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Thoracic endovascular repair (TEVAR) is a valuable alternative to open surgical repair for aortic aneurysms, offering several benefits. However, one potential complication that demands attention is endoleak. This case report highlights a unique occurrence of type 2 endoleak, typically associated with aortic aneurysms treated by TEVAR, originating from an undiagnosed patent ductus arteriosus (PDA). The patient, a 68-year-old woman, underwent TEVAR for an aortic aneurysm complicated by underlying lung disease and pulmonary artery hypertension. During the procedure, an unexpected shunt between the aorta and the pulmonary artery was identified and subsequently revealed to be an undiagnosed PDA. Remarkably, the decision was made to continue with TEVAR while simultaneously deploying a stent graft to close the PDA. This case underscores the significance of comprehensive preprocedural aortic assessment and careful consideration of PDA closure to prevent type 2 endoleak in TEVAR, reinforcing the importance of thorough evaluation before such procedures.

Background and purpose: This study investigated the relationship between oral health related quality of life and hyposalivation and dry mouth in patients with chronic renal failure (CRF) undergoing hemodialysis. Materials and methods: This descriptive-analytical study was conducted in 200 patients with CRF undergoing hemodialysis attending the dialysis department in Sari Imam Khomeini Hospital, 2021. Patients completed oral health-related quality of life questionnaires (OHIP-14) with additive and simple count assessment methods. To diagnose dry mouth, unstimulated saliva was collected and patients were asked nine questions, of which five positive answers indicated dry mouth. Data analysis was done in SPSS V18. Pearson's or Spearman's correlation coefficient were applied to investigate the association between quality of life score and unstimulated salivary flow, and t-test or Mann-Whitney test were used to compare the quality of life scores between the groups with and without dry mouth. Results: Hyposalivation was observed in 66 patients (33%). The OHIP-14 score was significantly higher in both additive and simple count methods in patients with dry mouth and hyposalivation (P

Abstract This paper investigates the manipulation of induced torque on a four-level tripod atom system through the interaction with two vortex probe beams featuring spatial inhomogeneity, along with a non-vortex control beam. The study explores both the linear and nonlinear regimes of torque induction. In the linear regime, where the intensity of the vortex beams is weaker than that of the control field, effective control over the induced torque is demonstrated by adjusting parameters such as magnetic field strength, control field intensity, detuning, and dephasing terms between relevant atomic levels. The analysis highlights the significant contribution of the Zeeman shift-induced magnetic field, which enhances the torque and exhibits a distinct sharp peak. Furthermore, higher-order contributions to the induced torque are discussed as the intensity of the probe fields approaches that of the control field, resulting in further enhancement of the induced torque. These findings offer opportunities for precise control over the rotational motion of atoms within the system, with potential applications in precision measurement, quantum information processing, and quantum control.

In restructured electricity markets, the consumers have various procurement strategies to supply their electricity demand from alternative resources such as self-generating facility, bilateral contracts and pool market purchase. This paper proposes a hybrid approach based on binary imperialist competitive algorithm (BICA) and binary particle swarm optimization (BPSO) to find optimal procurement for large consumers with multiple procurement options. The solution of these problems provides adequate information to obtain an electricity procurement problem for large consumers. Also, the results are compared with ICA and PSO methods. Test results show that the proposed hybrid approach is more effective and has higher capability in finding the optimum solutions in comparison with ICA and PSO methods. A case study is used to illustrate the efficiency of the proposed hybrid approach.

BackgroundOne of the common concerns of healthcare systems is the potential for re-admission of COVID-19 patients. In addition to adding costs to the healthcare system, re-admissions also endanger patient safety. Recognizing the factors that influence re-admission, can help provide appropriate and optimal health care. The aim of this study was to assess comorbidities that affect re-admission and survival in COVID-19 patients using a joint frailty model.MethodsThis historical cohort study was done using data of patients with COVID-19 who were re-hospitalized more than twice in a referral hospital in North of Iran. We used the joint frailty model to investigate prognostic factors of survival and recurrence, simultaneously using R version 3.5.1 (library "frailtypack"). P-values less than 0.05 were considered as statistically significant.ResultsA total of 112 patients with mean (SD) age of 63.76 (14.58) years old were recruited into the study. Forty-eight (42.9%) patients died in which 53.83% of them were re-admitted for a second time. Using adjusted joint model, the hazard of re-admission increased with cancer (Hazard ratio (HR) = 1.92) and hyperlipidemia (HR = 1.22). Furthermore, the hazard of death increased with hyperlipidemia (HR = 4.05) followed by age (HR = 1.76) and cancer (HR = 1.64). It Also decreased with lung disease (HR = 0.11), hypothyroidism (HR = 0.32), and hypertension (HR = 0.97).ConclusionConsidering the correlation between re-admission and mortality in the joint frailty model, malignancy and hyperlipidemia increased the risk of both re-admission and mortality. Moreover, lung disease probably due to the use of corticosteroids, was a protective factor against both mortality and re-admission.

Background and Objectives: Promoting emotion regulation and social relationships has a key role in students' health and can affect their future success. Therefore, the present study was conducted to determine the effect of play-based education on students' emotional regulation and social relationships. Materials and Methods: This quasi-experimental, pre-test-post-test study, included all female students of the second and third grades of Zahedan city in the academic year 2021-2022. Thirty patients were selected by purposive sampling and randomly assigned to two groups of 15; experimental and control. The participants answered the Gross & John (2003) Social Relations Regulation Questionnaire, Barton et al. (2006). The experimental group participated in 12 play therapy sessions, but the control group did not receive any intervention. Data were analyzed by multivariate analysis of covariance. Results: The results showed that there was a significant difference between the control and experimental groups in post-test in terms of emotion regulation and students' social relationships (P < 0.001). Conclusions: Game education was effective in improving students 'emotional regulation and social relationships, so play therapy can be used to improve students' emotion regulation and social relationships.

Groundwater is one of the most important sources of drinking water. Since the quality of water directly influences consumers' health, it is essential to assess the quality of water and related factors. This descriptive-analytical study was performed on physical and chemical variables of water samples collected in the dry and wet seasons during 2006–2020 period. Changes in groundwater quality were investigated by factor analysis (FA) model and geographic information system (GIS) software. Based on factor analysis model, EC, TDS, TH and Mg+2 levels were the most important factors affecting the quality of water. Due to the high level of hardness (dry seasons; 389.4 mg/l and wet seasons; 418.4 mg/l) and sodium in water (dry seasons; 138 mg/l and wet seasons; 158 mg/l), necessary measures should be taken before drinking and agriculture uses. Changes in the water quality were more related to natural factors and human activities. The invasion of saline water into the groundwater aquifers in the study area should be considered. HIGHLIGHTS The high water hardness.; Increasing the concentration of elements during these years in two region.; The ranks of abundance of the ions are as follows: anions including > > Cl− and cations including Ca2+ > Mg2+ > Na+ > K+.; The higher risk of water invasion in Aghghala region in comparison with Gorgan region.; Consistency of application of these two methods to analyze water quality data.;

ABSTRACT Background and objectives: Electrosurgical units produce the highest level of surgical smoke. Therefore, the present study aimed to determine concentration of surgical smoke compounds produced in orthopedic surgeries. Methods: The present study was performed on 20 patients in the operating room units of 5 Azar Hospital in Gorgan, Iran. Twenty smoke specimens were collected from electrosurgical units during orthopedic surgeries. The concentration of benzene, toluene, ethylbenzene, and xylene (BTEX) was determined using an air-sampling pump and SKC charcoal sorbent tubes. The collected data were analyzed using frequency distribution as well as generalized linear and ranked logistic regression tests in SPSS software (version 17). Results: Most patients had a body mass index (BMI) level of >24 kg/m2. The mean age of patients was 25.28 years. The average concentrations of benzene, toluene, ethylbenzene, and xylene were 540 µg/m3, 430 µg/m3, and 340µg/m3, and 390µg/m3, respectively. The concentration of particles with an aerodynamic diameter of 2.5 μm or less (PM2.5) was 22.75 µg/m3. Benzene values were higher than the National Institute for Occupational Safety and Health limit. The PM2.5 values were unhealthy for sensitive groups according to the Air Quality Index. Moreover, BMI had a significant association with the amount of benzene produced intraoperatively (p=0.016). The findings also showed that the surgery duration had a significant association with toluene production (p=0.049). Conclusion: The concentration of BTEX compounds was low, but the PM2.5 values are high in the studied operating rooms. Long-term exposure to BTEX compounds can be considered as a health risk for operating room personnel.

Coagulation and flocculation processes play a major role in surface water treatment. The aim of this study was to eliminate the rapid mixing unit in the water treatment plant. This experimental study was conducted on turbid water. Turbid water was synthesized by kaolin powder. The conventional jar test method was used. The flocculation and sedimentation processes were performed on the turbid water without a rapid mixing unit for getting the new optimal condition. When the PACl coagulant was used alone and in conjunction with chitosan, the percentages of turbidity removal in low, medium and high turbidities were obtained as 86.7%, 95.8%, 97.8% and 86.67%, 95.73%, 98.26%, respectively. When the rapid mixing unit was emitted, the efficiency of turbidity removal in the low turbidity was reduced from 5.26% to 21.73%. But, in higher turbidity in two states (presence and absence of the rapid mixing units) it did not have a significant difference. This study showed that the removal of the rapid mix unit on the removal efficiency of turbidity in the low turbidity is effective, but does not have an effect on higher turbid water. Also, using PACl in conjunction with chitosan was effective in the removal efficiency and to reduce residual aluminum. HIGHLIGHTS To decrease the cost of water treatment.; Changing the process related to coagulation and flocculation stages.; To decrease the time and the consumed coagulant.; To increase efficiency of turbidity removal.; Simplicity of process.;

Background and Objective: Overexposure to electromagnetic waves produces by computer cause health disorders by users. This study was performed to determine the employer's exposure risk to electromagnetic fields from monitors of computers in north of Iran Methods: This descriptive-analytical study was performed on 100 of computers using by 100 employee users (69 males and 31 femals) with the mean age of 40.83±7.37 in Gomishan county, Golestan province in north of Iran during 2018. The intensity of the magnetic and electric field caused by computers was measured at 30, 50 and 60 cm intervals and in four directions from the front, back, right and left side of the monitor using SVENSK standard method. The intensity of fields was measured by TM-190 instrument. Data were compared with OEL (Occupational Exposure Limit), MPRII and TCO (The Swedish Confederation of Professional Employees). The NIOSH (National Institute for Occupational Safety and Health) standard questionnaire was used to assess the side effects of working with computers. The health problems in employee users were recorded. Results: The mean±SD of the intensity of the electrical waves was 103.63±33.62 v/m that was less than the standard values. The mean±SD of the intensity of the magnetic waves was 0.1±0.09 mA/m that was higher than the TCO, MPRII standard values and less than OEL. The maximum magnetic-field invasion from the standard range with an average of 157.04 mA/m is on the front of the monitors, at a distance of 30 cm and the lowest of them with a mean of 19.2 mA/m for the off-mode computer and at a distance of 60 cm from the mantle. There was a significant difference between the time of working with computer in the day with burning eye, headache and eye fatigue. There were no significant difference of clinical symptoms in men and women and fatigue syndrome. Conclusion: The electrical waves of monitor of computers were lower than standard limit in all studied conditions, but the magnetic waves were much higher than standard limit.

Background : The purpose of the present study was to determine the effect of increasing cognitive load of rhythmic games on theory of mind in children with developmental coordination disorder. Method: This is a quasi-experimental research. Participants in this study were 25 children (9 boys and 16 girls) aged 8 to 10 years old who were screened based on Parental Developmental Coordination Disorder Questionnaire (DCD- Q07) and confirmed for their impairment using the Movement Assessment Battery for Children (MABC) Test. All participants underwent Raven's test in the same condition and students with normal intelligence entered the study. Participants were matched in two groups of experimental (n = 13) and control (n = 12). The experimental group performed rhythmic games with cognitive load for 8 weeks and 2 sessions of 45 minutes per week, but the control group received only rhythmic games intervention. Participants were assessed before and after the intervention by Steerneman theory of mind test. Statistical analysis was performed using univariate and multivariate covariance tests. Results: The results indicated that rhythmic games with cognitive load developed the theory of mind in children with developmental coordination disorder (P=0.01). Conclusion: Since cognitive load rhythmic games have a positive effect on the theory of mind in children with developmental coordination disorder, it is recommended that these exercises be included in the daily activities of these children.

This paper presents a fully-decentralized peer-to-peer (P2P) electricity and gas market for retailers and prosumers with coupled energy units, considering the uncertainties of wholesale electricity market price and prosumers’ demand. The goal is to improve the overall economy of the proposed market while increasing its flexibility. In this market, the retailers are equipped with self-generation and energy storage units and can bilaterally negotiate for electricity and gas transactions with prosumers to maximize their profit. Furthermore, they can sell power to the upstream market in addition to prosumers. The prosumers have access to several retailers to supply their required electricity and gas and can freely provide their energy needs from every retailer, contributing to dynamicity in the proposed market. Given that they have an energy hub consisting of boiler units, combined heat and electricity (CHP) units, and electric pumps, they can switch their energy supply source from electricity to gas and vice versa. A robust possibilistic programming approach is applied to address the uncertainties. A fully-decentralized approach called the alternating direction method of multipliers (ADMM) is utilized to solve the presented decentralized robust problem. The proposed decentralized algorithm finds an optimum solution by establishing a smart balance between the average expected value, optimality robustness, and feasibility robustness. The feasibility and competitiveness of the proposed approach are evaluated through numerical studies on a distribution system with two retailers and three prosumers. The data analysis of the simulation results verifies the effectiveness of the proposed decentralized robust framework as well as the proposed decentralized solution. According to the maximum deviation, the expected optimal value in the robust case, the retailer’s profit has decreased by 12.1 percent, and the prosumers’ cost has increased by 27.4 percent due to the feasibility penalty term.

Smart grids have introduced several key concepts, including demand response, prosumers—active consumers capable of producing, consuming, and storing both electrical and thermal energies—retail market, and local energy markets. Preserving data privacy in this emerging environment has raised concerns and challenges. The use of novel methods such as online learning is recommended to address these challenges through prediction of the behavior of market stakeholders. In particular, the challenge of predicting prosumers’ behavior in an interaction with retailers requires creating a dynamic environment for retailers to set their optimal pricing. An innovative model of retailer–prosumer interactions in a day-ahead market is presented in this paper. By forecasting the behavior of prosumers by using an online learning method, the retailer implements an optimal pricing scheme to maximize profits. Prosumers, however, seek to reduce energy costs to the greatest extent possible. It is possible for prosumers to participate in a price-based demand response program voluntarily and without the retailer’s interference, ensuring their privacy. A heuristic distributed approach is applied to solve the proposed problem in a fully distributed framework with minimum information exchange between retailers and prosumers. The case studies demonstrate that the proposed model effectively fulfills its objectives for both retailer and prosumer sides by adopting the distributed approach.

Background: One of the common concerns of healthcare systems is the potential for re-admission of COVID-19 patients. In addition to adding costs to the healthcare system, re-admissions also endanger patient safety. Recognizing the factors that influence re-admission, can help provide appropriate and optimal health care. The aim of this study was to assess comorbidities that affect re-admission and survival in COVID-19 patients using a joint frailty model. Methods: This historical cohort study was done using data of patients with COVID-19 who were re-hospitalized more than twice in a referral hospital in North of Iran. We used the joint frailty model to investigate prognostic factors of survival and recurrence, simultaneously using R version 3.5.1 (library "frailtypack"). P-values less than 0.05 were considered as statistically significant. Results: A total of 112 patients with mean (SD) age of 63.76 (14.58) years old were recruited into the study. Forty-eight (42.9%) patients died in which 53.83% of them were re-admitted for a second time. Using adjusted joint model, the hazard of re-admission increased with cancer (Hazard ratio (HR) = 1.92) and hyperlipidemia (HR = 1.22). Furthermore, the hazard of death increased with hyperlipidemia (HR = 4.05) followed by age (HR = 1.76) and cancer (HR = 1.64). It Also decreased with lung disease (HR = 0.11), hypothyroidism (HR = 0.32), and hypertension (HR = 0.97). Conclusion: Considering the correlation between re-admission and mortality in the joint frailty model, malignancy and hyperlipidemia increased the risk of both re-admission and mortality. Moreover, lung disease probably due to the use of corticosteroids, was a protective factor against both mortality and re-admission. [ABSTRACT FROM AUTHOR]