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Abstract This research was conducted to investigate the efficacy of putrescine (PUT) treatment (0, 1, 2, and 4 mM) on improving morphophysiological and biochemical characteristics of Zinnia elegans “State Fair” flowers under salt stress (0, 50, and 100 mM NaCl). The experiment was designed in a factorial setting under completely randomized design with 4 replications. The results showed that by increasing the salt stress intensity, the stress index (SSI) increased while morphological traits such as plant height decreased. PUT treatments effectively recovered the decrease in plant height and flower quality compared to the not-treated plants. Treatment by PUT 2 mM under 50 and 100 mM salt stress levels reduced the SSI by 28 and 35%, respectively, and increased plant height by 20 and 27% compared to untreated plants (PUT 0 mM). 2 mM PUT treatment also had the greatest effect on increasing fresh and dry biomass, number and surface area of leaves, flower diameter, internodal length, leaf relative water content, protein contents, total chlorophyll contents, carotenoids, leaf potassium (K+) content, and K+/Na+ ratio in treated plants compared to untreated control plants. The treatment of 2 mM PUT decreased the electrolyte leakage, leaf sodium (Na+) content, H2O2, malondialdehyde, and proline content. Furthermore, PUT treatments increased the activity of defense-related enzymes including catalase (CAT), peroxidase (POD), superoxide dismutase (SOD), and phenylalanine ammonium lyase (PAL), and reduced the abscisic acid (ABA) content while increased the level of gibberellin (GA) content compared to untreated samples under all different levels of salinity stress. In this research, enhancing the plant’s antioxidant system, increasing K+ absorption, K+/Na+ ratio, and reducing the ABA/GA ratio are likely the most important mechanisms of PUT treatment, which improved growth, and maintained the visual quality of zinnia flowers under salt stress conditions.

Abstract Diabetes mellitus (DM) is among the most widespread non-communicable diseases and poses a substantial global health challenge. The aim of this study was to examine the incidence of DM and its nutritional, anthropometric, laboratory, demographic, and behavioral determinants, as well as comorbidities, within a Kurdish population residing in western Iran. This research was conducted in the Ravansar Non-Communicable Disease (RaNCD) cohort study, followed 9170 participants aged 35–65 years, for an average ± SD of 7.11 ± 1.26 years, from 2015 until 2023. A hierarchical Cox regression model was used to estimates the adjusted hazard ratios (HRs). The incidence of DM was 4.45 (95% CI 3.96, 4.99) per 1000 person-years. We found several significant predictors for DM incidence, including prediabetes, comorbidity, urban residence, total antioxidant capacity (TAC), and the interaction between gender and body mass index (BMI). Prediabetes emerged as the strongest predictor of DM incidence, with a hazard ratio of 10.13 (CI 7.84, 13.09). Additionally, having two diseases (HR = 2.18; 95% CI 1.44, 3.29) or three and more diseases (HR = 3.17; 95% CI 2.06, 4.90) increased the risk of developing DM. Also, the hazard ratios for the effects of gender on DM incidence in the normal, overweight, and obese BMI groups were 0.24, 0.81, and 1.01, respectively. The presence of prediabetes and obesity serve as the crucial indicators for the onset of DM, emphasizing the pressing need for interventions to prevent DM in these circumstances. Furthermore, there are notable disparities between urban and rural populations in this study, warranting further investigations to ascertain the underlying causes of such variations.

BackgroundPresenting ongoing outbreaks and the potential for their spread to nearby neighborhoods and social classes may offer a deeper understanding, enable a more efficient reaction to outbreaks, and enable a comprehensive understanding of intricate details for strategic response planning. Hence, this study explored the spatiotemporal spread of COVID-19 outbreaks and prioritization of the risk areas among social classes in the Kermanshah metropolis.MethodsIn this cross-sectional study, the data of 58.951 COVID-19-infected patients were analyzed. In 2020, out of 24.849 infected patients, 10.423 were females, 14,426 were males, and in 2021, 15.714 were females, and 18,388 were males. To categorize social classes (working, middle, and upper), we utilized economic, social, cultural, and physical indicators. Our analysis utilized Arc/GIS 10.6 software along with statistical tests, including standard distance (SD), mean center (MC), standard deviational ellipse (SDE), and Moran’s I.ResultsThe results revealed that the average epicenter of the disease shifted from the city center in 2020–2021 to the eastern part of the city in 2021. The results related to the SD of the disease showed that more than 70% of the patients were concentrated in this area of the city. The SD of COVID-19 in 2020 compared to 2021 also indicated an increased spread throughout the city. Moran’s I test and the hotspot test results showed the emergence of a clustered pattern of the disease. In the Kermanshah metropolis, 58,951 COVID-19 cases were recorded, with 55.76% males and 44.24% females. Social class distribution showed 28.86% upper class, 55.95% middle class, and 15.19% working class. A higher disease prevalence among both males and females in the upper class compared to others.DiscussionOur study designed a spatiotemporal disease spread model, specifically tailored for a densely populated urban area. This model allows for the observation of how COVID-19 propagates both spatially and temporally, offering a deeper understanding of outbreak dynamics in different neighborhoods and social classes of the city.

Abstract This study aims to investigate the trends and project the major risk factors of Non-communicable Diseases (NCDs) in Iran. We obtained the trend of prevalence of main risk factors related to NCDs in 30 to 70-year-old-individuals. The data were extracted from WHO STEP wise approach to NCDs risk factor surveillance (STEPS) survey. Also,the previous studies conducted at national and subnational levels from 2001 to 2016 were employed. The prevalence of risk factors was projected by 2030 using Bayesian Model Averaging (BMA) and Spatio-temporal model stratified by sex and province. The percent change for the age-standardized prevalence of smoking in men between 2001 and 2016 was calculated to be − 27.0. Also, the corresponding values for the risk factors of diabetes, hypertension, obesity and overweight, physical inactivity (PI), and mean of salt intake were − 26.1, 29.0, 70.0, 96.8, 116.6, and 7.5, respectively. It is predicted that smoking and these risk factors will undergo a change to show values of − 1.26, 38.7, 43.7, 2.36, and 15.3 by 2030, respectively. The corresponding values in women for the time interval of 2001–2016 were − 27.3, 26.3, 82.8, 1.88, 75.2, and 4.2, respectively. Plus, projections indicate that the 2030 variation values are expected to be − 25.0, 16.7, 37.5, 28.7, 26.7, and 10.9 respectively. This study showed that the prevalence of four risk factors of PI, overweight and obesity, hypertension, and diabetes is increasing in Iran. Therefor, it is necessary to carry out effective interventions to adopt a healthy lifestyle and reduce the risk factors.

Introduction: In infectious diseases, there are essential indices used to describe the disease state. In this study, we estimated the basic reproduction number, R0, peak level, doubling time, and daily growth rate of COVID-19. Methods: This ecological study was conducted in 5 provinces of Iran. The daily numbers of new COVID-19 cases from January 17 to February 8, 2020 were used to determine the basic reproduction number (R0), peak date, doubling time, and daily growth rates in all five provinces. A sensitivity analysis was conducted to estimate epidemiological parameters. Result: The highest and lowest number of deaths were observed in Hamedan (657 deaths) and Chaharmahal and Bakhtiari (54 deaths) provinces, respectively. The doubling time of confirmed cases in Kermanshah and Hamedan ranged widely from 18.59 days (95% confidence interval (CI): 17.38, 20) to 76.66 days (95% CI: 56.36, 119.78). In addition, the highest daily growth rates of confirmed cases were observed in Kermanshah (0.037, 95% CI: 0.034, 0.039) and Sistan and Baluchestan (0.032, 95% CI: 0.030, 0.034) provinces. Conclusion: In light of our findings, it is imperative to tailor containment strategies to the unique epidemiological profiles of each region in order to effectively mitigate the spread and impact of COVID-19. The wide variation in doubling times underscores the importance of flexibility in public health responses. By adapting measures to local conditions, we can better address the evolving dynamics of the pandemic and safeguard the well-being of communities.

IntroductionThis study measures the COVID-19 vaccine effectiveness (CVE) against hospital admission and severe COVID-19.MethodsThis study is a test-negative case-control design using data from eight provinces in April, 2021 until March, 2022. The individuals were classified as cases and controls based on the results of the RT-PCR test for SARS-CoV-2 and matched based on the timing of the test being conducted as well as the timing of hospital admission. The measure of association was an odds ratio (OR) by univariate and multiple logistic regression. The multiple logistic regression has been carried out to take confounding factors and potential effect modifiers into account. The CVE was computed as CVE = (1 – OR)*100 with 95% confidence interval.ResultsAmong 19314 admitted patients, of whom 13216 (68.4%) were cases and 6098 (31.6%) were controls, 1313 (6.8%) died. From total, 5959 (30.8%) patients had received the vaccine in which one, two, and booster doses were 2443 (12.6%), 2796 (14.5٪), and 720 (3.7٪), respectively. The estimated adjusted effectiveness of only one dose, two doses and booter vaccination were 22% (95% CI: 14%-29%), 35% (95% CI: 29%-41%) and 33% (95% CI: 16%-47%), respectively. In addition, the adjusted vaccine effectiveness against severe outcome was 33% (95% CI: 19%- 44%), 34% (95% CI: 20%- 45%) and 20% (95% CI: -29%- 50%) for those who received one, two and booster vaccinations, respectively.ConclusionOur study concluded that full vaccination, though less effective compared to similar studies elsewhere, decreased hospital admissions and deaths from COVID-19 in Iran, particularly during the Delta variant period, with an observed decline during the Omicron variant dominance.

Abstract Background Interactions between risk factors may influence disease severity. Knowing this relationship is important for preventive interventions and disease control. The purpose of this study was to determine the interactions effects of obesity and hypertension on the risk of type 2 diabetes mellitus (T2DM). Methods The data of 9,283 adults 35 to 65 years were examined from the cohort study of Ravansar Non-Communicable Disease (RaNCD). Waist circumference (WC) was used to identify both general and abdominal obesity based on body mass index (BMI). To assess the interaction between hypertension and obesity (general/abdominal) and the risk of T2DM, the additive interaction was calculated. Results The adjusted odds ratios for T2DM were 2.38 (1.67, 3.41) in men and 4.02 (2.47, 6.47) in women for the combinations of hypertension and abdominal obesity. The adjusted odds ratios for T2DM were 2.53 (1.63, 3.82) in men and 2.66 (1.92, 3.70) in women for the combinations of hypertension and general obesity. The results of the additive interaction indicators were inconsistent with gender. The relative excess risk due to interaction (interaction between hypertension and central obesity) (RERI), attributable proportion due to interaction (AP) and synergy index (SI) were0.27 (-1.01, 1.54), 0.11 (-0.41, 0.63) and 1.23 (0.41, 3.68) in male and were 0.61 (-1.12, 2.33), 0.23 (0.08, 0.37) and 1.26 (0.60, 2.61) in female, respectively. Conclusion General/abdominal obesity and hypertension have a synergistic effect on the risk of T2DM. The recommendation for preventing T2DM is lifestyle modification. Large longitudinal studies are necessary to investigate causal relationships.

The presence of toxic pollutants in the aquatic environment is a significant environmental concern that requires the development of effective methods for their removal. This study focuses on applying perylene and triazine-based porous organic polymer (PT-POP) to effectively eliminate hazardous pollutants from industrial settings. Specifically, PT-POP was synthesized using two monomers, namely 3,4,9,10 perylenetetracarboxylic dianhydride (PTCDA) and 2,4,6 tris(hydrazino)-s-triazine (THTZ). The resulting PT-POP has outstanding adsorption performance and high chemical and thermal stability, making it an attractive adsorbent material. Based on the thermogravimetric analysis, it has been confirmed that PT-POP is thermally stable. The presence of aromatic rings in PT-POP is responsible for the extraordinary stability of the polymer. Then, the performance of PT-POP in the adsorption of cationic Nile blue and anionic Direct Fast Scarlet 4BS (DFS-4BS) was studied. The optimization process involves adjusting several factors, including temperature, concentration, pH, time, and adsorbent dosage. The highest adsorption capacities (qM) for the Nile blue dye and the DFS-4BS dye were 280.16 mg. g−1 and 87.50 mg. g−1, respectively. The adsorption behavior best fits the pseudo-second-order kinetic model, and the Langmuir isotherm showed the most agreement with adsorption isotherms for both. The thermodynamic study shows that the adsorption process for both dyes is spontaneous and endothermic, as evidenced by the negative value of ΔG and the positive value of ΔH. The findings show that PT-POP is more inclined toward cationic dyes due to its negative surface charge.

Introduction: Brucellosis is a common global zoonotic disease with a wide range of complex and nonspecific clinical manifestations that may lead to misdiagnosis and delayed treatment. Osteoarticular involvement is the most common complaint in brucellosis. Objective: This present study aims to describe the clinical and laboratory characteristics and treatment of brucellosis patients with arthritis and sacroiliitis. Methods: This retrospective descriptive study was performed on patients presenting to a teaching hospital in Kermanshah, Iran with a diagnosis of brucellosis from 2011 to 2019. The demographic and clinical characteristics, complications, laboratory findings, and treatment were recorded during the study period. Then, the difference in the collected data was investigated between brucellosis patients with and without arthritis or sacroiliitis. Results: Of 425 patients studied, 130 (30.58%) had osteoarticular involvement. Among them, 41 (9.64%) and 58 (13.6%) patients were diagnosed with arthritis and sacroiliitis, respectively. There were no significant demographic differences between patients with and without brucellar arthritis or sacroiliitis ( p > 0.05). The patients with Brucella arthritis had a significantly higher frequency of arthralgia and radiculopathy ( p ⩽ 0.05). Sacroiliitis was significantly more common in patients with arthralgia, neck pain, and low back pain, positive flexion-abduction-external rotation (FABER) test, radiculopathy, and vertebral tenderness compared to patients without sacroiliitis ( p ⩽ 0.05), while fever and headache were significantly more common in patients without sacroiliitis ( p ⩽ 0.05). The median Wright and 2-Mercapto Ethanol titers were higher in brucellosis patients with arthritis or sacroiliitis versus patients without arthritis or sacroiliitis, but the difference was not significant ( p > 0.05). Synovial fluid had been analyzed in 20 cases. The mean white blood cell count, glucose, and protein level were 3461 ± 2.70 cells/mm 3 , 58.54 ± 31.43 mg/dL, and 8.6 ± 11.85 g/dL, respectively. In 80% of the subjects, neutrophil cells were predominant. There were no significant laboratory differences between patients with and without brucellar arthritis or sacroiliitis, except for a higher median platelet count in patients with arthritis and higher median levels of aspartate aminotransferase (AST) and alkaline phosphatase (ALP) in patients with sacroiliitis. Most cases of arthritis and sacroiliitis were diagnosed with ultrasound (31.8%) and FABER test (79.3%), respectively. Conclusion: Arthritis and sacroiliitis were the two most important and common manifestations of brucellar osteoarthritis with a frequency of 9.64% and 13.6%, respectively. Any complaints of low back pain and radiculopathy as well as the presence of spondylitis in patients should raise suspicion of sacroiliitis. High levels of AST and ALP and a high platelet count may be associated with brucellar sacroiliitis and arthritis, respectively. The use of imaging methods such as MRI and bone scan seems necessary for the diagnosis of sacroiliitis.

Climate change can significantly affect and influence, both positively and negatively, the wine sector. In this context, the adoption of timely, cost-effective adaptation strategies may contribute to reduce such risks, maximise opportunities, and enhancing the sector’s resilience to changing climatic conditions. Climate services involve the production and use of climate information to support decision-makers adapting to climate variability and change. Assessing the value and benefits of using climate services constitutes a critical area of research and can help climate service providers identify any barriers in their development, uptake, and use. The climate service developed in this research benefitted from a co-production approach with a Portuguese Wine company − SOGRAPE. In this paper, we aim to assess the usability and value of the climate service co-developed with SOGRAPE and identify possible barriers that limited the tool’s usability and value. Engagement with SOGRAPE users was pursued based on mixed methods approach throughout the various stages of co-development and testing of the tool. The results show that the data provided in the Dashboard was perceived as reliable and legitimate. However, the saliency of the Dashboard was questioned, and some recommendations proposed to increase its saliency and overall usability. More importantly, SOGRAPE users were not able to use the climate information provided in the tool due to a number of barriers which are also reported in this study. The findings and recommendations from this study will help inform the design, development and usability of other climate services within and beyond the wine sector.

Abstract The incidence of colorectal cancer (CRC) is increasing in low- and middle-income countries. This study aimed to estimate the burden of CRC attributable to nutritional risk in the Middle East and North Africa (MENA) region. The GBD 2019 methods were used to estimate age-standardized mortality rates (ASMRs) and disability-adjusted life-years (DALYs) in 2019 and over the past three decades. We evaluated the 30-year trend in DALYs and mortality rates from nutrition-related risks of CRC, from 1990 to 2019 by sex and age groups in 21 countries in the MENA region. The rate of DALYs/100,000 due to diet-related risks for CRC in 2019 was 79.71 (95% UI: 56.79, 98.44) and 65.16 (95% UI: 45.86, 80.95) in men and women, respectively. The percent changes of DALYs/100,000 in men and women were 8.15% and 2.50%, respectively, between 1990 and 2019. The percent changes in ASMRs in men and women were 8.32% and 3.44%, respectively. The highest DALYs and ASMRs were observed in both sexes in the age group 75–79 years and above. The highest percent changes in DALYs/100,000 and ASMRs were observed between 1990 and 2019 in Afghanistan, Egypt, Iran, Iraq, Lebanon, Libya, Morocco, Palestine, Qatar, Saudi Arabia, Sudan and Yemen. DALYs and ASMRs attributed to dietary risk for CRC increased in 21 countries in the MENA region from 1990 to 2019. A modified diet with more fiber, dairy products and less red meat intake is a highly recommended strategy for prevention CRC.

Vaccine effectiveness (VE) studies provide real-world evidence to monitor vaccine performance and inform policy. The WHO Regional Office for the Eastern Mediterranean supported a regional study to assess the VE of COVID-19 vaccines against different clinical outcomes in four countries between June 2021 and August 2023. Health worker cohort studies were conducted in 2707 health workers in Egypt and Pakistan, of whom 171 experienced symptomatic laboratory-confirmed SARS-CoV-2 infection. Test-negative design case–control studies were conducted in Iran and Jordan in 4017 severe acute respiratory infection (SARI) patients (2347 controls and 1670 cases) during the Omicron variant dominant period. VE estimates were calculated for each study and pooled by study design for several vaccine types (BBIBP-CorV, AZD1222, BNT162b2, and mRNA-1273, among others). Among health workers, VE against symptomatic infection of a complete primary series could only be computed compared to partial vaccination, suggesting a benefit of providing an additional dose of mRNA vaccines (VE: 88.9%, 95%CI: 15.3–98.6%), while results were inconclusive for other vaccine products. Among SARI patients, VE against hospitalization of a complete primary series with any vaccine compared to non-vaccinated was 20.9% (95%CI: 4.5–34.5%). Effectiveness estimates for individual vaccines, booster doses, and secondary outcomes (intensive care unit admission and death) were inconclusive. Future VE studies will need to address challenges in both design and analysis when conducted late during a pandemic and will be able to utilize the strengthened capacities in countries.

Abstract Background Regarding the paucity of evidence on the side effects of the booster dose of Oxford AstraZeneca vaccine in vaccinated people with Sinopharm or Sputnik V, we aimed to set up a cohort event monitoring (CEM) study to capture adverse events occurring in individuals who will receive the booster doses of AstraZeneca (either the first or second booster dose) following being vaccinated with Sinopharm or sputnik V vaccines in Iran. Methods The present study is an active COVID-19 vaccine safety surveillance through an observational prospective cohort study that will be conducted in vaccination centers in Iran. The study will be conducted in twelve provinces of Iran. Study sites are vaccination centers where the AstraZeneca vaccine is administered to the cohort population. The study population includes all individuals who have received two doses of Sinopharm or Sputnik V vaccines and either the first or second booster dose of AstraZeneca according to the national guidelines for immunization in Iran in 2023. We are planning to include 30,000 eligible people in this study. Each individual will be followed up for 13 weeks after either the first or second booster dose of the AstraZeneca vaccine. Furthermore, convenience sampling is used to include participants in the present study. Participation in the study will be strictly voluntary. Discussion With the planned study we will provide a valid epidemiological evidence to improve the understanding of the safety of the booster dose of the AstraZeneca and to better evaluate the effectiveness of public health interventions. This could help policy makers in managing the COVID-19 pandemic according to scientific evidence.

Abstract High BMI related burden of knee and hip osteoarthritis (OA) is on a significant rise worldwide. OA not only causes joint pain and stiffness, but it also leads to disability. This study investigated the trend and burden of OA attributable to high body mass index (BMI) in Iran. The age-standardized disability-adjusted life years (DALYs) rates of knee and hip OA due to high BMI, were estimated using data from the Global Burden of Disease 2019. We evaluated DALYs rate trend of high BMI related OA by sex and age in span of 30 years from 1990–2019 across the 31 provinces of Iran. The age-standardized prevalence trend of OA in the knee and hip showed an increase from 1990 to 2019. In 2019 there were 29.92 (95% CI: 10.98–64.92) and 42.50 (95% CI: 16.32–97.37) DALYs/100,000 related to OA from high BMI in men and women, respectively. 2019 saw the greatest DALYs/100,000 rate in the 65–79 age group. From 2005 to 2019, men and women saw DALYs/100,000 rate changes of 24.87 and 17.43 percent, respectively. The burden of knee OA was significantly higher than that of hip OA. DALYs rate of OA due to high BMI was found to be positively associated with the Socio-demographic Index (SDI). The burden of knee and hip OA due to high BMI has increased significantly in recent years in Iran among all age groups of both men and women. It is recommended that health policymakers develop weight control strategies to reduce the burden of OA and implement them at the national level.

Background and Aim: All people living in a society are not equally at risk of COVID-19 infection and hospitalization. The current study is aimed to determine the factors related to COVID-19 infection and hospitalization among participants of Ravansar Non-Communicable Disease (RaNCD) cohort study. Materials and Methods: The present study was conducted between 28th February, 2020 to 27th November, 2021. Data from the RaNCD study, morbidity and hospitalizations cases (extracted from the medical care monitoring system, SAMA system and the handwritten list of the health department) and positive serological results were used. For the case-cohort study, 626 confirmed and/or probable cases and 2107 randomly selected participants as sub-cohort were recruited. For the case-control study, 188 COVID-19 hospitalized patients from RaNCD (as cases) and 632 positive outpatients identified as controls. Data were analyzed using Cox and logistic regression, respectively. Results: In case-cohort study, the hazard ratio of COVID-19 among people living in rural areas, in smokers and those in middle socioeconomic status was, 0.37 (0.24, 0.58), 1.50 (1.07, 2.11), as compared to the reference groups. While the hazard ratio of people aged 46-64 and those ≥65 years old, as compared to the reference group within the first year, was 3.47 (1.76, 6.86) and 6.45 (2.80, 14.85), the corresponding value after one year was 2.23 (1.13, 4.40) and 3.52 (1.53, 8.10), respectively. The hazard ratio among those with at least one comorbidity was 2.45 (1.53, 3.92) in the first year of study and after one year decreased to 1.82 (1.14, 2.92). In addition, moderate and vigorous physical activity decreased the hazard ratio. In case-control study the odds ratio of hospitalization increased by 0.03% (1.03(1.01, 1.05)) with an increase of one year in age and in people with at least three comorbidities was 2.43 (1.24, 4.73) times of those without comorbidity. Conclusion: Overall, one year after starting the study the decrease in hazard ratio of COVID-19 was significant. Increase in age and having comorbidities are factors that increased the odds ratio of hospitalization. Such people can be considered for the next waves of COVID-19 prioritized for health care and booster vaccination.

Abstract Aim and background Smoking is a modifiable risk factor for cancers. The aim of the study is to estimate the trend of mortality and DALYs of smoking-attributed cancers in the North Africa and Middle East (NAME) countries. Methods In this study, estimates from the Global Burden of Disease 2019 (GBD-2019) study were used to report the mortality and DALYs for 16 smoking-attributed cancers. The mortality and DALYs rates from smoking-attributed cancers were evaluated by age, sex, and the 21 countries of the NAME countries from 1990 to 2019. Results Age standardized mortality rates (ASMR) for the 29 smoking-attributed cancers in the NAME countries in 1990 and 2019 were estimated to be 24.7 (95% Uncertainty Interval: 21.5, 27.8) and 22.4 (95%UI: 19.8, 25.4) respectively, which shows a 9.2% decrease in the three decades. DALYs/100,000 for smoking-attributed cancers was, also, estimated to be 600.3 (95%UI: 521.6, 682.6) and 515.6 (95%UI: 454.9, 585.4) respectively, which indicates a 14.1% decreased in these three decades. In the last three decades, the percentage changes in DALYs/100,000 for smoking-attributed cancers in males and females were − 0.16 and − 0.03, respectively. Plus, The percentage changes in ASMR in males and females were − 12% and 8%, respectively. Furthermore, The highest ASMR and DALYs were observed in Lebanon, Turkey, and Palestine in 2019. Conclusion The mortality rates of cancers from smoking have increased substantially among females, in most countries of the NAME region, in recent years. The burden caused by smoking can be reduced through modifying lifestyle and applying strict laws on smoking by governments and policymakers.

Abstract The present study investigates different scenarios to project the chance of achieving SDG 3.4 in Iran. In this study, the Iranian Death Registry System data was employed to estimate the Unconditional Probability of Dying (UPoD) for the four major categories of NCDs; then, the Bayesian model averaging was used to project the UPoD at the national and sub-national levels. Also, the prevalence of the risk factors was projected by 2030 based on STEPs as well as some other study data. Plus, UPoD and the possibility of achieving the target were estimated once again based on the assumption that the global reduction in risk factors proposed by WHO would be adopted in Iran. The UPoDs for the four NCDs in Iran were 17.5% (95% UI: 16.3–19.2) and 14.7% (13.3–16.2) in 2010 and 2015 respectively and if the current trend continues, 2030 will mark the UPoD of 10.8% (7.9–14.3). However, If the risk factors are reduced to the WHO target level by 2030, the UPoDs will be reduced to 5.44% (3.51–7.39) and 6.55% (5.00–8.13) of the 2010 and 2015 baseline scenarios, respectively, to enable some provinces to meet SDG 3.4. If the current trend continues, Iran will and will not achieve the SDG 3.4 in 2010 and 2015 baseline scenarios, respectively. However, if the global target set for reducing risk factors is achieved, Iran will meet all expectations in SDG 3.4 except in Asthma and COPD. Therefore, effective interventions are recommended to be designed and followed to reduce Asthma and COPD.

Abstract Background Since the first official report of SARS-CoV-2 infection in Iran on 19 February 2020, our country has been one of the worst affected countries by the COVID-19 epidemic in the Middle East. In addition to demographic and clinical characteristics, the number of hospitalized cases and deaths is an important factor for evidence-based decision-making and disease control and preparing the healthcare system to face the future challenges of COVID-19. Therefore, this cohort study was conducted to determine the demographics, clinical characteristics, and outcomes of hospitalized COVID-19 patients in Kermanshah Province, west of Iran. Methods This multicenter retrospective cohort study included all suspected, probable, and confirmed cases of COVID-19 hospitalized in Kermanshah Province, Iran during the first year of the COVID-19 pandemic. Demographics, clinical characteristics, outcomes and other additional information of hospitalized patients were collected from the COVID-19 database of the Medical Care Monitoring Center (MCMC) of Kermanshah Province. Results Kermanshah Province experienced three waves of COVID-19 infection considering the hospitalization and mortality rates between February 20, 2020 and February 19, 2021. A total of 27,256 patients were included in the study: 5203 (19.09%) subjects were suspected, 9136(33.52%) were probable, and 12,917 (47.39%) were confirmed COVID-19 cases. The mean age of the patients was 53.34 ± 22.74 years and 14,648 (53.74%) were male. The median length of hospital stay among COVID-19 survivors and non-survivors patients were 4 (interquartile range [IQR] 1–6) and 4 (IQR 1–8) days, respectively. Among patients with COVID-19, 2646 (9.71%) died during hospitalization. A multivariable logistic regression revealed that odds of death among patients ≥ 85 years was significantly greater than among patients

Background Asthma is a chronic airway disease characterized by an overreaction of the airways to a wide range of stimuli. Objective To determine the relationship between the incidence and mortality rate of asthma and the levels of PM2.5, ozone, and household air pollution (HAP) from 1990 to 2016 in the world. Materials and methods This ecological study was conducted across 194 countries. The asthma incidence and mortality rates were extracted from IHME Global Burden of Disease databases. Data on average annual population-weighted HAP, PM2.5, and ozone were obtained from the State of Global Air website. A model-based clustering with a finite mixture of matrix-variate normal distributions was used to identify countries with a similar pattern of three air pollution index values. The number of clusters was determined by the Bayesian information criterion, and R software was used for integrated completed likelihood criterion. The random-effects model was applied to evaluate the relationship between asthma incidence in groups and different years by using the SAS software. Results The countries were classified into five clusters in terms of the mean of PM2.5, ozone, and HAP. The incidence rates had a decreasing trend during 1990–2005 and an increasing trend during 2011–2016 in the clusters. The lowest incidence and mortality rates were observed for countries of cluster 3. The highest incidence and mortality rates were observed for countries in clusters 1 and 2, respectively. The incidence and mortality ratio trends experienced an increase in cluster 1 and a decrease in other clusters. Conclusions Depending on the mortality and incidence trends of asthma in countries in each cluster, effective national and international intervention measures are recommended to deal with such pollutants.

Abstract Insufficient physical activity (IPA) caused approximately 5% of mortalities in 2017 in Iran, almost double its global average. Despite the relatively considerable burden, a knowledge gap exists regarding the trend of IPA in recent years. We described the trend of IPA prevalence utilizing the data from six rounds of STEPwise approach to risk factor Surveillance (STEPS) in Iran. We estimated the physical activity status of Iranian adults from 2006 to 2016 after adjusting for years of schooling, urbanization percentage, and wealth index. We used the spatiotemporal model to interpolate and extrapolate the IPA prevalence for the years in-between the series and from 2001 to 2006, respectively. We used the data of 177,910 participants from six STEPS surveys and found that the national prevalence of IPA had steadily increased over the course of 16 years and had almost doubled in this time period (23.1% in 2001 to 55.4% in 2016). The increase was persistent across all age and gender strata and in every province. Moreover, IPA was more prevalent among women than their male peers regardless of their age category or province of residence. The prevalence of IPA in Khuzestan (highest prevalence) was almost double compared to that in Lorestan (lowest prevalence) in 2016. The IPA prevalence increased considerably and almost doubled in 16 years among Iranian adults, particularly women. Policies need to target IPA as a high priority contributing to the burden of Non-communicable diseases.

Background:Access to medical care is one of the major issues affecting human health. This study aims to investigate inequality in access to medical care in the townships in Kermanshah, Iran.MethodsMethodology approach includes a descriptive-analytic study followed by determining the degree of development of the townships calculated in terms of access to medical care through the hierarchical cluster analysis and the combined model of human development index. Additionally, the mean center and standard distance tests are handled in a geographic information system software to identify the deployment pattern of the status of access to medical care indexes.ResultsAs for the ratio of physicians, nursing staff, paramedical staff, administrative staff of health care, dentists, pharmacists, hospitals, general and specialized clinics, radiology, rehabilitation centers and laboratories to a population of 10,000, the results of analyzing the findings were indicative of unequal distribution of facilities at the level of townships. This is based on The results of comparing the mean centers of population and health facilities showed that the centers of both data categories were located in Kermanshah. The two standard distances (i.e., population and health facilities) demonstrated that the health facilities witnessed more dispersion in the northwestern regions than the concentration of population in the central and southeastern regions of the province.ConclusionsThe results indicated that the indexes of development of facilities and healthcare resources were not distributed equitably and with a balance between the townships of the Kermanshah Province.

Abstract Background The Middle East and North Africa, is one of few regions where the number of new human immunodeficiency virus infections is increasing. The present study aimed to estimate the attributable burden of unsafe sex and drug use in Acquired immunodeficiency syndrome in the Middle East and North Africa countries. Methods We used the Global Burden of Disease data 2017 to estimate the attributable mortality and disability-adjusted life-years to unsafe sex and drug use in Acquired immunodeficiency syndrome in the Middle East and North Africa countries (21 countries) from 1990 to 2017 by region, sex and age. The percent change was calculated at three time points by country and sex. Results The rate of Disability-adjusted life years/100,000 attributed to drug use for Acquired immunodeficiency syndrome increased 1.10 (95% CI: 0.75–1.71) to 13.39 (95% CI: 9.98–18.17) in women of Middle East and North Africa countries from 1990 to 2017, and there is an increasing trend in Disability-adjusted life years attributable to drug use for Acquired immunodeficiency syndrome in men. The rate of Disability-adjusted life years/100,000 attributed to unsafe sex for Acquired immunodeficiency syndrome increased in women of Middle East and North Africa countries, 5.15 (95% CI: 3.34–8.07) to 53.44 (95% CI: 38.79–75.89); and 10.06 (95% CI: 6.61–16.18) to 46.16 (95% CI: 31.30–72.66) in men. Age-standardized mortality rate attributed to drug use and unsafe sex for Acquired immunodeficiency syndrome increased from 1990 to 2017 in both sex in Middle East and North Africa countries. Conclusion The rate of Disability-adjusted life years /100,000 and age-standardized mortality rate attributed to unsafe sex and drug use increased in Middle East and North Africa from 1990 to 2017. While most of such countries have traditional cultures with religious believes, such increase need to be addressed in more depth by all policy makers.

Abstract Background The present study was conducted to determine the trend and projection of premature mortality from gastrointestinal cancers (GI cancers) at national and subnational levels in Iran. Methods Employing the data obtained from Iranian Death Registry System (DRS) and population data from census, the mortality rates of GI cancers was calculated among 30–70 age groups. The trends of esophageal, colon and rectum, gallbladder, pancreases, stomach, and liver cancer premature mortalities were estimated and projected at the national and subnational levels from 2001 to 2030. Then, Spatio-temporal model was used to project spatial and temporal correlations. Results The overall mortality rate of GI cancers was higher in males than in females, indicating 6.1, 3.9 and 3.9% per 100,000 individuals among males in 2001, 2015 and 2030 respectively and 3.8, 3.1 and 3.7 per 100,000 individuals among females in the same time-frame. The overall mortality rate of GI cancers in males was decreasing until 2015 and will remain stationary into 2030; however, the rate will be increasing among females in both time-frames. Also, there was a considerable variation in the mortality trends of different cancers. Pancreatic, gallbladder, and liver cancers were shown to have an increasing trend while a drop was observed in the mortality rates of stomach, colon and rectum, and esophageal cancers. Conclusion Variation of GI cancers patterns and trends around the country indicated that a more comprehensive control plan is needed to include the predicted variations.

Temporary marriage is one of the accepted institutions in Islamic jurisprudence and law that it differs from permanent marriage in some rules and characteristics such as paying alimony to the wife. In the temporary marriage, unlike the permanent marriage, husband is not obliged to pay alimony to his wife; unless it is stipulated in the contract or the contract is based on it. The condition of paying alimony in a temporary marriage as a basic condition is one of the complementary laws in this type of marriage that has been accepted by jurisprudential legislator and the legal legislator and there is a consensus in it. The principle of sovereignty of two parties' will in the formation of contracts also confirms this, but it should be noted that conditional alimony in a temporary marriage does not follow the structures and rules of alimony in a permanent marriage, but follows the laws governing the terms of the contract. The period of paying alimony, which can be more or less than the time of temporary marriage, is another issue which is discussed because there is disagreement about this condition whether it will be remain or not in the case of temporary marriage dissolution due to contractual dissolution, involuntary dissolution or waiver of the remaining period. This research which is done by collecting documentary-library method and written by descriptive-analytical method explains and analyzes the mentioned cases.

Despite all the psychological advantages of alprazolam, its long list of toxic properties and interactions has caused concern and highlighted the need for a reliable sensing method. In this study, we developed a simple, highly sensitive electrochemical nanobiosensor to determine the desirable dose of alprazolam, averting the undesirable consequences of overdose. Gold nanourchins (AuNUs) and iron-nickel reduced graphene oxide (Fe-Ni@rGO) were immobilized on a glassy carbon electrode, which was treated beforehand. The electrode surface was characterized using cyclic voltammetry, Fourier transform infrared spectroscopy, scanning electron microscopy/energy-dispersive X-ray spectroscopy, and differential pulse voltammetry. The fabricated sensor showed two linear ranges (4 to 500 µg L−1 and 1 to 50 mg L−1), low limit of detection (1 µg L−1), high sensitivity, good repeatability, and good recovery. Increased –OH and carboxyl (-COOH) groups on the electrode surface, resulting in improved the adsorption of alprazolam and thus lower limit of detection. This nanobiosensor could detect alprazolam powder dissolved in diluted blood serum; we also studied other benzodiazepine drugs (clonazepam, oxazepam, and diazepam) with this nanobiosensor, and results were sensible, with a significant difference.

Abstract Aims/Introduction The purpose of the present study was to investigate the possible effect of oral magnesium sulfate (MgSO4) in the reduction of atherosclerosis plaques through inhibition of lectin‐like low‐density lipoprotein receptor‐1 (LOX‐1) gene expression in diabetic vessels. Materials and methods A total of 50 rats were divided into five groups, including non‐diabetic control, Mg‐treated non‐diabetic control, chronic diabetic, Mg‐treated chronic diabetic and insulin‐treated chronic diabetic. The induction of diabetes was carried out by streptozotocin. The Mg‐treated chronic diabetic and Mg‐treated non‐diabetic control groups were treated with 10 g/L of MgSO4 added to their drinking water. The insulin‐treated chronic diabetic group received 2.5 U/kg of insulin twice per day. The fasting blood glucose level and bodyweight were determined weekly. Blood pressure measurement and the intraperitoneal glucose tolerance test were carried out after 16 weeks, and the plasma levels of Mg, lipid profile and oxidized low‐density lipoprotein cholesterol (oxLDL) were determined. The mesenteric bed was isolated and perfused according to the McGregor method. The aorta was isolated for LOX‐1 genes and proteins expression, and pathological investigation. Results MgSO4 administration improved blood pressure, sensitivity to phenylephrine, intraperitoneal glucose tolerance test, lipid profile and plasma ox‐LDL level, and also lowered the blood glucose level to the normal range, and decreased LOX‐1 gene and protein expressions. Insulin decreased blood pressure, sensitivity to phenylephrine, blood glucose, lipid profiles and plasma oxLDL level, but it did not decrease LOX‐1 gene and protein expressions. Conclusions The present findings suggested that MgSO4 improves blood pressure and vessel structure through decreasing oxLDL, and LOX‐1 gene and protein expressions; however, insulin did not repair vessel structure, and LOX‐1 gene and protein expressions.

The global pandemic of COVID-19 has rapidly increased the number of infected cases as well as asymptomatic individuals in many, if not all the societies around the world. This issue increases the demand for accurate and rapid detection of SARS-CoV-2. While accurate and rapid detection is critical for diagnosing SARS-CoV-2, the appropriate course of treatment must be chosen to help patients and prevent its further spread. Testing platform accuracy with high sensitivity and specificity for SARS-CoV-2 is equally important for clinical, regional, and global arenas to mitigate secondary transmission rounds. The objective of this article is to compare the current detection technology and introduce the most accurate and rapid ones that are suitable for pandemic circumstances. Hence, the importance of rapid detection in societies is discussed initially. Following this, the current technology for rapid detection of SARS-CoV-2 is explained and classified into three different categories: nucleic acid-based, protein-based, and point of care (PoC) detection testing. Then, the current issues for diagnostic procedures in laboratories are discussed. Finally, the role of new technologies in countering COVID-19 is also introduced to assist researchers in the development of accurate and timely detection of coronaviruses. As coronavirus continues to affect human lives in a detrimental manner, the development of rapid and accurate virus detection methods could promote COVID-19 diagnosis accessible to both individuals and the mass population at patient care. In this regard, rRT-PCR and multiplex RT-PCR detection techniques hold promise.

The COVID-19 pandemic is a severe ongoing health crisisworldwide. Studying the socio-economic impacts of COVID-19 can help policymakers develop successful pandemic management plans. This paper focuses on the spatial epidemiology of COVID-19 among different social classes in the Kermanshah metropolis, Iran. This cross-sectional study uses the data of people infected with COVID-19 in the Kermanshah metropolis in 2020, acquired from the official COVID-19 Registry of Kermanshah. The results show that 2013 people were infected with COVID-19 (male = 1164 and female = 849). The mean age of the patients was 45 ± 18.69. The Moran’s I show that COVID-19 in different social classes was clustered across the neighbourhoods in the Kermanshah metropolis. The mean ages of men and women were 44.51 ± 18.62 and 45.69 ± 18.76, respectively. Importantly, COVID-19 was highly prevalent in the middle-class groups. Age group comparisons indicate that older people were the most infected in poorer neighbourhoods. In the middle-classtheage group of 0–14 years and in the rich neighbourhoods the age group of 15–64 years were the most exposed to the disease. The findings of this study suggest that older people and lower socioeconomic classes should be prioritised while developing and implementing preventative programs for COVID-19 and similar pandemics.

Amaç: Bu çalışmada, 2015 yılında seçilen hastanelerdeki hastaların güvenlik duygusu ile hizmet kalitesi arasındaki ilişkinin incelenmesi amaçlamıştır.Gereç ve Yöntem: Bu çalışmada uygulamalı araştırma olarak tanımlayıcı-analitik bir yaklaşım izlenmiştir. Çalışmamızda, Gemshahr'daki Vali Asr Hastanesi'ne ek olarak Sarı’da ki, İmam ve Shafa Hastanelerinin dahiliye, cerrahi, kadın ve çocuk koğuşlarında en az 24 saat yatan 600 hasta yer almıştır. Veriler, iki kısımdan oluşan standart SERVQUAL anketi ile toplanmıştır; bu kısımlardan biri demografik, diğeri ise 22 beş-puanlık özelleşmiş Likert ölçekli sorular ve akabinde 76 beş-puanlık hastaların güvenlik duygusuyla ilgili Likert ölçekli sorulardan oluşmaktadır.Bulgular: Çalışmanın sonuçları, aralığın ortalama, medyan ve mod değerlerinin (algı ve beklentiler arasındaki mesafe) 0.46 standart sapma ile sırasıyla -0.61, 0.59, -0.55'e eşit olduğunu göstermiştir. Boşluk ve güvenlik duygusu arasındaki ilişki incelendiğinde, Spearman korelasyon katsayısının 0.289 olduğu ve bu iki unsur arasında anlamlı bir ilişki olduğu görülmüştür.Sonuç: Hizmetteki noksanlık ile hastaların güvenlik duygusu arasındaki doğrudan ilişki göz önüne alındığında, hastanelerin hizmet kalitesini iyileştirmek için özel fırsatların sağlanması esastır.

Argument maps as schematic representations of arguments and their logical and evidential relationships are effective diagrams for instruction in education as well as in L2 development. However, their use for teaching L2 writing in EFL contexts has not been adequately studied. Therefore, this study investigated the effect of argument mapping instruction on Iranian EFL learners’ writing achievement and writing components, including grammar, coherence, cohesion, and task accomplishment in expository and descriptive essays. The participants were 60 intermediate EFL learners at Fadak language institute in Tehran. The selected participants were randomly divided into two groups: an experimental and a control group, each including 30 participants. Materials, coursebooks, and the teacher were the same for the study groups. However, the participants in the experimental group received specific instruction about the use of argument maps before and during their writing. After 10 sessions of treatment, the learners in the two groups were asked to write a descriptive and an expository paragraph. The paragraphs were rated by two raters and the final score was the average of the scores given by the two raters. The results of the data analysis revealed that argument mapping strategies had significant improvement impact on expository and descriptive writing tasks and could improve participants’ writing in terms of grammar, coherence, cohesion, and task achievement. However, argument mapping was not beneficial in improving the vocabulary of study participants’ writing. Findings of the study suggest that EFL language instructors and learners can use argument maps for teaching descriptive and expository writing.

Purpose Wasting and underweight are the 2 main indicators of children’s undernutrition. We aimed to estimate the prevalence of undernutrition at the national level in Iran. Methods We performed a search for original articles published in international and Iranian databases including MEDLINE, Web of Science, Google Scholar, Scopus, CINHAL (Cumulative Index to Nursing and Allied Health Literature), Scientific Information Database, Irandoc, Iranmedex, and Magiran during January 1989–August 2017. Seven keywords, in English and Persian, including malnutrition, protein energy malnutrition, growth disorders, underweight wasting, weight loss, children below 5 years old, and children, were used to search the databases. Results Finally, 17 articles were included in the meta-analysis, based on which the prevalence of underweight and wasting in Iranian children were estimated to be 11% and 5%, respectively. The prevalence rates of underweight among children in the central, western, southern, and northern parts of Iran and at the national level were 24%, 5%, 20%, 17%, and 6%, respectively. The prevalence rates of wasting in the central, western, southern, and northern parts of Iran and at the national level were 9%, 4%, 11%, 5%, and 4%, respectively. Conclusion Although the prevalence of underweight and wasting in Iran was low, some parts of the country showed high prevalence. The main reason behind this difference in the prevalence of malnutrition may be due to the level of development in different regions.

Objective: Cervical cancer (CC) is the third most common cancer in women after breast and colorectal cancers and is one of the leading causes of cancer death among women in the world. The aim this study is associations of cervix cancer incidence and mortality rates with Human Development Index (HDI). Methods: The Information of the incidence and mortality rates of CC obtained from the GLOBOCAN cancer project in year 2012 and data for the HDI 2013 obtained from the World Bank database. The linear regression models were used for assessment of the HDI effect on CC occurrence rates. Inequality in the age-specific incidence and mortality rates (ASR) of CC according to the HDI were assessed by using concentration index. Results: The results of this study that incidence and mortality rates of CC were very higher in regions with low & median HDI as compared to regions that had very high & high HDI, indeed Death and incidence from CC were more concentrated in low HDI countries. There was significant negative association between cervix cancer incidence and mortality rates with all the components of HDI including life expectancy (B= -0.98, P

Background and purpose: Pregnancy is one of the most critical periods in the lives of mothers during fertility years which could be accompanied by some complications. The current study aimed at investigating adverse pregnancy outcomes and associated factors in women residing in rural areas in Sari, Iran. Materials and methods: We conducted a cross-sectional study in 826 pregnant women. They were selected via two-way stratified sampling from rural health centers in Sari who had health care files and gave birth in 2016. Relevant information was collected using a checklist. Results: The frequency of abnormalities at birth time were as follows: low weights 3.6%, immature infants 2.3%, abortion 1.3%, stillbirth 0.1%, congenital disorders 1.2%, and premature delivery 3%. Chi Square test showed no significant difference between adverse pregnancy outcomes or congenital abnormalities and history of abortion, stillbirth, gestational age, mothers’ educational level, and gestational diabetes (P> 0.05). Conclusion: The present study did not show a significant association between the variables studied and adverse pregnancy outcomes. This could be due to the low frequency of such outcomes and inconsiderable number of some risk factors such as pregnancy at inappropriate age. Therefore, conducting analytical researches such as case-control studies are recommended.

Background: Cancer is the second leading cause of death worldwide and the third in Iran. Among cancers, cervical cancer is the third leading cause of death in women. Thus, recognizing the epidemiology and trends of cervical cancer can be effective for planning and policy-making. This study aims to investigate the incidence and trends of cervical cancer in Iran due to the few studies that have addressed this issue and the unclear trend for cervical cancer in Iran. Methods: This study re-analyzed existing data from the cancer data recording system in Iran during years 2003 to 2009. We used available data from the National Cancer Registry and Center for Disease Control of the Ministry of Health, Treatment and Medical Education. Stata software (version 11) was used for data analysis and the significance of the incidence trend diagram was derived with WINPEPI software. Results: Assessment of the National Cancer Registry statistics from 2003 to 2009 showed an increased trend in cervical cancer from 2003 to 2008 and a decreased trend from 2008 to 2009. During this period, there were 4273 cases of cervical cancer registered. From these, 394 cases were registered in 2003 which peaked at 907 cases in 2009. The registered cancer cases had an approximately 3-fold increase during this period. Most provinces reported an increased trend of incidence in cervical cancer. Conclusion: Based on the results of this study, the incidence of cervical cancer is increasing in Iran, especially in the central regions of the country. Therefore, considering the growing trend of cancer, we recommend early detection through screening programs, public awareness, and public training programs that particularly target high risk populations.

Phytophthora species are considered as the major cause of several plant diseases resulting in huge yield losses in agricultural crops. Despite years of effort to develop Phytophthora resistance varieties, there is no reports of a resistant cucumber variety. In this study, the effect of concomitant application of potassium phosphite (KPhi) and chitosan on some physiological and molecular responses of Phytophthora capsici-challenged cucumber plants were investigated. Cucumber plants were treated with KPhi and/or Chitosan at different concentrations and were then inoculated with zoospores of P. capsici and leaf samples were collected at different time courses. Results showed that Guaiacol peroxidase (GPOD) enzymatic activity surged immediately at first and second days after pathogen inoculation with a peak in plants treated with 4 gL-1 KPhi 2 days after inoculation. Compared to GPOD, the highest superoxide dismutase (SOD) activity was observed in the same treatment but later at 5 days after inoculation. It was indicated that the activity of antioxidant enzymes was greatly influenced by application of either KPhi or chitosan while their activity was not remarkably enhanced in control plants. qPCR analysis revealed that the highest increase in glutathione peroxidase (gpx) gene expression was achieved in plants concomitantly treated with 4 gL-1 KPhi and 200 mgL-1 chitosan 5 days after inoculation. The findings of this study provide novel information regarding inducing mechanisms of KPhi and chitosan which may be effective in mitigating disease severity.

Several heterocyclic bioactive fluorescent 3-alkyl-3H-pyrazolo[4,3-a]acridin-11-carbonitriles were conveniently synthesized from the reaction of 1-alkyl-1H-indazoles with different aryl acetonitrile in basic methanol solution in good yields. The interactions of 3H-pyrazolo[4,3-a]acridin-11-carbonitriles with Human Serum Albumin (HSA) were studied by fluorescence spectroscopy. The binding of 3-alkyl-3H-pyrazolo[4,3-a]acridin-11-carbonitriles quenches the HSA fluorescence, revealing a 1:1 interaction with a binding constant of about 1.28 × 103 – 1.85 × 103 M-1.A decrease in fluorescence intensity at 339 nm, when excited at 295 nm, is attributed to changes in the environment of the protein fluorophores caused by the presence of the ligand. The results show that pyrazolo[4,3-a]acridines with R=propyl, butyl, isobutyl and R'=chlorine substituents have suitable thermodynamic and binding parameters with HSA.

Background: Lung cancer is one of the most common cancers and most frequent cause of cancer-related death worldwide. In Iran, this cancer ranks second in cancerrelated deaths for men and third for women. The aim of this study is to discover the geographic distribution of the age-standardized incidence rate for lung cancer in both genders in Iran. Methods: This ecological study used re-analysis medical records aggregated to provinces from the National Registry of Cancer and Disease Control and Prevention Report of the Ministry of Health and Medical Education for lung cancer in 2008. For each province, we calculated the average annual age-standardized incidence rate. Results:Our study showed that squamous cell carcinoma and adenocarcinoma were the most common histological types of lung cancer in males (28.6%) and females (28.8%). The central and southern Iranian provinces had the highest age-standardized incidence rates for lung cancer. The highest age-standardized incidence rates in both genders related to the 80-84 year age group for both males (131.51) and females (38.82). Conclusion: The central and southern Iranian provinces are lung cancer hot zones. Thus, implementation of prevention programs and increased access to screening services should be considered.

Background: Esophageal cancer is the second most common malignancy in Iranian men and third most common in Iranian women.The aim of this study is to discover the geographic distribution for age-standardized incidence rate of esophageal cancer among both genders in Iran. Methods: This ecological study used re-analysis medical records aggregated to provinces from the National Cancer Registry and Disease Control and Prevention Report of the Ministry of Health and Medical Education for esophageal cancer in 2008. For each province, we calculated the average annual age-standardized incidence rate. Results: Squamous cell carcinoma was the most common histological type of esophageal cancer in males (65.4%) and females (75%). The age-standardized incidence rate for esophageal cancer in Western, Northwest, Northern and Northeast provinces of Iran were higher than other provinces. We observed the highest agestandardized incidence rate in both genders in the 80-84 year age group with 147.5 in males and 114.5 in females. Conclusion: Given that the Western, Northwest, Northern, and Northeast provinces were hot zones for esophageal cancer in Iran, increased access to screening services and implementation of prevention programs should be considered.

Objectives The aim of this study was to model the avoidable burden of the risk factors of road traffic crashes in Iran and to prioritize interventions to reduce that burden. Methods The prevalence and the effect size of the risk factors were obtained from data documented by the traffic police of Iran in 2013. The effect size was estimated using an ordinal regression model. The potential impact fraction index was applied to calculate the avoidable burden in order to prioritize interventions. This index was calculated for theoretical, plausible, and feasible minimum risk level scenarios. The joint effects of the risk factors were then estimated for all the scenarios. Results The highest avoidable burdens in the theoretical, plausible, and feasible minimum risk level scenarios for the non-use of child restraints on urban roads were 52.25, 28.63, and 46.67, respectively. In contrast, the value of this index for speeding was 76.24, 37.00, and 62.23, respectively, for rural roads. Conclusions On the basis of the different scenarios considered in this research, we suggest focusing on future interventions to decrease the prevalence of speeding, the non-use of child restraints, the use of cell phones while driving, and helmet disuse, and the laws related to these items should be considered seriously.

BackgroundFollowing the epidemiologic and demographic transition, non-communicable disease mortality is the leading cause of death in Iran. Projecting mortality trend can provide valuable tools for policy makers and planners. In this article, we have estimated the trend of non-communicable disease mortality during 2001-2015 and have projected it until 2030 at national and subnational levels in Iran.MethodsThe data employed was gathered from the Iranian death registration system and using the Spatio-temporal model, the trends of 4 major categories of non-communicable diseases (cancers, cardiovascular diseases, asthma and COPD, and diabetes) by 2030 were projected at the national and subnational levels.ResultsThe results indicated that age standardized mortality rate for cancers, CVDs, and Asthma and COPD will continue to decrease in both sexes (cancers: from 81.8 in 2015 to 45.2 in 2030, CVDs: 307.3 to 173.0, and Asthma and COPD: from 52.1 to 46.6); however, in terms of diabetes, there is a steady trend in both sexes at national level (from 16.6 to 16.5). Age standardized mortality rates for cancers and CVDs, in males and females, were high in all provinces in 2001. The variation between the provinces is clearer in 2015, and it is expected to significantly decrease in all provinces by 2030.ConclusionGenerally, the age standardized mortality rate from NCDs will decrease by 2030. Of course, given the experience of the past two decades in Iran, believing that the mortality rate will decrease may not be an easy notion to understand. However hard to believe, this decrease may be the result of better management of risk factors and early detection of patients due to more comprehensive care in all segments of society, as well as improved literacy and awareness across the country.

The incorporation of nanofillers such as graphene into polymers has shown significant improvements in mechanical characteristics, thermal stability, and conductivity of resulting polymeric nanocomposites. To this aim, the influence of incorporation of graphene nanosheets into ultra-high molecular weight polyethylene (UHMWPE) on the thermal behavior and degradation kinetics of UHMWPE/graphene nanocomposites was investigated. Scanning electron microscopy (SEM) analysis revealed that graphene nanosheets were uniformly spread throughout the UHMWPE’s molecular chains. X-Ray Diffraction (XRD) data posited that the morphology of dispersed graphene sheets in UHMWPE was exfoliated. Non-isothermal differential scanning calorimetry (DSC) studies identified a more pronounced increase in melting temperatures and latent heat of fusions in nanocomposites compared to UHMWPE at lower concentrations of graphene. Thermogravimetric analysis (TGA) and derivative thermogravimetric (DTG) revealed that UHMWPE’s thermal stability has been improved via incorporating graphene nanosheets. Further, degradation kinetics of neat polymer and nanocomposites have been modeled using equations such as Friedman, Ozawa–Flynn–Wall (OFW), Kissinger, and Augis and Bennett’s. The "Model-Fitting Method” showed that the auto-catalytic nth-order mechanism provided a highly consistent and appropriate fit to describe the degradation mechanism of UHMWPE and its graphene nanocomposites. In addition, the calculated activation energy (Ea) of thermal degradation was enhanced by an increase in graphene concentration up to 2.1 wt.%, followed by a decrease in higher graphene content.

An amendment to this paper has been published and can be accessed via the original article.

Kinetic modeling and degradation study of liquid polysulfide (LPS)/clay nanocomposite is possible through Ozawa–Flynn–Wall (OFW) and Kissinger methods. Comparing the results of these models with experimental data leads to provide an accurate degradation kinetic evaluation of these materials. To this aim, the morphology and distribution of clay nanoparticles (CNPs) within the LPS matrix were investigated using Field Emission Scanning Electron Microscopy (FESEM) and X-ray diffraction (XRD). To evaluate the interaction between the LPS and the CNPs, the Fourier transform infrared (FTIR) identification was utilized. Furthermore, to investigate the kinetics of degradation, the thermal gravimetric analysis (TGA) and derivative thermogravimetry (DTG) of the samples were used in the nitrogen atmosphere with the help of Kissinger and Ozawa–Flynn–Wall (OFW) models. The characterization results confirmed the homogenous dispersion of the CNPs into the LPS matrix. In addition, the presence of CNPs increased the thermal stability and activation energy (Ea) of the samples at different conversion rates. Moreover, the OFW method was highly consistent with the experimental data and provided an appropriate fit for the degradation kinetics.

Polyethylene (PE) is one the most used plastics worldwide for a wide range of applications due to its good mechanical and chemical resistance, low density, cost efficiency, ease of processability, non-reactivity, low toxicity, good electric insulation, and good functionality. However, its high flammability and rapid flame spread pose dangers for certain applications. Therefore, different flame-retardant (FR) additives are incorporated into PE to increase its flame retardancy. In this review article, research papers from the past 10 years on the flame retardancy of PE systems are comprehensively reviewed and classified based on the additive sources. The FR additives are classified in well-known FR families, including phosphorous, melamine, nitrogen, inorganic hydroxides, boron, and silicon. The mechanism of fire retardance in each family is pinpointed. In addition to the efficiency of each FR in increasing the flame retardancy, its impact on the mechanical properties of the PE system is also discussed. Most of the FRs can decrease the heat release rate (HRR) of the PE products and simultaneously maintains the mechanical properties in appropriate ratios. Based on the literature, inorganic hydroxide seems to be used more in PE systems compared to other families. Finally, the role of nanotechnology for more efficient FR-PE systems is discussed and recommendations are given on implementing strategies that could help incorporate flame retardancy in the circular economy model.

OBJECTIVES Colorectal cancer (CRC) is the third most common cancer and the fourth most common cause of cancer death in the world. The aim of this study was to investigate the provincial distribution of the incidence of CRC across Iran. METHODS This epidemiologic study used data from the National Cancer Registry of Iran and the Center for Disease Control and Prevention of the Ministry of Health and Medical Education of Iran. The average annual age-standardized rate (ASR) for the incidence of CRC was calculated for each province. RESULTS We found that adenocarcinoma (not otherwise specified) was the most common histological subtype of CRC in males and females, accounting for 81.91 and 81.95% of CRC cases, respectively. Signet ring cell carcinoma was the least prevalent subtype of CRC in males and females and accounted for 1.5 and 0.94% of CRC cases, respectively. In patients aged 45 years or older, there was a steady upward trend in the incidence of CRC, and the highest ASR of CRC incidence among both males and females was in the age group of 80-84 years, with an ASR of 144.69 per 100,000 person-years for males and 119.18 per 100,000 person-years for females. The highest incidence rates of CRC in Iran were found in the central, northern, and western provinces. Provinces in the southeast of Iran had the lowest incidence rates of CRC. CONCLUSIONS Wide geographical variation was found in the incidence of CRC across the 31 provinces of Iran. These variations must be considered for prevention and control programs for CRC, as well as for resource allocation purposes.

Background: There are few published studies that consider the joint effect of multiple risk factors on avoidable burden of cardiovascular diseases (CVDs). This study aimed to estimate the joint effect of avoidable burden of multiple risk factors to CVDs. Methods : Estimates of avoidable burden to CVDs were made using potential impact fraction (PIF). In order to calculate PIF, data on the Prevalence of the risk factors include diabetes, hypertension, central obesity, and hypercholesterolemia were obtained from 3 rd national Surveillance of Risk Factors of Non-Communicable Diseases-2007 in Iran and data on corresponding measures of effect were derived from a cohort study with multivariate adjusted hazard ratios. Then, joint effect of risk factors was calculated. Results : About 37% (95% uncertainty interval: 21.7-50.2) of attributable disability adjusted life years (DALYs) to CVDs in adult males and 59.4% (95% uncertainty interval: 30-76) in adult females due to selected risk factors are avoidable in theoretical minimum risk levels. After changing the current prevalence of these risk factors to the plausible minimum risk levels, 17.8% (95% uncertainty interval: 10.1-25.1) of CVDs′ attributable DALYs among adult males and 34% (95% uncertainty interval: 20-46.7) in adult females can be avoided. Conclusions : To better priority setting as well as reporting the magnitude of avoidable DALYs rather than the percentage of avoidable burden, PIF should be applied to updated and revised burden of CVDs.

OBJECTIVES Speeding and passing are considered to be the main human factors resulting in road traffic injuries (RTIs). This study aimed to estimate the population attributeable fraction (PAF) of speeding and passing in RTIs in rural Iran during 2012. METHODS The contribution of speeding and passing to RTI-related morbidity and mortality was estimated using the PAF method. The prevalence of speeding and passing was obtained from the national traffic police data registry. A logistic regression model was used to measure the association between the above risk factors and RTIs. RESULTS Speeding accounted for 20.96% and 16.61% of rural road-related deaths and injuries, respectively. The corresponding values for passing were 13.50% and 13.44%, respectively. Jointly, the PAF of these factors was 31.63% for road-related deaths and 27.81% for injuries. CONCLUSIONS This study illustrates the importance of controlling speeding and passing as a high-priority aspect of public-health approaches to RTIs in Iran. It is recommended that laws restricting speeding and passing be enforced more strictly.