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Background: Assessing the learning environment provides an overview of the current educational status and aids in identifying areas of concern. This study aimed to understand the students’ perceptions of the educational environment at the Paramedical Faculty of Ilam University of Medical Sciences in 2021.Methods: This cross-sectional research was conducted at Ilam University of Medical Sciences, where 300 paramedical students were recruited by census. The Dundee Ready Education Environment Measure (DREEM) was used as the data collection tool. An independent t-test and one-way analysis of variance were used to investigate the relationships between demographic variables and each dimension of the questionnaire. Data analysis was performed using SPSS-26 software.Results: The sample studied included 166 female and 134 male students with an average age of 24.68±7.837 years. The mean and SD of the perception of the educational environment were 112.34 (24.63). There was a significant relationship between marital status, education level, age, and academic semester with students’ understanding of the educational environment (P≤0.05). Twenty percent of the items in the questionnaire indicated a “problematic” situation, while the rest were in a “need of attention” status.Conclusion: The results of this study showed that paramedical students have a positive perception of the educational environment. The lowest mean and SD of the dimensions of the questionnaire were observed in students’ understanding of learning and social self-perception. The other dimensions were in a more satisfactory condition.

Crisis management in tourism complexes can play a crucial role in increasing tourist attraction and mitigating damages resulting from natural hazards. The Jahad-e Dāneshgahi of Tourism Complex in Kermanshah is a tourist destination, and this study aims to present a crisis management model for this complex. What crisis management model needs to be developed for the Jahad-e Dāneshgahi Tourism Complex in Kermanshah? This study aimed to propose a crisis management model for the Jahad-e Daneshgāhi Tourism Complex in Kermanshah. A questionnaire was used to collect research data. 50 individuals were recruited as the subjects of the study of whom 33 individuals were selected as the sample, considering the specified community characteristics. The results revealed that the economic recession indicator, with a value of 70.2%, was the most important of the economic indicators in the opinion of the respondents. Analyzing pairwise comparisons of social indicators showed that social participation recorded the highest significance among social indicators (0.158), ranking first in social indicators’ importance. Since environmental hazards are one of the most critical factors contributing to crises in any environment, vulnerability to earthquakes was reported by respondents to be of the highest importance among the examined physical-environmental indicators in the Kermanshah Tourism Complex.

Introduction: In this study, TLD 600 and TLD 700 pairs were used to measure the neutron dose of Elekta Precise medical linac. To this end, the optimum moderate thickness for the conversion of fast to thermal neutrons were evaluated. Materials and methods: 241Am-Be and 252Cf sources were simulated to calculate the optimum thicknesses of the moderator for the conversion of maximum fast neutrons (FN) into thermal neutrons (TN). Pair TLDs were used to measure F&TN doses for three different field sizes at four depths of the medical linac. Results: The maximum thickness of the moderator was optimized at 6 cm. The measurement results demonstrated that the TN dose increased with the expansion of field size and depth. The FN dose, which was converted TN, exhibits behaviors comparable to the TN due to its nature. Conclusion: This study presents the optimum thickness for the moderator to convert FN into TN and measure F&TN using TLDs.

Background and Aim: Gestational trophoblastic disease consists of a wide range of tumors related to the uterus, including complete and incomplete hydatidiform mole, placental trophoblastic tumor, and choriocarcinoma, which have different tendencies to local invasion and metastasis. In this study, we report a case of twin pregnancy with one fetus and a concomitant mole in a 40-year-old woman. Case report: A 40-year-old woman at 17-week of pregnancy referred with complaints of shortness of breath, headache and high blood pressure. Fetal heart rate was 110. According to the ultrasound of the fetus, the size of the placenta was much larger than normal and had cystic areas. The patient was diagnosed as a case of twin pregnancy with one fetus and a concomitant mole. Emergency hysterotomy was performed. The patient was discharged from the hospital after one week in good general condition and recommended to check weekly βHCG titer test and control blood pressure. conclusion: Molar pregnancy is diagnosed by abdominal ultrasound and serum βHCG measurement. Considering pregnancy complications such as gestational hypertension and metabolic disorders such as hyperthyroidism and bleeding which can increase after such pregnancies, early diagnosis and treatment are essential to reducing maternal mortality. In addition, after termination of such pregnancies, examination of the patients for early detection of trophoblastic tumors is very important.

Introduction National comprehensive cancer control programs combat cancer through different measures, including primary prevention, early detection, treatment, and palliative and supportive care. Among the others, early detection programs seem to be a promising intervention and lead to lower cancer mortality. We define research priorities for the early detection of cancers in Iran. Methods We applied the multiple criteria decision-making (MCDM) tools using three key attributes, including "5-year prevalence", "mortality to incidence ration as severity of disease," and "economic burden," to ranked different cancers for research priorities. The priorities were ranked based on four scenarios based on the weighting of the attributes. We also used the differences in the 5-year survival between localized and advanced tumors as the effect of early detection and incorporated it as the decision rule into the priority-setting model. Results Gastric cancer and cancers of the brain and nervous system ranked first in all the proposed scenarios. The most and least 5-year survival differences between localized and advanced cancers were observed for the kidney (80.5%) and the brain (3.3%) cancers. The top 10 priorities for early cancer detection in Iran were gastric, prostate, breast, lung, colorectal, ovarian, kidney, bladder, and cervical cancers. Conclusion We used a quantitative method and demonstrated the priority areas for research in the early detection of cancer in Iran. Researchers and government may use these results to optimize their research strategies for cancer prevention in Iran.

Satire is one of the literary genres used in poetry and prose. The difference between satire and low humour is that the purpose of the latter is simply jest and amusement, but behind the laughter created by satire, there is bitterness and sadness, which are caused by the problems of society. Although satire makes the audience laugh at first, it seeks to subtly expose individual and social flaws, so that the people or the social classes concerned try to overcome their defects. Satire has been popular in Persian literature for a long time and this genre is also used by many people in the contemporary period. Among those who were able to use this method in their articles in the contemporary period was Parviz Natel Khanlari. Khanlari was a poet, writer, translator, researcher, university professor, founder of Sokhan magazine, founder and director of Iran's Culture Foundation, and Iran's Minister of Culture, all of which connected him to society in some way. One of the ways he chose to reform society was to use satire in his articles. In this article, we have shown that Khanlari's satire can be divided into two categories: political and social. Each of these categories has its general and specific audiences. In another classification, we have examined Khanlari's satire in two formats: in the form of "sentence" and in the form of "word". We have also demonstrated that another method by which Khanlari applies satire is using "humorous allegories".

Background & Objective: Today, several well-known factors involved in the educational environment could influence students’ level of learning because of academic burnout. Academic self-efficacy, a factor affecting academic burnout, is likely to affect students’ performance levels. This study aimed to determine the relationship between the perception of the educational environment and academic self-efficacy with the academic burnout of paramedical students studying at the Ilam University of Medical Sciences, Ilam, Iran. Materials & Methods: The present study was a cross-sectional type in which 300 paramedical students participated as the study sample. Data collection tools included the Dundee Ready Educational Environment Measure (DREEM), College Academic Self-Efficacy (CASES), and Maslach Burnout Inventory (MBI). Pearson’s correlation test was used to examine the relationship between variables, and linear regression applied to model the correlation between multiple variables. Data analysis was performed by SPSS (version 26). Results: Mean scores of academic burnout, perception of the educational environment, and academic self-efficacy were 41.79±13.4, 112.34± 24.63, and 102.65±18.73, respectively. Through linear regression, the identified predictors of academic burnout were: perception of educational environment (β=-0.769, 95%CI; -0.985, -0.553, P

In medicine, the application of nanotechnology is related to the use of nanoscale materials to improve and develop new diagnostic and therapeutic methods. Due to the unique physicochemical and optical characteristics of titanium dioxide nanoparticles (TiO2 NPs), such as high biocompatibility, surface properties, and relative stability, they have been widely investigated for medical purposes, particularly as a theranostic agent in cancer diagnosis and treatment. This review concentrates on current progress in the applications of TiO2 nanostructures in cancer diagnosis and treatment domains. Studies have shown that TiO2 NPs can be promising in various medical imaging techniques. In the field of cancer treatment, researchers have evaluated the ability of TiO2 NPs in up-to-date therapeutic approaches, including drug delivery, sonodynamic, photodynamic, photothermal, and ionizing radiation therapies. In the current review, we focus on the ability of TiO2 NPS as a radiation sensitizer to improve the efficiency of cancer diagnosis and treatment. Finally, according to the studies that have been conducted on controlling and optimizing the factors involved in the TiO2 NP radiosensitization, the mechanism of TiO2 NPs in producing the radiosensitivity effect has been discussed.

Background & Objective: Soon after the outbreak of COVID-19, Universities of medical sciences was forced to shift from face-to-face education toward online educational activities according to WHO recommendation to observe physical distancing. Therefore, the present study was conducted to determine the quality of virtual education classes from the perspective of students and professors at Ilam University of Medical Sciences. Materials & Methods: This cross-sectional study was conducted in five faculties of Ilam University of Medical Sciences in 2020. Thirty professors and 370 students participated in the study by convenience sampling. Data were collected using a researcher-made questionnaire based on the viewpoint of university professors and students about the quality of virtual classes. The questionnaire included 30 questions in four sections: the ability to use the educational system, feelings and attitudes towards the virtual class, learning and educational environment, interactive learning and perceived effectiveness, plus five questions addressing satisfaction with the training course. The data were analyzed using independent t-test at a significance level of P

Introduction The prevalence of traumatic brain injury (TBI) among older adults is increasing exponentially. The sequelae can be severe in older adults and interact with age-related conditions such as multimorbidity. Despite this, TBI research in older adults is sparse. Minder, an in-home monitoring system developed by the UK Dementia Research Institute Centre for Care Research and Technology, uses infrared sensors and a bed mat to passively collect sleep and activity data. Similar systems have been used to monitor the health of older adults living with dementia. We will assess the feasibility of using this system to study changes in the health status of older adults in the early period post-TBI.Methods and analysis The study will recruit 15 inpatients (>60 years) with a moderate-severe TBI, who will have their daily activity and sleep patterns monitored using passive and wearable sensors over 6 months. Participants will report on their health during weekly calls, which will be used to validate sensor data. Physical, functional and cognitive assessments will be conducted across the duration of the study. Activity levels and sleep patterns derived from sensor data will be calculated and visualised using activity maps. Within-participant analysis will be performed to determine if participants are deviating from their own routines. We will apply machine learning approaches to activity and sleep data to assess whether the changes in these data can predict clinical events. Qualitative analysis of interviews conducted with participants, carers and clinical staff will assess acceptability and utility of the system.Ethics and dissemination Ethical approval for this study has been granted by the London-Camberwell St Giles Research Ethics Committee (REC) (REC number: 17/LO/2066). Results will be submitted for publication in peer-reviewed journals, presented at conferences and inform the design of a larger trial assessing recovery after TBI.

Introduction: White tea is a new ingredient in a wide range of phenolic, antioxidant and antimicrobial compounds. The most important catechins in white tea are epicatechin, epigallocatechin, epicatechin- 3- galate, and epigallocatechin- 3- galate, which are flavonol gallates. The concentration of these phenolic compounds in white tea is higher than green tea. Sesame seed oil, which is produced by cold pressing method, has a great ability to preserve antioxidant compounds. Significant oxidative stability of sesame oil is due to the presence of lignan non-soapy substances. Strong antioxidant compounds in sesame seed oil include sesamol, sesamulin (antioxidant precursor), sesaminol and its isomers. The aim of this study was to investigate the effect of natural antioxidants of sesame oil and white tea on inhibiting the effect of metals on oxidation of sesame oil. Materials and Methods: In this study, aqueous extract of white tea was extracted and sesame oil was produced using cold press. In the next step, six samples including control sample (sesame oil), sesame oil containing white tea extract, sesame oil containing white tea extract and 0.1 ppm iron, Sesame oil containing white tea extract and 0.1 ppm copper, sesame oil with tea and 0.1 ppm zinc extract and sesame oil containing 100 ppm BHT were prepared. In all samples, aqueous extract of white tea in the amount of 6 mg/ 10 g was added to sesame oil. Total phenol, antioxidant capacity, power reducing on white tea extract and antioxidant power, peroxide number, oxidation stability and fatty acids profile were measured. All experiments were performed in a completely randomized design with three replications and the means were compared with Duncan’s test at the level of (P

Today women are actively involved in various areas of economic and social activities and play an important role in creating businesses. Recognizing talents, individual abilities and their creative characteristics can be very effective in exploiting and guiding the capacities of this large part of society. The purpose of this study is to identify and prioritize personality traits of women entrepreneurs. Therefore this study is a fundamental research with applied results in terms of purpose and it has been conducted with a mixed research framework. The target population includes all women entrepreneurs in Khuzestan province, which is the non-random sampling voluntary, 40 of them were selected for semi-structured interviews and identification of entrepreneurial personality traits. The results of the content analysis of the interviews showed 13 entrepreneurial personality traits. The results of Friedman test for ranking these characteristics showed that women entrepreneurs have the highest degree of importance in the characteristics kinship, responsibility, practicalism and having an internal control center; and the characteristic of risk-taking is the least important. ‌ Qualitative Content Analysis, Ranking, Women Entrepreneurs, Entrepreneurial Personality Traits. ‌ ‌Introduction In today's fast-paced world, entrepreneurship can serve as a powerful driver of economic growth and development in the country and increase productivity and create employment and welfare. The condition for survival in this evolving world is to use all available resources and identify and empower all entrepreneurial capacities to enable the emergence of creative initiatives and entrepreneurial activities. In the meantime, recognizing the capabilities of women and directing their creative talents, considering that today they have entered various fields of economic activities and play a role in creating large-scale businesses, can effectively exploit the capacities of this sizeable social stratum. Thus, the discovery of creative traits and talents in women entrepreneurs, as well as the identification of their experiences, can create synergy among businesswomen or pass it on to the next generation. Therefore this study aims to identify and prioritize the personality traits of women entrepreneurs in Khuzestan province as one of the provinces prone to entrepreneurship. Methodology This study aims to identify and prioritize the personality traits of women entrepreneurs. Therefore this study is fundamental research with applied results in terms of purpose and the method of doing; it is mixed research in which the qualitative content analysis technique was adopted to analyze textual data. The statistical population of this study is all women entrepreneurs in Khuzestan province. According to the official statistics of the relevant institutions in the province, there are more than 240 women entrepreneurs who, due to dispersion, difficulty and lack of access to all people, sampled in a non-random, targeted and voluntary manner. To ensure theoretical saturation, the data collection process was continued until interviews with 40 women entrepreneurs were analyzed. The qualitative content analysis method was used to analyze the data obtained from the interview‌s. Lincoln and Guba's (1985) evaluation methods were used to assessing the study's validity and reliability. Finally, the Friedman ranking test was used to prioritize the traits. Findings As the research findings show, the influential personality traits in women's entrepreneurship are: risk-taking, the centre of internal control, achievement, open-mindedness, pragmatism, challenge, ambiguity tolerance, responsibility, emotional stability, extraversion, kinship, honesty in experience, and benevolent intentions. The results of the Friedman test for ranking these characteristics revealed that women entrepreneurs have the highest degree of importance in kinship, responsibility, practicalism and having an internal control centre, and the characteristic of risk-taking is the least important. Result The results of this study revealed that women who intend to enter entrepreneurship must first be familiar enough with the characteristics, capacities and capabilities necessary for this and enter this field consciously. The results of this research help managers and owners of entrepreneurial businesses to learn or strengthen the right way of behaving with employees, communication skills and improving the entrepreneurial spirit. Considering that the creation and development of an entrepreneurial culture in society, especially for women, can provide the ground for the mobilization of half of the population in a way that ultimately increases national production in the country and removes the problem of unemployment; Therefore, it is suggested that university administrators and policymakers make serious efforts to create conditions to increase these characteristics at the university.

Standard language is a genre of writing in scientific and academic contexts whose main objective is the fast and accurate transfer of concepts to the audience. For more than half a century there have been discussions among scholars as to the definition and instances of the standard language. Although there is no consensus among scholars vis-à-vis the standard language, it can be said that this language register has established itself through contemporary, and scientific written texts published in books and academic journals. This paper aims to describe standard language and show its uses and examples in the works of one of the prolific and outstanding contemporary writers, namely, Mohammad-Ali Eslami Nodushan. The results reveal that Eslami Nodushan has followed the role model of distinguished Persian writers such as Sa'adi while simultaneously has distanced himself from literary devices and has opted for an error-free language. Also, he was more inclined to write short and simple sentences and he could prove his own abilities and show his personal style and flexibility. Writing for more than sixty years, Eslami Nodushan has left behind a prose based on the natural functions of language that ordinary people can communicate with and experts have taken a liking to.

Today, in addition to having a skilled and capable manpower, organizations need an eager manpower and interested in work. Job engagement in employees has long been regarded by many researchers in behavioral science and attempts to identify its antecedents have been studied. One of these factors is the perception of organizational politics. Although some studies have shown that perceived organizational politics has a negative effect on job engagement, but the potential capacity of the two variables; organizational silence and voice as a mediator can play an important role in this effect. In this regard, the present study was conducted to investigate the effect of Perceived Organizational Politics on job engagement with emphasis on mediating role of organizational silence and voice. This study was conducted on a random sample of 367 employees of Khuzestan Steel Company. The research method is applied in terms of purpose and descriptive-correlation in terms of data collection. Data were collected by standard questionnaires with validity and reliability and analyzed using structural equation modeling with Smart PLS software. The results of testing the research hypotheses showed that perception of organizational politics both directly (with path coefficient of -0.195 and t-statistic, 3.357) and indirectly -with respect to the mediating role of organizational silence and voice- (with path coefficients of 0.025, -0.037 and t-statistic, 0.635, 0.96) has a significant effect on job engagement, respectively. The results of the data analysis showed that increasing the perception of organizational politics leads to increasing organizational silence and reducing organizational voice of employees, and thus affects and weakened their job engagement, and vice versa. In this regard, some approaches and frameworks have been proposed as practical recommendations to explain and prescribe policy-making, and limitations and research suggestions have been presented.

Background: One of the most important issues in all organizations is to improve performance of human resources to achieve goals. Therefore, it is necessary plans and solutions to reduce Job Strain (JS) and then increase Organizational Citizenship Behaviors (OCB), and Quality of Work-Life (QWL). The purpose of this study is to investigate the effect of JS on QWL with mediating role of OCB and moderator of employment status. Materials and Methods: This cross-sectional study was conducted on 300 nurses who were non-randomly voluntary selected among nurses working in seven educational hospitals in Ahvaz, Iran. Data were collected using demographic and occupational characteristics questionnaire and JS questionnaire with 12 items, OCB with 16 items & QWL with 26 items in the 5-point Likert scale. Data analysis was performed in SPSS22 using descriptive and inferential statistics, and structural equation modeling with SmartPLS3. Results: The results indicated the mean (SD) score of 49.56 (6.68) for JS (more than normal) and 58.84 (5.94) and 49.88 (7.69) for QWL and OCB, respectively. Spearman correlation coefficients show that JS has a negative relationship with QWL (r = -0.69, p < 0.001) and OCB (r = -0.54, p = 0.008). Also, nurses' employment status (Formal and Contractual) moderates the relationship between JS, QWL, and OCB. Conclusions: According to the results, job stress in nurses of Ahvaz hospitals was high and QWL was moderate (or less). Therefore, increased job stress leads to reduced QWL and OCBs of nurses. Also the employment Status and job security that it provides can modify this impact.

Abstract Despite considerable advances obtained by applying machine learning approaches in protein–ligand affinity predictions, the incorporation of receptor flexibility has remained an important bottleneck. While ensemble docking has been used widely as a solution to this problem, the optimum choice of receptor conformations is still an open question considering the issues related to the computational cost and false positive pose predictions. Here, a combination of ensemble learning and ensemble docking is suggested to rank different conformations of the target protein in light of their importance for the final accuracy of the model. Available X-ray structures of cyclin-dependent kinase 2 (CDK2) in complex with different ligands are used as an initial receptor ensemble, and its redundancy is removed through a graph-based redundancy removal, which is shown to be more efficient and less subjective than clustering-based representative selection methods. A set of ligands with available experimental affinity are docked to this nonredundant receptor ensemble, and the energetic features of the best scored poses are used in an ensemble learning procedure based on the random forest method. The importance of receptors is obtained through feature selection measures, and it is shown that a few of the most important conformations are sufficient to reach 1 kcal/mol accuracy in affinity prediction with considerable improvement of the early enrichment power of the models compared to the different ensemble docking without learning strategies. A clear strategy has been provided in which machine learning selects the most important experimental conformers of the receptor among a large set of protein–ligand complexes while simultaneously maintaining the final accuracy of affinity predictions at the highest level possible for available data. Our results could be informative for future attempts to design receptor-specific docking-rescoring strategies.

Obesity/bariatric surgery is rising as the most effective treatment for obesity. In previous studies, the history of Helicobacter pylori as the main cause of chronic abdominal pain in patients undergoing bariatric surgery has not been discussed. In this study, we determine in a set of patients how much of the number of people with positive H. pylori before the operation in one year later suffered from chronic abdominal pain. A retrospective study was conducted on 320 patients undergoing bariatric surgery. Data were collected by interviewing and referring to the medical records of patients. Of 320 patients, 125 were H. pylori-positive, and from these numbers, 43 had chronic abdominal pain (34.4%). Although in previous studies of bariatric surgery, the history of H. pylori has not been identified as the main cause of chronic abdominal pain after surgery. However, according to the available evidence in this study, with a prevalence of more than one-third of chronic abdominal pain in one year after surgery in patients with a history of preoperative H. pylori, pylori can be a potential cause of postoperative chronic pain.

Background: The importance of cellular dosimetry in both diagnostic and radiation therapy is becoming increasingly recognized. Objective: This study aims to compare surviving fractions, which were predicted using Geant4 and contained three types of cancer cell lines exposed to 188Re with the experimentally surviving fraction determined by MTT assay.Material and Methods: In this comparative study, Geant4 was used to simulate the transport of electrons emitted by 188Re from the cell surface, cytoplasm, nucleus or medium around the cells. The nucleus dose per decay (S-value) was computed for models of single cell and random monolayer cell. Geant4-computed survival fraction (SF) of cancer cells exposed to 188Re was compared with the experimental SF values of MTT assay. Results: For single cell model, Geant4 S-values of nucleus-to-nucleus were consistent with values reported by Goddu et al. (ratio of S-values by analytical techniques vs. Geant4 = 0.811–0.975). Geant4 S-values of cytoplasm and cell surface to nucleus were relatively comparable to the reported values (ratio =0.914–1.21). For monolayer model, the values of SCy→N and SCS→N, were greater compared to those for model of single cell (2%–25% and 4%–38% were larger than single cell, respectively). The Geant4 predicted SF for monolayer MCF7, HeLa and A549 cells was in agreement with the experimental data in 10μCi activity (relative error of 2.29%, 2.69% and 2.99%, respectively). Conclusion: Geant4 simulation with monolayer cell model showed the highest accuracy in predicting the SF of cancer cells exposed to homogeneous distribution of 188Re in the medium.

Abstract Background and Objective: Salinity is one of the most important environmental stresses that reduce the growth and yield of crops. The use of bio and organic fertilizers increases growth and yield of plants to various environmental stresses such as salinity. The purpose of this study was to investigate the role of vermicompost, humic acid and inoculation of seeds with Flavobacterium in improvment grain filling components and yield triticale. Materials & Methods: An experiment was conducted as factorial based on randomized complete block design with three replications in greenhouse research of the Faculty of Agriculture and Natural Resources, the University of Mohaghegh Ardabili during 2020. Factors experiment were included salinity levels (non-application of salinity as control, application of 50 and 100 mM salinity by NaCl), and bio-fertilizers application (no application of bio-fertilizers as control, application of vermicompost, seed inoculation with Flavobacterim,both application vermicompost and Flavobacterim) and foliar application humic acid (foliar application with water as control and foliar application of 2 g.L-1 humic acid). Results: The results showed that both application of vermicompost, Flavobacterim and foliar application of 2 g.L-1 humic acid under no salinity condition, increased chlorophyll a (83.38%), total chlorophyll (76.61%) and carotenoid (89.26%), maximum of grain weight (53.56%), grain filling period and effective grain filling period (19.39 and 55.11% respectively) in comparison with no application of bio-fertilizers and humic acid under the highest soil salinity level. Also, both application of vermicompost with Flavobacterim and foliar application of 2 g.L-1 humic acid under no salinity condition increased plant height, ear length, the number of grain per spike, 100 grains weight and grain yield of per plant of triticale. Conclusion: Application of bio-fertilizers and humic acid can increase grain yield of triticale under soil salinity conditions due to improve of chlorophyll content and grain filling components.

Purpose: E-tourism is the most cost-effective way to communicate with the target market and to publish information. It is also an easy way for customers to buy travel products. Recent advances in mobile communication technologies are leading the way for the next generation of travel commercial applications. Location-based services are among these facilities available on the mobile platform. These services use mobile tracking techniques to provide users with relevant information at the right time, based on their current location. This study investigates the LBSs value in tourism and their effect on destination brand equity components and tourist behavior. Method: The sample of the study totaled 210 visitors from Isfahan as one of the popular tourist cities in the world. The research hypotheses were analyzed using Smart-PLS3 software. Findings: The research findings revealed that LBSs have positive and significant effects on destination brand image, destination brand loyalty and WOM. Conclusion: As this paper is among the first studies investigating the positive effect of LBS on destination brand equity components and tourist behavior, the findings are beneficial for DMOs and their marketing managers. Due to their potential to create a unique travel experience as well as to personalize and tailor tourism services based on tourists' needs and personal preferences, LBS provide them with significant added value.

Background: Mental health is a significant problem in developed and developing countries which influences all aspects of life. We aimed to evaluate the status of Iranian students’ mental health. Methods: This cross-sectional study was performed on 2052 elementary school students located in Tehran, Iran, in September 2018. We used the Census sampling method for sampling and the general health questionnaire comprising 28 items. For statistical analysis SPSS software, version 21 was used. Results: A total of 2052 elementary school students (1373 girls and 679 boys) participated in this study. The mean ± standard deviation (SD) ages of the girls and boys were 14.1±1.7 and 13.9±1.1 years, respectively. The mean ± SD of anxiety, social dysfunction, and depression scores were 7.42±4.92, 7.35±3.33, 6.83±2.26 in the girls and 5.65±3.89, 6.30±3.09, 4.61±1.74 in the boys, respectively. The mean ± SD total scores in boys and girls were 20.48±12.31 and 27.90±14.66, respectively. Conclusion: The mental health status of elementary school students was generally low, especially in male students.

Background and Objectives: Organizations and administrative offices associated with crisis management play an important role in controlling crises in a country. This study aimed to present a crisis management model in Khuzestan Province, Iran, with an emphasis on environmental crises based on a three-pronged approach in 2018. Methods: Crisis management components were prioritized according to the analytic hierarchy process pairwise comparison method. These components were designed in the form of a questionnaire scored on a Likert scale. After determining the main components of crisis management in the three-pronged approach, the main priorities were identified based on the current status, and the management model in Khuzestan Province was presented with regard to the environmental crises. Results: In structural, behavioral, and contextual components, financing of crisis management in Khuzestan Province with a weighted eigenvalue of 0.146721, the commitment of managers and staff with a weighted eigenvalue of 0.143181, and urban infrastructure with a weighted eigenvalue of 0.18365 were determined as the most important components. According to expertschr('39') opinions, the most desirable item was the existence of planning and main strategies for crisis management with a mean score of 4.05 and the least desirable item was related to the urban infrastructure with a mean score of 1.6. Factor analysis revealed 9 explanatory factors, which respectively constituted 35.2%, 14.2%, 8.9%, 7.2%, 6.1%, 5.2%, 4.1%, 3.5%, 3.5%, and a total of 88.25% of the total variance. Conclusion: Finally, based on the analysis of the conceptual model of the research as well as the identified and prioritized components, the proposed model was presented.

Background: Poisoning is a major public health problem that constitutes a significant share of the global burden of disease. Previous studies conducted in this area indicated the importance of such epidemiological studies. The most critical impact of these studies is their effect on changing current regulations and, therefore, decreasing poisoning cases. We aimed to evaluate all poisoning cases with regard to the patients’ demographics and the involved intoxicants. Methods: The present study was conducted to investigate all poisoning cases who were admitted during a three-year period. Causes of poisoning, hospitalization, management procedures and outcome of the cases were surveyed. A total of 1448 patients referred to Shahid Beheshti Hospital (Babol, Iran) from 2015 to 2018. Results: More than half of the patients were females (51.7%), and the majority of poisoning cases were seen in patients aged between 15 to 25 years (34.2%). It was found that suicide made a large part of poisoning cases (65.6%), and females tend to attempt suicide more than males (64.3% vs. 35.7%, respectively). Also, regular drugs followed by club drugs were the most abundant toxic agents (52.1% and 23.3%, respectively). Aluminum phosphide (AlP) was the most lethal intoxicant in our study, accounting for 68.2% of all deaths. Conclusions: According to the results, it is concluded that the existing regulations for drug control and suicide prevention have not been efficient enough and further actions yet to be made to reduce the consequences of drug- and non-drug-related toxicities.

Although rooftop PV panels and battery energy storage systems have been well established for detached residential buildings, there is still a lack of access to the advantages of onsite renewable energy generation and consumption for residents of multi-unit buildings. To understand the effects of developing distributed renewable energy sources for multi-unit buildings, a new fair energy-sharing model in which different groups of residents can gain benefit from the shared energy systems is proposed. Despite the potential benefits of developing renewable technologies in multi-unit buildings, the energy trading and allocation processes in the buildings can be unfair for some groups of residents. Accordingly, this work studies the main principles of energy justice and analyses how these principles can be applied in the energy trading and allocation processes to achieve fair energy sharing. In addition to fairness and justice, the experimental results show that our method increases the sellers’ profit by 59.7–127% and decreases the buyers’ cost by 8–21%, compared to the baseline methods. Moreover, applying the energy justice principles in the proposed sharing models acts as an efficient incentive for the residents of the multi-unit buildings to invest in the shared distributed renewable energy sources.

Letter To Editor

The aim of this study is to survey the effects of leadership styles (transformational and servant leadership) on employees’ behavioral patterns regarding change (change reception, resistance to change and indifference to change). The statistical population included employees of Ahvaz governmental organizations. Non-probability sampling method (available sample) was used and finally, 307 questionnaires were returned by the subjects and provided the basis for data analysis. Validity was confirmed through evaluation of experts and reliability was measured through Cronbach's alpha coefficient. Results of data analysis, based on structural equation modeling, show that transformational and servant leadership styles have a positive and significant influence on the reception to change but have a negative and significant impact on the resistance and indifference to change.

Introduction: Ionizing radiation is widely used in industry and medicine; however, it causes a significant health hazard by making microscopic damage to living tissue. Various biological parameters, including cell survival fraction and relative biological effectiveness, are taken into account to assess the severity and extent of biological damages. Microdosimetry suffers from various shortcomings and limitations, but the development of some powerful simulation software has paved the way to resolve these problems in recent years. Material and Methods: In this study, the authors were looked for two keywords (Geant4 and radiobiology) in the title, abstracts, and keywords of Scopus and PubMed database articles. Results: More than 100 articles were found. The researchers extracted the articles that were devoted to the construction of different geometries for DNA, nucleus, and cells as simulate the parameters, such as relative biological effectiveness, SF, linear energy transfer, and single-strand breaks/double-strand breaks in the present study. Conclusion: Geant4 is one of the software commonly used to simulate biological factors. It has many properties, such as the ability to follow up physical processes in very low energy, open source code, and flexibility in complex geometries. In this paper, we reviewed some of the radiobiological parameters simulated with Geant4.

In today's competitive business world, several factors influence consumers’ purchasing behavior. In recent years, viral advertising has emerged as one of the most effective and efficient methods that can create awareness and interest as well as enhance testing and product acceptance. Viral advertising operates through the voluntary transfer of a provocative message of a brand from one person to another via the Internet in order to influence or persuade the message receiver to transfer it to others. The main objective of this study is to evaluate the effect of messages with emotional contents (i.e. anger, fear, disgust, happiness, sadness and surprise) and the credibility of viral advertising (i.e. trustworthiness, expertise, attractiveness) on consumers’ shopping behavior. The study population consisted of 320 Internet users in the city of Ahvaz selected by the accessible sampling method. The data were collected through valid and reliable questionnaires sent to the Internet users by e-mail along with a short advertising video. The results of the data analysis conducted by using the structural equation model and the Amos software showed that the emotional content and the credibility of the viral advertising messages in all the three advertised products has a positive and significant impact on the purchasing behavior of the customers. Also, the results showed the negative and significant effect of emotional contents on the consumer purchasing behavior in two other products, namely life insurance and electrical insecticides.

Objective Despite the recent advances in surgical techniques and perioperative care, liver resection (especially extended hepatectomy) is still a high-risk procedure with considerable morbidity and mortality. Experimental large animal models are the best option for studies in this regard. The present study was performed to present an easy-to-learn, fast, and multipurpose model of liver resection in a porcine model. Method Stepwise liver resections (resection of segments II/III, IVa/IVb, and VIII/IV) were performed in eight pigs with intraoperative monitoring of hemodynamic parameters. The technical aspects, tips, and tricks of this method are explained in detail. Results Based on the specific anatomical characteristics of the porcine liver, all resection types including segmental resection, hemihepatectomy, and extended hepatectomy could be performed in one animal in an easy-to-learn and fast technique. All animals were hemodynamically stable following stepwise liver resection. Conclusion Stepwise liver resection using stapler in a porcine model is a fast and easy-to-learn method with which junior staff and research fellows can perform liver resection up to extended hepatectomy under stable conditions.

Introduction Peritoneal fenestration is an effective preventive method for reducing the rate of lymphatic complications in kidney transplantation (KTx). The size of the fenestration plays an important role in its effectiveness. A large peritoneal window is no longer indicated, due to herniation and difficulties in performing biopsies. Small preventive fenestration is effective but will be closed too early. The aim of this study is to evaluate whether metal clips around the edges of a small fenestration result in optimal effects with minimum fenestration size.Methods and analysis This trial has been initiated in July 2019 and is expected to last for 2 and a half years. All patients older than 18 years, who receive kidneys from deceased donors, will be included. The kidney recipients will be randomly allocated to either a control arm (small fenestration alone) or an intervention arm (small fenestration with clipping). All fenestrations will be round, maximum 2 cm, and close to the kidney hilum. Clipping will be performed with eight metal clips around the peritoneal window (360°) in every 45° in an oblique position. The primary endpoint is the incidence of symptomatic post-KTx lymphatic complications, which require interventional treatment within 6 months after KTx. Secondary endpoints are intraoperative and postoperative outcomes, including blood loss, operation time, severity grade of lymphocele/lymphorrhea and relative symptoms.Ethics and dissemination This protocol study received approval from the Ethics Committee of the University of Heidelberg (Registration Number S-318/2017). A Standard Protocol Items: Recommendations for Interventional Trials checklist is available for this protocol. The results will be disseminated through peer-reviewed journals and conference presentations.Trial registration number ClinicalTrials.gov Registry (NCT03682627).

Objectives: Common variable immunodeficiency (CVID) is a heterogeneous disorder characterized by hypogammaglobulinemia and increased susceptibility to recurrent infections. Methods: We searched PubMed, Web of Science, and Scopus databases to find eligible studies from the earliest available date to January 2018 with standard keywords. Pooled estimates of the infection prevalence and the corresponding 95% confidence intervals were calculated using random-effects models. Results: We found that pneumonia (67.7%) was the most prevalent infection followed by upper respiratory tract (59.0%) and gastrointestinal infections (36.3%). Furthermore, bacterial complications (41.7%) were higher in CVID patients compared to viral (25.4%), parasitic (18.8%), or fungal (3.4%) infections. Patients with longer age at diagnosis presented with fewer disease comorbidities. There was an inverse correlation between T lymphocyte count and viral infections. Moreover, we found that immunoglobulin M (IgM) serum level was inversely correlated with hepatitis C and gastrointestinal infections, and IgG serum level was inversely correlated with infectious arthritis. Higher numbers of CD4 and CD8 T cells were associated with the lower frequencies of otitis media. CVID patients with infections had significantly lower percentages of CD3 T cells. In contrast, higher percentages of CD19 lymphocytes were found in CVID patients who had a history of infections. Conclusions: Our findings demonstrated that in addition to hypogammaglobulinemia, patients with CVID have an imbalance in the frequency of T lymphocytes, which is in parallel with the higher frequency of infectious complications.

Background: The systemic inflammatory cascade triggered in donors after brain death enhances the ischemia-reperfusion injury after organ transplantation. Intravenous steroids are routinely used in the intensive care units for the donor preconditioning. Immunosuppressive medications could be potentially used for this purpose as well. Data regarding donor preconditioning with calcineurin inhibitors or inhibitors of mammalian target for Rapamycin is limited. The aim of this project is to investigate the effects of (oral) donor preconditioning with a calcineurin inhibitor (Cyclosporine) vs. an inhibitor of mammalian target for Rapamycin (Everolimus) compared to the conventional administration of steroid in the setting of donation after brain death in porcine renal transplantation.Methods: Six hours after the induction of brain death, German landrace donor pigs (33.2 ± 3.9 kg) were randomly preconditioned with either Cyclosporine (n = 9) or Everolimus (n = 9) administered via nasogastric tube with a repeated dose just before organ procurement. Control donors received intravenous Methylprednisolone (n = 8). Kidneys were procured, cold-stored in Histidine-Tryptophane-Ketoglutarate solution at 4°C and transplanted in nephrectomized recipients after a mean cold ischemia time of 18 h. No post-transplant immunosuppression was given to avoid confounding bias. Blood samples were obtained at 4 h post reperfusion and daily until postoperative day 5 for complete blood count, blood urea nitrogen, creatinine, and electrolytes. Graft protocol biopsies were performed 4 h after reperfusion to assess early histological and immunohistochemical changes.Results: There was no difference in the hemodynamic parameters, hemoglobin/hematocrit and electrolytes between the groups. Serum blood urea nitrogen and creatinine peaked on postoperative day 1 in all groups and went back to the preoperative levels at the conclusion of the study on postoperative day 5. Histological assessment of the kidney grafts revealed no significant differences between the groups. TNF-α expression was significantly lower in the study groups compared with Methylprednisolone group (p = 0.01) Immunohistochemistry staining for cytochrome c showed no difference between the groups.Conclusion: Oral preconditioning with Cyclosporine or Everolimus is feasible in donation after brain death pig kidney transplantation and reduces the expression of TNF-α. Future studies are needed to further delineate the role of oral donor preconditioning against ischemia-reperfusion injury.

Enterococci are found worldwide and are considered to be opportunistic pathogens. Antimicrobial resistance in these bacteria is increasing and is associated with their capability to sustain in the wastewater. We, therefore, aimed to determine the antimicrobial resistance of Enterococcus spp. that are isolated from the wastewater and clinical specimens. Isolation, identification, and determination of the antibiotic susceptibility patterns in the Enterococcus isolates were performed according to the standard procedures. The concentration of amoxicillin in the wastewater was determined by high-performance liquid chromatography (HPLC). A total of 20 Enterococci were isolated and identified in this study. Of all the Enterococcus spp. isolates, 85 and 70% were resistant to tetracycline and ciprofloxacin, respectively. Surprisingly, the antimicrobial susceptibility tests revealed that the wastewater isolates had a higher rate of resistance than the clinical isolates. Amoxicillin concentrations in both the teaching hospitals were analyzed to be 8.6 and 6.8 ppm, respectively. The results of this study revealed that the hospital wastewater, which mixes with the environment, usually comprises resistant Enterococci. The use of HPLC allows the detection of amoxicillin concentrations in the wastewater samples of the teaching hospitals.

Background: Exophthalmos is the protrusion of eye from the orbital cavity. It may be due to inflammation, infection, tumors and thyroid disorders.Normal value of ocular protrusion is different in each population. It is related to age, gender and ethnicity. The measurement of eye protrusion is helpful in the diagnosis and management of exophthalmos. The aim of this study is to determine the normal values for eye protrusion in Bushehr port population. Materials and Methods: In this study, 1303 subjects of healthy population (15-75 years old) in Bushehr were randomly selected from eccompannies persons of patients that referred to our endocrine clinic. Subjects with previous history of orbital surgery, eye trauma, strabismus, myopia (>-2 Diopter), orbital inflammatory disease, skull and face abnormality were excluded. Extent of eye protrusion was measured by one endocrinologist using Hertel exophthalmometry. Results: The mean protrusion values for right eye and left eye were 17.9±11.55 and 18.08±1.5mm, respectively. The exophthalmometric measurements were lower in right eye than left eye (p

Creating a safe of health care system requires the establishment of High Reliability Organizations (HROs), which reduces errors, and increases the level of safety in hospitals. This model focuses on improving reliability through higher process design, building a culture of accreditation, and leveraging human factors. The present study intends to determine the readiness of hospitals for the establishment of HROs model in Tehran University of Medical Sciences from the viewpoint of managers of these hospitals. This is a descriptive-analytical study carried out in 2013-2014. The research population consists of 105 senior and middle managers of 15 hospitals of Tehran University of Medical Sciences. The data collection tool was a 55-question researcher-made questionnaire, included six elements of HROs to assess the level of readiness for establishing HROS model from managers’ point of view. The validity of the questionnaire was calculated through the content validity method using 10 experts in the area of hospitals’ accreditation, and its reliability was calculated through test-retest method with a correlation coefficient of 0.90. The response rate was 90 percent. The Likert scale was used for the questions, and data analysis was conducted through SPSS version 21 Descriptive statistics was presented via tables and normal distributions of data and means. Analytical methods, including t-test, Mann-Whitney, Spearman, and Kruskal-Wallis, were used for presenting inferential statistics. The study showed that from the viewpoint of senior and middle managers of the hospitals considered in this study, these hospitals are indeed ready for acceptance and establishment of HROs model. A significant relationship was showed between HROs model and its elements with demographic details of managers like their age, work experience, management experience, and level of management. Although the studied hospitals, as viewed by their managers, are capable of attaining the goals of HROs, it seems there are a lot of challenges in this way. Therefore, it is suggested that a detailed audit is conducted among hospitals’ current status regarding different characteristics of HROs, and workshops are held for medical and non-medical employees and managers of hospitals as an influencing factor; and a re-assessment process afterward, can help moving the hospitals from their current position towards an HROs culture.

Objective: This study aimed to design and validate a model for commercializing academic research with an approach focused on the development of knowledgebased employment within Iran's health system. Methodology: The research method was applied-developmental in terms of its goal and descriptive-survey in nature. The statistical population included experts in the field of academic research commercialization and faculty members from medical universities in Iran. In this phase, seven commercialization experts and senior managers from the Vice-Presidency for Science, Technology, and Knowledge-based Economy, along with five academic experts in management, were selected. Theoretical sampling was used to select participants, continuing until theoretical saturation was achieved. Data were simultaneously collected and coded. Findings: The designed model, based on grounded theory, was formulated into a questionnaire and distributed among 400 research center managers, faculty members, and senior managers of the aforementioned universities. Data collection in the qualitative section was conducted through interviews. Grounded theory was utilized for data analysis in the qualitative section. The results indicated that the model for commercializing academic research with an approach to developing knowledge-based employment within the health system is valid and desirable. Conclusion: Commercializing academic research in the medical and health domain plays a fundamental role in advancing economic growth and creating knowledgebased employment. By bridging the gap between academia and industry, universities can transform scientific discoveries into innovative products and services that address critical healthcare needs while stimulating economic growth. [ABSTRACT FROM AUTHOR]