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Background & Aims: Cardiovascular diseases are among the most important causes of death worldwide. The present study aimed to evaluate the trend of changes in the death rate due to cardiovascular diseases, with an emphasis on short- and long-term effective variables. Materials & Methods: In this descriptive-analytical (time series) study, all deaths due to cardiovascular diseases registered in the health registration system of death cases by the Health Vice-Chancellor of Urmia University of Medical Sciences from 2018 to 2021 were analyzed. A total of 27,146 cases of death due to cardiovascular causes were recorded and included in our study. SPSS, Minitab, and SAS software were utilized for data analysis. Results: The rate of death due to cardiovascular causes in this study was 30.51% during the investigated period. The univariate time series model (ARMA 1, 2) was deemed the most suitable fit model for cardiovascular death data. Also, age and education were identified as effective factors in the rate of cardiovascular deaths. Conclusion: The trend of cardiovascular deaths has not been rising. It has increased with age and lower education levels over time. This rate has been further exacerbated during the COVID-19 pandemic.

Background & Aims: Islam, as one of the world's major religions, places great importance on human health and well-being and provides rich concepts related to nutrition and health. The main objective of this article was to examine the relationship between health and well-being and nutrition in Islamic teachings and to elucidate the role of Islam in promoting healthy eating. Materials & Methods: This study was applied in terms of its purpose, descriptive in terms of data collection method, and qualitative in terms of data nature. Based on this, first, religious teachings related to health, well-being, and their relationship with nutrition were identified and extracted through qualitative content analysis. Then, the extracted religious teachings were analyzed through grounded theory until a contextual pattern was found and theoretical saturation was reached. This analysis was carried out through three coding processes: open coding, axial coding, and selective coding. Results: A total of 456 open codes were extracted, excluding overlaps. In the next step, 117 common codes were obtained based on overlaps and similarities, and ultimately, 26 themes were identified. Conclusion: In general, it can be said that nutrition in Islam is a comprehensive and multidimensional concept that, in accordance with the teachings of the Quran and traditions, can contribute to the promotion of human health and well-being. This study can be a useful and credible source for researchers, officials, educators, and the general public.

Introduction: Hodgkin lymphoma (HL) is one of the pediatric and adult cancers, with the treatment of chemotherapy alone or combined with radiotherapy. Objectives: We aimed to evaluate the consequences and outcomes of the treatment with or without radiotherapy in a retrospective study. Patients and Methods: We carried out a cross-sectional retrospective study by referring and reviewing records for all patients admitted to Motahari hospital with HL diagnosis from 1995 to 2016. The Ann Arbor staging system classified the staging of disease. Results: Totally, 35 patients enrolled in our study that 54.3% were female, and 45.7% were male patients. The mean age of patients was 10.08±6.38 years. 10 (28.6%) cases classified in stage 1, 13 (37.1%) case in stage 2, 9 (25.7%) cases in stage 3, and 3 (8.6%) cases in stage 4. 30 patients (85.7%) were treated by chemotherapy and 5 (14.3%) patients with chemotherapy and radiation combination. In our study, the overall survival was 97.1% of patients treated with chemotherapy alone, and one patient died due to drug side effects. That is comparable with other studies that treated patients with chemotherapy and radiotherapy. Conclusion: According to our findings, chemotherapy without radiotherapy as initial treatment in HL would have similar results to concomitant radiotherapy and chemotherapy, so considering the cost and harms of radiotherapy, we suggest a limitation of radiotherapy to patients with resistant diseases that do not respond to chemotherapy solo-protocols.

Abstract Demyelination and failure of remyelination in the central nervous system (CNS) characterize a number of neurological disorders. Spontaneous remyelination in demyelinating diseases is limited, as oligodendrocyte precursor cells (OPCs), which are often present in demyelinated lesions in abundance, mostly fail to differentiate into oligodendrocytes, the myelinating cells in the CNS. In addition to OPCs, the lesions are assembled numbers of activated resident microglia/infiltrated macrophages; however, the mechanisms and potential role of interactions between the microglia/macrophages and OPCs are poorly understood. Here, we generated a transcriptional profile of exosomes from activated microglia, and found that miR-615-5p was elevated. miR-615-5p bound to 3′UTR of myelin regulator factor (MYRF), a crucial myelination transcription factor expressed in oligodendrocyte lineage cells. Mechanistically, exosomes from activated microglia transferred miR-615-5p to OPCs, which directly bound to MYRF and inhibited OPC maturation. Furthermore, an effect of AAV expressing miR-615-5p sponge in microglia was tested in experimental autoimmune encephalomyelitis (EAE) and cuprizone (CPZ)-induced demyelination model, the classical mouse models of multiple sclerosis. miR-615-5p sponge effectively alleviated disease progression and promoted remyelination. This study identifies miR-615-5p/MYRF as a new target for the therapy of demyelinating diseases.

Background & Aims: Atopic dermatitis (AD) has a detrimental impact on the quality of life (QoL) for both patients and their families. Our investigation delved into the correlation between the severity of the disease and the QoL experienced by individuals with AD. Materials & Methods: This cross-sectional descriptive-analytical study included AD children, between 0 to 16 years of age, along with their parents. The influence of childhood AD on parents' QoL was studied using several questionnaires, which measures four areas of physical health, mental health, social relations, and environmental health. Results: Of 100 AD children, 52% were boys and 48% were girls with a mean age of 5.96 ± 4.72 years. Ninety percent of children had moderate AD. The mean score of QoL for children aged 5-16 years (CDQOL questionnaire) was 17.51, and for children aged 0-4 years (IDQOL questionnaire) was 15.80. The mean score of parents' QoL, according to the FDLQI questionnaire, was 13.90, and according to the DFI questionnaire, it was 6.39. The mean scores of health and QoL in four areas of physical health, mental health, social relations, and environmental health were 20.79, 17.75, 9.72, and 25.9, respectively. There was a significant correlation between disease severity and scores obtained from CDQOL and IDQOL questionnaires (p < 0.001). Conclusion: Childhood AD had a greater impact on QoL of parents in the areas of social relationships and psychological well-being. The influence of AD on the QoL of family members is significant, and this should be taken into account in the therapeutic process.

Abstract Background Polycystic ovary syndrome (PCOS) is the most common endocrine disorder in women. This disorder affects 6–15% of women of childbearing age worldwide. It is diagnosed with hyperandrogenism, polycystic ovaries, and chronic anovulation with insulin resistance. This study aimed to assess the prevalence of insulin resistance (IR) in 4 phenotypes of PCOS, and its relationship with demographic, clinical, and paraclinical individual characteristics in a sample of Iranian PCOS patients. Methods This particular cross-sectional investigation involved 160 female participants, aged between 18 and 45 years, who were receiving care at gynecology clinics in Urmia, northwestern Iran. All the participants had been diagnosed with PCOS and were categorized into one of four phenotypes. All the participants underwent clinical evaluations, paraclinical assessments, and ultrasound scans. IR was defined as HOMA-IR > 2.5. The statistical significance level was 0.05. Results Among the 160 participants, the prevalences of the 4 phenotypes were: A: 83 (51.9%), B: 37 (23.1%), C: 21 (13.1%), and D: 19 (11.9%). IR was detected in 119 participants (74.4%); its rate was significantly different between the 4 phenotypes (p-value: 0.008) as A: 62 (74.7%), B: 34 (91.9%), C: 12 (57.1%), D: 11 (57.9%). Linear and logistic regression analyses were performed to control confounding factors. In linear regression, PCOS phenotype, classic phenotype (A&B), economic status, and Hb levels were significantly related to HOMA-IR; in logistic regression Hb levels, exercise, economic status, and PCOS phenotypes were significantly associated with insulin resistance. Conclusions The most prevalent PCOS phenotype in this study was A. PCOS phenotypes were significantly related to insulin resistance and HOMA-IR, with the highest levels of insulin resistance and HOMA-IR observed in phenotype B. Determining the phenotype of PCOS may be helpful for better management of PCOS and its associated complications. However, further investigations are recommended in this regard.

Abstract Background Retirement is a challenge that, as a process, influences the individual’s role, status, life patterns, expectations, and available resources. Therefore, the present study aims at determining the predictors of retirement satisfaction among men in the city of Urmia. Methods In this descriptive-analytical study, 140 retired men living in Urmia were selected by multi-stage sampling method. The instruments used are the Retirement Satisfaction Scale, life satisfaction, and quality of life questionnaires. Data were analyzed in SPSS v.21 using descriptive statistics, one-way ANOVA, and regression at a significance level of p ≤ 0.05. Results Based on the results of this study, the mean score of retirement satisfaction was 115.37 + 10.13 and there was no significant difference (p = .068) in retirement satisfaction of the retired men based on level of education. Also, the retrospective multiple linear regression model indicated that 44.4% of the variance of retirement satisfaction score is predicted by two subscales of life satisfaction and quality of life. Conclusion According to the results, it seems that life satisfaction and quality of life are inseparable, effective factors in retirement satisfaction, so, to promote retirement satisfaction in all of its scales and subscales, it is recommended to improve these two factors.

Abstract Gold nanoparticles (GNPs) are materials that make the tumor cells more radiosensitive when irradiated with ionizing radiation. The present study aimed to evaluate the impact of different physical interaction models on the dose calculations and radiochemical results around the GNP. By applying the Geant4 Monte Carlo (MC) toolkit, a single 50-nm GNP was simulated, which was immersed in a water phantom and irradiated with 5, 50, and 150 MeV proton beams. The present work assessed various parameters including the secondary electron spectra, secondary photon spectra, radial dose distribution (RDD), dose enhancement factor (DEF), and radiochemical yields around the GNP. The results with an acceptable statistical uncertainty of less than 1% indicated that low-energy electrons deriving from the ionization process formed a significant part of the total number of secondary particles generated in the presence of GNP; the Penelope model produced a larger number of these electrons by a factor of about 30%. Discrepancies of the secondary electron spectrum between Livermore and Penelope were more obvious at energies of less than 1 keV and reached the factor of about 30% at energies between 250 eV and 1 keV. The RDDs for Livermore and Penelope models were very similar with small variations within the first 6 nm from NP surface by a factor of 10%. In addition, neither the G-value nor the REF was affected by the choice of physical interaction models with the same energy cut-off. This work illustrated the similarity of the Livermore and Penelope models (within 15%) available in Geant4 for future simulation studies of GNP enhanced proton therapy with physical, physicochemical, and chemical mechanisms.

Astrocytes are highly heterogeneous in their phenotype and function, which contributes to CNS disease, repair, and aging; however, the molecular mechanism of their functional states remains largely unknown. Here, we show that activation of sirtuin 1 (SIRT1), a protein deacetylase, played an important role in the detrimental actions of reactive astrocytes, whereas its inactivation conferred these cells with antiinflammatory functions that inhibited the production of proinflammatory mediators by myeloid cells and microglia and promoted the differentiation of oligodendrocyte progenitor cells. Mice with astrocyte-specific Sirt1 knockout (Sirt1–/–) had suppressed progression of experimental autoimmune encephalomyelitis (EAE), an animal model of CNS inflammatory demyelinating disease. Ongoing EAE was also suppressed when Sirt1 expression in astrocytes was diminished by a CRISPR/Cas vector, resulting in reduced demyelination, decreased numbers of T cells, and an increased rate of IL-10–producing macrophages and microglia in the CNS, whereas the peripheral immune response remained unaffected. Mechanistically, Sirt1–/– astrocytes expressed a range of nuclear factor erythroid–derived 2–like 2 (Nfe2l2) target genes, and Nfe2l2 deficiency shifted the beneficial action of Sirt1–/– astrocytes to a detrimental one. These findings identify an approach for switching the functional state of reactive astrocytes that will facilitate the development of astrocyte-targeting therapies for inflammatory neurodegenerative diseases such as multiple sclerosis.

Abstract Introduction Nurses are the largest group of health‐care providers and their clinical decisions have an essential role in patients' clinical condition. Evidence‐based nursing has been proposed as a health‐care method based on the latest findings and evidence. Therefore, we aimed to determine the effect of evidence‐based nursing education on dialysis nurses' clinical decision‐making. Material and Methods This single‐blind experimental study conducted in 2021 at dialysis wards of teaching hospitals affiliated to Urmia University of Medical Sciences. In this study, a total of 60 dialysis nurses were recruited using convenience sampling and allocated to two groups of intervention (n = 30) and control (n = 30). Data were collected at three time points of before, 1 week after, and 1 month after the intervention using a demographic questionnaire and the Lauri and Salantera Clinical Decision‐Making Questionnaire (LSCD‐MQ). Nurses in the intervention group received 12 sessions of evidence‐based nursing education, while nurses in the control group received no intervention. Results The results showed the mean score of clinical decision‐making had a significant decreasing trend over time (p

Inducible conditional knockout mice are important tools for studying gene function and disease therapy, but their generation is costly and time-consuming. We introduced clustered regularly interspaced short palindromic repeats (CRISPR) and Cre into an LSL-Cas9 transgene-carrying mouse line by using adeno-associated virus (AAV)-PHP.eB to rapidly knockout gene(s) specifically in central nervous system (CNS) cells of adult mice. NeuN in neurons and GFAP in astrocytes were knocked out 2 weeks after an intravenous injection of vector, with an efficiency comparable to that of inducible Cre-loxP conditional knockout. For functional testing, we generated astrocyte-specific Act1 knockout mice, which exhibited a phenotype similar to mice with Cre-loxP-mediated Act1 knockout, in an animal model of multiple sclerosis (MS), an autoimmune disorder of the CNS. With this novel technique, neural cell-specific knockout can be induced rapidly (few weeks) and cost-effectively. Our study provides a new approach to building inducible conditional knockout mice, which would greatly facilitate research on CNS biology and disease.

GM-CSF-producing T helper (Th) cells play a crucial role in the pathogenesis of autoimmune diseases such as multiple sclerosis (MS). Recent studies have identified a distinct population of GM-CSF-producing Th cells, named ThGM cells, that also express cytokines TNF, IL-2, and IL-3, but lack expression of master transcription factors (TF) and signature cytokines of commonly recognized Th cell lineages. ThGM cells are highly encephalitogenic in a mouse model of MS, experimental autoimmune encephalomyelitis (EAE). Similar to Th17 cells, in response to IL-12, ThGM cells upregulate expression of T-bet and IFN-γ and switch their phenotype to Th1. Here we show that in addition to T-bet, TF RUNX3 also contributes to the Th1 switch of ThGM cells. T-bet-deficient ThGM cells in the CNS of mice with EAE had low expression of RUNX3, and knockdown of RUNX3 expression in ThGM cells abrogated the Th1-inducing effect of IL-12. Comparison of ThGM and Th1 cell transcriptomes showed that ThGM cells expressed a set of TFs known to inhibit the development of other Th lineages. Lack of expression of lineage-specific cytokines and TFs by ThGM cells, together with expression of TFs that inhibit the development of other Th lineages, suggests that ThGM cells are a non-polarized subset of Th cells with lineage characteristics.

Objective: Secondhand smoke (SHS) during pregnancy is associated with many maternal-fetal complications. Iran has a high male smoking prevalence rate. This study aimed to determine the effect of motivational interviewing with couples on exposure to SHS at home in pregnant women referring to health centers in Urmia in 2019. Materials and methods: A randomized control trial was performed on 112 non-smoking pregnant women with smoking husbands, randomly allocated into two groups (each with 56 members). The participants were asked to specify the daily average times and duration of exposure during the last week. Five motivational interviewing sessions were held for the members of the intervention group. Each session lasted90 minutes and two sessions were held per week. The data were collected before and four weeks after the intervention. The data were analyzed using the repeated-measures analysis of variance (ANOVA) by SPSS-20 at a significance level of 0.05. Results: Of 112 couples who were randomized, 102 (91.07%) completed the trial. There was a significant reduction in terms of the daily frequency and duration of SHS exposure of the husband one week and one month after the intervention in the intervention group. The daily frequency and duration of SHS exposure of people other than the spouse at home did not decrease over time. Conclusion: Following the results of the study, the couple-based motivational interviewing approach can be used to reduce SHS exposure in women at home.

Background: Chemotherapy drugs may have numerous side effects for patients. Thus, this study was conducted with the aim to determine the effect of peer education on the management of chemotherapy side effects in patients with cancer. Materials and Methods: This randomized, controlled trial was conducted on 80 patients with cancer in 2018. They were allocated to two groups of intervention and control. The self-care education on chemotherapy side effects was provided by the peers to the individuals in the intervention group. The data collection tools included a demographic characteristics form and the Self-Care Diary (SCD). Data analysis was performed using independent t-test and Chi-square test in SPSS software. Results: The results showed that the mean scores of the effectiveness of self-care behaviors were significantly higher in the intervention group compared to the control group after the intervention (p < 0.05). Conclusions: Peer education is recommended for cancer patients undergoing chemotherapy.

Coagulopathy is a frequently reported finding in the pathology of coronavirus disease 2019 (COVID-19); however, the molecular mechanism, the involved coagulation factors, and the role of regulatory proteins in homeostasis are not fully investigated. We explored the dynamic changes of nine coagulation tests in patients and controls to propose a molecular mechanism for COVID-19-associated coagulopathy. Coagulation tests including prothrombin time (PT), partial thromboplastin time (PTT), fibrinogen (FIB), lupus anticoagulant (LAC), proteins C and S, antithrombin III (ATIII), D-dimer, and fibrin degradation products (FDPs) were performed on plasma collected from 105 individuals (35 critical patients, 35 severe patients, and 35 healthy controls). There was a statically significant difference when the results of the critical (CRT) and/or severe (SVR) group for the following tests were compared to the control (CRL) group: PTCRT (15.014) and PTSVR (13.846) (PTCRL = 13.383, p

IFN-β has been the treatment for multiple sclerosis (MS) for almost three decades, but understanding the mechanisms underlying its beneficial effects remains incomplete. We have shown that MS patients have increased numbers of GM-CSF+ Th cells in circulation, and that IFN-β therapy reduces their numbers. GM-CSF expression by myelin-specific Th cells is essential for the development of experimental autoimmune encephalomyelitis (EAE), an animal model of MS. These findings suggested that IFN-β therapy may function via suppression of GM-CSF production by Th cells. In the current study, we elucidated a feedback loop between monocytes and Th cells that amplifies autoimmune neuroinflammation, and found that IFN-β therapy ameliorates central nervous system (CNS) autoimmunity by inhibiting this proinflammatory loop. IFN-β suppressed GM-CSF production in Th cells indirectly by acting on monocytes, and IFN-β signaling in monocytes was required for EAE suppression. IFN-β increased IL-10 expression by monocytes, and IL-10 was required for the suppressive effects of IFN-β. IFN-β treatment suppressed IL-1β expression by monocytes in the CNS of mice with EAE. GM-CSF from Th cells induced IL-1β production by monocytes, and, in a positive feedback loop, IL-1β augmented GM-CSF production by Th cells. In addition to GM-CSF, TNF and FASL expression by Th cells was also necessary for IL-1β production by monocyte. IFN-β inhibited GM-CSF, TNF, and FASL expression by Th cells to suppress IL-1β secretion by monocytes. Overall, our study describes a positive feedback loop involving several Th cell- and monocyte-derived molecules, and IFN-β actions on monocytes disrupting this proinflammatory loop.

Antigen (Ag)-specific tolerance induction by intravenous (i. v.) injection of high-dose auto-Ags has been explored for therapy of autoimmune diseases, including multiple sclerosis (MS). It is thought that the advantage of such Ag-specific therapy over non-specific immunomodulatory treatments would be selective suppression of a pathogenic immune response without impairing systemic immunity, thus avoiding adverse effects of immunosuppression. Auto-Ag i.v. tolerance induction has been extensively studied in experimental autoimmune encephalomyelitis (EAE), an animal model of MS, and limited clinical trials demonstrated that it is safe and beneficial to a subset of MS patients. Nonetheless, the mechanisms of i.v. tolerance induction are incompletely understood, hampering the development of better approaches and their clinical application. Here, we describe a pathway whereby auto-Ag i.v. injected into mice with ongoing clinical EAE induces interferon-gamma (IFN-γ) secretion by auto-Ag-specific CD4+ T cells, triggering interleukin (IL)-27 production by conventional dendritic cells type 1 (cDC1). IL-27 then, via signal transducer and activator of transcription 3 activation, induces programmed death ligand 1 (PD-L1) expression by monocyte-derived dendritic cells (moDCs) in the central nervous system of mice with EAE. PD-L1 interaction with programmed cell death protein 1 on pathogenic CD4+ T cells leads to their apoptosis/anergy, resulting in disease amelioration. These findings identify a key role of the IFN-γ/IL-27/PD-L1 axis, involving T cells/cDC1/moDCs in the induction of i.v. tolerance.

Context: The hydroalcoholic extract of Dorema aucheri Bilhar (Umbelliferae) (DA) leaves, a medicinal plant, has powerful antioxidant properties. Objective: This study evaluates the neuroprotective effects of pre-treatment with DA leaves extract against cerebral ischaemia-induced brain injury through alteration of the antioxidant capacity. Materials and methods: The study was conducted in three groups of Wistar rats (N = 47) as follows; sham, control ischaemic and pre-treated ischaemic groups. Rats were administered a fresh hydroalcoholic extract of DA leaves at a dosage of 200 mg/kg/day for 14 days. Then, the middle cerebral artery (MCA) of the right hemisphere was occluded for 90 min to achieve cerebral ischaemia. After 24 h reperfusion, cerebral infarction and superoxide dismutase (SOD) and catalase activities, as well as malondialdehyde (MDA), glutathione, and NOx contents were determined in the right hemispheres. Results: Occlusion of the right MCA caused noticeable cerebral infarction (298 ± 21 mm3) in control ischaemic group, but pre-treatment with DA extract considerably attenuated it (92 ± 14 mm3) in the pre-treated ischaemic group. DA extract significantly decreased the levels of MDA by 28% and NOx by 11% in pre-treated ischaemic group compared to the control ischaemic group. DA extract also enhanced glutathione content by 7%, SOD activity by 16% and catalase activity by 46% in pre-treated ischaemic rats compared to control ischaemic rats. Discussion and conclusions: DA is able to improve the antioxidant capacity and injuries of ischaemic brain. It is proposed as a neuroprotectant following cerebral ischaemia to decrease the injuries of ischaemic stroke.

There is growing appreciation for astrocyte heterogeneity both across and within central nervous system (CNS) regions, as well as between intact and diseased states. Recent work identified multiple astrocyte subpopulations in mature brain. Interestingly, one subpopulation (Population C) was shown to possess significantly enhanced synaptogenic properties in vitro, as compared with other astrocyte subpopulations of adult cortex and spinal cord. Following spinal cord injury (SCI), damaged neurons lose synaptic connections with neuronal partners, resulting in persistent functional loss. We determined whether SCI induces an enhanced synaptomodulatory astrocyte phenotype by shifting toward a greater proportion of Population C cells and/or increasing expression of relevant synapse formation-associated genes within one or more astrocyte subpopulations. Using flow cytometry and RNAscope in situ hybridization, we found that astrocyte subpopulation distribution in the spinal cord did not change to a selectively synaptogenic phenotype following mouse cervical hemisection-type SCI. We also found that spinal cord astrocytes expressed synapse formation-associated genes to a similar degree across subpopulations, as well as in an unchanged manner between uninjured and SCI conditions. Finally, we confirmed these astrocyte subpopulations are also present in the human spinal cord in a similar distribution as mouse, suggesting possible conservation of spinal cord astrocyte heterogeneity across species.

Objective(s): The beneficial outcomes of bone marrow-derived mesenchymal stem cell (BMSC) treatment on functional recovery following stroke has been well established. Furthermore, 5-hydroxy-3-methylglutaryl-coenzyme A (HMG-CoA) reductase inhibitors have also been shown to increase neuronal survival and promote the movement of BMSCs towards the sites of inflammation. However, the precise mechanisms mediating the improved neurological functional recovery in stoke models following a combination treatment of Simvastatin and BMSCs still remained poorly understood. Materials and Methods: Here, an embolic stroke model was used to experimentally induce a focal ischemic brain injury by inserting a preformed clot into the middle cerebral artery (MCA). Following stroke, animals were treated either with an intraperitoneal injection of Simvastatin, an intravenous injection of 3 ×106 BMSCs, or a combination of these two treatments.Results: Seven days after ischemia, the combination of Simvastatin and BMSCs led to a significant increase in BMSC relocation, endogenous neurogenesis, arteriogenesis and astrocyte activation while also reducing neuronal damage when compared to BMSC treatment alone (PConclusion: These results further demonstrate the synergistic benefits of a combination treatment and help to improve our understanding of the underlying mechanisms mediating this beneficial effect.

Abstract: Mood disorder is one of the complications of stroke. The inability to cope with stress is also a prognosis of depression and anxiety. The aim of this study is to assess the response of stress system in the post stroke patients. Twelve healthy controls (HC) and twelve post-stroke patients after filling in the State-Trait Anxiety Inventory completed the Trier Social Stress Test (TSST) which induces acute stress. Salivary samples were collected to determine salivary cortisol levels and ECG record were taken in four times (before, right after stress, after two recoveries: 20 and 40 minutes after stress). ECG was also recorded during TSST and then the linear and non-linear features of Heart Rate Variability (HRV) were analyzed. The results showed that trait anxiety score and baseline salivary cortisol level were higher in post stroke than HC group (P-value

Background: A child with a language impairment in the absence of significant sensory, psychiatric, neurological, or intellectual disorders should be diagnosed as having a specific language impairment (SLI). Data regarding the prevalence of SLI are rare and vary widely. A number of studies have been conducted in order to determine the prevalence of SLI in different populations. However, the prevalence of child language disorders in an Iranian population is unknown due to the limited epidemiologic studies in the field. In addition, many studies have found that children with SLI are at risk for social, behavioral, emotional, and educational difficulties. Objectives: The aim of this study was to estimate the prevalence of specific language impairment in 6-year-old Persian-speaking children. Patients and Methods: This research was an epidemiological study conducted over a three-month period in the summer of 2015 in Shiraz. The sample size was 180 children aged 6 years that included 95 boys and 85 girls who were recruited from 10 preschool centers in 9 urban areas in Shiraz using stratified sampling. The EpiSLI system was used to diagnose SLI. The Persian version of the test of language development (TOLD-P: 3) was employed to evaluate the children’s oral language skills. A number of descriptive statistics was employed, such as rates, mean, and standard deviation. In addition, the Chi-square test was used to analyze the correlation between the prevalence of SLI with sex and area at a significance level of 0.05. Results: This study estimated the prevalence of SLI in 6-year-old Persian-speaking children to be 2.7%. In addition, the estimated prevalence rates of SLI in boys and girls were 2% and 3.5%, respectively. Also, there was no significant correlation between the estimated prevalence of SLI with sex and area (P > 0.05). Conclusions: According to the findings of this study, 2.7% of the 6-year-old Persian-speaking children living in urban areas of Shiraz and enrolling at preschool centers have a specific language impairment. Therefore, it is important to employ a screening system to identify these preschool children in order to prevent subsequent problems in school-aged children.

Background & Objective: Paraoxon (POX) as one of the most toxic organophosphorus pesticides, is widely used in agriculture, which can reduce the antioxidant capacity of the cell. The aim of this study was to investigate the effect of N-acetyl cysteine (NAC) as an antioxidant against POX-induced oxidative stress in rat liver and kidney. Material & Methods: In the present experimental study, male Wistar rats were randomly divided into four groups; control (corn oil as POX solvent), POX (0.7 mg/kg), NAC (160 mg/kg), and NAC+POX. 24 hours after the intraperitoneal injection, animals were anesthetized and the liver and kidney tissues were quickly removed. Followed by the tissues hemogenation, superoxide dismutase (SOD), catalase (CAT), glutathione S-transferase (GST) and lactate dehydrogenase (LDH) activities, as well as glutathione (GSH) and malondialdehyde (MDA) levels were determined by the biochemical methods. The data were statistically analyzed using the analysis of variance (ANOVA) followed by the post hoc analysis using Tukey test. Results: POX increased SOD, CAT and GST activities and decreased GSH content in rat liver and kidney as compared to control. In addition, the increased MDA level and decreased LDH activity were observed in the liver. The administration of NAC inhibited changing of these parameters. Conclusion: The administration of NAC as antioxidant, ameliorates POX-induced oxidative stress in rat liver and kidney by scavenging the free radicals and GSH synthesis, but does not provide the complete protection.

Background: Although it is usually recommended that children begin care after their second or third year, some employed parents have to enroll their children in childcare from under the age of 6 months in Iran. Regardless of when children enter care parents and experts are concern about how childcare affects children’s language, social and intellectual development. The aim of this study was to assess the language development in the 6-15 month-old Persian-speaking children enrolled in center-based care. Methods: This was a descriptive, cross-sectional study. The sample size comprised of 13 Persian-speaking 6-15 month-old children who were recruited through consecutive sampling from the Namazi childcare center in Shiraz, Iran. The child’s development was assessed by using two assessment tools including the Ages and Stages Questionnaire and the Rossetti Infant-Toddler Language Scale. Descriptive statistics were employed in order to presentation of the findings. Results: Overlay, the results showed that all children could successfully achieve the nonverbal and verbal communication and interaction behaviors. Conclusion: Based on the findings, the quality of childcare centers and the quality of parents-child interaction may be two crucial factors in children’s language development. Also, the Rossetti Infant-Toddler Language Scale is a useful assessment tool for Persian-speaking children.

Background: Specific Language Impairment (SLI) is one of the most common developmental problems resulting in referral to speech therapy clinics in the preschool years. A number of studies have been conducted to determine the prevalence of SLI in different populations. However, the prevalence of childhood language disorders in Iranian population is unknown because of the limited epidemiologic studies in the field. The aim of this study was therefore, to estimate the prevalence of SLI in 5-year-old Persian-speaking children. Methods: This research was an epidemiological study which conducted in a three-month period in the spring of 2015 in Shiraz. The sample size was 180 children aged 5 years old including 95 boys and 85 girls whom recruited from 12 preschool centers of 9 urban areas in Shiraz by stratified sampling. The EpiSLI system was used to diagnose SLI. The Persian version of Test of language Development (TOLD-P: 3) was employed to evaluate the children’s oral language skills. A number of descriptive statistics were calculated. In addition, Chi-square test was used to analyze the correlation between the prevalence of SLI with sex and area. The significant level was set to 0.05. Results: The estimated prevalence of SLI in the population under study was estimated to be %3.3. In addition, the estimated prevalence of SLI in boys and girls was 4.2% and 2.4%, respectively. There were no significant correlation between the estimated prevalence of SLI with sex and area (P>0.05). Conclusion: According to the findings of this study, it is important to employ screening system to find preschool children with SLI to prevent subsequent problems.

Background: Auditory rehabilitation is one of the important tasks of speechlanguage pathologists. So, it is necessary to know auditory behaviors in order to make some decisions about the children with hearing loss such as determining the effectiveness of the current rehabilitation programs and/or devices. The Auditory Behavior in Everyday Life (ABEL) questionnaire is a valid and reliable assessment tool in English which is developed by Purdy et al. (1995). The aim of this study was to translate and adapt ABEL questionnaire for Persian language. Methods: The ABEL consists of three factors of auditory-oral, auditory awareness, and conversational/social skills. First, the questionnaire was translated and culturally adapted from English to Persian by an independent Iranian translator. The back translated version was compared with the original one in terms of the semantic/idiomatic equivalence. Then the questionnaire was completed two times by 43 mothers of 4-to-6 year old children with hearing loss who were using either hearing aids or cochlear implants. Finally, the results of the test-retest reliability were statistically compared in order to assess internal consistency. The statistical tests which were used include Cronbach’s Alpha, Spearman correlation, and Pearson correlation tests in significance level of 0.05. Results: There was a significant strength correlation among the items of the factor 1 (Alpha=0.94), factor 2 (Alpha=0.86), factor 3 (Alpha=0.82) and three factors (Alpha=0.96). There was a significant strength correlation at the 0.01 level between the scores of each factor in test-retest include auditory-oral (Spearman’s rho=0.94, P

Background and Objectives : Sulfur mustard (SM) is a lipophilic blistering agent that alkylates a wide range of cellular macromolecules including DNA, RNA and protein, leading to cell death in different tissues. In spite of numerous studies, the mechanism of action of SM is still unknown. The aim of this study was to investigate the effect of SM on antioxidant system enzymes in different tissues of rats. Methods: Male Wistar rats were randomly divided into seven groups as followed: Group 1 control that received DMSO (dimethyl sulfoxide used as solvent), group 2-7 as experimental groups that received SM (1-80mg/kg) by intraperitoneal injection only once. 24 hours after injection, animals were anesthetized and kidney, lung and heart tissues were quickly removed. Blood was also collected by cardiac puncture, plasma and erythrocytes were obtained. Then, the enzyme activities of superoxide dismutase (SOD), catalase (CAT), glutathione peroxidase (GPx), glutathione reductase (GR) and glutathione S-transferase (GST) in different tissues were determined by biochemical methods. The data were analyzed using one way variance analysis followed by post hoc analysis using Tukey test. The significance level was considered as p

Peripheral tolerance to autoantigens is induced via suppression of self-reactive lymphocytes, stimulation of tolerogenic dendritic cells (DCs) and regulatory T (Treg) cells. Interleukin (IL)-27 induces tolerogenic DCs and Treg cells; however, it is not known whether IL-27 is important for tolerance induction. We immunized wild-type (WT) and IL-27 receptor (WSX-1) knockout mice with MOG35–55 for induction of experimental autoimmune encephalomyelitis and intravenously (i.v.) injected them with MOG35–55 after onset of disease to induce i.v. tolerance. i.v. administration of MOG35–55 reduced disease severity in WT mice, but was ineffective in Wsx−/− mice. IL-27 signaling in DCs was important for tolerance induction, whereas its signaling in T cells was not. Further mechanistic studies showed that IL-27-dependent tolerance relied on cooperation of distinct subsets of spleen DCs with the ability to induce T cell-derived IL-10 and IFN-γ. Overall, our data show that IL-27 is a key cytokine in antigen-induced peripheral tolerance and may provide basis for improvement of antigen-specific tolerance approaches in multiple sclerosis and other autoimmune diseases.

Introduction: To evaluate students critical thinking skills effectively, change in assessment practices is must. The assessment of a student’s ability to think critically is a constant challenge, and yet there is considerable debate on the best assessment method. There is evidence that the intrinsic nature of open and closed-ended response questions is to measure separate cognitive abilities. Aim: To assess critical thinking ability of medical students by using multi-response format of assessment. Materials and Methods: A cross-sectional study was conducted on a group of 159 undergraduate third-year medical students. All the participants completed the California Critical Thinking Skills Test (CCTST) consisting of 34 multiple-choice questions to measure general critical thinking skills and a researcherdeveloped test that combines open and closed-ended questions. A researcher-developed 48-question exam, consisting of 8 shortanswers and 5 essay questions, 19 Multiple-Choice Questions (MCQ), and 16 True-False (TF) questions, was used to measure critical thinking skills. Correlation analyses were performed using Pearson's coefficient to explore the association between the total scores of tests and subtests. Results: One hundred and fifty-nine students participated in this study. The sample comprised 81 females (51%) and 78 males (49%) with an age range of 20±2.8 years (mean 21.2 years). The response rate was 64.1%. A significant positive correlation was found between types of questions and critical thinking scores, of which the correlations of MCQ (r=0.82) and essay questions (r=0.77) were strongest. The significant positive correlations between multi-response format test and CCTST’s subscales were seen in analysis, evaluation, inference and inductive reasoning. Unlike CCTST subscales, multi-response format test have weak correlation with CCTST total score (r=0.45, p=0.06). Conclusion: This study highlights the importance of considering multi-response format test in the assessment of critical thinking abilities of medical students by using both open and closedended response questions.

Background and Objectives. Cardiovascular diseases are the leading cause of death worldwide, with coronary artery disease being the most common. With increasing numbers of patients, Coronary Artery Bypass Grafting (CABG) has become the most common operation in the world. Respiratory disorder is one of the most prevalent complications of CABG. Thus, weaning off the mechanical ventilation and extubation are of great clinical importance for these patients. Some post-operative problems also relate to the tracheal tube and mechanical ventilation. Therefore, an increase in this leads to an increase in the number of complications, length of hospital stay, and treatment costs. Since a large number of factors affect the post-operative period, the present study aims to identify the predictors of extubation time in CABG patients using casualty network analysis.Method. This longitudinal study was conducted on 800 over 18 year old patients who had undergone CABG surgery in three treatment centers affiliated to Shiraz University of Medical Sciences. The patients’ information, including pre-operative, peri-operative, and post-operative variables, was retrospectively extracted from their medical records. Then, the data was comprehensively analyzed through path analysis using MPLUS-7.1 software.Results. The mean of extubation time was 10.27 + 4.39 h. Moreover, extubation time was significantly affected by packed cells during the Cardiopulmonary Bypass (CPB), packed cells after CPB, inotrope use on arrival at ICU, mean arterial pressure 1st ICU, packed cells 1st ICU, platelets 1st ICU, Blood Urea Nitrogen 1st ICU, and hematocrit 1st ICU.Conclusion. Considering all of the factors under investigation, some peri-operative and post-operative factors had significant effects. Therefore, considering the post-operative factors is important for designing a treatment plan and evaluating patients’ prognosis.

The present study aimed to explore some risk factors affected the mean of the number of tuberculosis (TB) in West Azerbaijan Province, Iran between 2001 and 2010.Our time series study analyzed the data of 2,560 TB patients as registered with TB Patients Care System in West Azerbaijan Province from early 2001 to 2010. A checklist was prepared for collecting the data and they were then analyzed in SPSS V.16 software.The percentage of male and percentage of female were close to each other (52.2% against 47.8%, respectively). A significant increasing trend of TB rate was found over the years of 2001and 2010 with a pick at 2008 (P