undergraduate nursing students weigh their future career options from various academic, personal, professional, and work environment dimensions. The findings provide new insights for decision makers to design and implement innovative strategies to promote retention in nursing careers. We recommend to provide academic counseling for all students and applicants of nursing before they enter the nursing education. Furthermore, we suggest to improve study and work environments, and to implement incentive programs to enhance enthusiasm of nursing students for pursuing a nursing career.

Abstract Background Aspergillus spp. are among the fungal pathogens that can cause life-threatening infections in patients with a history of COVID-19. Case presentation We present the case of a 58-year-old Iranian woman with post-COVID-19 Aspergillus fumigatus endocarditis complicated by numerous thromboembolisms. She underwent mitral valve replacement surgery and multiple lower extremity embolectomies and was treated with voriconazole, which led to her final recovery. Conclusions Aspergillus endocarditis should be considered in any patient with suspected endocarditis who has a history of COVID-19 infection and does not respond to routine antibiotic and antifungal therapy, as COVID-19 interferes with proper immune function, and lack of underlying cardiac conditions and immunodeficiencies does not preclude the diagnosis. Culture and histopathological evaluation of vegetations and emboli, as well as PCR, can confirm the diagnosis. Early initiation of antifungal therapy and surgical removal of infected valves and emboli can improve prognosis in patients with Aspergillus endocarditis.

Objective: As a principle in the communication system between visual elements and the visual perception of the audience, the effective law of proximity of Prägnanz creates a two-way communication that facilitates the process of perception. Prägnanz principles form the central core of the Gestalt theory of visual perception, some of which were first proposed in 1910 by Max Wertheimer, a Czech psychologist. The principle of proximity, among the principles and laws of Gestalt visual perception, is an effective factor in the quality of design, which causes correlation, continuity, balance, rhythm, proportion, and unity and cohesion of visual elements. One of the copies that can be considered in the field of Gestaltology is the title of the Qajar era gilded Gur'an from the central library of Tabriz. In this research, while introducing the law of proximity of Prägnanz and the above mentioned gilded Gur'an, the effective factors in the formation of a balanced and coherent work based on this principle are studied.Methodology: How the role and presence of the law of proximity in the desired work and its function in the process of visual perception of the elements of the title, as well as how it is related to other principles raised in this process, are the basic questions of this research. This research, the data of which was collected through library sources, was carried out in a descriptive-analytical method.Findings: The presence of this law and its impact on the process of visual perception in the mentioned title is 96 percent, which includes four recognizable types with the following frequencies: 30 percent of the type of proximity to the edges, 24 percent of the contact type, 28 percent of overlapping type, 15 percent of combined type. These four principles are well organized in many positions of the headboard, including the section of the sharfas, table drawing, decorations, verses of the Quran, inscriptions and frames.Conclusion: The result of this investigation showed: Despite the high density of decorations in the target work of this research and their organization based on one of the two modes of style and prominence in the motifs, the principle of proximity causes the process of visual perception to happen and annoyance. And don't let the audience get tired. This article confirms Wertheimer's interpretation of Prägnanz law that psychological organization is good as a result of the simplicity and clarity of perception, which is related to the Gestalt principles presented in this research and under it is the set of proximity principle and its types. A strong Prägnanz is present under the conditions prevailing in the mentioned title. The proximity of visual elements in contact with each other and the combination of various visual motifs and colors next to each other have created the most coherent overlap in the structure of the mentioned work, which creates a calm and clear visual communication during the process of perception.

BackgroundMultiple sclerosis (MS) is a chronic neuroinflammatory disease of the central nervous system, characterized by demyelination and neurodegeneration, which has a profound impact on the quality of life. Dysregulated inflammatory processes are a major driver of MS progression, with many areas of research being dedicated to modulating inflammation in people with MS. Several dietary patterns have been associated with improvements in inflammatory biomarkers; although, the findings have been inconsistent. Thus, this study aims to evaluate the effects of dietary interventions on inflammatory markers in adults with MS.MethodsElectronic databases, including PubMed/MEDLINE, Web of Science, Scopus, and Cochrane/Central, will be searched. Screening, selection, and extraction of data, along with quality assessment of included studies, will be done by two separate reviewers, and any potential conflicts will be settled through discussion. Two reviewers will independently assess the risk of bias in included studies using the Cochrane Risk of Bias Tool. If plausible, the results will be synthesized and pooled for meta-analysis. The overall quality of evidence of each study will be evaluated using the NutriGRADE tool, which is a modification to the Grading Recommendations Assessment, Development, and Evaluation (GRADE) developed specifically for nutrition research.DiscussionStudies have demonstrated conflicting results regarding the effects of dietary interventions on serum levels of inflammatory biomarkers among people with MS. Thus, it is expected that the planned systematic review and meta-analysis will yield robust evidence on the effects of diet on inflammatory profile in the setting of MS.

Introduction: Recurrent pregnancy loss refers to the occurrence of two or more consecutive abortions before the 20th week of pregnancy, which has a high prevalence and it is necessary to identify the factors affecting it. Therefore, this study was performed with aim to investigate the frequency of various factors affecting pregnancy loss in patients with history of recurrent pregnancy loss. Methods: This cross-sectional study was performed on 280 women with at least two abortions less than 20 weeks who had referred to the only infertility treatment center in Sistan and Balouchestan province in 2017-2018. Data related to abortion was collected based on the patients' file. Data were analyzed using SPSS software (version 20) and Kolmogorov-Smirnov test with lilliefors correction, Student t, Mann-Whitney and Fisher's exact tests. P

Abstract Introduction This systematic review and meta‐analysis aims to investigate the mutual impact of COVID‐19 and psoriasis to inform clinical practice and future research. Methods We followed the Preferred Reporting Items for Systematic Reviews and Meta‐analysis protocol for systematic reviews and searched PubMed, Web of Science, Scopus, and Google Scholar until May 1, 2022. Eligibility criteria included full‐text articles in English reporting COVID‐19 treatment outcomes in psoriasis patients. Studies on animals, letters to editors, non‐English studies, and studies with no access to full articles were excluded. Search results were screened and data were extracted by two groups of reviewers with any discrepancies resolved by the senior author. The risk of bias was assessed using ROBINS‐I for nonrandomized studies. The hospitalization rate, Intensive Care Unit (ICU) admission rate, case fatality rate, odds ratios of COVID‐19 infection and hospitalization rate in psoriasis patients were extracted and analyzed using random effects analysis to calculate pooled prevalence and odds ratios, as well as to explore heterogeneity. Results We found 1980 records from four databases and included 20 studies after screening and removing duplicates. These studies evaluated 185,000 psoriasis patients and included eight retrospective cohort studies, one case‐control study, three cross‐sectional studies, and eight case series studies. The impact of the COVID‐19 pandemic on psoriasis treatment and the outcome of COVID‐19 infection in psoriasis patients receiving different forms of treatment were evaluated. The pooled data from included studies showed that the incidence rate of COVID‐19 infection among psoriasis patients was 0.03% (confidence interval [CI]: 0.01–0.06), with a pooled odds ratio of 1.97 (CI: 0.69–5.60) compared to the general population. The hospitalization rate, ICU admission rate, and case fatality rate for psoriasis patients with COVID‐19 were 0.17 (CI: 0.10–0.31), 0.06 (CI: 0.06–0.46), and 0.02 (CI: 0.01–0.04), respectively. Additionally, psoriasis patients receiving systemic nonbiologic therapy had a pooled odds ratio of 2.32 (CI: 1.18–4.57) for hospitalization compared to those using biologic agents. Conclusion Studies have shown that biologic therapy for psoriasis did not increase the risk of hospitalization due to COVID‐19 infection and may have even offered some protection. Treatment adherence was higher in psoriasis patients receiving biologic therapies than those receiving conventional therapies. These findings suggest that psoriasis treatment did not negatively impact COVID‐19 infection and that treatment could be continued on a case‐by‐case basis during the pandemic.

Abstract Background The current absence of gold‐standard or all‐aspect favorable therapies for COVID‐19 renders a focus on multipotential drugs proposed to prevent or treat this infection or ameliorate its signs and symptoms vitally important. The present well‐designed randomized controlled trial (RCT) sought to evaluate the efficacy and safety of N‐acetylcysteine (NAC) as adjuvant therapy for 60 hospitalized Iranian patients with COVID‐19. Methods Two 30‐person diets, comprising 15 single diets of Kaletra (lopinavir/ritonavir) + hydroxychloroquine (HCQ) with/without NAC (600 mg TDS) and atazanavir/ritonavir + HCQ with/without NAC (600 mg TDS), were administered in the study. Results At the end of the study, a further decrease in C‐reactive protein was observed in the NAC group (P = 0.008), and no death occurred in the atazanavir/ritonavir + HCQ + NAC group, showing that the combination of these drugs may reduce mortality. The atazanavir/ritonavir + HCQ and atazanavir/ritonavir + NAC groups exhibited the highest O2 saturation at the end of the study and a significant rise in O2 saturation following intervention commencement, including NAC (P > 0.05). Accordingly, oral or intravenous NAC, if indicated, may enhance O2 saturation, blunt the inflammation trend (by reducing C‐reactive protein), and lower mortality in hospitalized patients with COVID‐19. Conclusion The NAC could be more effective as prophylactic or adjuvant therapy in stable non‐severe cases of COVID‐19 with a particularly positive role in the augmentation of O2 saturation and faster reduction of the CRP level and inflammation or could be effective for better controlling of COVID‐19 or its therapy‐related side effects.

Abstract Background and Aim Metabolic syndrome (MetS) is a well‐known noncommunicable disease that plays a significant role in emerging other chronic disorders and following complications. MetS is also involved in the pathophysiology of numerous dermatological diseases. We aim to evaluate the association of MetS with the most prevalent dermatological diseases. Methods A systematic search was carried out on PubMed, Science Direct, Web of Science, Cochrane, as well as the Google Scholar search engine. Only English case‐control studies regarding MetS and any skin disease from the beginning of 2010 up to November 15, 2022, were selected. The study was conducted based on the Preferred Reporting Items for Systematic Reviews and Meta‐Analysis (PRISMA). Results A total of 37 studies (13,830 participants) met the inclusion criteria. According to our result, patients with psoriasis, hidradenitis suppurativa (HS), vitiligo, androgenetic alopecia (AGA), and lichen planus (LP) have a higher chance of having MetS compared to the general population. Furthermore, people with seborrheic dermatitis (SED) and rosacea are more prone to insulin resistance, high blood pressure (BP), and higher blood lipids. After pooling data, the meta‐analysis revealed a significant association between MetS and skin diseases (pooled odds ratio [OR]: 3.28, 95% confidence interval: 2.62−4.10). Concerning the type of disease, MetS has been correlated with AGA (OR: 11.86), HS (OR: 4.46), LP (OR: 3.79), and SED (OR: 2.45). Psoriasis also showed a significant association but with high heterogeneity (OR: 2.89). Moreover, skin diseases and MetS are strongly associated in Spain (OR: 5.25) and Thailand (OR: 11.86). Regarding the metaregression model, the effect size was reduced with increasing age (OR: 0.965), while the size increased with AGA (OR: 3.064). Conclusions MetS is closely associated with skin complications. Dermatologists and other multidisciplinary teams should be cautious while treating these patients to prevent severe complications resulting from MetS.

Objective: This study, while studying the process of visual perception and familiarity with Pergnans' laws, introduces and explains the main features of the Qajar Quranic religious version preserved in the archives of Tabriz Central Library under registration number 3089 with a psychological approach. This study examines four Pergnans (the law of symmetry, similarity, continuity and context) according to the nine Pregnancy laws. Investigating the visual relationship and effectiveness of Gestalt in the mind of the audience and also achieving a scientific and reasonable visual structure with an approach to Gestalt theory and the extent to which the rules of visual perception are used in this version are other objectives of the present study. Methodology: The present study is applied in terms of purpose and descriptive in terms of study approach, which has been done using scientometric indicators. Descriptive-analytical research method and methods of reviewing texts, sources and pictorial documents in the context of library studies, as well as case study method and observational research method in the field of field studies have been used. After extracting the relevant indicators, the method of gilding analysis process is described based on the output of data and information obtained from the results of the law of visual perception and Pergnans' laws. After reviewing the criteria, the recognition of the importance of Gestalt visual values ​​was assessed by collecting field information in a survey manner at the level of Quranic gilding, to examine the variables and metrics on site. This research was conducted by a qualitative method with the approach of Gestalt theory of psychology. Findings: According to the studies, it was found that 91 percent of the law of similarity, 93 percent of the law of symmetry, 58 percent of the law of continuity, and 68 percent of the law of bedding have been observed. In fact, it can be said that there is a strong two-way communication between the eyes and the brain and everything that is felt and understood. Conclusion: The result of the research showed the mind, understanding and comprehension of human beings from the environment is not a paper in which whatever it is can be embodied and imagined and drawn in it, but a kind of awareness, consciousness, foresight and tact in what (information Primary imported from the eye) observes, there. Man recognizes the tangible reality that science deals with through sensory and visual perception. What can be seen in this version of the Quranic religion in terms of visual quality of the four Pregnancy laws (similarity, symmetry, principle of continuity and context), is the presence of balance, symmetry, complexity, multifactoriality, dynamism, diversity and the element of emphasis.

This paper covers three datasets containing texts in Ancient Greek, manually aligned at word level against translations in English (Grc-Eng), Portuguese (Grc-Por) and Latin (Grc-Lat). The datasets were collected by two domain experts through annotation on the Ugarit Translation Alignment Editor (https://ugarit.ialigner.com/). The quality of each dataset was measured through Inter-Annotator-Agreement (IAA) above 80%. Each dataset contains the aligned pairs and an Annotation Style Guide, and serves as a Gold Standard for translation alignment of Ancient Greek, for the evaluation of automatic translation alignment models, and as high-quality training data. The Annotation Style Guide provides a starting point to approach the task of translation alignment for research and teaching. The data is stored on GitHub and Zenodo.

Background & Objective: Coronavirus disease 2019 (COVID-19) is progressively spreading, and many researchers have focused on the prognostic value of laboratory analyses. This study reviewed routine blood parameters, upper respiratory viral load, and chest imaging in recovered and expired COVID-19 patients and evaluated possible correlations.Methods: In this retrograde study, 138 COVID-19 cases were enrolled. Chest tomography scores of patients, routine hematologic and biochemical parameters, and respiratory viral loads were measured. Furthermore, their correlation with severity of disease and the outcome was investigated during a week of admission.Results: The mean age of participants was 58.6±16; 36.2% of whom were diagnosed as critical, 8.7% expired, and 46% showed less than 50% lung opacity. The expiring rate was only correlated to the severity of illness and viral load. During admission, hemoglobin concentration was decreased in critical patients (from 11.49±0.27 to 10.59±0.36, P=0.042) and also among CT-scan scoring groups (P=0.000), while neutrophils (P=0.04), WBC (P=0.03), and platelets (P=0.000) count were increased. In patients with more than 50% lung opacity, leukocyte counts were decreased, but neutrophil and platelets counts showed raise (all P

BackgroundPreliminary dietary intervention trials with the low-saturated fat (Swank) and modified Paleolithic elimination (Wahls) diets have shown favorable effects on fatigue among people with multiple sclerosis (MS); however, their impact on metabolic health is unknown.ObjectiveTo evaluate the impact of the Swank and Wahls diets on markers of metabolic health and to determine the association and mediation effect between changes in metabolic health and perceived fatigue among people with relapsing-remitting MS (RRMS).MethodsAs part of a randomized parallel-arm trial, vital signs, blood metabolic biomarkers, and the fatigue scale for motor and cognitive functions (FSMC) were collected from participants with relapsing-remitting MS (n = 77) at four study visits spaced 12 weeks apart: (1) run-in, (2) baseline, (3) 12-weeks, and (4) 24-weeks. Participants followed their usual diet at run-in, then were randomized at baseline to either the Swank or Wahls diets and followed for 24 weeks.ResultsBoth groups had significant reductions in weight, body mass index (BMI), total cholesterol, and low-density lipoprotein (LDL) at 12- and 24-weeks compared to respective baseline values (p ≤ 0.04 for all). The Swank group also had a significant reduction in high-density lipoprotein (HDL) at 12- and 24-weeks (p = 0.0001 and p = 0.02, respectively), while the Wahls group had significant reductions in diastolic blood pressure (DBP). In addition, both groups had significant reductions in FSMC total perceived fatigue and the motor and cognitive fatigue subscales at 12- and 24-weeks (p ≤ 0.01 for all); however, change in the cognitive subscale was not significant at 12-weeks in the Swank group (p = 0.06). Furthermore, the favorable effects, of both diets, on markers of metabolic health were not associated with and did not mediate the effect of the diets on perceived fatigue (p > 0.05 for all).ConclusionBoth diets lead to significant reductions in perceived fatigue, weight, BMI, total cholesterol, and LDL, but the significant reductions in perceived fatigue were independent of changes in markers of metabolic health.

This study conducted a systematic review of studies on the relationship between androgenic alopecia and metabolic syndrome. We performed a comprehensive review of databases including PubMed, Web of Knowledge, Google Scholar, Scopus, and Embase, and extracted relevant articles published from 2010 to 2018. The case reports, review articles, or studies lacking full-text articles were excluded. We examined nine studies for the meta-analysis step. The results showed a significant relationship between alopecia and metabolic syndrome (OR = 2.81; CI 95% = 2.16-3.66; I2 = 73%; P = 0.0003). There is a significant correlation between androgenic alopecia and metabolic syndrome.

Abstract Background Metabolic syndrome is a combination of metabolic risk factors causing a pathological condition that increases the risk of non-communicable diseases, such as diabetes and cardiovascular diseases. A variety of dietary approaches have been examined to halt this rapid trend; however, the effects of modified-Paleo diet and medium-carbohydrate diet on inflammation, adipokines, hepatokines, and the profile of endothelial microparticles in individuals with metabolic syndrome have not been investigated in detail. The present study is designed to examine the effect of modified-Paleo and moderate-carbohydrate diet with two delivery modes: “fixed diet plan” vs “calorie counting” on weight, body composition, serum levels of some hepatokines and adipocytokines, and flow cytometric analysis of endothelial microparticles in adults with metabolic syndrome. Methods Eighty metabolic syndrome patients will be recruited in this study. They will be randomly allocated to one of the following 4 groups: (1) receiving a modified-Paleo diet with calorie counting, (2) receiving a modified-Paleo diet with a fixed diet plan, (3) receiving a medium-carbohydrate diet with calorie counting, and (4) receiving a medium-carbohydrate diet with a fixed diet plan for 10 weeks. Weight, height, waist circumference, and body composition will be assessed at the study baseline and at the end of the trial. Serum insulin, asprosin, chemerin, FGF-21, CTRP-1, PYY, ghrelin, plasma EMPs (CD31+/CD42b− and CD144+/CD42b−), lipid profile, glycemic indices, hs-CRP, leptin, vitamin C, creatinine and satiety, hunger, fullness, and desire to eat (via visual analog scales) will be measured at the study baseline and at the end of the trial. Insulin resistance and insulin sensitivity will be determined using the HOMA-IR and QUICKI equations. Discussion To the best of our knowledge, this is the first randomized controlled trial that will determine the effect of modified-Paleo and moderate-carbohydrate diet on weight, body composition, serum levels of some hepatokines and adipocytokines, and the profile of EMPs in adults with metabolic syndrome. Moreover, the effects of different diet delivery modes, including “fixed diet plan” and “calorie counting” will also be analyzed. The results of this trial can provide clinical witnesses on the effectiveness of carbohydrate-restricted diets in ameliorating metabolic status and prevent the development of chronic diseases. Trial registration Iranian Registry of Clinical Trials IRCT2016121925267N4 . Registered on 26 July 2017

Background: Glomerular filtration rate (GFR) is the best indicator to assess renal function; however, it is difficult to perform it, especially in neonates. Serum creatinine is the most commonly used marker of GFR; nevertheless, it has some limitations since it can be affected by factors other than renal function. Cystatin C, another endogenous marker used to estimate GFR, is not affected by non-renal factors. The results of some studies suggest that serum cystatin C levels are more accurate tests of kidney function than serum creatinine levels. This study aimed to estimate GFR with cystatin C-based formulas among neonates and determine the correlations between these methods and the Schwartz formula. Methods: The population of this research consisted of 99 neonates whose serum creatinine and cystatin C levels were measured concurrently. Moreover, the glomerular filtration rate was estimated using the Schwartz formula and 14 cystatin C-based formulas separately. Results: Based on the findings, all GFR values based on cystatin C formulas correlated significantly with each other (p 0.05). The only cystatin C formula that yielded values correlating with the Schwartz formula was CysCrEq, which used serum cystatin C and creatinine concomitantly. Conclusion: It can be concluded that since all GFR values based on cystatin C correlated significantly and cystatin Cwasindependent of non-renal factors, cystatin C reflected the real GFR more accurately than serum creatinine. Nonetheless, further studies with gold standard techniques are required to verify the usefulness of cystatin C-based formulas.

Background: Considering the importance of quality of life which is related to various physical, psychological, social, and political dimensions of the individual and the importance of the class which plays a decisive role in forming a successful and healthy society. Also, considering the importance of high-risk behaviors in today’s society and the harm that these behaviors create, five variables of quality of life, type of parent-child relationship and sensation seeking, self-efficacy, and high-risk sexual behaviors have been studied together. Methods: The research method was descriptive-correlational with structural equation modeling (SEM). The statistical population included all male and female undergraduate students of Bandar Abbas Branch of Azad University who were studying in the first semester of the 2018-2019 academic year. 260 people were selected through purposive sampling. The inclusion criteria were being an undergraduate student, conscious satisfaction with the implementation method and research process. Data were gathered by the Child-Parent Relationship Quality Questionnaire (PCRS), Zuckerman Sensation Seeking Scale, Quality of Life Questionnaire, High-Risk Sexual Behaviors Questionnaire and Emotional Self-efficacy Scale. Data were analyzed using structural equations with Amos software, version 8.80. Results: The path coefficient between high-risk sexual behaviors and quality of life was -0.84, which indicates the negative and inverse effect of high-risk sexual behaviors and quality of life. The path coefficient between the quality of the parent-child relationship and high-risk sexual behaviors was -0.86, which indicates the negative and inverse effect of the quality of the parent-child relationship and high-risk sexual behaviors. Conclusion: High-risk sexual behaviors mediate the quality of the parent-child relationship and the quality of life of students.

Abstract This narrative review article was conducted to lay out a summarized but exhaustive review of current literature over mucocutaneous manifestations in 4 dimensions of SARS‐CoV‐2 pandemic: virus itself, treatment‐related, vaccine‐induced, and alteration of chronic dermatologic diseases following infection. Virus and vaccine‐related were mainly self‐limited and non‐severe. Treatment‐related reactions could be life‐threatening.

Background: The diagnosis of acute kidney injury (AKI) is focused on the measurement of glomerular filtration rate based on serum creatinine; nevertheless, due to the effects of the underlying confounding parameters, this procedure tends to have some problems. Recent findings identified neutrophil gelatinase-associated lipocalin (NGAL) to be a critical marker for predicting AKI in humans. The aim of the present study was to evaluate changes in urinary NGAL levels in neonates with AKI and those without AKI.Methods: This cross-sectional analytical study was conducted on a total of 75 neonates hospitalized for AKI and 81 neonates hospitalized for reasons not related to kidney disease. The serum concentrations of NGAL creatinine and urine were measured in both groups.Results: The mean NGAL levels were 825.81±175.08 and 292.20±322.03 ng/ml in the case and control groups with a substantial difference, respectively. The NGAL had a sensitivity of 100%, specificity of 55.6%, positive predictive value of 67.6%, negative predictive value of 100%, and accuracy of 76.9% in predicting AKI. Assessing the region under the receiver operating characteristic curve (ROC curve) showed that measurement by NGAL effectively discriminated AKI from normal conditions (area under the ROC curve=0.899). The NGAL’s best cut-off value for predicting AKI among neonates was estimated at 427 ng/ml, resulting in a sensitivity of 100% and specificity of 67.9%. Using Pearson’s correlation coefficient test revealed a strong linear connection between the NGAL level and altered creatinine level (r=0.395; p

هدف:هدف این مقاله بررسی مؤلفه‌های حاکم درصفحه‌آرایی نسخه‌های قرآنی عصرتیموری است.از طرفی ضمن تشریح میزان عملکرد وکارکرد تناسبات در اصول صفحه‌آرایی این نوع نسخه‌ها، میزان اندازه‌گیری‌های شاخص و غالب درصفحه‌آرایی نسخه‌های دوموزه‌ نام‌برده را مورد ارزیابی، تحلیل و تطبیق قرار می‌دهد. روش پژوهش/جامعه آماری: این پژوهش ضمن توصیف آثار موردنظر به روش پیمایشی انجام شده است و با رویکرد تحلیلی-تطبیقی مورد بررسی قرارگرفته است. گردآوری مطالب ازطریق منابع کتابخانه‌ای است. به دلیل محدودیت تعداد بالای اخذ نسخه‌ها از موزه‌های مورد نظر، انتخاب نمونه‌های مطالعاتی اندک بوده و با مشاوره کارشناسان خبره این بخش‌ها، به روش هدفمند آثاری مورد مطالعه قرار گرفتند که دارای صفحات افتتاح و تزئینی باشند. لذا 5 مصحف مذهب قرآنی از هر موزه منتخب گردید. یافته‌ها: تناسبات حاکم در اصول صفحه‌آرایی و قطع نسخه‌های قرآن‌های مورد مطالعه از موزه‌های مذکوربر مبنای تناسبات طلایی و مستطیل پویا است. با این تفاوت که تناسبات طلایی، مستطیل پویا با معیار 2√ و قطع صفحات آثار قم با 8 /52 درصد بیشتر ازآثار رضوی سنجیده شده است. در بررسی صفحه‌آرایی و تطبیق آن با دیگر کادرهای موجود صفحه میزان تناسبات حاکم بر اساس نسبت‌های مستطیل ایستا استنباط گردید به گونه‌ای که آثار رضوی با 6/ 57 درصد بیشتر از آثار قم از این مقیاس برخوردار است. نتایج: برآیند این پژوهش نشان داد، مهمترین و اصلی‌ترین عامل مؤثر در صفحه‌آرایی نسخه‌های قرآنی مذهب انتخاب قطع ‌کاغذ بوده است. سایز خوشنویسی و کتابت نیز در میزان طراحی و مسطرکشی، نوع فرم و کارکرد تذهیب‌ها نیز نقش تعیین‌کننده‌ای درترسیم داخلی آرایش صفحات دارند. ضابطه شاخص در اندازه‌گیری اوراق، تناسبات طلایی محاسبه شده است.

Background: One of the main problems following organ transplantation is the spread of various microbial infections, especially opportunistic infections, including Epstein-Barr Virus (EBV). Objectives: We aimed to determine the prevalence rate of EBV infection in children undergoing kidney transplantation by recognizing the virus titers before and after transplantation. Methods: In this case series study, 16 children who underwent kidney transplantation and hospitalization were retrospectively assessed. The EBV serology was assessed by virus Deoxyribonucleic Acid (DNA) quantitative assessment using the Polymerase Chain Reaction (PCR) technique. A brief review was also performed on post-kidney transplantation EBV infection in the explored children. Results: All studied patients were seronegative for EBV before transplantation; while two (12.5%) male children had positive serology after transplantation with the loads of 278 copies/mL and 14655 copies/ML, and none resulted in the rejection of kidney transplantation. The duration after transplantation was significantly longer in those children with positive serology after transplantation (P=0.025). No significant association was detected between the serological positivity for EBV and patients’ gender, causes for kidney insufficiency before transplantation, baseline underlying disorders, initial medications, the type of donor, and the mean age. Conclusions: Among the investigated children undergoing renal transplantation, none were seropositive to EBV before transplantation; while 12.5% have been converted to EBV seropositivity after transplantation. The odds of EBV seropositivity was only linked to the time interval from the transplantation.

Purpose: This research aims at identifying and structurally investigating the Quranic works of Qajar dynasty available in the Central Library of Tabriz, as well as analyzing the Quranic verses of religion in terms of the structure of the pages and the forms of motifs. Methodology: It was conducted using descriptive-analytical survey method and information was collected using related literature. Of the 20 Qajar Quranic manuscripts, ten ones were selected. The data were analyzed using SPSS and EXCEL softwares. Findings: 39.9% of the coronation of the Quran was crowned with the inscription of the sura head and 60.91% crowned with upper and lower inscriptions. 47/67% of the text pages are marked with decorations. In the section of decorative elements and motifs, 44.1% were decorative motifs, 8.9% were Arabic designs, 14.2% were abstract designs, 3.3% were Chinese knit, 18.1% had chalking, and the average elements were 4.11% percent relative proportions are in the distribution of motifs. Conclusion: The results of this research indicate that decorative elements such as Khatei, Slavic, crown inscription, types of casts, shrub designs, and abstract patterns have been observed in the works. The use of round flowers, Shah Abbasi, Anari, Hollow slices and simple framing, spiral composition, color variation in flowers and tables, and the high use of gold color are considerable.

We demonstrate a rare case of inferior mesenteric artery arteriovenous malformations leading to ischemic colitis in a 76-year-old female. Our patient presented with three months of nausea, vomiting, and diarrhea. Colonoscopy displayed diffuse mucosal vascular congestion while CTA and MRA displayed AVMs in the region of the IMA; however, cohesive clinical agreement on AVM from multiple specialties was difficult given its rare occurrence and nonspecific clinical, histopathologic, and directly visualized findings. The three noted dominant AVMs were eventually selected with coil and liquid embolization with successful cessation of symptoms and no major complications. Our discussion focuses on intervention and stressing the importance of radiologic findings, as IMA AVMs, rarely present as ischemic colitis and therefore can clinically masquerade as other etiologies.

Ugarit is a public web-based tool for manual annotation of parallel texts for generating word-level translation alignment. We aimed to develop a user-friendly interactive interface to visualize aligned texts and collect training data in the form of translation pairs to be used later, (i) for training an automatic translation alignment system for historical languages at the word/phrase level, (ii) as a gold standard to evaluate automatic alignment and machine translation systems. Ugarit is now widely used for learning new languages, especially historical languages, and as a reading environment for parallel texts. In the following sections, we present the related works and similar projects; then, we give an overview of the visualization techniques used to present the alignment results. Further, we explain how we could derive the translation graph from the aligned translation pairs. Finally, we discuss the usage limitations of Ugarit, possible improvements, and future development plans.

Abstract This experiment was conducted in 2014 at research greenhouse, in a completely randomized design based on factorial arrangement with three replications. Treatments included irrigation regimes at 50, 75 and 100 % FC and humic acid spraying at three levels 0, 150 and 300 mg. lit-1. The greatest and the least plant height, fresh and dry weight, number and length of leaves, chlorophyll a and carbohydrates was achieved at 100 and 50% FC, respectively. Plant cultivated at 300 mg. lit-1humic acid had the greatest growth components. Interaction of irrigation at 100% of field capacity and 300 mg l-1 of humic acid had the greatest plant height, fresh and dry weight, leaf length and carbohydrates. While the greatest proline was obtained at irrigation at 50% FC and no humic acid spraying. Interaction effects was not significant for number of leaves, chlorophyll (a and b) and carotenoids. Growth parameters decreased with increasing drought severity. The results suggested savory planted at 300 mg. lit-1of humic acid and no drought stress had the greatest productivity.

Background: Coronary artery disease (CAD) is the most prevalent form of cardiovascular disease that is caused by the formation of plaque in the arteries walls. Both genetic and environmental factors play an important role in the development of CAD. Aim: The aim of this study was to determine the association of 5,10-methylenetetrahydrofolate reductase (MTHFR) C677T gene polymorphism with CAD in an Iranian population. Subjects and methods: In this case/control study, sequence specific primer-polymerase chain reaction (SSP-PCR) method was used for genotyping of 310 patients with CAD and 367 healthy controls. Results: Frequency of C/T genotype was significantly higher in the patients group than the control group (P = .03, OR: 1.6, 95% CI: 1.04–2.47). Based on the assumption that T is a risk allele, dominant model compares C/C genotypes to C/T + T/T genotypes. A significant association was observed in MTHFR C677T when the effect of the polymorphism was considered under a dominant genetic model (OR = 1.59; 95% CI = 1.03–2.46; P = .02). Evaluating genotype frequencies in 4 different ethnic groups (Fars, Turkmen, Sistani, and others) demonstrated significant statistical association of C/T genotype in Fars sub-groups (OR = 1.8; 95% CI = 1.11–3.06; P = .01) but this association is not observed in other populations. Significant association of C/T (P = .01, OR: 2.21, 95% CI: 1.15–4.4) genotype was found in women, but this association was not observed in men. Conclusion: The results of this study showed that C/T genotype in MTHFR C677T position is a causative factor, especially in women, and might be associated with susceptibility to CAD in the Iranian population.

Purpose: This research aimed to investigate the Quranic illuminations of the Timurid era preserved in Astan Quds Razavi Museum and to identify the Qur'anic figures such as: Shamsa, opening prayer, frontispiece, text pages (page margins), verse marks (Juz’, Sajdah, Hizb), the flower of the verses, the list of Surahs and ending pages, deals with the layout and structure of the form of paintings and colors. Methodology: The present research was conducted through a descriptive-analytical survey method. The needed data were collected through library resources and collecting pictures available in the museums. By studying the Qur'anic works available in the museum of Astan Quds Razavi and consulting with the experts of this department, seven exquisite manuscripts related to the Timurid era and the subject matter of this study were selected using targeted sampling method. By examining these manuscripts, the characteristics of their figures were specified. Results: The findings showed that the structure of visual elements included types of decorative motifs including arabesque, khataei, geometric, and calligraphic patterns. Arabesque motifs with 38.8% were the most frequently used decorative motifs, and calligraphy (27.3%), khataei flowers (22.4%) and geometric patterns (3.4%) were distributed on the pages. The layouts were structured in 3 inscriptions, 5 inscriptions and 6 inscriptions. On average, pages were decorated with gold divisions. Azure and gold were the most frequently used colors in these works. Conclusion: Considering that the Astan Quds Razavi Museum is one of the great collections in the world and housed the most precious illuminated Qurans, the Qur'anic manuscripts of the Timurid era have outstanding features, including strength, logic, order and rhythm, symmetry, organized structures, and golden layouts. Therefore, the recognition of the formal structure of decorative elements - visual and written elements- and their application in the Quran decoration is necessary for an accurate understanding of the authenticity of motifs. The original decorative motifs such as arabesque, khatei, geometric patterns as well as calligraphy styles such as Naskh, Mohaqiq, etc. have been used to decorate the Timurid Qur'ans, which describe the original features of the Timurid Quranic illuminations, and using these analyzed elements play a crucial role in strengthening the intellectual foundations of the artistic educational system of Iran.

Although relatively infrequent, bile duct leaks are among the primary complications of hepatobiliary surgery and cholecystectomy given the large number of these operations performed annually around the world. Variant biliary anatomy increases the risk of surgical complications, especially if unrecognized on preoperative imaging or intraoperatively. Presented here is a case of a patient with an unrecognized cholecystohepatic duct at the time of surgery leading to bile leak after cholecystectomy. Numerous factors made for a technically difficult surgery with obscuration of the true anatomy, ultimately resulting in transection of the cholecystohepatic duct. Understanding normal and variant biliary anatomy will help prevent avoidable complications of hepatobiliary surgery.

Background: Coronaviruses are major pathogens of respiratory system causing different disorders, including the common cold, Middle East respiratory syndrome, and severe acute respiratory syndrome. Today's global pandemic coronavirus disease 2019 (COVID-19) has high mortality rate, with an approximate of 20% in some studies, and is 30–60 times more fatal than the common annual influenza, However, there is still no gold standard treatment for it. N-acetylcysteine (NAC) is a well-known multi-potential drug with hypothetically probable acceptable effect on COVID-related consequences, which we completely focused in this comprehensive review. Materials and Methods: PubMed, Scopus, Science Direct, and Google Scholar have been searched. Study eligibility criteria: efficacy of NAC in various subclasses of pathogenic events which may occur during COVID-19 infection. Efficacy of NAC for managing inflammatory or any symptoms similar to symptoms of COVID-19 was reviewed and symptom improvements were assessed. Results: Randomized clinical trials introduced NAC as an antioxidant glutathione analog and detoxifying agent promoted for different medical conditions and pulmonary disorders to alleviate influenza and reduce mortality by 50% in influenza-infected animals. The beneficial effects of NAC on viral disorders, including Epstein–Barr virus, HIV and hepatitis, and well-known vital organ damages were also exist and reported. Conclusion: We classified the probable effects of NAC as oxidative-regulatory and apoptotic-regulatory roles, antiviral activities, anti-inflammatory roles, preventive and therapeutic roles in lung disorders and better oxygenation functions, supportive roles in intensive care unit admitted patients and in sepsis, positive role in other comorbidities and nonpulmonary end-organ damages or failures and even in primary COVID-associated cutaneous manifestations. Based on different beneficial effects of NAC, it could be administered as a potential adjuvant therapy for COVID-19 considering patient status, contraindications, and possible drug-related adverse events.

Background: Colorectal cancer is one of the mostly diagnosed malignancies worldwide. The main risk factors for colorectal cancer include the mutation of tumor suppressor genes or proto-oncogenes and unhealthy lifestyle. Vegetable and fruit consumption with multiple anticancer agents can reduce the risk of colon cancer. Resveratrol is a natural polyphenolic product that inhibits proliferation and induces apoptosis through several pathways. In this study the effects of resveratrol on β-catenin (CTNNB1) and GSK-3β expression in the Wnt-signaling pathway were examined and, morphology changes were analyzed in colon cancer cells with high levels of β-catenin such as HCT-116. Methods: HCT-116 cells were seeded into 6-well plates, and the cells were treated with various concentrations of resveratrol (25, 50 and 100 μM) for 24, 48 and 72 hours respectively. Quantitative Real-time PCR examined β-catenin and GSK-3β expression and morphology changes were analyzed. Results: The results showed that, in 25 and 50 μM concentrations, resveratrol reduced β-catenin and GSK-3β expression in 24 h (p-value; 0.001). Gene expressions were found to increase in 48 h and 72 h treatment with resveratrol in the concentrations of 50 and 100 μM respectively (p-value; 0.001). Conclusion: considering our data, it can be concluded that low doses of resveratrol could reduce β-catenin expression, which can affect the Wnt-signaling pathway. High doses can increase the GSK-3β expression, playing a role in the destruction of β-catenin, inhibition of its accumulation in the cytoplasm and nuclear, apoptosis induction and cellular proliferation inhibition while low doses of resveratrol can decrease GSK-3β expression and suppress proliferation. Abbreviations: LEF/TCF, lymphoid enhancing factor/T-cell factor; APC, adenomatous polyposis coli; GSK-3β, glycogen synthase kinase 3B; CK, casein kinase 1; RSV, resveratrol; DMSO, dimethyl sulfoxide; DMEM-F12, Dulbecco's Modified Eagle's Medium F-12; FBS, fetal bovine serum; CIN, chromosomal instability; PI3K, phosphatidylinositol-3-kinase; TGF-β, transforming growth factor-β; GFR, Growth Factor Receptor; KRAS, Kirsten rat sarcoma viral oncogene homolog; PTEN, Phosphatase and tensin homolog; COX, Cytochrome c oxidase; IGF-1R, insulin-like growth factor 1 (IGF-1) receptor; Akt, Protein kinase B (PKB);

Intravascular large B-cell lymphoma is a rare subtype of extranodal diffuse B-cell lymphoma characterized by proliferation of neoplastic cells within the lumen of small and medium sized vessels. Clinical and imaging findings are nebulous as the intravascular subtype of lymphoma can involve a multitude of organs. Involvement of the gallbladder is extremely uncommon, and imaging findings can be easily confused for more prevalent pathologies. We report a case of intravascular large B-cell lymphoma in an 83-year-old male and review clinical presentation and imaging findings on CT, ultrasound, hepatobiliary iminodiacetic acid (HIDA) scan, and MRI. It is important for the radiologist to know about this disease as the imaging findings are atypical of other types of lymphoma, and this may lead to a delay in diagnosis and treatment.

Background: Infections are one of the correctable causes of infertility with low cost and cost effective treatment. The 50% of infertile cases is related to men in some way, and 30% of them are absolutely related to them. Mycoplasmas are the smallest microorganisms with capability of DNA replication. Present study is planned to compare the mycoplasma infection in infertile men and men with established fertility.Materials and Methods: 45 Semen samples were collected from case and control persons who reffered to Royan Infertility and Fertility Institute between 2004 and 2005 and stored in -20°C until time of test. DNA was extracted from semen using phenol chloroform. PCR reaction was done by mycoplasma specific primers.Results: Mycoplasma genitalium gene was amplified in 6 (40%) cases from 15 infertile semen samples and 11 (36.6%) from 30 control semen samples.Conclusion: Probability of genital infection, at least, in these studies group, is very lower than other communities' reports.

Background and objectives : Medication errors can be a threat to the safety of patients. Preventing medication errors requires reporting and investigating such errors. The present study was conducted with the purpose of investigating medication errors in educational health centers of Kermanshah. Material and Methods: The present research is an applied, descriptive-analytical study and is done as a survey. Error Report of Ministry of Health and Medical Education was used for data collection. The population of the study included all the personnel (nurses, doctors, paramedics) of educational health centers of Kermanshah. Among them, those who reported the committed errors were selected as the sample of the study. The data analysis was done using descriptive statistics and Chi 2 Test using SPSS version 18. Results: The findings of the study showed that most errors were related to not using medication properly, the least number of errors were related to improper dose, and the majority of errors occurred in the morning. The most frequent reason for errors was staff negligence and the least frequent was the lack of knowledge. Conclusion: The health care system should create an environment for detecting and reporting errors by the personnel, recognizing related factors causing errors, training the personnel and create a good working environment and standard workload.

Background and objectives : Since a major part of the budget for the health system is devoted to hospitals, continuous and constant supervision and evaluation of hospitals using performance indicators is a necessary undertaking. Therefore, the purpose of this study was to investigate the relationship between changes in the grade rating of hospitals and performance indicators of the university hospitals in Kermanshah. Material and Methods : This research was a descriptive-analytic study with all those university hospitals in Kermanshah as its statistical community whose grade ratings have changed during the past ten years. Due to the limited volume of this community, the statistical method was used. The documents related to performance indicators and certificates of grade rating of the hospitals were the tools used for collecting information. Finally, for determining the relationship between research variables, Pearson regression coefficient and SPSS version 21 were used. Results : Our findings in this research showed that in general, there were no statistically significant relationships between any of the performance indicators and the grade ratings, except for a significantly negative relationship between the indicator of the rate of hospital bed occupancy and grade ratings. There were negative relationships between grade ratings and the average length of stay of patients in hospitals, their mortality rate and their turnover rate of hospital beds while there was a positive relationship between grade ratings and the bed turnover interval. Conclusion : Results of our research show that the evaluation system was inefficient in the past and that rating hospitals is not a sufficient criterion of desirability of services offered by hospitals. It is felt that a new system together with a financing system is needed to investigate the efficiency and the qualitative and quantitative performance of hospitals. ​

​Background and objectives : Health tourism has drastically grown during the last decade as a form of specialized tourism. The development of this industry in Iran and Kermanshah requires attention to important factors such as marketing techniques, the performance of organizations and the surrounding environment situation. This study was designed and conducted to identify effective factors in attracting health tourists to Kermanshah Province. Material and Methods : In this descriptive-analytical research, the opinions of 70 major experts involved in health tourism of Kermanshah province were investigated using a researcher-made questionnaire in 2011. Descriptive statistical methods, diagrams, tables and SPSS Version 18 were used to display and analyze the data. Results : Cumulative frequency of responses with “much” and “very much” to the questions related to hypothesis one (the performance of the organizations related to health tourist attraction to the province), hypothesis two (marketing mix with health tourists to the province) and hypothesis three (the situation of surrounding environment of the province) were 95.%, 98.%, and 94.3 %, respectively. Thus, marketing factors, the performance of related organizations and the surrounding environment situation of the province are respectively the priorities in the prioritization among these three hypotheses. These findings are nearly in a similar line with several recent findings in Iran and the world. Conclusion : The prioritization of the mentioned factors in the hypotheses showed that effort for the development of the factors related to marketing mix should be placed in the highest priority in comparison with the other factors in Kermanshah province.

Objectives: It has been found that older adults fall or sway significantly more than younger ones under sensory conflict conditions. Considering the prospects of future increases in the elderly population size of Iran and the lack of proper postural control and the high costs of its probable consequences, this study investigated the effects of multi balance training on postural control. Methods & Materials: In this semi-experimental study, 34 elderly women participated in two training and control groups with the mean ages of 72.4 and 72.9 respectively. Before and after training, to investigate the functional balance and postural control, the Berg Balance Scale and a force plate were used. The training group participated in multisensory balance training sessions of 1 hour classes held three days per week for five weeks. Data was analyzed using an independent sample and a paired t-test. Results: The analysis showed significant differences between the training group and the control after balance training in the measured parameters of postural control consisting of path length and mean velocity in the eyes open (P=0.001) and eyes closed (P=0.0001) conditions and the Berg Balance Scale (P=0.002). Conclusion: Results indicate that multisensory balance training can improve the parameters of postural control even in short term.

Introduction: Hyperalgesia is considered as one of the marked signs of subchronic diabetes mellitus in patients that could affect their lifestyle. This study was designed to investigate the anti-nociceptive effect of chronic administration of quercetin in streptozotocin (STZ)-diabetic rats using formalin and hot tail immersion tests. Methods: Rats were divided into control, control or diabetic groups receiving sodium salicylate, untreated diabetic, and quercetin-treated control and diabetic groups. The treatment groups received i.p. administration of quercetin at a dose of 10 mg/kg for 6 weeks. Finally, hyperalgesia were assessed using standard formalin and hot tail immersion tests. Meanwhile, some markers of oxidative stress were also measured in brain tissue.Results: Quercetin or SS treatment of diabetic rats significantly reduced pain score in chronic phase of formalin test (p

مقدمه: آسیب شناختی خفیف (Mild cognitive impairment یا MCI) یک وضعیت بینابینی میان وضعیت شناختی طبیعی سالمندی و دمانس می‌باشد و سندرم بالینی است که در گروه آسیب‌های شناختی قرار می‌گیرد. سالمندان مبتلا به MCI خطر پیشرفت بیماری را تا دمانس و به خصوص بیماری آلزایمر دارند. با توجه به روند پیر شدن جامعه ضرورت شناسایی ابزارهایی که بتواند با روشی آسان موارد مشکوک به این اختلال را شناسایی کنند، به شدت احساس می‌شود. این مطالعه با هدف بررسی همخوانی بین دو آزمون MMSE (Mini-Mental state examination) و MoCA (Montreal cognitive assessment) در تعیین اختلال شناختی در سالمندان سالم که علایم بالینی اختلال شناختی خفیف را نشان نمی‌دهند، طراحی و انجام شده است. مواد و روش‌ها: در این مطالعه مقطعی 47 سالمند (25 زن و 22 مرد) با سن 60 سال به بالا در سطح شهر شیراز از طريق نمونه‌گيري در دسترس، مورد بررسی قرار گرفتند. از افراد شرکت کننده آزمون‌های MMSE و MoCA به صورت آزمون- پس‌آزمون و با فاصله 2 ماه گرفته شد و روش‌های آماری به کار گرفته شده جهت مقایسه همخوانی این دو آزمون شامل Regression analysis بود. یافته‌ها: میانگین سنی افراد سالمند 05/22 ± 43/69 بود. ضریب همبستگی Pearson (0001/0 > P، 69/0 = r) رابطه معنی‌دار مثبتی بین آزمون MoCA درtest و retest نشان داد. عدم وجود همخوانی بین دو آزمون MMSE و MoCA توسط تحلیل رگرسیون ساده (602/0 = r و 362/0 = 2R) نشان داده شد. نتیجه گیری: نتایج نشان داد که بین دو آزمون همخوانی قابل قبولی وجود ندارد. به نظر می‌رسد به دلیل بالا بودن ثبات داخلی آزمون ارزیابی شناختی مونترآل و سالم بودن جمعیت مورد مطالعه می‌باشد. عدم همخوانی بین نمرات این دو آزمون به معنی عدم توانایی آزمون معاینه مختصر وضعیت روانی در تشخیص اختلال شناختی خفیف شناختی می‌باشد. کلید واژه‌ها: آزمون معاینه مختصر وضعیت روانی،آزمون ارزیابی شناختی مونترآل، اختلال شناختی خفیف، سالمندان

Background: Epilepsy is a rare neurologic disorder during pregnancy. Despite its rarity, it could cause different clinical problems in this natural phenomenon of a woman′s life. The aim of this study was to evaluate and compare the course of pregnancy and labor and their outcome in epileptic and healthy women. Materials and Methods: This study was performed during years 2009--2011 in Alzahra and Beheshti hospitals affiliated to Isfahan University of Medical Sciences. A total of 51 pregnant women, who were known cases of epilepsy and were on antiepileptic drugs treatment for at least 3 months, were compared with 47 matched healthy pregnant women without epilepsy. They were followed before and during their pregnancy in several visits and all of their neurologic and obstetric information were collected. For statistical analysis of continuous variables, the t-test was used. The chi-square test was used for dichotomous variables. Results: The rate of monotherapy was more than polytheraphy especially during the pregnancy. The epileptic attacks stopped in majority of patients during the pregnancy. Vaginal bleeding (P=0.020) and abortion (P=0.015) were significantly more frequent among epileptic mothers. The gestational age was lower meaningfully (P= 0.010) in epileptic patients′ neonates and the first minute Apgar score was lower in these babies too (P=0.028). Conclusions: Antiepileptic drugs could have some unsuitable effects on pregnancy course especially by increasing the rate of abortion, preterm labor, and vaginal bleeding. Their adverse effects on neonates′ health could not be neglected.

Metallic nanoparticles (NPs) have been highlighted to improve plant growth and development in the recent years. Although positive effects of some NPs have been reported on medicinal plants, the knowledge for stimulations application of iron (Fe) and zinc (Zn) NPs is not available. Hence, the present work aimed to discover the effects of Fe NPs at 10, 20, and 30 mg L -1 and Zn NPs at 60 and 120 mg L -1 on growth, water content, photosynthesis pigments, phenolic content, essential oil (EO) quality, and rosmarinic acid (RA) production of lemon balm (Melissa officinalis L.). The results showed that Fe NPs at 20 and 30 mg L -1 and Zn NPs at 120 mg L -1 significantly improved biochemical attributes. Compared with control plants, the interaction of Fe NPs at 30 mg -1 and Zn NPs at 120 mg L -1 led to noticeable increases in shoot weight (72%), root weight (92%), chlorophyll (Chl) a (74%), Chl b (47%), RA (66%), proline (81%), glycine betaine (GB, 231%), protein (286%), relative water content (8%), EO yield (217%), total phenolic content (63%), and total flavonoid content (57%). Heat map analysis revealed that protein, GB, EO yield, shoot weight, root weight, and proline had the maximum changes upon Fe NPs. Totally, the present study recommended the stimulations application of Fe NPs at 20-30 mg L -1 and Zn NPs at 120 mg L -1 to reach the optimum growth and secondary metabolites of lemon balm., (© 2024. The Author(s), under exclusive licence to Springer-Verlag GmbH Germany, part of Springer Nature.)

Objective: To compare the Kadish and the modified Dulguerov staging of individual participants to determine the impact of stage and other prognostic factors on disease-free (DFS) and overall survival (OS)., Data Sources: Systematic review of EMBASE, MEDLINE, Cochrane Library, and CINAHL databases., Review Methods: The Preferred Reporting Items for Systematic Reviews and Meta-analysis (PRISMA) was followed for this study. Articles including patients with olfactory neuroblastoma (ONB) staged with both Kadish and Dulguerov staging systems were reviewed. The raw data from eligible studies were requested to perform an individual participant data (IPD) meta-analysis., Results: Pooled data from 21 studies representing 399 patients with ONB undergoing treatment with curative intent showed that increasing age, treatment with chemotherapy, and positive or unreported margin status portended worse DFS ( P < .05). Increasing stage for both Kadish and Dulguerov staging systems was prognostic for worse DFS and OS ( P < .05), with Kadish C representing a heterogeneous group with regard to outcome and corresponding Dulguerov T stage. Using the Akaike information criterion, the Dulguerov staging system had superior performance to the Kadish system for DFS (1088.72 vs 1092.54) and OS (632.71 vs 644.23)., Conclusion: This study represents the first IPD meta-analysis of ONB directly comparing the outcomes of Kadish and Dulguerov staging systems in patients treated with primary surgery. Both systems correlated with DFS and OS, with superior performance in the Dulguerov system. Furthermore, the Kadish C group represented a heterogeneous group with regard to outcomes after stratification by the Dulguerov system. Dulguerov T4 patients had the worst outcome, with most being approached with open resection.

Traumatic injuries to the skull base can involve critical neurovascular structures and present with symptoms and signs that must be recognized by physicians tasked with management of trauma patients. This article provides a review of skull base anatomy and outlines demographic features in skull base trauma. The manifestations of various skull base injuries, including CSF leaks, facial paralysis, anosmia, and cranial nerve injury, are discussed, as are appropriate diagnostic and radiographic testing in patients with such injuries. While conservative management is sometimes appropriate in skull base trauma, surgical access to the skull base for reconstruction of traumatic injuries may be required. A variety of specific surgical approaches to the anterior cranial fossa are discussed, including the classic anterior craniofacial approach as well as less invasive and newer endoscope-assisted approaches to the traumatized skull base.

Objectives: Lymphatic malformations are congenital vascular anomalies that occur from abnormal development of the lymphatic channels. Studies have shown that sclerotherapy can be a reliable alternative to surgery. The purpose of this retrospective study is to evaluate the safety and efficacy of percutaneous sclerotherapy with doxycycline and 3% Sotradecol as primary treatment for pediatric head and neck LMs, and to assess outcomes based on lesion classification, location and sclerosant used., Study Design: This study was a single center, retrospective, case series study., Materials and Methods: The medical records of 38 children who underwent percutaneous sclerotherapy of LMs in the head and neck region at our tertiary care center between 1/1/2006 and 1/31/2011 were reviewed. A mean average of 2.9 (range 1-10) sclerotherapy sessions per child were performed. LMs involved primarily the face (61.3%), posterior neck (48.4%), submental area (45.2%), and anterior neck (35.5%)., Results: Twenty-nine subjects had adequate follow-up data, with 51.7% demonstrating complete resolution, 27.6% moderate improvement, and 20.7% no response. There was no significant difference in the outcome based on the sclerosant agent used or location of the lesion. Lesion type did affect outcome and macrocystic lesions were found to have a significantly higher resolution rate (95.2%) than microcystic or mixed lesions (p < 0.05). The total number of complications was similar between agents and all were minor., Conclusion: Our results indicate that percutaneous therapy with doxycycline and Sotradecol is safe and effective for children with LMs of the head and neck. Better outcomes were observed with macrocystic LMs., Level of Evidence: 4., (Copyright © 2015 Elsevier Ireland Ltd. All rights reserved.)

Objectives/hypothesis: Congenital aural atresia is a rare condition affecting 1 in 10,000-20,000 children a year. Surgery is required to restore hearing to facilitate normal development. The objective of this study was to compare outcomes in hearing, complications, and quality of life of surgical reconstruction of the external auditory canal reconstruction (EACR) and bone-anchored hearing aid (BAHA) in a pediatric population with congenital aural atresia., Study Design: Subjects were children who had a diagnosis of congenital aural atresia or stenosis and who received either BAHA or EACR., Methods: The medical records of 68 children were reviewed for operative complications and audiometric results. A quality of life questionnaire was prospectively administered to a subset of subjects., Results: Pre-operatively, air conduction threshold was not significantly different between groups at 500, 1000, 2000, and 4000 Hz (p > 0.05). Post-operatively, the BAHA group (44.3 ± 14.3 and 44.5 ± 11.3) demonstrated a significantly larger hearing gain than the EACR group (20.0 ± 18.9 and 15.3 ± 19.9) in both the short and long-term periods (p < 0.001). Overall, the incidence of complications and need for revision surgery were comparable between groups (p > 0.05). Quality of life assessment revealed no statistical significance between the two groups (p > 0.05)., Conclusion: Although the quality of life and incidence of surgical complications between the two interventions was not significantly different, BAHA implantation appears to provide a better, more reliable audiologic outcome than EACR.