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Abstract Background Fatigue leads to an acute decline in muscle strength, altered patterns of lower extremity muscle activation, changes in hip and knee kinematics. In terms of the effects of fatigue on knee joint kinematics during plyometric training, there is still a lack of knowledge regarding kinematic differences between athletes who passed the ACL reconstructions rehabilitation period and healthy athletes. Therefore, this study aimed to compare lower limb joint kinematic parameters between reconstructed cruciate ligament and healthy control soccer players during jump landing in a fatigued setting. Methods Lower limb kinematic parameters were recorded in 20 professional soccer players (age, 24.95 ± 2.92 years; body mass, 77.20 ± 12.88 kg; height, 1.77 ± 3.19 m) during jump landing task before and after the fatigue protocol. The control group consisted of healthy subjects and the experimental group consisted of subjects with ACL reconstruction by thigh transplantation. Kinematic data was recorded with 4 cameras to measure lower limb angles at first foot contact and maximum range of motion. Results The results showed that before fatigue, there was only a significant difference between the two groups in the maximum range of motion of the non-involved hip joint (P = 0.022) and angle of the involved hip at first contact (P = 0.049). In other data on joint range of motion or initial contact angle, no significant difference was observed between the two groups (P > 0.05). After fatigue protocol, there was a significant difference in initial foot contact in non-involved (P = 0.030), and involved (P = 0.020) hip joint angles between the two groups. However, no significant difference in initial contact angle or range of motion of other joints was observed between the groups. Conclusions This study shows that plyometric fatigue does not contribute to numerous changes in contact angles and range of motion in lower extremity joints in healthy soccer players and those with a history of cruciate ligament repairs.

Introduction: Evidence supports the clinical applicability of near-infrared spectroscopy (NIRS) in intracranial hematoma detection in prehospital settings. This systematic review and meta-analysis aimed to determine the diagnostic yield of NIRS for detecting intracranial hematoma in traumatic brain injury (TBI) patients. Methods: A systematic search was performed in July 2024 in Medline, Embase, Scopus, and Web of Science databases. We included studies that evaluated the diagnostic performance of NIRS in detecting intracranial hematoma in both adult and pediatric patients suspected of TBI in prehospital or emergency settings, using brain computed tomography (CT) scan or magnetic resonance imaging as the gold standard. Results: Eighteen studies enrolling 2979 patients were included. NIRS exhibited an Area Under the Curve (AUC) of 0.91 (95% confidence interval [CI]: 0.88, 0.93), with a sensitivity of 0.86 (95% CI: 0.78, 0.91), and specificity of 0.82 (95% CI: 0.72, 0.89) across all age groups. In children, the results demonstrated an AUC of 0.92 (95% CI: 0.89, 0.94), sensitivity of 0.95 (95% CI: 0.21, 1.00), and specificity of 0.81 (95% CI: 0.65, 0.91). Among adults, the AUC was 0.91 (95% CI: 0.88, 0.93), with sensitivity and specificity of 0.86 (95% CI: 0.78, 0.92) and 0.83 (95% CI: 0.70, 0.91), respectively. Performance improved when NIRS was operated by non-physicians (AUC = 0.94 [95% CI: 0.91, 0.96], sensitivity = 0.90 [95% CI: 0.79, 0.95], specificity = 0.85 [95% CI: 0.71, 0.93]) compared to physicians (AUC = 0.90 [95% CI: 0.87, 0.92], sensitivity = 0.88 [95% CI: 0.77, 0.94], specificity = 0.75 [95% CI: 0.59, 0.76]). Patients' age group and operator type were identified as potential sources of heterogeneity. Sensitivity analyses confirmed the robustness of the findings, particularly in mild TBI cases and studies implementing a ΔOD > 0.2 as the threshold for a positive NIRS result. Conclusion: NIRS proves to be an effective diagnostic tool for detecting traumatic intracranial hematoma in both pediatric and adult groups, with high sensitivity and specificity. Its utility in prehospital triage, operated by physicians or paramedics, underscores its potential for broader clinical application.

The utilization of Cold Plasma (CP) technology for decontamination and disinfection has garnered considerable attention across diverse industries. This study aims to investigate the interaction between pH and electrical conductivity (EC) (μS/cm) in Cold Plasma-Activated Water (CPAW) enriched with metal cations and its potential as an antifungal agent against two Penicillium (P.) mold strains. The investigation focuses on elucidating the augmented chemical interactions induced by plasma between radicals, charged particles, and microorganisms' cell membranes within an aqueous environment. Our findings demonstrate a positive correlation between the inactivation potential of CPAW (operating at 10 kV voltage, 2.5 kHz high frequency, and 500 mA current intensity) and pH and EC(μS/cm) values. Notably, the relative chemical reactivity and solubility of calcium oxide emerge as significant factors, highlighting the pronounced link between P. Italicum and Plasma-Activated Water containing Copper cations (CPAW + Cu2+) (p

Introduction: A comprehensive analysis of the epidemiological features of aortic dissections in Azerbaijan Province, Iran, and their influence on patient survival remains unexplored. This study aimed to determine the incidence of aortic dissection and identify the associated factors of mortality in these patients. Methods: A retrospective longitudinal study was conducted using hospital records of patients diagnosed with aortic dissection in Tabriz, Iran, between 2017 and 2021. The 3-month mortality was followed up via telephone calls using the contact numbers provided in the patients’ records. Then, independently associated factors of mortality were identified using a multivariate stepwise logistic regression analysis. Results: Among the 150 cases of aortic dissection identified, 74% (n = 111) were classified as type A, and 26% (n = 39) were classified as type B. The overall incidence proportion of aortic dissections was 2.35 per 100000 population. In type A dissections, 64% (71 out of 111) of patients received surgical treatment, while 21.6% (24 out of 111) received medical treatment. Among type B dissections, only 23.1% (9 out of 39) underwent surgery. The all-cause mortality rate at 3 months was 52.5% (73 out of 139 patients with complete follow-up), 47 male (54%) and 26 female (50%). Multivariate analysis showed that higher age was independently associated with increased mortality (odds ratio [OR] = 1.03; 95% confidence interval [CI]: 1.00-1.06, p = 0.027). In contrast, patients with DeBakey Type III classification (OR = 0.29; 95% CI: 0.01-0.87, p = 0.027), hypothyroidism (OR = 0.12; 95% CI: 0.01-0.99, p = 0.049), and those who received either surgical treatment (OR = 0.19; 95% CI: 0.05-0.76, p = 0.019) or medical treatment (OR = 0.18; 95% CI: 0.04-0.80, p = 0.024) had a lower chance of mortality. Gender was not found to be associated with the outcome. Conclusion: The study revealed an annual incidence rate of aortic dissection as 2.35 per 100000 population. Aortic dissection, regardless of type, remains a highly fatal condition, with over half of patients dying within 3 months of the initial event. To reduce the high mortality rates associated with aortic dissections, it is crucial to implement specific measures for the early identification of patients and ensure prompt and appropriate care.

Abstract The current study aimed to explore the effects of proprioception versus core stability training over 8 weeks on the gait parameters of deaf adolescents. A total of 20 deaf adolescents were randomized into two groups: one group receiving proprioception training (PT, n = 10), another group receiving core stability training (CST, n = 10), and eleven typically developing adolescents assigned into the control group (CON; n = 11). Gait was recorded by two digital cameras; then, using the Kinovea software, the parameters of gait included: gait velocity, cadence, stride length, stride time, stance time, and swing time were calculated in terms of percentages of the walking cycle. After 8 weeks of PT, no significant differences were observed for all gait parameters between PT and control groups (p > 0.05). Also, after 8 weeks of CST, no significant differences were observed in gait velocity and cadence between the CST and control groups (p > 0.05). However, after 8 weeks of CST, stride length (p = 0.02) was higher in the control group; Stride time (p = 0.03), stance time (p = 0.04) and swing time (p = 0.04) were higher in the CST group. Moreover, after 8 weeks of PT, values showed significant improvements in all gait parameters (p = 0.001). Also, after 8 weeks of CST, values showed significant improvements in gait velocity and cadence (p = 0.001), but no significant differences were observed in other gait parameters (p > 0.05). The findings of this study indicated that PT improved all gait parameters, whereas CST improved gait velocity and cadence. The results of the present study also demonstrated that PT had a greater effect on gait parameters of deaf adolescents compared with CST. It seems that PT induces more training effects than CTS for enhancing gait parameters of deaf adolescents. Trial registration: Clinical trial registry number: IRCT20170312033029N2. URL: https://en.irct.ir/trial/25584 .

Objective The objective of this systematic review and meta-analysis was to assess the efficacy of exercise in neuropathic pain following traumatic spinal cord injuries. Methods The search was conducted in MEDLINE, Embase, Scopus, and Web of Science by the end of 2022. Two independent researchers included the articles based on the inclusion and exclusion criteria. A standardized mean difference was calculated for each data and they were pooled to calculate an overall effect size. To assess the heterogeneity between studies, I2 and chi-square tests were utilized. In the case of heterogeneity, meta-regression was performed to identify the potential source. Results Fifteen preclinical studies were included. Meta-analysis demonstrated that exercise significantly improves mechanical allodynia (standardized mean difference [SMD], -1.59; 95% confidence interval [CI], -2.16 to -1.02; p < 0.001; I2 = 90.37%), thermal hyperalgesia (SMD, 1.95; 95% CI, 0.96–2.94; p < 0.001), and cold allodynia (SMD, -2.92; 95% CI, -4.4 to -1.43; p < 0.001). The improvement in mechanical allodynia is significantly more in animals with a compression model of SCI (meta-regression coefficient, -1.33; 95% CI, -1.84 to -0.57; p < 0.001) and in mild SCI (p < 0.001). Additionally, the improvement was more prominent if the training was started 7 to 8 days postinjury (coefficient, -2.54; 95% CI, -3.85 to -1.23; p < 0.001) and was continued every day (coefficient, -1.99; 95% CI, -3.07 to -0.9; p < 0.001). Likewise, voluntary exercise demonstrated a significantly more effect size (coefficient, -1.45; 95% CI, -2.67 to -0.23; p = 0.02). Conclusion Exercise is effective in the amelioration of neuropathic pain. This effect in mechanical allodynia is more prominent if voluntary, continuous training is initiated in the subacute phase of mild SCI.

Introduction: Large vessel occlusion (LVO) strokes are associated with worse functional outcomes and higher mortality rates. In the present systematic review and meta-analysis, we evaluated the diagnostic yield of the Cincinnati Prehospital Stroke Scale (CPSS) in detecting LVO. Methods: We performed an extensive systematic search among online databases including Medline, Embase, Web of Science, and Scopus, until July 31st, 2023. We also conducted a manual search on Google and Google scholar, along with citation tracking to supplement the systematic search in retrieving all studies that evaluated the diagnostic accuracy of the CPSS in detecting LVO among patients suspected to stroke. Results: Fourteen studies were included in the present meta-analysis. CPSS showed the sensitivity of 97% (95% CI: 87%–99%) and the specificity of 17% (95% CI: 4%–54%) at the cut-off point of ≥1. The optimal threshold was determined to be ≥2, with a sensitivity of 82% (95% CI: 74%–88%) and specificity of 62% (95% CI: 48%–74%) in detecting LVO. At the highest cut-off point of ≥3, the CPSS had the lowest sensitivity of 60% (95% CI: 51%–69%) and the highest specificity of 81% (95% CI: 71%–88%). Sensitivity analyses showed the robustness of the results regardless of study population, inclusion of hemorrhagic stroke patients, pre-hospital or in-hospital settings, and the definition of LVO. Conclusion: A very low level of evidence demonstrated that CPSS, with a threshold set at ≥2, is a useful tool for identifying LVO stroke and directing patients to CSCs, both in prehospital and in-hospital settings.

Introduction: Traumatic brain injury (TBI) represents a significant global health burden. This systematic review delves into the comparison of S100B and Neuron-Specific Enolase (NSE) regarding their diagnostic and prognostic accuracy in TBI within the adult population. Methods: Conducted on October 21, 2023, the search identified 24 studies encompassing 6454 adult patients. QUADAS-2 and QUAPAS tools were employed to assess the risk of bias. The analyses aimed to evaluate the diagnostic and prognostic performance of S100B and NSE based on sensitivity, specificity, and area under the curve (AUC). The outcomes were detecting intracranial injury, mortality, and unfavorable outcome. Results: Pooled data analysis tended towards favoring S100B for diagnostic and prognostic purposes. S100B exhibited a diagnostic AUC of 0.74 (95% confidence interval (CI): 0.70-0.78), sensitivity of 80% (95% CI: 63%-90%), and specificity of 59% (95% CI: 45%-72%), outperforming NSE with an AUC of 0.66 (95% CI: 0.61–0.70), sensitivity of 74% (95% CI: 53%-88%), and specificity of 46% (95% CI: 24%-69%). Notably, both biomarkers demonstrated enhanced diagnostic value when blood samples were collected within 12 hours post-injury. The analyses also revealed the excellent diagnostic ability of S100B with a sensitivity of 99% (95% CI: 4%-100%) and a specificity of 76% (95% CI: 51%-91%) in mild TBI patients (AUC = 0.89 [0.86–0.91]). In predicting mortality, S100B showed a sensitivity of 90% (95% CI: 65%-98%) and specificity of 61% (95% CI: 39%-79%), slightly surpassing NSE's performance with a sensitivity of 88% (95% CI: 76%-95%) and specificity of 56% (95% CI: 47%-65%). For predicting unfavorable outcomes, S100B exhibited a sensitivity of 83% (95% CI: 74%-90%) and specificity of 51% (95% CI: 30%-72%), while NSE had a sensitivity of 80% (95% CI: 64%-90%) and specificity of 59% (95% CI: 46%-71%). Conclusion: Although neither biomarker has shown promising diagnostic performance in detecting abnormal computed tomography (CT) findings, they have displayed acceptable outcome prediction capabilities, particularly with regard to mortality.

Background: Due to the mobility problems of the elderly, it is better to use low-cost and applicable methods in any place, which do not require expertise to measure gait. One of these ubiquitous methods is functional gait assessment (FGA). Objectives: The purpose of this study was to collect and evaluate FGA in the elderly. Materials & Methods: This study conducted a comprehensive study of FGA in the elderly by searching the databases of PubMed, MEDLINE, Web of Science, ScienceDirect, Cochrane Central Register of Controlled Clinical Trials, Google Scholar, Scopus, MAGIRAN, IRANDOC, Iran Medex, MedLib, and SID from 1996 to November 2020. After compiling the search results, we first studied the titles and then the abstracts. If an article matched the inclusion and exclusion criteria, its results were used in the review study; otherwise, it was excluded. Results: Based on the research criteria and objectives, from 23 different tests, the results of 19 articles that studied FGA in the elderly were selected and reported. Conclusion: Studies seem to attempt FGA in the elderly using different methods and for different purposes. For example, studies to assess gait velocity, normal gait, and gait, along with functional and cognitive tasks, have measured FGA in the elderly. Besides, the two main features of a valid test including sensitivity and specificity have been less studied. Therefore, more studies should focus on these test features in measuring FGA in the elderly.

Background: Considering the high prevalence of flat feet and cavus feet abnormalities among people and the adverse effects resulting from these complications on both balance and function, a systematic review on the effectsof various exercise programs on postural control and dynamic balance of these individuals seems to be essential. Thus, the current systematic review and metaanalysis examined the effects of exercise training programs on postural control and dynamic balance among individuals with flat feet and cavus feet.Methods: Relevant articles were identified through searches across the eight databases of PubMed, SCOPUS, LILACS, CINAHL, CENTRAL, Web of Science,PEDro, and Google Scholar. The search period ranged from the beginning ofavailable date to November 2021. Manual searches and a complete investigation of the references of papers were also performed.Results: The current systematic review and meta-analysis included 13 studies.Meta-analysis results indicated that the exercise programs had a significant effect on posture control (P=0.001) and dynamic balance (P=0.001) among individuals with flat feet and cavus feet. The effect size of Hedges’s g of the exercise programs on postural control was 1.81 with a confidence interval of 95% (1.40-2.22). The effect size of Hedges’s g of the exercise programs on dynamic balance was 1.32 with a 95% confidence interval (0.98-1.67).Conclusion: The present systematic review found that exercise programs had a significant effect on the postural control and dynamic balance of individuals with flat feet and cavus feet abnormalities. Study results have revealed that to better correct abnormalities and thus further improve postural control and dynamic balance, the period of exercise program should be increased. Moreover, exercise programs should also focus on greater involvement ofneuromuscular systems and direct effects on the central nervous system so that a greater effect on improving postural control and dynamic balance can be observed.

Introduction: High-arch and flat foot deformities can negatively impact an individual’s performance in different situations. They may also balance as well as disturb postural control, which is essential for performing optimal routine and port activities, in addition to preventing injuries. This is a comparative meta-analysis of postural control in people with high-arch and flat foot deformities with normal feet. Materials and Methods: This is a systematic review of articles published from 2004 to 2021 in Medline/PubMed, Embase/Scopus, LILACS, CINAHL, CENTRAL (cochrane central register of controlled trials), Web of Science, PEDro, and Google Scholar databases. Results: The results revealed that the total balance score in people with high-arch and flat foot deformities was lower (P=0.001), compared to normal people. However, no significant difference was observed in the total balance of people with high-arch and flat foot deformities (P>0.05). Additionally, flat-foot people showed a weaker balance in the postural control test on a force plate, when compared to individuals with high-arch feet (P=0.001). Nevertheless, the results of dynamic balance were the same for all groups (P>0.05). Conclusion: Our findings indicate that people with high-arch and flat foot deformities suffer from weaker postural control when compared to their normal peers. Moreover, flat-foot people showed lower scores on postural control tests on force plates, compared to subjects with high-arch feet, even though they had no significant differences for static and dynamic tests. There was no difference in the results of dynamic balance among the 3 groups.

Background and Aims: Balance is one of the important factors that help to maintain the independent life of people with intellectual disabilities. A variety of methods are used to assess balance in these individuals. However, so far no review study has been conducted to determine what kind of tests are used to assess balance in this group. Therefore, The purpose of this study was to investigate the methods of assessing postural control and balance used in studies on intellectual disabilities.Methods: In this study, a comprehensive search was performed on functional assessment tests of balance in people with intellectual disabilities. PubMed, Medline, Web of Science, ScienceDirect, Cochrane Central Register of Controlled Clinical Trials, Google Scholar, Scopus, Magiran, IranDoc, Iran Medex, MedLib, and SID were searched from 1991 to November 2020. After collecting the search results, first, the title and then the summary of the articles were studied. If the articles met the inclusion criteria, the results were used in the review study and otherwise discarded.Results: Based on the criteria and objectives of the research, 20 articles were selected after the evaluation process. All articles were provided in full text. Then, 23 Functional Balance Assessment Tests were used to measure functional balance in people with intellectual disabilities.Conclusion: Studies had examined the evaluation of functional balance in intellectual disabilities in several ways; therefore, it seems that a specific test cannot be suggested to measure the balance of intellectually disabled people.

Background: Knowledge of the functional balance tests for the patients with Multiple Sclerosis (PwMS) may provide useful and accurate information about the balance function of these patients under different situations. Objectives: This study aims to review the functional balance tests for PwMS. Materials and Methods: This is a systematic review. The search was conducted in PubMed, Scopus, LILACS, CINAHL, CENTRAL, Web of Science, PEDro, and Google Scholar databases on relevant studies published until November 2021. Results: Twenty-five articles and 25 different tests were found to evaluate the functional balance of PwMS. It was found that the studies used 6 tests to assess the static balance, 13 tests to assess dynamic balance, and 6 multi-item tests to assess functional balance in PwMS. Single-leg stance test, balance error scoring system test and steady stance test is a test battery for static balance; six-spot step test, timed up and go test, and figure-of-8 hop test are better for dynamic balance, and the balance evaluation systems test is a better multiitem test to assess the balance of PwMS by examining the postural control components. Conclusion: Single-limb standing test, balance error scoring system (BESS) test and steady stance test provide accurate data on static balance; six spot step test, Timed Get up and go test and figure-of-8 hop test provide valuable data on the dynamic balance and Balance Evaluation Systems Test (BESTest) is a valid test to assess the balance of PwMS from the perspective of the review of posture control components.

Introduction In recent years, various peptides have been introduced for the complementary treatment and management of post-reperfusion injuries. Nesfatin-1, a peptide secreted by the nervous system and peripheral tissues, modulates cardiac function, and plays an important role in the cardiovascular response to stress conditions. This systematic review and meta-analysis aims to investigate the preclinical evidence on the effect of Nesfatin-1 administration in the improvement of cardiac ischemia/reperfusion injury. Method Online databases of PubMed, Embase, Web of Science, and Scopus were searched until November 2nd, 2022, for articles investigating the therapeutic effects of Nesfatin-1 administration on myocardial ischemia/reperfusion injury in preclinical models. Cardiac functions, infarct size, myocardial tissue fibrosis, inflammation, oxidative stress, apoptosis, necroptosis, and necrosis were chosen as outcomes. The results are reported as an overall standardized mean difference (SMD) and 95% confidence interval (CI). Results Our results demonstrate that the administration of Nesfatin-1 improves cardiac parameters such as ejection fraction (SMD = 3.94, 95% CI: 0.30 to 7.58), heart rate (SMD = 3.30, 95% CI: 0.41 to 6.18), and negative dp/dt (SMD = 2.05, 95% CI: 0.60 to 3.50) and positive dp/dt (SMD = 2.78, 95% CI: 0.56 to 4.99). Nesfatin-1 was shown to significantly reduce myocardial infarct size (SMD = -4.32, 95% CI: -5.95 to -2.69 and fibrosis (SMD = -3.91, 95% CI: -5.67 to -2.15). Apoptotic score (SMD = -2.07, 95% CI: -3.51 to -0.63) and oxidative stress were also reduced subsequent to Nesfatin-1 administration. Nesfatin-1 was not shown to decrease inflammation, necroptosis, and necrosis. Conclusion In conclusion, we demonstrated that Nesfatin-1 could serve as a potential therapeutic agent in ameliorating the secondary damages during myocardial I/R injury. Nesfatin-1 administration can preserve cardiac function by reducing oxidative stress, apoptosis, and myocardial necrosis. However, much more studies are required to endorse further clinical translation of Nesfatin-1 to be utilized in the management of myocardial I/R injury.

The Navy of the Islamic Republic of Iran has very valuable capabilities such as land, water, equipment and manpower, which, if considered, will give good results to the force. Therefore, the present study has been conducted with the aim of explaining how to exploit the existing economic capacities by constructing aquaculture ponds in the lands of Khorramshahr naval base. The method of this research is descriptive with a mixed approach and the study population was 125 people and 68 people as a sample size. The results show that the most important source for employing and providing manpower is "using retired employees with skills and expertise (fisheries) with a coefficient of variation of 0.183 (high and very high), an average of 4.32 and the first priority." From the point of view of the sample community, the most important source for providing equipment and facilities is "purchase and use of up-to-date and modern equipment with coefficient of variation of 0.114 (high and very high), average of 4.59 and first priority" and finally the most important source for financing and capital "Establishment and creation of a cooperative company with the membership of volunteer employees to provide the required financial resources with a coefficient of variation of 0.139 (high and very high), an average of 4.56 and the first priority."

Background and Objectives: Sleep deprivation has negative effects on consciousness and performance. N-methyl-D-aspartate receptors are a subset of glutamate receptors consisting of subunits NR1 and NR2. In the present study, the effect of a traditional Chinese medicine supplement called NeuroAid on the levels of NR1 and NR2 proteins in the striatum and prefrontal cortex of rat under total sleep deprivation (TSD) was evaluated. Methods: ats were randomly divided into four groups of control (n=5), sham (n=5), TSD (n=5), TSD + supplementation (n=5) and sham + supplemention (n=5). After 24 hours of testing, the prefrontal cortex and striatum of the rats were removed and the levels of NR1 and NR2 proteins were assessed by Western blotting. Differences between protein levels were analyzed using one-way analysis of variance (ANOVA) and t-test. Results: TSD reduced the expression of both NR1 and NR2 proteins in the striatum and prefrontal cortex of rats. There was no significant difference in the expression of any proteins in the two regions of sham group compared to the control rats. Two intraperitoneal injections of 0.8 mg/kg NeuroAid significantly increased the expression of both proteins in both regions compared to the TSD group. In the sham + supplemention group, the expression of both proteins in the two regions increased significantly compared to the sham group. Conclusion: The use of NeuroAid supplement can increase the levels of NR1 and NR2 proteins in rats with TSD.

Introduction: The Corticosteroid Randomization After Significant Head injury (CRASH) and the International Mission for Prognosis and Analysis of Clinical Trials (IMPACT) are two prognostic models frequently used in predicting the outcome of patients with traumatic brain injury. There are ongoing debates about which of the two models has a better prognostic value. This study aims to compare the CRASH and IMPACT in predicting mortality and unfavorable outcome of patients with traumatic brain injury. Method: We performed a literature search using Medline (via PubMed), Embase, Scopus, and Web of Science databases until August 17, 2022. After two independent researchers screened the articles, we included all the original articles comparing the prognostic value of IMPACT and CRASH models in patients with traumatic brain injury. The outcomes evaluated were mortality and unfavorable outcome. The data of the included articles were analyzed using STATA 17.0 statistical program, and we reported an odds ratio (OR) with a 95% confidence interval (95% CI) for comparison. Results: We included the data from 16 studies. The analysis showed that the areas under the curve of the IMPACT core model and CRASH basic model do not differ in predicting the mortality of patients (OR=0.99; p=0.905) and their six-month unfavorable outcome (OR=1.01; p=0.719). Additionally, the CRASH CT model showed no difference from the IMPACT extended (OR=0.98; p=0.507) and IMPACT Lab (OR=1.00; p=0.298) models in predicting the mortality of patients with traumatic brain injury. We also observed similar findings in the six-month unfavorable outcome, showing that the CRASH CT model does not differ from the IMPACT extended (OR=1.00; p=0.990) and IMPACT Lab (OR=1.00; p=0.570) in predicting the unfavorable outcome in head trauma patients. Conclusion: Low to very low level of evidence shows that IMPACT and CRASH models have similar values in predicting mortality and unfavorable outcome in patients with traumatic brain injury. Since the discriminative power of the IMPACT Core and CRASH basic models is not different from the IMPACT extended, IMPACT Lab, and CRASH CT models, it may be possible to only use the core and basic models in examining the prognosis of patients with traumatic injuries to the brain.

Background: Multiple Sclerosis (MS) is one of the most common diseases of the Central Nervous System (CNS). Numerous studies have reported Fear of Falling (FOF) among MS patients. FOF is a factor limiting physical activity. Regular physical activity is very important for maintaining good health and preventing the complications of MS patients and can make these people more active and reduce FOF. Objectives: The aim of the present study was to do a meta-analyze about the effect of exercise programs on FOF among MS patients Materials & Methods: Primary sources were obtained from 9 databases including, PubMed, EMBASE, SCOPUS, LILACS, CINAHL, CENTRAL, Web of Science, PEDro, and Google Scholar, from inception until April 2021. Data analysis was carried out using Comprehensive Meta-Analysis ver. 2. Results: Nine studies with 350 participants were included in the review. The results of the meta-analysis showed the effect of exercise programs on the FOF among MS patients. The Hedges’ adjusted Effect Size (ES) regarding the effects of exercise programs on FOF among MS patients was -0.15 (95%CI: -0.52 - 0.22). The results of the meta-analysis showed no significant difference between the effect of exercise programs on FOF among MS patients (p=0.44). Conclusion: It was found that all exercise programs have a significant effect on FOF among MS patients. There was no statistically significant difference between exercise programs regarding which exercise programs led to a higher reduction in FOF among these patients; however, Pilates and virtual reality exercises were more effective than other exercise programs.

Objective(s): Catheters are one of the factors for complicated urinary tract infections. Uropathogenic bacteria can attach to the catheter via cell surface hydrophobicity (CSH), form biofilms, and remain in urinary tract. The study was evaluated phenotypic and genotypic characteristics of fimbriae in Klebsiella pneumoniae and uropathogenic Escherichia coli (UPEC) isolates from patients with catheter-associated urinary tract infections (CAUTIs) and their association with biofilm formation. Materials and Methods: Urine specimens were collected through catheters in patients with CAUTIs. Sixty bacterial isolates were identified by biochemical tests. For determination of biofilm formation a tissue culture plate was used. Microbial adhesion to hydrocarbons (MATH) was conducted for CSH determination. The mannose-sensitive haemagglutination (MSHA) and mannose-resistant haemagglutination (MRHA) were determined for type 1 and type 3 fimbriae. Finally, the presence of genes encoding fimbriae was determined by PCR.Results: All isolates showed strong CSH, biofilm capacity and MRHA phenotype. The results showed that 20% of UPEC and 23% of K. pneumoniae isolates contained MSHA phenotypes. There was a significant association between biofilm formation and MSHA phenotype in UPEC isolates. The frequency of fimA (80%) and fimH (96.6%) in K. pneumoniae isolates was higher than UPEC isolates. Both types of bacterial isolates with MSHA phenotypes harbored the fimH gene. Conclusion: The phenotypic and genotypic characteristics of two bacterial species were highly similar. Also, the type of fimbriae affected bacterial biofilm formation through catheterization. It seems that fimH and mrk gene cluster subunits are suitable markers for identifying bacterial pathogenesis.

Abstract A Pd-Co bimetallic alloy encapsulated in melamine-based dendrimer supported on magnetic nanoparticles denoted as γ-Fe2O3@MBD/Pd-Co was synthesized by a facile co-complexation-reduction method and characterized sufficiently. The catalytic evaluation of γ-Fe2O3@MBD/Pd-Co showed promising results in the Mizoroki–Heck and Buchwald–Hartwig amination reactions of various iodo-, bromo- and challenging chloroarenes in aqueous media. The synergetic cooperative effect of both Pd and Co and dispersion of the catalyst in water due to the encapsulation of γ-Fe2O3 by melamine-based dendrimer lead to high catalytic performance compared with the monometallic counterparts. The dispersion of the magnetic catalyst also facilitates the recovery and reuse of the catalyst by ten consecutive extraction and final magnetic isolation with no loss of catalytic activity, keeping its structure unaltered.

Purpose: This paper reviews the studies on balance in the blind. Methods: The paper comprehensively reviewed studies on balance in the blind from the following databases: PubMed, MEDLINE, Web of Science, ScienceDirect, Cochrane Central Register of Controlled Clinical Trials, Google Scholar, and Scopus, from 2001 to 2019. Also, other available papers were examined. Results: Out of 35 evaluated studies, 32 articles were fully represented and the rest were only summarized. These articles covered two issues: 1) balance adaptation in the blind, 2) the effects of training protocols on the balance in the blind. Conclusion: The blind suffer from poor balance. However, they tend not to differ from normal people, when sufficient data from the vestibular and proprioception systems are available. Also, balance in the blind improves by age, which increases the efficiency and maturity of vestibular and proprioception systems. The blind tend to be more reliant on the hip than ankle strategy. All the training protocols reviewed in this paper have positively affected balance in the blind. Nevertheless, it was impossible to determine the most efficient protocol, and further qualitative studies are required for this purpose.

Purpose: The present study examined the relationship between muscle strength and range of motion in lower extremity with balance and risk of falling in the elderly. Methods: This was a cross-sectional study. The statistical population included healthy elderly (Mean±SD age: 65.64±4.95 y) in Rasht City, Iran. The study was conducted on 65 healthy elderly males who met the study inclusion criteria and were selected by convenience sampling method. In this study, to measure static and dynamic balance, Sharpened Romberg test and Get Up and Go test were conducted, respectively. Additionally, the falling risk was measured by the Berg Balance Scale. Moreover, the maximum isometric force of the muscle groups in the lower extremities was measured using a hand-held dynamometer, and the range of motion was measured by a goniometer. The obtained data were analyzed using descriptive and analytical statistics by SPSS. Results: The present study results demonstrated that the muscle strength of hip extension, hip abduction, hamstring, quadriceps, and ankle plantarflexion had a significant relationship with static balance; while being negatively related to dynamic balance (P≤0.05). Furthermore, we observed a significant and negative relationship between the muscle strength of ankle dorsiflexion and dynamic balance and risk of falling (P≤0.05). There was also a positive and significant relationship between the range of motion hip extension, knee flexion, plantar flexion, and ankle dorsiflexion and static balance, while indicating a negative and significant relationship between these variables and dynamic balance and risk of falling (P≤0.05). Conclusion: The muscle strength hip abduction, hip extensions, hamstring, quadriceps, plantar flexion, ankle dorsiflexion and range of motion hip extension, knee flexion, ankle plantar flexion, and dorsiflexion seem to affect balance maintenance and fall risk in the elderly.

Objective Damage to parts of the vestibulocochlear nerve not only results in sensory-neural hearing loss and deafness but may also lead to balance problems. This is the reason why the hearing-impaired and deaf people are struggling with balance problems. Given the ever-increasing development of the adaptive sports, specific to the deaf, who are considered as part of the active individuals in the community, detailed studies are required on the balance of the deaf, which is an important part of routine activities and sports performances. Therefore, this study generally aims to investigate the balance skills of the deaf in comparison to their normal counterparts. Materials & Methods In this study, a comprehensive review on ‘the balance of the deaf’ has been carried out by searching English databases, such as Science Direct, PubMed, Cochrane review, TRIP, PEDro, EMBASE, CINAHL, and Google Scholar, for the following keywords: “Deaf”, “Postural control in Deaf Hearing Loss”, “Deafness”, “Balance” and “Balance in Deaf”. In addition, the Persian databases, such as Magiran, Irandoc, IranMedex, MedLib, Sid were searched for the following Persian equivalent keywords: Balance in the deaf, postural control in the deaf, deaf, congenital deafness and balance, from 1932 to June 2018. Moreover, manual searching and full reviewing of resources of the articles were carried out to find the respective articles. Articles were narrowed down and sorted out by the titles such as the English language, Persian language, Human, original article, and review article. After collecting the search results, the titles and abstracts of the articles were studied. If the articles met the inclusion and exclusion criteria, their results would be employed in the review study; otherwise, they would be excluded. Results Based on the criteria and objectives of the research, 51 articles were selected. Forty-eight papers were provided in full text and the rest were summarized. In general, the balance of the deaf was investigated in three different respects of 1) a comparison of the balance of the deaf with that of the normal counterparts, 2) the effect of age on the balance of the deaf, and 3) the effect of the training protocols on the balance of the deaf. Conclusion The deaf people appear to struggle with balance problems when the vestibular system information is the only sensory source available; however, when the information of the proprioception and vision systems is available, there can be no balance problem as compared to normal counterparts. Several studies have also shown that the deaf, as they age, make up for the balance impairment resulting from vestibular impairments with proprioception and vision systems; it also appears that their proprioception and vision systems are better than or equal to those of their normal counterparts. However, it has not been determined yet that by increasing age in the deaf people, which proprioception system dominates and contributes to maintaining the balance of the deaf better than other systems. Furthermore, a review of studies has shown that all training programs and rehabilitation protocols have positive effects on the balance of the deaf. However, it has not been determined yet which training programs have a long and lasting effect on the balance of the deaf, and few studies have been carried out in this area. In addition, the same balance tests are used in all community groups, which may be inappropriate for measuring the balance in deaf people, since it is still not clear which motion strategies have been employed by the deaf to maintain balance. Therefore, to reach the final conclusion about the balance of the deaf people, further studies should be conducted on the proper tests to measure the balance of the deaf so that accurate and high-quality reports on their balance can be obtained.

Introduction: The deaf usually have different motion and social behaviors, some of which are quite evident to detect. These characteristics are usually seen in balance, strength, and stability of body. These characteristics can be categorized in the field of physical fitness factors; the deaf are reportedly seen as less capable in these factors than their normal counterparts. This study aimed to evaluate the effect of the combined training program (endurance and core stability) on the physical fitness of deaf boy students. Materials and Methods: 24 deaf boy students were randomly divided into two equal groups of experimental and control. Static balance was examined via evaluating balancing errors, dynamic balance via using Y balancing test, trunk muscular endurance by using Sorensen test, abdominal muscular endurance using sit-up, and cardiorespiratory endurance by using stairs. The experimental groups did a combined training program (endurance and core stability) for 8 weeks, 3 sessions a week (each session 60 minutes). In order to analyze the data, dependent and independent t tests were used. Results: In the experimental group, using paired t test, there were significant differences between pretest and posttest results of static and dynamic balances, trunk muscular endurance, abdominal muscular endurance, and cardiorespiratory endurance (P < 0.001 for all). Besides, using independent t test, there were significant differences between the experimental and control groups in terms static and dynamic balances, trunk muscular endurance, muscular endurance, and cardiorespiratory endurance showing the effect of combined training (endurance, core stability) (P < 0.001 for all). Conclusion: According to the findings, it is notable that a set of core stability and endurance exercises leads to improvement of health status among deaf students.

Intensity modulated radiation therapy (IMRT) and three-dimensional conformal radiation therapy (3D CRT) are two treatment modalities in prostate cancer, which provide acceptable dose distribution in tumor region with sparing the surrounding normal tissues. IMRT is based on inverse planning optimization; in which, intensity of beams is modified by using multileaf collimators and also compensators with optimum shapes in step and shoot (SAS) and compensator-based method, respectively. In the recent study, some important parameters were compared in two IMRT and 3D CRT methods. Prescribed dose was 80 Gy for both IMRT procedures and 70 Gy for 3D CRT. Treatment plans of 15 prostate cancer candidates were compared to target the minimum dose, maximum dose, V 76 Gy (for IMRT plans) V 66.5 Gy (for 3D CRT), mean dose, conformity index (CI), and homogeneity index (HI). Dose conformity in compensators-based IMRT was better than SAS and 3D CRT. The same outcome was also achieved for homogeneity index. The target coverage was achieved 95% of prescribed dose to 95% of planning target volume (PTV) in 3D CRT and 95% of prescribed dose to 98% of PTV in IMRT methods. IMRT increases maximum dose of tumor region, improves CI and HI of target volume, and also reduces dose of organs at risks.

Background: Insertion of the advanced airway during induction of general anesthesia can cause undesirable sympathetic stimulation such as increased intraocular pressure (IOP) and hemodynamic parameters. In this study, we compared insertion of three different advanced airway devices; endotracheal tube (ETT), laryngeal mask airway (LMA) and I-gel in terms of IOP, hemodynamic changes and postoperative nausea and vomiting (PONV) following induction of general anesthesia with propofol and remifentanil in children undergoing strabismus surgery. Materials and Methods: A total of 90 children (5.68 ± 1.49 years old) were randomly assigned to one of the three groups, ETT, LMA, or I-gel insertion as advanced airway devices IOP and also hemodynamic variables were measured before (T0 and T1) and immediately after (T2) the insertion of these airway devices, although 2 min (T3) and 5 min (T4) after it. PONV was assessed about 2 h after the completion of surgery in the recovery room. Results: The mean arterial pressure (MAP), IOP, and systolic and diastolic blood pressures were significantly different between the three groups immediately (T2), 2 min (T3), and 5 min (T4) after the insertion of airway devices. The heart rate (HR) was significantly different between the three groups in all measurement times except of T0. Within-group comparisons showed that the three groups had significant changes in MAP, IOP, HR, systolic and diastolic pressure before and after airway insertion (T1 and T2). The trend in the LMA and ETT groups was descending-ascending-descending, whereas in the I-gel group, it was quite descending. There was no significant difference among the three groups in terms of PONV. Conclusion: As a result, our study showed that, compared with LMA and ETT, the I-gel had less impact on undesirable stress responses and seems to be superior to LMA and ETT in children undergoing strabismus surgery.

Background: one of the most killing cancers globally and the fourth most relevant cancer, the pancreatic cancer has a great numbers of victims every tear, therefore, the goal of this study was to investigate the rate of incidence among residents of ilam in time span of 10 years, from 1385 till 1394. Materials and Methods: this is a retrospective study during 1385 till 1394 in Ilam city. Our source of patients was the afflicted patients. The sample size and the statistical society of research were determined based on census. The research materials included of two types first included the demographic information of patients (age, gender, tumor type, level of education, residency, smoking and lipid profile) and the second part was some information about the pancreatic cancer (anatomical site, pathologic findings and lipid profile).using SPSS version 19, the data was analyzed. Results: the statistical society included 25 individuals afflicted with pancreatic cancer in which the most prevalent age group was men older than 70 years (60 years) (31.3%). Furthermore, as time went on, the number of new cases increased. Conclusion: the risk factors for occurring the cancer were the age group greater than 70 years, being male, lower educational situation, unemployment, living in an urban areas, smoking, hereditary, hyperlipidemia (LDL, TG, CHOL) and finding tumor in middle third of pancreatic (because of existing helicobacter pylori virus and impropriate diet). Being able to identify endangered people, one could begin treating patients and thereby, saving time, cost and increasing the rate of survivors. Key words: pancreatic cancer, retrospective, epidemiology

Abstract The education in every field of science is important and plays a vital role. It may happen during radiotherapy some errors that may have detrimental effects on treatment outcome. We designed this study to investigate the effect of using a protocol on range of errors. Materials and Methods A check list including 5 sets of errors was designed to investigate whether having a certain protocol has any effect on workflow. To reach that, 106 patient profiles compiled randomly to ascertain those five factors in two radiotherapy and oncology centers. Results Based on concluded data from statistical analyze, all 5 factors including MU, shield, coach rotation, field size and second phase had a significant changes in terms of statistic (p

Background: esophagus cancer is the sixth deadly cancer among other types with high rate of death which has made it one of the common cancers. Based on what mentioned, this retrospective study was designed to assess the tumor incidence rate in a 10 years period in Ilam city. Materials and methods: this is a retrospective study during 1385 till 1394 in Ilam city. Our source of patients was the afflicted patients. The sample size and the statistical society of research were determined based on census. The research materials included of two types first included the demographic information of patients (age, gender, tumor type, level of education, residency, smoking and lipid profile) and the second part was some information about the esophagus cancer (anatomical site, pathologic findings and lipid profile).using SPSS version 19, the data was analyzed. Results: the statistical society included 150 individuals afflicted with esophagus cancer in which the most prevalent age group was men older than 70 years (31.3%). In terms of anatomical site, the middle third of esophagus had 75 cases (50%), the last third had 45 cases (30%) and the first third had 30 (20%) individuals. Furthermore, as time went on, the number of new cases increased. Conclusion: the risk factors for occurring the cancer were the age group greater than 70 years, being male, lower educational situation, unemployment, living in an urban areas, smoking, hereditary, hyperlipidemia (LDL, TG, CHOL) and finding tumor in middle third of esophagus (because of existing helicobacter pylori virus and impropriate diet). Being able to identify endangered people, one could begin treating patients and thereby, saving time, cost and increasing the rate of survivors.

Objective(s): Bacterial biofilm has been considered responsible for many deaths and high health costs worldwide. Their better protection against antibacterial agents compared to free living cells leads to poor treatment efficiency. Nanotechnology is promising approach to combat biofilm infections. The aim of the present study was to eradicate Staphylococcus epidermidis biofilm with silver nanoparticles (SNPs). Materials and Methods: SNPs were used at different concentrations (two fold dilutions) and incubation times (24, 48, 72 h). The crystal violet staining and pour plate assays were used to assess biofilm biomass and bacterial viability, respectively. The ability of SNPs on biofilm matrix eradication was assessed through optical density ratio (ODr). Positive control was defined as an ODr =1.0. Results: The crystal violet assay indicated that the biofilm matrixes were intact at different concentrations of SNOs and incubation times. There were no significant differences between these parameters (P >0.05). Bacterial enumeration studies revealed that higher concentrations of SNPs were more effective in killing bacteria than lower ones. Although, longer incubation times led to enhancement of anti-biofilm activity of SNPs. Conclusion: The anti-biofilm activity of SNPs was concentration- and time-dependent. The results of this study highlighted that SNPs were effective against cell viability; however they were ineffective against biomass.