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Increasing the salinity in the water and soil can negatively affect plant growth and development. Mycorrhizal fungi application is one of the ways to reduce the undesirable effect of salt stress on plants. An experiment was conducted in 2017 to assess the effect of salt stress on Nitraria schuberi, as a native Iranian plant in arid regions, inoculated with mycorrhizal fungi. Seedlings of this plant were treated under three different levels of NaCl in three stages. The stages including low salt concentrations (0, 20, 60, and 100 mM NaCl), medium salt concentrations (0, 40, 120, and 200 mM NaCl) and high salt concentrations (0, 80, 240, and 400 mM NaCl). Mycorrhizal treatment including two levels: non-inoculated (control) and mycorrhizal inoculated. Experimental designs were factorials (4×2 treatments) based on the completely randomized design with four replications. In this study, the content of chlorophyll, carotenoid, sugar, proline and Na, Mg, K, Fe and Ca were measured. The results indicated that with increasing salinity levels from the first (low) to third (high) stage, chlorophyll content was decreased while carotenoid, proline, and sugar were increased. The application of NaCl salinity led to a reduction in Fe and enhancement in Na. In the mycorrhizal plants, sugar content decreased but magnesium, calcium and potassium levels increased. Based on these findings it seems that Nitraria schuberi is a salt tolerant plant and mycorrhizal fungi can mitigate salinity stress in this plant. Therefore this plant could be applied in the urban landscape of arid and semi-arid regions.

Determination of growth rate and planting space of trees in urban spaces is needed for the planting design programs and land scape management. To determine the growth rate of two tree species, Chinaberry (Melia azedarach) and Mulberry (Morus alba), data was collected on different dimensions of these trees including, tree height, tree crown height and tree crown diameter at various ages at Pardis campus of Ferdowsi University of Mashhad during their growth. Regression analysis of these dimensions as a dependent variable and age as an independent variable produced different models that can be used for estimating the growth of the measured dimensions of these two species. The results showed that the highest regression coefficient among the models was linear, polynomial and exponential function, but logarithmic types were selected as the most acceptable model for estimating the growth of measured dimensions in the two tree species of Chinaberry (tree height with r2=0.87, crown height with r2=0.67, crown diameter with r2=0.67) and Mulberry (total height with r2=0.60, crown height with r2=0.40, crown diameter with r2=0.65). Also, in both species, the most increase in growth rate of measured dimensions for the 15 years old trees was found in crown diameter.

BACKGROUND AND OBJECTIVE: Menopause is a global phenomenon for women and about 74 to 80% of women worldwide suffer from symptoms of menopause. The symptoms women experience during this period include night sweats, sleep disorders, heart problems and flushing. The treatment currently used for these complications is hormone replacement method, which has serious side effects. One alternative method for the hormone replacement method is the use of plants from the family of phytoestrogens such as evening primrose. METHODS: This triple-blind clinical trial was conducted among 100 postmenopausal women with menopausal symptoms in both drug and placebo groups. First, the symptoms of menopause were measured based on scores of 0 – 16. The participants arbitrarily used placebo or evening primrose oil 1g perle twice a day for one month. After one month, the symptoms of menopause were measured and compared using Menopause Health Questionnaire. IRCT:1N2017012432161. FINDINGS: The results of the study demonstrated that evening primrose has considerable effects on the reduction of flushing (3.33±0.79 vs. 0.89±0.64), sleep disorders (2.65±0.6 vs. 1.3±0.66) and musculo-skeletal disorders (3.41±0.74 vs. 3.41±0.73 vs. 0.82±0.73) in evening primrose group compared with placebo group (p

Leaf area (LA) is a valuable key for plant physiological studies, therefore accurate and simple models for LA determination are important for many experimental comparisons. A greenhouse experiment was conducted from October 2009 to February 2010 in two basil cultivars (Purple Ruffles and Genovese) to estimate LA, leaf dry weight (DW), leaf fresh weight (DW) and leaf dimensions (width-W and length-L). The aim of the work was to establish a non-destructive model of leaf are estimation. Regression analyses of LA versus FW, DW, L and W revealed several models that could be used for estimating the area of individual basil leaves. Among the models, one based on the sum of dimension squares was the most accurate for Genovese [LA = 0.209 (L2 + W2) + 0.25, R2 = 0.895, RMSE = 0.794 and while the product of dimension squares was the most suitable for Purple Ruffies [LA=O.O l 3 (L2W2) +4.963 R2= 0.8 1 7, RMSE = 1 . 1 70]. [ABSTRACT FROM AUTHOR]

Background and Aims: Nurses are highly susceptible to developing low back pain (LBP), which is considered a common occupational hazard. The present study investigated the efficacy of flexible learning methods on the nurses' awareness, perspectives, and practice regarding the prevention of LBP., Methods: In pre-test posttest quasi-experimental study conducted from June to December 2019, 153 eligible nurses working in three hospitals were participated. Researchers divided the hospitals into three groups with similar numbers of participants (around 55 each) using a random process. One group received an educational intervention using an audio-visual animation, another group got a visual pamphlet, and the last group served as a control with no intervention. All nurses completed a validated questionnaire designed by the researchers to assess their awareness, perspectives, and practices related to preventing lower back pain. The questionnaire was given three times: before the intervention, 1 week after, and 4 weeks after., Results: The study found that participants in the audio-visual and visual pamphlet groups scored significantly higher on awareness, perspective, and practice measures compared to the control group. Interestingly, the visual pamphlet group showed even greater awareness and practice scores compared to the audio-visual group ( p  < 0.001). However, the audio-visual group achieved a higher perspective score compared to the visual pamphlet group ( p  < 0.001)., Conclusion: Nurses' perspective, awareness, and practice towards LBP prevention can be improved by blending the visual pamphlet and audio-visual animation., Competing Interests: The authors declare no conflicts of interest., (© 2024 The Authors. Health Science Reports published by Wiley Periodicals LLC.)

Background: Pilates has captured interest due to its possible advantages during pregnancy and childbirth. Although research indicates that Pilates may reduce labor duration, alleviate pain, and improve satisfaction with the childbirth experience, consensus on these outcomes remains elusive, underscoring the necessity for additional studies., Aim: This systematic review and meta-analysis aimed to assess the impact of Pilates exercises on labor duration among pregnant women., Methods: The online database was searched to yield the literature using the terms of 'Pilates', 'childbirth', and 'labor duration', and similar terms including PubMed, Clinical Key, Scopus, Web of Science, Embase, and Cochrane Database of Systematic Reviews up to June 25, 2023. Studies were considered eligible if they were randomized or clinical controlled trials (RCTs/CCTs) published in English, focusing on healthy pregnant women without exercise contraindications. The studies needed to include interventions involving Pilates or exercise movement techniques, a comparison group with no exercise, and outcomes related to labor duration, the period of the active phase, and the second stage of delivery., Results: Eleven studies, totalling 1239 participants, were included in the analysis. These studies provided high-quality evidence from exercise only RCTs/CCTs. The findings indicated a significant reduction in the active phase of labor (8 RCTs, n = 1195; Mean Difference [MD] = -56.35, 95% Confidence Interval [CI] [-89.46 to -23.25]) and overall labor duration (8 RCTs, n = 898; MD = -93.93, 95% CI [-138.34 to -49.51]) in pregnant women who engaged in Pilates exercises compared to those who did not but doesn't affect on the duration of the second stage of labor (7 RCTs, n = 1135; MD = -0.11, 95% CI [-7.21 to 6.99])., Conclusions: While this review primarily addresses the effects of Pilates on healthy and low-risk pregnant women, the findings suggest a potential role for Pilates in shortening labor duration. Therefore, engaging in Pilates or similar physical activities is recommended for pregnant women to potentially facilitate a more efficient labor process., (© 2024. The Author(s).)

Vaccine effectiveness (VE) studies provide real-world evidence to monitor vaccine performance and inform policy. The WHO Regional Office for the Eastern Mediterranean supported a regional study to assess the VE of COVID-19 vaccines against different clinical outcomes in four countries between June 2021 and August 2023. Health worker cohort studies were conducted in 2707 health workers in Egypt and Pakistan, of whom 171 experienced symptomatic laboratory-confirmed SARS-CoV-2 infection. Test-negative design case-control studies were conducted in Iran and Jordan in 4017 severe acute respiratory infection (SARI) patients (2347 controls and 1670 cases) during the Omicron variant dominant period. VE estimates were calculated for each study and pooled by study design for several vaccine types (BBIBP-CorV, AZD1222, BNT162b2, and mRNA-1273, among others). Among health workers, VE against symptomatic infection of a complete primary series could only be computed compared to partial vaccination, suggesting a benefit of providing an additional dose of mRNA vaccines (VE: 88.9%, 95%CI: 15.3-98.6%), while results were inconclusive for other vaccine products. Among SARI patients, VE against hospitalization of a complete primary series with any vaccine compared to non-vaccinated was 20.9% (95%CI: 4.5-34.5%). Effectiveness estimates for individual vaccines, booster doses, and secondary outcomes (intensive care unit admission and death) were inconclusive. Future VE studies will need to address challenges in both design and analysis when conducted late during a pandemic and will be able to utilize the strengthened capacities in countries.

Background: The present study was conducted with the aim of designing and validating questionnaires for evaluating the public health students' knowledge, performance, and satisfaction (KPS) in the course of educational technology., Methods: The present study was conducted with qualitative-quantitative approach. Qualitative stage was done based on experts' opinion and related articles and questionnaires for developing, designing, and validating the tools. For validating the tools, face validity and content validity was done based on the opinion of the 10 expert panel. In quantitative stage, all initial validated tools were implemented on 50 students of public health for determining the reliability. The reliability of the tools was calculated using the internal consistency method of the items with Cronbach's ⍺ coefficient, and Kuder-Richardson. All analyses were conducted using SPSS-19 software., Results: In the field of qualitative research, an assessment tool consisting of 20 four-option questions was designed. The content validity of this tool was confirmed based on the opinions of 10 educational experts, with CVI Total = 0.862 and CVR = 0.885. Additionally, the reliability of the tool was validated through testing on 50 public health students, resulting in a reliability coefficient of r  = 0.780. Furthermore, for performance evaluation, four assessment tools each comprising 20 questions (totaling 80 questions) were designed. The validity values for these tools in the areas of PowerPoint (CVI = 0.981, CVR = 0.960), pamphlet (CVI = 0.866, CVR = 0.877), poster (CVI = 0.871, CVR = 0.906), role-playing (CVI = 0.871, CVR = 0.980), and the reliability of the tools with Cronbach's ⍺ r  > 0.80 were confirmed. In the satisfaction assessment section, a researcher-made questionnaire consisting of 18 questions across seven domains was designed, with confirmed content validity (CVI = 0.949, CVR = 0.861) and reliability ( r  = 0.928)., Conclusions: It seems that this tool can be used to measure the KPS of students from the educational technology course of the health field and similar fields., Competing Interests: The authors declare no conflict of interest., (© 2024 The Authors. Health Science Reports published by Wiley Periodicals LLC.)

Background and Aims: The present study was conducted with the aim of investigating the relationship between health-promoting lifestyle profile (HPLP) among medical students and contextual factors such as gender, age, field of study, academic level, marital status, history of physical and mental illnesses, and smoking., Methods: The present research was conducted in a cross-sectional method in 2021 on 500 students of Shiraz University of Medical Students. An e-questionnaire link was sent to them via email. The research tool was the HPLP questionnaire consisting of 52 questions in six domains in a 4-point Likert scale. Data were analyzed using SPSS software version 24 with one-sample t -test, independent t -test, analysis of variance, and Tukey's post hoc test., Results: A total of 500 students fully answered the questions completely. All components of a healthy lifestyle-except for exercise-obtained a score higher than the cut-off point. The component of Self-Actualization (spiritual growth) (3.035 ± 0.68) had the highest score, while the lowest score was related to exercise and physical activity (2.126 ± 0.60). Married individuals had a better average health score compared to singles ( p  = 0.047). The average health score did not have a significant relationship with gender, but significantly related to age, field of study ( p  < 0.001), history of mental illnesses ( p  < 0.001) and Smoking ( p  < 0.001)., Conclusion: It seems that university officials should pay more attention to the health domain of students' lifestyles, such as nutrition, the development of exercise and physical activities, and the management of stress and mental health. Additionally, providing necessary awareness and considering training courses, as well as developing sports and recreational facilities, can be effective in creating a better environment for the growth and development of students and ensuring their well-being., Competing Interests: The authors declare no conflicts of interest., (© 2024 The Authors. Health Science Reports published by Wiley Periodicals LLC.)

Objective: The purpose of this study was to determine the students' attitudes before and after the flipped classroom, and the effectiveness of this method to promote the students' lateral cephalograms tracing abilities, students' satisfaction and their final exam scores., Materials and Methods: This is a single-group quasi-experimental research conducted on dental students of Shiraz University of Medical Sciences (SUMS), Iran in 2019. The intervention was carried out in a blended learning approach with the flipped classroom model. Thirty-five fourth-year dental students participated in a flipped classroom held during a semester for the lateral cephalograms tracing course. The students were provided with the educational materials before the class time through multimedia learning tools and the class time was devoted to discussions. The students were asked to fill out four questionnaires (pretest/posttest attitudes, pretest/posttest self-assessments of theoretical knowledge and practical skills in cephalograms, posttest of satisfaction from quality of the course, and posttest of students' views about effectiveness of blended learning tools) and final exam scores of students., Results: Students' attitudes toward e-Learning were improved after the flipped classroom and the quality of this method was acceptable to the students (p < .001). Their self-assessment of theoretical knowledge and practical skills were promoted (p < .001). While all blended learning tools averaged more than the cut-off-point, short lecture (5.11 ± 0.98) and live feedback (4.98 ± 1.07) were considered to be the most efficient interactive tools., Conclusion: It seems that the flipped classroom has a positive effect on increasing students' knowledge, attitude, and satisfaction. In general, this method of learning seems to be favored by dental students., Clinical Significance: The findings showed that blended learning had a positive effect on increasing knowledge, performance, and satisfaction among dental students. Therefore, blended learning as a reliable method might be used in training dental students., (© 2024 The Authors. Clinical and Experimental Dental Research published by John Wiley & Sons Ltd.)

In recent years, researchers have extensively investigated the remediation of heavy metal-contaminated soil using plants, microorganisms, and iron nanoparticles. The objective of this study was to investigate and compare the individual and simultaneous effects of Paulownia elongata S. Y. Hu, cyanobacteria (Oscillatoria sp.), arbuscular mycorrhizal fungi (AMF) including Glomus mosseae and Glomus intraradices, and zero-valent iron nanoparticles (nZVI) on the remediation of heavy metal-contaminated soil containing chromium (Cr VI and Cr III) and nickel (Ni). The study found significant variations in parameters such as pH (acidity), electrical conductivity (EC), nitrogen (N), phosphorus (P), potassium (K), and organic carbon (OC) among different treatments. The addition of cyanobacteria, AMF, and nZVI influenced these properties, resulting in both increases and decreases compared to the control treatment. The treatment involving a combination of cyanobacteria, AMF, and nZVI (CCAN25) exhibited the highest increase in growth parameters, such as total dry mass, root length, stem diameter, and leaf area, while other treatments showed varied effects on plant growth. Moreover, the CCAN25 treatment demonstrated the highest increase in chlorophyll a, chlorophyll b, and carotenoid levels, whereas other treatments displayed reductions in these pigments compared to the control. Moderate phytoaccumulation of Cr and Ni in P. elongata samples across all treatments was observed, as indicated by the bioconcentration factor and bioaccumulation coefficient values being less than 1.0 for both metals. The findings provide insights into the potential application of these treatments for soil remediation and plant growth enhancement in contaminated environments., (© 2024. The Author(s), under exclusive licence to Springer-Verlag GmbH Germany, part of Springer Nature.)

Background: The evaluation of e-learning systems ensures the provision of quality training. The goal was to identify the perspectives of teachers and students on e-learning in medical education during the COVID-19 pandemic at Shiraz University of Medical Sciences (SUMS), Iran., Methods: This study utilized a convergent mixed methods research design with a two-phase approach to collect and analyze data between June and August 2022. In the first stage, a cross-sectional descriptive study was conducted to evaluate the quality of e-learning systems from the perspective of 400 students. In the second stage, semi-structured interviews were conducted with 10 virtual education professors and 10 student representatives to identify the strengths, weaknesses, opportunities, and threats of virtual education. A validated questionnaire was administered to assess the quality of the e-learning system, and data were analyzed using SPSS-21. Qualitative data were subjected to content analysis., Results: Our findings revealed that the student support system, the course structure, and the infrastructure and technology subscales' mean scores were significantly higher than the average level (P < 0.001). However, the professors' methods of teaching and learning strategies were unsatisfactory. The results of the present study showed that the evaluation mean score was significantly higher among, younger, female, and undergraduate students. Virtual education has strengths and weaknesses, and innovative approaches are needed to enhance student engagement. The lack of appropriate infrastructure and virtual teaching tools for teachers and students is a significant challenge that needs to be addressed. Blended learning is effective in medical education, and the shift from teacher-centered to learner-centered teaching approaches is an opportunity to explore innovative teaching approaches., Conclusion: From the perspective of students, the quality of eLearning systems at the universities was moderate. Virtual education offers both benefits and drawbacks, and there is a requirement for innovative solutions to enhance student engagement and lessen boredom., (© 2024. The Author(s).)

Introduction: Biochemistry is one of the main courses of basic sciences in the medical curriculum, along with other difficult subjects that are difficult to learn. The emergence of new technologies has made it possible to test new methods such as e-Learning. In this study, we compared two methods of Flex-Flipped Classroom (FFC) and face-to-face., Method: A quasi-experimental research was done which involved both medical and dental students studying the clinical biochemistry course in the joint semester in 2019. A total of 100 medical students were trained in biochemistry through face-to-face teaching, and 60 dental students were trained in the same course through the FFC model. Three researcher-made tools were used to compare the two groups to assess the student's satisfaction, scores, and self-evaluation. The content validity of the tools was checked using the opinions of 10 experts through the CVI index. The results were analyzed using one-sample t-tests, independent t-tests, and ANOVA., Results: Both groups scored significantly more than the cut-off-point (Mean > 3.5) in their average scores of the total and sub-components of the self-evaluation questionnaire (P < 0.05). Face-to-face teaching was viewed more favorably than the FFC teaching except for considering the flexibility (4.14 ± 1.55), but the difference was not significant (P > 0.05). The students' knowledge score in the FFC was slightly higher than that in the face-to-face method, but this difference was not significant(P = 0.758)., Conclusion: Both face-to-face and FFC methods were effective according to the students, but the level of satisfaction with the face-to-face method was higher. It seems that teacher-student interaction is an important factor in students' preferences. However, the students preferred the flexibility of multimedia. It seems necessary to use the advantages of each method in a model appropriate to the students' conditions and available facilities., (© 2024. The Author(s).)

Introduction: Individuals vary in their selection of health messengers. This research aimed to construct an instrument to measure the preferences of medical students in selecting health messengers and in the next step to validate the aforementioned questionnaire., Method: This research is a descriptive survey with an approach to construct a questionnaire. The statistical population included all students studying at Shiraz University of Medical Sciences in March to June 2022 in the academic year 2021-2022. 500 participants were involved in the study. To determine the types of health messengers and review the texts, a group of 15 primary items consisting of the 6 components of academic sources (2-items), formal news sources (2-items), mass media (3-items), internet search (2-items), social networks and messenger applications (4-items), and informal conversation (2-items) were compiled. A 4-point scale was developed the content validity of which was confirmed using CVI and CVR method and the reliability index was calculated to be 0.818. Factor analysis was also used to determine the construct validity and factor loading of each item., Results: The research covers university students in different medical fields. Using factor analysis, together with KMO = 0.810 and Bartlett's sphericity index P < 0.0001, saturation and the suitability of the test were confirmed. Students' preferences based on factor load were social media (28.92%), official and unofficial health sources(10.76%), academic sources (9.08%), internet search (8.18%), and mass media (7.13%), respectively. Among social media, Telegram (0.85) had the highest factor load followed by Instagram (0.79), and WhatsApp (0.71)., Conclusion: Medical students are always on the move and naturally prioritize mobile-based methods. They prefer messengers that are free from time and space restrictions. The widespread availability of mobile devices and the ability to search for and access information make it easier to test health information. Therefore, in health policy, attention should be paid to the virtual capabilities, especially mobile-based approaches., (© 2024. The Author(s).)

Background: With the prevalence of new technologies and evolving student learning styles, virtual teaching methods have become increasingly popular. As a result, more and more students are opting to learn online. However, one common concern is that they may feel disconnected from their teachers, leading to feelings of loneliness and doubts about the quality of education they are receiving. To address this issue, a study was conducted to gather data on students' preferences for virtual education and to validate a tool for measuring students' preferences for virtual education., Methods: The research was conducted in a mixed method with a quantitative-qualitative sequence. A virtual education preferences questionnaire (VEPQ) for students with a total of 17 items was created and validated as part of the qualitative component by looking at the theoretical underpinnings and experts' opinions in the focus group. The scale of the six-point Likert questionnaire was from very high to very low. To validate the tool and determine preferences, exploratory factor analysis was used. A total of 155 samples answered the questions and the data were analyzed using SPSS-24 software., Results: A total of 155 complete questionnaires were returned; among them, 110 (71%) were filled out by women, 73 (47.1%) by respondents between the ages of 36 and 45, 107 (69%) were already employed in paramedical fields, and 48 (31%) were enrolled in a medical school. The opinions of ten experts were used to confirm the face validity of the questionnaire. With CVI = 0.924 and CVR = 0.805, content validity was verified. Using the internal consistency method of the questions with a Cronbach's alpha coefficient of R = 0.824, the validity of the entire questionnaire was confirmed. Exploratory factor analysis revealed that a total of five components-self-directed projects (29.58%), e-content (13.00%), online presentation (10.97%), face-to-face interactions (9.12%), and text interactions (7.11%) had the highest load, with a total of 69.77% of the structure explaining virtual education preferences. The factor analysis test and the suitability of the sample are both confirmed by the value of KMO = 0.721 and the significance of Pvalue < 0.001., Conclusion: It appears that the highly valid tool developed can be used to ascertain the educational preferences of students. Also, the high factor load of self-directed educational methods and e-content shows that independence and flexibility in time and place are more important for students., (© 2023. BioMed Central Ltd., part of Springer Nature.)

The undeniable impact of plants in reducing air pollution and the crucial role of nutrition in improving stress tolerance in plants has brought attention to the use of eco-friendly fertilizers. The objective of the study was to investigate how Biogas-digestate (BD) can enhance the tolerance of green roof plants in capturing air pollutants. Four plant species, namely reflexed stonecrop (Sedum reflexum), blue fescue (Festuca glauca), garden mum (Chrysanthemum morifolium), and Peppermint (Mentha piperita) were planted in three urban sites in Mashhad, Iran, with different levels of air pollution. The physiological, biochemical, and morphological characteristics of the treated plants were compared to assess their ability to trap air pollutants. The results showed that the treated M. piperita at Razavi with BD, exhibited the highest level of APTI. Although it was influenced by the site conditions, the determination of the optimum API yielded same results. The F. glauca treated in Khayyam had the highest proline content, while S. reflexum at the Honarestan site had the lowest H 2 O 2 level, without significantly affecting BD. F. glauca, S. reflexum, and M. piperita exhibited the highest levels of SOD, PPO, and GPX activity, respectively, which were significantly increased by the BD treatment. Most of the heavy elements showed increased levels with BD treatment, and M. piperita had the highest concentrations of heavy elements. The leaf surfaces of S. reflexum and M. piperita, had the highest and lowest deposition of particulate matter (PMs), respectively. Carbon and oxygen constituted the majority of PMs on the surface of leaves at all three study locations. The following ranks included the elements Si, Ca, Mg, and Al. BD, particularly in the case of S. reflexum and M. piperita, enhanced the plants' tolerance to air pollution. It is recommended to cultivate S. reflexum using BD on the green roof in polluted areas due to its superior capacity to absorb PMs and the fact that it is not edible., Competing Interests: Declaration of competing interest The authors declare that they have no known competing financial interests or personal relationships that could have appeared to influence the work reported in this paper, (Copyright © 2023 Elsevier Ltd. All rights reserved.)

Objectives: Preeclampsia (PE) is a leading cause of maternal death worldwide and involves vascular endothelial dysfunction. The aim of this study was to investigate the association of the G894T polymorphism in the endothelial nitric oxide synthase (eNOS) gene and the risk of preeclampsia in a case-control design in an Iranian population, which was followed by a meta-analysis and an in silico approach., Methods: In the case-control study, 300 people including 135 pregnant women with preeclampsia and 165 healthy pregnant women were included. The genotype of G894T polymorphism was determined by the PCR-RFLP method. We searched authoritative scientific databases to find eligible studies for meta-analysis. The odds ratio with a 95% confidence interval was estimated to find the strength of the association of the mentioned polymorphism with the risk of preeclampsia. In addition, the effect of G894T transversion on eNOS gene function was evaluated by some bioinformatics tools., Results: Our case-control data showed that the G894T polymorphism is associated with an increased risk of preeclampsia. In the meta-analysis, 33 eligible studies were included, and the results showed that the G894T polymorphism is associated with an increased risk of preeclampsia in the overall analysis and some stratified analyses. In addition, the structural analysis showed that the G894T variant can affect the splicing process as well as the protein stability., Conclusions: Based on the results, the aforementioned polymorphism may be a risk factor for preeclampsia and could be considered a potential molecular biomarker for screening susceptible individuals., Competing Interests: Declaration of Competing Interest The authors declare that they have no known competing financial interests or personal relationships that could have appeared to influence the work reported in this paper., (Copyright © 2023 Elsevier Ltd. All rights reserved.)

Background: Complementary and integrative medicine may be effective for postoperative outcomes. This study aimed to determine the effect of lemon inhalation aromatherapy on pain, nausea, and vomiting and neurovascular assessment in patients for lower extremity fracture surgery., Methods: This is a randomized clinical trial study. Ninety patients who had undergone lower extremity fracture surgery were randomly assigned to the intervention (lemon aromatherapy) and control groups. Lemon aromatherapy was started in the morning of the surgery and extended at two-hour intervals until the end of the surgery, in the recovery room, and 16 h after surgery. Numerical pain and nausea and vomiting scales, the Rhodes Index of Nausea, Vomiting, and Retching, and the WACHS Neurovascular Observation Chart were used to assess the outcomes before and after the intervention (in the recovery room and 4, 8, 12, and 16 h post-surgery). The data were analyzed using the Wilcoxon test, ANCOVA, and Repeated Measure ANCOVA., Results: A significant difference was observed between the groups in terms of the intensity of pain (P < 0.001) and nausea and vomiting (P = 0.001) during the study period. Moreover, a significant difference was found between groups as to the frequency and severity of nausea, vomiting, and retching. The amount and duration of postoperative vomiting and nausea were significantly lower in the intervention group compared to the control group. In addition, lemon inhalation aromatherapy decreased the frequency of anti-emetic drug administration in the recovery room (P = 0.04) and 16 h post-surgery (P = 0.03)., Conclusions: This study indicated that aromatherapy reduced pain intensity, postoperative nausea, vomiting, and retching, as well as the incidence of anti-emetic drug administration. Therefore, using lemon inhalation aromatherapy to relieve pain and reduce nausea and vomiting is suggested for lower extremity fracture patients who have undergone surgery., Trial Registration: This study was registered in the Iranian Registry of Clinical Trail (Number = 57,331, IRCT20130616013690N10, approved 24/07/2021) ( https://www.irct.ir/trial/57331 )., (© 2023. The Author(s).)

With the rising demand for new cultivars of carnation, efficient transformation protocols are needed to enable the bioengineering of new traits. Here, we established a novel and efficient Agrobacterium-mediated transformation system using callus as the target explant for four commercial carnation cultivars. Leaf-derived calli of all cultivars were inoculated with Agrobacterium tumefaciens strain LBA4404 containing the plasmid pCAMBIA 2301 harboring genes for β-glucuronidase (uidA) and neomycin phosphotransferase (nptII). Polymerase chain reaction (PCR) and histochemical assays confirmed the presence of uidA and β-glucuronidase (GUS), respectively in transgenic shoots. The effect on transformation efficiency of medium composition and the presence of antioxidants during inoculation and co-cultivation was investigated. The transformation efficiency was increased in Murashige and Skoog (MS) medium lacking KNO 3 and NH 4 NO 3, and also in MS medium lacking macro and micro elements and Fe to 5% and 3.1% respectively, compared to 0.6% in full-strength medium. Transformation efficiency was increased dramatically to 24.4% across all carnation cultivars by the addition of 2 mg/l melatonin to nitrogen-depleted MS medium. Shoot regeneration was also doubled in this treatment. The establishment of this efficient and reliable transformation protocol can advance the development of novel carnation cultivars through molecular breeding approaches., (© 2023. The Author(s).)

"Pro re nata" (PRN) or "as needed" medicine administration and usage is a relatively neglected area in medication management (pharmacotherapy/pharmaceutical care) which contributes to error-prone use of medications and is unsafe for patients. In this case, we report the incident of diclofenac toxicity in a 51-year-old woman due to a prescription of 100 mg diclofenac suppositories PRN, or as needed, for postoperative pain control without explanation of the maximum daily dose (150 mg daily), which led to arbitrary consumption of 3 g of diclofenac over 5 days (600 mg daily) by the patient, and subsequent development of metabolic acidosis, acute kidney injury, and sudden cardiac arrest. The implementation of practical guidelines and training programs for health care workers to appropriately prescribe, dispense, and administer PRN medicines are necessary, and should at least include providing clarification for their indication, dose and frequency, as well as any cautionary instructions to ensure safe and effective use of such medicines., (© 2023 American Society for Healthcare Risk Management of the American Hospital Association.)

Aim: This study aimed to compare the efficacy of e-flipped and online case-based workshops on the nurses' knowledge, attitude and behaviour regarding thalassemia during the COVID-19 pandemic., Design: A pre-test-posttest interventional study was conducted with two intervention groups and a control group., Methods: One hundred and fifty nurses were recruited from comprehensive urban health centres in June-December 2020. The nurses were randomly allocated to one of the three groups: case-based e-flipped workshop (n = 50), case-based online workshop (n = 50) and control (n = 50). A researcher-made questionnaire was completed by eligible subjects at baseline, after the end of the training sessions and 4 weeks after interventions to assess their knowledge, attitude and behaviour. Data were analysed in IBM SPSS v16.0. ANOVA and Tukey's post hoc tests were used to compare the three groups., Results: The mean knowledge, attitude and behaviour scores in the intervention groups increased significantly more than that in the control group (p < .001). One week and 4 weeks following the intervention, the mean score of knowledge, attitude and behaviour in the e-flipped group was greater than that in the online group (p < .001). According to the results, e-flipped and online case-based workshops can improve nurses' knowledge, attitude and behaviour regarding thalassemia., (© 2022 The Authors. Nursing Open published by John Wiley & Sons Ltd.)

Using nanofertilizers in certain concentrations can be a novel method to alleviate drought stress effects in plants as a global climate problem. We aimed to determine the impacts of zinc nanoparticles (ZnO-N) and zinc sulfate (ZnSO 4 ) fertilizers on the improvement of drought tolerance in Dracocephalum kotschyi as a medicinal-ornamental plant. Plants were treated with three doses of ZnO-N and ZnSO 4 (0, 10, and 20 mg/l) under two levels of drought stress [50% and 100% field capacity (FC)]. Relative water content (RWC), electrolyte conductivity (EC), chlorophyll, sugar, proline, protein, superoxide dismutase (SOD), polyphenol oxidase (PPO) and, guaiacol peroxidase (GPO) were measured. Moreover, the concentration of some elements interacting with Zn was reported using the SEM-EDX method. Results indicated that foliar fertilization of D. kotschyi under drought stress with ZnO-N decreased EC, while ZnSO 4 application was less effective. Moreover, sugar and proline content as well as activity of SOD and GPO (and to some extent PPO) in treated plants by 50% FC, increased under the influence of ZnO-N. ZnSO 4 application could increase chlorophyll and protein content and PPO activity in this plant under drought stress. Based on the results, ZnO-N and then ZnSO 4 improved the drought tolerance of D. kotschyi through their positive effects on physiological and biochemical attributes changing the concentration of Zn, P, Cu, and Fe. Accordingly, due to the increased sugar and proline content and also antioxidant enzyme activity (SOD, GPO, and to some extent PPO) on enhancing drought tolerance in this plant, ZnO-N fertilization is advisable., Competing Interests: The authors declare that the research was conducted in the absence of any commercial or financial relationships that could be construed as a potential conflict of interest., (Copyright © 2023 Karimian and Samiei.)

Preschool age is a great time to learn a healthy lifestyle, for behavior therapy. Mobile health procedures are inexpensive, reliable, and accessible. This project has two phases. The KidFood mobile game and two nutrition knowledge questionnaires were designed during the first phase. In the second phase, a six-month, parallel, blinded, randomized controlled trial will perform on 120 Iranian children aged 5 to 6 years. Before and after nutritional education via KidFood, the dietary habits, the nutritional knowledge of parents and children, and the anthropometric indices of children will be evaluated., Competing Interests: The authors declare that they have no known competing financial interests or personal relationships that could have appeared to influence the work reported in this paper., (© 2023 Published by Elsevier B.V.)

Background: Sexual health is one of the most important aspects of health. In Iran, most services associated with reproductive and sexual health are provided by midwives at health centers. As different factors are effective in providing care services associated with sexual health, the present study aims to investigate the factors affecting the provision of sexual health services by midwives., Materials and Methods: In this qualitative content analysis study, data were collected by conducting in-depth interviews with 16 midwives, 7 key informants, and 6 stakeholders. Besides, the sampling method was purposeful, and data analysis was conducted using conventional content analysis and MAXQDA software., Results: After analyzing the content of the qualitative data, two themes were extracted, which included facilitators of and barriers to providing sexual health services by midwives., Conclusions: By modifying educational curricula, providing in-service training, and adopting appropriate policies, barriers for providing accessible sexual health services by midwives can be reduced., Competing Interests: Nothing to declare., (Copyright: © 2023 Iranian Journal of Nursing and Midwifery Research.)

One of the most pressing issues confronting the civilized and modern world is air pollution. Particulate matter (PM) is a well-known pollutant that contributes significantly to urban air pollution and has numerous short- and long-term adverse effects on human health. One method of reducing air pollution is to create green spaces, mainly green walls, as a short-term solution. The current study investigated the ability of nine plant species to reduce traffic-related PM using a green wall system installed along a busy road in Mashhad, Iran. The main aims were (1) estimate the tolerance level of plant species on green walls to air pollution using the air pollution tolerance index (APTI); (2) assess the PM capture on the leaves of green wall species using scanning electron microscopy (SEM), energy dispersive X-ray (EDX) analysis, and accumulation of heavy metals using inductively coupled plasma (ICP); (3) select the most tolerance species for reducing air pollution using anticipated performance index (API). The plants' APTI values ranged from 5 to 12. The highest APTI value was found in Carpobrotus edulis and Rosmarinus officinalis, while Kochia prostrata had the lowest. Among the APTI constituents, leaf water content (R 2 = 0.29) and ascorbic acid (R 2 = 0.33) had a positive effect on APTI. According to SEM analysis, many PM s were adsorbed on the adaxial and abaxial leaf surfaces, as well as near the stomata of Lavandula angustifolia, C. edulis, Vinca minor, and Hylotelephium sp. Based on EDX analysis, carbon and oxygen formed the highest amount (more than 60%) of metals detected in the elemental composition of PM deposited on the leaves of all species. The Sedum reflexum had the highest Cr, Fe, Pb, and As accumulation. The concentrations of all heavy metals studied in green wall plants were higher than in the control sample. Furthermore, the C. edulis is the best plant for planting in industrial, urban areas of the city based on APTI, biological, economic, and social characteristics. It concludes that green walls composed primarily of plants with small leaves can significantly adsorb PM and accumulation of heavy metal., (© 2022. The Author(s), under exclusive licence to Springer-Verlag GmbH Germany, part of Springer Nature.)

Background: The use of organic nanoparticles to improve drought resistance and water demand characteristics in plants seems to be a promising eco-friendly strategy for water resource management in arid and semi-arid areas. This study aimed to investigate the effect of chitosan nanoparticles (CNPs) (0, 30, 60 and 90 ppm) on some physiological, biochemical, and anatomical responses of Salvia abrotanoides under multiple irrigation regimes (30% (severe), 50% (medium) and 100% (control) field capacity)., Results: The results showed that drought stress decreases almost all biochemical parameters. However, foliar application of CNPs mitigated the effects caused by drought stress. This elicitor decreased electrolyte conductivity (35%), but improved relative water content (12.65%), total chlorophyll (63%), carotenoids (68%), phenol (23.1%), flavonoid (36.4%), soluble sugar (58%), proline (49%), protein (45.2%) in S. abrotanoides plants compared to the control (CNPs = 0). Furthermore, the activity of antioxidant enzymes superoxide dismutase (86%), polyphenol oxidase (72.8%), and guaiacol peroxidase (75.7%) were enhanced after CNPs treatment to reduce the effects of water deficit. Also, the CNPs led to an increase in stomatal density (5.2 and 6.6%) while decreasing stomatal aperture size (50 and 25%) and semi-closed stomata (26 and 53%) in leaves., Conclusion: The findings show that CNPs not only can considerably reduce water requirement of S. abrotanoides but also are able to enhance the drought tolerance ability of this plant particularly in drought-prone areas., (© 2022. The Author(s).)

Background/objectives: Breast neoplasm is one of the most common cancers in Iranian women due to the late diagnosis. Awareness of breast neoplasm and using Breast Self-Examination (BSE) assist in the early detection and treatment of cancer. This study examined the effectiveness of video-based multimedia training versus face-to-face training in awareness of breast neoplasm and BSE and possible factors affecting their effectiveness., Methods: This research was a pre-test, a post-test experimental study comparing the knowledge, attitude, and performance of women about BSE across two training intervention groups (face-to-face versus video-based multimedia). The study was conducted at Shiraz University of Medical Sciences (SUMS), and 100 women between 20 to 60 years old were allocated to each intervention group via multi-stage cluster sampling (n:110). Three valid and reliable researcher-made questioners were used. Data were analyzed using SPSS 24 with independent t-test, paired t-test, and ANOVA., Results: Both video-based multimedia and face-to-face training methods significantly increased the participant's knowledge, attitude, and skills about breast self-examination (P < 0.001). In the sub-categories, the results showed that the face-to-face training improved negligence and forgetfulness in applying BSE (P = 0.03) and correcting or modifying the previous knowledge around the issue (P = 0.02). The effect of the video-based method on participants with university education was more than on non-university (P = 0.04)., Conclusion: Incorporating video-based multimedia training in awareness of breast neoplasm and breast self-examination provides an easy, flexible, and affordable way for detection, particularly considering crisis restrictions. This can be of particular attention in more populated, developing/low-income countries and rural and remote areas to enhance equitable access to training and facilitation diagnosis and treatment if applicable., (© 2022. The Author(s).)

Objectives: Using the Kirkpatrick evaluation model, investigate the effect of the e-flipped learning approach on the knowledge, attitudes, and perceived behaviour of medical educators., Results: This interventional study was conducted on 140 eligible medical educators at Shiraz University of Medical Sciences (SUMS) from 2019 to 2021. A researcher-made questionnaire was developed to assess the impact of the course on three levels of reaction, knowledge, and perceived behaviour using the Kirkpatrick evaluation model. According to the findings, the average reaction and knowledge scores are higher than the desired level, but the perceived behaviour score is slightly lower than the desired level. The e-flipped learning approach can improve medical educators' knowledge, attitude, and behaviour regarding online teaching., (© 2022. The Author(s).)

The COVID-19 crisis has had a profound effect on higher education, especially medical education due to its sensitive nature, dealing with people's life and wellbeing. This study presented a crisis management model of how to direct medical education during crises. A qualitative design was used via a focus group among 83 medical education administrators at Shiraz University of Medical Sciences. Four major challenges emerged regarding medical education during the COVID-19 pandemic including "The health and wellbeing of faculty members and students"; "Spatial constraints"; "Time constraints", and "Access to resources". A total of 13 strategies were suggested to tackle the challenges, including virtualization, technological support, empowerment, participation, sharing, helping, integration, compression, omission, flexibility and diversity, severance, protection; and monitoring. For a sustainable educational pathway in medical education, personalized approach to education via the incorporation of technology is essential. This provides opportunities to tackle the issues caused by the crisis, by provision of any time and anywhere approach to education via flexible technologies/platforms adjusted based on the audiences. The scope of crisis management expands not only on individual and academic levels but also on social and global relations., Competing Interests: Conflict of InterestThe authors declare that they have no competing interests., (© The Author(s), under exclusive licence to Springer Science+Business Media, LLC, part of Springer Nature 2021.)

Background: The incidence of application of medicinal herbs during pregnancy has increased significantly among women over the past years; however, the safety and efficacy of medicinal herbs during pregnancy are still unclear. The aim of the present study was to categorize the predictors of self-medication with herbal remedies during pregnancy based on the theory of planned behavior (TPB)., Methods: The present descriptive-analytical study was conducted on 300 pregnant women referred to Kashan health center to receive prenatal care services in 2020. The study participants were randomly selected using stratified random sampling with proportional allocation. The data collection tool was a two-part researcher made questionnaire. The first part of the questionnaire included demographic information, midwifery information, and questions related to women's awareness about herbal medicine. The second part of the questionnaire was designed based on the theory of planned behavior including attitudes, perceived behavioral control, subjective norms, intention, and behavior performance. Data were analyzed using descriptive statistics, regression analysis, and SPSS version 18.0., Results: The mean age of participants was 28. 7±5.4 years (range, 15-45 years), the majority were housewives (88.3%) and had secondary education (39.3%). A total of 164 women (57. 1%) used medicinal herbs during pregnancy. The individual's attitude towards herbal medicines consumption, subjective norm, and perceived behavioral control was correlated with behavioral intention (P < 0.05). Similarly, subjective norms were the most predictor of using herbal medicine among pregnant women (P < 0.05)., Conclusion: The findings revealed that more than 50 % of pregnant women used medicinal herbs during pregnancy. The present study showed that the individual's attitude towards herbal medicines consumption, subjective norm, and perceived behavioral control was correlated with intention of herbal medicine use among pregnant women. Likewise, subjective norms were the most predictor of herbal medicine use among pregnant women. The TPB should be addressed in planning health education programs and modifying health behaviors, including self-medication, especially during pregnancy., (© 2021. The Author(s).)

Background: Men's involvement in perinatal care has benefits including reduced preterm childbirth, and better development of children. This study was conducted with the aim to determine the attitude and participation of men in prenatal, childbirth, and postpartum care., Materials and Methods: This cross-sectional study was performed on 280 men in industrial units in Kashan city, Iran (November 2014-March 2015). The participants were selected using cluster sampling method. They completed a researcher-made three-part questionnaire. The data were analyzed using independent-samples t test and analysis of variance (ANOVA)., Results: The mean (SD) score of men's attitude and practice regarding perinatal care were 40.12 (5.00) and 61.65 (6.87), respectively. A significant difference was observed between the practice of men with different education levels (F 2,75 = 3.63, p = 0.001)., Conclusions: The participation of men in perinatal care was low. It is recommended that healthcare providers make visits in the presence of husbands and simultaneously provide training for the couples during the perinatal period., Competing Interests: Nothing to declare., (Copyright: © 2021 Iranian Journal of Nursing and Midwifery Research.)

There is extensive evidence showing the impact of climate change on the biology and biogeography of species. Adopting drought-tolerant plants to conserve water is a potential adaptation to reduce the consequences of climate change. Accordingly, it was hypothesized that climate change would not affect potential distributions of drought-tolerant species. Here, this hypothesis was tested to model the potential distribution of three drought-resistant plant. Here, the potential distribution of Agropyron cristatum, Agropyron desertorum , and Festuca arundinacea was studied in Iran under current and future climate conditions, using 10 species distribution models. Sixty-two climate change scenarios (19 global climate models (GCMs) under four Representative Concentration Pathways (RCPs)) were used to model the potential distribution of the three plants in Iran in the future. The three species have different responses to predicted climate change due to species-environment interactions, species morphological and physiological advancement. The three species showed different responses to predicted climate change due to species-environment interactions. Festuca arundinacea and Agropyron cristatum will, respectively, experience the most and least severe decline in suitable habitats in the next 50 years. This result is because decreased annual precipitation caused an increase in habitat suitability for A. cristatum , while the same variable had the opposite effect for A. desertorum and F. arundinacea . On the other hand, F. arundinacea grows on moist soils that decreased annual precipitation caused a decrease in habitat suitability. Also, our results have clearly shown that plant species drought-stress tolerant are not immune to climate change and their current distributions undergo significant changes as a result of the changing of climate.

Background: Rosa canina is one of the most popular rose species which is widely used as the rootstock for the propagation of rose cultivars. The purpose of the present study is to improve the in vitro propagation efficiency of this valuable plant species using various growth stimulants in a proliferation medium. In this study, in vitro-derived axillary buds of R. canina were inoculated in Vander Salm (VS) medium supplemented with varying levels of organic or inorganic elicitors including casein hydrolysate (200, 400, and 600 mg/l), glutamic acid (2, 4, 8, and 12 mg/l), proline (500, 1000, 1500, and 2000 mg/l), and silver nitrate (25, 50, 75, and 100 mg/l), separately. Benzyl amino purine (BAP) as well as naphthalin acetic acid (NAA) were added to all media at a constant rate to promote shoot proliferation., Results: The results indicated that the supplementation of casein hydrolysate to the VS medium markedly stimulated shoot regeneration by 173% in comparison to control. Shoot proliferation was also positively influenced by glutamic acid at all levels, however, at a lesser extent compared to casein hydrolysate. Silver nitrate at 100 mg/l induced the longest shoots (2.52 ± 0.248 cm) and maximum leaf number (8.90 ± 0.276) among all treatments. Although it did not encourage efficient shoot regeneration, the highest quality shoots with maximum growth vigor were observed in this treatment., Conclusion: In this study, the promising role of casein hydrolysate in combination with plant growth regulators has been emphasized for the improved efficiency of R. canina regeneration protocol. Moreover, the addition of silver nitrate to the culture medium seems vital for enhancing the quality of regenerated shoots. The results of this study could be beneficial either for the further pharmaceutical or biochemical investigations of R. canina or commercial purposes for mass propagation of this specimen.

Background: While immune-checkpoint inhibitors (ICIs) have transformed the field of oncology for advanced-stage cancers, they can lead to serious immune toxicities. Several systematic reviews have evaluated the risk of immune-related adverse events (irAEs); however, most have focused on published articles without evaluating trial registries. The objective of this methodological review was to compare the quality of reporting of safety information and in particular, serious irAEs (irSAEs), in both publications and ClinicalTrials.gov for all current FDA-approved ICIs., Methods: PubMed was searched to retrieve all published phase III randomized controlled trials (RCTs) evaluating ICIs. For each eligible trial, we searched for corresponding registration on ClinicalTrials.gov and extracted relevant safety data from both the publication and results posted on registry. We then compared the quality of reporting and the value of safety data between both sources., Results: Of 42 eligible published trials, 34 had results posted on ClinicalTrials.gov . Considerable variability was noted in the reporting of safety in both sources. SAEs were reported for all trial results in ClinicalTrials.gov compared to 23.5% of publications. An overall incidence for irAEs and irSAEs was reported in 58.8 and 8.8% of publications respectively, compared to 11.8 and 5.9% in registry results. Comparing the value of specific irSAEs was not possible between the two sources in 32/34 trials either due to different reporting formats (61.8%) or data not being reported in one or both sources (32.4%). From the 2 studies with compatible irSAE format, only 1 had matching data in both sources., Conclusions: The reporting of irAEs / irSAEs varies considerably in publications and registries, which outlines the importance of standardizing the terminologies and methodologies for reporting safety information relevant to ICIs.

Regardless of the extraction method, optimized RNA extraction of tissues and cell lines are carried out in four stages: 1) homogenization, 2) effective denaturation of proteins from RNA, 3) ribonuclease inactivation, and 4) removal of contamination from DNA, proteins, and carbohydrates. However, it is very laborious to maintain the integrity of RNA when there are high levels of RNase in the tissue. Spontaneous autolysis makes it very difficult to extract RNA from pancreatic tissue without damaging it. Thus, a practical RNA extraction method is needed to maintain the integrity of pancreatic tissues during the extraction process. An experimental and comparative study of existing protocols was carried out by obtaining 20-30 mg of rat pancreatic tissues in less than 2 minutes and extracting the RNA. The results were assessed by electrophoresis. The experiments were carried out three times for generalization of the results. Immersing pancreatic tissue in RNA stabilization reagent at -80 °C for 24 h yielded high integrity RNA, when the RNA extraction reagent was used as the reagent. The results obtained were comparable to the results obtained from commercial kits with spin column bindings.

Background: Many women of childbearing age suffer from problems such as dysmenorrhea and irregular menstruation., Objectives: The objective of the study is to determine the relationship between the duration of menstrual bleeding and obesity-related anthropometric indices in students., Methods: This cross-sectional study was carried out on 250 students in 2016. Data were collected by a questionnaire composed of: 1) demographic information, 2) information concerning menstrual cycle and 3) obesity-related anthropometric parameters. Anthropometric parameters include height, weight, waist circumference, hip circumference, and arm circumference. Independent t -test, Pearson correlation coefficient, and multiple linear regressions with backward strategy were used., Results: The average age of students was 21/295 (±1/585) years. For most participants, the duration of menstrual bleeding was 3-7 days (87/2%, 218 people). None of the participants had menstrual bleeding <3 days, and the duration of bleeding was >7 days for 32 participants (12/800%). A significant relationship was observed between the intervals of menstruation and the waist-to-hip ratio ( r = 0/136, P < 0/041). Based on multiple linear regression, hip circumference and waist-to-weight, hip-to-waist, arm-to-weight, hip-to-thigh, and arm-to-height ratios are predictors for menstrual duration., Conclusions: In this study, a significant association was found between the anthropometric indices and menstrual characteristics. These findings suggest the need for modifying anthropometric indicators to control menstrual cycle problems., Competing Interests: There are no conflicts of interest.

Medication errors are the second most common cause of adverse patient safety incidents and the single most common preventable cause of adverse events in medical practice. Given the high human fatalities and financial burden of medication errors for healthcare systems worldwide, reducing their occurrence is a global priority. Therefore, appropriate policies to reduce medication errors, using national data and valid statistics are required. The primary objective of this study was to provide a national 'characteristic profile' of medication error-associated adverse drug reactions (ADRs), which are also known as preventable ADRs (pADRs). A retrospective study of pADR reports submitted to the national pharmacovigilance center (PCV) within Iran's Food and Drug Administration was conducted over a 2-year period (2015-2017). Preventability Method (P-Method), which is a standardized tool developed and recommended by the World Health Organization (WHO), was used for preventability assessment. The results of the analyses revealed that while the number of pADRs increased from year one to two (601 to 630), their proportion out of all ADRs per year decreased (7.32% to 6.44%). The percentage of pADRs was higher in females (61.01%) and adults (83.27%), and the highest number of reports were received by nurses (71.57%). Having 'a documented hypersensitivity to an administered drug or drug class' was the most common preventable factor in both years (61.23% and 54.29% respectively), and 'anti-infectives used systemically' were the medication class which primarily contributed to both serious (53.29%) and non-serious pADRs (39.19%). The specific characteristics of medication errors associated with ADRs from this study, especially the preventable criteria which led to their occurrence, can help devise more specific preventative policies., (© 2018 The Author(s); Published by Kerman University of Medical Sciences. This is an open-access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/4.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.)

Background: Atrial fibrillation (AF) is the most common cardiac arrhythmia, and its prevalence increases with advancing age. Pulmonary vein isolation is a standard approach in drug refractory paroxysmal AF which could be performed by cryoballoon ablation (CBA). We tried to evaluate its efficacy and safety in Iranian patients with AF., Methods: From 2015 to 2017, 97 patients with paroxysmal and persistent AF were enrolled in our observational historical cohort study. They were visited 1 and 6 months post-procedure in order to assess the efficacy (recurrence) and safety. Recurrence was defined as 30 seconds of arrhythmia on their 48-hours Holter monitoring., Results: Ninety-seven patients enrolled in the study, 64 (66.0%) of them were men, and their mean age was 55 ± 12 years. Hypertension was reported in 41 patients (42.3%), as the most common cardiac risk factor. 71 patients (73.2%) patients with paroxysmal AF and 15 patients (15.5%) with persistent AF underwent the procedure. After 6 months, recurrence was documented in only 17 patients (17.5%), and 82.5% of the patients were free from the recurrence. Post-procedural complication was detected only in 3 patients (3.1%)., Conclusion: In our study, the mid-term success and safety of CBA in patients with paroxysmal AF was showed. CBA is a safe and effective method in paroxysmal AF, and even in some cases with persistent AF.

Bachground: Women's sexual well-being has been the center of attention in the field of sexology. Study of sexual behavior and investigating its predictors are important for women's health promotion. This study aimed to explore the components of women's sexual behaviors and their possible associations with demographic variables., Materials and Methods: This study was a cross-sectional study (descriptive and analytic) that was conducted in Kashan city, Iran. A National Sexual Behavior Assessment Questionnaire was completed by 500 women of 15 to 49 who referred to the public health centers. To analyze the data, R software was used, ANOVA or Kruskal-Wallis (for parametric or nonparametric data, respectively) were used to compare outcomes among different groups. In order to evaluate the correlation between the subscales, the Pearson correlation coefficient was used., Results: From all participants, 31.8% obtained high scores in the sexual capacity, 21.2% had high scores in sexual motivation and 0.2% had high scores in sexual function. In sexual script component, 86.2% of women who held traditional beliefs toward sexual behaviors; the majority (91.5%) of women believed in mutual and relational sexuality, 83.4% believed in androcentricity (male-dominated sexuality). Pearson correlation test showed a significant positive correlation between sexual capacity, motivation, function and sexual script. Linear Regression model showed that sexual capacity is associated with women's education and age of her spouse. Sexual function and sexual motivation were significantly associated with the age of subjects' spouses., Conclusion: In this study, subjects had low scores in sexual performance while higher scores were achieved in sexual capacity and motivation. This discrepancy can be attributed to the role of sexual scripts dominating the participants' sexual interactions in this study. We suggest gender-specific and culturally-sensitive education should become a part of women's health programs in Iran., Competing Interests: The authors declare no conflicts of interest., (Copyright© by Royan Institute. All rights reserved.)

Objective: To determine the effects of a prenatal breastfeeding self-efficacy intervention on breastfeeding self-efficacy and breastfeeding outcomes., Design: Randomized controlled trial., Setting: Four health centers in Ahvaz, Iran., Participants: A total of 120 low-risk, nulliparous women between 35 and 37 weeks gestation who intended to breastfeed their singleton infants., Methods: Women were randomly assigned to receive the breastfeeding self-efficacy intervention (n = 60) or standard care (n = 60). The intervention was multifaceted and included two prenatal group sessions, an information package with breastfeeding images, and text messages until 8 weeks postpartum to promote exclusive breastfeeding. The primary outcome was breastfeeding self-efficacy measured with the Breastfeeding Self-Efficacy Scale-Short Form, translated into Persian, at 8 weeks postpartum. Additional outcomes included rates of breastfeeding exclusivity, duration, practices, satisfaction, and problems., Results: At 8 weeks postpartum, participants in the intervention group had significantly higher mean Breastfeeding Self-Efficacy Scale-Short Form scores and rates of exclusive breastfeeding than those in the control group. No significant group differences were found with regard to breastfeeding duration., Conclusion: Emerging evidence supports the use of breastfeeding self-efficacy interventions to improve breastfeeding self-efficacy and rates of exclusive breastfeeding. Further evaluation of this prenatal intervention is warranted., (Copyright © 2018 AWHONN, the Association of Women's Health, Obstetric and Neonatal Nurses. Published by Elsevier Inc. All rights reserved.)

Background: Delivery of sexual health services rely on rigorous facts extracted from surveys, but often those facts cannot be available due to the lack of culturally-sensitive questionnaires., Objective: our aim was to show the validity and reliability of the Persian version of the Acquisition of Sexual Information Test (ASIT), a measure selected due to its assemblages with Iranian culture., Materials and Methods: Forward-backward procedure was applied to translate the questionnaire. Cross-sectional study was carried out and psychometric properties of the Iranian version were tested in a thirty sample of reproductive-age women. Face validity was assessed by qualitative and quantitative methods. Content validity was also assessed by calculating two quantitative indicators as content validity index (CVI) and content validity ratio (CVR). Reliability was assessed by test-retest analyses., Results: Impact score was 1.5, the majority of participants (83.3%) stated that the overall level of questionnaire was high but some of the questions were irrelevant to sexual knowledge. Many questions (90%) gained a CVR less than 0.56, and all of them gained CVIs lower than 0.7. Correlation in test-retest reliability was 0.85., Conclusion: sexual knowledge questionnaire seems to be culturally inappropriate for Iranian women. Although, we need survey data for assessing the evidence-based needs for sexual health and best practice, but the questions addressing various dimensions of sexuality must be culturally sensitive, comprehensive and appropriate. Our findings suggest that ASIT as a well-known measure should be used in Iranian population with caution., Competing Interests: Authors declare that they have no competing interests.

Background: There are currently ten intravenous enzyme replacement therapy (ERT) products available for the treatment of eight different lysosomal diseases (LD) in the USA. Additional ERT products are in clinical trials. The most common ERT adverse events are infusion reactions (IR). While IR are often defined as hypersensitivity or anaphylactoid reactions occurring concurrently with (i.e., during) infusion administration (CIR), there exists the potential for delayed infusion reactions (DIR), which present after completion of infusion administration., Hypothesis: Concurrent infusion reactions (CIR) are not the only infusion reactions associated with enzyme therapy., Methods: This study evaluated the occurrence of infusion reactions in 46 patients with LD who had received ERT for a minimum of 2 years. Infusion reactions were evaluated according to symptoms, time of onset, and duration of reactions. The frequency of infusion reactions with each ERT product was compared to that reported in the FDA-approved product package insert., Results and Conclusions: In this study, DIR were observed and occurred as often as CIR in the study population, despite not being characterized or reported in most ERT product package inserts. Effective methods for managing DIR and CIR differed, thus emphasizing the importance of monitoring for both types of infusion reactions in order to optimize outcomes for patients using ERT.