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Abstract Objective The purpose of this study is a new update on the resistance profile, Macrolide–Lincosamide–Streptogramin B resistance mechanisms and biofilm formation in the Staphylococcus aureus isolated from health care workers (HCWs) nasal carriage at a children’s teaching hospital in Babol (Northern Iran). Results A total of 143 non-repetitive nasal swab samples were collected from volunteers, where 53.8% (n; 77/143) were HCWs, 33.6% (n; 48/143) medical students, and 12.6% (n; 18/143) resident students. The prevalence of nasal carriers of S. aureus was 22.4% (n; 32/143), among them, 40.6% (n; 13/32) were identified as methicillin-resistant Staphylococcus aureus (MRSA( carriers. Antimicrobial susceptibility testing showed that erythromycin (68.8%, n; 22/32) and ciprofloxacin (15.6%, n; 5/32) had the highest and lowest resistance rate, respectively. The frequency of resistance genes in the strains was as follows; ermC (n; 17/32, 53.1%), ermA (n; 11/32, 34.4%), ermB (n; 6/32, 18.7%), ereA (n; 3/32, 9.4%). Moreover, 50.0% (n; 16/32), 28.1% (n; 9/32) and 21.8% (n; 7/32) of isolates were strongly, weakly and moderately biofilm producer, respectively. Macrolides-lincosamides-streptogramins B (MLSB) antibiotic resistance among S. aureus isolates from HCWs nasal carriage have found significant prevalence rates throughout the globe. It is crucial to remember that the development of biofilms and MLS B antibiotic resistance are both dynamic processes.

Metaphor is a symbolic and indirect language that conveys concealed and supplementarymeanings. Interpretive narratives may also exhibit gender metaphors and stereotypes. Thework is founded on the interpretive accounts of three Persian interpretations of Rowz al-Jannan, Jala al-Azhan, and Manhaj al-Sadeghin in this research. This article has selectednarratives that have employed gender metaphors or whose content is reminiscent of gendermetaphors. Subsequently, the qualitative content analysis method has been employed toinvestigate the value of these metaphors and their correlation with gender stereotypes.Examples of gender metaphors in these narratives include “bed,” “Boyut,” “Atbah,” and“Denya.” While some of these metaphors have a positive connotation, others have a negativeconnotation. The most significant findings of this research are that the majority of negativemetaphors about women are based on the role of a woman as a wife or sexual companion,which emphasizes her physical appearance. These metaphors are influenced by prevalentgender stereotypes that are detrimental. On the contrary, the majority of positive metaphorsare centered on the role of the mother and the qualities of kindness, creation, origin, andcommencement that are associated with the mother. In addition, this research demonstratesthat the female body is depicted in two distinct ways: the “heavenly body” and the “infernalbody.” The female heavenly body is a symbol of complete delight and benefit, while thefemale infernal body is a symbol of deception, sin, Satan, and adultery.

Abstract Background Obstructive sleep apnea (OSA) is nowadays introduced as a risk factor for white matter brain changes. Research on OSA and white matter changes provides contradictory evidence for the contextual link between the two conditions. This study aimed to determine the prevalence and severity of OSA and changes in the brain's white matter and the relationship between severity levels of both diseases. Methods This was a cross-sectional study in which 40 patients with OSA and 40 patients without OSA underwent polysomnography to determine the severity of OSA and MRI for detecting white matter changes. The severity of white matter changes was classified according to the age-related white matter change (ARWMC) score, and the severity of OSA based on the apnea–hypopnea index (AHI). To evaluate the independent effect of OSA on white matter changes, a multivariate regression model, including the severity of OSA and risk factors, was used. Results 76.5% of affected people did not show any changes, and from 13 (32.5%) patients with OSA who experienced white matter changes, 10% were mild, and 22.5% were moderate to severe changes. The white matter changes score increased with increasing OSA severity. The univariate analysis also showed a significant positive correlation between OSA severity and ARWMC score. Conclusion Our major finding was that moderate to severe OSA was independently associated with the prevalence of white matter changes. We also observed a higher prevalence of moderate to severe OSA associated with increasing white matter changes, suggesting that the severity of the disease affects brain structural modification.

Abstract Background The aim of the present study was to compare the epidemiological patterns of severe acute respiratory syndrome coronavirus 2 (SARS-CoV2) infections, hospitalizations, deaths, and duration of hospitalization during the fourth, fifth and sixth epidemic waves of coronavirus disease 2019 (COVID-19) in Iran. Methods A multicenter retrospective observational study was conducted on hospitalized patients in four hospitals in the Babol district of northern Iran. The study periods were during the fourth, fifth, and sixth waves of the epidemic in Iran, (March 2021 to March 2022). A total of 13,312 patients with suspected COVID-19 were included. Patient demographics, medical history, length of hospital stay, and clinical outcomes were obtained from the hospital information system. Data on the cycle threshold (Ct) and SARS-CoV2 variant were collected for SARS-CoV2-positive cases. Results The highest number of hospitalized patients was reported during the fifth (Delta) wave (5231; 39.3%), while the lowest number of hospitalized patients was reported during the sixth (Omicron) wave (2143; 16.1%). In total, 6459 (48.5%) out of 13,312 hospitalized patients with suspected COVID-19 had a positive rRT-PCR result. The fifth (Delta) wave had the highest number of SARS-CoV2 rRT-PCR-positive hospitalized patients (3573, 55.3%), while the sixth (Omicron) wave had the lowest number (835, 12.9%). Moreover, 238 (3.7%) patients with laboratory-confirmed COVID-19 died. The hospital mortality rate was 6.8% in the fourth (Alpha) wave, which reduced to 2.7 and 3.5% in the fifth (Delta) and sixth (Omicron) waves, respectively (p

An outer rotor double permanent magnet (PM) excited flux switching generator is designed and optimized in this paper for direct drive wind turbine applications. This generator consists of two sets of PMs: ferrite PMs embedded in the stator yoke and neodymium PMs sandwiched between the rotor segments. In this regard, the main justification for employing ferrite PMs in the stator yoke is that the risk of demagnetization of ferrite PMs at high temperatures is lower than that of neodymium PMs (the temperature of the machine’s stationary parts is higher than that of its rotating parts). For the design of the machine, the Taguchi design of experiments is deployed, while a decision-making algorithm based on the technique for order of preference by similarity to the ideal solution is used to solve the contradiction that results from the Taguchi design of experiments in the multi-objective design optimization process. During the multi-objective design optimization steps, simultaneously maximizing the no-load phase voltage and minimizing the cogging torque and total harmonic distortion of the no-load phase voltage are defined as the objective functions. The optimally designed machine is prototyped and subsequently subjected to experimental validation to verify the predictions in satisfying the objective functions.

Background & Aims: AIDS is a disease for which there is currently no effective vaccine and basic treatment, the only way to fight AIDS is to prevent infection, which is possible with health education. This study was conducted with the aim of comparing the effect of two types of AIDS prevention, educational interventions by peer and adult groups on awareness and behavior among high school students in Mashhad. Materials & Methods: This interventional study was performed to compare two methods of education via peers against education by adults about awareness towards HIV/AIDS among high school students of Mashhad city in 2014- 2015. The studied groups included three groups of peer education, adult education, and control. Examining the level of knowledge and attitude of the subject was conducted through a questionnaire of the designated researcher, whose validity and reliability were tested again in a pilot. Results: The initial awareness of students was evaluated at about 28%. The most important source of information was television. In enhancing the level of awareness post-intervention in different areas of the peer and adult intervention groups, there was significant difference compared to the control. However, no significant difference was found between the two genders when comparing the peer and adult groups. Conclusion: The peers' good understanding of the social and cultural environment of the target group would improve social norms and healthy behaviors, which are among the advantages of this method. The results can be used for the educational planning of students because it shows the level of knowledge of students at the pre-university level and the educational needs of students for appropriate educational planning.

In the present study, bulk refined-structured Al 5083 alloy with high mechanical properties was successfully fabricated by hot consolidation process of nanostructured melt- spun flakes. The influence of cooling rate and pressing conditions on the microstructure and mechanical properties of the alloy were investigated using X-ray diffractometer (XRD), optical microscopy (OM), field emission scanning electron microscopy (FE-SEM), microhardness, and compression tests. Rapid solidification combined with the hot consolidation at T=753 K (480 °C) and P= 800 MPa for 20 min produced a bulk sample with the desirable bonding, good microhardness (184.2±12.4 HV), and high strength (273±8 MPa) combined with 7 pct. fracture strain. These amounts are 78.6±5.1 HV, 148 ±9 MPa and about 5 pct. for the as-cast sample. Microstructural refinement during the controlled consolidation of nanostructure rapidly- solidified flakes contributes to such high mechanical properties of the bulk sample.

Nowadays, by expanding the application of thin layers in industry and medical sciences, their fabrication methods have also received attention. One of those methods is the vaporizing material method with the help of an electron gun. The most important part in the electron gun is the electron optic, which is responsible for producing and accelerating electrons, so that it becomes possible to vaporize refractory materials in a shorter period of time by better modifying and controlling the electron beam (the shape and diameter of the electron beam) at the target location. The reduction and control of the beam diameter in this evaporation source depends on various parameters such as device geometry, magnetic field intensity, electric power, etc. Therefore, in this research, the effect of those parameters was investigated by conducting experiments and using finite element and modeling software. The simulation results revealed that the effect of the effective parameters on the beam diameter can be predicted to a good extent, so that the diameter of the electron beam decreases by changing the geometrical shape, size and displacement of the output beam components. Then, the new electron gun, compared to the existing prototype, is optimized by applying these changes in the construction of the device and conducting experiments, and its beam diameter is reduced by 40% to be more focused.

Objectives: As glutamatergic system dysfunction is involved in bipolar depression pathophysiology, the glutamate receptor modulators such as Ketamine have been applied as complementary medication for mood stabilizers. While the treatment is currently just the intravenous injection of a single dose, and there is no robust conclusion on Ketamine effectiveness or its side effects in bipolar patients, this study aimed to consider single- and double-dose intravenous injections of Ketamine in bipolar patients compared to the placebo. Method: In a randomized, double-blind controlled clinical trial, 30 patients diagnosed with bipolar I and II disorders according to DSM-IV-TR (SCID-I) were randomly divided into three groups: the first group received an intravenous injection of Ketamine (0.5 mg/kg) and placebo with a three-day interval, the second group received two doses of Ketamine (0.5 mg/kg) in the same interval, and the third group received two placebo injections. Patients were assessed for depression, anxiety, and mania at various time points, including before the injection, 60 minutes after the injection, on the first, third, fifth, seventh, and 14th day, as well as at the end of the first month using the Hamilton Depression Rating Scale, Beck Anxiety Inventory, and Young Mania Scale, respectively. Data were analyzed using ANOVA and Repeated measure tests. Results: The mean age of patients was 36.8 ± 7.9 years, with 18 females (60%) and 12 (40%) males. Depression and anxiety showed significant differences in both the single- and double-dose Ketamine groups over time (P < 0.01). Moreover, mania displayed significant changes during the study time in the single- and double-dose Ketamine groups, as well as the in the control group. However, during the study time, there were no significant differences observed in depression, anxiety, and mania among the three groups (P = 0.198, P = 0.416, and P = 0.540, respectively). Patients did not indicate any side effects during the study. Conclusion: Intravenous Ketamine administration may relieve depressive manifestations in bipolar patients. The findings suggest that a double dose of Ketamine does not lead to greater improvement than a single dose.

Abstract Cerebral venous sinus thrombosis (CVST) is a rare type of venous thromboembolism mostly affecting young adults. Despite improved imaging studies, the diagnosis is usually delayed by several days. An average diagnostic delay of seven days from the onset of symptoms is still reported for this condition, and it is crucial for radiologists to detect this potentially lethal condition in routine imaging studies. In this study we aimed to investigate the diagnostic value of multi-detector brain CTA in diagnosing acute CVT. We searched our Picture Archiving and Communicating System (PACS) of our tertiary-level academic hospital between March 2016 and March 2019, and collected all patients for whom both contrast-enhanced MRV and brain CTA were acquired at the same admission. A total of 242 patients were found on our PACS database who met our criteria. In the blinded multidetector-row computed tomographic angiography (MDCTA) evaluation, there was a sensitivity of 96.1%, specificity of 98.6% and accuracy of 98.3% for MDCTA in detecting CVST. In the emergency settings, and in centers in which MRI scanners are not available, MDCTA can be used instead of CE-MRV for diagnosis of CSVT with a good sensitivity and specificity.

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

Abstract The trace elements copper (Cu) and zinc (Zn) are essential for maintaining oxidative balance, and cardiac surgery is known to provoke an increase in oxidative stress. We investigated the variations in serum Zn and Cu concentrations before and after surgery in patients undergoing on‐ and off‐pump CABG and heart valve replacement. We performed a prospective study on patients undergoing on‐ or off‐pump CABG, or heart valve replacement surgery (48, 51, and 47 patients, respectively). Venous blood samples were obtained, and serum Cu and Zn concentrations were measured preoperatively, 24 h postoperatively, and the time of discharge. In addition, echocardiography was carried out on all patients before surgery and again on the day of discharge. We found the temporal changes in Cu, Zn, and Zn/Cu ratio were significantly different in all three groups of surgery (p 0.05). In conclusion, the concentrations of Cu and Zn were markedly reduced after on‐ and off‐pump CABG and valve replacement surgery. This may suggest that supplementary Zn and Cu administration could be beneficial during open‐heart surgeries. However, more long‐term studies with more patients are needed to confirm this hypothesis.

Abstract Background Anovulation is one of the common causes of infertility. Polycystic ovary syndrome (PCOS) is the most common disorder with chronic Anovulation. To the best of our knowledge, insulin resistance relates significantly to PCOS. Therefore administration of insulin-sensitizing drugs such as pioglitazone can be used for ovulation stimulation in PCO patients. Methods After obtaining approval from the Ethics Committee of Mashhad University of Medical Sciences, 61 patients with PCOS were enrolled in the study based on inclusion/ exclusion criteria. Patients were divided into two groups. The first group received 30 mg (mg) of pioglitazone daily from the second day of the menstrual period. The second one received a placebo. 150 mg clomiphene citrate was administered from the third to the seventh day of the menstrual cycle. Vaginal sonography was performed in all women, and in cases with the mature follicle, intrauterine insemination was conducted after human chorionic gonadotropin injection. Ovary stimulation and pregnancy rate were compared between groups. Results There were no differences between groups regard to demographic characteristics and infertility type. Body mass index was higher in the pioglitazone group (28.3 ± 3.8 versus 26.2 ± 3.5, P value = 0.047). The size of the follicle was not significantly different between groups (2.2 ± 1.4 versus 1.3 ± 1.1, P value = 0.742). pregnancy rate [4 (12.9%) versus 4 (13.3%), P value = 1] had no differences between groups. Conclusion Although the number of follicles was higher in the pioglitazone group, our study showed no differences in ovary stimulation and pregnancy rate.

The aim of this study was to investigate the relationship between social support and social resilience of women affected by floods in Delgan. The statistical population of the study was all urban and rural women over 15 years old affected by the flood of 2020 in Delgan city, whose number was estimated at 34,280 people. The statistical sample of the research was 256 women and the sampling was done by simple random sampling. Data collection tools included a Perceived Social Support Questionnaire and the Connor and Davidson Resilience Scale. Data were analyzed using Pearson correlation coefficient and path analysis method in AMOS software. The results showed that there was a direct relationship between family support and resilience. There was also an inverse relationship between friends support with resilience (Positive acceptance of change and safe relationships and Spiritual Influences) and Significant others' support with resilience (Personal competence, Self-Control and spiritual influences) of women affected by flood. On the other hand, there was a direct relationship between the Significant Others' support and resilience (Positive acceptance of change and safe). Overall, the results showed a positive relationship between social support and resilience of flood-affected women. Keywords Social Support, Social Resilience, Women, Flood Extended Abstract In the list of the most common natural disasters, flood is in the first place. Disasters do not affect men and women in the same way, and in the meantime, they have a more significant impact on women. False assumptions and prejudices, as well as ignorance, lead women to face a host of discriminatory and exploitative situations in post-disaster situations. The fact is that the consequences of natural disasters cannot be prevented entirely, so the capacity of people to live and resist these disasters must be improved. The new approach to reducing the effects of natural disasters is to make people resilient to natural disasters. Resilience is a concept that describes how people cope with unexpected situations and means stubbornness in the face of stress, the ability to return to normal functioning after a stressful event, and surviving and trying through adverse conditions. Flood resilience has mainly measured with the concept of physically, environmentally and spatial resilience and with a geographical approach, little research has looked at resilience in its social context studied people affected by natural hazards and disasters such as floods. The previous study in the situation of natural disasters in Iran, such as flood, shows that residents of flooded areas do not have the necessary resilience to floods and need social support from family, friends and others. Social support from family, friends and important others plays a prominent role in strengthening and expanding people's resilience in the face of natural hazards and disasters such as a flood. Given that little research has studied the effects of social support on women's social resilience in the face of the flood, therefore, this study intends to investigate the relationship between social support from family, friends and others with social resilience of women affected by flood in Delgan county. Specifically, the main issue of the study is what effect does social support from family, friends and others have on the social resilience of women affected by the flood in Delgan county in Sistan and Baluchestan province? The study is descriptive-correlational research. The statistical population of the study was all urban and rural women over 15 years old affected by the flood in 2020 in Delgan city, whose number was estimated at 34,280 people. The sample includes 256 women aged 15 years and above affected by flood in Delgan county were selected by random sampling method. In order to data collection, Connor and Davidson Resilience Scale and Perceived Social Support Questionnaire were used. The results showed that among the three components of social support, the highest mean was allocated to the support from others, and the lowest mean was assigned to the component of friends' support. Also, the compound mean and standard deviation of the total perceived social support score were 3.95 and 0.29, respectively. Among the five components of resilience, the highest mean was assigned to spiritual influences (M = 3.13, SD = 0.49), and the lowest mean given to trust in one's instincts (SD = 0.68, SD = 2.08) M); also the average mean and standard deviation of the total resilience score are equal to 2.52 and 0.43, respectively. The correlation matrix of the research variables showed that the correlation of the predictor and criterion variables was significant in most cases (P

Heavy metals (HMs) are persistent and toxic environmental pollutants that pose critical risks toward human health and environmental safety. Their efficient elimination from water and wastewater is essential to protect public health, ensure environmental safety, and enhance sustainability. In the recent decade, nanomaterials have been developed extensively for rapid and effective removal of HMs from water and wastewater and to address the certain economical and operational challenges associated with conventional treatment practices, including chemical precipitation, ion exchange, adsorption, and membrane separation. However, the complicated and expensive manufacturing process of nanoparticles and nanotubes, their reduced adsorption capacity due to the aggregation, and challenging recovery from aqueous solutions limited their widespread applications for HM removal practices. Thus, the nanofibers have emerged as promising adsorbents due to their flexible and facile production process, large surface area, and simple recovery. A growing number of chemical modification methods have been devised to promote the nanofibers' adsorption capacity and stability within the aqueous systems. This paper briefly discusses the challenges regarding the effective and economical application of conventional treatment practices for HM removal. It also identifies the practical challenges for widespread applications of nanomaterials such as nanoparticles and nanotubes as HMs adsorbents. This paper focuses on nanofibers as promising HMs adsorbents and reviews the most recent advances in terms of chemical grafting of nanofibers, using the polymers blend, and producing the composite nanofibers to create highly effective and stable HMs adsorbent materials. Furthermore, the parameters that influence the HM removal by electrospun nanofibers and the reusability of adsorbent nanofibers were discussed. Future research needs to address the gap between laboratory investigations and commercial applications of adsorbent nanofibers for water and wastewater treatment practices are also presented.

Background: Rheumatoid arthritis (RA) is described as a systemic and chronic autoimmune disease characterized by inflammatory polyarthritis. Lymphocyte-activation gene 3 (LAG3) is a membrane glycoprotein expressed on activated, exhausted, and regulatory T cells. LAG3 plays a major role in the function of Treg cells. LAG3 also has a soluble form (sLAG3) with a controversial role. Objective: To evaluate the serum level of sLAG3 in rheumatoid arthritis patients in comparison with healthy subjects and assess its association with the disease activity. Methods: This cross-sectional study was performed on 105 patients with RA referred to Ghaem hospital of Mashhad, Iran. We divided the participants into four groups: 1) 35 untreated patients with newly diagnosed RA, 2) 35 active RA patients, 3) 35 patients in the remission phase of the disease, and 4) 35 healthy individuals matched in terms of age and sex. After completing the interview and questionnaire, the sLAG3 was evaluated by commercial ELISA. Results: The serum level of sLAG3 significantly increased in RA patients (76.78 ng/ml) as compared with the healthy participants (51.67, p=0.002). However, there was no significant difference between RA patients in the remission phase of the disease (114.11 ng/ml) and those with moderate to high disease activity (63.06 ng/ml, p=0.076). Conclusion: This study provided insights into the role of sLAG3 in the immunopathogenesis of ‎RA disease, but further investigations are also warranted.

Background and Objective: Laboratory-based education is one of the basic pillars of change in the management of teaching and learning of students of basic medical sciences. In this study, we designed a workshop with a new approach to teach Real time –PCR technique to postgraduate students of basic medical sciences and to evaluate the practical skills learned in the workshop, we used the standard OSPE assessment. Methods: In this study, 18 graduate students of Babol university of medical sciences were included and they were divided into two groups of intervention and control. Pre-test was performed in both groups. The intervention group was provided with an electronic content (including theoretical and practical outlines of the workshop) before participating in the workshop. At the end of the workshop and before the OSPE assessment, a post-test was taken from all participants. On the third day of the workshop, the performance of students in practical and laboratory skills of Real time-PCR technique was evaluated using OSPE examination. Findings: Pre-test and post-test scores of the intervention group in both cognitive and skill domains were higher than the control group. High satisfaction of students in each of OSPE stations in both groups indicates their acceptance of this approach. Conclusion: Using the OSPE examination in practical and laboratory courses is a good way to both assess and learn skills.

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

Background: To compare thyroid volume, thyroid stimulating hormone (TSH), free t4 and the prevalence of thyroid nodules between obese and non-obese subjects. Also, the association between BMI and insulin resistance status with various parameters of thyroid gland was evaluated. Methods: Fifty–two patients with obesity and 38 volunteers aged 20-50 years with normal body mass index (BMI), were enrolled in this cross-sectional study. Patients with diabetes, history of thyroid disorders, and patients, who were taking medications that influence their blood glucose or insulin levels or modified thyroid function tests, were excluded. TSH, free t4, insulin and glucose and thyroid sonography were carried out and the results compared between two groups. P

Introduction: Gynecologic cancers are the important cause of women's mortality in the world. Considering the importance of epidemiological recognition of gynecologic cancers in regional form for planning the preventive measures, this study was performed with aim to assess the epidemiologic characteristics of patients with gynecologic cancers referring to Mashhad oncologic centers in 1982-2016. Methods: In this cross-sectional study, after evaluation of all patients’ files recorded in the last 35 years, the required data were extracted and recorded. The study period was categorized into 4 intervals: before 1990, 1991-2000, 2001-2010, and 2011-2016. The relative frequency, mean age at the time of diagnosis, and the 35-year trend were then assessed. Data were analyzed by SPSS software (version 16) and Chi-Square, Anova, and Scheffe tests. P Results: Among 2953 studied patients, mean age was (49.32 ± 13.69 years. The highest mean age was observed among the patients with uterine body neoplasms (52.21±12.49) and the lowest mean age in those with ovarian cancer (46.09±16.09). The mean age at the time of diagnosis of ovarian cancer has significantly increased in the last decades (p

Climate change, severe droughts, population growth, demand increase, and poor management during the recent decades have further stressed the scarce freshwater resources worldwide and resulted in severe water shortages in many regions. The water utilities address the water shortage by providing alternative source of water, augment the supplied water, supply intermittently, and even bulk water delivery under severe water shortage conditions. On the other hand, many households store water in building storage tanks to cope with insufficient delivery of potable water due to frequent interruptions. All these practices could pose crucial risks to the chemical and microbiological quality of the water. However, consistent monitoring and implementation of mitigation strategies could lower the potential risks associated with these practices. It is critical to identify the potential hazards resulting from the alternative water supplies and distribution practices to develop temporary and long-term monitoring and mitigation plans and reduce the microbial and chemical contamination of potable water delivered to the consumers. This paper provides a holistic review of the significant hazards associated with the practices employed by the water utilities and water consumers to alleviate the potable water shortage and discusses the required monitoring and mitigation practices.

Purpose- To identify and prioritize factors influencing the creation of rural entrepreneurship opportunities in Iran Design/methodology/approach- A deductive approach was adopted. In this applied research, a mixed method was employed, which consisted of a descriptive-analytical method and a survey. The main data gathering tool was questionnaire. The research population comprised of university professors specialized in the field of rural entrepreneurship, rural entrepreneurs, rural managers and rural experts (n=30). In the first step, based on a review of literature, indicators influencing the creation of entrepreneurial opportunities were identified, and then the ANP-DEMATEL was used for evaluation and prioritization of the indicators. Findings- Based on cause-effect chart, the economic and infrastructural factors were assigned to the category of causes and individual, socio-cultural and political factors to the category of effects. On the other hand, the economic and political factors had the highest and lowest interaction with other factors, respectively. The results of the integrated analytical network process (ANP) and DEMATEL method showed that the economic factor had the greatest effect followed by infrastructural, sociocultural and individual components (with slight weight difference). The political component with the value of 0.1253 not only had the lowest importance, but was significantly different from other factors in terms of weight values. Research limitations/implications- Measuring the effects of factors influencing the creation of entrepreneurial opportunities along with their interrelation and mutual impact using a system approach or ISM technique. Practical implications- Given the myriad of problems affecting rural areas, such as unemployment, migration of rural labor to urban areas and diminished sense of belonging, among other things, it is essential to pay greater attention to entrepreneurship and its implementation to achieve sustainable rural development. Besides, by identifying the root causes and factors influencing rural entrepreneurship, it is possible to offer solutions for organizing entrepreneurship. If policy makers, planners, and rural managers adopt these strategies, sustainable rural development could be reinforced. Originality/value- Providing the most important indicators influencing the creation of rural entrepreneurship opportunities, prioritizing and measuring the impact of those factors on each other using ANP-DEMATEL method. In particular, the results of this research can benefit managers and decision makers in the field of rural entrepreneurship. The results can also be beneficial to universities, higher education institutions and students.

Introduction: Regarding to high prevalence of breast cancer, it is important to find strategies for early, rapid, convenient and accessible diagnosis. After screening and detecting a lesion in the breast, the type of lesion and the degree of malignancy should be determined.This study was performed with aim to evaluate the concordance between sonographic and histologic findings in breast lesions under core needle biopsy. Methods: This cross-sectional prospective study was performed on 149 patients referred to Omid Hospital, Mashhad University of Medical Sciences who underwent core needle biopsy from breast lesions during 2015 to 2018. Patients who had BI-RADS 3, 4, and 5 and according to the surgeon's recommendation required biopsy of the lesion underwent ultrasonically guided biopsy. Also, the lesions which had a malignant sonographic view, but were placed in the benign lesions group after core needle biopsy and histologic examination, were evaluated with excision. Data were analyzed using SPSS software (version 22) and descriptive statistics (frequency distribution table and frequency percentage). Results: The histological findings of BI-RADS 3 lesions were completely benign (11 cases). The frequency of malignancy in lesions with BI-RADS 4 was 31% (39 cases). All cases with BI-RADS 5 were malignant according to histological finding. 8 (44%) of 18 cases with BI-RADS 4b lesions that were benign according to needle biopsy findings were malignant in excisional biopsy findings. Conclusion: In cases that breast lesions are BI-RADS 4b in sonography and the results of core needle biopsy showed benign lesions, additional histological diagnostic evaluation is recommended to rule out malignancy. More studies with higher sample sizes are recommended to confirm the results of this study.

Introduction: By crossing the borders of cities and countries, air pollution is now a global problem so that it can be claimed that there is no sound and clean air. This study aimed to investigate the effect of meteorological parameters on the concentration of particulate matter (PM2.5 and PM10) in the air of Arak city. Materials and methods: In this study, Arak city was divided into three regions using geographic information system (GIS). Based on air pollution monitoring stations in Arak city, it was tried to select one station from each region for analysis. Meteorological parameters including temperature (°C), relative humidity (٪), precipitation (mm), and wind speed (m/s), were obtained from Arak Meteorological Organization. Finally, the association between the concentration of PM (PM2.5 and PM10) and meteorological parameters were evaluated by SPSS. Results: Annual changes in PM (PM2.5 and PM10) showed that the average particle concentrations were 25.34 and 46.81 µg/m3 in the two study periods, respectively. It was also found that the citizens of Arak were 2.5 times more exposed to PM (PM2.5 and PM10) pollutants than the standard recommended by the World Health Organization. Our findings also showed strong positive linear correlations of wind velocity and temperature with PM2.5 and PM10, as well as relative humidity with PM10, and negative correlations of precipitation with PM2.5 and PM10, as well as relative humidity with PM2.5. Conclusion: The distribution map of Arak city indicated that the citizens of Shariati station and the governorate office were facing high concentrations of pollutants, posing them to a serious threat. Moreover, more pollution was recorded toward the north and northwest of the city. To protect the health of citizens in Arak, therefore, it is necessary to adopt appropriate policies and rules to reduce the concentrations of PM and other pollutants in the air of this city.

Current knowledge about the potential impacts of microplastics (MP) on vadose zone hydrology is scarce. The primary goal of this study was to address some of the limitations of previous research by developing more reliable and conclusive statistical evidence to better understand whether MP pollution can potentially cause hydrological impacts. We examined the effects of MP shape (type), as well as the magnitude of pollution (MP/soil mass ratio, λ) on water holding capacity (WHC) and bare soil water evaporation (ER) of fine sand, under controlled laboratory conditions. Three different shapes (types) of MP—fiber (polyacrylic), strand (polymethyl methacrylate), and pellet (acrylonitrile butadiene styrene), with six environmentally relevant MP concentration levels (MP/soil mass ratio), all ≤1.5%, were studied. Statistical regressions and non-parametric analyses of variance (i.e., Kruskal–Wallis analysis) indicate that MP pollution has a substantial potential to change WHC and late-stage evaporation, even at relatively low MP concentrations, but has minimal impacts on early stage evaporation of the studied fine sand. The magnitude of the impacts depends on individual MP shape (type) and concentration, connoting those MP impact mechanisms are complex. These findings suggest that the global issue of growing soil–MP pollution should be regarded as a concerning environmental and water resources stressor that could potentially cause widespread environmental change by altering soil-water dynamics at the watershed scale.

Abstract Background Lupoid cutaneous leishmaniasis (LCL) is known as a rare but serious complication of anthroponotic cutaneous leishmaniasis (ACL) resistant to conventional treatments. Sodium chlorosum, a pro-oxidative preparation of pharmaceutical sodium chlorite (NaClO2), has been successfully used for the treatment of Old World cutaneous leishmaniasis lesions (OWCL) and of some LCL cases in Afghanistan. This clinical trial study aimed to evaluate the effect of a last resort therapy with topical 0.09% sodium chlorosum on LCL in Iran. Methods Twenty Iranian patients (12 women and 8 men) with LCL refractory to treatment were included in this salvage study. A magistral preparation of sodium chlorosum (10 mM NaClO2 in amphiphilic basic cream) was applied twice daily to the lesions for 6 weeks and continued up to 12 weeks in patients who showed a clinical response within the first 6 weeks. Responders were followed up for a maximum of 1 year. Lesions were photographed during weekly visits. Disappearance of erythema and indurated lesions were rated as complete clinical response. Results Patients with a mean age of 28.6 (±24.3) and with an ACL proven lesion history of 3.8 (±1.4) years were treated for an average of 7.9 (±1.8) weeks. At the end of the treatment period (12th week), a complete response was observed in 9 of 20 patients (45%). During the one-year follow-up period, LCL lesions recurred in 4 of these 9 patients (with one patient showing only a tiny lesion) and one case lost to follow up whereas the other four remained completely lesion-free. Mild temporary side-effects such as erythema and itching were seen in 4 of 20 patients (20%). Conclusions Topical sodium chlorosum showed promising therapeutic results and can be considered as safe, painless, and relatively effective treatment for LCL, an ethical prerequisite for a two-armed controlled trial. Trial registration This study was registered in Iranian registry of clinical trials on 2019-02-02 with registration number IRCT20190114042356N1.

Introduction: Lower-limb varicose is a common disorder, which is caused in some occupations and is exacerbated over time, imposing direct and indirect costs on individuals and the community. The present study aimed to validate the Persian version of Aberdeen varicose vein questionnaire (AVVQ). Methods: This cross-sectional study was conducted on 75 patients with varicose veins referring to Imam Reza Hospital in Mashhad, Iran in 2014. The subjects were selected via census sampling. The AVVQ was translated into Persian, and its reliability and validity were assessed using face, content, criterion, and construct validity and Cronbach’s alpha coefficient for reliability. To evaluate content validity, the content validity ratio (CVR) was calculated, and the criterion validity was determined based on Pearson’s correlation-coefficient. In addition, the correlation of the obtained score of each questionnaire item with the total score was verified. Results: The mean age of the patients was 43±16 years. Content validity was assessed based on Lawshe’s method and CVR index of >0.7. The mean score achieved in the AVVQ was 62.3± 8.8, and significant correlations were observed between the total score of AVVQ and physical domain (P

Introduction: Precocious puberty can cause important physical and psychiatric complications, although timely diagnosis and treatment can prevent these complications. The gonadotropin-releasing hormone stimulation test is the diagnostic test for central precocious puberty that due to the limitation and invasiveness of the test, this study was performed with aim to evaluate the complementary role of pelvic ultrasound as a noninvasive and cost benefit test for diagnosis of precocious puberty. Methods: This cross-sectional study was performed on 15 girls aged < 8 years who had referred by their parents with complain of secondary sexual characteristic to the pediatric endocrinology clinic of Imam Reza and Ghaem hospitals in Mashhad in 2018. In addition to the measurements of height and weight and BMI, gonadotropin-releasing hormone stimulation test was performed for the subjects. Girls with LH levels ≥ 5 IU / L were referred to the radiology department of Imam Reza hospital for pelvic ultrasonography. Pelvic ultrasonography was performed by radiologist using a conventional full-bladder 2- to5-MHz transducer. Length, width and height of the uterus, uterus volume, length, width, height and volume of the ovaries were measured. Then, the results were compared with ultrasonography of 15 subjects as control group. Data were analyzed by SPSS software (version 16) and t-test and Mann-Whitney test. P

Background: research has shown the relationship between emotional schemas, attachment styles and personality traits in patients with Body dysmorphic disorder. But could this relationship be predicted in individual prone to cosmetic surgery?Aims: The present study aimed to determine the roles of emotional schemas, attachment styles, and personality traits in body dysmorphic disorder in individuals prone to facial cosmetic surgery. Method: The study sample included 273 people selected using non-randomized sampling method among all individuals prone to cosmetic surgery in the city of Ahvaz. Participants completed Stoizin et al. body dysmorphic questionnaire (2007), Leahy’s emotional schema (2002), the NEO-short form of personality traits (2003), and Hazen and Shaver’s attachment style (1987). Results: The results of this study showed that according to the cut-off score of the body dysmorphic questionnaire, 1.7 percent of men and 8.8 percent of women suffered from body dysmorphic disorder. Conscientiousness in the first step (β=-0/34), avoidance attachment in the second step (β=0/28), and the simplistic view of emotions in the third step (β=0/21) as well as the control component in the fourth step (β=0/16) predicted body dysmorphic in women. In men, only validation predicted body dysmorphic (β=0/27). Conclusions: The results of this study indicated the role of personality traits, attachment style, and emotional schemas in body dysmorphic disorder in men and women.

PURPOSE: This study aims to evaluate visual outcome after Descemet's membrane stripping automated endothelial keratoplasty (DSAEK) and relate to interface and corneal higher-order aberrations (HOAs). MATERIALS AND METHODS: We enrolled 16 eyes of 16 patients (eight males and eight females) in this interventional case series and followed DSAEK operation for about two to 20 months. OCULUS Pentacam, as well as other ophthalmic evaluations in follow-up visits, examined interface reflectivity and HOAs. Statistical relations were analyzed. RESULTS: There was statistically significant correlation between interface reflectivity and best corrected visual acuity (BCVA) (r = 0.56, P = 0.021). Pachymetry (central corneal thickness) and BCVA had a moderate correlation (r = 0.6, P = 0.013). There was no statistically significant correlation between pachymetry and follow-up time (r = −0.36, P = 0.16). Negative correlation between follow-up and interface reflectivity was also not statistically significant (r = −0.24, P = 0.35). Coma had a significant correlation with BCVA in cornea and cornea front maps (r = 0.74, P = 0.009 and r = 0.71, P = 0.013, respectively). CONCLUSION: Significant correlation between interface reflectivity and BSCVA was found, and anterior corneal HOAs are significantly higher than posterior HOAs.

Background: Cancer antigen 15-3 and carcinoembryonic antigen are used in clinical and laboratory diagnosis of metastatic breast cancer. Previous studies have noted conflicting results about the association between carcinoembryonic antigen and cancer antigen 15-3 in metastatic breast cancer. The present study examined serum tumor marker levels of carcinoembryonic antigen and cancer antigen 15-3 among patients with different subtypes of metastatic breast cancer. Methods: In this cross-sectional study, we assessed metastatic breast cancer patients diagnosed between 2005 and 2012 who referred to academic Hospitals affiliated with Mashhad University of Medical Sciences. The patients were selected by systematic randomization sampling. Demographic, clinical, pathological, and therapeutic data were collected from patients’ hospital records. Statistical analyses were performed by Statistical Package for the Social Sciences version 16.0 software. Results: A total of 298 eligible patients enrolled in the study. Patients’ median age was 48.39±12.57 years. Elevated serum levels of carcinoembryonic antigen were identified in 65.17% of patients and cancer antigen 15-3 in 57.29% of patients. Based on molecular subtype categorization, 109 (39.5%) patients were human epidermal growth factor receptor 2 negative and 105 (38.0%) patients were in the luminal group. There was no significant correlation between serum carcinoembryonic antigen and cancer antigen 15-3 with subtypes of the tumor. The most common sites for metastasis were bones and liver, respectively. However, there was no significant correlation between serum carcinoembryonic antigen and cancer antigen 15-3 with the site of metastasis. There was a significant association between serum carcinoembryonic antigen level and stages IIA and IV. Conclusion: One of the most significant findings of the current study was the increased serum carcinoembryonic antigen and cancer antigen 15-3 levels in most metastatic breast cancer participants. We postulate that regular measurement of serum cancer antigen 15-3 and carcinoembryonic antigen could be useful for earlier detection and prediction of outcomes.

Since the notion of topological insulator (TI) was envisioned in late 2000s, topology has become a new paradigm in condensed matter physics. Realization of topology as a generic property of materials has led to numerous predictions of topological effects. Although most of the classical topological effects, directly resulting from the presence of the spin-momentum-locked topological surface states (TSS), were experimentally confirmed soon after the theoretical prediction of TIs, many topological quantum effects remained elusive for a long while. It turns out that native defects, particularly interfacial defects, have been the main culprit behind this impasse. Even after quantum regime is achieved for the bulk states, TSS still tends to remain in the classical regime due to high density of interfacial defects, which frequently donate mobile carriers due to the very nature of the topologically-protected surface states. However, with several defect engineering schemes that suppress these effects, a series of topological quantum effects have emerged including quantum anomalous Hall effect, quantum Hall effect, quantized Faraday/Kerr rotations, topological quantum phase transitions, axion insulating state, zeroth-Landau level state, etc. Here, we review how these defect engineering schemes have allowed topological surface states to pull out of the murky classical regime and reveal their elusive quantum signatures, over the past decade.

Objectives: Recently, intravenous acetaminophen has been introduced as an intervention with analgesic potential similar to that of opioid analgesics in labor pain management. This study aimed to compare the pain score and maternal and neonatal complications following acetaminophen and pethidine injections during vaginal delivery. Methods: This randomized, double-blind clinical trial was conducted on pregnant women during the first stage of delivery referred to Ghaem and Omolbanin Hospitals in Mashhad, Iran, from March to December 2017. The subjects were assigned randomly to one of two groups: acetaminophen and pethidine. The pain intensity was measured before and 15, 60, 120, 180, and 240 minutes after injection. Results: The pain score and pain score changes showed no significant difference between the two groups at different times. The incidence of maternal complications during delivery and the first hour after delivery was not statistically significant between the two groups, but 15 minutes after injection, vomiting (p = 0.001), nausea (p = 0.001), and dizziness (p = 0.001) were significantly higher in the pethidine group. The mean one and five minutes Apgar scores were significantly higher in the acetaminophen group. Conclusions: Intravenous acetaminophen led to fewer maternal complications than pethidine, especially during the first 15 minutes after injection and fewer neonatal complications, especially in the Apgar score.

Various methods are used in order to describe the heart rate patterns of the fetus. The use of electronic monitoring during labor is widely accepted today. The aim of this study was to compare the neonatal outcomes of continuous Fetal Heart Rate (FHR) monitoring to intermittent auscultation among low-risk pregnant women during labor. This randomized clinical trial was conducted among 900 low-risk pregnant women who met inclusion criteria and were admitted to maternity wards of academic hospitals of Mashhad University of Medical Sciences for labor. They were randomly divided into two groups: the intermittent auscultation group and the Continuous FHR monitoring group. The pregnancy and neonatal outcomes were compared in two groups; data were processed in SPSS16 software. P less than 0.05 was considered as significant level. In this study, the first and fifth minutes Apgar scores, the rate of NICU admission, advance resuscitation requirement, neonatal seizure incidence, and the neonatal or fetal death did not differ significantly between two groups (P>0.05). In the Continues monitoring group, the rate of cesarean section due to fetal distress and operative vaginal delivery was significantly higher rather than the other group (P=0.001). The results of this study showed that continuous FHR monitoring in low-risk pregnancies during labor increases the risk of cesarean and instrumental delivery without improving neonatal outcomes.

Climate change and the expected increase in frequency of dry summers are likely to affect the growth of important tree species. We investigated relationships between morphological and chemical leaf traits of European beech (Fagus sylvatica L.) and environmental factors along a water availability gradient consisting of 12 sites located throughout Switzerland. We found that leaf dry mass and leaf area tended to decrease with increasing long-term mean annual precipitation (MAP) and actual to potential transpiration (AT/PT), two correlated variables that form the water availability gradient. These results contrast with those of several other studies, and might be explained by favorable temperature and humidity conditions during leaf formation in spring at the dry sites. Although the relationship was not linear over the whole gradient, the drier sites were characterized by beech with a lower specific leaf area, along with higher foliar potassium (K) and lower foliar nitrogen (N) concentrations. These patterns likely reflect strategies developed as an adaptation to reduced water availability, but they also result from variation in the availability of nutrients in soil across our sites. In the case of N, there are indications that atmospheric deposition plays a role in foliar concentrations.

Introduction: Lichen planopilaris (LPP) and frontal fibrosing alopecia (FFA) are skin diseases that affect the quality of life. Although a systematic review on LPP and FFA treatment was published in 2013, further updates are needed. The aim of this study is to review systematically the studies published after the last systematic review.Methods: We searched Scopus, PubMed, Embase, and ISI Web of Science. All the studies published during March 2012-June 2017 were included in this review. Two reviewers separately selected the studies and extracted the data. The results of studies were categorized as unimproved, stabilized, and improved based on the articles reports.Result: Among the 38 studies, 20, 17, and one studies assessed LPP, FFA, and both treatments, respectively. The papers were case reports, case series, cohorts, and randomized controlled trials. Antimalarial agents and pioglitazone resulted in enhancement in 73 and 71% of the LPP patients, respectively. Improvement and stabilization were observed in almost one third of the topical steroid users and 6/12 of Tacrolimus/Pimecrolimus users in LPP. Improvement and stabilization in FFA was found in 68% of the individuals using antimalarial agents, 83% of intralesional steroid users, all cases of finasteride users, and 95% of the people utilizing dutasteride.Conclusion: Contrary to the previous systematic review, we found antimalarial agents more effective than steroids in LPP. Finasteride/dutasteride may have favorable impacts on FFA. Intralesional steroids showed to be more effective than antimalarial agents in FFA. Still further studies are needed in order to define a treatment protocol. Low quality and heterogeneity of the articles were among the limitations for making a conclusion.

Objective: Septic shock is a response to infection and tissue hypoperfusion which does not respond to fluid therapy and eventually leads to organ dysfunction. Aggressive treatment of a broad-spectrum antimicrobial and supportive measures are the cornerstones of successful treatment. In addition to the main treatment, there are adjunctive therapies. Steroids are one of the treatments which have been studied in the management of refractory septic shock. Despite numerous studies on the role of steroids in the mortality of severe sepsis and septic shock, still lots of controversies exist. These conflicts are often about the steroid dose and duration of administration. Methods: This was a prospective, randomized-controlled, two-group assignment study. Patients referred to Imam Reza (AS) hospital in Mashhad who had refractory septic shock criteria were randomly divided into two groups: 80 patients were included in each group. After obtaining the baseline cortisol level and cosyntropin test, one group was treated with intravenous hydrocortisone, and the other group was treated with placebo. The response to hydrocortisone, the return of shock duration, and mortality at 28 days were investigated. The data were analyzed using SPSS version 16. For the normally distributed variables, a t test was used for comparisons. Concerning qualitative variables, the chi-square test or Fisher exact test were applied accordingly. Results: The return of shock duration and mortality in intervention group patients was more than control group, but it was not statistically significant. Conclusion: Despite numerous studies in this field, there are various outcomes (mortality rate, rate of return of shock, time of return of shock). These differences can be attributed to high degree of heterogeneity. Perhaps considering the underlying disease and more differentiation could change the return of shock and mortality rate.

Introduction: The present research aimed to examine Visual Working Memory (VWM) test scores, as well as hormonal, genomic, and brain anatomic changes in the male rhesus macaques exposed to Extremely Low Frequency Magnetic Field (ELF-MF). Methods: Four monkeys were exposed to two different ELF-MF frequencies: 1 Hz (control) and 12 Hz (experiment) with 0.7 µT (magnitude) 4 h/d for 30 consecutive days. Before and after the exposure, VWM test was conducted using a coated devise on a movable stand. About 10 mL of the animals blood was obtained from their femoral vain and used to evaluate their melatonin concentration. Blood lymphocytes were used for assaying the expressions of N-Methyl-D-aspartate NMDA-receptor genes expression before and after ELF exposure. Anatomical changes of hippocampus size were also assessed using MRI images. Results: Results indicated that VWM scores in primates exposed to 12 Hz frequency ELF increased significantly. Plasma melatonin level was also increased in these animals. However, these variables did not change in the animals exposed to 1 Hz ELF. At last, expression of the NMDA receptors increased at exposure to 12 Hz frequency. However, hippocampal volume did not increase significantly in the animals exposed to both frequencies. Conclusion: In short, these results indicate that ELF (12 Hz) may have a beneficial value for memory enhancement (indicated by the increase in VWM scores). This may be due to an increase in plasma melatonin and or expression of NMDA glutamate receptors. However, direct involvement of the hippocampus in this process needs more research.

Background: Humans in modern societies expose to substantially elevated levels of electromagnetic field (EMF) emissions with different frequencies.The neurobiological effects of EMF have been the subject of debate and intensive research over the past few decades. Therefore, we evaluated the effects of EMF on visual learning and anatomical dimensions of the hippocampus and the prefrontal area (PFA) in male Rhesus monkeys. Materials and Methods:In this study, four rhesus monkeys were irradiated by 0.7 microtesla ELF-EMF either at 5 or 30 Hz, 4 h a day, for 30 days. Alterations in visual learning and memory were assessed before and after irradiation phase by using a box designed that cchallenging animals for gaining rewards Also, the monkeys’ brains were scanned by using MRI technique one week before and one week after irradiation. The monkeys were anesthetized by intramuscular injection of ketamine hydrochloride (10–20 mg/kg) and xylazine (0.2–0.4 mg/kg), and scanned with a 3-Tesla Magnetom, in axial, sagittal, and coronal planes using T2 weight­ed protocol with a slice thickness of 3 mm. The anatomical changes of hippocampus and the prefrontal area (PFA) was measured by volumetric study. Results: Electromagnetic field exposure at a frequency of 30 Hz reduced the number of correct responses in the learning process and delayed memory formation in the two tested monkeys. While, ELF-EMF at 5 Hz had no effect on the visual learning and memory changes. No anatomical changes were found in the prefrontal area and the hippocampus at both frequencies. Conclusion: ELF-EMF irradiation at 30 Hz adversely affected visual learning and memory, pprobably through these changes apply through effects on other factors except changes in brain structure and anatomy.

Introduction: Esophageal cancer is among the most common malignancies. Hospital mortality in the past decade reduced; but its morbidity is still high. Pulmonary complications are the most common complications after esophageal resection. In this study we examined the effect of steroids administration during surgery to reduce postoperative morbidity with a focus on respiratory complications.Material and Methods: Patients with esophageal cancer who underwent transhiatal esophagectomy, randomly divided into two groups to thirty patients: The intervention group (received 125mg methylprednisolone sodium succinate). After surgery, patients admitted in the ICU for a day. Oral feeding initiated on day 7th and patients discharged home on the day 8th or 9th.Postoperative complications included anastomotic fistula, wound infection in the neck and abdomen and pulmonary complications. We analyzed pulmonary complications included pneumonia, Acute lung injury (ALI) or acute respiratory distress syndrome (ARDS) occurred before the seventh day. The leukocyte counts and CRP levels measured on the 2nd and 7th days after surgery.Results: 60 patients enrolled in the study. Incidence of ARDS, ALI and pneumonia in the control group was 3, 5 and 2 and in steroid group 1, 1 and 1 respectively. CRP levels and blood leukocyte count was similar in two groups on the second day but seventh day values and difference between the two levels between the second and seventh days were significantly different between the two groups (p

Kidney transplantation is usually followed by immunosuppressive therapy to prevent early rejection and prolong graft survival. The calcineurin inhibitors (CNIs) represent the most commonly used agents. However, available evidence suggests the poor outcome over the long term, maybe be due to the potential nephrotoxicity associated with CNIs. Several randomized trials have compared tacrolimus (TAC) with cyclosporine, to find the optimal agent for renal transplantation; however, studies have shown conflicting results. The aim of this study was to systematically review and update the evidence for the benefits and harm of TAC versus cyclosporine as the primary immunosuppression after renal transplantation. The study was a systematic review and meta-analysis. An electronic literature search was conducted to identify appropriated trial studies. The outcomes were presented as relative risk (RR), with 95% confidence intervals (CI). Statistical analysis used was meta-analysis. Twenty-one eligible randomized controlled trials were included in this systematic review. TAC was significantly superior to cyclosporine considering the total effect size of graft loss (RR 0.089; 95% CI0.057–0.122, P

Objective: To study earthquake planning and crisis management with an emphasis on the facilities, utilities, and services of the health care centers of Tiran and Karvan County, Isfahan Province. Methods: This is a descriptive-analytical survey based on the quantitative and qualitative characteristics of Tiran and Karvan County Health Care Centers(HCCs). Twenty quantitative and qualitative indicators were derived from the studied HCCs and analyzed using the strengths, weaknesses, opportunities and threats analysis technique. The top crisis management strategies were identified and a number of strategies and solutions were proposed. Results: The HCC utilities such as water, electricity, gas, and heating and cooling systems were in average condition, whereas the facilities of the majority of HCCs were in vulnerable-to-average condition. In addition, they sustained relatively high degree of instability which calls for reassessment and effective policies to minimize weaknesses and eliminate threats using strengths and opportunities. Conclusions: It is recommended that the condition of Tiran and Karvan County HCCs be enhanced by distributing new HCCs based on the population density, expanding the road network and creating vast, wide-open spaces to enable field hospital construction in times of crisis.

Background: Serum cartilage oligomeric matrix protein (COMP) is a non-collagen glycoprotein produced by the cartilage, synovium, tendon, and meniscus. Recent studies showed that COMP is a reliable factor for monitoring cartilage damage. Objective: To determine the relationship between serum COMP concentration and the severity of rheumatoid arthritis (RA). Methods: This cross-sectional study lasted from 2013 to 2015 at the Rheumatology Clinic of Ghaem Hospital, Mashhad, Iran. The study population consisted of eligible patients who presented to our clinic during the study period. Four groups (150 subjects) were included as early RA (50 patients), late RA (50 patients), grades II and III OA (osteoarthritis) (25 cases, 17 grade II and 8 grade III joint destruction), and healthy controls (25 individuals). These were included consecutively. Serum COMP level was assessed by sandwich ELISA technique. In addition, ESR, hs-CRP, serum RF, and anti-CCP were assayed. X-rays of the knees (in OA) and hands (in RA) were examined for the degree of joint damage/erosion using the Short Erosion Scale (SES) in RA and Kellgren-Lawrence grading in OA. Analysis of variance (ANOVA) to compare mean COMP level among the groups and ROC (Receiver Operating Characteristic) analysis to determine the diagnostic accuracy of COMP in diagnosis of late RA were used by SPSS software (ver. 20.0). Results: Mean (±SD) serum COMP levels were 18 (±10.6) U/L in early RA, 19.3 (±9.6) U/L in late RA, 10.9 (±4.5) U/L in OA, and 4.2 (±3.8) in controls; p

Introduction Tracheobronchial foreign body aspiration is a common life-threatening condition in children. There are controversies in the management of this condition, including the type of ventilation during bronchoscopy. This study aims to compare anesthesia with controlled ventilation versus spontaneous ventilation in rigid bronchoscopy in children with foreign body aspiration. Materials and Methods: Patients who were candidates for rigid bronchoscopy due to foreign body aspiration were randomly assigned to either anesthesia with spontaneous ventilation or controlled ventilation. End tidal CO2 (ETCO2), electrocardiogram (ECG), heart rate (HR), oxygen saturation (SpO2), non-invasive blood pressure (NIBP) and complications and accidents during the surgery and recovery were recorded for each patient. Surgeon comfort during the procedure was also evaluated for each patient. A 20% change in HR or NIBP was considered significant. SpO2 values under 90% are considered desaturation. Results: Fifty-one patients (31 male and 20 female) entered the study. The mean age was 26.76 months, ranging from 6 to 100 months. Choking and cough were present in 94% and 96.1% of the patients, respectively. Nuts were the most common foreign body (76.9%). The controlled ventilation group had significantly fewer complications, and surgeon comfort was significantly higher in this group. Oxygen desaturation was significantly more prevalent in the spontaneous ventilation group during laryngoscopy and bronchoscopy (P

Introduction Urumieh-Dokhtar Magmatic Arc (UDMA) is a good prospective area for Cu, Cu-Mo and Cu-Au deposits (Fig. 1A and B). The Zafarghand district is located in the central part of the UDMA and the northeastern Isfahan. The present study concerns geological observations, alteration investigations, geochemical data and fluid inclusion studies. The purpose of the research is to identify geochemical anomalies and source of metals in this area. Geochemical anomalies for mineralizing elements and element associations were identified by using statistical analysis methods. Additionally, these results together suggest a site for exploration drilling in this study area. Materials and methods We collected 186 samples (rock) along multi-cross sections oriented perpendicular to the strike of the South -Ardestan fault (Fig. 2).Trace element concentrations were determined by the ICP-MS technique in Amdel laboratory (Australia). Thin sections and doubly polished sections (100–200 µm thick) from quartz veins were prepared from samples collected from the Zafarghand district in the University of Isfahan. Heating and freezing experiments on fluid inclusions were performed as defined (by Goldstein and Reynolds (1994) on a Linkam THM600 stage. Results Igneous rocks in the Zafarghand area are dominated by the Eocene and post Eocene acidic-intermediate rocks that include dacite, rhyodacite and andesite associated with diorite, quartz diorite and microdiorite intrusions. The present investigations indicate that all rocks of the Zafarghand district exhibit a variety of alterations. Hydrothermal alterations include phyllic, potassic, silicification, and argillic with widespread propylitic. The mineralization consists of malachite, azurite, hematite, and goethite, rare amounts of magnetite, pyrite, and chalcopyrite. Numerical traditional statistical analysis techniques have been applied to interpret the geochemical data of the study area. These methods are aimed at producing maps resulting from the detecting of anomaly or threshold values from the background (Aitchison, 1986; Sun et al., 2009). Anomalies of Cu, Mo, Au, Ag, Pb, Zn and Sb were determined by Mean + 2 standard deviation (Cheng, 2007; Zuo et al., 2009; Chen et al., 2016). Geochemical maps for these elements in rocks and soils (Fig. 4) show significant contrasts in haloes concentrations within the diorite and dacite rocks in the southeast of the study area. The addition of concentrations in rocks is suggested indicating that a district-scale geochemical present is confined to either base metals or precious metals. The obtained fluid inclusion results are compiled in Table 3. Primary fluid inclusions in quartz mostly consist of two-phases and rarely three phases. Homogenization temperatures (Th) in quartz samples represent wide variations from 123° to 550°C. They were classified according to the mode of homogenization into two immiscible types (Fig. 8): These are early inclusions stage with a high Th (between 328° and 550°C) and late stage inclusions with a low Th (between 123° and 390°C). The salinity measured using the equation of Bodnar (1993) for fluid inclusions varies from 1.15 to 43 eqv.wt% NaCl. It was divided into two groups including high salinity (32 to 43 eqv.wt% NaCl) and low salinity (1.15 to 5.16 eqv.wt% NaCl). Discussion The predictive results obtained by field observations, geochemical and micro thermometric studies are in good agreement with the known deposits. Geochemical anomalies are associated with phyllic and rare silicified altered rocks. The host rocks of anomalies are mainly dacite and diorite, respectively with an Eocene and younger age. District-scale geochemical patterns of several elements (Cu, Mo, Au, Pb, Ag, As, and Sb) in the surface coincide with the southeastern area and can be used to explore for epithermal and/or porphyry-type deposits. Anomalies of Cu and Mo are suitable for targeting Cu-Mo mineralization. Weak anomalies associated with Au concentration should also be combined with other exploration methods to identify mineralization in the Zafarghand district. Quartz veins are classified as V1 and V2 (Fig. 3G). Based on the properties of quartz hydrothermal fluids in the Zafarghand district, they are interpreted to have evolved in two-types of fluid fields (Fig. 7): - Stage 1 fluid inclusion: This inclusion included 32 to 43 wt percent NaCl eqv (high salinity) and homogenizing between 328° and 550°C. Primary quartz in stage 1 veins (V1) is poor inclusion and associated with sulfide minerals. It can be represented by fluids trapped during aporphyry- system episode. - Stage 2 fluid inclusion. This inclusion typically contains

BACKGROUND AND AIM: Perception of the need for oral healthcare plays a key role in creating motivation and demand for utilization of oral healthcare services. Furthermore, while the lack of resources, people with perceived needs to oral healthcare, due to the higher profit potential of services, will be on higher priority for services. The aim of this study was to undertake a systematic review of the existing literature about questionnaires used for assessing the perceived oral healthcare needs. METHODS: The search was conducted in PubMed, ISI and Scopus databases in March 2016. Questionnaire-based and the papers which aimed to determine the perceived need for any type of oral healthcare and dental treatment were included to this study. After determining the appropriate papers, related data were extracted and reviewed. RESULTS: Out of 7069 records found, 190 questionnaire-based papers were included in the review. Ninety-four papers were related to the overall evaluation of oral healthcare need, which did not ask the need for types of oral healthcare service. Sixty-six papers studied the need for a specified dental service, and thirty papers recorded the types of oral healthcare service via asking the open or multiple choices questions. There were not comprehensive and standard questionnaires covering all the common types of oral healthcare services. CONCLUSION: Despite the importance of considering the perception of needs for oral healthcare, there is a lack of the comprehensive and standard questionnaires. Studies aimed to assess perceived oral healthcare needs should use questionnaires which include appropriate items on common types of oral healthcare services based on the characteristics of the target group. Concordance with perceived and normative need is an issue that should be addressed in future researches.

Objective(s): In the present study the effect of stress on monkeys that had learned to retrieve food from a five-chamber receptacle, as well as the relationship between their behavior and the serum cortisol and epinephrine levels and relative size of the amygdala was evaluated. Materials and Methods: Six male rhesus monkeys were individually given access to the food reward orderly. They could easily retrieve the rewards from all chambers except for the chamber 4, which a brief, mild electric shock (3 V) was delivered to them upon touching the chamber’s interior. The coping behaviors were video-recorded and analyzed offline. Baseline serum cortisol and epinephrine levels were measured before the experiments using monkey enzyme-linked immunosorbent assay kit. One week after the behavioral experiment, the monkeys’ brains were scanned using magnetic resonance imaging under general anesthesia. The cross-sectional area of the left amygdala in sagittal plane relative to the area of the whole brain in the same slice was evaluated by the planimetric method using ImageJ software. Results: Exposure to the distressing condition caused different behavioral responses. Monkeys with higher baseline levels of serum cortisol and epinephrine and larger amygdala behaved more violently in the face of stress, indicating adopting emotion-focused stress-coping strategies. Conversely, those with low plasma epinephrine, moderate cortisol, and smaller amygdala showed perseverative behavior, indicating a problem-focused coping style. Conclusion: In dealing with the same stress, different responses might be observed from nonhuman primates according to their cortisol and epinephrine levels as well as their amygdala dimensions.

The Ardestan study area lies in the northeast of Isfahan and at the outer margin of Urumieh -Dokhtar Volcanic Arc (UDMA). In this area, copper mineralization is associated with dikes. Mineralization occurred as sulfides (chalcocite, chalcopyrite and bornite) and oxides (malachite and azurite). According to field studies as well as petrographic and geochemical investigations, two different types of dikes are present. The first type, trending NW-SE and comprising fine crystalline gabbro, whereas the second type with relatively E-W trend are gabbro and pyroxene diorite. Geochemically, these rock are characterized by SiO2 = 45.8 to 52.8 wt.%, MgO with 6.9 wt.% (average), Na2O+K2O = 5.6 wt.%, and Al2O3/TiO2 = 16.8%. All dikes are alkaline, related to back-arc tectonic setting in a wider concept associated with changing in source of magmatism. The second type shows enrichment in Ba, Sr, Rb, K, Zr, Nb, Ti, Cr and Ni in comparison to the first type. The first type is generated as a result of a subducted modified mantle while the latter shows an enriched astenospheric mantle source. It appears that there is a weak correlation between ore-forming and volatile elements in the mafic dikes. Overall, the same tectonic stresses are an essential controlling factor for the formation of second type E-W dikes associated with mineralization.

Introduction: Adolescence is a critical period in life, which is associated with tumultuous transitions and “storm and stress. The present study aimed to evaluate the correlation between depression, anxiety, and stress with the high-risk behaviors among the adolescents in Torghabeh and Shandiz towns, Iran. Materials and Methods: This cross-sectional study was conducted on 90 adolescents from the high schools. Participants were selected via two-stage sampling. Data were collected using the validated Depression, Anxiety, and Stress Scale (DASS-21) and history of high-risk behaviors in the students. Data analysis was performed in SPSS version 16. Results:Variable degrees of depression, anxiety, and stress were reported in 43.3%, 43.3%, and 38.9% of the students, respectively. Although the difference was not statistically significant, female students were more affected by the mentioned disorders compared to the male students. Among the high-risk behaviors, smoking cigarettes was significantly correlated with the depression, anxiety, and stress subscales. In addition, a significant association was observed between opium consumption and stress. However, no significant correlation was observed between smoking hookah and the DASS-21 subscales. Regular alcohol consumption was found to be significantly correlated with the higher rate of depression in the studied adolescents. Also, premarital sexual behaviors had a significant association with the stress and depression subscales. Conclusion: Lack of attention to depression, anxiety, and stress and their risk factors in adolescents may lead to variable degrees of life dissatisfaction in the community. Therefore, it is recommended that on-school mental screening programs be performed for high-school students in order prevent these complications.