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Background: Preparation for a crisis is necessary. The experiences of nursing and midwifery professors and students involved in the Covid-19 pandemic have helped us clarify and better prepare for future crises, particularly for biological crises. Therefore, the present research aimed to explore the views and experiences of nursing and midwifery instructors and students regarding in-hospital crisis management during the Covid-19 pandemic.Materials and Methods: In this qualitative study, data collection was done using semi-structured interviews with 14 nursing and midwifery instructors and students with experience in caring for coronavirus patients during the covid-19 pandemic; data analysis was conducted according to the conventional content analysis approach.Results: The analysis of the interviews was accompanied by 425 inference codes, which finally ended in 9 categories and 3 main categories after merging the repeated cases (integrated management, professional ethics and development of specialized knowledge).Conclusion: In order to prepare for biological crises such as the Covid-19 pandemic, the cooperation of various organizations is necessary for a more proper management of the situation. It is also necessary for health managers to recruit workers after assessing the severity of the crisis, and to help them develop their knowledge and skills with evidence-based training, while sticking to the principles of professional ethics, and paying special attention to maintaining and improving the mental health of the workers.

Objective Menopause-related sleep disorders do not necessarily affect the amount of sleep, but they affect the quality of sleep. This study aims to review the results of clinical trials on the effect of valerian on sleep disorders of postmenopausal women in Iran. Methods In this systematic review study, a search was first conducted in SID, IranMedex, PubMed, Web of Science, Cochrane library, EMBASE, Scopus, Science Direct, and Google Scholar databases for the related articles published until December 2021 using keywords based on PICO strategy and MeSH terms including insomnia, menopause, valerian, sleep disorders, herbal medicine, complementary medicine, and clinical trial in Persian and English with Boolean operators (OR, AND) . The Jaded scale was used to evaluate the quality of the articles. Results Of 389 articles found by the initial search, 6 studies (sample size= 637) were reviewed. Of these, 3 studies examined the effect of valerian on sleep disorders, 2 studies examined the effect of valerian on sleep quality, and 1 study examined the effect of valerian on the sleep dimensions of postmenopausal women. Conclusion Valerian can be considered as a safe treatment for sleep disorders of postmenopausal women in Iran. Further studies are recommended to provide evidence for the best dose of valerian with the least side effects.

Background: Fecal incontinence is an embarrassing problem and decreases the woman’s quality of life. The literature has shown that women with obstetric trauma especially by episiotomy had damaged anal sphincter (Internal and External). We aimed to find the role of episiotomy in the fecal incontinence in women after delivery. Methods: In this study, 71 females with previous vaginal deliveries were investigated by endoanal ultrasonography. The degree of FI was measured using the incontinence score of Wexner. The number of episiotomies was measured for each patient. Results: The mean Wexner score was 9.0±0.7 in the incontinent patients. The mean of normal vaginal delivery was 3.48±0.3 and 33.8% of the patients whom had a history of hemorrhoidectomy. Of patients, 70% had undergone one or more prior episiotomies during their deliveries. Conclusion: Episiotomy could be one of the risk factors in fecal incontinence but we did not find any significant difference in Wexner score between patients with or without episiotomy. Endoanal sonography seems an effective tool to evaluate and prediction of anal injury during episiotomy in some critical cases.

Introduction: The coexistence of mental health problems in diabetic patients can lead to poor disease management. This study aimed at investigating the mediating role of resilience and diabetes distress in the relationship between depression and treatment adherence in type 2 diabetes among Iranian patients. Methods: It is a type of analytical study conducted from 2019 to 2020. The statistical population of this study consisted of all-diabetic patients in Tehran. The subjects (200) were selected after purposeful clinical evaluation and qualification of research. In this study, Beck Depression Inventory (BDI), the Persian Version of the Morisky Medication Adherence Scale-8, Diabetes Distress Scale (DDS), Conner & Davison Resilience Scale (CDRS) were used to collect the data. Pearson correlation test by SPSS version 24 and Confirmatory Factor Analysis in AMOS software version 22 were used for analysis (P

Machine learning techniques play a significant role in agricultural applications for computerized grading and quality evaluation of fruits. In the agricultural domain, automation improves the quality, productivity, and economic growth of a country. The quality grading of fruits is an essential measure in the export market, especially defect detection of a fruit’s surface. This is especially pertinent for mangoes, which are highly popular in India. However, the manual grading of mango is a time-consuming, inconsistent, and subjective process. Therefore, a computer-assisted grading system has been developed for defect detection in mangoes. Recently, machine learning techniques, such as the deep learning method, have been used to achieve efficient classification results in digital image classification. Specifically, the convolution neural network (CNN) is a deep learning technique that is employed for automated defect detection in mangoes. This study proposes a computer-vision system, which employs CNN, for the classification of quality mangoes. After training and testing the system using a publicly available mango database, the experimental results show that the proposed method acquired an accuracy of 98%.

Parallel robots are closed-loop mechanisms presenting very good performances in terms of accuracy, rigidity, and the ability to manipulate large loads. Inverse kinematics problem for most parallel robots is straightforward, while the direct kinematics is not. The latter requires the solution of the system of nonlinear coupled algebraic equations and has many solutions. Except in a limited number of these problems, there is difficulty in finding exact analytical solutions. So these nonlinear simultaneous equations should be solved using some other methods. Continuation or path-following methods are standard numerical techniques to trace the solution paths defined by the Homotopy. This paper presents the direct kinematics solutions for a 3RCC parallel robot by using a semi-analytical Homotopy method called Homotopy Continuation Method (HCM). The HCM has some advantages over the conventional methods and alleviates drawbacks of the traditional numerical techniques, namely; the acquirement of good initial guess values, the problem of convergence and computing time. The direct kinematic problem of the 3RCC parallel robot leads to a system of nonlinear equations with 9 equations and 9 unknown parameters. The proposed method solved these nonlinear equations and extracted all the 36 solutions. Results indicate that this method is effective and reduces computation time in comparison with the Newton–Raphson method.

Smart maintenance is essential to achieving a safe and reliable railway, but traditional maintenance deployment is costly and heavily human-involved. Ineffective job execution or failure in preventive maintenance can lead to railway service disruption and unsafe operations. The deployment of robotic and autonomous systems was proposed to conduct these maintenance tasks with higher accuracy and reliability. In order for these systems to be capable of detecting rail flaws along millions of mileages they must register their location with higher accuracy. A prerequisite of an autonomous vehicle is its possessing a high degree of accuracy in terms of its positional awareness. This paper first reviews the importance and demands of preventive maintenance in railway networks and the related techniques. Furthermore, this paper investigates the strategies, techniques, architecture, and references used by different systems to resolve the location along the railway network. Additionally, this paper discusses the advantages and applicability of on-board-based and infrastructure-based sensing, respectively. Finally, this paper analyses the uncertainties which contribute to a vehicle’s position error and influence on positioning accuracy and reliability with corresponding technique solutions. This study therefore provides an overall direction for the development of further autonomous track-based system designs and methods to deal with the challenges faced in the railway network.

Background Because of resources deficiency, a well-funded budget system is very important for achieving organizational goals. Hence, providing a specific pattern for performance analysis is important to allocate funds to medical universities Objectives In this study, econometric method and linear regression estimation were used to investigate the economic behaviour of the budget allocation process. Methods Data used in the present study were panel data from medical universities obtained during an eight-year period. The explanatory variables in this model included the numbers of faculty members and students. Also, separate linear regression was estimated as a dependent variable for the levels of expenditure budget and total budget. Results Our findings showed that if budgeting is done solely based on faculty members, allocation of public budget for each faculty member is 113.7 million Tomans, and if it is performed based on students, the allocated budgets are 9.8, 2.2, and 25.9 million Tomans for each undergraduate, professional doctorate (medicine, pharmacy, and dentistry) and postgraduate student, respectively. Conclusions In general, budget allocation for university education sector had a strong relationship with faculty members and students. However, the place of budget consumption and performance quality indicators still remain unclear. The results of this study can be applied for quantitative modelling to predict and allocate budget to medical universities.

Background: The current challenges that confront the medical education field have necessitated the need for transformation and revisions in curriculum design practices. In this regard, core curriculum development and integration are examples of such changes. The purpose of this study was to investigate the concepts of core curriculum and integration in the realm of medical education and to explore the relationship between these two concepts. Methods: This study is a narrative review article. In this study, databases such as Science Direct, Ovid, PubMed, SID, Magiran and Google Scholar were searched using keywords such as core curriculum, integration, medical education, curriculum design and curriculum. Results: The importance of meaningful learning, organized knowledge and practical knowledge for students of medical sciences requires planning of integrated curricula. This is more accentuated based on the increasing volume of knowledge, educational content, continuous changes in community needs, responsibility to meet those needs and the need for medical students to gain clinical competencies in their profession. Conclusion: The concepts of core curriculum and integration are very closely linked, with some of the experts in the field of curriculum planning considering integration as one of the forms of designing core curriculum. Indeed, both concepts were developed in response to the overload of knowledge, the need to teach and learn basic and clinical sciences together and the need to create meaningful learning.

Customer satisfaction is the most important step in the process of identifying customer expectations. Identify customer expectations ‎without referring to him and get his view, is impossible. In order to identify customer expectations, service suppliers are also using ‎statistical techniques, surveyed their customers. According to the studies, there is no appropriate framework for expectation model to ‎prioritize regions of organizations and make the favorable selection according to the organization’s policies and strategies. In this ‎research, a combination of fuzzy multiple criteria decision making is used for the optimal selection. The research method used in this ‎study is of descriptive and applied type, and field method is used to collect data. For Identifying customer expectations, data has ‎been collected from study population (customers of Zanjan municipality) is 303 people through random sampling method. To ranking ‎the dimensions of customer's expectations and make optimal selections of municipality zones, data has been collected from study ‎population (engineer contractor of the municipality) is 30 people. The data collection instrument was questionnaire and interview, which ‎had been valid. The Expert Choice, Web-based TOPSIS, SPSS and Excel software were used for calculations. It is interesting to ‎observe that the choices of the best municipality zone solely depend on the criterion having the maximum priority value. Based on ‎calculations on the stages of the proposed model, "municipality Zone 2" was selected as the optimal the region and had the highest rating ‎in response to customer expectations. Results show that the proposed model has a systematic fit with the defined procedures and known ‎inputs.‎

Background The operating room is considered a learning platform for technical and non-technical skill training. Training in operating rooms helps learners from different groups, especially surgery residents, acquire the necessary clinical competence. Nevertheless, operating room training is only effective if it is accompanied by efficient and applicable teaching methods. Objectives The current study aimed at reviewing the strategies and methods to enhance teaching and learning of residents in operating room settings. Methods The current review study was conducted based on library studies and review of the literature. PubMed, SID, and MagIran databases, as well as Google Scholar search engine, were searched using relevant phrases and keywords. A total of 60 articles were retrieved, out of which 22 articles were identified as consistent with the study objectives. Results The data obtained from the literature review were categorized into three sections: “General structure of training in the operating room”, “strategies and methods to strengthen teaching and learning in the operating room”, and “structured training models in the operating room”. Finally, application of these strategies in clinical teaching was summarized in three stages: Before operation, during operation, and after operation. Conclusions The operating room is a clinical facility with specific characteristics, which can challenge teaching in this setting. However, application of effective strategies and methods, as well as efficiently structured training based on the proposed models can facilitate teaching and learning enhancement in operating rooms.

BACKGROUND: Clinical training during internship is an important part of medical education. The maternity ward is a clinical environment in which medical students pass their obstetrics and gynecology internship to obtain competencies in this field. The present study was conducted to explain medical interns' manner of learning in the maternity ward. MATERIAL AND METHODS: The present study was conducted using a qualitative approach with the inductive content analysis method. This study observed the maternity wards of teaching hospitals affiliated to medical sciences universities of Isfahan and Shahrekord. Data were collected through observation and semi-structured individual interviews. RESULTS: Two main categories and seven subcategories emerged from the analysis of the data. Inadequate participation in learning opportunities included the following three subcategories: the incongruousness of the learning opportunities with the educational goals, inadequate readiness for participation in learning opportunities, and the overlap between learning opportunities and diminished autonomous practice. Inadequate formal and structured education included the following four subcategories: inadequate learning support and direction, subordinate roles and aimless presence, the pale educational role played by the attendants and senior residents, and learning through the support of midwifery educators. CONCLUSION: Participation in and access to learning opportunities in the maternity ward are very difficult for interns. Interns, therefore, need to attend the maternity ward by a structured program and in the company of training supervisors or competent educators to obtain the required competencies in pregnancy and childbirth.

In order to equip medical students with all the necessary skills in dealing with patients to provide optimal treatment, the need for the use of real patients in educational settings has become prominent. But all the required skills cannot be practiced on real patients due to patients’ safety and well-being. Thus, the use of standardized patients (SPs) or simulated patients (SiPs) as a substitute for real patients signifies their importance in simulationbased medical education. One question raised in regard to using SPs or SiPs in order to enhance medical students’ tangible and intangible skills in a safe controlled environment is whether these two terminologies are the same or different? Various studies use these terms interchangeably and do not consider a difference between them. Based on our literature review, there seems to be differences between these two modalities. We also try to highlight the advantages of these modalities in clinical encounters.

Intelligent fault diagnosis methods have replaced time consuming and unreliable human analysis, increasing anomaly detection efficiency. Deep learning models are clear cut techniques for this purpose. This paper’s fundamental purpose is to automatically detect leakage in tanks during production with more reliability than a manual inspection, a common practice in industries. This research proposes an inspection system to predict tank leakage using hydrophone sensor data and deep learning algorithms after production. In this paper, leak detection was investigated using an experimental setup consisting of a plastic tank immersed underwater. Three different techniques for this purpose were implemented and compared with each other, including fast Fourier transform (FFT), wavelet transforms, and time-domain features, all of which are followed with 1D convolution neural network (1D-CNN). Applying FFT and converting the signal to a 1D image followed by 1D-CNN showed better results than other methods. Experimental results demonstrate the effectiveness and the superiority of the proposed methodology for detecting real-time leakage inaccuracy.

Introduction: The main purpose of education is to develop clinical competencies among the students of health sciences. Meaningful and constructive feedback is necessary to the learners to attain constructive knowledge. The goal of this study was to assess "the perceived feedback" by the midwifery students of Isfahan University of Medical Sciences. Methods: We performed this descriptive cross-sectional study on 25 senior midwifery students studying at Isfahan University of Medical Sciences in 2013-2014 academic years. Participants were selected through census and data were collected using a researcher-made questionnaire. Medical education specialists and midwifery experts assessed the content and face validity of the questionnaire and its reliability was measured through Cronbach’s alpha coefficient (α = 0.86). The five-point Likert Scale was used (Never=1, Rarely=2, Sometimes=3, Very Often=4, Always=5) in the questionnaire. The expected mean was considered 4 (above the average). The collected data were analyzed using descriptive statistics tests, one-sample t-test and Anova. Results: 24 students of midwifery completed 180 questionnaires according to the classification of courses and instructors. The mean scores obtained for perceived feedback were 3.69±0.66 for the content of feedback area, 3.71±0.55 for the method of providing feedback, and 3.94±0.67 for the skills of providing feedback area. No significant difference was found between the different courses regarding the mean scores in different areas. Conclusion: The results showed that basic rules of providing feedback in all three areas of content, method, and skills of providing feedback were not implemented appropriately and at a desirable level. Therefore, it seems necessary to increase the instructors’ knowledge on the importance of presenting feedback and training them on appropriate methods of giving feedback in order to improve the quality of clinical education in midwifery.

مقدمه: ندول‌های تیروییدی از شایع‌ترین بیماری‌های تیرویید هستند که در نیمی از جمعیت بالغین یافت می‌شوند. روش‌های تشخیصی متعددی برای ارزیابی بیماران به کار می‌رود. اسکن رادیونوکلیید غده‌ی تیرویید توسط 99mTcO4 فعالیت بافت ندول را مشخص می‌کند. معاینه‌ی فیزیکی گردن و علامت‌گذاری ندول با مارکر سربی پیش از انجام سنتی‌گرافی می‌تواند با تعیین مکان ندول در هنگام تفسیر سنتی‌‌گرام از اشتباهات در گزارش فعالیت ندول‌ها بکاهد. روش‌ها: 117 بیمار مبتلا به ندول تیروییدی که جهت اسکن رادیونوکلیید از غده‌ی تیرویید به مرکز پزشکی هسته‌ای سیدالشهدا (ع) اصفهان ارجاع شده بودند، در فاصله‌ی زمانی مهر ماه 1392-1391 مورد مطالعه قرار گرفتند. پس از اخذ شرح حال عدم مصرف داروها و مواد مداخله‌گر با اسکن، تکنسیوم رادیواکتیو به بیمار تزریق شد و بیمار مورد اسکن قرار گرفت. سپس غده‌ی تیرویید بیمار معاینه شد و به طور مجدد اسکن انجام شد. در مرحله‌ی سوم بعد از معاینه‌ی تیرویید بیمار، ندول لمس‌شده توسط مارکر سربی علامت‌گذاری شد و سپس اسکن تکرار شد. در آخر نتایج حاصل از تفسیر هر سه تصویربرداری مقایسه گردید. یافته‌ها: طبق آزمون 2χ معاینه‌ی فیزیکی گردن و علامت‌گذاری ندول تیروییدی لمس‌شده با مارکر سربی، بر تفسیر نتیجه‌ی اسکن تیرویید مؤثر بود و باعث کاهش نتایج مثبت کاذب در ندول‌های گرم و سرد شد (05/0 > P). وطبق آزمون Wald استفاده از روش معاینه‌ی فیزیکی و نیز علامت‌گذاری ندول تیروییدی با مارکر سربی پس از معاینه، باعث کاهش خطای تشخیص در تفسیر نتیجه‌ی اسکن تیرویید می‌شود. نتیجه‌گیری: این مطالعه نشان داد که با افزودن معاینه‌ی فیزیکی که روشی ساده و مقرون به صرفه است، با اسکن رادیونوکلیید، می‌توان در راستای تشخیص ندول‌های تیروییدی سود جست.

This paper presents a numerical study of melting of Nanoprticle-Enhanced phase change material (NEPCM) inside a shell and tube heat exchanger using RT50 and copper particles as base material and nanoparticle, respectively. In this study, the effects of nanoparticles dispersion (, 0.03, and 0.05) on melting time, liquid fraction, and penetration length are investigated. The results show that the melting time decreases to 14.6% and the penetration length increases to 146% with increasing volume fraction of nanoparticle up to .

Background Anal fissure is a painful tear or crack in the distal part of anal canal. It usually involves the epithelium, but in the long term it may extend to the whole anal mucosa. Platelet Lysate (PL) hydrogel is a hemoderivitive pharmaceutical formulation that contains plenty of growth factors. These growth factors can induce tissue regeneration and revascularization as well as fibroblast proliferation. Objectives This study aimed to evaluate the effectiveness of PL hydrogel in the treatment of the anal fissure or retardation of its development. Patients and Methods The patients with chronic and acute anal fissure were randomly divided into groups of A and B. Group A received PL hydrogel and Rectol, while group B received placebo and Rectol. Then, they were followed and evaluated for two weeks. Results Although it was anticipated that platelet growth factors would be effective in anal fissure healing process, no significant difference was observed between the control group and the case group after the treatment. Nevertheless, a significant difference was observed within the two groups after the treatment. Conclusions PL hydrogel does not seem to have beneficial effects compared to the placebo or Rectol on the healing of anal fissure.

Introduction: Employee empowerment is a process that requires appropriate conditions in the organization. The application of information systems in the health sector as a pragmatic approach and critical element in empowering employees provides the possibility of enhancement of the capacities and development capabilities of human resources. The purpose of this study was to investigate the relationship between the application of hospital information systems (HIS) and psychological empowerment of hospital staff. Methods: This was a descriptive correlational study. The statistical population consisted of 304 staff members of Vali-asr Hospital in Tehran, Iran, who were associated with HIS in 2015. The sample size was determined using the Morgan and Krejcie table. The sample consisted of 170 individuals selected through stratified random sampling. Data were collected via two researcher-made questionnaires. The reliability and validity of these questionnaires were approved by specialists and using Cronbach's alpha coefficient (α = 0.93), respectively. Normality of data was approved by Kolmogorov-Smirnov test. To analyze the data, descriptive statistics, the Pearson correlation coefficient, and linear regression were used in SPSS software. Results: The results of the Pearson correlation and linear regression analysis showed a significant positive correlation between HIS use and each component of psychological empowerment (P = 0.001, R = 0.567, R2 = 0.322). Conclusion: A significant positive relationship was observed between HIS and psychological empowerment of hospital staff. HIS has an effective role in the development and empowerment of human resources in all aspects including increased knowledge, improved performance quality, reinforcement of decision making skills, and staff profession development, increased employment opportunities, and increased self-management responsibility. The development of information technology in the health sector requires the modification of the structure and improvement of appropriate cultural, communicative, and organizational infrastructure.