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The magnetic pressure, plasma pressure and the ratio between them which represent the beta (b) have been determined in a D.C electric arc discharge for current values (3.5-24A) under argon gas pressure ranged from (0.1-50torr). The obtained electron density and temperature from the double probes characteristic were used to calculate the magnetic and plasma pressure as well as the beta. The electron temperature explicit relation of product of gas pressure and radius of discharge arc that holds in schottky limit is used to determine the later parameter. The results show that the magnetic pressure varies nearly exponentially with gas pressure while it increases as a function of square value of arc current in agreement with the theoretical magnetic pressure. Plasma pressure and the beta plasma decreases exponentially with both arc current and gas pressure due to decreasing electron temperature.

Background: The prevalence of Coronary artery ectasia (CAE) varies from 0.‌3 to 5% in different countries. The prevalence of CAE has varied in different parts of the world and the study of risk factors can be effective in the process of diagnosis and treatment of patients, we reviewed patients who underwent coronary angiography for 5 years to determine the prevalence of isolated CAE and its associated risk factors. Methods: A retrospective analysis was conducted on 16600 patients who underwent coronary angiography at Shahid Sadoughi and Afshar hospitals between March 2015 to April 2020. Diagnosis and confirmation of CAE was defined as a vessel diameter greater than 1.5 times the normal diameter of the vessel, which must be confirmed by at least two cardiologists. Demographic variables, angiography and echocardiography reports were included in our final analysis. Results: Isolated CAE was diagnosed in 287 (1.7%) patients. After triple-vessel disease (53%), the left anterior descending artery (LAD) was the commonest affected vessel by ectasia 16% (46 cases). Diffuse isolated CAE was diagnosed in 52% of LAD, 76.6% of Right coronary artery (RCA), and 74.1% of left circumflex artery. A significant association was seen between the vessel involved and the nature of ectasia (p

Background: The coronary angiography results in a group of patients with myocardial infarction (MI) are normal or near-normal; which is diagnosed as myocardial infarction with non-obstructive coronary arteries (MINOCA). This study aimed to compare the mortality rate and risk factors between MINOCA and myocardial infarction with obstructive coronary artery (MI-CAD). Methods: This retrospective cohort study was conducted from January 1, 2018, to December 31, 2019. A total of 679 patients admitted to Afshar Hospital in Yazd with a diagnosis of ST-elevation myocardial infarction (STEMI) from 2018-2019 who underwent primary Percutaneous Coronary Intervention (PCI) were enrolled in the study. Demographic, and clinical variables, ECG finding and one-year mortality, were extracted using MI registry data from the Yazd Cardiac Research Center. Results: The estimated frequency of MINOCA was 4.6%. Patients with MINOCA ( 47.14±6.2) were younger than patients with MI-CAD (57.61±9.1) (P

Abstract Background and Aims Electrocardiography (ECG) is a widely accessible, noninvasive, and cost‐effective diagnostic instrument used to evaluate patients with suspected heart failure (HF). The aim of this study is to investigate electrocardiographic changes in patients with different stages of HF in a random population of Yazd city. Methods This prospective cross‐sectional study included 319 individuals, randomly selected, aged 40 years and more, registered in the Yazd Health Study was conducted from March 2022 to May 2023 at Afshar Hospitals. In accordance with the AHA/ACC guidelines, HF was classified into four stages (A, B, C, and D). Results The 159 individuals were classified in the stage 0 group, 77 were in Stage A, 65 were in Stage B, and 18 were in Stage C of HF. In the Stage 0, the PR interval (PRi) was 130.5 ± 18.1 ms, while in Stage C, it was 143.3 ± 21.9 ms, with a significant difference (p = 0.047). Similarly, the QRS interval (QRSi) increased with HF staging (p = 0.001). The frequency of diabetes mellitus (DM), hypertension (HTN), hyperlipidemia (HLP), chronic heart disease, alcoholism, and PRi, QRSi, QT interval levels were independent predictors of HF stage in multivariate regression analysis. Conclusion The prevalence of HF stages, as classified by the AHA/ACC guidelines, was observed, with significant correlations between ECG parameters and HF progression. abnormal rhythms, left bundle branch block, ischemia, hypertrophy, and left atrial enlargement increased with higher HF stages. Major risk factors like DM and HTN exhibited a heightened prevalence in advanced HF stages, accentuating their pivotal role in the progression of HF.

Abstract Background Foramen ovale (FO) is an obligate fetal shunt that typically resolves after birth, although patency throughout life is not uncommon. The natural history of patent FO (PFO) is known in term infants, but less is known about its course in extremely preterm infants. We describe the echocardiographic changes in FO size from birth to discharge in extremely low birth weight (ELBW) infants in this retrospective study. Methods Cohort was divided based on size of FO at birth. Size of FO at discharge was measured and evaluated relative to postnatal weight gain. Demographics and clinical outcomes were compared between the two groups. Results Of the 54 ELBW infants, 50 were born with FO less than 3 mm in diameter (small), and 4 were born with FO greater than 3 mm (large). Of small defects, the majority (44/50, 88%) did not increase in size with weight gain, and minority (6/50, 12%) increased in size, and three of these 6 patients, FO grew to be slightly larger than 3 mm. In contrast, all large defects (4 of 4, 100%) nearly doubled in size with postnatal growth. These 4 ELBW infants with enlargement of FO had a flap valve evident on echocardiogram obtained prior to discharge, and subsequently closed on outpatient follow-up echocardiograms, although time to resolution was variable (6 months – 3 years). One infant had presumptive resolution because of the presence of flap valve. Conclusion No maternal or neonatal demographic characteristics were predictive of FO enlargement, although, demonstrable flap valve on discharge echocardiogram correlated with resolution of FO on outpatient follow-up echocardiogram. Therefore, based on our data, we recommend that ELBW infants born with large FO should have echocardiographic re-evaluation of the atrial septal opening prior to discharge, to specify the presence of a flap valve or lack thereof, which is an important detail that can help a neonatologist determine the need for outpatient cardiac follow-up.

North American rail is unlikely to be electrified in the near term. Although strategies such as improving fuel efficiency, enhanced logistics, etc., are already being pursued, the primary way to reduce the carbon intensity (CI) of the rail sector will be through the use of low-CI fuels such as bio/renewable diesel. Alternatives such as battery-electric and hydrogen fuel cells are still evolving and, while liquid/compressed natural gas (LNG/CNG) can be used as “transition (lower-CI) fuels”, they are not drop-in, requiring considerable investment in engines and infrastructure. By contrast, bio-based diesels are low-carbon solutions that can be readily deployed to reduce rail associated GHG emissions. However, the high price of bio-based diesels, competition with other modes of transport (e.g., trucking), and the lack of “enabling” policies have limited bio/renewable diesel use by the rail sector. Canada’s current biodiesel production could supply 40% of Canada’s rail sector fuel needs, reducing its GHGs by about 34%.

This paper focuses on a novel model of the U-shaped assembly line balancing problem, in which the objective functions include cost, capacity, and quality. It is assumed that each task requires a set of equipment. In addition, the quality of tasks performed by each worker varies. Hence, the purpose of the model is that the total cost of the equipment is minimized and the quality of the work is maximized. Additionally, the number of workstations is minimized. At first, a multi-objective non-linear mixed-integer programming model is provided. Then, the model is linearized, and simulated annealing (SA) algorithm and two of its modified modes have been proposed to solve the problem. The proposed algorithm includes a new encoding/decoding scheme, as well as a local search for assigning the worker to each station. To determine the parameters in three algorithms, the experimental design has been used and various modes have been created by combining the parameters. Moreover, numerical examples were established based on the graphs found in the literature and the solution is compared with three algorithms, revealing the efficiency of each algorithm. Additionally, a case study on the nozzle assembly line in oil refineries was conducted to evaluate the efficiency of the proposed model and algorithm. Results from the case study show that the modified SA algorithms performed better.IntroductionNowadays, assembly lines play a crucial role in the production of standardized and high-volume products. If task allocation to workstations is done without considering the balance of the assembly line, it can lead to high levels of idle time in some workstations and decreased line efficiency. Therefore, assembly line balancing is an important stage in the production process to enhance production line productivity. This study focuses on the single-model U-shaped assembly line balancing problem. Assembly lines can be divided into four categories based on their layout, and in this research, the U-shaped assembly lines are specifically considered. The objectives of this problem include minimizing the number of workstations, minimizing equipment costs, and minimizing the level of work quality deviation at each workstation (equivalent to maximizing work quality). Additionally, constraints related to occurrence, precedence, and capacity, as well as limitations on tool and worker allocations, have been considered in the problem model. In terms of research gaps in this field, it should be noted that in previous studies on U-shaped assembly line balancing problems, objective functions combining cost, capacity, and quality have not been simultaneously addressed within a single problem. Furthermore, simultaneous allocation of workers (based on skill levels) and tools has not been studied in the context of U-shaped assembly line balancing problems.Materials and MethodsIn this study, a nonlinear mixed-integer multi-objective programming model is proposed for balancing a single-model U-shaped assembly line. The problem modeling assumes realistic conditions where each task requires a set of tools, and in this regard, the quality of task execution by workers is considered to be different. The modeling of quality in the assembly line balancing problem (as one of the objective functions) is approached differently compared to previous studies in this field, aiming to minimize the level of work quality deviation in all workstations. Additionally, for solving the problem, the allocation of workers and tools to the workstations is performed based on a neighborhood algorithm, which is a notable innovation in the research. In this study, a modified simulated annealing metaheuristic algorithm is developed with innovations in encoding and decoding procedures to solve the proposed model in three optimization scenarios. To compare the results of these algorithms, numerical examples based on graphs available in the research literature are solved using the three algorithms. Furthermore, a case study is conducted on the assembly line of component δ, which is used in oil refineries, to evaluate the efficiency of the proposed model and algorithm in real assembly lines.Discussion and ResultsIn this study, to validate the proposed algorithms, 10 numerical examples of different sizes (small, medium, and large) were designed based on valid graphs available in the research literature. Then, for various parameter values, each problem was solved 10 times using each algorithm, and the results of each algorithm were analyzed. In these examples, the costs of tools and the data related to task quality were randomly generated. Additionally, workers with different skills were defined to perform the tasks. Furthermore, the cycle time proportional to the activity durations was considered. It is observed that in all solved examples, the values of the third objective function (quality objective function) obtained from the third algorithm are better than the values obtained from the first and second algorithms. These results are not unexpected because in the third algorithm, due to the presence of an improvement loop for the third objective function, its value decreases compared to the other two algorithms, resulting in a reduction in the overall objective function and its improvement compared to the other two algorithms. For the cost minimization objective function (first objective function) and the number of workstations minimization objective function (second objective function), the values obtained from the three algorithms are approximately the same, and the difference in the obtained values for the overall objective function is primarily dependent on the value of the quality objective function (third objective function). Additionally, the results of solving the numerical examples show that the third algorithm achieves the best values for the overall objective function (compared to the other two algorithms) on examples with more than 25 activities, indicating that employing a local search for worker allocation in the modified simulated annealing algorithm makes the algorithm stronger and more efficient compared to its classical form.ConclusionIn this research, the modeling and problem-solving of the U-shaped assembly line balancing problem were investigated considering tool allocation constraints and quality conditions. To this end, a mixed integer nonlinear programming model was presented for the problem, where equipment and workers were simultaneously considered as two objectives in terms of minimizing equipment cost and the level of task quality. In addition to these two objectives, the number of workstations was also minimized. To solve the problem, a metaheuristic algorithm called simulated annealing was employed, as well as two improved versions of it (by introducing innovations in the random allocation of workers to workstations and applying a local search for improving worker allocation). The proposed model was solved using well-known graphs in the literature of assembly line balancing problems (as numerical examples) with the proposed algorithms, and the results obtained from the algorithms were compared and the performance of these algorithms was analyzed and examined.

Background: Obesity and overweight are important public health problems which are rapidly growing throughout the world. This study aims to provide 10-year incidence estimates of obesity and overweight in adults along with their risk factors in an Iranian adult population. Methods: This cohort study was conducted within the framework of the Yazd Healthy Heart Project (YHHP) throughout phases from 2005-2006 to 2015-2016 among urban adult population. The participants comprised of 1000 males and 1000 females aged 20-74 years from urban areas of Yazd. Cox proportional hazards model was used to examine the potential risk factors for obesity and overweight. Results: A total of 2000 participants aged 47.09 ± 16.97 years and body mass index (BMI) of 21.99 ± 2.21 kg/m2 were entered in this study at baseline. After 10 years of follow-up, the cumulative incidence of overweight for the entire population was 38.6% (41.6% in women and 36.8% in men). Furthermore, the 10-year cumulative incidence of obesity was 14.8% in the population (20.8% for women and 10.5% for men). Female participants showed a significantly higher incidence rate compared to males either for obesity or overweight. Regarding risk factors, there was a significant association between non-smoking (HR= 1.54, 95% CI: 1.06-2.25), socio-economic status (HR= 1.82, 95% CI: 1.13-2.94), and education (HR= 1.56, 95% CI: 1.14-2.13) with overweight (P < 0.05). Conclusion: This study revealed the incidence rate of obesity and overweight is significantly high in adult population of Yazd, Iran especially in women. The most important predictors of overweight seem to be smoking, lower socio-economic status, and education.

Introduction: Massive open online courses (MOOCs) are known as new advances in e-learning. Learning through MOOCs requires different education than what happens in face-to-face learning. In these courses, it is important to connect with participants from different backgrounds and personalize learning. Therefore, with the development of MOOC as a new teaching method, training-based businesses need to acquire new knowledge and skills to obtain the desired training and gain acceptable learning outcomes. An important aspect of innovation in this business is tied to the role of the Internet and the related technologies, but this feature is not necessarily the only aspect that leads to innovation in the MOOC business model. This is because, with the advent of these technologies, there has been a significant shift in attitudes towards training and skill development systems that have changed the education business environment. Besides, the characteristics of this business are different from those of other web-based businesses which require that a business model be provided specifically for MOOC. The business model explains the logic of an organization on how to create, deliver, and acquire values. Thus, the business model helps to understand the relevant factors in the business context and to recognize and interact with them. In this environment, business logic is constantly changing and improving. A business model can integrate resources, activities and knowledge and facilitate the identification of competency resources. The model also helps businesses to fulfil their mission and reduce budgetary and financial pressures and constraints. Despite the increased number of MOOCs in Iran, some entrepreneurs have failed due to several factors, including the weakness of these institutions to adapting to environmental conditions and their changes as well as the weakness of their commercialization strategy. Therefore, setting up MOOC courses requires structures and resources that must be identified in interactions with the business environment before any action is taken. A business model can identify the important components of creating a competitive advantage in accordance with environmental factors and promote the development of businesses based on economic principles as well as educational policies. Accordingly, this paper aimed to provide a business model in line with the features of the MOOC that can specify important business components and develop a business strategy in accordance with educational policies.Methodology: In this study, the mixed research method has been used to create comprehensible designs from the analysis of complex data. This method is a process for collecting, analyzing and describing qualitative and quantitative data that help to better understand the challenges of research. Using only a qualitative or quantitative research approach reveals only a few aspects of the phenomenon being studied. Therefore, the mixed research method provides a better understanding of various phenomena. This research is based on a mixed approach, qualitative and quantitative, in two stages. In the qualitative phase, a systematic review approach has been used to identify the components of the e-business model. Then, experts' opinions are used to match the components of the e-business model (obtained from systematic review) with the characteristics of the MOOC business model and to reach the proposed components for the MOOC business model. In the quantitative phase, a questionnaire has been prepared and provided to the experts to evaluate the proposed components for the MOOC business model. The t-test serves to analyze the answers and finalize the components of the model, and the Friedman test prioritizes the components. In the second stage, the fuzzy Delphi approach is used to present the MOOC business model.Results and Discussion: The elements of the MOOC model proposed in this study are highly consistent with a business model. In a sense, the components of the MOOC model project the aspects of a business model in more details. The sub-components in the model address features that are specific to MOOC businesses and, therefore, do not apply to other types of e-businesses in general. To develop the model, the opinions of MOOC business experts and entrepreneurs were taken into consideration, which could be fruitful to improve MOOC implementation plans in Iran as well as its competitive position.Conclusion: According to the findings of this research, the model of earnings, the proposed value and the customer are the most important components of a MOOC business model. It is presented in the form of 55 concepts in 12 main components. The use of the proposed model has such benefits as promoting MOOC planning and facilitating the acquisition of competitive advantage. Besides, the results of this study can be used by entrepreneurs in this field to create successful business models. The insight provided by this study can lead to a common understanding among e-learning activists about the challenges in the MOOC business. Due to technological innovations, it also lays the ground for future changes in the field.

Study Design Cross-sectional study. Purpose To translate and culturally adapt the original English version of the 24-item Early-Onset Scoliosis Questionnaire (EOSQ-24) to the Persian language as well as assess its reliability and validity. Overview of Literature Early-onset scoliosis (EOS) patients with progressive curves require active treatments, such as serial elongation–derotation–flexion casting, bracing, and surgery, which are stressful and expensive. In order to evaluate the impact of EOS and its treatment strategies, it is important to consider the patients and their parents’ quality of life as the clinical and radiological parameters. The EOSQ-24 is a parent-based measure that evaluates the health-related quality of life of patients with EOS and their caregivers/parents. Similar to other widely used questionnaires, EOSQ-24 needs to be translated into other languages to make it usable in populations from different cultures and societies. Methods We evaluated the translation and back translation of the EOSQ-24 and made the required revisions as per the analysis performed by the expert committee and an international guideline to adapt it for use in this study. Thereafter, we recruited 100 EOS patients in order to evaluate its reliability and validity. The reliability was assessed with internal consistency. Convergent validity was assessed by comparing the scores of the EOSQ-24 and the 22-item Scoliosis Research Society Questionnaire (SRS-22r). Finally, the known groups validity was assessed as per patient’s sex, curve magnitude, and treatment type. Results The Persian EOSQ-24 demonstrated very good internal consistency (Cronbach’s α=0.88). All the items had an acceptable corrected item-total correlation (>0.3). Further, the EOSQ-24 and the SRS-22r scores (p

This study describes an investigation of the pyrolysis and combustion of flax straw as biofuel, focusing on the physicochemical properties and kinetic and thermodynamic parameters, and evaluates the type of degradation products using the thermogravimetry analysis–Fourier transform infrared spectroscopy (TGA-FTIR) technique. Pyrolysis and combustion processes were studied via thermogravimetric analysis at different heating rates of 5-10-15 and 20 °C min, one using three isoconversional methods and one using a model-fitting method. The activation energies, frequency factors, and thermodynamic parameters of flax straw biomass were investigated using different models. The obtained activation energy values for pyrolysis varied between 101.0 and 109.6 kJ mol−1 and for combustion were between 203.3 and 239.2 kJ mol−1. The frequency factors were determined to be 1.7 × 109 for pyrolysis and 1.5 × 1017 s−1 for combustion. The change in Gibbs free energy (ΔG) for the pyrolysis of flax straw was calculated to be 162.6 kJ mol−1, whereas for combustion it increased to 203.9 kJ mol−1. A notable contrast between the volatiles produced by pyrolysis and combustion is evident from the real-time analysis of the degradation products. Specifically, carboxylic acids, aromatics, alkanes, and alcohols are the principal degradation products during pyrolysis, while carbon dioxide is the primary component produced during combustion. These encouraging research outcomes regarding flax straw pyrolysis and combustion can broaden its application in bioenergy and biofuel, thus contributing significantly to it for resource recovery.

Abstract Heavy metals contaminate the soil that alters the properties of soil and negatively affect plants growth. Using microorganism and plant can remove these pollutants from soil. The present investigation was designed to evaluate the induced effect of Bacillus pumilus on maize plant in Cadmium (Cd) contaminated soil. Three different concentrations of Cd (i.e. 0.25, 0.50 and 0.75 mg kg−1) were applied in soil under which maize plants were grown. The germination percentage, shoot length, leaf length, number of leaves, root length, fresh weight and nutrient uptake by maize plant were determined. The experiment was conducted by using complete randomized design (CRD) with three replicates. The result indicated that germination percentage, Shoot length, leaf length, root length, number of leaves, and plant fresh weight were reduced by 37, 39, 39, 32 and 59% respectively at 0.75 mg kg−1 of CdSO4 concentration but when maize seeds inoculated with Bacillus pumilus significantly increased the germination percentage, shoot length, leaf length, number of leaves, plant fresh weight at different concentrations of CdSO4. Moreover, the plant protein were significantly increased by 60% in T6 (0.25 mg kg−1 of CdSO4 + inoculated seed) and Peroxidase dismutase (POD) was also significantly higher by 346% in T6 (0.25 mg kg−1 of CdSO4 + inoculated seed), however, the Superoxide dismutase (SOD) was significantly higher in T5 (0.75 mg kg−1 of CdSO4 + uninoculated seed) and was 769% higher as compared to control. The Cd contents in Bacillus pumilus inoculated maize roots and shoots were decreased. The present investigations indicated that the inoculation of maize plant with Bacillus pumilus can help maize plants to withstand Cd stress but higher concentration of Cd can harm the plant. The Bacillus pumilus has good potential to remediate Cd from soil, and also have potential to reduce the phyto availability and toxicity of Cd.

Summary: Background: Early death after cancer surgery is higher in low-income and middle-income countries (LMICs) compared with in high-income countries, yet the impact of facility characteristics on early postoperative outcomes is unknown. The aim of this study was to examine the association between hospital infrastructure, resource availability, and processes on early outcomes after cancer surgery worldwide. Methods: A multimethods analysis was performed as part of the GlobalSurg 3 study—a multicentre, international, prospective cohort study of patients who had surgery for breast, colorectal, or gastric cancer. The primary outcomes were 30-day mortality and 30-day major complication rates. Potentially beneficial hospital facilities were identified by variable selection to select those associated with 30-day mortality. Adjusted outcomes were determined using generalised estimating equations to account for patient characteristics and country-income group, with population stratification by hospital. Findings: Between April 1, 2018, and April 23, 2019, facility-level data were collected for 9685 patients across 238 hospitals in 66 countries (91 hospitals in 20 high-income countries; 57 hospitals in 19 upper-middle-income countries; and 90 hospitals in 27 low-income to lower-middle-income countries). The availability of five hospital facilities was inversely associated with mortality: ultrasound, CT scanner, critical care unit, opioid analgesia, and oncologist. After adjustment for case-mix and country income group, hospitals with three or fewer of these facilities (62 hospitals, 1294 patients) had higher mortality compared with those with four or five (adjusted odds ratio [OR] 3·85 [95% CI 2·58–5·75]; p

The large number of verses in the Qur'an about the resurrection indicates the great importance of this principle of belief, and one of its important issues is the resurrection of man on the Day of Resurrection, which the Qur'an considers certain. The main question is, according to the Qur'an, how will the human body return on the Day of Resurrection? This article tries to provide a descriptive and analytical method in accordance with scientific theories of the return of the human body on the Day of Resurrection based on verse 51 of Surah Yasin. To this end, various views of commentators on how this return, including the theory of objectivity (return to all parts of the body), the theory of similarity (return of a typical form without a specific substance) and the theory of existential intensity of the soul (evolved body) were proposed and criticized. Emphasis on the word "Yanseloon" and the use of a narration that considers the return of the human body on the Day of Resurrection as a part called "wonder of the Prophet" and also the adaptation of this interpretation to the theory of simulation, provides a result that the human body is a major component. The remnant of the worldly body is formed, which is the main component, the origin of the body of the hereafter.

Abstract Background Several factors might contribute to the delay to get cancer care including poor cancer awareness and having barriers to seeking help. This study described these barriers in Gaza and their association with recalling and recognizing cancer symptoms and risk factors. Methods A cross-sectional study was conducted in Gaza. Adult visitors (≥18 years) to the largest three governmental hospitals and adolescent students (15–17 years) from ten high schools were recruited. A translated-into-Arabic version of the validated Cancer Awareness Measure (CAM) was used to collect data in face-to-face interviews. It described demographic data, barriers to seek cancer care as well as recall and recognition of cancer symptoms and risk factors. Responses were compared between adults and adolescents as well as males and females. Results Of 3033 participants approached, 2886 completed the CAM (response rate= 95.2%). Among them, 1429 (49.5%) were adult (702 females; 49.1%) and 1457 (50.5%) were adolescent (781 females; 53.6%). The mean age± standard deviation (SD) of adult and adolescent participants was 33.7±11.7 years and 16.3±0.8 years, respectively. Emotional barriers were the most common barriers with ‘feeling scared’ as the most reported barrier (n=1512, 52.4%). Females and adolescents were more likely to report ‘feeling scared’ as a barrier than males and adults, respectively. Higher recall scores for cancer symptoms were associated with lower likelihood to report ‘embarrassment’, ‘worry about wasting doctor’s time’ and ‘difficulty arranging transport’. This was also seen for recalling risk factors, where ‘embarrassment’ and all practical barriers showed significant inverse associations with higher scores. In addition, greater recognition scores of cancer risk factors were inversely associated with reporting ‘embarrassment’ and ‘feeling scared’. Conclusions The most commonly perceived barriers to seeking cancer care were ‘feeling scared’ and ‘feeling worried about what the doctor might find’, followed by practical and service barriers. Females and adolescents were more likely to report ‘fear’ as a barrier to seek medical advice. Having a higher recall of cancer symptoms and risk factors was inversely associated with reporting most barriers. To improve patient outcome, early presentation can be facilitated by targeting barriers specific to population groups.

Objective: The risk of cardiovascular disease increased in diabetic patients due to lipoprotein metabolism disorder and insulin resistance. There is different type of dyslipidemia in diabetic patient. The nicotinic acid (niacin) is categorized as vitamin B family and decreases low-density lipoproteins (LDL) and triglyceride (TG) level and increases high-density lipoproteins (HDL). The aim of this study was to compare the effect of niacin treatment with and without atorvastatin on lipid profile on diabetic patient. Materials and Methods: This study is cross over clinical trial on 30 diabetic patients (9 men, 21women) referred to diabetes research center of Yazd (IRAN). At initiation of study administered atorvastatin alone (20 mg/day) for 6 weeks (protocol A), and after 3 weeks washout period, started atorvastatin (20 mg/day) with niacin (50 mg/day) for 6 weeks (protocol B). Statistical analysis was accomplished by using SPSS for windows, version 11.50 and kappa and paired T-test. Results: Patients on protocol B had statistically significant more increase of HDL-C (P-value= 0.08) and decrease of TG than profile A (P-value= 0.024). Also, 2 hours post prandial blood sugar and HbA1c changes in two groups were not significant A (P-value= 0.226), B (P-value= 0.918). Patient in group B had statistically significant decrease in systolic blood pressure and diastolic blood pressure than group A (P-value= 0.010, P-value= 0.015). Conclusion: This study showed decrease of TG, LDL-C and total cholesterol and increase of HDL in both groups. There are significant changes in HDL-C and TG in group B that used niacin with atorvastatin than group A.

Abstract Objectives Adenosine has an analgesic and anti-inflammatory role and its injections are used for perioperative pain management. We aimed to study efficacy of intrathecal injection of adenosine for post-operative radicular pain after lumbar discectomy. Forty patients with unilevel lumbar discectomy who had radicular lower limb pain were treated by 1000 micrograms of intrathecal injection of adenosine in this single-arm prospective open-label trial between November 2015 to October 2016. Radicular pain severity using visual analogue scale (VAS) and pain killer consumption per day were assessed during a 3 months follow up period. Results Radicular pain severity was significantly reduced in 3 month follow-up period in comparison to the baseline (F = 19,760, df = 2.53, p-value

Abstract Background In low-income settings, cancer is often diagnosed in advanced stages due to late presentation. Good public awareness of cancer signs and symptoms has a positive impact on the time patients take before they present to healthcare professionals. Therefore, this study examined public knowledge of cancer signs and symptoms as well as risk factors in Gaza. Methods This was a cross-sectional study. Participants were recruited from adult visitors (≥18 years) to governmental hospitals covering all five governorates of Gaza, and adolescent students (15 to 17 years) from 10 high schools in corresponding locations. An Arabic version of the Cancer Awareness Measure (CAM) was completed in a face-to-face interview. It described demographic data and knowledge of: cancer prevalence, age-related risk, signs and symptoms as well as risk factors both in recall and recognition questions. Results Of 3033 participants invited, 2886 completed the CAM (response rate = 95.2%). Adult mean age ± standard deviation was 33.7 ± 11.7 years and that of adolescents was 16.3 ± 0.8 years. Half of the participants (n = 1457, 50.5%) were adolescent (781 females; 53.6%) and 1429 (49.5%) were adult (702 females; 49.1%). About two thirds (n = 1885) thought about cancer as unrelated to age. Only 196 participants (6.8%) identified colorectal cancer as the most common cancer among men. Awareness of cancer signs/symptoms was poor to fair, where ‘lump’ was most commonly recognized (n = 2227, 77.2%) and ‘change of bowel habit’ the least (n = 670, 23.2%). Only 217 participants (7.5%) had a good level of recognizing risk factors with ‘smoking’ being the most identified and ‘eating less than five portions of fruits and vegetables a day’ the least. There was a higher likelihood for adults to identify most cancer signs/symptoms and risk factors than adolescents, except for recalling ‘unexplained pain’, ‘persistent cough/hoarseness’, ‘non-healing ulcer’, ‘smoking’, and ‘eating less than five portions of fruits and vegetables a day’. Conclusion Public awareness of cancer signs/symptoms and risk factors needs to improve to facilitate early presentation and diagnosis in Gaza. Combining the delivery of public campaigns with tailored education to population groups, including the youth, may increase their knowledge and maintain its impact.

Introduction: Lymphedema due to breast cancer treatment has a wide range of complications, including carpal tunnel syndrome (CTS). This syndrome causes disability for breast cancer survivors, so knowing its prevalence is essential for future action. This study was performed with aim to evaluate the frequency ratio of carpal tunnel syndrome in women with breast cancer treated with lymphedema. Methods: This descriptive cross-sectional study was performed on 160 breast cancer survivors with lymphedema in Tabriz city health centers in 2018-2019. Demographic data and Boston CTS Questionnaire (CTS) were used for the purposes of the study. Data were analyzed by SPSS software (version 20) and Regression and Spearman Correlation tests. P

Abstract Background The hydrotreatment of oleochemical/lipid feedstocks is currently the only technology that provides significant volumes (millions of litres per year) of “conventional” biojet/sustainable aviation fuels (SAF). However, if biojet fuels are to be produced in sustainably sourced volumes (billions of litres per year) at a price comparable with fossil jet fuel, biomass-derived “advanced” biojet fuels will be needed. Three direct thermochemical liquefaction technologies, fast pyrolysis, catalytic fast pyrolysis and hydrothermal liquefaction were assessed for their potential to produce “biocrudes” which were subsequently upgraded to drop-in biofuels by either dedicated hydrotreatment or co-processed hydrotreatment. Results A significant biojet fraction (between 20.8 and 36.6% of total upgraded fuel volume) was produced by all of the processes. When the fractions were assessed against general ASTM D7566 specifications they showed significant compliance, despite a lack of optimization in any of the process steps. When the life cycle analysis GHGenius model was used to assess the carbon intensity of the various products, significant emission reductions (up to 74%) could be achieved. Conclusions It was apparent that the production of biojet fuels based on direct thermochemical liquefaction of biocrudes, followed by hydrotreating, has considerable potential.

This study has been conducted with the aim of designing, constructing, and standardizing a life satisfaction scale from the viewpoint of Islam; thus, the main components of life satisfaction were extracted from Islamic sources by an analytical-descriptive method and then 62 statements were provided by the data and experts' ideas. Some of those statements were omitted after its primary performance in a 30-people sample and finally, a factor analysis of a 48-statement scale called LS (Life Satisfaction) was carried out in a 255-people sample and three factors were obtained. These factors, with a total alpha of 0.92, are, respectively, as follows: satisfactory benevolence (Cronbach's alpha: 0.90), satisfactory performance (Cronbach's alpha: 0.84), and satisfactory realism (Cronbach's alpha: 0.77). According to the results, these three factors can be considered as the three sides of a triangle that the triangle of life satisfaction is based on the principle of satisfaction realism

The electrochemical reduction of molybdate ions in tartaric electrolyte has been investigated in this work. Kinetics and mechanism of the electrochemical process have been studied by cyclic and linear voltammetric polarization methods. The effect of the temperature, the rate of potential-scanning and the concentration of the molybdate ions on the electrochemical process has been also studied. By estimating the effective activation energy, it was revealed that the electroreduction process is accompanied by mixing kinetics control.

The output of a generator in power plant is the electricity, and it consists of two parts, active and reactive power. These quantities are expressed as complex numbers in which the real part is the active power and the imaginary part is the reactive power. Reactive power plays an important role in an electricity network. Ignoring it will exclude a lot of information. With regard to the importance of the generators in power plants, surely, calculating the efficiency of these units is of great importance. Data Envelopment Analysis (DEA) is a nonparametric approach to measure the relative efficiency of Decision-Making Units (DMUs). Since the generators data are complex numbers, thus, if we the use classical DEA models in order to measure the efficiency of the generators in power plants, the reactive power cannot be considered, and the measurement is limited to the real number of electric power. In this paper, a new DEA model with complex numbers is developed in order to assess the performance of the power plant generators. (original abstract)

Abstract The present study, titled "Educational Leadership University" based on manager’s entrepreneurship is objectively fundamental; part of the quantitative studies in terms of data, and based on research questions, the type of study conducted is of a field-based nature and also of a single-variable type. The statistical population of this research included faculty members of universities of the country who had management experience at the university or had a managerial position during the implementation of the research, and 446 of them were randomly selected. The research instruments were two questionnaires of Ramsden academic leadership with 57 items and manager’s entrepreneurship with 75 items which performed and validated. To answer the main question of this study, SPSS, SAS software has been used with the fundamental correlation statistical method. The fundamental correlation analysis of the production of linear combinations from the main variables is not intended to explain the variance in a set of variables, but rather to explain the maximum value of the relationship between two sets of variables (Hooman, 2015; 278). Generally, it can be concluded that different linear combinations of the entrepreneurial components of managers create different linear combinations of educational leadership in the university, and this contingency of the model distinguishes the research. Introduction Higher education systems should be responsive to the current and future needs of the community, and must be transformed into responsibility for accountability. One of the evolutionary developments is the phenomenon of information and communication technology, which is called technological changes, and the other is to adapt to the global marketplace and move towards entrepreneurship. Nowadays, the age of the University of Static has been passed which trains and recruits the traditional method of training a manpower, and a new college campus is that educates entrepreneurial, creative and efficient staff. Changing structure, physical space, and most importantly updating the way universities are managed, and moving from management to leadership, from university leadership to entrepreneur leadership, will be an effective step in today's successful universities. According to Bennett (1998), academic leaders are not meant to be heads of departments or deputies, although they are often the ones who are responsible for the leadership line. Indeed, his viewpoint refers to the practical and everyday practice of supporting, managing, developing, and stimulating academic colleagues. Ramsden (2008) believes that leadership should emphasis and focus on change and innovation, and also closely monitor the traditional academic values ​​for responding the new and sometimes weird needs . Academic leadership is in fact a change, and Bush (2012), in view of the complexities of humanity in the present era, and the need for human capital ready to operate in changing environments, academic leaders should be familiar with the theory and practice of educational management to achieve such a philosophy and Thinking. With the increasing complexity and environmental dynamism, leaders find it necessary to adopt a new approach to leadership, entrepreneurial leadership. According to Fernald, Salomon, George and Tarabishi (2009), entrepreneurial leadership is identifying the beneficial opportunities in the dynamic market and the process of penetrating others in order to identify and exploit the entrepreneurial opportunities and the internal benefits of the organization. Materials and Methods The research instruments were two questionnaires of academic leadership with 57 items and manager’s entrepreneurship with 75 items which performed and validated. α = 0.9267 credit score for manager's entrepreneurship questionnaire and α = 0/9692 credit score for educational leadership questionnaire at university, resulted in internal consistency of questionnaires questions. The Bartlett test showed that the correlation matrix for manager's entrepreneurship questionnaire with a value of 15330/552 is significant at the level less than 0.001. Therefore, the value of KMO = 0.83 and also the Bartlet test in the university leadership questionnaire with a value of 19004.969, is significant at the level less than 0.001. Therefore, KMO = 0.95 was calculated, which indicates that sample size is sufficient for sampling. Findings and Conclusions The findings of the data analysis showed that in the manager’s entrepreneurship variable, the internal control position component has the highest mean and the lowest standard deviation, and the lowest mean to the self confidence component and the highest standard deviation to the risk factor component. Also, in the academic leadership variable, the highest mean and minimum standard deviation belongs to the component of the developmen( evolutionary) and the lowest mean of the quasi-component of interpersonal relations and the highest standard deviation to the component of the induction. In general, for the manager’s entrepreneurship,it also has got an average of 3.093 and a standard deviation of 0.314 and for academic leadership an average of 2.887 and a standard deviation of 0.636. Also, the results of the data analysis indicate that the entrepreneurial component of the manager was generally reported with a mean of 3.093 and a standard deviation of 0.314. With a statistic of t =39.80. The zero hypothesis was rejected and the level of this variable is very high in a society where the group and sample are extracted, such as its constituent components, and the academic leadership component was generally reported with a mean of 2.887 and a standard deviation of 0.363, and with a statistical of t =12.85. Overall, the research findings show: the need for progress ( F3) and the high self-esteem generate stimulation ( R2) and very high interpersonal skills ( R5), the risk ( F5), and tolerating the high degree of ambiguity ( F6) manufacture understanding ( R3) and very high development (R4), and at the end, managers with internal control ( F2) and interest ( F8) and high flexibility ( F9) are very capable of achieving the objective ( R1) and high development( R4) of the educational leadership at the university. Finally, with the help of the correlation model, in the final output, three contingency models are introduced; in the first model, the understanding and development, and in the third model, the induction is independent of entrepreneurship of managers. Also, age and service experience are not a good predictor of educational leadership at the university. Generally, it can be concluded that different linear combinations of the entrepreneurial components of managers create different linear combinations of educational leadership in the university, and this contingency of the model distinguishes the research.

We describe a case of an extremely low birthweight infant with a large patent ductus arteriosus and closed foramen ovale resulting in markedly increased pulmonary blood flow, pulmonary venous congestion, and pulmonary hemorrhage.

Context: The incidence of postoperative discitis is relatively uncommon. The paucity of physical examination findings with a high index of suspicion in any patient presenting with increasing back pain after prolapsed lumber intervertebral disc (PLID) operation gives clue of diagnosis. Purpose: To see the incidence, pathophysiology, laboratory markers and imaging finding of postoperative discitis, at the same time recommendation on treatment strategies with long term clinical outcome of discitis patient in Dhaka Medical College Hospital (DMCH), a tertiary level hospital in Dhaka, Bangladesh. Methods: In this observational study, 20 patients were recruited who underwent PLID operation in the Department of Neurosurgery, DMCH, Dhaka, from January 2012 to June 2014. After preliminary selection of patients a specific protocol was followed, by taking history, clinical examination, biochemical parameters and neuroimaging. Result of treatment was observed on the basis of symptomatic improvement, with laboratory and imaging findings. Results: The most common etiological agent is staphylococcus aureus. The C-reactive protein is the most sensitive clinical laboratory marker to assess the presence of infection and effectiveness of treatment response. MRI is the imaging modality of choice in the diagnosis of discitis (100%). The majority of patients are managed adequately with culture specific antibiotics and immobilization with good long term outcomes (75%). Operative intervention in those patients who fails to respond to medical treatment (25%). Conclusion: Postoperative discitis is a rare complication after PLID operation. Its diagnosis needs high index of suspicion, appropriate laboratory and imaging studies helps in diagnosis. In the majority of patients antibiotics and spinal immobilization has been shown to produce good long term outcomes. Operative intervention is rarely necessary in patients failing conservative treatment. [ABSTRACT FROM AUTHOR]

Abstract Background: Transient ischemic dilation (TID) measures left ventricle (LV) volume changes which can be associated with combination of myocardial and endocardial ischemia. Various stress methods, single photon emission computerized tomography (SPECT) imaging protocol, camera and software incite controversy on TID cut off. The purpose of this study was to evaluate the TID ratio in detection of coronary artery disease (CAD) categories in a systematic review and meta-analysis. Method: We conducted a systematic search of electronic databases (PubMed, Scopus, Embase and Web of Science) up to 1 January 2017. The reference lists of all included studies were searched for a higher accuracy. The search strategy was according a defined PICO as P: none, I: Transient ischemic dilation, O: Coronary Artery Diseases, C: Angiographies. Statistical analysis was done by Comprehensive meta-analysis software version 2 (CMA-2). Result: After study selection process, 7 studies were selected for data extraction. TID was studied from 1987. The sample size of included studies ranged between 86 and 545. The mean age of included patients varied between 58 and 69 years old. Ranges of TID in CAD categories were excluded. The pooled estimates of TID in single and dual pharmacological stress test in three CAD categories were calculated. Conclusion: Our findings show that more studies are needed to compare the TID variability. Although in this study meta-analysis was done and TID was summarized from studies but the software differences were ignored.

Background and Aim: This research was conducted in order to investigate secondary metabolite contents such as ellagic acid, total phenol, total flavonoid and antioxidant capacity in some commercial Iranian pomegranate (Punica granatum L.) cultivars under drought stress. Materials and Methods: The experiment was a factorial arrangement based on a completely randomized design with three replications. Two factors, including pomegranate cultivars (Rabab Neyriz, Nadery badroud, Shyshah cap Ferdous, Ardestany Mahvelat, Malase Yazd and Shirinshavar Yazd) and irrigation levels (60% and 40% field capacity), the moderate and severe stresses respectively, and 80% field capacity as "control" were used and the plants were kept for six weeks. Subsequently, the alteration of some secondary metabolite contents, including ellagic acid content, total phenol, total flavonoid and antioxidant capacity in fully developed leaves were measured under above treatments. Results: In this research, all the examined cultivars had similar responses to drought stress treatments, but the intensity of these responses was different in various cultivars. Drought stress caused an increase in ellagic acid content, total phenol, total flavonoid and antioxidant capacity in all cultivars. Conclusion: According to the ultimate results, due to the high amount of ellagic acid, total phenol, total flavonoid and the consequent antioxidant capacity of the pomegranate leaf, it can be used in medicinal industry to produce herbals drugs.

One of the central issues of progress model relates to area of politics; political jurisprudence claims it can resolve many of problems in this field. In the Islamic Republic of Iran Regime model, political jurisprudence should be made possible to undergo further consideration because it is arena of newly emerged issues and events. Jurisprudential inferences overseeing political action can help determine situation of a Muslim individual in political life. This, on one hand, necessitates explication of indexes of Iranian-Islamic model of progress. The present article has postulated the indexes concerned by the supreme leader of the Islamic revolution in order to standardize the religious necessities of political life in the international and internal areas. On the other hand, it has paid attention to capacities of political jurisprudence in order to provide necessary tenets for directionality of the subject model. The article has hypothesized that the Shiite political jurisprudence has the ability to present religious necessities pertinent to political life based on the Iranian-Islamic model of progress. To confirm this, analytic-descriptive methodology has been applied. As a result, in addition to “tradition-centered” ijtihad, “intellect-centered ijtihad shall be emphasized and individual-centered jurisprudence shall be transitioned to society-centered jurisprudence.

Broad-range bacterial rDNA polymerase chain reaction (PCR) followed by sequencing may be identified as the etiology of infective endocarditis (IE) from surgically removed valve tissue; therefore, we reviewed the value of molecular testing in identifying organisms' DNA in the studies conducted until 2016. We searched Google Scholar, Scopus, ScienceDirect, Cochrane, PubMed, and Medline electronic databases without any time limitations up to December 2016 for English studies reporting microorganisms involved in infective endocarditis microbiology using PCR and real-time PCR. Most studies were prospective. Eleven out of 12 studies used valve tissue samples and blood cultures while only 1 study used whole blood. Also, 10 studies used the molecular method of PCR while 2 studies used real-time PCR. Most studies used 16S rDNA gene as the target gene. The bacteria were identified as the most common microorganisms involved in infective endocarditis. Streptococcus spp. and Staphylococcus spp. were, by far, the most predominant bacteria detected. In all studies, PCR and real-time PCR identified more pathogens than blood and tissue cultures; moreover, the sensitivity and specificity of PCR and real-time PCR were more than cultures in most of the studies. The highest sensitivity and specificity were 96% and 100%, respectively. The gram positive bacteria were the most frequent cause of infective endocarditis. The molecular methods enjoy a greater sensitivity compared to the conventional blood culture methods; yet, they are applicable only to the valve tissue of the patients undergoing cardiac valve surgery.