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Background: Colon carcinoma poses a significant health challenge globally, particularly in developed nations where sedentary lifestyles, poor dietary choices, and genetic factors play a crucial role in its prevalence. Chemotherapy, the primary treatment method, carries severe side effects that can jeopardize patients' lives. Herbal extracts such as Ocimum Basillicum extract have shown effectiveness against cancer cells. Additionally, nanoparticles can significantly enhance drug delivery efficacy in these scenarios. Aim: This article aims to investigate the impact of copper nanoparticles coated with Ocimum Bassilicum at chemoradiotherapy of Colon Carcinoma to hopefully create new treatment options with fewer side effects for patients. Methodology: CuO bio-NPs were produced by the addition of 15 mL of extract dropwise to 80 mL of a 5 mM Cu (OAc)2 aqueous solution, which was then refluxed for 2 h at 100 °C. The mixture gradually became darker brown in color as a result of the heating procedure. The production of CuO NPs and the hydrogen-donating activity of antioxidant phenols within the plant are signaled by surface plasmon resonance excitation, which is the cause of this. In the cell culture, LS174t colon cancer cells were treated with OB extract, CuNPs, and OB-coated CuNPs with and without different radiation levels in order to assess cell viability, through the MTT assay, and the pro-apoptotic BAX and anti-apoptotic BCL2 expressions, through qPCR assay. Results: The results demonstrate a decrease in cell viability and the expression of BCL2 and an increase in the expression of BAX especially when treated with OB-coated CuNPs and even furthermore when paired with radiation therapy. Conclusions: After doing the clinical trial studies, the recent nanoparticles can be used for the treatment of Colorectal carcinoma.

Current methods of colon cancer treatment, especially chemotherapy, require new treatment methods due to adverse side effects. One important area of interest in recent years is the use of nanoparticles as drug delivery vehicles since several studies have revealed that they can improve the target specificity of the treatment thus lowering the dosage of the drugs while preserving the effectiveness of the treatment thus reducing the side effects. The use of traditional medicine has also been a favorite topic of interest in recent years in medical research, especially cancer research. In this research work, the green synthesis of Fe nanoparticles was carried out using Mentha spicata extract and the synthesized nanoparticles were identified using FT-IR, XRD, FE-SEM and EDS techniques. Then the effect of Mentha spicata, Fe nanoparticles, and Mentha spicata -loaded Fe nanoparticles on LS174t colon cancer cells, and our result concluded that all three, especially Mentha spicata -loaded Fe nanoparticles, have great cytotoxic effects against LS174t cells, and exposure to radiotherapy just further intensified these results. The in vitro condition revealed alterations in the expression of pro-apoptotic BAX and anti-apoptotic Bcl2, suggesting a pro-apoptotic effect from all three components, particularly the Mentha spicata-loaded Fe nanoparticles. After further clinical trials, these nanoparticles can be used to treat colon cancer.

Background: Multiple sclerosis (MS) is one of the critical diseases due to its adverse clinical, social, and economic consequences for affected people. This study aims to assess the quality of life (QoL) of patients with MS in East Azerbaijan, Iran. Methods: This cross-sectional study was conducted using the multiple sclerosis quality of life-54 (MSQoL-54) questionnaires to interview 300 randomly selected MS patients in East Azarbaijan Province, Iran. The independent t-test, analysis of variance (ANOVA), and Tukey post hoc test were used to examine the relationship between demographic variables, and QoL, and all analyses were performed using SPSS software, version 19. Results: The QoL score in MS patients is 48.22±22.48. The “life satisfaction” is the best and “physical role limitation” is the worst QoL aspect. Significant relationships were observed between marital status, education level, employment status, age of symptoms onset, and years of illness with QoL (P

Abstract Background Pregnant women are considered one of the high-risk groups during the COVID-19 pandemic, so paying attention to preventive behaviors among them is highly important. This study aimed to examine the effect of multimedia education based on the Health Belief Model (HBM) in preventing COVID-19 among pregnant women. Methods This quasi-experimental intervention study was conducted on 120 pregnant women referring to Comprehensive Health Services Centers affiliated with East and West health centres of Ahvaz city, Iran, in 2021. Participants were divided into two control (n = 60) and intervention (n = 60) groups. A researcher-made questionnaire was used for data collection. The intervention group was given the required educational content using social networks virtually and multimedia in 12 sessions. Both groups were reinvestigated after two months. Data were analyzed using SPSS software version 24, independent t-test and paired t-test tests. Results The mean age and mean gestational age of participants were estimated at 28 years old and 18 weeks, respectively. Before the educational intervention, there was no significant difference in mean constructs of HBM. In contrast, the mean of all constructs increased significantly in the intervention group after intervention. The greatest change was related to the constructs of self-efficacy and perceived susceptibility, and the lowest change was related to the perceived barriers construct. Conclusion Our findings suggest multimedia education using the HBM to COVID-19 preventive behaviors among pregnant women can benefit behavior change.

Background: Financial protection of populations against healthcare costs is one of the fundamental responsibilities of governments. This study aimed to investigate the incidence of catastrophic health expenditures (CHE) and it’s affecting factors in hospitalized patients with delta variant of COVID-19. Methods: In this cross-sectional study, we included 400 hospitalized COVID-19 patients at Kosar Hospital of Semnan in 2022, using a researcher-made checklist. Based on qualitative nature of the variables, chi-square test was used to investigate the statistical associations between the demographic/background characteristics and the incidence of CHE. Results: On average, COVID-19 imposed 1833.43 USD direct medical costs per one hospitalized patient. The ratio of direct-medical costs to household’s non-food expenses was 2.35, and 61% (CI:±4.78%) of the patients were subject to CHE. Besides, residence place, basic insurance type, benefitting from supplementary insurance, suffering from underlying diseases, hospitalization in ICU, falling into a coma, facing pulmonary failure, and performing hemoperfusion had significant associations with CHE (P

Purpose: Calcineurin inhibitors (CNIs) such as tacrolimus are a major immunosuppressive therapy after renal transplantation, which inhibit cytokine expression. The pharmacokinetics of such drugs is influenced by cytochrome P450 (CYP) enzymes, multi-drug resistance-1 (MDR-1), and C25385T pregnane X receptor (PXR). This study aimed to investigate the impact of single nucleotide polymorphisms (SNP) in these genes on the ratio of tacrolimus level per drug dosage (C/D ratio), acute graft rejection, and viral infections. Methods: Kidney transplantation recipients (n=65) under similar immunosuppressive treatment were included. Amplification refractory mutation systempolymerase chain reaction (ARMS-PCR) method was applied to amplify the loci containing the SNPs of interest. Results: Overall, 65 patients with a male/female ratio of 37/28 were included. The mean age was 38±1.75 years. The variant allele frequencies of CYP3A5*3, MDR-1 C3435T, and PXR C25385T were 95.38, 20.77, and 26.92%, respectively. No significant correlations were found between the studied SNPs and the tacrolimus C/D ratios. However, there was a significant difference in the C/D ratios at 2 and 8 weeks in homozygote CYP3A5 *3/*3 carriers (P=0.015). No significant association was found between the studied polymorphisms and viral infections and acute graft rejection (P>0.05). Conclusion: Homozygote CYP3A5 *3/*3 genotype could influence the tacrolimus metabolism rate (C/D ratio).

Introduction: Evidence on the impacts of accreditation on primary health care (PHC) services is inconsistent. Thus, this study aimed to assess the impacts of accreditation on the performance of PHC centres. Methods: This study systematically reviewed articles published from 2000 to 2019 in the Web of Science, Scopus, ScienceDirect, Springer, PubMed and ProQuest. The following keywords were used: ((primary care OR primary health care) AND (accreditation) AND (impact OR effect OR output OR outcome OR influence OR result OR consequences)). The database search yielded a total of 41256 articles, among which 30 articles were finally included in the review. Results: Accreditation showed the most positive impacts on the quality, effectiveness, human resource management and strategic management of PHC services. Accreditation also positively affected safety, responsiveness, accessibility, customer satisfaction, documentation, leadership, efficiency and continuity of care. Few negative impacts were noted, including the possibility of accreditation being used as a bureaucratic tool, high cost of acquiring accreditation, difficulties in understanding the accreditation process, high staff turnover rate in accredited PHC centres and weak sustainability of some accreditation programmes. Conclusion: Given its numerous positive impacts, accreditation could be used to effectively improve the performance of PHC centres.

Introduction and purpose: Relationship incompatibility is one of the potential risk factors for marital problems. General studies have demonstrated a decrease in couples' marital adjustment regarding infertility. The present study aimed to assess the effect of life skills training on marital adjustment in infertile women referred to the infertility center of Kurdistan province. Methods: In this interventional study, 90 infertile women who were referred to the infertility clinic located in the center of the province for follow-up, diagnosis and treatment were selected through continuous sampling. The data collection tool was the Spanier questionnaire. Data were entered into SPSS software (version 20) and analyzed using statistical tests. Results: There was no statistically significant difference between the two groups before the intervention in the scores of marital satisfaction, solidarity, agreement, expression of love, and adjustment. After the educational intervention, the score of marital satisfaction, solidarity, expression of love, and total adjustment in infertile women in the intervention group was significantly higher than those in the control group (P>0.05). Nonetheless, there was no significant difference in mutual agreement between the two groups (P= 0.29). Conclusion: As evidenced by the obtained results, the necessary training can be designed and implemented to increase the level of marital satisfaction in infertile couples.

The Oliveria decumbens Vent. is a wild, rare, annual medicinal plant and endemic plant of Iran that has metabolites (mostly terpenes) which make it a precious plant in Persian Traditional Medicine and also a potential chemotherapeutic agent. The lack of genetic resources has slowed the discovery of genes involved in the terpenes biosynthesis pathway. It is a wild relative of Daucus carota. In this research, we performed the transcriptomic differences between two samples, flower and root of Oliveria decumbens, and also analyze the expression value of the genes involved in terpenoid biosynthesis by RNA-seq and its essential oil’s phytochemicals analyzed by GC/MS. In total, 136,031,188 reads from two samples of flower and root have been produced. The result shows that the MEP pathway is mostly active in the flower and the MVA in the root. Three genes of GPP, FPPS, and GGPP that are the precursors in the synthesis of mono, di, and triterpenes are upregulated in root and 23 key genes were identified that are involved in the biosynthesis of terpenes. Three genes had the highest upregulation in the root including, and on the other hand, another three genes had the expression only in the flower. Meanwhile, 191 and 185 upregulated genes in the flower and root of the plant, respectively, were selected for the gene ontology analysis and reconstruction of co-expression networks. The current research is the first of its kind on Oliveria decumbens transcriptome and discussed 67 genes that have been deposited into the NCBI database. Collectively, the information obtained in this study unveils the new insights into characterizing the genetic blueprint of Oliveria decumbens Vent. which paved the way for medical/plant biotechnology and the pharmaceutical industry in the future.

Background: Adolescents are the most frequent fast food consumers. This unhealthy behavior lead to overweight that is associated with diabetes mellitus, hypertension, and heart diseases. The present study aimed to determine factors associated with behavior of fast food consumption (FFC) of female high school students based on the Theory of Planned Behavior (TPB) in the city of Tonekanon, north of Iran. Methods: The present cross-sectional study was conducted on 197 female students studying at high school. The constructs of the theory of planned behavior including attitude, subjective norms, perceived behavioral control, as well as intention and behavior of fast food consumption were assessed using a pre-tested psychometric questionnaire. Spearman correlation coefficient and linear regression method were used to test the study hypotheses. Results: The constructs of attitude, subjective norms, and perceived behavioral control were accounted for 37.8% in variation of fast food consumption intention. The construct of subjective norms and perceived behavior control was significantly associated with intention of FFC. Intention of FFC was significantly associated with behavior (B coefficient = 0.76, P-value = 0.001) and predicted 63.8 % of the variance of fast food consumption behavior. Conclusion: The present study showed that the TPB is a powerful theory in predicting FFC behavior. Subjective norms followed by perceived behavioral control were the strongest predictors of FFC intention.

Health Care Services Utilization in Iran

Background & objectives : CXCL5, also known as epithelial cell-derived neutrophil-activating peptide (ENA-78), is a chemokine that has a role in some diseases. CXCL5 blocks insulin signaling by activating the Jak2/STAT5/SOCS2 pathway. It is reported the association between -156G>C (rs352046) polymorphism in the promoter region and diabetes. The aim of this study was to examine whether there is an association between this polymorphism and diabetes mellitus in Ardabil province population. Methods : A total of 100 patients affected diabetes were recruited from Ardabil province population 100 healthy control subjects also were recruited from the same area. The region containing the CXCL5 - 156G>C polymorphism was genotyped by PCR amplification and restriction fragment length polymorphism analysis, and allele frequency data were analyzed using Fisher test. Results : The results show a higher frequency of carrying both the G/G and G/C genotype in patients with diabetes compared with healthy controls (p-value=0.01 and 0.006, respectively). In addition, the frequency of allele C was significantly increased (p-value = 0.028) in patients with diabetes (25.5%) compared with controls (12%). Conclusions : Our findings suggest a role of CXCL5 in the pathogenesis of diabetes. Also, replications in other populations with larger sample sizes are required to confirm these findings.

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Letter to the Editor

This study tended to present a model for examining the effective factors on adoption of blockchain-based intelligent transportation systems (ITS). The methodology employed was correlational descriptive approach using structural equation modeling. The research involved collecting data through a survey, which was completed by 368 individuals residing in prominent cities across Iran. The findings of the study suggest that perceived quality of digital services significantly impacts perceived ease of use, perceived usefulness, and trust in a positive manner. Additionally, the positive influence of information technology infrastructure and social influence on perceived ease of use and perceived usefulness is evident. Moreover, perceived ease of use and perceived usefulness play pivotal roles in building trust and fostering adoption of blockchain-based ITS. The study also highlights the positive and significant impact of transparent governance on trust and adoption. Furthermore, policies and regulations are identified as key drivers of perceived usefulness and adoption of such systems. Lastly, perceived trust and security are found to positively influence adoption. These findings underscore the potential of the examined variables to serve as robust predictors for the adoption of blockchain-based ITS by citizens.

Introduction: The evolution of the international retail industry is to move from individual stand-alone stores that sell limited products to chain stores that offer more diverse product categories on a more economical scale. Thus, the chain store industry is one of the newer forms of offering fast-moving products to consumers. In this area, the most important decisions related to marketing and sales policies that directly affect the company's performance and the quality of service to end-users, and ultimately profitability. The purpose of this study is to provide a model for marketing and sales strategy for companies operating in the chain stores industry, and by adopting a comprehensive approach, an attempt made to remove some of the existing limitations in the field of research and implementation. Therefore, in this research and a forward-looking and innovative perspective, this question answered: what is the model of marketing and sales strategies in the chain store industry? Methodology: This research-based on the purpose is of developmental type, based on the nature is of exploratory and descriptive type and based on the type is of data of the qualitative and quantitative type and has an integrated strategy, that is, to achieve the objectives of the research, two qualitative and quantitative methods have been used together. The statistical population of this research is the marketing and sales managers of three companies, Hyperstar, Canbo, and Ofoq Kourosh. Thus, after an in-depth study and review of books and articles related to marketing and sales concepts, an attempt made to identify a significant part of the important factors in developing marketing and sales strategies for companies active in the chain stores industry. After that, in the qualitative part, by content analysis method, a semi-structured interview conducted with 10 industry experts of chain stores from the three mentioned companies based on judgmental sampling. Qualitative sampling continued until the researcher reached theoretical saturation. In the quantitative part by survey method, 116 questionnaires distributed among the marketing and sales managers of these three companies. Analyzing the qualitative data obtained from the interviews based on the analysis of words, sentences, themes, and idioms of experts in the field of marketing and sales of the chain stores industry, led to the extraction of 391 primary codes. After several reviews and integration of codes based on similarity in several stages, 73 codes were finally extracted, which became the basis for the quantitative questionnaire design. Following a review of content analysis in the qualitative section, the competitive environment of the chain stores industry, online promotions, and online service features added as new variables to the original research model. In the quantitative part, the data analyzed by structural equation method using Smart PLS software. Results and Discussion: In response to the main research question, which is also the ultimate goal of the research, we found that developing a sales strategy in companies operating in the chain stores industry without considering the marketing strategy and its components is irrational. In addition, the effect of the moderating variable of the competitive environment of the chain stores industry didnot ignored because not paying attention to this factor can fail the strongest marketing and sales strategy of chain stores companies. Findings showed that marketing mix is ​​the most important factor in marketing strategy and the use of sales technologies is the most important factor in sales strategy in the chain store industry. Evidence suggests that the presence of a moderating variable of the competitive environment of the chain stores industry affects the relationship between marketing and sales strategies. Conclusion: Adopting a comprehensive approach to the elements of marketing and sales strategies, taking into account the competitive environment prevailing in the industry, and using online environment-based methods are important issues in developing marketing and sales strategies of companies operating in the chain stores industry, which have not been considered in Iran. It is necessary to plan for reach a successful chain stores industry for leading consumer satisfaction and achieving financial goals for companies. Companies operating is better to pay attention to the competitive environment of the chain store industry and then taking a broad view of having a marketing strategy that takes into account issues related to marketing objectives, pricing, branch location, competitive advantage, resource allocation, consumer behavior analysis, consumer segmentation, online and traditional promotions, product, online service features, as well as sales strategy that is formed by considering the issues related to the use of sales technologies, sales team training and the use of multiple sales channels.

According to landscape definition, interaction is a key concept in landscape formation. Using strategies to increase the influence of the interaction elements (humans and the environment) in shaping and communicating with the landscape is an emerging concern that can be a major part of technology implementation in recent times. The interactive landscape is a different step towards strengthening the relationship between humans and places in a more purposeful approach. As a result, this article attempts to more precisely identify the interaction, as well as the characteristics and features that effectively improve the relationship between humans and the environment. In this regard, the environment and the occurrence of interaction, and the characteristics that affect it, are identified on the one hand, and human beings and human characteristics that affect the two-way relationship with the environment are identified on the other hand. The current study aims to answer the following question: What environmental and human characteristics are efficient in enhancing human interaction with the environment and forming an interactive landscape? This study aims to develop people’s relationships with the environment and strengthen the landscape’s interactive aspect. This article employs a descriptive-analytical approach to first investigate the concept of interaction and then analyze it to determine the effective indicators of interaction occurrence. Then, taking into account the importance of humans and the environment in the concept of landscape, it identifies environmental and human components that affect the strengthening of effective characteristics on the occurrence of interaction in the landscape by analyzing the contents based on human nature and the environment. This research suggests that to enhance the occurrence of interaction between humans and the environment, characteristics such as two-way relationships, activeness, variability, responsiveness, effectiveness, and affectedness need to be taken into consideration. Furthermore, the conditions of occurrence of interaction with the environment can be strengthened by using human and environmental characteristics based on their natures.

Introduction: The present research has been done with the aim of designing a strategic branding model in the saffron industry. Company branding requires a comprehensive approach to brand management, so that all the members and aspects of an organization can act in harmony or in line with the brand (Herstein and Zvilling, 2011). Therefore, designing a strategic model of saffron branding is something that designers and brand makers should pay attention to. This should be done according to marketing studies and customer attraction in a way that the brand is associated with the product. Being aware of the importance and the economic position of the brand and the brand names of the country's exported products such as saffron and pistachio helps traders create top brands so as to be present and survive in the global market. This ultimately stabilizes the world economy.Methodology: The research was conducted as a basic one using exploratory data and the Grand theory. The data collection tool was a semi-structured in-depth interview. The statistical population included the university professors familiar with the subject of branding as well as the managers of companies exporting saffron. A theoretical method was used for sampling. The collected data were analyzed through open, axial and selective coding, and the final pattern was extracted. The final model consisted of a set of central categories, causal conditions, necessary contexts, intervening variables, strategies and branding consequences for the saffron industry.Results and Discussion: Each of the conditions and factors that make up the model have variables and categories. Paying attention to them will achieve the ultimate goal of strategic saffron branding. In general, due to the high economic value of saffron, high global demand and uniqueness of Iranian saffron, optimal production methods, enough storage capacity, targeted advertising, competitiveness, promotion of competitive advantages, research and development, policy-making, proper government support, identification of brand stakeholders, monopolizing the saffron market, increasing productivity, increasing the value of the saffron brand and attracting investors are the necessary tasks to do.According to the results, the most important consequences of implementing a strategic branding plan in the saffron industry include economic growth, monopolization of the saffron market, increasing productivity, increasing the value of the saffron brand and attracting investors. In this regard, by designing a suitable branding model for saffron, more profit may be expected. Also, it will be possible to expand funding sources and create sustainable employment, increase the income level of farmers and help to distribute income fairly. The strategic branding of Iranian saffron can increase the added value and quality of the product, which enhances the ability of the product to remain in the minds of customers. That is, the image and association of the saffron brand develops and can have a positive effect on customers' desire to consume. All of these factors can ultimately provide more investment and opportunity for investors. It can be said that the very high volume of saffron production in the country has enabled the producers to produce innovative, creative and new products.Saffron branding allows saffron producers to facilitate their access to the market, diversify their products and enjoy government legal protection. Moreover, the high demand for this product and the uniqueness of Iranian saffron from the experts' point of view have doubled the importance of presenting a brand in this field. In this regard, the correct knowledge of stakeholders and the presentation of targeted advertising have led to increased product competitiveness. Creating a brand can ultimately lead to economic growth in the country and introduce the Iranian saffron brand as a reputable saffron brand in the world. To achieve this goal and implement this strategy, it is important to make strategical plans that can be implemented in time and place.Conclusion: With proper and correct branding and by promoting the identity and personality of the Iranian saffron brand, we can expect to achieve economic growth rate and GDP, monopolize the saffron market, increase productivity, increase the value of the Iranian saffron brand and attract more investors. The necessary strategies for implementing a strategic branding plan in the saffron industry include proper government policy-making, promotion of competitive advantages, research and development, identification of brand stakeholders, promotion of competitiveness and targeted advertising. According to the results, government policy-making means that the government does not formulate cumbersome laws but organizes exporters properly and creates packaging units to provide active and qualified people with appropriate loans. It also creates proper infrastructure and adequate financial support to greatly prevent the bulk export of expensive products.

Background: 99mTc-MIBI cardiac perfusion scanning is recognized as a clinically useful method in evaluating coronary artery disease. By the implementation of new imaging techniques and systems, it seems possible to obtain high-quality images with a lower dose of radiopharmaceuticals. The purpose of this study was to evaluate the effect of injection dose of 99mTc-MIBI on quantitative parameters of cardiac perfusion scan. Materials and Methods: Eighty-three patients with the known probability of coronary artery disease were imaged three times (15, 120, and 180 min) after one injection during the stress phase. Assuming that 99mTc-MIBI has not any significant redistribution at this time, the only parameter which has been changed is the amount of accumulated radioactivity within the myocardium. In this way, we have three different images with different deposited doses in the myocardium from each patient. Then quantitative data of End Systolic Volume (ESV), End Diastolic Volume (EDV), and Ejection Fraction (EF) were calculated and compared. Results: Examination of quantitative scanning data indicates that the changes in EF data were non-significant and that the changes in ESV and EDV were significant over time. Conclusion: In this study, assuming a dose reduction of radioactivity up to 50% of the initial dose based on cumulative dose in myocardial and imaging time, no clinically significant changes in quantitative cardiac perfusion scan variables such as ESV, EDV and EF occurred.