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Background and Objectives: Sexual satisfaction is one of the important and influential factors in the couples' stability and quality of marital life. Therefore, it is important to study the factors affecting it (such as; mindfulness, marital forgiveness, & mental well-being). Accordingly, the purpose of the present study was to investigate the mediating role of marital forgiveness and mental well-being in the relationship between mindfulness and sexual satisfaction. Materials and Methods: The present study is descriptive. The sample size included 300 married men and women in Tehran in the period of 2020-2021who were selected through the accessible sampling method.To collect the data, the Larson's Sexual Satisfaction Questionnaire (LSSQ), the Freiburg Mindfulness Inventory (FMI-SH), the Warwick-Edinburg Mental Well-being Scale (WEMWBS), and the Paleari et al.'s Marital Offence-Specific Forgiveness Scale (MOFS) were used. Data were analyzed by using Pearson's correlation coefficient and path analysis. Results: The results of the mediation analysis indicated that the direct effect of mindfulness on sexual satisfaction was significant (β=0.136, p=0.043). The indirect effect of mindfulness on sexual satisfaction through both marital forgiveness and mental well-being was also significant (β=0.056, p=0.017, β=0.289, p=0.010, respectively). Therefore, marital satisfaction and mental well-being had a partial mediating role in the relationship between mindfulness and sexual satisfaction. Conclusion: The results obtained in this research can help mental health researchers and therapists in both the theoretical (expanding and enriching the theoretical concepts in the field of couple therapy) and practical (developing therapeutic and educational programs) aspects. [ABSTRACT FROM AUTHOR]

Hepatocellular carcinoma (HCC) is the most prevalent type of liver cancer, mainly occurring in Asian countries with an increased incidence rate globally. Currently, several kinds of therapies have been deployed for HCC therapy including surgical resection, chemotherapy, radiotherapy and immunotherapy. However, this tumor is still incurable, requiring novel strategies for its treatment. The nanomedicine has provided the new insights regarding the treatment of cancer that liposomes as lipid-based nanoparticles, have been widely applied in cancer therapy due to their biocompaitiblity, high drug loading and ease of synthesis and modification. The current review evaluates the application of liposomes for the HCC therapy. The drugs and genes lack targeting ability into tumor tissues and cells. Therefore, loading drugs or genes on liposomes can increase their accumulation in tumor site for HCC suppression. Moreover, the stimuli-responsive liposomes including pH-, redox- and light-sensitive liposomes are able to deliver drug into tumor microenvironment to improve therapeutic index. Since a number of receptors upregulate on HCC cells, the functionalization of liposomes with lactoferrin and peptides can promote the targeting ability towards HCC cells. Moreover, phototherapy can be induced by liposomes through loading phtoosensitizers to stimulate photothermal- and photodynamic-driven ablation of HCC cells. Overall, the findings are in line with the fact that liposomes are promising nanocarriers for the treatment of HCC., Competing Interests: Declaration of competing interest The authors declare no conflict of interest., (Copyright © 2024. Published by Elsevier Inc.)

In modern society, the use of social networks is more than ever and they have become the most popular medium for daily communications. Twitter is a social network where users are able to share their daily emotions and opinions with tweets. Sentiment analysis is a method to identify these emotions and determine whether a text is positive, negative, or neutral. In this article, we apply four widely used data mining classifiers, namely K-nearest neighbor, decision tree, support vector machine, and naive Bayes, to analyze the sentiment of the tweets. The analysis is performed on two datasets: first, a dataset with two classes (positive and negative) and then a three-class dataset (positive, negative and neutral). Furthermore, we utilize two ensemble methods to decrease variance and bias of the learning algorithms and subsequently increase the reliability. Also, we have divided the dataset into two parts: training set and testing set with different percentages of data to show the best train-test split ratio. Our results show that support vector machine demonstrates better outcomes compared to other algorithms, showing an improvement of 3.53% on dataset with two-class data and 7.41% on dataset with three-class data in accuracy rate compared to other algorithms. The experiments show that the accuracy of single classifiers slightly outperforms that of ensemble methods; however, they propose more reliable learning models. Results also demonstrate that using 50% of the dataset as training data has almost the same results as 70%, while using tenfold cross-validation can reach better results., Competing Interests: Conflict of interestThe authors declare that they have no competing interests., (© The Author(s), under exclusive licence to Springer-Verlag GmbH Austria, part of Springer Nature 2022, Springer Nature or its licensor (e.g. a society or other partner) holds exclusive rights to this article under a publishing agreement with the author(s) or other rightsholder(s); author self-archiving of the accepted manuscript version of this article is solely governed by the terms of such publishing agreement and applicable law.)

Introduction: Many patients with chronic diseases often use traditional medicine, as well as conventional medicine. The aim of this study was to evaluate the epidemiological factors of patients with dermatological conditions referring to traditional Persian Medicine (TPM) clinic., Materials and Methods: In this cross-sectional study, we reviewed all the patients' medical documents, from March 2018 to March 2019, with dermatological conditions referred to the TPM clinic at Shiraz, Southern Iran. Then, the epidemiological factors of the patients were recorded in a researcher-made data collection form. SPSS software version 22 was used to analyse the data., Results: Overall, 631 patients consisting of 151 (23.9%) males and 580 (76.1%) females were enrolled in the study. Most of the patients were aged from 31 to 40 years, 347 (55%) patients were married, and most of them were housewives. The frequency of patients in the spring was higher than in other seasons. Furthermore, most of the patients were university educated. Acne, eczema and hair loss were the three most complaints of the patients who were referred to the traditional medicine clinic. 301(47.7%) patients reported gastrointestinal problems as another complaint concomitant with their skin problems., Conclusion: It seems that women with skin problems, including acne, eczema, and hair loss, were more likely to refer to the TPM clinic. Therefore, the development of TPM clinics in the dermatology field as a scientific and academic approach can be effective in the treatment of patients with dermatological conditions accompanied by traditional medicine., (© 2021 John Wiley & Sons Ltd.)

With the advent of spectral-domain optical coherence tomography, imaging of the posterior segment of the eye can be carried out rapidly at multiple anatomical locations, including the optic nerve head, circumpapillary retinal nerve fiber layer, and macula. There is now ample evidence to support the role of spectral-domain optical coherence tomography imaging of the macula for detection of early glaucoma. Macular spectral-domain optical coherence tomography measurements demonstrate high reproducibility, and evidence on its utility for detection of glaucoma progression is accumulating. We present a comprehensive review of macular spectral-domain optical coherence tomography imaging emerging as an essential diagnostic tool in glaucoma., (Copyright © 2020 Elsevier Inc. All rights reserved.)

Purpose: The purpose of this study was to compare rates of change of various macular thickness measures and evaluate the influence of baseline damage on macular rates of change., Methods: One hundred twelve eyes (112 patients) with ≥ 2 years of follow-up and ≥ 5 macular optical coherence tomography (OCT) images and 10-2 visual field (VF) tests were included. OCT measures of interests were full macular thickness (FMT), ganglion cell complex (GCC), ganglion cell/inner plexiform layer (GCIPL), ganglion cell layer (GCL), and outer retinal layer (ORL) thickness in 3° × 3° superpixels. Rates of change were estimated with linear regression and normalized by dividing rates by the average normative superpixel thickness. We compared rates of change and proportion of significantly worsening superpixels (detection rate) and improving superpixels (false discovery rate [FDR]) among macular measures as a function of baseline thickness and 10-2 VF status., Results: Median (interquartile range [IQR]) baseline VF mean deviation, follow-up time, and number of VFs/OCTs were -7.6 dB (-11.8 to -3.8 dB), 4.5 years (4.0-5.0 years), and 9 (8-10), respectively. Normalized FMT and GCC rates of change were faster and detection rates were higher than GCIPL and GCL ( P < 0.001), but FMT had lower FDR than GCC ( P = 0.02); faster FMT rates were partially explained by ORL rates of change. GCC detection rates were less likely than GCIPL and GCL rates to decrease with diminishing baseline thickness or worse VF damage. In eyes with 10-2 VF worsening, GCC and GCL demonstrated the fastest rates of change., Conclusions: GCC measurements are most likely to detect structural worsening along the spectrum of glaucoma severity. Although FMT rates of change are least influenced by baseline thickness, they partially reflect likely age-related ORL changes., Translational Relevance: GCC thickness measurements seem to be the optimal macular outcome measure for detection of glaucoma deterioration., Competing Interests: Disclosure: A. Rabiolo, Santen Italy srl; V. Mohammadzadeh, None; N. Fatehi, None; E. Morales, None; A.L. Coleman, None; S.K. Law, None; J. Caprioli, Aerie, Alcon, Allergan, Glaukos, New World Medical; K. Nouri-Mahdavi, Heidelberg Engineering, Aerie, (Copyright 2020 The Authors.)

Purpose: To review central structure-function (SF) relationships in glaucoma; to compare contributions of within-session and between-session variability to total variability of macular optical coherence tomography (OCT) thickness measurements; and to test the hypothesis that longitudinal within-eye variability of central SF relationships is smaller than between-individual variability., Methods: We reviewed the pertinent literature on central SF relationships in glaucoma. Thirty-eight eyes (20 normal or glaucoma subjects) had ×3 macular images per session over 3 sessions, and superpixels thickness measurements for ganglion cell layer (GCL), ganglion cell/inner plexiform layer (GCIPL), ganglion cell complex (GCC), and full macular thickness (FMT) were exported. Linear mixed models were used for estimating contributions of between- and within-session variability to total thickness variability. One hundred twenty eyes with ≥3 10° visual fields (VFs)/OCT images were enrolled for the longitudinal study. We investigated within-eye longitudinal SF relationships (GCIPL thickness vs VF total deviations) with a change-point regression model and compared within-eye to between-individual variabilities with components-of-variance models., Results: In the cross-sectional study, the between-session component contributed 8%, 11%, 11%, and 36% of total variability for GCL, GCIPL, GCC, and FMT, respectively. In the longitudinal study, between-individual variability explained 78%, 77%, and 67% of total SF variability at 3.4°, 5.6°, and 6.8° eccentricities, respectively (P < .05). SF relationships remained stable over time within individual eyes., Conclusions: Within-session variability accounts for most of macular thickness variability over time. Longitudinal within-eye SF variability is smaller than between-individual variability. Study of within-eye SF relationships could help clinicians better understand SF linking in glaucoma and help refine progression algorithms. NOTE: Publication of this article is sponsored by the American Ophthalmological Society., (Copyright © 2019 Elsevier Inc. All rights reserved.)

Purpose: To explore factors influencing the inner plexiform layer (IPL) in healthy subjects and to test the hypothesis that IPL thickness is preferentially decreased in glaucoma as compared with ganglion cell layer (GCL) thickness., Methods: Ninety-nine glaucomatous eyes and 66 healthy eyes (165 subjects) underwent macular spectral-domain optical coherence tomography (SD-OCT) imaging and GCL and IPL were segmented creating 8 × 8 arrays of 3° × 3° superpixels. The central 24 superpixels were categorized into three levels of eccentricity (∼1.5°, 4.5°, and 7.5° from the foveal center). Linear mixed models were used to determine predictive parameters for IPL thickness in healthy subjects and to explore the influence of diagnosis of glaucoma on IPL thickness taking into account the effect of GCL thickness and other covariates., Results: Being located at 4.5° eccentricity predicted thicker IPL compared with 1.5° eccentricity ( P < 0.001) in multivariable models in healthy subjects, whereas older age ( P = 0.001) and Asian ethnicity ( P = 0.021) were associated with thinner IPL. Diagnosis of glaucoma was not associated with thinner IPL regardless of eccentricity after accounting for age and ethnicity. The results were similar when only eyes with mean deviation greater than -6 dB were analyzed., Conclusions: Ethnicity and distance from the fovea are the main determinants of IPL thickness in the central macula. Preferential thinning of the macular IPL, compared with GCL, could not be detected in this study regardless of glaucoma stage., Translational Relevance: There is no evidence for preferential thinning of the macular IPL in glaucoma compared with GCL based on currently available SD-OCT-imaging technology., (Copyright 2019 The Authors.)

Purpose: To test the hypothesis that cataract surgery slows the apparent rate of visual field (VF) decay in primary open-angle glaucoma patients compared with rates measured during cataract progression., Design: Retrospective cohort study., Methods: Consecutive open-angle glaucoma patients who underwent cataract surgery and who had ≥4 VFs and ≥3 years of follow-up before and after surgery were retrospectively reviewed. Mean deviation (MD) rate, visual field index (VFI) rate, pointwise linear regression (PLR), pointwise rate of change (PRC), and the Glaucoma Rate Index (GRI) were compared before and after cataract surgery., Results: A total of 134 eyes of 99 patients were included. Median (interquartile range) follow-up was 6.5 (4.7-8.1) and 5.3 (4.0-7.3) years before and after cataract surgery, respectively. All intraocular pressure (IOP) parameters (mean IOP, standard deviation of IOP, and peak IOP) significantly improved (P < .001) after cataract surgery. All VF indices indicated an accelerated VF decay rate after cataract surgery: MD rate (-0.18 ± 0.40 dB/year vs -0.40 ± 0.62 dB/year, P < .001), VFI rate (-0.44% ± 1.09%/year vs -1.19% ± 1.85%/year, P < .001), GRI (-5.5 ± 10.8 vs -13.5 ± 21.5; P < .001), and PRC (-0.62% ± 2.47%/year before and -1.35% ± 3.71%/year after surgery; P < .001) and PLR (-0.20 ± 0.82 dB/year before and -0.42 ± 1.16 dB/year after surgery; P < .001) for all VF locations. Worse baseline MD and postoperative peak IOP were significantly associated with the postoperative VF decay rate and the change in the decay rate after cataract surgery., Conclusion: Although all IOP parameters improved after cataract surgery, VFs continued to progress. Cataract surgery does not slow the apparent rate of glaucomatous VF decay as compared to rates measured during the progression of the cataract., (Copyright © 2019 Elsevier Inc. All rights reserved.)

Aim: We report patient safety and intraocular pressure (IOP) control after placement of a glaucoma drainage device (GDD) in eyes with a history of treated malignant uveal melanoma., Methods: A retrospective review of the records of patients with uveal melanoma was performed. Outcomes were local tumor recurrence, rate of metastases, and to-nometric success, based on survival curves, defined as IOP < 21 mm Hg., Results: Eleven eyes with choroidal melanoma, 4 with iris melanoma, and 1 with ciliary body melanoma were followed for a median (interquartile range) of 2.1 (1.1-3.2) years. Two subjects developed liver metastases; one had monosomy 3 and tumor gene expression profile class 2. The other case with ciliary body melanoma was negative for monosomy 3. There were no cases of local treatment failure. Mean preoperative IOP decreased from 30.5 ± 7.7 to 15.9 ± 8.1 mm Hg at 1 year after surgery (1-year success rate 80%)., Conclusions: Our case series with a median follow-up of 2 years shows that placing a GDD in patients with treated uveal melanoma does not expose patients to greater risk of local or extraocular recurrence. A larger series and longer follow-up time are required to fully evaluate the safety of GDDs in this clinical scenario.

Importance: There is evidence that patients of African descent (AD) experience higher surgical failure rate after trabeculectomy without antimetabolites., Objective: To compare outcomes of initial trabeculectomy with mitomycin C in AD patients with those of patients of European descent (ED) and to identify prognostic factors for failure., Design, Setting, and Participants: In this retrospective matched cohort study, 135 eyes of 105 AD patients were matched with 135 eyes of 117 ED patients by age (within 5 years), surgeon, lens status, and follow-up time (within 1 year) from a single tertiary academic center., Interventions: Initial trabeculectomy with mitomycin C., Main Outcomes and Measures: Criteria A, B, and C defined qualified success rates as final intraocular pressure of 18 mm Hg or less, 15 mm Hg or less, and 12 mm Hg or less, respectively, in addition to 20% or more, 25% or more, and 30% or more reduction of intraocular pressure or reduction of 2 or more medications. Kaplan-Meier survival curves were compared with log-rank test in AD and ED patients, and Cox proportional hazard models were used to estimate the influence of race/ethnicity on surgical success accounting for confounding variables., Results: Of the 105 AD patients, 56 (53.3%) were female, and the mean (SD) age was 67.5 (10.4) years; of the 117 ED patients, 64 (54.7%) were female, and the mean (SD) age was 68.2 (10.0) years. For AD patients compared with ED patients, the qualified success rates at 5 years for criteria A were 61% and 67%, respectively (difference, 7.3%; 95% CI, 4.4-10.4); for criteria B, 43% and 60% (difference, 17.6%; 95% CI, 15.2-20.0); and for criteria C, 25% and 40% (difference, 15.8%; 95% CI, 11.1-20.5). On multivariable Cox regression analyses, AD was associated with higher failure rate with criteria B and C for qualified success and with all criteria for complete success (ie, no need for medications). Incidence of bleb leaks was higher in the AD group (29 vs 11 eyes; P = .002). Additionally, AD patients required additional glaucoma surgeries more often than ED patients (47 vs 26 eyes; P = .004)., Conclusions and Relevance: African descent was associated with higher failure rates and higher incidence of bleb leaks after initial trabeculectomy with mitomycin C compared with European descent. If this is subsequently shown to be a cause and effect, the findings need to be considered when surgical treatment of glaucoma is contemplated in AD patients.

Purpose: To evaluate the long-term outcomes of second Ahmed glaucoma valve (AGV) implants in eyes with glaucoma., Design: Retrospective interventional case series., Methods: Patients with sequential second Ahmed valves implanted in the same eye from 1994 to 2016 were included. Success was defined with 3 criteria: (1) intraocular pressure (IOP) ≤ 21 mm Hg and IOP reduction of 20%; (2) IOP ≤ 18 mm Hg and IOP reduction of 25%; and (3) IOP ≤15 mm Hg and IOP reduction of 30%. The primary analysis was the 5-year Kaplan-Meier survival rate for each criterion. Failure was established when the success criterion was not met at 2 consecutive visits at least 3 months after the surgery. Loss of light perception, requirement for additional glaucoma surgery, hypotony maculopathy, and serious complications were also considered failures., Results: One hundred ten eyes from 104 patients were included with a mean follow-up of 5.0 years (interquartile range [IQR] 1.6-7.33 years). The median (IQR) age at the second AGV was 68.0 (53.5-77.9) years. The median (IQR) time between surgeries was 2.1 (0.7-4.0) years. The 5-year Kaplan-Meier survival rates were 57%, 51%, and 30% for criteria 1, 2, and 3, respectively., Conclusion: A second AGV is effective in reducing IOP in patients who require additional IOP lowering after a first AGV. The success rates are comparable to primary AGV implantation, and to trabeculectomy in eyes with a previously implanted glaucoma drainage device. A second AGV is a viable option in eyes with inadequate IOP levels after a primary AGV., (Copyright © 2017 Elsevier Inc. All rights reserved.)

Purpose: To test the hypothesis that structural and functional measures predict contrast sensitivity (CS) outcomes in glaucomatous eyes., Design: Cross-sectional prospective study., Methods: One hundred five eyes of 65 patients who underwent macular spectral-domain optical coherence tomography imaging, 24-2 standard achromatic visual fields (VF), and CS measurement on the same day were enrolled. Association of CS at 4 spatial frequencies (3, 6, 12, and 18 cycles per degree, cpd) with structural and functional outcomes was explored with correlation and regression analyses., Results: The median (IQR) 24-2 visual field mean deviation was -7.6 (-11.1 to -3.0). Significant correlations were found between CS at 6 cpd and ganglion cell/inner plexiform layer thickness at inferotemporal and inferonasal macular sectors (ρ = 0.222, P = .023 and ρ = 0.209, P = .032, respectively). CS at 6 cpd demonstrated higher correlations with full macular thickness measurements, the strongest of which was with the central macular thickness in the superior 6 × 3-degree region (ρ = 0.311, P = .001). Contrast sensitivity at 6 cpd also had the strongest correlation with mean deviation of the 4 central VF points (ρ = -0.420; P < .001). There was a significant correlation between logMAR visual acuity and contrast sensitivity at 6, 12, and 18 cpd (ρ = -0.306, ρ = -0.348 and ρ = -0.241, P < .013, respectively)., Conclusions: Structural and functional measures showed a fair relationship with contrast sensitivity. This association was most prominent between full-thickness macular measures or central VF parameters and CS at 6 cpd. Contrast sensitivity was not a reliable surrogate for glaucoma severity in this cross-sectional study., (Copyright © 2017 Elsevier Inc. All rights reserved.)

Background: Tube feeding is used for patients, who are not able to eat orally but their digestive system can digest food. This method is safe and economical for patients, maintains the functions of the digestive system and reduces the risk of infection and sepsis. However, incorrect administration of this method of feeding results in problems such as aspiration pneumonia, infection, diarrhea, NG tube obstruction, and etcetera. If tube feeding is performed according to its standard procedure, it can have a major role in reducing complications, providing adaptability and the desired lifestyle, reducing the duration of hospitalization, and reducing the relevant costs., Materials and Methods: This research is a descriptive-analytic cross-sectional study on 37 nurses who worked in the general surgery and neurology wards and fed patients suffering from gastrostomy. A valid and reliable checklist was used for data collection. To analyze the data, the descriptive statistical method (frequency and mean) and inferential method (paired t-test, Spearman Correlation Coefficient and variance Analysis with repetition of observations) were used., Findings: The findings showed that the mean score of measures in all the stages (before, during, and after administration) was significantly lower than the standard (p < 0.001). There was a significant reverse relation between the score of measures in all the three stages (before, during, and after administration), and work record and work experience in the ward. Furthermore, the mean score of measures in all the three stages was significantly different between female and male subjects (p value = 0.031), in that the mean score of women was higher than that of men. There was also a significant difference between the mean score of measures in all the three stages, and the employment status of samples; so that the mean score of provisionally employed personnel was higher than that of permanently employed personnel., Conclusions: The findings of the research showed that the mean score of measures before, during, and after administration of feeding through gastrostomy was lower than the standard (p < 0.001). Therefore, a gastroenterology advisor, a clinical nurse and a nutrition specialist should train the patients and their families, and the personnel about preparation and storage of food, method of administering food, protection of tube entrance and NG tube by considering the problems and complications arising from this type of feeding. Based on the findings of the present research, it is necessary to retrain the nurses and especially male nurses, nurses with more work experience, and permanently employed nurses in terms of correct performance of clinical nursing skills including this type of feeding.

Background: One of the essential components of learning and educational program is evaluation or examination. There are various methods for evaluating clinical skills among which objective structured clinical examination (OSCE) has been recognized as the most reliable method for evaluation of the clinical skills., Methods: This was a one-step single-group descriptive study which was conducted through a researcher-made questionnaire., Results: Results indicated that the view of most of the students in OSCE test has been good in terms of equipment and facilities with relative frequency of 59.2 percent, conditions of holding the examination with relative frequency of 50.9% and total test with relative frequency of 55.1%; in terms of physical environment, students' view was moderate with relative frequency of 469%., Conclusions: The results of the study showed that appropriateness of physical environment and equipment and facilities to hold OSCE can directly be involved in enhancing the quality of this test.