Search

We have investigated the expression of integrins by rat oligodendroglia grown in primary culture and the functional role of these proteins in myelinogenesis. Immunochemical analysis, using antibodies to a number of alpha and beta integrin subunits, revealed that oligodendrocytes express only one detectable integrin receptor complex (alpha OL beta OL). This complex is immunoprecipitated by a polyclonal anti-human beta 1 integrin subunit antibody. In contrast, astrocytes, the other major glial cell type in brain, express multiple integrins including alpha 1 beta 1, alpha 3 beta 1, and alpha 5 beta 1 complexes that are immunologically and electrophoretically indistinguishable from integrins expressed by rat fibroblasts. The beta subunit of the oligodendrocyte integrin (beta OL) and rat fibroblast beta 1 have different electrophoretic mobilities in SDS-PAGE. However, the two beta subunits appear to be highly related based on immunological cross-reactivity and one-dimensional peptide mapping. After removal of N-linked carbohydrate chains, beta OL and beta 1 comigrated in SDS-PAGE and peptide maps of the two deglycosylated subunits were identical, suggesting differential glycosylation of beta 1 and beta OL accounts entirely for their size differences. The oligodendrocyte alpha subunit, alpha OL, was not immunoprecipitated by antibodies against well characterized alpha chains which are known to associate with beta 1 (alpha 3, alpha 4, and alpha 5). However, an antibody to alpha 8, a more recently identified integrin subunit, did precipitate two integrin subunits with electrophoretic mobilities in SDS-PAGE identical to alpha OL and beta OL. Functional studies indicated that disruption of oligodendrocyte adhesion to a glial-derived matrix by an RGD-containing synthetic peptide resulted in a substantial decrease in the level of mRNAs for several myelin components including myelin basic protein (MBP), proteolipid protein (PLP), and cyclic nucleotide phosphodiesterase (CNP). These results suggest that integrin-mediated adhesion of oligodendrocytes may trigger signal(s) that induce the expression of myelin genes and thus influence oligodendrocyte differentiation.

This study examines the role of recast frequency and its effectiveness in the acquisition of English articles in a computer-mediated context. Sixty-one pre-intermediate university language learners in Turkey were randomly divided into four main groups: high frequency recast (HF), low frequency recast (LF), test control, and task control groups. The learners in the HF and LF recast groups completed five and two tasks, respectively, in a video-conferencing environment and received oral recasts on their incorrect use of English articles. Learners in the test control group only took the pre and posttests, and learners in the task control group completed five tasks without receiving feedback on the target structure. The outcome was measured through online picture description and error correction tasks. Findings showed that in the picture description task, learners in the HF group performed significantly better than those in the LF recast group and the control groups. In the error correction task, the results revealed a short-term advantage for learners in the HF group, which faded away in the delayed posttest. Significant correlations were also found between the recast frequency and learners’ score improvement in the immediate and delayed picture description tasks but not in the error correction tasks. These results suggest that recast quantity may play an important role in improving learners’ accuracy of their oral production.

The role of organizational knowledge in the economic development of countries and the creation of added value, especially in developing countries, has been the focus of development-oriented economists and politicians. In this view, knowledge-based industries and new technologies, as well as the growth of knowledge-based companies, are very important. Technological learning is one of the important topics for developing innovation and improving the business performance of these companies. The purpose of this research is to provide an integrated model for improving the business performance of knowledge-based nanotechnology companies based on technological learning modes. In terms of purpose, this research is applied, in terms of data collection method, it is a correlational description and in terms of data type, it is a quantitative research. Structural equation modeling and partial least squares method and SPSS and SMART PLS software were used for data analysis. Using appropriate techniques, the reliability and validity of the structures were measured and confirmed. The results of the model in the standard estimation mode showed that the direction and intensity of the relationship between all the variables were acceptable and the model had appropriate validity. The findings of this research confirmed the existence of a positive and significance relationship between different modes of technological learning, innovation and commercial performance of nanotechnology companies. Also, the experience-based learning mode has a greater impact on the innovation and business performance of these companies than the science-based learning mode, and external drivers have a greater impact on the technological learning modes of nanotechnology companies than internal drivers.

Chronic restraint stress induces cognitive abnormalities through changes in synapses and oxidant levels in the amygdala and hippocampus. Given the neuroprotective effects of fruit of Terminalia chebula (Halileh) in different experimental models, the present investigation aimed to address whether Terminalia chebula is able to reduce chronic restraint stress-induced behavioral, synaptic and oxidant markers in the rat model. Thirty-two male Wistar rats were randomly divided into four groups as follows: control (did not receive any treatment and were not exposed to stress), stress (restraint stress for 2 h a day for 14 consecutive days), Terminalia chebula (received 200 mg/kg hydroalcoholic extract of Terminalia chebula), and stress + Terminalia chebula groups (received 200 mg/kg extract of Terminalia chebula twenty minutes before stress) (n = 8 in each group). We used the shuttle box test to assess learning and memory, Golgi-Cox staining to examine dendritic spine density in the dentate gyrus region of the hippocampus and the basolateral and central nuclei of the amygdala, and total antioxidant capacity (TAC) and total oxidant status (TOS) in the brain. The shuttle box test results demonstrated that Terminalia chebula treatment had a profound positive effect on memory parameters, including step-through latency (STL) and time spent in the dark room, when compared to the stress group. Daily oral treatment with Terminalia chebula effectively suppressed the loss of neural spine density in the dentate gyrus region of the hippocampus and the basolateral and central nuclei of the amygdala caused by chronic restraint stress, as demonstrated by Golgi-Cox staining. Additionally, the results indicate that Terminalia chebula significantly reduced the TOS and increased TAC in the brain compared to the stress group. In conclusion, our results suggest that Terminalia chebula improved memory impairment and synaptic loss in the dentate gyrus of the hippocampus and the basolateral and central nuclei of the amygdala induced by restraint stress via inhibiting oxidative damage.

Background Identifying the challenges of implementing clinical practice guidelines (CPGs) can provide valuable information for decision-makers and health policymakers at the national and local levels. The implementation of CPGs requires the development of strategies to facilitate their use. This research aimed to determine the challenges, barriers and solutions for implementing CPGs from the expert point of view in Bushehr University of Medical Sciences.Methods This qualitative research uses content analysis conducted in 2022 in southern Iran. In-depth interviews were conducted with the physicians and experts in the health system. Interviewing continued until reaching the saturation level. Altogether, 22 experts were interviewed. The interview guide was used to explore experts’ opinions. All the interviews were recorded and then transcribed. Finally, coding and data analysis was done using MAXQDA 2022 software.Results The analysis revealed 4 main themes and 20 subthemes. The four main themes included challenges related to physicians, medical education, the health system and patients. The most common themes were the lack of sufficient training (related to the medical education system), equipment and infrastructure, and the lack of adaptation of clinical guidelines (related to the health system). The solutions included 4 main themes and 19 subthemes.Conclusion The most mentioned topic by the experts was training CPGs in medical schools. In Iran’s current medical education system, the training of CPGs is not included in the curriculum. It is proposed to reform the medical education system in Iran. In addition, health inequalities such as lack of access to equipment, supplies and insurance in under-resourced areas and disparities in research/training/medical education should be addressed to improve the validity of guidelines.

Background: Sleep disorders are accompanied by increased anxiety and somatic pain. In addition, it has been observed that anxiety and pain have a boosting effect on each other, resulting in continued sleep disturbances. Amygdala's (CeA) central nucleus plays a crucial role in these processes. Cinnamaldehyde (Cinn) is an aromatic compound with anti-anxiety, antioxidant, and sleep-promoting properties. The present study uses sleep-deprived rats to examine the effects of an intra-CeA injection of Cinn on pain and anxiety. Methods: Sleep deprivation (SD) was induced using the platform technique. 35 male Wistar rats were divided into five groups. Anxiety state and nociception were evaluated among groups using formalin test (F.T.), open field test (OFT), and elevated plus maze (EPM). Anxiety tests (OFT and EPM) were conducted in all groups. The first group was undergone FT without induction of SD (SD−FT+). The second group received SD without FT(SD+FT−). The third group received both SD and FT(SD+FT+). The treatment and vehicle groups have undergone both SD and FT in addition to the respectively intra-CeA injection of Cinn (SD+FT+ Cinn) and Cinn vehicle (SD+FT+ VC). The recorded behaviors were analyzed between groups using IBM SPSS 24th version. Results: SD did not lead to any significant difference in nociceptive behaviors in FT between groups SD−FT+ and SD+FT+ (P ≥ 0.05). At the same time, there was a considerable discrepancy in rearing behaviors (P

Abstract Background This study aimed to evaluate the socio-demographic, clinical, and laboratory risk factors in hospitalized COVID-19 patients during the first 6 months of the SARS-CoV-2 epidemic. Method This retrospective hospital-based cross-sectional study included all laboratory-confirmed cases of the COVID-19 virus that were admitted to the Shohadaye-Khalije-Fars Hospital in Bushehr, Iran, from February 22, 2020 to September 21, 2020. The patients' records were reviewed during the hospitalization period. The global COVID-19 clinical platform, i.e., the World Health Organization Rapid Case Report Form was used as the data collection tool. We conducted the survival analysis using the Kaplan–Meier and the Stepwise Cox regression analyses. Results The analysis included 2108 confirmed cases of COVID-19 with a mean age of 47.81 years (SD 17.78); 56.8% men, 43.2% women and 6.3% (n = 133) deaths. After adjustment, it was found that factors associated with an increased risk of death consisted of chronic kidney disease, intensive care unit admission, cancer, and hemoptysis. The 7-day survival rate was 95.8%, which decreased to 95.1%, 94.0%, and 93.8% on days 14, 21, and 28 of hospitalization, respectively. Discussion and conclusion Older COVID-19 patients with manifestation of hemoptysis and a past medical history of chronic kidney disease and cancer, should be closely monitored to prevent disease deterioration and death, and also should be admitted to the intensive care unit.

Background: Since the high rate of inappropriate MRI prescription has a significant financial burden on the health system, the specialists’ opinion, as the people engaged in prescribing such orders, would help the policymakers to solve the problem more efficiently. The present study investigates specialists' opinions about the reasons behind the inappropriate prescription of MRI in 2021. Method and Materials: This study was exploratory-descriptive qualitative research. The interviews were semi-structured. They were all recorded. Then the interviews were coded and analyzed using MAXQD2022. Results: Sixteen specialists participated in the present study. The reasons for inappropriate prescription were classified into 3 subjects: physician-related, patient-related, and health system-related factors. The reason for the prescription part, the negative motivation of physicians, and the pressure of patients were focused on Developing and implementing indication-based guidelines by the insurance system and educating society presented as solutions Conclusion: It seems the reasons for the inappropriate prescription of MRI are not considering the indications, the patients' pressure and the doctors' motivation to visit more patients and spend less time on physical examination. Induced demand of physicians is another reason. Experts suggested community education, indication-based insurance coverage, and increased MRI costs. Developing appropriate national guidelines for prescribing MRI and monitoring its implementation by the insurance system can be one of the best approaches to preventing inappropriate prescribing of MRI.

Background and Aim: Nitric oxide is involved in response to stress-induced anxiety and depression in the dorsal hippocampus. In this study we investigated the effects of L-arginine and L-NAME in the dorsal hippocampus on anxiety, depression, and brain-derived neurotrophic factor (BDNF) levels in stressed male NMRI mice. Materials and Methods: Electric foot-shock stress (10 Hz, 40 mV for 60 seconds) was applied to animals for four consecutive days. Three doses of L-arginine or L-NAME (1, 5 and 10 μg/mouse) were injected bilaterally into the dorsal hippocampus five minutes before starting foot-shock stress. Anxiety and depression-like behaviors and brain BDNF levels were measured 24 hours after stress using an elevated plus maze, forced swim test, and ELISA, respectively. Results: Injection of different doses of L-arginine and L-NAME before stress showed that the number of entries in the open arm decreased in elevated plus maze. The number of entries in the closed arm increased more in the stress group than that in the control group. Also, intra dorsal hippocampus injections of different doses of L-arginine and L-NAME before stress significantly decreased swimming time and increased floating and struggling time in the forced swim test compared to the control group. In addition, ELISA results showed that injections of different doses of L-arginine and L-NAME before stress had no significant effects on brain BDNF level. Conclusion: Nitric oxide in the dorsal hippocampus may mediate the induced anxiety and depression behaviors by foot-shock stress.

The function of hypothalamic-pituitary-adrenal (HPA) axis and psychosocial behaviors are affected in post-traumatic stress disorder (PTSD). Based on presence of several beneficial alkaloids in Papaver rhoeas (PR) plant, we assessed the effects of PR hydroalcoholic extract on blood corticosterone and psychosocial behaviors in the mice model of predator exposure-induced PTSD. Male NMARI mice were assigned into two main groups (control or PTSD) according to stress exposure (presence or absent of the predator). Each main group was divided into four subgroups according to treatment with the different doses of PR extract. Mice were treated intraperitoneally by PR extract at three different doses (1,5&10 mg/kg) 30 min before the beginning of test on days 1, 2&3. Corticosterone concentration determined in the blood samples on days 1, 3&21, and mice examined for the psychosocial behaviors on the third day. PTSD induction in mice by exposing to hungry predator increased blood corticosterone and changed the psychosocial and physiological behaviors. PR extract decreased blood corticosterone in PTSD mice on the third day as well as 21st day. Also, PR extract improved the psychosocial and physiological behaviors in PTSD mice. Moreover, PR extract increased blood corticosterone in control mice at a dose-response manner. PR extract is able to decrease blood corticosterone in PTSD condition and probably prevent the HPA hyperactivity in PTSD mice when exposed to the stress stimuli. Accordingly, decreased blood corticosterone by PR extract might be involved in improvement of the physiological and psychosocial behaviors in PTSD mice.

Introduction: Living near high-voltage power lines and exposure to high-frequency electromagnetic fields (EMFs) is a potentially serious hazard to animal and human health. The present study was conducted to evaluate the effect of high-frequency EMFs from simulated high-voltage electric towers on cognitive, anatomical, and biological changes in the male macaque. Methods: In this study, two Rhesus macaque were recruited, one experimental and one control. The experimental subject was exposed to EMFs from 3 kV/m simulated electric towers with a specific protocol and the control subject was tested without irradiation (4h per day, for 30 days). All required tests were performed before and after the intervention on experimental and control monkeys. The anatomical alternation of the prefrontal area (PFA) was measured by MRI images. All tests were performed on irradiated and control animals before and after the intervention and the results were compared between irradiated and control animals. Results: The results of the present study indicated increased white blood cell counts after high-frequency EMFs irradiation. Also, the red blood cell counts showed a decreasing trend after irradiation. The plasma adrenaline level increased after irradiation. Besides, the blood glucose levels increased after irradiation. The PFA was different before and after the irradiation. Moreover, some behavioral disorders, such as fatigue, drowsiness, anorexia, and insomnia were observed after irradiation. Conclusion: The results of biological tests and MRI showed an elevated risk of immunodeficiency disorders, weakness, and behavioral disorders. People who live or work near high-voltage electric towers with high-frequency EMFs are warned.

Background: The use of advanced and expensive technologies requires financial, human and capital resources. Brain Magnetic Resonance Imaging (MRI) has high contrast sensitivity for visualizing differences among the tissues. Unnecessary diagnostic imaging imposes excessive cost on health systems. This study aimed to determine the appropriateness of brain MRI prescriptions in 2021. Methods: This cross-sectional study recruited 274 patients who referred to Bushehr teaching hospital. They had been prescribed MRI of the brain due to headache and dizziness. We used the data collection form developed in the previous study. The appropriateness of the brain MRI prescription was determined based on the appropriate indications during 2021. Results: About 61 % of the referrals were due to headache and 39 % were because of dizziness. Overall, MRI was evaluated as inappropriate for about 38 % of the patients. The appropriateness of prescriptions had a significant relationship with age, gender, education, job status, complaint, prescribing physician, and MRI applicant with P-value > 0.050. Conclusion: Findings revealed more than one-third of brain MRI services were not clinically appropriate. Due to the high cost of MRI, it is necessary to make prescriptions in accordance with indications to prevent unnecessary diagnostic procedures and to prevent induced demand. Health system policymakers and healthcare providers should develop clinical guidelines and implement them to reduce the costs of health systems.

Introduction: In the present study, the effects of prenatal stress on spatial learning and memory deficit and its relationship with hippocampal insulin resistance were examined in male and female offspring. Methods: Female NMRI mice were mated with males overnight, and the 0-day of pregnancy was detected (Gestational day 0-GD0). The pregnant mice were then randomly divided into stress and control groups. The stress group received stress from the GD0 to GD10. On post natal day 30 (PND30), the offspring were divided into 4 subgroups, namely: male-control, female-control, male-stress, and female-stress. Barnes maze method was used for spatial learning evaluation. Plasma cortisol and insulin levels were measured at the beginning of the experiments. At the end of the experiments, the animals’ brains were removed, and their hippocampus was extracted. The hippocampus was homogenized, and its insulin and insulin-receptor contents were evaluated. Results: The stressed animals needed more time for reaching to target hole. In addition, they spend more distance to find the target hole, which was more pronounced in the male offspring. Both plasma and hippocampal insulin content were reduced in the stressed groups. Moreover, the hippocampal insulin receptors protein was reduced in the stressed animals. There was a positive relationship between plasma and hippocampal content and memory deficit in the stressed groups. Conclusion: These results indicated that prenatal stress could induce spatial learning and memory deficit in offspring, which is associated with plasma and hippocampal insulin and receptor content reduction (hippocampal insulin resistance) in these animals.

Summary: Background: The COVID-19 pandemic highlighted gaps in health surveillance systems, disease prevention, and treatment globally. Among the many factors that might have led to these gaps is the issue of the financing of national health systems, especially in low-income and middle-income countries (LMICs), as well as a robust global system for pandemic preparedness. We aimed to provide a comparative assessment of global health spending at the onset of the pandemic; characterise the amount of development assistance for pandemic preparedness and response disbursed in the first 2 years of the COVID-19 pandemic; and examine expectations for future health spending and put into context the expected need for investment in pandemic preparedness. Methods: In this analysis of global health spending between 1990 and 2021, and prediction from 2021 to 2026, we estimated four sources of health spending: development assistance for health (DAH), government spending, out-of-pocket spending, and prepaid private spending across 204 countries and territories. We used the Organisation for Economic Co-operation and Development (OECD)'s Creditor Reporting System (CRS) and the WHO Global Health Expenditure Database (GHED) to estimate spending. We estimated development assistance for general health, COVID-19 response, and pandemic preparedness and response using a keyword search. Health spending estimates were combined with estimates of resources needed for pandemic prevention and preparedness to analyse future health spending patterns, relative to need. Findings: In 2019, at the onset of the COVID-19 pandemic, US$9·2 trillion (95% uncertainty interval [UI] 9·1–9·3) was spent on health worldwide. We found great disparities in the amount of resources devoted to health, with high-income countries spending $7·3 trillion (95% UI 7·2–7·4) in 2019; 293·7 times the $24·8 billion (95% UI 24·3–25·3) spent by low-income countries in 2019. That same year, $43·1 billion in development assistance was provided to maintain or improve health. The pandemic led to an unprecedented increase in development assistance targeted towards health; in 2020 and 2021, $1·8 billion in DAH contributions was provided towards pandemic preparedness in LMICs, and $37·8 billion was provided for the health-related COVID-19 response. Although the support for pandemic preparedness is 12·2% of the recommended target by the High-Level Independent Panel (HLIP), the support provided for the health-related COVID-19 response is 252·2% of the recommended target. Additionally, projected spending estimates suggest that between 2022 and 2026, governments in 17 (95% UI 11–21) of the 137 LMICs will observe an increase in national government health spending equivalent to an addition of 1% of GDP, as recommended by the HLIP. Interpretation: There was an unprecedented scale-up in DAH in 2020 and 2021. We have a unique opportunity at this time to sustain funding for crucial global health functions, including pandemic preparedness. However, historical patterns of underfunding of pandemic preparedness suggest that deliberate effort must be made to ensure funding is maintained. Funding: Bill & Melinda Gates Foundation.

Introduction: Evidence-based medicine is considered as a new and reliable approach which has new discussions on judgment to find the best evidence or qualitative evidence. This study was designed in Bushehr province for designing, implementing, and evaluating physician empowerment courses in evidence-based MRI prescriptions in the training hospitals of Bushehr University of Medical Sciences in 2021. Methods: The present study was an educational scholarship which was conducted in Bushehr province. This study was performed in two phases in accordance with Glassic criteria. A number of five workshops were designed and conducted by researchers using the ADDIE Model in systemic educational design. The course was designed through the review of texts and interviews with experts and in-depth group discussions (FGD) with the presence of seven experts. After that, this training course was evaluated and the end-of-course test was performed using the Kirkpatrick model. In order to evaluate the reaction of participants during the training course, a questionnaire was designed and its face validity and content validity were approved by experts. In addition, a four-choice test was designed based on the presented scientific content to evaluate the learning level of participants. A number of 40 questions were designed for five workshops. Descriptive statistics (frequency, mean) were used in SPSS22 for data analysis. Results: In terms of gender, 53.7 % were male and 46.3 % were female. In terms of age, 24.4 % were in the age group of 31-35 years. In terms of improving awareness, 34.1 % of participants were at a very good level after the empowerment course. Learning findings indicated that 85.7 % of participants in the final test received a passing score while 14.3 % failed. Conclusion: In general, the findings of the study indicated that holding an empowerment course for physicians in Bushehr improved their awareness and knowledge. In fact, such improvement in awareness and knowledge can reduce unnecessary prescriptions and treatment costs but improve the quality of services.

Background: Economic sanction is a United Nations' pressure tool on a target government and civilians for changing strategic decisions about violating international norms of behavior, but many authors argue that in several cases, sanctions do not work. A nonpolitical and noneconomic study about economic sanction outcomes is scarce. In this study, we reviewed the related official documents, translated the sanction process by neuroscience language, and tried to recognize the type of stress process related to different outcomes in the target countries. Methods: We do this job in three phases: phase one is related to the literal review, phase two focuses on definition analysis according to neuroscience approaches, and phase three comes on neuroscientific target analysis. Defining stress process related to different outcomes by neuroscience is mentioned in the discussion based on using of other papers' data. Results: Stress act of sanctions As: Act of aggression, Threat, Keeping enemy, Restriction, Pursuing, Blocking, Compression to force, and Loss of some things are means that how could sanctions affect civilians and run the process of social pressure in the target entities. Conclusion: We concluded that sanctions are always threatening political tools and their effectiveness completely depends on the politicians view to threat proximity and the type of response to stresses of sanctions.

Introduction: Today, humans live in a world surrounded by electromagnetic fields. Numerous studies have been conducted to discover the biological, physiological, and behavioral effects of electromagnetic fields on humans and animals. Given the biological similarities between monkeys and humans, The present research aimed to examine Visual Memory (VM), hormonal, genomic, and anatomic changes, in the male rhesus macaques exposed to an Extremely Low-Frequency Magnetic Field (ELF-MF). Methods: Four male rhesus macaques (Macaca mulatta) were used. For the behavioral tests, the animals should be fasting for 17 hours. For the tests such as visual memory, the animal’s cooperation was necessary. Using the radiation protocol, we exposed two monkeys to a 12-Hz electromagnetic field with a magnitude of 0.7 µT (electromagnetic radiation) four hours a day for a month. Before and after the exposure, a visual memory test was conducted using a coated device (visible reward) on a movable stand. Ten milliliters of blood was obtained from the femoral artery of each monkey, and half of it was used to examine cortisol serum levels using the MyBioSource kit (made in the USA). The other half of the blood was used to extract lymphocytes for assaying expressions of Glucocorticoid Receptor (GR) genes before and after radiation using the PCR method. Anatomic studies of the amygdala were carried out based on pre- and post-radiation Magnetic Resonance Imaging (MRI). Results: Research results indicated that visual memory in male primates increased significantly after exposure to the 12-Hz frequency. Hormonal analysis at the 12-Hz frequency showed a decrease in cortisol serum levels. However, visual memory and serum cortisol levels did not change considerably in male primates in the control group. There was no considerable amygdala volumetric difference after exposure to the 12-Hz frequency. The expression of the GR genes decreased in the 12-Hz group compared to the control group. Conclusion: In short, these results indicated that ELF might benefit memory enhancement because exposure to the 12-HZ ELF can enhance visual memory. This outcome may be due to a decrease in plasma cortisol and or expression of GR genes. Moreover, direct amygdala involvement in this regard cannot be recommended.

Abstract Background Policymaking in the pharmaceutical sector plays a pivotal role in achieving the health systems’ goals. Transparency in the pharmaceutical policy could increase confidence in decision-making processes. This study aims to assess transparency in the public pharmaceutical sector of Iran. Methods This qualitative study with a content analysis approach was conducted in 2017 using the World Health Organization tool to explore pharmaceutical transparency. The perceptions of the various stakeholders of the health system through semi-structured interviews with a maximum variation of stakeholders were obtained in eight functions, including registration, licensing, inspection, promotion, clinical trials, selection, procurement, and distribution of medicines. Results There are some problems in two main categories: (1) General problems, including lack of transparency, conflict of interest, centralization, and monopoly. (2) Ethical problems include illegal payments, gifts, bribes, conflicts of interest, hidden power, hoarding, relationship-oriented behavior, medicine trafficking, and counterfeit medicine. Suggested solutions include evidence-based decision-making, the use of transparent and accountable processes, standardization, needs assessment, declaring a conflict of interest, skilled human resources, and tracking prescription. Conclusion Despite the development of effective pharmaceutical policy in the health care system and government interventions for the control of the market, in some functions, reviewing the pharmaceutical policy is essential. Additionally, declaring a conflict of interest statement must be at the core of policy development to provide greater transparency.

Introduction: Computer games as an interactive media play a significant role in the cognitive and behavioral health of the players. Computer games have either positive or negative effects on cognitive indices among players. They also directly influence the lifestyle and quality of life of children, adolescents, and young adults. The present study aimed to evaluate the short-term effects of the brain teaser game on players. Methods: Among 45 male volunteers, 40 subjects with an average age of 20 years were recruited and divided into two groups: the experimental group and the control group. All required tests were conducted before and after the intervention (playing the game) on the experimental group. Also, the same tests were performed on the control group, in which the participants were not allowed to play the game. All participants completed a questionnaire comprised demographic characteristics and specific information regarding the game (e.g., game style and hours spent on playing the game). The saliva samples were collected to measure levels of cortisol and α-amylase. The salivary α-amylase (sAA) and cortisol levels were analyzed using the relevant ELISA kits. The cognitive tests were performed using PASAT software before and after the game to assess the perceptual-cognitive abilities of the players. The brain waveforms were acquired by a 14-channel Emotiv brain signal recording device before and after the game. Data analysis was conducted in R and MATLAB software. Results: PASAT test suggested that mental health and sustained attention were significantly improved after the intervention. In addition, the sAA and salivary cortisol levels were significantly higher before the intervention. The results of the brainwave analysis revealed that stress index and attention were significantly higher before the intervention. Conclusion: Findings of the present study suggest that brain teaser games positively influence the central nervous system and activate stress path, leading to changes in brain signals and subsequently improved cognitive elements, such as attention among players.

Objective: The coronavirus (COVID-19) pandemic negatively affects public mental health around the world. Individuals’ reactions to COVID-19 vary depending on their temperament, individual differences, and personality traits. Therefore, the current study is conducted to assess the association of demographical features, Persian temperament, and psychological characteristics with the severity of COVID-19. Method: An online survey was sent to COVID-19 patients to collect their demographic information, COVID-19 symptoms, and clinical data. The Depression, Anxiety and Stress Scale (DAAS-21) questionnaire, Beck Depression Inventory (BDI-II), Spiel Berger State-Trait Anxiety Inventory (STAI) , Pittsburgh Sleep Quality Inventory (PSQI), and Persian general and brain temperament Questionnaire were also completed by 258 participants (127 men and 131 women) 45 days after recovery from COVID-19. Non-parametric analysis was used for statistical analysis. Results: Results showed the significant relationship of demographic factors such as weight, age and gender with the severity of the COVID-19 (P < 0.05). Mean scores of brain temperament (warm/cold) in the severe group were significantly lower than the moderate and mild groups (P < 0.05). There was a significant increase in the dry/wet temperament of the brain in the severe and moderate groups compared to the mild group (P < 0.05). The results of DASS-21 showed a significantly higher anxiety in patients with severe COVID-19 compared with moderate and mild groups (P < 0.05). The severe group was found to be significantly different compared to moderate group in the results of BDI-II (P < 0.05). The result of STAI (state and trait) showed a significant difference between the severe group and the mild and moderate groups. The score of PSQI between the moderate and mild groups was significant (P < 0.05). Conclusion: These results indicate the relationship between demographic factors such as weight, age and gender, brain temperament, as well as some psychological factors such as sleep quality and anxiety with the severity of the COVID-19 disease.

Abstract Background Inappropriate prescriptions can lead to adverse consequences for patients. It also imposes excessive cost on the patients, payers and health systems. The current study aimed at estimating the rate of inappropriate brain Magnetic Resonance Imaging (MRI) prescriptions and their financial burden in Iran. Methods Using systematic stratified sampling method, this cross-sectional study recruited 385 participants from three public teaching hospitals in Shiraz, Iran. Demographic information, questions related to brain MRI prescription and its indications checklist were collected using study-specific data collection tools. The completed indications checklist was compared to the appropriateness status table of indications and scenarios to detect the percent of the appropriateness of prescriptions. Results About 21 percentage of total brain MRI prescriptions are inappropriate. Previous treatment, number of referrals to physician, having other diagnostic tests and the applicant of MRI (P

LetRbe a Noetherian ring andMbe a finitely generatedR-module. Let I(M) be the first nonzero Fitting ideal ofM. The main result of this paper asserts that when I(M) = Qis a regular maximal ideal ofR, thenM≅R∕Q⊕P, for some projectiveR-modulePof constant rank if and only ifT(M)⊈QM. As a consequence, it is shown that ifMis an ArtinianR-module and I(M) = Qis a regular maximal ideal ofR, thenM≅R∕Q. [ABSTRACT FROM AUTHOR]

Background: Outsourcing as an effective strategy in public management has attracted policy-makers. Awareness of quantity and quality of implementing this strategy can help policy-makers and managers to remove barriers to this policy. This study aimed to investigate outsourced services and the applied models in Bushehr University of Medical Sciences. Materials and Methods: This descriptive cross-sectional study was carried out in Bushehr University of Medical Sciences in 2019 in four separate steps of literature review, shortlisting outsourceable services, data quality assurance and categorization of outsourced services into clinical and non-clinical services. Finally, the collected data were entered into Excel® version 8 to calculate and report descriptive indicators. Results: Result showed that totally 24 types of services have been outsourced. Half of them were clinical and the other haf were non-clinical. Among the outsourcing models, service purchasing model and management outsourcing model were the most and the least applied models, respectively. Conclusion: Although various outsourcing models are available, the type and the number of outsourced services are still limited. Given the diversity of services in health sector especially clinical services, it is possible to use the capacity of outsourcing strategy more effectively.

Seawater desalination is one of the prominent solutions to cope with the water crisis. Suppling demanded energy and high investment and operation costs have been the most critical challenges facing the sustainable development of these plants. Previous studies have shown that renewable resources can be used as an alternative for sustainable desalination. Wind energy is a renewable resource with good potential, especially in coastal areas with a severe water crisis. In previous studies of wind-powered desalination units, typical values have been used for turbines, and also, the desalination unit’s capacity is considered equal to the peak water demand. In this paper, a new optimization model for wind-powered desalination is presented wherein the optimal number of turbines will be defined based on the technical specifications of different commercially available turbine types. Also, simultaneous selection of several different turbines is modeled and optimized. The proposed mathematical model is implemented on a test case to evaluate its effectiveness. The simulation results show the proposed model’s functionality to obtain optimal results while considering available commercial turbine types. The study demonstrates a 2.38 to 35.28 reduction in the net planning cost resulting from multiple turbine technology selections and optimization concerning the various single turbine installation cases.

In attempt to determine the amount of hydrocarbon generated from Sargelu Formation, the outcrop and bore hole samples were used. The areal distribution, density, and weight of Sargelu Formation were determined by using traditional methods and using geographic information system. The amount of hydrocarbon generated was determined to be 3.4199 x 1012 kg.

Background: Low back pain (LBP) is currently the most common musculoskeletal disorder and a major cause of disability. A remarkable percentage of diagnostic imaging prescriptions are not necessary, therefore, this study aimed to determine the necessity of lumbar MRI prescriptions in Bushehr teaching hospitals in 2018. Materials and Methods: This cross-sectional descriptive-analytical study recruited a sample size of 273 individuals from a population of all patients presenting to Bushehr teaching hospitals for low back pain and undergoing lumbar MRI. Data were collected using a questionnaire with demographic questions and prescription-related questions. SPSS 24 software was used for data analysis. Results: Of the 273 patients studied, 54% were female and 46% male. The mean age of patients was 43 years and 72% of all patients were between 21 and 50 years old. MRI was deemed unnecessary for approximately 44% of patients. Furthermore, MRI results were reported absolutely normal in 30% of the patients. Conclusion: It can be concluded that many MRI services provided are not clinically necessary, and given the high hospital costs, especially for MRI, it is necessary to use valid indications to prevent ordering unnecessary tests, and imposed requests. Such indications will reduce the costs incurrd to healthcare system and patients.

Introduction: The present study investigated the role of the Basolateral Amygdala (BLA) N-methyl-D-aspartate (NMDA) receptors in stress-induced spatial memory disturbance among the male Wistar rats. Methods: The male Wistar rats (Average weight =200 g) were cannulated bilaterally in the BLA, and entered the study (n=6-8) after one week. They received seven electro–foot-shock stress sessions on seven consecutive days. Memantine (0.1, 1, and 5 µg/rat) or saline (0.5 µL/rat) was injected into the BLA, five minutes before each stress session. The control groups received the same doses of memantine and no stress. After the end of the stress sessions, blood samples were taken from all animals to evaluate their plasma corticosterone. Also, the spatial learning and memory of the study animals were evaluated using the Barnes maze method. The animals experienced five consecutive days of training on the maze for spatial learning. On the sixth day, their spatial memory was evaluated on the maze. Time, distance, the number of errors, and the taking strategy for reaching the target hole were considered as the parameters for the spatial learning and memory evaluation. Results: Stress increases the plasma corticosterone level, while memantine preadministration reduces the stress effects. Besides, stress increases the time and distance to the target hole and the number of errors. Stress changed the animals’ strategy from serial to random type. However, the intra-BLA memantine reversed all the disturbances induced by the stress. Conclusion: This study indicated that the BLA glutamate NMDA receptors modulate the effect of stress on spatial learning and memory deficit.

Background: Many prevalent disorders were observed in and around the knee joint. Magnetic resonance imaging (MRI) was a modern and costly diagnostic technology that was progressively applied worldwide. This study was conducted in the Bushehr educational hospitals in 2018 with the purpose of determining the necessity of knee MRI prescriptions. Methods: This paper was a kind of cross-sectional descriptive-analytical study. The statistical population of the study was all patients who were prescribed knee MRI due to the appearance of knee problems and referred to the MRI Center of Bushehr University of Medical Sciences in 2018. The sampling method was convenient sampling. The sample in this study included 274 patients. The indications and data collection form of Vojdani et al.'s study were used to specify the necessity of the mentioned prescriptions. In this study, SPSS 22 software was applied to analyze data. Also, the Chi-Square test was used to for analyzing the data. Results: Among the total studied population in this study, MRI prescription was evaluated inappropriately for approximately 24 % of patients. In this study, the appropriateness of the prescriptions had a significant relationship with age, job, education level, physician prescribing, and requesting MRI (P-value < 0.05). Conclusion: It could be deduced that about a quarter of MRI was not appropriate to clinical prescription. Regarding the high cost of hospital and the necessity of their reduction, induced demand would be prevented by using valid indications. Therefore, reducing unnecessary prescriptions yielded to fewer costs of the health system and patients.

Introduction: This research investigated the effects of violent and football video games on cognitive functions, cortisol levels, and brain waves. Methods: A total of 64 participants competed in a single-elimination tournament. Saliva samples of all players were obtained before and after the games for the assessment of cortisol levels. The cognitive performances of the players were also assessed by paced auditory serial addition test. Moreover, the electroencephalogram recording was conducted during the games. Results: The results showed that salivary cortisol levels significantly decreased after playing both games. Also, playing the football game increased reaction time, whereas decreased sustained attention and mental fatigue. Conclusion: Conversely, following playing a violent game, the reaction time decreased, and sustained attention and mental fatigue increased. Furthermore, the results of the EEG recording revealed that playing a violent game engaged more brain regions than the football game. In conclusion, playing violent game more effectively improved cognitive performances in the players than the football game.