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Abstract The present study sought to examine the association between depression and anxiety with health-related quality of life (HRQoL) among clinical and non-clinical medical students. This study was conducted on newly entrance students (2019 and 2020) in Neyshabur University of Medical Science (NUMS). 471 students participated in this cross-sectional study. The Beck Depression (BDI-II), Anxiety Inventory (BAI), and SF-12 questionnaires were used. To assess the correlation between depression, anxiety, and HRQoL, the Pearson correlation was used. The independent t-test was performed to evaluate the association among different variables with HRQoL. Further, a multiple linear regression model was used to control the confounding effects of the covariates. The mean age of the study population was 21.9 (SD = 6.1), majority of them were female (62.4%). More than 21% and about 32% of students had mild to severe levels of depression and anxiety, respectively. According to correlation analysis (Pearson’s r), the correlations between depression, anxiety, and total HRQoL were relatively strong and negative. The multiple linear regression model revealed a statistically significant association between depression and anxiety with different subscales, components, and total HRQoL (p

Abstract Parenchymal distribution of nebulized drug in healthy and diseased lungs has not, as evident from a literature review, been well characterized. We use a vibrating mesh nebulizer to deliver fluorescein solution in vivo to healthy or intratracheal‐lipopolysaccharide (LPS)‐instilled anesthetized rats in dorsal recumbency, or ex vivo to the lungs of LPS‐instilled rats. Following in vivo nebulization (healthy/LPS‐instilled), we quantify fluorescein intensity distribution by confocal microscopy in standard locations on the surface of freshly isolated lungs. Following LPS instillation (in vivo/ex vivo nebulization), we quantify fluorescein intensity in visibly injured locations. In standard locations, there is uniform, low‐intensity basal fluorescein deposition. Focal regions receive high deposition that is, in upper (cranial), middle, and lower (caudal) locations, 6.4 ± 4.9, 3.3 ± 3.0, and 2.3 ± 2.8 times greater, respectively, than average basal intensity. Following LPS instillation, deposition in moderately injured regions can be high or low; deposition in severely injured regions is low. Further, actively phagocytic cells are observed in healthy and LPS‐instilled lungs. And LPS particularly impairs mechanics and activates phagocytic cells in the male sex. We conclude that a low level of nebulized drug can be distributed across the parenchyma excepting to severely injured regions.

Background and Objective As the quantity of sleep can influence our mental health, this study examined the association of sleep duration with depression and anxiety in freshman students of Neyshabur University of Medical Sciences (NUMS). Methods This study was conducted on 471 freshman students who enrolled at NUMS in the academic years of 2019 and 2020. Data collection and evaluation of sleep duration, depression, and anxiety were done using the Persian versions of the Pittsburgh Sleep Quality Index, Beck Depression Inventory-II, and Beck Anxiety Inventory. The association between sleep duration with depression and anxiety was analyzed using the multinomial logistic regression models. Results The prevalence of inadequate and excessive sleep duration in the participants was 41.8% and 6.4%, respectively. More than 20% of the students reported depression (mild = 10.2%, moderate = 7.0%, and severe = 4.2%), and approximately one-third reported anxiety (mild = 20.6%, moderate = 7.9%, and severe = 3.4%). The analytical results showed that the odds of moderate and severe depression in individuals with inadequate sleep were three times higher compared to the individuals with adequate sleep (p < 0.05). Further, the odds of moderate anxiety in individuals with inadequate sleep was relatively three times higher compared to individuals with adequate sleep (p < 0.05). Conclusions Inadequate sleep predisposes students to mental disorders such as depression and anxiety. Therefore, policymakers and educators should develop psychological interventions to prevent anxiety and depression in students and help students live a healthy lifestyle such as improving sleep.

Background: The risk of pregnancy-associated complications is considerably elevated in transplant recipients compared to the general population, and it should be managed aggressively to preserve the allograft function and avoid complications. In the present case report, we described a 24-year-old woman with a transplanted heart and kidney who got pregnant after 6 years. Case presentation: A 24-year-old female who was diagnosed with congenital dilated cardiomyopathy and end-stage renal disease due to reflux nephropathy underwent combined heart and kidney transplantation. In her follow-up, she experienced pregnancy after 6 years. Afterward, a multidisciplinary team of different specialists monitored the pregnancy. After 40 weeks of pregnancy, a cesarean section was performed with obtaining a live female sex newborn with a weight of 2450 g, height of 50 cm, and Apgar score of 9, without any congenital malformations. In the follow-up, after 5 years, normal growth and development without any malformations and congenital disorders were observed. Conclusion: The successful outcome of pregnancy in this woman could be due to the proper cooperation between the medical team and patient, and also the appropriate timing of pregnancy.

Introduction: Today, tourism is one of the leading sectors in the global economy and includes a huge source of income, job creation, cultural exchanges, etc. On the other hand; Tourism managers believe; Human resources and its management is an effective factor in success, therefore; The city of Kerman, having a vast historical background, is now one of the effective bases of the discourse of Islamic resistance and the burial place of General Martyr Soleimani; It can accommodate historical-religious tourists.Data and Method: The method of this research is descriptive-survey of correlation type. In the qualitative part, the cultural dimensions of the discourse of Islamic resistance are known using the exploratory approach. The statistical population includes all managers, employees and tourism activists of Kerman city, which due to the high volume of the population using Cochran's formula and at the error level of 5. The number of statistical sample is estimated to be 384 people. SPSS software was used in the descriptive statistics section and PLS software was used for confirmatory factor analysis so that the data could be properly analyzed. MAXQDA software has also been used to achieve the cultural dimensions of the Islamic resistance discourse.Results: The cultural dimensions of the discourse of Islamic resistance include; Idealism, professional ethics, humility and respect, service, field management, national identity and realism. also; Dimensions of sustainable human resource management include; Health promotion, education, self-responsibility, stakeholder perspective, performance management, competitive advantage and innovation.Conclusion: There is a positive and significant relationship between the cultural aspects of the discourse of Islamic resistance and sustainable human resource management in the field of religious tourism, therefore; It is suggested that tourism managers use the obtained concepts to introduce Kerman as a world city of resistance and an exemplary model in religious tourism.

There have been very rare reports on the migration of foreign bodies that are left or implanted in the body, and so far, they have only been reported in the gastrointestinal tract and intestines (a process similar to phagocytosis), later manifesting as an obstruction in the lumen. Meanwhile, no such cases have yet been reported in the cardiovascular system.The case reported here is a 14-month-old girl who had undergone pulmonary artery banding (PA band made of PTFE) around the pulmonary artery at the age of 8 months due to severe pulmonary hypertension and failure to thrive. She underwent reoperation six months later for a final treatment. It was discovered that the PA band was no longer around the pulmonary artery and had migrated completely into the pulmonary artery while remaining intact and circular and was drawn into the pulmonary artery in a process similar to phagocytosis. The PA band was removed completely. The uneven surface inside the main pulmonary artery was resected and the artery was repaired end-to-end. A total heart repair surgery was again performed on the patient. No problem was observed in the 2.5-year follow-up after the second surgery.Overall, the authors’ case is the first instance of migration of a biologically-neutral foreign body into the cardiovascular system that had occurred six months after the PA-band implantation, and the first case of erosion of a foreign body into the lumen outside the gastrointestinal tract. Although the authors could not find the cause of the presented case, reports on future cases can help find the underlying reason There have been very rare reports on the migration of foreign bodies that are left or implanted in the body, and so far, they have only been reported in the gastrointestinal tract and intestines (a process similar to phagocytosis), later manifesting as an obstruction in the lumen. Meanwhile, no such cases have yet been reported in the cardiovascular system.The case reported here is a 14-month-old girl who had undergone pulmonary artery banding (PA band made of PTFE) around the pulmonary artery at the age of 8 months due to severe pulmonary hypertension and failure to thrive. She underwent reoperation six months later for a final treatment. It was discovered that the PA band was no longer around the pulmonary artery and had migrated completely into the pulmonary artery while remaining intact and circular and was drawn into the pulmonary artery in a process similar to phagocytosis. The PA band was removed completely. The uneven surface inside the main pulmonary artery was resected and the artery was repaired end-to-end. A total heart repair surgery was again performed on the patient. No problem was observed in the 2.5-year follow-up after the second surgery.Overall, the authors’ case is the first instance of migration of a biologically-neutral foreign body into the cardiovascular system that had occurred six months after the PA-band implantation, and the first case of erosion of a foreign body into the lumen outside the gastrointestinal tract. Although the authors could not find the cause of the presented case, reports on future cases can help find the underlying reason

Allah SWT has established permissible and prohibited matters in Islam, including the consumption of food and beverages. Muslim consumers must carefully select and choose the products they consume based on the Halal (permissible) and Haram (prohibited) guidelines outlined in the Quran and Hadith. Thus, it is crucial to comprehend the Islamic legal perspective on consumer choices regarding food and beverages without Halal certification. This study employs the library research method, utilizing secondary legal sources such as books, journals, scholarly works, and others to gather relevant data. The research involves reading, examining, and analyzing pertinent literature to provide a deeper understanding of the Islamic legal foundations concerning the consumption of food and beverages lacking Halal certification. Additionally, it depicts the differences of opinions among scholars and their implications for Muslim consumers. The research also offers insights into the role of Halal certification institutions and alternative solutions to assist consumers in selecting Halal food and beverages. The primary sources of Islamic law are the Quran and the Sunnah of Prophet Muhammad, with the utilization of ijtihad by scholars to address matters indirectly regulated by these sources. [Dalam Islam, Allah SWT telah menetapkan hal-hal yang dilarang dan diperbolehkan, termasuk dalam mengkonsumsi makanan dan minuman. Konsumen muslim perlu memilih dengan bijak produk yang akan mereka konsumsi, mengingat adanya aturan tentang halal dan haram yang telah tercantum dalam Al-Quran dan Hadis. Oleh karena itu, pemahaman terhadap perspektif hukum Islam terhadap pilihan konsumen dalam memilih makanan dan minuman yang tidak memiliki sertifikat halal sangat penting. Penelitian ini menggunakan metode library research dengan menggunakan sumber sekunder seperti buku, jurnal, dan karya ilmiah yang berkaitan dengan topik penelitian. Dalam penelitian ini, penulis membaca, menelaah, dan menganalisis bahan pustaka yang relevan terhadap masalah yang diteliti. Tujuannya adalah memberikan pemahaman yang lebih mendalam tentang landasan hukum Islam terkait konsumsi makanan dan minuman tanpa sertifikat halal, serta menggambarkan perbedaan pendapat di antara ulama dan implikasinya bagi konsumen muslim. Selain itu, penelitian ini juga memberikan wawasan tentang peran lembaga sertifikasi halal dan alternatif solusi dalam membantu konsumen dalam memilih makanan dan minuman yang halal. Sumber utama hukum Islam adalah Al-Qur’an dan Sunnah Nabi Muhammad, dengan pengggunaan ijitihad (penafsiran) oleh ulama untuk memecahkan masalah yang secara tidak langsung diatur oleh sumber-sumber tersebut. Konsep halal dan haram memiliki signifikasi penting dalam Islam.]

Background and Purpose: Considering the possible role of fungal sensitization in the treatment of resistant asthma, which may lead to the remodeling of bronchial structure, we theorized that itraconazole could result in better control of asthma. In this regard, this study aimed to compare the effects of itraconazole and prednisolone (routinely prescribed) on clinical, structural, and biomarker findings of the remodeling of asthma.Materials and Methods: This double-blind controlled randomized clinical trial was performed on 70 adult patients suffering from severe persistent asthma. The intervention group received 200 mg of itraconazole per day, and the control group received 10 mg of prednisolone per day, for 32 weeks, in addition to the classic treatment of asthma. The subjects were randomly divided into two groups, and assigned by sealed envelope. Blinding was performed by repacking the drug in a similar container. Primary outcomes were asthma control test score, fibroblast growth factor 2, and wall area percentage on RB1 bronchus measured by computed tomography. The outcomes were compared in subjects classified as allergic, eosinophilic, T2 low asthma, and four types of inflammatory cell classification in sputum.Results: Seventy subjects finished the 32-week trial (35 subjects in each group). Baseline data did not show significant differences between groups. A comparison of asthma variants showed significantly more severe cough and dyspnea in the allergic variant and higher spirometry results in T2-low asthma. Sputum cytology revealed a mixed pattern as the most frequent type (47%). After the trial, two groups improved in many parameters; however, FGF-2 improved more significantly by itraconazole (4.66±16.92 decreased to 1.14±2.98), and FEV1/FVC was significantly higher in the itraconazole group,compared to the control group. These results did not change in terms of asthma variants and sputum classification.Conclusion: Itraconazole was superior to prednisolone in the treatment of many clinical and spirometry aspects in severe persistent asthma.

Background. The SUMO fusion system is advantageous in improving the solubility and correct folding of proteins that are difficult to produce. SUMO-protease-1 (Ulp1) is a key enzyme in this system, and its proper expression and purification in Escherichia coli BL21 (DE3) are critical to its efficiency. Objective. To optimize Ulp1 expression and purification using His6-SUMO-SDF-1 as a model, aiming to improve efficiency across similar fusion proteins. Methods. We provided a codon-optimized Ulp1 gene into the pET28a vector. Essential culture factors, including IPTG concentration, incubation length of time, and temperature, were precisely adjusted. Ulp1 was purified using Ni-NTA affinity chromatography. A cleavage activity assay of recombinant Ulp1 is carried out using the His6-SUMO-SDF-1 fusion protein to demonstrate how well the optimized settings work. Furthermore, the activity of recombinant SDF-1 was evaluated using the scratch wound healing assay. Results. Ulp1 expression was optimized in E. coli using the pET28a vector, with optimum conditions including 0.1 mM IPTG, 28°C incubation temperature, and an overnight period of time. Recombinant Ulp1 was purified using Ni-NTA affinity chromatography, resulting in high purity. Enzymatic activity was shown by the effective cleavage of the His6-SUMO-SDF-1 fusion protein. In the scratch wound-healing assay, recombinant SDF-1 increased cell migration following cleavage, confirming that biological activity was retained. These findings illustrate Ulp1’s efficient synthesis and effectiveness for prospective applications in biology. Conclusion. This study successfully showed the expression and purification of the recombinant Ulp1 enzyme, showing the most suitable growing conditions for productive protein production. Ulp1’s functionality was validated by its specific cleavage of the His6-SUMO-SDF-1 fusion protein, as well as the fragmented SDF-1 purified and its biological activity in promoting cell migration. These findings highlight Ulp1’s potential in protein processing as well as its application in biotechnological and biological research.

Background and Aim. As an integral matter at the global level, sleep quality can be pertinent to some factors, namely, depression and anxiety. Considering this critical issue and its effects and consequences, the current cross-sectional study has centralized its aim on assessing the association between depression and anxiety with sleep quality in freshmen students in the context of Neyshabur University of Medical Sciences (NUMS). Methods. A total number of 471 freshmen students (NUMS) participated in the study, pinpointing that the data are collected in 2019 and 2020. In line with measuring depression, anxiety, and sleep quality, the Persian Beck Depression Inventory-II, Beck Anxiety Inventory, and Pittsburgh Sleep Quality Index were employed. The associations between depression and anxiety with sleep quality were assessed by using the multiple logistic regression model. All statistical analyses were conducted in STATA14, and the significant level was set at P

Today, one of the most common methods used in the emergency room or intensive care unit (ICU) in patients is the Seldinger technique to access the central venous system, shunting for hemodialysis, intra-aortic balloon pump, or arterial insertion. Accidental leaving of the guide wire is an uncommon but important complication that can occur as a result of an incorrect technique, and it is sometimes found accidentally or due to complications years after the procedure. The case is a 53-year-old patient who underwent aortic valve replacement with a mechanical valve and mitral valve repair with a ring 12 years ago and was treated with warfarin. Two years after the heart surgery, due to chronic renal failure, the patient underwent dialysis, and after the preparation of an arteriovenous fistula, he underwent stenting. After approximately ten years, the patient developed fever, chills, and shortness of breath. During the examination, endocarditis was diagnosed, and a part of the aortic valve was released. There was a severe paravalvular leak in the aortic valve, and an abscess was formed in the aorta root. We also noticed a forgotten guide wire in the superior vena cava, right atrium, inferior vena cava, and hepatic vein, and echogenic masses were located on the guidewire. The diagnosis was confirmed by echocardiography, chest x-ray, and phenocopy. After antibiotic therapy, the patients underwent heart surgery, aortic valve replacement, and aortic root repair, and the guidewire was removed (70 cm long). Unfortunately, despite all measures, the patient died a few days after the surgery. Due to complications, a forgotten guidewire should be removed immediately after diagnosis. The preferred intervention is the removal of the guidewire by endovascular interventions, but surgical treatment should also be considered in some cases.

Background and Objective Sleep duration and quality are important factors for health-related quality of life (HRQoL). This study aimed at investigating the association of sleep duration and quality with HRQoL in fresher students of Neyshabur University of Medical Sciences. Methods The study included 471 fresher students. The sleep duration and sleep quality were measured with the Persian version of Pittsburgh Sleep Quality Index (PSQI) and the HRQoL was evaluated with the Persian version of the 12-Item Short Form Survey (SF-12). The data were collected from late September to early October in 2019 and 2020. The multiple linear regression model was used to determine the independent association of sleep duration and quality with HRQoL. A p-value ≤ 0.05 was considered statistically significant. Results The mean age of the participants was 21.8 ± 6.0 years and the majority of them (62.4%) were female. The total HRQoL score and the prevalence of poor sleep quality were 81.6% and 28.0%, respectively. Among the students, 51.8% and 6.4% reported a sleep duration shorter than 7 hours and equal or more than 9 hours, respectively. The multiple linear regression model showed that excessive sleep duration (≥ 9 h) and sleep quality were associated with Mental Component Summary (MCS) and total HRQoL, respectively (p = 0.036, p = 0.018). Conclusions Referring to the results, enough and quality sleep has beneficial effects on HRQoL in students. Therefore, future strategies should be developed to improve sleep and consequently HRQoL among university students.

Key clinical massage A 23‐year‐old rancher was admitted with the diagnosis of brucellosis. In evaluations, a massive vegetation in the aortic valve was seen. A combination of antibiotic therapy and cardiac surgery were performed, it seems this approach reduces mortality and complications. Abstract Brucellosis (also known as “undulant fever,” “Mediterranean fever,” or “Malta fever”) is a zoonotic infection transmitted to humans from infected animals (cattle, sheep, goats, camels, pigs, or other animals) by ingestion of food products (such as unpasteurized dairy products) or by contact with tissue or fluids. It is the most frequent zoonosis globally and a major public health issue in many resource‐poor nations. Endocarditis is one of the rarest and most dangerous consequences of brucellosis. Additionally, the combination of endocarditis with cardiomyopathy increases its rarity. This condition is usually treated with a high level of suspicion Serological, clinical, and epidemiological data can all be used to make a diagnosis. The use of echocardiography aids in the early diagnosis. Due to the high risk of recurrence and the extent of tissue destruction brought on by Brucella, the majority of experts advise an early surgical intervention; nevertheless, other writers assert that low‐risk patients also require cautious therapy. In this article, we discuss the situation of a patient who underwent surgery and had Brucella endocarditis and heart failure. In conclusion, a combination of antibiotic therapy and cardiac surgery, reduces mortality and complications associated with Brucella endocarditis and improves patient quality of life.

This research is focused on assessing how the incorporation of Padlet technology affects the evaluation of historical thinking skills in high school history education. The research methodology involved a pretest-posttest approach with a randomly selected group of 70 students. The research tool employed questionnaires aligned with the study's objectives. Data analysis utilized comparative statistics, specifically the paired sample t-test. The outcomes of the study reveal a significant positive impact resulting from the integration of Padlet technology in assessing historical thinking skills. This is substantiated by the sign value being less than 0.05 for all aspects examined. Consequently, this research provides compelling evidence that this approach can serve as an effective alternative for improving the quality of history education at the high school level. The findings of this study have important implications for educators, learners, and other stakeholders. These results may be used by educators to create more successful teaching strategies that will improve their students' historical thinking and comprehension. As a personal learning tool, Padlet technology can help students comprehend the historical subjects they are studying better. For those involved, this study offers compelling proof that using Padlet technology in high school history curricula may improve its caliber.

Introduction: Healthcare as an industry has unique requirements such as patient security and privacy, interoperability, sharing, transmission, and access control of patient data. On the other hand, the advantages of blockchain technology and the compliance of these advantages with the requirements of the health industry have encouraged researchers to investigate the methods of applying blockchain in healthcare. The rapid increase in blockchain and health research has created many applications. Despite the high potential of this technology for health applications, there are still challenges to be reviewed. In this article, we provide a narrative overview of blockchain applications and challenges in the healthcare industry. Method: In this narrative review, published studies until October 2022 that were accessible in PubMed, IEEE Xplore, Web of Science, and Scopus databases were searched; from 254 related studies, 171 were identified by their titles, and finally, after applying inclusion and exclusion criteria, 30 articles were selected to be reviewed. Results: The results showed that 10 applications of blockchain technology in healthcare are as follows: safe sharing of health data, establishing electronic medical records, medical record tracking, opioid prescription tracking, deep learning, drug supply chain, clinical trials, COVID-19 pandemic management, and remote patient monitoring. The application of blockchain technology in healthcare also has challenges such as interoperability, security and privacy, immutability, scalability, patient engagement, transparency, and confidentiality. Conclusion: The compatibility between the requirements of the health industry and the characteristics of the blockchain has created a suitable platform for the use of this technology in the health industry. However, there are challenges in the path of these applications that must be solved.

Background: Bladder cancer is the sixth most common cancer in men and the tenth most common cancer in women. The role of viral infections in the development of urinary bladder cancer has been discussed a lot in recent years. The role of Epstein-Barr Virus (EBV) as a cocarcinogen has been proven in some human cancers. Therefore, the aim of this research is the molecular investigation of EBV in bladder masses in Bushehr province. Materials and Methods: The current research is a descriptive-analytical study. The study population includes bladder tissue biopsies of people diagnosed with bladder cancer referred to Persian Gulf Martyrs Hospital in Bushehr. The paraffin-embedded bladder biopsy tissue of 181 patients with bladder cancer with an average age of 64.52±13.78 as well as 30 non-cancerous bladder tissue samples as the control group were examined for molecular tests after deparaffinization and nucleic acid purification. In order to ensure the absence of PCR inhibitors, human beta globin gene was first detected as an internal control, and then the BKRF1 gene of EBV was detected by nested PCR method. Finally, SPSS software version 26 was used to analyze the data and perform statistical tests. Results: Out of 181 bladder carcinoma samples, 7 cases (3.9%) were infected with EBV, but no statistically significant relationship was found for age, sex, and stage and grade of tumor with EBV positive samples (P>0.05). In addition, EBV was not detected in any of the non-cancerous control samples; however, the difference in the prevalence of EBV between the bladder cancer patients' group and the control group was not statistically significant (P=0.33). In addition, the sequencing of the nested PCR products of the BKRF1 gene and the phylogenetic analysis indicate the presence of EBV type 1 in the positive samples. Conclusion: Based on the findings of the present study and despite the fact that the percentage of EBV infection in cancerous samples was higher than in non-cancerous samples, it is unlikely that EBV is an effective factor in causing bladder cancer in Bushehr province, and other risk factors are probably involved in the etiology of bladder tumors in our study population, such as increasing air pollution in this region of the country, high-risk occupations, smoking, and other carcinogenic viral factors.

Introduction: Suicide is known as one of the main causes of death. Identifying its antecedents is important. Therefore, this study aimed to investigate the relationship between lifestyle, emotion regulation, and negative perfectionism with suicidal ideation. Materials and Methods: The statistical population of the present study consisted of all the married women of Bushehr, Iran. A total of 100 participants were selected through the convenient sampling method. The research instruments included the Miller-Smith Lifestyle Assessment Inventory (LSI), the Cognitive Emotion Regulation Questionnaire (CERQ), the Positive and Negative Perfectionism Scale, and the Beck Scale for Suicide Ideation (BSI). Data analyzed by the descriptive statistics, Pearson correlation coefficient, and SPSS software. Results: Based on the findings, the independent variables could predict 41% of the variance of suicidal ideation (P< 0.05). Also, negative perfectionism, lifestyle, and emotion regulation can predict suicidal ideation (P< 0.05). Among the independent variables, the adaptive emotion regulation has the most impact. Negative perfectionism is also in the next order, and for every unit added to its standard deviation, suicide tendency is increased by 0.267 standard deviations (P< 0.05). Conclusion: According to the findings, lifestyle, emotion regulation, and negative perfectionism can predict suicide ideation in women. So, healthy lifestyles trainings, adaptive emotion regulation strategies, and reducing negative perfectionism can reduce suicide attempts among women.

BACKGROUND: There is still a controversy about the best method for preoperative skin preparation (skin cleaning).The main antiseptic solution used in the cardiac surgery room is Povidone Iodine (PI), which is used to prepare the area to be operated on.This study aimed to determine the urinary iodine level in children (newborns, infants, and toddlers) undergoing (open and closed) heart surgery, in whom preoperative skin preparation was performed using PI solution.Methods: This study was conducted over eight years on a total of 212 children who underwent cardiac surgery. A form was developed for each patient in which all their details, condition, and type of surgery were recorded. A urine sample was taken after the patients were anesthetized and before they were painted with PI through the urinary catheter that had to be attached to them for the cardiac surgery. The patients were then prepped with PI and draped and the surgery was performed. Afterwards, the second and third urine samples were taken 24 and 48 hours after the surgery from the urine collection bag. The samples were transferred to polyethylene tubes with screw caps in a cold box at -20 °C and sent to the iodine reference laboratory of the Endocrinology Research Center of Shahid Beheshti University. The samples were measured using the kinetic colorimetric reaction proposed by Sandell and Kolthoff after the acid digestion of urine.Results: total of 212 patients (newborns, infants, toddlers) who underwent (open and closed) cardiac surgery entered the study, including 104 (49.1%) males and 108 (50.9%) females. The patients ranged in age from 1 day to 14 years (mean = 168 months).The urinary iodine level was 40.6±21.9 μgr/dl in the first stage (pre-surgery),204.1±92.5 μgr/dl in the second stage (24 hours’ post-surgery), and 130.3±56.2μgr/dl in the third stage (48 hours’ post-surgery).Discussion: Urinary iodine levels increased dramatically after PI use, and the second-stage urinary iodine changes (24 hours’ post-surgery) were in the excessive range according to the WHO classification, and they decreased gradually over the next 24 hours, but did not reach normal levels until 48 hours’ post-surgery. The difference between the samples was significant (P

AbstractIn Ayyari Persian short stories, women have a prominent, vivid, pivotal, and influential role and presence. It is reflected in various ways and forms in these texts. Ayyari discourse in the history of Iran has always been formed in opposition to the existing dominant order, seeking rights and equality, and eliminating authoritarianism, discrimination, and oppression. Ayyar women in Ayyari's stories represent the same discourse and, in a way, represent Ayyari's subculture in the face of an oppressive and immoral male-dominated system. This research has been done with a qualitative approach. It uses content analysis method. First, the stories of Ayyari women are collected, then the way of thinking of women in the face of all kinds of oppression and tyranny of men, especially in the field of gender discrimination, are counted, analyzed, and explained. According to the research findings, the highest frequency of these tricks is dedicated to humiliation, deception, disguise, use of anesthesia, and secret escape. Most of the tricks used by women are reactionary, that is they are responses from women to male sexual diversity, injustice, inequality, oppression, coercion, authoritarianism, and the exercise of power in a patriarchal society. It is in this context that women find opportunity for "masculinity."

IntroductionPrevalence of congenital heart disease (CHD) has increased in recent years, and patients with CHD have to deal with sequelae of the multiple medical and surgical treatments that can affect different aspects of their life which could be reflected in their quality of life (QoL). In Iran, to the best of our knowledge, QoL of adult patients with CHD has not been investigated, so this study aimed to investigate the QoL of adult patients with CHD referred to two Iranian outpatient settings.MethodsIn 2022, a double center, cross-sectional study was performed on adult patients with CHD receiving out-patient care at Besat Clinic in Kerman, Iran, and Clinic of Shahid Rajaee Hospital in Tehran, Iran. Inclusion criteria were documented diagnosis of CHD based on guidelines, ejection fraction of above 45% and age of 18–55 years. We recruited a sample of 120 individuals using a simple random sampling method. At the day of referring to the adult congenital heart diseases clinic, after ensuring their written consent to participate in the study, we asked patients to fill in two questionnaires of demographic questionnaire and Persian version of the Ferrans and Powers Quality of Life Index. Data were analyzed using descriptive statistics and chi square via SPSS-22.ResultsA total of 101 patients with a mean age of 31.05 years participated in the study. Demographic and socio-economic factors had no significant relationship with the patients’ QoL. But factors related to the disease were significantly different among QoL groups (P-value > 0.05).DiscussionAdults with CHD had a low QoL, which is not related to their demographic and socio-economic factors. That is, the existence of the disease alone and its accompanying complications can affect the QoL of these people. Hence, the mental health of adult patients with CHD should be monitored during their routine cardiac care.

Obesity incidence in children, especially primary school children, is increasing. This obesity can be caused by environmental factors: availability of food at home and the home environment or home environment such as the physical environment, exposure to screen time, mother knowledge, and maternal behaviour in providing feeding practices. This study aims to determine the difference between food availability and home environment for obese and non-obese children. The design of this research was case-control conducted with the subject of elementary school-age children in Yogyakarta city. The research was conducted in March-November 2017. Samples were chosen by the multistage sampling method. Subjects were grouped into children with obese nutritional status as a case (n=71) and children with normal nutritional status as control (n=71) based on the BFA index. The data were collected by anthropometric measurements, interviewing, and filling out Home Environment Survey questionnaires on children and their parents. Data analysis using Mann Whitney statistical test, Spearman test, McNemar test, and logistic regression. Food availability showed significant mean differences in case and control groups (p

Introduction: One of the weaknesses associated with buying non-textbooks in the field of children is that parents do not trust their contents. At the same time, ethical measures and ethical marketing in book sales companies, and brands active in the field of children's books, including written and illustrated books, can create a suitable culture for Iranian children from an early age by raising the per capita reading rate. In the meantime, because the decision-making power of children in choosing right books is low, the role of parents in choosing books is very important. Therefore, ethical marketing and doing pathology in this field can play important roles in creating a culture of reading at an early age.Objectives: The purpose of this study is to focus on a corrective mechanism in the children’s book market and explain the required immoral actions in this area. Lack of a pathological approach in the field of book marketing can reduce trust in brands in the field of written and illustrated books, and the market share of these brands declines over time due to the inability to provide value to the customer. This also degrades the reading culture in childhood. Thus, the main focus of this research is on the pathology of ethical marketing practices and the presentation of a process model in the field of children's book marketing.Methodology: The present research is developmental-applied in terms of purpose and qualitative in terms of data collection and nature. The study made use of a data-based theory along with the "Strauss and Corbin systematic approach". Therefore, the phenomenon-centrality of ethical marketing in the field of cultural products, especially in the field of non-textbooks for children, causal conditions, contextual conditions, intervening conditions, and finally reaction measures and ethical marketing consequences were studied through the data theory. Open, axial and selective codings were done to analyze the data in this method. In order to collect the data, in-depth semi-structured interviews were conducted with open-ended interviews along with the views of experts in the field of ethical marketing of children's textbooks. The participants were selected through purposive and snowball sampling. Open-ended questions asked about the experts' understanding of ethical marketing, the harms of ethical marketing in the non-textbook publishing industry; the consequences of paying attention to ethical marketing in the non-textbook publishing industry and certain other issues. The statistical population of the study included all the senior managers, consultants, managers and marketing experts in the brands active in the field of compiling and selling children's textbooks as well as university professors. The sampling continued until theoretical adequacy was achieved. In total, 20 interviews were conducted, and no new codes were obtained from 15 to 20 people in the interview process.Results and Discussion: The results suggest the existence of uncertainty in parents' decision-making as a causal condition, ethical marketing as a central phenomenon, contextual conditions including the broad categories of rules and regulations and ethical culture, intervening conditions including vendor personal characteristics and organizational support, strategies in three major categories of ethical branding, vendor ethical responsibility and ethical attachment. The results of this study reinforce the culture of reading and improve sales performance. In this study, in the section on causal conditions, parents' decision uncertainty was raised. In fact, these conditions refer to the creation of the main phenomenon. It seems that one of the major weaknesses and disadvantages in the field of ethical marketing is the inability of parents to make sure about purchasing non-textbooks for children. The main tenet of this research has been ethical marketing.Conclusion: Ethical marketing in this study includes normative and descriptive marketing that seeks to explain the ethical characteristics of marketing. In the normative part, the main focus is to explain the principles. Also, in the field of background conditions, the researcher achieved two major categories of rules and regulations as well as moral culture, which shows weaknesses in the country in these two areas. In fact, these two major categories suggest that organizations are not in a stable and supportive position in terms of specific and precise frameworks so as to achieve ethical marketing. Moreover, regarding the interventionist conditions that can affect the identified strategies, the research points to the individual characteristics of the salesperson and organizational support that can affect ethical marketing programs. The fifth dimension concerned strategies and included ethical branding, vendor ethics, and general ethics. Finally, for the target community and the whole Iranian society, it is important to enhance the sales performance for all brands active in the field of publishing non-textbooks and strengthen the culture of reading books, especially non-textbooks among children.

Background: Ethical marketing strategy based on position analysis, identifies market opportunities and by defining different market segments and identifying the strengths and weaknesses of the organization, enables competition conditions. Designing a marketing strategy is one of the most important tasks of business planning for publishing companies. This study provides a model for designing a mixed ethical marketing strategy in a children's book based on the parents purchase intention. Method: The research is applied in terms of purpose and descriptive-survey in terms of implementation method. The statistical population included the employees of cultural institutions that produce children's books. Sampling was done by simple random sampling and 110 people were selected as the statistical sample. The data collection tool was a mixed marketing ethics questionnaire and finally Friedman test was used to analyze and rank the data. Results: The results finally led to a proposed model for explaining the C4 marketing mix strategy by highlighting the advertising element in line with the marketing strategy and the integration of the specific strategy of each mix. Conclusion: Commitment to ethics in marketing and business creates a kind of trust that is a social and valuable capital and guarantees the long-term success of the relevant enterprises.