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Purpose: Despite the importance of patient satisfaction (PS) on healthcare outcomes, the factors that influence PS in radiation oncology remain unexplored. This study assesses the influence of socioeconomic status (SES) on PS in radiation oncology, using the Area Deprivation Index (ADI) as a measure of SES. Methods: This single-institution cross-sectional study used the National Research Council (NRC) PS survey at four radiation oncology sites from 2021 to 2023. SES was measured using ADI data from the Neighborhood Atlas. Univariate (UVA) and multivariable (MVA) logistic regression analyses were conducted on recommendation scores (0–10 scale, with 9 or higher indicating a likelihood to recommend). Results: In our analysis of 7,501 survey responses, most patients were female (55.3 %), had curative treatment intent (81.5 %), and were diagnosed with breast cancer (30.4 %), with most being follow-up visits (69.0 %). Average scores for state and national ADI were 3.94 and 50.75, respectively. UVA identified factors such as curative intent (OR 1.68, p

The purpose of this research is to identify the main components and dimensions of digital content marketing according to the conditions of Iran and to present a model using a qualitative method based on the Grounded Theory approach. Data were collected through semi-structured in-depth interviews with experts. These experts included university professors in the field of digital content marketing and managers and activists of advertising and digital marketing agencies. Using targeted sampling and after conducting 15 in-depth interviews, theoretical saturation was achieved after the implementation and analysis of interviews and open, axial, and selective coding. The results showed that digital content marketing is realized by these conditions. Causal conditions (Internet development, ease of use, popularity of cyberspace, ease of communication with customers, virtual network features, The appeal of Digital Content Marketing, changing customer behavior, changing current structures), contextual conditions (personal characteristics, social characteristics), intervening factors (technical limitations, increasing competitors, lack of access, unawareness, severity of the spread of Covid-19), central category (Digital Content Marketing), strategies (make it enjoyable, increasing participation, providing various services to users, using various methods to increasing audience, exchange of information, infrastructure improvement, audience-friendly style, customer orientation), and consequences (market expansion, increasing profitability, groundwork for brand creation). The results indicate that the research model is acceptable level. IntroductionThe emergence of digital networks and the wide spread of technology dramatically changed human life compared to the latest technological tools of the previous decades (Torkestani et al, 2020), so that nowadays customers have significantly changed their behavior in line with the technology and economic environment of the world (Rostami et al, 2022). Modern advertising is more cost-effective and inexpensive than traditional advertising (Abdulle, 2022). Therefore, to attract customers, trust must be gained first, and customers should feel satisfied with our brand before purchasing a product or service. These features can be found in digital content marketing (Mozaffari et al, 2023). Inflation and the prevailing economic recession have created difficult conditions for individuals and businesses (Naseri, 2017). To overcome these difficult conditions, a native model must be explained in the field of digital content marketing.Research Question (s)The main research question is as follows: What is the conceptual model for digital content marketing? What are the main components and dimensions of this model? Literature ReviewTorkestani et al. (2022) discussed the possibility of personalizing content for each audience, the emotions hidden in the content and the date of publication of the content, the way the author is a member and his identity in the online community. Tahmasebpour et al. (2022) considered digital marketing elements to include six components: technical features of digital tools, relative advantage, cost to customers, management of items and processes, promotion, service quality, and information quality. Rostami et al. (2022) also prioritized the factors affecting marketing in digital businesses in their research and did not provide a model that included all aspects of this issue. (Naseri, 2017) also only looked at content features in four categories, content inherent elements, form elements, content distribution media elements and effectiveness measurement elements. (Naseri, 2017) examined only the characteristics of the content in four categories; intrinsic content elements, form elements, content distribution media elements, and effectiveness measurement elements. (Lou & Xie, 2020) also emphasized in their research on shaping brand experience and customer loyalty of. Boban et al. (2020) only investigated the relationship between content entertainment and informational social influence and between self-expression and normative social influence and electronic word-of-mouth communication. Furr. (2019) considered digital content marketing as a branding tool for colleges and universities. Taiminen & Ranaweera, (2019) focused on support, engagement, and interaction in brand communication and perceptions. MethodologyIn terms of purpose, this research is fundamental and applied, and in terms of nature, it is in the category of qualitative research. In terms of approach, the Grounded Theory and paradigm model of Strauss and Corbin have been used as a research plan, which is based on the identification of causal conditions, contextual conditions, central category, intervening conditions, strategies and consequences, and describing the relationships between them. A semi-structured in-depth interview was conducted with 15 experts who were selected in a non-probable and purposeful manner. Sampling was performed until theoretical saturation using the snowball method. The research community includes digital experts (academic and non-academic). This group includes university professors in the field of digital content marketing, as well as activists and specialists in the field of digital content production (institutions and agencies of digital marketing and advertising). They have at least five years of scientific, research, and executive experience in DCM and at least a master's degree or doctorate in the fields of marketing management, information technology management, and other related fields. In the analysis of the data obtained from the interviews, after the full implementation of the text of the interviews, MaxQuda 2020 was used. Immediately after each interview, the interview text was extracted and typed, entered into the software, and open, axial, and selective coding procedures were performed. ResultsThe information obtained from the interviews resulted in the extraction of 135 concepts (open coding), which were placed in the form of 26 subcategories (axial coding) and 5 main categories (selective coding), as follows: Internet development, ease of use, popularity of cyberspace, ease of communication with customers, virtual network features, the appeal of Digital Content Marketing, changing customer behavior, changing current structures, technical limitations, increasing competitors, lack of access, unawareness, severity of the spread of Covid-19, personal characteristics, social characteristics, make it enjoyable, increasing participation, providing various services to users, using various methods for increasing the audience, exchange of information, infrastructure improvement, audience-friendly style, customer orientation, market expansion, increasing profitability, groundwork for brand creation.The paradigm model is presented in figure 1.Figure.1. Paradigm model of the research ConclusionThis article aims to design a digital content marketing model. Making it enjoyable in this research includes gamification in social networks, visualizing content according to people's tastes, using humorous content, and entertaining content. The obtained results showed that making it enjoyable is an effective strategy for digital content marketing. In this research, the following were discovered to increase participation in digital content: using celebrities, participating in online campaigns, holding contests, and building trust and commitment in customers. The results also show that increasing participation is an important strategy in digital content marketing. The services that can be paid in the production of digital content to attract the audience are as follows: offering discounts, bonuses to users, free training, and support. The obtained results also show that providing diverse services to users is an influential factor in digital content marketing strategies. Various methods of increasing the audience in this research include: providing outstanding and strange information, producing educational content, producing therapeutic content, producing sports content, using new ideas to produce content, producing fresh and new content, teaching new methods of producing content, increasing quality, extensive advertising, social network viral marketing, and content creation based on frequent words. The results show that the use of methods to increase the audience is the most effective strategy. Information exchange includes modeling external pages, modeling successful pages, participation in online campaigns, and content exchange. The obtained results show that information exchange has a significant impact on digital content marketing strategies. Improving the infrastructure in the field of digital content includes increasing the speed of the Internet, website design, and the production of powerful internal applications, which the results show is one of the most important strategies. Audience-friendly style also includes creating differentiation, special and unique style, being up-to-date; using one of the special effects is the mastery of body language. The results show that an audience-friendly style is one of the most effective strategies in digital content marketing. Customer orientation also includes content production based on society's problems, compliance with professional ethics, monitoring customer needs, finding customers' tastes, and honesty in content production. The obtained results show that customer orientation is an important strategy in digital content marketing.Keywords: Digital Content Marketing, Online Marketing, Brand Awareness, Grounded Theory. The purpose of this research is to identify the main components and dimensions of digital content marketing according to the conditions of Iran and to present a model using a qualitative method based on the Grounded Theory approach. Data were collected through semi-structured in-depth interviews with experts. These experts included university professors in the field of digital content marketing and managers and activists of advertising and digital marketing agencies. Using targeted sampling and after conducting 15 in-depth interviews, theoretical saturation was achieved after the implementation and analysis of interviews and open, axial, and selective coding. The results showed that digital content marketing is realized by these conditions. Causal conditions (Internet development, ease of use, popularity of cyberspace, ease of communication with customers, virtual network features, The appeal of Digital Content Marketing, changing customer behavior, changing current structures), contextual conditions (personal characteristics, social characteristics), intervening factors (technical limitations, increasing competitors, lack of access, unawareness, severity of the spread of Covid-19), central category (Digital Content Marketing), strategies (make it enjoyable, increasing participation, providing various services to users, using various methods to increasing audience, exchange of information, infrastructure improvement, audience-friendly style, customer orientation), and consequences (market expansion, increasing profitability, groundwork for brand creation). The results indicate that the research model is acceptable level. IntroductionThe emergence of digital networks and the wide spread of technology dramatically changed human life compared to the latest technological tools of the previous decades (Torkestani et al, 2020), so that nowadays customers have significantly changed their behavior in line with the technology and economic environment of the world (Rostami et al, 2022). Modern advertising is more cost-effective and inexpensive than traditional advertising (Abdulle, 2022). Therefore, to attract customers, trust must be gained first, and customers should feel satisfied with our brand before purchasing a product or service. These features can be found in digital content marketing (Mozaffari et al, 2023). Inflation and the prevailing economic recession have created difficult conditions for individuals and businesses (Naseri, 2017). To overcome these difficult conditions, a native model must be explained in the field of digital content marketing.Research Question (s)The main research question is as follows: What is the conceptual model for digital content marketing? What are the main components and dimensions of this model? Literature ReviewTorkestani et al. (2022) discussed the possibility of personalizing content for each audience, the emotions hidden in the content and the date of publication of the content, the way the author is a member and his identity in the online community. Tahmasebpour et al. (2022) considered digital marketing elements to include six components: technical features of digital tools, relative advantage, cost to customers, management of items and processes, promotion, service quality, and information quality. Rostami et al. (2022) also prioritized the factors affecting marketing in digital businesses in their research and did not provide a model that included all aspects of this issue. (Naseri, 2017) also only looked at content features in four categories, content inherent elements, form elements, content distribution media elements and effectiveness measurement elements. (Naseri, 2017) examined only the characteristics of the content in four categories; intrinsic content elements, form elements, content distribution media elements, and effectiveness measurement elements. (Lou & Xie, 2020) also emphasized in their research on shaping brand experience and customer loyalty of. Boban et al. (2020) only investigated the relationship between content entertainment and informational social influence and between self-expression and normative social influence and electronic word-of-mouth communication. Furr. (2019) considered digital content marketing as a branding tool for colleges and universities. Taiminen & Ranaweera, (2019) focused on support, engagement, and interaction in brand communication and perceptions. MethodologyIn terms of purpose, this research is fundamental and applied, and in terms of nature, it is in the category of qualitative research. In terms of approach, the Grounded Theory and paradigm model of Strauss and Corbin have been used as a research plan, which is based on the identification of causal conditions, contextual conditions, central category, intervening conditions, strategies and consequences, and describing the relationships between them. A semi-structured in-depth interview was conducted with 15 experts who were selected in a non-probable and purposeful manner. Sampling was performed until theoretical saturation using the snowball method. The research community includes digital experts (academic and non-academic). This group includes university professors in the field of digital content marketing, as well as activists and specialists in the field of digital content production (institutions and agencies of digital marketing and advertising). They have at least five years of scientific, research, and executive experience in DCM and at least a master's degree or doctorate in the fields of marketing management, information technology management, and other related fields. In the analysis of the data obtained from the interviews, after the full implementation of the text of the interviews, MaxQuda 2020 was used. Immediately after each interview, the interview text was extracted and typed, entered into the software, and open, axial, and selective coding procedures were performed. ResultsThe information obtained from the interviews resulted in the extraction of 135 concepts (open coding), which were placed in the form of 26 subcategories (axial coding) and 5 main categories (selective coding), as follows: Internet development, ease of use, popularity of cyberspace, ease of communication with customers, virtual network features, the appeal of Digital Content Marketing, changing customer behavior, changing current structures, technical limitations, increasing competitors, lack of access, unawareness, severity of the spread of Covid-19, personal characteristics, social characteristics, make it enjoyable, increasing participation, providing various services to users, using various methods for increasing the audience, exchange of information, infrastructure improvement, audience-friendly style, customer orientation, market expansion, increasing profitability, groundwork for brand creation.The paradigm model is presented in figure 1.Figure.1. Paradigm model of the research ConclusionThis article aims to design a digital content marketing model. Making it enjoyable in this research includes gamification in social networks, visualizing content according to people's tastes, using humorous content, and entertaining content. The obtained results showed that making it enjoyable is an effective strategy for digital content marketing. In this research, the following were discovered to increase participation in digital content: using celebrities, participating in online campaigns, holding contests, and building trust and commitment in customers. The results also show that increasing participation is an important strategy in digital content marketing. The services that can be paid in the production of digital content to attract the audience are as follows: offering discounts, bonuses to users, free training, and support. The obtained results also show that providing diverse services to users is an influential factor in digital content marketing strategies. Various methods of increasing the audience in this research include: providing outstanding and strange information, producing educational content, producing therapeutic content, producing sports content, using new ideas to produce content, producing fresh and new content, teaching new methods of producing content, increasing quality, extensive advertising, social network viral marketing, and content creation based on frequent words. The results show that the use of methods to increase the audience is the most effective strategy. Information exchange includes modeling external pages, modeling successful pages, participation in online campaigns, and content exchange. The obtained results show that information exchange has a significant impact on digital content marketing strategies. Improving the infrastructure in the field of digital content includes increasing the speed of the Internet, website design, and the production of powerful internal applications, which the results show is one of the most important strategies. Audience-friendly style also includes creating differentiation, special and unique style, being up-to-date; using one of the special effects is the mastery of body language. The results show that an audience-friendly style is one of the most effective strategies in digital content marketing. Customer orientation also includes content production based on society's problems, compliance with professional ethics, monitoring customer needs, finding customers' tastes, and honesty in content production. The obtained results show that customer orientation is an important strategy in digital content marketing.

BackgroundMachine learning offers quantitative pattern recognition analysis of wearable device data and has the potential to detect illness onset and monitor influenza-like illness (ILI) in patients who are infected. ObjectiveThis study aims to evaluate the ability of machine-learning algorithms to distinguish between participants who are influenza positive and influenza negative in a cohort of symptomatic patients with ILI using wearable sensor (activity) data and self-reported symptom data during the latent and early symptomatic periods of ILI. MethodsThis prospective observational cohort study used the extreme gradient boosting (XGBoost) classifier to determine whether a participant was influenza positive or negative based on 3 models using symptom-only data, activity-only data, and combined symptom and activity data. Data were collected from the Home Testing of Respiratory Illness (HTRI) study and FluStudy2020, both conducted between December 2019 and October 2020. The model was developed using the FluStudy2020 data and tested on the HTRI data. Analyses included participants in these studies with an at-home influenza diagnostic test result. Fitbit (Google LLC) devices were used to measure participants’ steps, heart rate, and sleep parameters. Participants detailed their ILI symptoms, health care–seeking behaviors, and quality of life. Model performance was assessed by area under the curve (AUC), balanced accuracy, recall (sensitivity), specificity, precision (positive predictive value), negative predictive value, and weighted harmonic mean of precision and recall (F2) score. ResultsAn influenza diagnostic test result was available for 953 and 925 participants in HTRI and FluStudy2020, respectively, of whom 848 (89%) and 840 (90.8%) had activity data. For the training and validation sets, the highest performing model was trained on the combined symptom and activity data (training AUC=0.77; validation AUC=0.74) versus symptom-only (training AUC=0.73; validation AUC=0.72) and activity-only (training AUC=0.68; validation AUC=0.65) data. For the FluStudy2020 test set, the performance of the model trained on combined symptom and activity data was closely aligned with that of the symptom-only model (combined symptom and activity test AUC=0.74; symptom-only test AUC=0.74). These results were validated using independent HTRI data (combined symptom and activity evaluation AUC=0.75; symptom-only evaluation AUC=0.74). The top features guiding influenza detection were cough; mean resting heart rate during main sleep; fever; total minutes in bed for the combined model; and fever, cough, and sore throat for the symptom-only model. ConclusionsMachine-learning algorithms had moderate accuracy in detecting influenza, suggesting that previous findings from research-grade sensors tested in highly controlled experimental settings may not easily translate to scalable commercial-grade sensors. In the future, more advanced wearable sensors may improve their performance in the early detection and discrimination of viral respiratory infections.

ABSTRACT The availability of syndrome-based panels for various ailments has widened the scope of diagnostics in many clinical settings. These panels can detect a multitude of pathogens responsible for a particular condition, which can lead to a timely diagnosis and better treatment outcomes. In contrast to traditional identification methods based on pathogen growth on culture, syndrome-based panels offer a quicker diagnosis, which can be especially beneficial in situations requiring urgent care, such as intensive care units. One such panel is the Biofire Filmarray Pneumonia plus Panel (BFP), which we have compared against microbiological culture and identification. The lower respiratory samples from patients were tested with BFP, culture, and identification with culture considered the gold standard. The phenotypic antibiotic susceptibility results (Vitek 2) were compared with the antimicrobial resistance (AMR) genes detected in BFP. Statistical analysis was carried out using GraphPad 7.0 and MS Excel (Microsoft Inc.). The results showed a positive percent agreement of 100% and a negative percent agreement of 47.8% with an overall agreement of 76.72% compared to culture. BFP was better at identifying fastidious bacteria, and the agreement with culture was higher for high bacterial identification numbers (107 and 106). There was also a correlation between the number of pathogens detected and growth in culture. Carbapenemase genes were detected in around 80% of phenotypically resistant samples and correlated with in-house PCR 60% of the time. Hence, BFP results need to be interpreted with caution especially when multiple pathogens are detected. Similarly, the presence or absence of AMR genes should be used to guide the therapy while being watchful of unusual resistance or susceptibility. The cost constraints and low throughput call for patient selection criteria and prioritization in emergency or resource-limited conditions.IMPORTANCEApplication of syndrome-based panels in clinical microbiology is of huge support in infectious conditions requiring urgent interventions, such as pneumonia. Interpreting the results requires caution; hence, we have compared the results obtained from Biofire Filmarray Pneumonia plus Panel with standard microbiological methods.

Purpose: Hip fractures in elderly have a high mortality. However, there is limited literature on the excess mortality seen in hip fractures compared to the normal population. The purpose of this study was to compare the mortality of hip fractures with that of age and gender matched Indian population. Methods: There are 283 patients with hip fractures aged above 50 years admitted at single centre prospectively enrolled in this study. Patients were followed up for 1 year and the follow-up record was available for 279 patients. Mortality was assessed during the follow-up from chart review and/or by telephonic interview. One-year mortality of Indian population was obtained from public databases. Standardized mortality ratio (SMR) (observed mortality divided by expected mortality) was calculated. Kaplan-Meir analysis was used. Results: The overall 1-year mortality was 19.0% (53/279). Mortality increased with age (p

This study utilizes a semi-analytical approach to examine the nonlinear dynamic responses of multilayer functionally graded (MFG) cylindrical shells reinforced by FG spiral stiffeners (FGSSs), which may have symmetric or asymmetric angles, under a thermal condition. It is presumed that the temperature is distributed across the thickness direction. The shell includes three layers: an outer ceramic-rich layer, a middle FG layer, and an inner metal-rich layer. By applying classical shell theory (CST), the smeared stiffeners technique, von Kármán equations, and the Galerkin method, the problem of nonlinear vibrations (NVs) has been addressed. Furthermore, the method of multiple scales (MMSs) is applied to investigate the nonlinear vibrational characteristics of the MFG cylindrical shells reinforced by FGSS, particularly focusing on the 1:2:4 internal resonance and the subharmonic resonance of order 1/2. This study finds that FG spiral stiffeners with symmetric or asymmetric angles and ambient temperature significantly affect the vibrational properties of the MFG cylindrical shells reinforced by spiral stiffeners.

This study investigates and analyses empirically the impact of Foreign Direct Investment (FDI) inflows on the exports for a panel series of five large-scale manufacturing industries of Pakistan during the period 2000-2020. For this purpose, we establish export production function as based on endogenous growth theory in which role of FDI is considered as additional determinant of export. The Pedroni residual-based co-integration test and Error Correction Model (ECM) are applied for the long and short-run relationships. Pedroni residual based approach highlighted that human capitals, domestic capitals, foreign direct investments, exports, and domestic sales are co-integrated in the long run. According to results of ECM, coefficient of FDI appears to have statistical significant impact on exports and has a positive sign in the long run. Whereas, FDI does not contribute to export growth in the short run but it takes time to influence the growth patterns of the sector. On the basis of theoretical notion of endogenous growth theory, long-run coefficient of FDI may be interpreted as evidence in favour of the hypotheses that FDI has an impact on exports via export development. Thus, it can be concluded that “FDI-based endogenous growth theory” is valid in the case of Pakistan.

A 19-year-old man had an accidental fall from the 2nd floor and sustained multiple injuries. On radiological evaluation, the patient had symmetrical quadruple limb involvement with bilateral humerus shaft, bilateral olecranon, bilateral femur shaft, and bilateral patella fractures. The patient was actively managed using damage control orthopaedics, and a sequence of skeletal fixation was planned based on the hemodynamic stability and periodical serum lactate assessment. Symmetrical quadruple limb fractures are very rare, which could be associated with higher mortality. A meticulous clinical evaluation, periodical blood parameter assessment and strict adherence to the principles of damage control orthopaedics can be conducive to prevent life-endangering complications.

Summary: Lung cancer is the third most common cancer with Black/AA men showing higher risk and poorer outcomes than NHW men. Lung cancer disparities are multifactorial, driven by tobacco exposure, inequities in care access, upstream health determinants, and molecular determinants including biological and genetic factors. Elevated expressions of protein arginine methyltransferases (PRMTs) correlating with poorer prognosis have been observed in many cancers. Most importantly, our study shows that PRMT6 displays higher expression in lung cancer tissues of Black/AA men compared to NHW men. In this study, we investigated the underlying mechanism of PRMT6 and its cooperation with PRMT1 to form a heteromer as a driver of lung cancer. Disrupting PRMT1/PRMT6 heteromer by a competitive peptide reduced proliferation in non-small cell lung cancer cell lines and patient-derived organoids, therefore, giving rise to a more strategic approach in the treatment of Black/AA men with lung cancer and to eliminate cancer health disparities.

Purpose: Collecting data from users using conventional traditional methods, in order to achieve a specific purpose, is often expensive, time-consuming, and accompanied by disadvantages affecting the research results, the aim of the current research is to provide a model based on gamification in order to obtain the way of thinking of people through a case study of internet taxi applications in Iran (Snapp, Tapsi, and Carpino). Method: Research is applied in terms of aim and descriptive in terms of nature. Data collection was done by a researcher-made questionnaire, whose validity and reliability were confirmed based on expert opinion and Cronbach's alpha coefficient. The statistical population was all the users of the mentioned applications and members of Telegram, which was 180 people as a statistical sample. Findings: Comparing the results to determine the popularity of brands in the two methods was almost the same, in addition, the cost and time of using the proposed method was significantly less and the percentage of audience participation was higher. Conclusion: By presenting the proposed framework, the limitations of common data collection methods were removed and more accurate and higher quality data were used to understand people's thinking, it is also possible to use this method for all researchers.

Background: With the onset of the COVID-19 pandemic and the impossibility of face-to-face learning, universities sought alternative methods to continue education and adapt to the upcoming conditions. Although technology development and virtual education methods created many opportunities in dental education, these modern solutions were not free of problems.Objectives: The current study explored the challenges, opportunities, and future directions of dental education from the experience of dental students, faculty members, and the dean of Alborz Dental School during the COVID-19 pandemic.Methods: The current qualitative study was conducted in 2021 using the content analysis method and in-depth semi-structured interviews with faculty members and students of Alborz Dental School. Purposive sampling was implemented to collect data with maximum variability in the faculty and student groups. In addition, 19 semi-structured interviews were transcribed verbatim immediately after each interview. The results were analyzed using MAXQDA version 10 software through the content analysis method.Results: The results of data analysis in the evaluation of challenges and opportunities of dental education from the experience of dental students, faculty members, and the dean of Alborz Dental School during the COVID-19 pandemic detected three emerging categories: opportunities, challenges, and future direction with subcategories of e-learning, clinical training, infrastructures, and personal life.Conclusion: Despite creating new learning opportunities during the COVID-19 pandemic, faculty members and dental students faced many challenges. Therefore, identifying these challenges, taking advantage of opportunities, and using faculty members' and students' experiences and suggestions can improve the learning experience and quality of education during the post-pandemic era.

Orthopedic trauma is one of the commonest injuries necessitating surgical intervention in a trauma patient. The management protocols in such severely injured orthopedic patients have evolved from conservative treatment to 'early total care' (ETC) to 'damage control orthopedics' (DCO) and recently to 'early appropriate care' (EAC)/'safe definitive surgery' (SDS). 'DCO' involves emergent, basic minimum life- or limb-saving surgery with continued resuscitation and definitive fixation of fractures being done later, once the patient has been resuscitated and stabilized. An insight into the immunological processes at a molecular level evoked in a poly-traumatized patient led to the evolution of the 'two-hit theory;' 'first hit' being the injury itself while the 'second hit' caused by the surgical trauma. As the 'two-hit theory' gained popularity, it led to a delay of definitive surgery for 2–5 days following trauma, since a higher complication rate was observed following definitive surgery within the first 5 days of the injury. This is a review article on the historical perspectives of DCO, immunological mechanisms involved, and various injuries requiring damage control approach or EAC/ETC and their anesthetic management.

AbstractThis study aims to provide a model for aligning IT and business strategy in order to improve performance in the banking system.This research is based on empirical philosophy and has been done by deductive-inductive method. The present study is a fundamental research in terms of purpose and in terms of data collection method, is among the survey research. Quantitative and qualitative methods have been used in this research, so it is a mixed research. The statistical population of this article includes experienced professors and experts in the management of Bank Mellat. The snowball method was used for sampling. Finally, 11 qualified experts participated in this study. In this research, the meta-combined method has been used to identify the underlying categories of performance management. Also, using interpretive-structural modeling, an alignment model of IT and business strategy to improve banking performance has been presented.IntroductionStrategic alignment is at the heart of strategic management literature, because maintaining such balance with the organization's priorities increases the organization's ability to respond to environmental pressures. Many studies have been conducted on how to create alignment between organizational strategies and information technology, but no scientific research has been conducted specifically in relation to Iran's banking system.Case StudyIn recent years, performance management has been considered as a key activity and an essential factor in the success of the banking system.The present research is aimed at identifying and recognizing the effective factors in aligning the information technology and business strategies in order to improve performance in the Iranian banking system and specifically in Bank Mellat.Materials and MethodsA mixed method approach (which involves the mixing of both quantitative and qualitative research methods) is used in the present study. In the qualitative part of the study, the data was gathered through a meta-synthesis technique. After determining the categories using the meta-synthesis technique, a questionnaire was developed based on Interpretative Structural Modeling (ISM). The statistical population includes experts and experienced managers of Bank Mellat. 11 participants were chosen through applying the snowball sampling method.Discussion and ResultsThe categories and subcategories of the research were identified through coding the texts of the selected internal and external studies and articles and removing the synonymous and frequent items. As a result, the pattern of information technology and business strategies alignment in Iran's banking system was extracted, and then the structures of the desired pattern were tested in relation with the case study (Bank Mellat).The results indicate that the structures constituting the pattern of information technology and business strategies alignment used to improve the performance of the banking system of Iran are as follows:Business strategies, banking processes, information technology strategies, information technology infrastructures, quality of banking services, banking performanceConclusionIn this research, a pattern of information technology and business strategies alignment in line with the performance of Iran's banking system was extracted. The results indicated that information technology and banking business increase the quality of banking services through strategic alignment. Increasing the quality of banking services also leads to the improvement of banking performance.

Proton therapy with accelerator systems has been used in the last 30 years to destroy tumors by producing highly energetic ion beams. Although different systems have been introduced and designed to accelerate ions, the superconductive cyclotron accelerator is one of the most efficient treatment equipment compared to other systems. In this research, the design study of Iranian Medical Proton Superconducting Cyclotron (IMSIC-250) was considered. The IMSIC-250 system is a fixed frequency cyclotron with four spiral sector magnets designed to accelerate protons in the form of H2+ particles up to 250 MeV/amu. In the current study, the design process of the superconducting magnet and coil structure was reported. The 3D model of the spiral pole magnet alongside the superconducting coil was modeled. The main characteristics of the cyclotron magnet and coil structure were also studied. It was demonstrated that the designed magnet is capable of producing the desired isochronous magnetic field in order to accelerate protons up to 250 MeV. The stability of the acceleration process was achieved by a nonnegative value of flutter over the acceleration of particles. For coil structure, the current density over coil turns and the applied force was modeled. The flutter concept was also used to investigate the stability of the acceleration process. It was discovered that flutter has a nonnegative value when compared to particle acceleration. Finally, the stability of a magnetic coil against applied magnetics (Lorentz) force was investigated and it was demonstrated that the applied magnetic field on the coil would not have a destructive influence on the superconducting structure of the coil.

Background: This study assessed the potential cost-effectiveness of high (80–100%) vs low (21–35%) fraction of inspired oxygen (FiO2) at preventing surgical site infections (SSIs) after abdominal surgery in Nigeria, India, and South Africa. Methods: Decision-analytic models were constructed using best available evidence sourced from unbundled data of an ongoing pilot trial assessing the effectiveness of high FiO2, published literature, and a cost survey in Nigeria, India, and South Africa. Effectiveness was measured as percentage of SSIs at 30 days after surgery, a healthcare perspective was adopted, and costs were reported in US dollars ($). Results: High FiO2 may be cost-effective (cheaper and effective). In Nigeria, the average cost for high FiO2 was $216 compared with $222 for low FiO2 leading to a −$6 (95% confidence interval [CI]: −$13 to −$1) difference in costs. In India, the average cost for high FiO2 was $184 compared with $195 for low FiO2 leading to a −$11 (95% CI: −$15 to −$6) difference in costs. In South Africa, the average cost for high FiO2 was $1164 compared with $1257 for low FiO2 leading to a −$93 (95% CI: −$132 to −$65) difference in costs. The high FiO2 arm had few SSIs, 7.33% compared with 8.38% for low FiO2, leading to a −1.05 (95% CI: −1.14 to −0.90) percentage point reduction in SSIs. Conclusion: High FiO2 could be cost-effective at preventing SSIs in the three countries but further data from large clinical trials are required to confirm this.

The integrity of the patella is pivotal for the efficient functioning of the knee extensor mechanism. Thus, patella fracture management cannot be neglected and utmost priority should be determined for its preservation and maintenance of knee functioning. Tension band wiring (TBW) is the most widely and commonly used mode of fixation of patella fractures with consistently favourable outcomes. However, the complications associated with the same could be challenging and may compromise the integrity of the patella. This case report highlights the salvage of the failed TBW for a patella fracture with biomechanically stronger angular stable Star-shaped patella plate.

AbstractIntroduction:Today, many fields of research and business deal with the thoughts, images and mental patterns of their users and audiences. Knowing and being aware of the way of thinking of people, customers and audiences of a collection has a great impact on making appropriate decisions by the managers of that collection, in order to advance the goals and solve various problems. One of the important requirements of managers in any collection is to have sufficient knowledge of how they think about the collection and its performance. This helps them guide the group properly and make appropriate decisions in the way of advancing its goals. Therefore, collecting data from customers should be done with measured and accurate methods to achieve high quality information and obtain valid results. This research, by raising the question of "how can you use the analysis of people's feelings to find out how they think about a certain issue?", tries to provide a new approach on the platform of the Twitter social network to obtain reliable and high-quality information from people in relation to a certain topic. The purpose of the current research is to provide a new approach to collect data from people, in order to measure their perception about a specific issue. It will also examine the impact of the presented method on the speed, quality and cost of collecting data from people using a case study approach.Materials and Methods:In this research, their comments on the social network Twitter were used to check the satisfaction of users of three internet taxi applications in Iran, namely Snap, Tapsi, and Carpino. The data collection approach used in this research was descriptive, with results used by users, managers, and researchers. The research population consisted of all users of the three applications and members of the Twitter social network who had published their thoughts about these applications. The research collected and analyzed a total of 682 relevant tweets cross-sectionally during the summer of 1400 using the Twitter application interface and related hashtags. The analysis steps included data collection, pre-processing of tweets - including linguistic, sentiment, and thematic analysis, followed by sentiment analysis.Discussion and Results:The comparison of the analysis results from this research to the face-to-face interview method showed that the participation of respondents was challenging, and the traditional field method came with its own disadvantages. However, this method is able to overcome those issues and provide reliable results at a lower cost and time. Moreover, the results obtained from analyzing the data collected were similar to the results obtained through the face-to-face interview method, which speaks to the accuracy and quality of the data. Overall, the proposed method can provide valuable insights into people's thoughts and opinions on a particular topic, at a lower cost and time.Conclusions:The proposed method can be widely applicable to various fields, including business, research, and even everyday life. Managers, researchers, and business owners can use it to collect data and insights from their target audience, which can be analyzed to make informed decisions. Further development of the method can lead to even more useful and accurate reports, helping individuals and businesses stay ahead of their competitors. All students and researchers dealing with data collection can use this method to conduct their studies more effectively. Additionally, market research companies can use it to gain valuable feedback from consumers, informing their next steps in providing products and services.Overall, the applications of this research are far-reaching, and it provides a valuable resource for individuals and organizations looking to better understand their audience.Keywords: Sentiment analysis, text mining, how people think, Twitter, Internet taxi.

Ankylosing spondylitis (AS) is an underdiagnosed inflammatory condition in the initial stages of disease that can cause vertebral fractures in young adults after trivial trauma. Hence, low-energy spinal fractures in young patients must be carefully evaluated to exclude AS as the treatment protocol (fixation levels, period of immobilization) may change drastically if AS is diagnosed. Here, we present cases of 3 patients who presented at emergency after low-velocity spinal trauma and diagnosed as AS during workup for fracture management. This cases series indicates underdiagnosis of AS in general population as well as importance of strong suspicion of AS in low-energy spinal fractures in the younger age-group.

Given the importance of financing small and medium-sized manufacturing companies in order to provide working capital and their profitability, this study has presented a mathematical model for financing these companies by factoring in the supply chain. Factoring is one of the most important ways to finance the business world, especially for small and medium-sized enterprises. Therefore, considering the relationship between the enterprise and the bank, suppliers and buyers based on the integration of financial and physical flows in the supply chain, this research has financed the enterprise in the above-mentioned method. In order to analyze the validity of financing methods, goals, parameters and important variables in modeling, the perspective of experts based on the index of content validity ratio has been used. The goals of modeling are to maximize profits and achieve the desired liquidity in time periods, and in order to solve the model, goal programming has been used and in order to cover uncertainty conditions, interval programming has been used. Finally, the model was solved using GAMS software and CPLEX solver, and the results, in addition to proposing appropriate financial and physical flows in the supply chain, have proposed an appropriate factoring financing program to small and medium-sized manufacturing enterprises to provide the necessary liquidity in each period and increase profitability.

Fractures of the supracondylar and intercondylar region of the distal femur usually result from high velocity injury that is uncommonly associated with violation of the integrity of the extensor mechanism. The consequences of missed quadriceps injury associated with a distal femur fracture are devastating. The present case report illustrates the importance of recognizing the rare association of quadriceps tear with distal femoral fractures, an appropriate surgical approach to repair the tear as well as fixation of fracture, and a protocol of postoperative rehabilitation to achieve a successful outcome.

Background: Psychosocial experiences such as life-orientation, subjective well-being and social support are punitive in determining the health related quality of life of patients in end stage of Chronic Renal Disease; also termed as End Stage Renal Disease (ESRD). Objectives: to investigate the phenomenon of life-orientation, subjective well-being, social support and perceived health related quality of life in patients with end stage renal disease. ESRD patients' life orientation, social support and subjective well-being are significant predictors of their perceived quality of life that further determines their disease management and health status. Materials and Methods: This research has been laid out through cross sectional survey research design. The data was collected between the time span of Jan, 2016 to June, 2016. The sample comprised of 200 respondents from both gender, equally distributed within the age range of 50 to 60 years, going through last stage of ESRD and relying on dialysis from at least past one year or more. Indigenously translated WHO QoL, Subjective Wellbeing Scale, multidimensional Social Support Scale, Life Orientation Scale and a demographic information sheet was used to collect the data. Results: The results revealed that life orientation, social support and subjective well-being significantly and positively predicted the health related quality of life; greater social support and higher levels of subjective wellbeing after controlling for the effects of age, gender, income and education were found when the patients 'carried optimistic and positive life-orientation. Conclusion: The current research findings therefore incriminate preemptive direction in understanding the phenomenon of life-orientation, social support, subjective wellbeing and health related quality of life in patients with last stage ESRD. This further embarks onto highlighting the insightful guidelines for health and clinical psychologists in devising management interventions, targeting the increased subjective well-being, and promotion of optimistic life-orientation in order to facilitate health related quality of life in the patients with end stage renal disease. [ABSTRACT FROM AUTHOR]

The aim of the study was to review published literature on traumatic lumbar spondylolisthesis. Traumatic spondylolisthesis of the lumbosacral region is a relatively rare but serious spinal injury necessitating careful clinico-radiological evaluation and management for a successful outcome. Limited literature is available to date to guide clinicians to treat the injury comprehensively. This article analyses the published literature and promulgates an evidence-based management plan for this injury. PubMed, Cochrane, Scopus, Google Scholar databases were searched using the keywords “traumatic lumbar” AND “spondylolisthesis” following PRISMA guidelines. In total, 118 relevant articles were considered for full-text review; among them, 68 articles were finally selected for the analysis. In each article, the pathomechanism; clinical and radiological features; classifications; indications for nonoperative and operative management; operative approaches, techniques, and rehabilitation; and long-term outcomes were analyzed. Traumatic lumbar spondylolisthesis is high-energy spine trauma requiring thorough evaluation. Radiographs are the initial investigation technique used in the emergency department, computed tomography scans define the bony details of the injury, and magnetic resonance imaging is important for deciding the treatment protocol depending on the disc injury. Decompression and instrumented fusion are the standard treatment protocol. A satisfactory outcome is to be expected in the majority of cases.

Study Design Prospective, comparative. Purpose To compare the histopathological and electron microscopic changes in the ligamentum flavum (LF) between degenerative lumbar canal stenosis (LCS) and lumbar disk herniation (LDH). Overview of Literature The LF has been implicated as a key structure in the pathogenesis of LCS. With aging, the LF undergoes morphological changes–a decrease in the elastic component and an increase in the collagen component, in addition to other focal changes. By comparing the histopathological and electron microscopic picture of the LF in elderly patients with LCS with that in young patients with LDH, the role of this ligament in the pathogenesis of LCS may be clarified. Methods Forty patients were prospectively recruited and divided into two groups: group 1 included 20 patients with degenerative LCS aged >55 years and group 2 included patients with LDH aged

OBJECTIVE: To assess and correlate fear, uncertainty and practice of precautionary measures in relation to Dengue Fever (DF) in community from Lahore, Pakistan. METHODS: This cross-sectional study was conducted in Lahore, Pakistan between September to November 2016. Multistage random sampling technique was used to enroll 400 adults from nine different towns. A self-constructed questionnaire was used to assess uncertainty, fear and practice of preventive measures. Data was analyzed using SPSS Version 21. RESULTS: Out of 400 participants, 214 (53.5%) were males and 186 (46.5%) were females, with age ranging between 16-65 years. In correlation analysis, fear had a slightly positive correlation with uncertainty (r=0.02), and preventive practice (r=0.01), whereas uncertainty had a negative correlation with preventive practice (r=-0.22). In demographic components, age had the best correlation with fear (r=012) as compared to others. Men reported to have greater uncertainty, t (1,198=2.11, p

Todays, Investments on Information Technology is increasing day to day and IT Governance and strategic alignment between Business and IT Goals has been more important than to the past. Also. Business manager have been faced with IT governance multi-dimensional issue, due to salient growth of cloud computing and its governance challenges. Context and nature dependency of Cloud computing governance is one of the above complexity dimensions. Therefore, in this research, governmental enterprises challenges, as a one of the actors of country economic and industrial ecosystem, identified and prioritized, with using 94 experts comments by questionnaire and interview techniques. Finding of this research demonstrate that there are 18 fundamental challenges at 9 domain. Culture, direction and strategy are the most important challenging domains in cloud computing governance objectives achieving process and lack of transparency in governmental enterprises, lack of business knowledge of IT managers, information security, lack of tailored governance frameworks and lack of believe to IT strategic role by business managers, are 5 top challenges in governmental enterprises.

Abstract Background Cerebral cavernous malformations (CCMs), a major neurosurgical condition, characterized by abnormally dilated intracranial capillaries, result in increased susceptibility to stroke. KRIT1 (CCM1), MGC4607 (CCM2), and PDCD10 (CCM3) have been identified as causes of CCMs in which at least one of them is disrupted in most familial cases. Our goal is to identify potential biomarkers and genetic modifiers of CCMs, using a global comparative omics approach across several in vitro studies and multiple in vivo animal models. We hypothesize that through analysis of the CSC utilizing various omics, we can identify potential biomarkers and genetic modifiers, by systemically evaluating effectors and binding partners of the CSC as well as second layer interactors. Methods We utilize a comparative omics approach analyzing multiple CCMs deficient animal models across nine independent studies at the genomic, transcriptomic, and proteomic levels to dissect alterations in various signaling cascades. Results Our analysis revealed a large set of genes that were validated across multiple independent studies, suggesting an important role for these identified genes in CCM pathogenesis. Conclusion This is currently one of the largest comparative omics analysis of CCM deficiencies across multiple models, allowing us to investigate global alterations among multiple signaling cascades involved in both angiogenic and non-angiogenic events and to also identify potential biomarker candidates of CCMs, which can be used for new therapeutic strategies.

AbstractIn this paper, a model for evaluating electronic services in nonprofit institutions is presented. The idea of this model was due to a vacuum of research in this field. Regarding this issue, independent variables have been extracted from the perspective of members of the research community for the evaluation of electronic services based on inductive method and fundamental conceptualization theory. These variables include governance issues, tools, and customers.Indicators for measuring two variables of government and a measurable tool refer to financial systems and based on cost accounting methodology. However, it was not possible to determine the amount (rials) of the customer variable in this way. Therefore, a process was developed using existing theoretical foundations, including the relative estimation method for accounting, the Delon and McLean evaluation model, and the value engineering and how these two variables influence the management and tools. Then, in order to test the model and development process, the municipality of Tehran decided to evaluate the electronic license of the traffic plan. The result of determining the value of electronic services allows the use of this model in real terms

Background. Fair distribution of sports facilities is very effective in the tendency of citizens to exercise. Therefore, the distribution of sports and recreational facilities in cities should be carefully and scientifically explored. Objectives. The purpose of this study was analytical review of fair distribution of recreational and sport services in the city of Mashhad by using Topsis model. Methods. The present research is a descriptive-analytical research, which is applied type that has been surveyed data collection. The statistical population of this research is the referrals of sports halls under the supervision of the Sports and Youth Organization of Mashhad, and Mashhad municipality and their totalnumber is 25,000 and according to the Morgan table, 341 people were selected from the Sports and Youth Organization sport halls and 347 from the halls under the supervision of the municipality were selected as the statistical sample. The data gathering tool is a researcher-made questionnaire that measures fair distribution. The validity of the research tool was verified by ten sports management professors and its reliability was calculated by Cronbach's alpha of 0.785 and indicates a high reliability of the research tool. Topsis method was used to analyze the data. Results. The research findings showed that in Mashhad, in addition to building sites, regardless of the fair distribution of urban areas, facilities were also unfairly distributed (Zone 1 ranked 0.9995 and Zone 6 ranked 0.8226. Conclusion. In order to develop and expand the city of Mashhad, there is a strong need for proper decision making and fair implementation of urban projects and the equitable deployment of sports equipment in Mashhad, as well as fair distribution of them in the 13 areas of Mashhad.

Cardiovascular disease includes coronary artery diseases (CAD), which include angina and myocardial infarction (commonly known as a heart attack), and coronary heart diseases (CHD), which are marked by the buildup of a waxy material called plaque inside the coronary arteries. Heart attacks are still the main cause of death worldwide, and if not treated right they have the potential to cause major health problems, such as diabetes. If ignored, diabetes can result in a variety of health problems, including heart disease, stroke, blindness, and kidney failure. Machine learning methods can be used to identify and diagnose diabetes and other illnesses. Diabetes and cardiovascular disease both can be diagnosed using several classifier types. Naive Bayes, K-Nearest neighbor (KNN), linear regression, decision trees (DT), and support vector machines (SVM) were among the classifiers employed, although all of these models had poor accuracy. Therefore, due to a lack of significant effort and poor accuracy, new research is required to diagnose diabetes and cardiovascular disease. This study developed an ensemble approach called “Stacking Classifier” in order to improve the performance of integrated flexible individual classifiers and decrease the likelihood of misclassifying a single instance. Naive Bayes, KNN, Linear Discriminant Analysis (LDA), and Decision Tree (DT) are just a few of the classifiers used in this study. As a meta-classifier, Random Forest and SVM are used. The suggested stacking classifier obtains a superior accuracy of 0.9735 percent when compared to current models for diagnosing diabetes, such as Naive Bayes, KNN, DT, and LDA, which are 0.7646 percent, 0.7460 percent, 0.7857 percent, and 0.7735 percent, respectively. Furthermore, for cardiovascular disease, when compared to current models such as KNN, NB, DT, LDA, and SVM, which are 0.8377 percent, 0.8256 percent, 0.8426 percent, 0.8523 percent, and 0.8472 percent, respectively, the suggested stacking classifier performed better and obtained a higher accuracy of 0.8871 percent.

Nurses are the most significant part of human resources in a sanitary and health system. Job satisfaction results in the enhancement of organizational productivity, employee commitment to the organization and ensuring his/ her physical and mental health. The present research was conducted with the aim of predicting the level of job satisfaction based on hardiness and its components among the nurses with tension headache. The research method was correlational. The population consisted of all the nurses with tension headache who referred to the relevant specialists in Tehran. The sample size consisted of 50 individuals who were chosen by using the convenience sampling method and were measured and investigated by using the research tools of “Job Satisfaction Test" of Davis, Lofkvist and Weiss and “Personal Views Survey" of Kobasa. The data analysis was carried out by using the Pearson Correlation Coefficient and the Regression Analysis. The research findings demonstrated that the correlation coefficient obtained for “hardiness", “job satisfaction" was 0.506, and this coefficient was significant at the 0.01 level. Moreover, it was specified that the sense of commitment and challenge were stronger predictors for job satisfaction of nurses with tension headache among the components of hardiness, and, about 16% of the variance of “job satisfaction" could be explained by the two components (sense of commitment and challenge). [ABSTRACT FROM AUTHOR]