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This study investigates the effect of interactive games on improving reading comprehension skills and attitudes toward games among Iranian learners of English as a foreign language. In this quantitative study, the participants in the control group received reading comprehension instruction through traditional models of teaching reading while the participants in the experimental group developed their reading skills through participating in interactive games. A reading comprehension test was administered as a posttest. The mean performance of the two groups was compared by performing an independent-samples t-test and a paired-samples t-test. The analysis revealed that participants in the experimental group (N = 30, M = 26.33, SD = 2.80) significantly outperformed those in the control group (N = 30, M = 16.80, SD = 3.71) in the posttest. Moreover, an examination of the participants' perceptions showed they have a positive attitude toward games. The findings of this study suggest that interactive games are powerful tools for improving student engagement, motivation, and learning outcomes in the classroom. The study also provides some practical suggestions for further research.

This paper pilots a method of testing the learning effects of a role-playing simulation of negotiations over the Nile basin. Players negotiate how to apply general principles from international law, such as sharing water equitably and avoiding significant harm, to specific circumstances of the river basin. Students are presented with a set of factual statements about the basin and surveyed before and after play as to which facts will be (were) most important in negotiations. Surveys of 75 participating graduate students show interesting patterns: (1) a shift from emphasis on managing risks to exploiting cooperative opportunities; (2) change in the value orientation of the statements students consider most important, with development-oriented values increasing and environment-oriented values decreasing; and (3) change in the dimensions of power students consider most salient, including an increased appreciation for the institutional and knowledge-related elements of power and a de-emphasis on the structural aspects of power. Before-and-after surveying offers an alternative to the more common methods of learning assessment, based on knowledge acquisition or student satisfaction, while discussion of the survey results with students allows for a richer, more reflective learning experience.

Abstract Background Falls are a common cause of fractures in older adults. This study aimed to investigate the factors associated with spontaneous falls among people aged ≥ 60 years in southern Iran. Methods The baseline data of 2,426 samples from the second stage of the first phase of a prospective cohort, the Bushehr Elderly Health (BEH) program, were included in the analysis. A history of spontaneous falls in the year before recruitment was measured by self-report using a standardized questionnaire. Demographic characteristics, as well as a history of osteoarthritis, rheumatoid arthritis, low back pain, Alzheimer’s disease, epilepsy, depression, and cancer, were measured using standardized questionnaires. A tandem gait (heel-to-toe) exam, as well as laboratory tests, were performed under standard conditions. A multiple logistic regression model was used in the analysis and fitted backwardly using the Hosmer and Lemeshow approach. Results The mean (standard deviation) age of the participants was 69.34 (6.4) years, and 51.9% of the participants were women. A total of 260 (10.7%, 95% CI (9.5–12.0)%) participants reported a spontaneous fall in the year before recruitment. Adjusted for potential confounders, epilepsy (OR = 4.31), cancer (OR = 2.73), depression (OR = 1.81), low back pain (OR = 1.79), and osteoarthritis (OR = 1.49) increased the risk of falls in older adults, while the ability to stand ≥ 10 s in the tandem gait exam (OR = 0.49), being male (OR = 0.60), engaging in physical activity (OR = 0.69), and having high serum triglyceride levels (OR = 0.72) reduced the risk of falls. Conclusion The presence of underlying diseases, combined with other risk factors, is significantly associated with an increased risk of falls among older adults. Given the relatively high prevalence of falls in this population, it is crucial to pay special attention to identifying and addressing these risk factors.

Abstract Background The rise of the internet and social media has led to increased interest among diabetes patients in using technology for information gathering and disease management. However, adequate eHealth literacy is crucial for protecting patients from unreliable diabetes-related information online. Objective To examine the psychometric characteristics and explore the preliminary validity of the Persian version of the Condition-specific eHealth Literacy Scale for Diabetes (Persian CeHLS-D) to assess eHealth literacy in the context of diabetes care. Methods After adapting, translating, examining content validity, and pilot testing the questionnaire, it was administered to 300 patients with type 2 diabetes mellitus (T2DM). Construct validity was assessed through confirmatory factor analysis, convergent and known-groups validity. The internal consistency (Cronbach’s alpha), composite reliability and maximum reliability, and test-retest correlation were assessed. Results Factor analysis supported the hypothesized two-factor model with 10 items, and the standardized factor loadings ranged from 0.44 to 0.86 (P-values

Species of the phylum Blastocladiomycota, early-diverging zoosporic (flagellated) lineages of fungi, are vastly understudied. This phylum includes the genus Coelomomyces, which consists of more than 80 fungal species that are obligate parasites of arthropods. Known Coelomomyces species lack a complete asexual life cycle, instead surviving through an obligate heterecious alternation of generations life cycle. Despite their global distribution and interesting life cycle, little is known about the genomics of any Coelomomyces species. To address this, we generated three draft-level genomes and annotations for C. lativittatus representing its haploid meiospore, orange gamete, and amber gamete life stages. These draft genome assemblies ranged in size from 5002 to 5799 contigs, with a total length of 19.8-22.8 Mb and a mean of 7416 protein-coding genes. We then demonstrated the utility of these genomes by combining the draft annotations as a reference for analysis of C. lativittatus transcriptomes. We analyzed transcriptomes from across host-associated life stages, including infected larvae and excised mature sporangia from the mosquito Anopheles quadrimaculatus. We identified differentially expressed genes and enriched GO terms both across and within life stages and used these to make hypotheses about C. lativittatus biology. Generally, we found the C. lativittatus transcriptome to be a complex and dynamic expression landscape; GO terms related to metabolism and transport processes were enriched during infection and terms related to dispersal were enriched during sporulation. We further identified five high mobility group (HMG)-box genes in C. lativittatus, three belonging to clades with mating type (MAT) loci from other fungi, as well as four ortholog expansions in C. lativittatus compared with other fungi. The C. lativittatus genomes and transcriptomes reported here are a valuable resource and may be leveraged toward furthering understanding of the biology of these and other early-diverging fungal lineages.

This study investigates persuasive strategies used in the writings of Iranian university students in the field of teaching English as foreign language (TEFL). The study utilized the 7 principles of persuasive strategies presented by Cialdini (The psychology of persuasion, Quill William Morrow, New York 1984; Pre-suasion: A revolutionary way to influence and persuade, Simon & Schuster, New York 2016), which include 'reciprocity', 'commitment and consistency', 'social proof', 'liking', 'authority', 'scarcity', and 'unity'. The results indicate that strategies such as 'liking', 'unity', and 'authority' were used more frequently than other persuasive strategies. On the other hand, 'scarcity' was the least used strategy by the participants. Significant gender differences were also observed in the data. These findings have important pedagogical implications and suggest the need to incorporate persuasive strategies into instructional materials and teaching practices to enhance the persuasive writing skills of university students. Furthermore, gender differences highlight the importance of considering individual differences when teaching persuasive writing. Finally, the study discusses the pedagogical implications of these findings in the context of learning and teaching.

The present study explores communication strategies used by Iranian advanced EFL learners to overcome communication problems. This study aims to explore EFL learners' awareness of communication strategies. To this end, 17 advanced EFL learners who were willing to participate in the study were selected through snowball sampling. Their awareness of communication strategies was then explored through open-ended interviews and analyzed in line with the coding schemes of grounded theory (Strauss & Corbin, 1991). Iterative data collection and analysis yielded four main categories including explicit, reciprocal, implicit, and reduction strategies. Each of these strategies covers some subcategories. To visualize the findings and explore the degree to which the abstracted strategies reflect the participants' perspective, the transcribed data, along with the emerged strategies were fed to MAXQDA. This study can contribute to effective oral communication by elaborating on the notion of communication strategies and reaching communicative goals. The findings have implications for language learners, language teachers, and materials developers.

Background The aim of this study was to investigate the association of osteosarcopenia with frailty and poor health conditions among older Iranian adults. Methods This cross-sectional study analyzed data from the Bushehr Elderly Health Program. Osteosarcopenia was defined as the presence of osteopenia/osteoporosis and sarcopenia, while the Fried criteria were used to assess frailty. We assessed the history of falls and health-related quality of life (HRQoL), including physical and mental component summaries (PCS and MCS, respectively), history of fractures, activities of daily living (ADL), and instrumental activities of daily living (IADL), as indicators of poor health conditions. Results This study included a total of 2,371 older adults. The prevalence rates of osteosarcopenia-only, frailty-only, and osteosarcopenia with frailty were 17.4%, 3%, and 4.8%, respectively. The prevalence of a history of falls, poor ADL, and poor IADL was significantly higher in the frailty-only and osteosarcopenia with frailty groups. Osteosarcopenia with frailty was significantly associated with a history of falls (adjusted odds ratio [adjOR]=1.94; 95% confidence interval [CI], 1.20–3.15), poor ADL (adjOR=2.85; 95% CI, 1.81–4.50), and poor IADL (adjOR=5.09; 95% CI, 2.85–9.11). However, the frailty-only group also showed an association with falls and poor ADL and IADL. Only osteosarcopenia was associated with an increased OR for fracture. Frailty had the greatest effect on the MCS and PCS scores, whereas osteosarcopenia with frailty had a moderate impact. Conclusion Osteosarcopenia with frailty significantly increased the odds of falls, poor ADL, poor IADL, and lower HRQoL compared with the robust group. Combined osteosarcopenia and frailty were not associated with poor health. These findings indicate the importance of diagnosing osteosarcopenia and frailty as separate entities to provide appropriate interventions and treatment.

Abstract Background Substance use disorder (SUD) presents a range of public health challenges and consequences. Despite the prevention potential of screening and brief intervention (SBI) in the primary care setting, implementation is low. The purpose of this study was to assess associations of primary care clinicians’ knowledge of SBI and SUD treatment, subjective norms, and perceived behavioral control with intention to incorporate SBI and SUD treatment into regular clinical practice. Methods This online survey was administered to primary care clinicians who practice in Texas between March 1, 2021, and February 5, 2023. Survey questions were mapped to factors in the Theory of Planned Behavior and included measures of knowledge, subjective norms, and perceived behavioral controls related to SBI and SUD treatment. Intention to engage in SBI and SUD treatment was assessed as the outcome. Results Of 645 participants included in this study, 59.5% were physicians. Knowledge was low, with less than half correctly reporting what was considered a standard drink (39.6%) and only 20% knew the correct number of alcoholic beverages considered risky drinking in 21-year-old non-pregnant women. Subjective norms, such as having colleagues within their practice support addressing SUDs, and perceived behavioral control such as having SUD screening routinized within clinic workflows, were positively associated with intention to implement SBI and SUD treatment in primary care settings. Conclusions Modifying knowledge gaps, subjective norms, and perceived behavioral control requires a multipronged interventional approach that blends accessible clinician training with systemic workplace enhancements and a collective shift in professional norms.

Abstract Objectives This study aimed to estimate the incidence rate of re-fracture and all-cause mortality rate in patients with hip fractures caused by minor trauma in the first year following the event. Materials and methods This is a retrospective cohort study of patients over 50 years of age conducted in a referral hospital located in Tehran (Shafa-Yahyaian). Using the hospital information system (HIS), all patients hospitalized due to hip fractures caused by minor trauma during 2013–2019 were included in the study. We investigated the occurrence of death and re-fracture in all patients one year after the primary hip fracture. Results A total of 945 patients with hip fractures during a 307,595 person-days of follow-up, were included. The mean age of the participants was 71 years (SD = 11.19), and 533 (59%) of them were women. One hundred forty-nine deaths were identified during the first year after hip fracture, resulting in a one-year mortality rate of 17.69% (95% CI: 15.06–20.77). The one-year mortality rate was 20.06% in men and 15.88% in women. Out of all the participants, 667 answered the phone call, of which 29 cases had experienced a re-fracture in the first year (incidence rate = 5.03%, 95% CI: 3.50–7.24). The incidence rates in women and men were 6.07% and 3.65%, respectively. Conclusion Patients with low-trauma hip fractures have shown a high rate of mortality in the first year. Considering the increase in the incidence of hip fractures with age, comprehensive strategies are needed to prevent fractures caused by minor trauma in the elderly population.

Abstract Background The COVID-19 pandemic affected the control of many chronic conditions, including hip fractures, worldwide. This study was to examine the impact of the COVID-19 pandemic on the management of hip fractures in a referral orthopedic hospital in Iran. By understanding how the pandemic has influenced the care of hip fracture patients, we can gain valuable insights into the challenges, adaptations, and potential improvements in orthopedic healthcare during such public health crises. Methods Data was collected on hip fracture patients aged 50 and above who were admitted to the hospital before and during the pandemic. The number of admissions and operations, length of hospital stay, and time from admission to surgery were recorded from the hospital information system (HIS) and compared between the two periods. Results The median number of admitted hip fracture patients per month increased slightly during the pandemic (11%), although this increase was not statistically significant (p = 0.124). After adjusting for potential confounders, the mean length of hospital stay was significantly lower during the pandemic period, indicating that patients were discharged sooner (p = 0.019) and the time from admission to surgery was shorter during the pandemic (p = 0.004). Although the increase in the number of hip fracture surgeries per month during the pandemic was not statistically significant (P = 0.132), a higher percentage of patients underwent surgery during the pandemic compared to before (84.8% VS. 79.4%). Conclusion The study suggests that the COVID-19 pandemic did not have a negative impact on hip fracture management in the investigated orthopedic hospital in Iran. further research is needed to explore the effects of the pandemic on other aspects of healthcare services, particularly in general hospitals.

Some universities in Iran have recently witnessed a shift in admission criteria from university admission test performance towards high school records. This sudden change seems to be unwarranted since the predictive power of high school records has not been explored. To fill in this gap, this study aims at showcasing the predictive validity of high school records for undergraduate students of English language and literature. To this end, a random sample of undergraduate students studying at Shahrood University of Technology was selected as the participants, the predictor variables were operationally defined as the participants' grade point average (GPA) in three school subjects including English, Persian and Arabic languages along with their overall high school GPA, and the outcome variable was operationalized as the participants' overall GPA for the first academic year. The results of the Pearson correlation revealed a significant but very low correlation between the variables of interest. Moreover, the results of multiple regression analysis revealed that none of the predictor variables well predicts academic success in the English language and literature. Although the results of this study are case-specific, they have clear implications for policymakers and interested researchers nationwide.

Quorum sensing (QS) is a regulatory mechanism used by bacteria to coordinate group behavior in response to high cell densities. During QS, cells monitor the concentration of external signals, known as autoinducers, as a proxy for cell density. QS often involves positive feedback loops, leading to the upregulation of genes associated with QS signal production and detection. This results in distinct steady-state concentrations of QS-related molecules in QS-ON and QS-OFF states. Due to the slow decay rates of biomolecules such as proteins, even after removal of the initial stimuli, cells can retain elevated levels of QS-associated biomolecules for extended periods of time. This persistence of biomolecules after the removal of the initial stimuli has the potential to impact the response to future stimuli, indicating a memory of past exposure. This phenomenon, which is a consequence of the carry-over of biomolecules rather than genetic inheritance, is known as "phenotypic" memory. This theoretical study aims to investigate the presence of phenotypic memory in QS and the conditions that influence this memory. Numerical simulations based on ordinary differential equations and analytical modeling were used to study gene expression in response to sudden changes in cell density and extracellular signal concentrations. The model examined the effect of various cellular parameters on the strength of QS memory and the impact on gene regulatory dynamics. The findings revealed that QS memory has a transient effect on the expression of QS-responsive genes. These consequences of QS memory depend strongly on how cell density was perturbed, as well as various cellular parameters, including the Fold Change in the expression of QS-regulated genes, the autoinducer synthesis rate, the autoinducer threshold required for activation, and the cell growth rate.

Introduction: Complementary and alternative medicine (CAM) has gained popularity as a therapeutic approach outside conventional medicine for various medical conditions. This study aimed to assess the prevalence, patterns, and disclosure of CAM use among patients with thyroid diseases in Iran. Methods: This descriptive-analytic cross-sectional study involved patients with thyroid diseases who were visiting Internal Medicine Clinics in Shiraz. The use of CAM was assessed by employing the Persian edition of the I-CAM-Q (I-CAM-IR) questionnaire. Results: A total of 343 individuals took part in the study, and 85.4 % of them reported using CAM within the previous 12 months. Medicinal herbs were the most commonly used CAM modality (63 %). CAM use was primarily for enhancing overall well-being. Among self-care CAM practices, praying was the most frequently employed (70 %). Women exhibited a significantly higher CAM utilization rate (four times greater) compared to men (p