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Abstract A novel electrochemical probe is developed to detect amlodipine (AMD) in unprocessed plasma samples. The fabrication process involves the synthesis of platinum nanocubes (Pt NCs) and Mn(TPDCA)2 complexes, which are then immobilized them onto the glassy carbon electrode (GCE) surface. The developed electrochemical probe demonstrates exceptional detection performance, with a wide dynamic range, outstanding selectivity, and commendable reproducibility. The linear range and lower limit of detection of the developed method are 53 nM-3.5 µM and 53 nM, respectively. Electrochemical experiments have been conducted to study the kinetics of electrooxidation on the modified electrode, revealing that the process is diffusion-controlled. Furthermore, method validation studies are performed to assess the accuracy, precision, and selectivity of the sensor, demonstrating excellent performance in all these aspects. Consequently, it can be concluded that the sensor is highly suitable for practical applications in drug analysis.

Abstract The main objective of this work was to use hydroxyl-functionalized graphene as a compatibilizer for an immiscible blend. A neat polyoxymethylene/styrene-butadiene-styrene binary blend was prepared at a constant ratio (80/20) and then was compounded with different loading amounts of hydroxyl-functionalized graphene (0.25, 0.5, 0.75, and 1 wt%). The formation of droplet-matrix morphology during blending was observed in microscopy images. A deep understanding of the compatibility was inspected through studying the mechanical, rheological, and microstructural properties. By inspecting the localization of nanoparticles, triple functions of hydroxyl-functionalized graphene as a compatibilizing/reinforcing/lubricating agent were elucidated. The mechanical properties showed that the best compatibility with the ultimate performance was related to the nanocomposite containing 0.25 wt%. Furthermore, the electrical conductivity of the prepared nanocomposites was investigated. Thermodynamic/kinetic studies showed the tendency of hydroxyl-functionalized graphene to disperse droplets, however as the loading value increases, the probability of its presence in the matrix also increases, creating conductive pathways for conductive purposes. The lowest resistance and highest volume of electrical conductivity (8.4 × 10−6 S.cm−1) were shown by 1 wt% FG.

Abstract Background Redondoviridae is a newly discovered virus family linked to oral and respiratory conditions in people, while there is still debate about whether it is also coinfected with other respiratory viruses. This study aimed to determine the frequency of Redondovirus (ReDoV) in nasopharyngeal samples and to investigate any possible links to SARS-CoV-2 infections. Methods A polymerase chain reaction (PCR) test was conducted on 731 nasopharyngeal samples from individuals referred to medical centers in Tehran, Iran, for SARS-CoV-2 testing to investigate the prevalence of ReDoV. An oral interview was performed to complete information on dental issues and the individuals’ demographics, symptoms, and vaccination history. Results The prevalence of ReDoV was 25.99%, and 15.26% had a coinfection with SARS-CoV-2. No notable correlation was found regarding ReDoVs and SARS-CoV-2 infections (p > 0.05). Women had a higher ReDoV positivity rate of 18.47% compared to men at 7.52% (p = 0.12), and there was no significant correlation between age groups and ReDoV presence. Nonetheless, a significant association was noted between ReDoVs and dental/gum issues (p

Background: The use of different educational methods and programs, such as simulation and virtual training, plays an important role in effective Cardiopulmonary Resuscitation (CPR) learning for nursing students. This study was conducted with the aim of comparing mannequin-based simulation training with virtual training on CPR learning among nursing students. Materials and Methods: This parallel randomized controlled trial was conducted in 2022. We selected 73 nursing undergraduate students and randomly assigned them to two groups: mannequin-based simulation and virtual training groups. The knowledge, attitude, and performance of CPR in both groups were evaluated and compared before, immediately after, and 1 month after the intervention. Data analysis was performed using independent t-test and the repeated-measure analysis of variance (ANOVA) using the Statistical Package for Social Sciences (SPSS) software. Results: Within-group differences were significant in both mannequin-based simulation and virtual training groups in terms of knowledge, attitude, and CPR performance before and after training, as well as between before and 1 month after training (p < 0.001). In addition, the mean performance of simulation group students was significantly higher than the virtual group (p < 0.001), but no significant difference was observed between the two groups in terms of knowledge and attitude dimensions before training, after training, and 1 month after training. Conclusions: Both mannequin-based simulation and virtual training methods increase CPR learning. Considering that students’ knowledge and attitude increase significantly using both training methods and the performance of students in the simulation group is better than in the virtual group, the use of a multimodal approach is recommended for CPR training of nursing students.

Introduction: Breast cancer is the most common cancer and the leading cause of cancer-related death among women worldwide. Breast cancer treatment has been improved by the development of targeted chemotherapies such as antibodies against HER2 receptors and now Trastuzumab is the standard treatment for HER2 positive breast cancer. Cardiotoxicity is the most prominent adverse effect of Trastuzumab that restricts the usage of this drug. This study is designed to assess cardiomyopathy in patients with breast cancer under Trastuzumab chemotherapy with special respect to both right and left ventricles.Materials and Methods: A total number of 38 cases were evaluated. Echocardiography was done at the baseline and three to six months after the initiation of Trastuzumab chemotherapy.Results: According to the second echocardiography 24 cases (63.8%) developed cardiotoxicity based on decrease in ejection fraction or decrease in the absolute value of the left and/or right ventricular Global Longitudinal Strain (LV and/or RV GLS). There was a significant difference between the mean values of echocardiographic indices including RVSm, RV Tei-index, LV Tei-index, RV GLS, LV GLS, LVEF, MAPSE, and TAPSE before and after chemotherapy (the p-value for comparison of MAPSE was 0.006, and the p-value for comparison of other parameters was

Abstract Predicting postpartum hemorrhage (PPH) before delivery is crucial for enhancing patient outcomes, enabling timely transfer and implementation of prophylactic therapies. We attempted to utilize machine learning (ML) using basic pre-labor clinical data and laboratory measurements to predict postpartum Hemoglobin (Hb) in non-complicated singleton pregnancies. The local databases of two academic care centers on patient delivery were incorporated into the current study. Patients with preexisting coagulopathy, traumatic cases, and allogenic blood transfusion were excluded from all analyses. The association of pre-delivery variables with 24-h post-delivery hemoglobin level was evaluated using feature selection with Elastic Net regression and Random Forest algorithms. A suite of ML algorithms was employed to predict post-delivery Hb levels. Out of 2051 pregnant women, 1974 were included in the final analysis. After data pre-processing and redundant variable removal, the top predictors selected via feature selection for predicting post-delivery Hb were parity (B: 0.09 [0.05–0.12]), gestational age, pre-delivery hemoglobin (B:0.83 [0.80–0.85]) and fibrinogen levels (B:0.01 [0.01–0.01]), and pre-labor platelet count (B*1000: 0.77 [0.30–1.23]). Among the trained algorithms, artificial neural network provided the most accurate model (Root mean squared error: 0.62), which was subsequently deployed as a web-based calculator: https://predictivecalculators.shinyapps.io/ANN-HB . The current study shows that ML models could be utilized as accurate predictors of indirect measures of PPH and can be readily incorporated into healthcare systems. Further studies with heterogenous population-based samples may further improve the generalizability of these models.

Background: The global COVID-19 pandemic, declared in January 2020, necessitated urgent preventive measures, with vaccination as a key strategy. Despite progress in vaccine development and distribution, widespread hesitancy persists, impeding global disease control efforts. This study specifically explores COVID-19 vaccine hesitancy and acceptance among Iranian children with asthma, aiming to understand factors unique to this subgroup. Method: A cross-sectional investigation was carried out in an allergy clinic in Iran, including a total of 522 asthmatic children between the ages of 5 and 18 years. A comprehensive questionnaire, built upon previous studies, investigated the factors that influence vaccine hesitation and acceptance. Data pertaining to demographics, vaccination status, and factors influencing hesitancy or acceptance were collected. Results: Among the participants, 27.5% were administered the COVID-19 vaccine. Decisions were greatly influenced by family dynamics, with a notable association between parent and child vaccination. Children’s vaccination rates were associated with their age and the frequency of COVID-19 diagnosis among their parents. The primary factors motivating individuals to get vaccinated were safety concerns (67.1%) and a strong belief in the severity of COVID-19 (43.4%). On the other hand, vaccine hesitancy resulted from concerns about potential adverse effects (77%), lack of confidence (28.3%), and a belief that children who had already contracted COVID-19 did not require vaccination (22.5%). Conclusion: The study highlights COVID-19 vaccine hesitancy and acceptance among asthmatic children in Iran, emphasizing parental decision-making factors. Tailored interventions are required due to the lower vaccination rate in this specific group. Healthcare providers play a vital role in influencing opinions, urging actions against misinformation, enhancing vaccine understanding, and promoting positive attitudes.

Abstract We have developed an innovative tool, the Intelligent Catchment Analysis Tool (iCAT), designed to identify and address healthcare disparities across specific regions. Powered by Artificial Intelligence and Machine Learning, our tool employs a robust Geographic Information System (GIS) to map healthcare outcomes and disease disparities. iCAT allows users to query publicly available data sources, health system data, and treatment data, offering insights into gaps and disparities in diagnosis and treatment paradigms. This project aims to promote best practices to bridge the gap in healthcare access, resources, education, and economic opportunities. The project aims to engage local and regional stakeholders in data collection and evaluation, including patients, providers, and organizations. Their active involvement helps refine the platform and guides targeted interventions for more effective outcomes. In this paper, we present two sample illustrations demonstrating how iCAT identifies healthcare disparities and analyzes the impact of social and environmental variables on outcomes. Over time, this platform can help communities make decisions to optimize resource allocation.

Abstract The pain associated with chest tube removal (CTR) is one of the significant complications of cardiac surgery. The management of this pain is recognized as a vital component of nursing care. The application of distraction techniques using virtual reality (VR) is an effective and straightforward non-pharmacological approach to alleviate pain. This study aimed to determine the impact of VR technology on the management of pain caused by CTR following coronary artery bypass grafting (CABG). This randomized clinical trial was conducted on 70 patients undergoing CABG at Imam Reza and Qaem hospitals in Mashhad, Iran, in 2020. The patients were randomly divided into two groups of 35. For the intervention group, a 360-degree video was played using VR glasses 5 min before the CTR procedure. The pain intensity was measured before, immediately after, and 15 min after CTR, using the Visual Analogue Scale. Also, the Depression Anxiety and Stress Scale-21 (DASS-21), and the Rhoten Fatigue Scale (RFS) were used to evaluate intervention and control groups before the CTR procedure. The collected data was analyzed using statistical tests, such as Chi-square, independent t-test, and Mann–Whitney test. The patients were homogeneous in terms of stress, anxiety, and fatigue levels before CTR, and they did not show any significant differences (P > 0.05). The average pain intensity score of patients in the intervention group significantly decreased immediately and 15 min after CTR, compared to the control group (P

Background: Because nurse prescription has numerous benefits for the health systems, in many countries around the world, nurses are given the right to prescribe medication. In Iran, the role of nurses in prescription drugs is not well understood, and nurses face various challenges in this regard. Materials and Methods: A qualitative content analysis methodology based on the Graneheim and Lundman model was used. Thirteen nurses working in medical wards of hospitals affiliated with the Tehran University of Medical Science were selected to participate in this study by purposeful sampling. Participants were interviewed via telephone using a semi-structured tool. After thirteen interviews, data saturation was reached. Data collection was undertaken between April 2020 and April 2021. Results: The results of this study are summarized in one theme, four categories, and ten subcategories. The theme extracted from the data analysis was “the practical challenges of nurse prescription,” which included four main categories: structure challenges, personnel-related barriers, interprofessional separation, and society's attitudes. Conclusions: The results of this study explain the barriers and practical challenges of nurse prescription in Iran. Identifying these challenges and barriers provides the necessary evidence for policymakers to remove and adjust these challenges and barriers. Moreover, the elimination of identified challenges will help nurses better perform their new roles and develop the nursing scope and profession.

In this article, the effects of productivity, foreign prices and oil exports shocks on the main variables including production and consumption were investigated, in a small open economy and in a situation where the country has adopted a policy of stabilizing the exchange rate. In this analytical space, under certain conditions, a cycle between the government and the financial and real sectors is created, which leads to the repeated reduction of the government primary surplus, and thus increases the probability of the government's inability to repay previously issued bonds and decreases the value of government bonds. This process ultimately leads to government debt-overhang, banking crisis and the reduction of total production and Consumption. For this purpose, the literature of "Fiscal Theory of the Price Level" (FTPL) has been used to analyze the performance of the government, which seems to be compatible with the institutional and legal conditions of Iran. According to this theory, the government, in some situations, can become the dominant actor in determining the general price level, and monetary policies are mainly regulated in accordance with the government fiscal policies. The above-mentioned process was implemented in a simple dynamic general equilibrium model that describes the behavior of actors in the economic environment, and the results on the variables of the model were analyzed. As a result, it was observed that the introduced shocks, such as nominal or real, even without any price stickiness and in conditions where domestic goods are priced based on global values, can have detrimental real impacts on key economic variables and public welfare.

Abstract Background High quality end-of-life care is essential. Yet for those experiencing heart failure, the provision of high-quality end- of -life care can be challenging. The aim of this study was to explore Iranian nurses’ perceptions of the challenges involved in providing of end-of-life care to people with heart failure. Methods Conventional content analysis was used to analyze qualitative data collected from nurses (n = 33) using semi-structured and individual interviews. Participants were aged between 29 and 51 years. The majority of participants were women (n = 20). Most had a bachelor’s degree (n = 24), and work experience of between 7 and 18 years. Results Nurses challenges in providing end-of-life care to those with heart failure included (1) adverse consequences relating to compassion fatigue and continued futility in care and (2) lack of palliative care services with regards to a lack of specialists, lack of support from health systems, and poor teamwork. Conclusions This is the first qualitative study to explore Iranian nurses’ challenges in providing end-of-life care to those with heart failure. Investment is required in education and research in this area. Particular attention must be paid to prevention of compassion fatigue. Law changes would enable the delivery of higher-quality palliative care in this context overall.

Abstract The cancer is a serious health problem, which is The cancer death rate (cancer mortality) is 158.3 per 100,000 men and women per year (based on 2013–2017 deaths). Both clinical and translational studies have demonstrated that chronic inflammation is associated with Cancer progression. However, the precise mechanisms of inflammasome, and the pathways that mediate this phenomenon are not fully characterized. One of the most recently identified signaling pathways, whose activation seems to affect many metabolic disorders, is the “inflammasome” a multiprotein complex composed of NLRP3 (nucleotide-binding domain and leucine-rich repeat protein 3), ASC (apoptosis associated speck-like protein containing a CARD), and procaspase-1. NLRP3 inflammasome activation leads to the processing and secretion of the proinflammatory cytokines interleukin-1β (IL-1β) and IL-18. The goal of this paper is to review new insights on the effects of the NLRP3 inflammasome activation in the complex mechanisms of crosstalk between different organs, for a better understanding of the role of chronic inflammation in cancer pathogenesis. We will provide here a perspective on the current research on NLRP3 inflammasome, which may represent an innovative therapeutic target to reverse the malignancy condition consequences of the inflammation. Video Abstract

Elite controllers (ECs) defined as a small subclass of subjects with HIV capable of controlling human immunodeficiency virus (HIV) replication in the lack of antiretroviral treatment. One class of RNA molecules that serve as vital components in the network of HIV-related transcriptional regulation, are long noncoding RNAs (lncRNAs). The critical part that they take is in transcriptional regulation of HIV through monitoring various cellular signaling pathways. Reportedly, AKT and MAPK signaling pathways serve a crucial role in modulation of HIV infection. In the current investigation, we utilized bioinformatics tools to predict the lncRNAs that have the ability to interact with MAPK3, AKT, and FOXO1. Then, PBMC expression levels of lncRNAs and their target genes (AKT, FOXO1 and MAPK3) measured in the ECs (n = 15), HIV-positive (n = 40) patients and healthy control subjects (n = 40). We found a significant increase and decrease in the level of AKT and FOXO1 expression within the ECs group, respectively than in the HIV + group (P-value

BackgroundCancer is a significant public health issue, causing various challenges for individuals affected by it. As cancer progresses, patients often become dependent on others for support. Family caregivers and members play a crucial role in the recovery and rehabilitation of these patients. However, caregivers themselves face numerous challenges throughout the course of their family member’s illness. Exploring the experiences of family caregivers can inform long-term planning and supportive interventions to address their caregiving difficulties. This study reviews previous literature on caregiving outcomes.MethodThis study presents a narrative review of qualitative studies, analyzing a total of 23 articles. The results were extracted and organized into subcategories. After revision by the research team, main categories were identified. These categories encompass both positive and negative outcomes of caregiving.ResultsThe findings of this review demonstrate that caring for a family member with cancer has significant implications for caregivers. These implications include: (A) Positive outcomes of caregiving (such as achieving self-management and balance, promoting kinship intimacy, finding meaning and purpose, and experiencing spiritual growth) and (B) Negative outcomes of caregiving (including care-related physical exhaustion, disruption of personal life plans, psycho-emotional consequences, and socio-economic burden).ConclusionThe results of this study highlight the challenges faced by family caregivers and emphasize the importance of addressing their needs within the healthcare system. By providing support and attention to their well-being, caregivers can enhance their resilience and adaptability in managing caregiving difficulties.

Cardiovascular complications of Brucellosis are not common and affecting less than 2% of cases. In clinical practice, endocarditis is the most frequent cardiovascular complication and is responsible for most of the brucellosis-related mortality cases and usually diagnosed lately in the course of the disease with mostly aorta valve involvement. In this case report, we present the case of a 27-year-old woman who was admitted to the hospital with fever, sudden onset right side hemiparesis, and horizontal gaze palsy. During the stroke work up, she underwent cardiac evaluation, including echocardiography with susceptibility to septic emboli with cardiac origin, and the result indicates presence of vegetations on prosthetic aortic valve suggestive of infective endocarditis. Hopefully our patient responded well to combination of heart surgery and antibrucellosis regimen and was finally discharged with stable general condition. It is important to raise awareness of this rare but potentially serious complication of brucellosis, especially in the endemic area, and to emphasize the value of early diagnosis and treatment.

Background: Failure to wean a patient from mechanical ventilation after cardiac surgery is associatedwith poor outcome.Aim: The present study was performed aimed to investigate the risk factors of prolonged mechanicalventilation (PMV) following isolated coronary artery bypass graft (CABG) surgery.Method: This retrospective cohort study was performed on 2155 consecutive adult patientsundergoing isolated coronary artery bypass graft surgery (May 2012 to November 2016 at Imam Rezahospital, Mashhad, Iran). The subjects were assessed for duration of weaning from mechanicalventilation, predictive risk factors for prolonged mechanical ventilation and associated outcomesincluding intensive care unit (ICU) and hospital length of stay (LOS), and mortality. Data wereanalyzed by SPSS (version 22). P

Background: Studies show that leaving the hospital with personal consent is increasing. This phenomenon has unpleasant and sometimes irreversible consequences. This study aims to investigate the causes and consequences of leaving the hospital with the personal consent of patients referred to the emergency department of hospitals affiliated with Qom University of Medical Sciences in 2021. Materials and Methods: In this descriptive-analytical study, 345 patients were selected who, with personal consent, left the emergency department of selected hospitals affiliated with Qom University of Medical Sciences in 2021. The study data were collected via a questionnaire and a checklist. The questionnaire comprised demographic variables, patient-related factors, personnel-related factors, and hospital-related factors. The checklist of the consequences included questions about leaving the hospital with personal consent. The data were analyzed using descriptive and inferential statistics in SPSS software, version 20. Results: Of 345 patients included in the study, 55.9% were male and the mean age of patients was 47.1 years. The most important reasons for leaving the hospital with personal consent were as follows: personal reasons (22.9%), fear of continuing treatment (11.9%), preference to continue the treatment in other medical centers (9.3%), the suggestion of other hospital staff (35.1%), not having the desired doctor (27%), nurses’ suggestion (19.4%), lack of care (20.4%), and inadequate hospital space and facilities (14.0%). The consequences of leaving the hospital with personal consent in this study included re-admission and hospitalization (10.3%), mortality (3.4%), heart disease (0.87%), and mental disorders (0.57%). Conclusion: After identifying the reasons for leaving the hospital with personal consent and highlighting the irreparable human and financial consequences, these causes should be eliminated to prevent irreparable and unfortunate consequences. Such causes include personal reasons, fear of continuing the treatment, and lack of care. Fixing the causes requires proper planning and effective actions.

Background and Objective: Nowadays, it has been proven that the immune system plays a major role in the occurrence or treatment of some cancers. The PDL-1 proteins are among the components of the immune system, which are expressed in different body cells, including B cells and T cells. In this regard, the present study was conducted to determine the frequency of PDL-1 protein expression and its relationship with tumor histopathology in patients with gastric cancer. Materials and Methods: In this case series study, 100 patients referred to the Oncology Clinic, located in Imam Khomeini Clinic, Hamadan, Iran, between 2016-2021, with the diagnosis of gastric cancer (confirmed by endoscopic biopsy pathology) were selected. Moreover, their PDL-1 protein expression (with IHC) and its relationship with age, gender, metastasis, stage, and grade of the tumor were evaluated. Results: The average age of patients was 65.53 ± 10.83 years, and 72% were male. The result of PDL-1 protein expression showed that 2 patients were negative, 25 patients were weakly positive and 73 patients were strongly positive. In addition, 69 Out of 100 patients had metastases, 69 cases had high grade and 68 were in stage 4 of the disease. A significant relationship was observed between PDL-1 expression with metastasis, higher grade, and higher stage of the tumor (P

Background and Objectives: Patients have certain rights that are expected to be observed and respected by healthcare providers. These rights include universal as well as local rights determined by the social and cultural context of any society. Patient’s rights consist of statements issued to declare the duties of the health providers pertaining to patients. There are charters of patient rights in different countries including Iran. However, it seems necessary to investigate more exactly the patient rights in accordance with the Islamic perspective as the fundamental value system of the country. This study was conducted to explore and explain the patient’s rights from the clerics’ point of view. Methods: This was a conventional qualitative content analysis study. The participants were 20 clerics living in Qom selected through purposeful sampling, who met the inclusion criteria and could provide their understanding of the patient’s rights in the context of Islam. Deep semi-structured interviews were conducted. The interviews were coded and categorized through qualitative content analysis. Results: This study led to the identification of four themes as the main features of patient’s rights from the clerics’ point of view including respect for patient autonomy, considering non-physical needs of patients, high-quality healthcare, and moral conduct. Conclusion: According to the findings of this study, patient rights from the viewpoint of the clerics includes besides attending other needs of patients, their spiritual needs that should be addressed by healthcare providers.

Background and Objectives: Emergency medical technicians (EMTs), as the front line of dealing with patients with COVID-19, are exposed to the intensification of stress caused by these conditions, and it is essential to identify related factors, such as resilience and spiritual intelligence in this context. This study was conducted to determine the relationship between perceived stress, spiritual intelligence, and resilience of EMTs during the COVID-19 pandemic. Methods: This cross-sectional study was conducted on 108 EMTs in Shahroud in 2021. Data collection tools included the demographic checklist, Cohen’s perceived stress questionnaire, King’s spiritual intelligence questionnaire, and Conrad Davidson’s questionnaire (CD-RISC). To analyze the data, descriptive and inferential (independent t-test, Pearson correlation, and multiple regression) statistics were used. Results: The mean scores of perceived stress and resilience of employees were at medium and high levels, respectively. There was no significant relationship between perceived stress and spiritual intelligence (r=-0.49, P=0.24), but there was a meaningful negative correlation between perceived stress and resilience (r=-0.31, P=0.002). A positive and significant relationship was observed between perceived stress score and age and work experience. Conclusion: Considering the significant relationship between perceived stress and resilience in the present study, it is suggested that the administrators provide solutions such as creating training courses to manage stress and increase resilience in EMTs.

Objective: The aim of this study was to evaluate the effect of crocin on the prevention of atrial fibrillation after coronary artery bypass grafting (CABG) and heart valve replacement.Materials and Methods: 100 patients who were scheduled for CABG or heart valve replacement surgeries were randomly assigned into two groups of treatment and placebo. In the treatment group, patients received crocin tablets from three days prior to surgery and on the first three postoperative days (for a total of six days). During the first three days after surgery, postoperative atrial fibrillation (POAF) was assessed by electrocardiogram monitoring. Prooxidant–antioxidant balance (PAB) and c-reactive protein (CRP) levels were also assessed.Results: POAF developed in 7 patients in the treatment group versus 18 patients in the control (p=0.02). PAB levels were significantly lower in the crocin group (p

Introduction: According to previous research, an individual’s mood affects selective attention and false memory, but the answer to the question of which type of mood (negative or positive) and emotional situation (negative or positive) creates the highest false memory requires further research. Aim: The present study was conducted to determine the extent and manner of the effect of mood induction and situational-emotional load on false memory based on the misinformation paradigm with emphasis on controlling cognitive and emotional factors. Method: The research was conducted with a quasi-experimental block design. Of the students of Kurdistan University in the academic year 2018-2019, 90 subjects (45 girls; age range= 18-33 years) were selected by the recall and voluntary method. The Stroop cognitive assignments, point scanning, n-back and misinformation paradigm, as well as the Depression Anxiety Stress Scale (DASS-21) and the Positive and Negative Affect Schedule (PANAS), were used to collect the data. Data were analyzed using SPSS-24 through one-way and two-way Kruskal-Wallis and U-Mann-Whitney methods. Results: Negative emotional load of the task caused the highest amount of false memory (p=0.001) and the positive emotional load and the lack of emotional load caused the lowest amount of false memory (p=0.001). The type of mood induction did not affect the amount of false memory (p=0.578). The highest false memory was created in association with negative mood induction and negative emotional load of the task and the lowest false memory was created in association with positive mood induction and the task without emotional load (p=0.019). Conclusion: This study shows that the effect of the emotional load of the task on creating false memory is greater than mood induction. It is suggested that in future research, the effects of the emotional load of the task and mood induction on false memory (in two stages of decoding and retrieval) at different arousal levels should be investigated. In addition, the findings of this study should be reviewed to determine the applicability in judicial and clinical settings as well.

Background & Objective: The study of academic burnout and its predictors as one of the main challenges of the educational system is of great importance. This research was conducted to investigate and explain the role of hope for employment and its subscales in predicting academic burnout. Materials & Methods: All health sciences students at Ilam, Arak, Birjand, Semnan, and Hamedan Universities of Medical Sciences, Iran, in 2019 were examined in this descriptive-correlation study. The samples were selected using a stratified random sampling method (n=400). The required data were gathered using the Academic Burnout Questionnaire (developed by Berso et al.) and the Qureshi Rad Employment Hope Questionnaire. The collected data were analyzed in the SPSS-20 software using an independent t-test, one-way ANOVA, and simple and multiple linear regressions. Results: The results of the study showed that 2.3%, 61.3%, and 36.5% of students suffered from low, medium, and high levels of academic burnout, respectively. The mean ± SD of the hope for employment score was 55.69±14.61, indicating a moderate level of hope for employment among the study participants. Based on the study results, 8.4% of the variance of academic burnout could be predicted by hope for employment (F=37.58, R=0.298, R2=0.086, adjusted R2=0.084, P

Citizens' financial security is the principle that generates the systematization and stability of the legal order and guarantees civil and social rights. It is of high significance as the inspirational principle of the entire legal system. From this perspective, the present article, after expanding the conceptual space of the subject, examined the issues of financial security. According to the thematic documents presented in this research, a descriptive-analytical method has been used to analyze the data collected from the library sources. The research questions asked how official documents provided financial security and how this issue has been raised in jurisprudence and law. In regard to the questions raised, the research hypotheses were formulated as follows: it seems that the official documents can eliminate the sense of legal and financial insecurity in society and promote a sense of financial and legal security both in Imami jurisprudence and in subject law. The findings showed that, although the official document is emphasized in the subject and jurisprudential laws of Iran, in practice, the ownership of many real estates is based on ordinary documents and lacks the registration records. Hence, if the document is revoked, it causes insecurity of the citizens' financial rights. Therefore, it is proposed that with a new look based on Islamic jurisprudence, which emphasizes writing and documenting, the official document can be used to guarantee the financial rights of the citizens.

Non-destructive testing (NDT) is a crucial method for detecting damages in concrete structures. Structural damage can lead to functional changes, necessitating a range of damage detection techniques. Non-destructive methods enable the pinpointing of the location of the damage without causing harm to the structure, thus saving both time and money. Damaged structures exhibit alterations in their static and dynamic properties, primarily stemming from a reduction in stiffness. Monitoring these changes allows for the determination of the failure location and severity, facilitating timely repairs and reinforcement before further deterioration occurs. A systematic approach to damage detection and assessment is pivotal for fortifying structures and preventing structural collapse, which can result in both financial and human losses. In this study, we employ image processing to categorize damaged beams based on their crack growth and propagation patterns. We also utilize support vector machine (SVM) and k-nearest neighbor (KNN) methods to detect the type, location, and extent of failures in reinforced concrete beams. To provide context and relevance for the laboratory specimens, we will compare our findings to the results from controlled experiments in a controlled laboratory setting.

Abstract Clinicians must pay attention to the clinical presentation and consequences of hydatid cysts in rare sites. Cysts close to the aorta require planning and assistance of a cardiac or vascular surgeon before surgical intervention can be considered.

Abstract MicroRNAs (miRNAs) are fundamental post-transcriptional modulators of several critical cellular processes, a number of which are involved in host defense mechanisms. In particular, miRNA let-7 functions as an essential regulator of the function and differentiation of both innate and adaptive immune cells. Let-7 is involved in several human diseases, including cancer and viral infections. Several viral infections have found ways to dysregulate the expression of miRNAs. Extracellular vesicles (EV) are membrane-bound lipid structures released from many types of human cells that can transport proteins, lipids, mRNAs, and miRNAs, including let-7. After their release, EVs are taken up by the recipient cells and their contents released into the cytoplasm. Let-7-loaded EVs have been suggested to affect cellular pathways and biological targets in the recipient cells, and can modulate viral replication, the host antiviral response, and the action of cancer-related viruses. In the present review, we summarize the available knowledge concerning the expression of let-7 family members, functions, target genes, and mechanistic involvement in viral pathogenesis and host defense. This may provide insight into the development of new therapeutic strategies to manage viral infections.

Background: An overview of spiritual care studies can help reveal the dimensions of spiritual care and summarize the findings of available studies. Thus, we designed the present study based on existing studies to explain the dimensions of spiritual care. Materials and Methods: In this thematic analysis, we gathered the related articles published in Persian and English in the last 8 years (2013–2021) with the help of the keywords of Care, Support, Spirituality, Religion, Treatment, Hospice, and Palliative, and searching in electronic databases, including PubMed, Scopus, Web Of Sciences, Magiran, Islamic Science Citation (ISC), and Scientific Information Database (SID). We accurately studied 79 articles that met the inclusion criteria, and then the spiritual care components were extracted and coded, and finally, the codes were categorized as themes and sub-theme. Results: Thematic analysis of available studies revealed that the dimensions (theme) of spiritual care include: spiritual and religious assessment, developing a structure for providing spiritual care, establishing effective and supportive communication with the patient, training the patient, answering his questions, encouraging, maintaining, and improving social communications, encouraging the patient to live happily, helping the patient to achieve peace and calmness, supporting for spiritual rituals and activities, supporting and training the patient's family, and supporting the dying patient. Conclusions: Spiritual care includes various and numerous dimensions. Considering the widespread dimensions of spiritual care, it seems necessary to design and plan appropriate studies to reveal other spiritual care dimensions from the perspective of patients and care providers in different cultures.

Unsupervised learning methods are commonly used to detect features within transcriptomic data and ultimately derive meaningful representations of biology. Contributions of individual genes to any feature however becomes convolved with each learning step, requiring follow up analysis and validation to understand what biology might be represented by a cluster on a low dimensional plot. We sought learning methods that could preserve the gene information of detected features, using the spatial transcriptomic data and anatomical labels of the Allen Mouse Brain Atlas as a test dataset with verifiable ground truth. We established metrics for accurate representation of molecular anatomy to find sparse learning approaches were uniquely capable of generating anatomical representations and gene weights in a single learning step. Fit to labeled anatomy was highly correlated with intrinsic properties of the data, offering a means to optimize parameters without established ground truth. Once representations were derived, complementary gene lists could be further compressed to generate a low complexity dataset, or to probe for individual features with >95% accuracy. We demonstrate the utility of sparse learning as a means to derive biologically meaningful representations from transcriptomic data and reduce the complexity of large datasets while preserving intelligible gene information throughout the analysis.

Hydatid cysts have been widely recognized for decades as a common medical problem that affects millions of people. A revolution in medical treatment may be on the prospect of nanotechnology enhancing chemotherapy against hydatid cysts. An overview of nanotechnology’s impact on chemotherapeutics is presented in the current review. It discusses some of the challenges as well as some of the opportunities. The application of nanotechnology to enhance chemotherapy against hydatid cysts is what this review will explore. Nanotechnology is a critical component of delivering therapeutic agents with greater precision and efficiency and targeting hydatid cysts with better efficacy, and minimizing interference with surrounding tissue. However, there are biodistribution challenges, toxicity, and resistance problems associated with nanotherapeutics. Additionally, nanobiosensors are being investigated to enable the early diagnosis of hydatid cysts. A nanobiosensor can detect hydatid cysts by catching them early, non-invasively, rapidly, and accurately. The sensitivity and specificity of diagnostic tests can be enhanced with nanobiosensors because they take advantage of the unique properties of nanomaterials. By providing more precise and customized treatment options for hydatid cysts, nanotechnology may improve therapeutic options and strategies for diagnosing the disease. In conclusion, treatment with nanotechnology to treat hydatid cysts is potentially effective but presents many obstacles. Furthermore, nanobiosensors are being integrated into diagnostic techniques, as well as helping to diagnose patients earlier and more accurately.

Objectives: Aging is associated with an increased prevalence of chronic diseases and multidrug therapy, which increases the risk of drug side effects and changes in quality of life. With the increase of the world’s aging proportion, the quality and safety of prescribing drugs has become a global health concern. This study aims to determine the prevalence of Potentially Inappropriate Medications (PIMs) in the elderly in Qom, Iran according to STOPP (Screening Tool of Older Persons’ Prescriptions) criteria and its association with their Health-Related Quality of Life (HRQOL). Methods & Materials: In this cross-sectional and descriptive-analytical study, participants were 783 older patients hospitalized in internal and surgical wards of selected hospitals affiliated to Qom University of Medical Sciences who were selected using a convenience sampling method. The instruments were a demographic/ health information form, Charlson Comorbidity Index (CCI), STOPP version 2, and the 15 D HRQOL questionnaire. The data were analyzed in SPSS v. 20 software using descriptive statistics and logistic regression analysis. Results: The Mean±SD number of medications used by the elderly was 7.21±3.16, and 79.57% of patients had multidrug use. The CCI score of 29.9% was 4. The prevalence of PIM was 46.10% and the most common category of PIM were Drugs that adversely affect those prone to falls (13.79%), Duplicate Drug Class (12.39%), Central Nervous System and Psychotropics (5.36%). The Mean±SD score of HRQOL was 0.85± 0.12. Logistic regression analysis results showed that HRQOL (95%CI: 0.030-0.307, OR= 0.096), multidrug use (95%CI: 4.780-14.966, OR=8.46), and CCI (95%CI: 1.36-3.17, OR=2.079) had significant association with PIM use by the elderly (P

Background and Objectives: The incidence of rectal cancer is increasing in developing societies, especially in younger age groups. The aim of this study was to evaluate the factors affecting the survival of patients with rectal cancer in the presence of competing risks. Methods: In this retrospective cohort study, the data of 121 patients with rectal cancer during 2001-2017 were studied. Death related to cancer progression was considered as the interest outcome and other causes of death were considered as competing risks. Cause-specific and sub-distribution hazard models were used to investigate the factors affecting patient survival in the presence of competing risk. Results: The mean (SD) age of the patients was 53.4 (13.9) years and 68 patients (56.2%) were male. The results of log-rank test showed that sex, age, metastasis, type of first treatment, rate of penetration into intestinal wall, tumor location, number of lymphomas involved and tumor size had significant effects on the patient survival (P

The effects of joint geometry parameters, such as adherend thickness (1.76, 3.52 mm), joint width (10, 20, 30 mm), and overlap length (10, 20 mm), on the behavior of single-lap joints (SLJs) under tensile loading are investigated in this study. Peak force, joint stiffness, shear stress, and normal stress are the investigated properties. SLJs are manufactured with carbon fiber composite adherends and two different types of adhesives, polyurethane and epoxy, which present a flexible and rigid mechanical response. The results showed that increasing all 3 geometric parameters (L, W, T) leads to a significant increase in the load capacity of polyurethane joints (on average, 88.4, 101.5, and 16.9%, respectively). For epoxy joints, these increases were 47.7, 100, and 46%, respectively. According to these results, W is the parameter with the most influence on the load capacity of the joints. However, it was observed that an increase in joint width has no significant effect on adhesive shear and a substrate’s normal stresses. Epoxy SLJs behave approximately elastically until failure, while polyurethane SLJ load-displacement curves include an initial linear elastic part followed by a more ductile behavior before the failure. Joint stiffness is affected by all the parameters for both adhesive types, except for overlap length, which led to a negligible effect on epoxy joints. Moreover, the damage surfaces for both types of joints are analyzed and the internal stresses (shear and peel) are assessed by using the analytical model of Bigwood and Crocombe.

Cardiovascular complications of Brucellosis are not common and affecting less than 2% of cases. In clinical practice, endocarditis is the most frequent cardiovascular complication and is responsible for most of the brucellosis‐related mortality cases and usually diagnosed lately in the course of the disease with mostly aorta valve involvement. In this case report, we present the case of a 27‐year‐old woman who was admitted to the hospital with fever, sudden onset right side hemiparesis, and horizontal gaze palsy. During the stroke work up, she underwent cardiac evaluation, including echocardiography with susceptibility to septic emboli with cardiac origin, and the result indicates presence of vegetations on prosthetic aortic valve suggestive of infective endocarditis. Hopefully our patient responded well to combination of heart surgery and antibrucellosis regimen and was finally discharged with stable general condition. It is important to raise awareness of this rare but potentially serious complication of brucellosis, especially in the endemic area, and to emphasize the value of early diagnosis and treatment. [ABSTRACT FROM AUTHOR]

BACKGROUND: Metabolic disorders, and their consequences, are among the most important hygienic problems of mod-ern life. OBJECTIVES: Due to the increased global interest in natural remedies and their importance in the treatment of diseases, Ferulago angulata, as one of the oldest known medicinal plants of folk medicine, was evaluated its hypolipidemic and hypoglycemic effects. METHODS: A total of 147 adult male rats were randomly divided into seven groups, each with three replicates (n=7): control group, untreated hyperlipidemia group, three treated hyperlipidemia groups, treated with 125, 250, and 500 mg/kg of the F. angulata hydroalcoholic extract (FAHE), two hyperlipidemia groups treated with atorvastatin (10 mg/kg), and metfor-min (500 mg/kg). After 21 days, serum glucose and total cholesterol (TC), triglyceride (TG), low-density lipoprotein cholesterol (LDL-C), high-density lipoprotein cholesterol (HDL-C), very low-density lipoprotein (VLDL), and the ratios of LDL/HDL and TC/LDL, were measured. RESULTS: In all hyperlipidemia groups treated with different doses of FAHE, glucose, TG, TC, LDL-C, and LDL/HDL ratios were significantly reduced, while significant increases in HDL-C and cholesterol/LDL ratios were observed com-pared to the untreated hyperlipidemia group; however, a significant reduction of VLDL was only observed at the dose of 500 mg/kg FAHE. Hypolipidemic and hypoglycemic effects of FAHE at 250 and 500 mg/kg doses were comparable to atorvastatin and metformin. CONCLUSIONS: These results indicated the hypolipidemic and hypoglycemic effects of FAHE, which may be due to the high phenolic, flavonoids, and trace element contents, providing powerful antioxidant potential and affecting the en-zymatic pathways of lipid and glucose synthesis and metabolism

Background and Purpose: The importance of evaluating the performance indices of the emergency department as one of the most important hospital wards is obvious to everyone. Therefore, in the present study, we determined emergency performance indices in emergency centers of educational hospitals of Zanjan University of Medical Sciences. Methods: This is a cross-sectional descriptive study. In this study, data related to performance indices of emergency center in educational hospitals of Gilan University of Medical Sciences were collected during one full week in Ayatollah Moosavi and Valiasr hospitals by simple random sampling of the Poisson model in a continuous and gradual manner and we recorded the data. In this study, in total, 1341 samples were evaluated in relation to the variable of indices. Finally, the data were analyzed using proper descriptive and inferential statistics and SPSS Ver. 22. The instrument was a questionnaire which included the underlying profile (age, gender, marital status, insurance status, place of residence and degree of education) of the referrals to the emergency department and data of performance indices. Given that the questionnaire used is a checklist related to the standard performance indices recommended by the Ministry of Health of the country, it is reliable and valid. Results: Emergency performance indices in Zanjanchr(chr(chr(chr('39')39chr('39'))39chr(chr('39')39chr('39')))39chr(chr(chr('39')39chr('39'))39chr(chr('39')39chr('39'))))s educational centers was at a favorable level in comparison with other studies; except in cases when there is a triage time interval up to the first physicianchr(chr(chr(chr('39')39chr('39'))39chr(chr('39')39chr('39')))39chr(chr(chr('39')39chr('39'))39chr(chr('39')39chr('39'))))s visit that is suggested that by doing provisions on the physical environment and ease in the process of patient admission, reduce this time interval and to reduce the long-term stay of patients in emergency departments we can mention strategies such as preventing multiple services, making the number of counseling purposeful and restricting them to essential counseling and ultimately, following up on the treatment as soon as possible by the relevant services. Conclusion: Emergency performance indices in Zanjan educational and treatment centers is at a favorable level in comparison with other studies; except in cases when there is a triage time interval up to the first physicianchr(chr(chr(chr('39')39chr('39'))39chr(chr('39')39chr('39')))39chr(chr(chr('39')39chr('39'))39chr(chr('39')39chr('39'))))s visit that is suggested that by doing provisions on the physical environment and ease in the process of patient admission, reduce this time interval and to reduce the long-term stay of patients in emergency departments we can mention strategies such as preventing multiple services, making the number of counseling purposeful and restricting them to essential counseling and ultimately, following up on the treatment as soon as possible by the relevant services.

Although the macroscopic volume-delay function (VDF) has been widely used in static traffic assignment for transportation planning, the planning community has long recognized its deficiencies as a static function in capturing traffic flow dynamics and queue evolution process. In the existing literature, many queueing-based and simulation-based dynamic traffic assignment (DTA) models involving various traffic flow parameters have been proposed to capture traffic system dynamics on different spatial scales; however, how to calibrate these DTA models could still be a challenging task in its own right, especially for real-world congested networks with complex traffic dynamics. By extending the fluid-based polynomial arrival queue (PAQ) model with quadratic inflow rates proposed by Newell (1982) and cubic inflow rates by Cheng et al. (2022), this paper attempts to propose a cross-resolution Queueing-based Volume-Delay Function (QVDF) to explicitly establish a coherent connection between (a) the macroscopic average travel delay performance function in a long-term planning horizon and (b) the mesoscopic dynamic queuing model during a single oversaturated period. By introducing two types of elasticity functional forms, this paper develops a relationship from the macroscopic inflow demand-to-capacity (D/C) ratio to the congestion duration of a bottleneck, from the congestion duration to the magnitude of speed reduction. The QVDF can be directly utilized to provide closed-form expressions for both average travel delay performance and the time-dependent speed profiles. The proposed cross-resolution QVDF provides a numerically reliable and theoretically rigorous performance function to characterize oversaturated bottlenecks at both macroscopic and mesoscopic scales.

Abstract Curing of colorectal cancer (CRC) occurs at the time of resection but it is not immediately observable. If the cancer is not completely eliminated, the patient will not be cured of cancer and will experience recurrence as the tumor has regrown to a detectable size. The main propose of the present study was to assess the effects of different covariates on the probability of being cured as well as the time-to-recurrence, and time-to-death in CRC patients by using multi-state cure model. The information of 283 patients with CRC, who underwent resection, from 2000 to 2015 in Imam Khomeini Hospital of Hamadan, Iran, were analyzed. The results of multi-state cure model reveal that females and who experience metastasis were more likely to be apparently cured. It has been shown that sex has a significant effect on the time-to-recurrence given patient was in the not cured group. The survival time of patients of the not cured group was affected by the stage of disease. However, the survival of the apparently cured patients were affected by age at diagnosis and metastasis status. The multi-state cure model provided a flexible framework to study the effects of prognostic factors simultaneously on the transition between different states and the probability of being apparently cured of CRC.

Given the nature of heart disease and the importance of continuing heart surgery during the pandemic and its aftermath and in order to provide adequate safety for the surgical team and achieve the desired result for patients, as well as the optimal use of ICU beds, the medical team, blood, blood products, and personal protective equipment, it is essential to change the usual approach during the pandemic. There are still a lot of evidences and experiences needed to produce the perfect protocol. Some centers may have a special program for their centers during this period of epidemics that can be respected and performed. Generally, in pandemic conditions, the use of non-surgical approaches is preferred if similar outcomes can be obtained.

Background and Objectives: Irrational use of antibiotics can lead to increased drug resistance. The Anatomical Therapeutic Chemical/ Defined Daily Dose (ATC/DDD) system is a tool to monitor medication use, evaluate the improvements in drug consumption quality, and make comparisons between international and other levels in this regard. This study aimed to determine the status of antibiotic prescription in hospitals in Qom, Iran. Methods: This cross-sectional study was performed on 1200 medical records of the patients using a multi-stage sampling method in 2019. The data were collected through a researcher-made questionnaire to seek demographic information and antibiotics used by patients, as well as ATC/DDD based on the DDD/100 bed-days index. Furthermore, the data were analyzed in SPSS software (version 20) through descriptive statistics and analysis of variance. Results: The results showed no significant relationship between the number of prescribed antibiotics and the hospitalization season (P>0.05). The majority of the antibiotics were injectable (93.5%) prescribed by surgical specialists (50.70%). Gynecology and Childrenchr('39')s hospitals obtained the highest (18.4%) and the least (12.4%) level of antibiotic prescription, respectively. The daily recommended doses for every 100 days of bed rest for the most common antibiotics were Amikacin (21.81), Ceftriaxone (33. 62), Ampicillin (19. 34), Meropenem (6.10), and Vancomycin (11.28). Conclusion: The results show that Amikacin, Ceftriaxone, Ampicillin, Meropenem, and Vancomycin were the most common antibiotics used in the present study accounting for more than 70% of the total antibiotics administered. The DDD/100 bed-days of the most commonly used antibiotics were higher than those reported by the World Health Organization.

Background and Objectives: Breast cancer is associated with unique changes and experiences in all physical, psychological, social, and spiritual aspects of one’s life. In this regard, the present study aimed to investigate the spiritual experiences of breast cancer patients. Methods: This qualitative study was conducted using a hermeneutic phenomenological approach. In total, 20 eligible breast cancer patients were selected, through maximum variation and purposive sampling method, from the oncology ward of Shahid Beheshti Hospital in Qom, Iran in 2019. The required data were collected using semi-structured in-depth interviews which lasted between 50-75 min. The collected data were analyzed using the six-step Van Manen method. Results: After the data analysis, the main theme of the spiritual experience of the patients was "return to the Holy". This theme included "spiritual beliefs and attitudes", "spiritual growth and excellence", "spiritual support", and "restoration of the power of life". Conclusion: According to the lived experiences of the participants of this study, breast cancer highlights the spiritual aspect of one’s life and the tendency towards spirituality. Therefore, the healthcare team can use the findings of this study to develop educational plans and provide spirituality-based services to breast cancer patients.

Background and Objectives: Brucellosis is the most common disease in humans and animals, where its distribution is roughly global, so the control of this disease has an important impact on human health and livestock industry. The most important causes of this disease are environmental parameters (location). In this regard, identifying and discovering the relationship between environmental parameters and the outbreak and incidence of the disease can be effective in controlling and providing preventive measures and thus reducing the cost of treatment for humans and animals. Material and Methods: In this research, using spatial data and multidimensional association rules, the association between the occurrence of Brucellosis with environmental and human parameters such as temperature, humidity, altitude, land use, occupation and history of contact with the livestock and use of non-pasteurized dairy has been investigated with emphasis on location. The statistical population of this study is people with brucellosis in Hamedan province in 1394. Results: The results of this study indicate that factors of location and non location included temperature, altitude, humidity, history used of non-pasteurized dairy, history of contact with infected animals sick people, job and land use, can be effective in the spread of the disease. Conclusion: The results of the study show that the factors of temperature and elevation have had more effects in the discovered laws, so that areas with higher temperatures and lower altitudes than other areas include more patients. Also, people with agricultural and livestock jobs occupy the highest rates of patients in the laws that were discovered.