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Abstract Background Promoting prevalence of metabolic syndrome (MetS) in Rheumatoid arthritis (RA) patients might occur secondary to RA therapy as well as sedentary life style. However, conflicting observations have been reported on the correlation between MetS and RA. This study aimed to determine the frequency of MetS and association of its components in RA. Methods In this study, 500 RA patients and 500 age- and gender-matched healthy controls were enrolled. MetS was fulfilled through the International Diabetes Federation (IDF) criteria. A multivariate regression model was used to control for variables independently associated with the risk of MetS in RA patients. Results The prevalence of MetS was 58.8% on IDF criteria in RA patients that was higher than controls (20.4%). Higher incidence of cardiovascular disease (CVD), the familial history of CVD, hypertension, type 2 diabetes mellitus (T2DM), smoking, dyslipidemia, and higher levels of body mass index (BMI), waist circumference (WC), total cholesterol level, fasting blood sugar (FBS), triglyceride (TG) level, low-density lipoprotein (LDL) level, while lower levels of high-density lipoprotein (HDL) were associated with an increased risk of MetS in RA patients. Multivariate regression analysis indicated that age, WC, dyslipidemia, LDL, and DAS28 were independent predictors of MetS in the RA patients. Conclusions The prevalence of MetS is higher in RA patients. Our findings suggest an association between cardiovascular risk factors and the increased prevalence of MetS in RA patients.

Introduction: Phytoremediation is a sustainable, cost-effective, and environmentally friendly process that utilizes plants and microorganisms for purification of the polluted land. In this study, the fast-growing species Salix acmophylla from the Salicaceae family was selected for phytoremediation purposes. Materials and Methods: With the aim of exploring the potential of Salix acmophylla in wastewater purification, a research initiative was launched in 2020, Following initial land preparation on a 5-hectare site next to a wastewater treatment plant, 60,000 Salix acmophylla cuttings were planted. By 2022, the trees had matured to a height of 3-4 meters. Wastewater samples were then collected and analyzed for pollutant levels both before entering the planted area and after passing through drainage channels built among the trees. This allowed researchers to calculate the average efficiency of Salix acmophylla in reducing wastewater pollutants. Results: The results regarding the impact of Salix acmophylla trees on the reduction of wastewater Characteristics in the cultivation area were the following: COD, BOD5, TSS, TDS, EC, and turbidity exhibited reductions of 38%, 42%, 17.5%, 79%, 52.2%, and 45.6%, respectively. Additionally, the estimated income from the cultivation of these trees was approximately $49,000. Conclusion: Planting Salix acmophylla trees significantly contributes to the reduction of wastewater pollutant parameters, suggesting the recommendation of this species for similar climates.

Abstract Background The aim of the present study was to investigate the possible connection between occupational status and chronic respiratory diseases (CRDs) among the Iranian population. Methods The present cross-sectional study was conducted on 9934 individuals aged 35–70 years enrolled in the Rafsanjan Cohort Study (RCS), a component of the Prospective Epidemiological Research Studies in Iran (PERSIAN). Detailed questionnaires were used to collect information on various factors, such as occupation, sociodemographic characteristics, medical history, anthropometric measurements, physical activity, cigarette and hookah smoking, opium use, and alcohol consumption. The association between occupational class and CRD was evaluated using logistic regression models for rare events. Results In the present study, 4624 (46.55%) participants were male, and 5310 (53.45%) were female. The prevalence of CRD among all participants was 2.61%. Occupational activities were classified into two categories: In class I, the largest group was the homemaker and unemployment category (41.73%), followed by self-employment (34.39%), employment (13.03%), and retired individuals (10.84%). In class II, there were pistachio farmers (12.61%), copper miners (3.62%), and others in various occupations (83.76%). Subjects with CRD were significantly more likely to be homemakers, unemployed, elderly, female, less educated, and obese. There was no significant relationship between CRD and job type/occupational status after adjusting for some potential confounding variables. Conclusions There was no significant relationship between CRD and job type/occupational status. However, longitudinal studies are needed to assess the impact of job type/occupational status on the risk of CRD.

Abstract Background Interleukin-17 (IL-17) family plays a role in the pathogenesis of knee osteoarthritis (KOA) by contributing to the inflammatory and destructive processes in the affected joint. This study aimed to measure levels of IL-17 A and IL-25 (IL-17E) in serum of KOA patients and determine their roles in the disease severity of patients. Methods In this, 34 patients with KOA and 30 age and sex-matched healthy subjects (HS) were enrolled. Patients were categorized based on their Western Ontario and McMaster Universities Osteoarthritis Index (WOMAC), Visual Analog Scale (VAS), and Body Mass Index (BMI) scores. The enzyme-linked immunosorbent assay (ELISA) technique was employed to measure serum levels of IL-17 A and IL-25. Results Level of IL-25 was significantly higher (P

Managers strive for comprehensive, reliable, and flexible solutions to evaluate their organization's performance. Nonetheless, recognizing practical performance components has always remained relatively unanswered among managers and researchers. Accordingly, the present study aims to identify the elements influencing sustainable performance management processes considering research literature in the contingent field and eventually pinpointing potentially relevant elements. These elements would assist managers, specifically human resource managers, pursue their objectives. Researchers have already identified keywords related to the research topic by employing meta-word analysis and brainstorming methods with the help of Qiqqa software. Afterward, using VOSviewer, they extracted the vocabulary items of the co-occurrence network. This network and the hotspots identified hereafter established a solid foundation for meta-synthesis, taken as a meta-synthesis approach in this study. Then, four contingent keywords, including “sustainable development”, “sustainable development management”, “sustainable performance development”, and “sustainable performance management,” were considered to explore and analyze scholarly global databases such as Emerald, Proquest, SID, and Web of Science, as well as Google Scholar database and the dissertations defended by postgraduate students. Sources initially entering this research included 312 studies in full text, of which 80 were excluded due to lack of inclusion criteria. Eventually, the contents of the remaining 232 articles were surveyed. The number of overarching themes stands at one constructive theme, four primary themes, and seven, and the frequency of extracted codes hit 513. The findings of this research demonstrated that the components of innovation, technology, supply chain, organizational knowledge, economic, social, and environmental factors could cover all aspects of performance evaluation and would introduce a new literature called “Sustainable Performance Management” into the management field. The components of innovation, technology, supply chain, and organizational knowledge fail to be identified except through meta-synthesis and library analysis. This unprecedented aspect of the present study makes it distinguishable from previous studies. Considering this article's findings, managers, researchers, and other related professionals will be able to conceptualize and comprehend performance management issues in an alternative way. Consequently, human resource managers could identify components related to the sustainability of organizational performance management and put them into research and practice.

Abstract Background Inflammasomes are a group of molecules that are strongly involved in causing inflammation. This study aimed to evaluate the expression of NLR family pyrin domain containing 1 (NLRP1), NLRP3, and Apoptosis-associated speck-like protein containing a CARD (ASC) as well as their association with serum level of interleukin (IL)-1β in patients with coronavirus disease 2019 (COVID-19). Methods Thirty COVID-19 patients and 30 healthy subjects (HS) were recruited. Peripheral blood specimens were collected from subjects to assess NLRP1, NLRP3, and ASC gene expression by Real time-PCR technique. Serum levels of IL-1β were also measured via the enzyme-linked immunosorbent assay (ELISA). Results The findings showed no significant differences in serum IL-1β level between COVID-19 patients and the HS group. mRNA expression of ASC (P = 0.008) and NLRP1 (P = 0.03) gene had a significant increase in COVID-19 patients compared to HS, while there was no significant increase in the expression of NLRP3 between the studied group. There were significant correlations between patient’s data and expression levels of NLRP1, NLRP3, IL-1β, and ACS. Conclusions NLRP1 and ASC may have a more critical role in the generation of the active form of IL-1β in COVID-19 patients compared to NLRP3. However, serum levels of IL-1β in patients did not show a significant increase, which may be due to the patient’s condition and the application of virus escape mechanisms through impaired NLRP3 expression and its malfunction.

This study investigates the effect of the filter on the visibility of fringes in single-photon interference. A pair of photons by spontaneous parametric down-conversion is produced using a nonlinear crystal. One of them passes through a Mach-Zehnder interferometer due to the principle of indistinguishability of the paths, which interferes with itself. By changing the length of the paths of the Mach-Zehnder arms with the help of a stage, the interference happens in the coincidence pattern. In order to align the optical elements and minimize the optical path difference in the interferometer arms, interferometry with laser and white light has been used before single photon interferometry. By placing filters with different bandwidths in the signal and idler photons path, we see interference fringes with different visibility. An interference pattern is obtained by recording the coincidence between the correlated photons. The results show that the frequency bandwidth of filters affects the coherence length of generated photons and so the visibility of interference fringes.

Abstract Background Peptidyl arginine deiminase 4 (PADI4) has been implicated in Rheumatoid arthritis (RA) pathogenesis. Here we aimed to evaluate the association of PADI4 gene rs11203367 and rs1748033 single nucleotide polymorphisms (SNPs) with RA proneness. Methods The mRNA expression of PADI4 was determined in the whole blood samples. The genotyping of PADI4 polymorphisms was conducted using allelic discrimination TaqMan genotyping Real-time PCR. Results The alleles and genotypes of rs11203367 polymorphism were not associated with susceptibility to RA risk. The T allele (OR = 1.58, 95%CI: 1.21–2.04, P = 0.0005), TT genotype (OR = 2.79, 95%CI: 1.53–5.06, P = 0.0007), TC genotype (OR = 1.52, 95%CI: 1.04–2.23, P = 0.0291), dominant (OR = 1.72, 95%CI: 1.19–2.47, P = 0.0034) and recessive (OR = 2.19, 95%CI: 1.25–3.82, P = 0.0057) models of rs1748033 SNP were associated with higher risk of RA. There was a significant upregulation of PADI4 mRNA in the RA patients compared to controls. mRNA expression of PADI4 had significantly positive correlation with anti-CCP level (r = 0.37, P = 0.041), RF level (r = 0.39, P = 0.037), and CRP level (r = 0.39, P = 0.024). Conclusion PADI4 gene rs1748033 SNP was associated with increased RA risk. This polymorphism might affect the RA pathogenesis regardless of impressing the levels of PADI-4 in serum.

Abstract Background Components of metabolic syndrome (MetS) was reported to contribute to severe and worse outcomes of coronavirus disease 2019 (COVID-19). Hereby, we evaluated the association of MetS and its components with susceptibility to COVID-19. Methods Here, 1000 subjects with MetS were recruited that were diagnosed via the International Diabetes Federation (IDF) criterion. Real-time PCR was exerted to detect SARS-CoV-2 in the nasopharyngeal swabs. Results Among the MetS patients, 206 (20.6%) cases were detected to have COVID-19. Smoking (OR = 5.04, 95%CI = 3.53–7.21, P

Abstract Background There is limited and conflicting evidence on the association between selenium and non-alcoholic fatty liver disease (NAFLD). Therefore, the present population-based cross-sectional study aimed to explore the relationship between dietary selenium intake and the risk of NAFLD. Methods A total of 3026 subjects from the PERSIAN (Prospective Epidemiological Research Studies in IrAN) Kavar cohort study were included in the analysis. The daily selenium intake was evaluated using a semi-quantitative food frequency questionnaire, and energy-adjusted quintiles of selenium intake (µg/day) were calculated. NAFLD was defined as the fatty liver index (FLI) ≥ 60 or the hepatic steatosis index (HSI) > 36. The association between dietary selenium intake and NAFLD was evaluated using logistic regression analysis. Results The prevalence rates of NAFLD were 56.4% and 51.9%, based on the FLI and HSI markers, respectively. The odds ratios (ORs) for FLI-defined NAFLD were 1.31 (95% confidence interval (CI): 1.01–1.70) and 1.50 (95% CI: 1.13–1.99) for the fourth and fifth quintiles of selenium intake, respectively, after adjustment for sociodemographic variables, smoking status, alcohol drinking, physical activity, and dietary factors (P trend = 0.002). There was also a similar association between selenium intakes and HSI-defined NAFLD (OR = 1.34 (95% CI: 1.03–1.75) for the fourth quintile and OR = 1.50 (95% CI: 1.12–2.01) for the fifth quintile of selenium intake) (P trend = 0.006). Conclusion In this large sample study, we observed a weak positive association between dietary selenium intake and NAFLD risk.

BACKGROUND: Evaluating the experiences and the satisfaction level of the academic members is an important parameter in planning for virtual education during COVID-19 pandemic. The present study was designed to evaluate the satisfaction level of faculty members of Rafsanjan School of Medicine regarding virtual education in COVID-19 crisis in two stages between 2019 and 2022. MATERIAL AND METHODS: This descriptive study was conducted on the faculty members of Rafsanjan Medical School. The satisfaction level with virtual education during the COVID-19 pandemic was determined using a researcher-made questionnaire with appropriate validity and reliability. For analysing of quantitative variables, the Kolmogorov–Smirnov test, independent t tests and one-way analysis of variance and multiple linear regression were used. RESULTS: Data showed that only 15.2% of the faculty members had a previous experience of virtual teaching prior to the pandemic and 30.3% had a history of passing the empowerment course on virtual education before the COVID-19 crisis. Moreover, 68.2% passed the empowerment course on virtual education at the same time as the COVID-19 epidemic spread. The overall satisfaction with virtual education in the first and second stages of the study was 49.05 and 49.22 out of 100, respectively. The satisfaction of NAVID learning management system was 66.66 percent among faculty members. The level of satisfaction in non-clinical members was significantly more than clinical members. CONCLUSION: The overall satisfaction of faculty members with virtual education was at an average or medium level. From the point of view of the faculty members, some aspects of virtual education need to be improved. Therefore, it seems necessary to improve the infrastructure and empower the faculty members to enhance the quality of virtual education.

Background and Objectives: Spiritual well-being is very important in adaptation and peace of mind, especially in certain periods of life. Middle age is associated with many biological, psychological, and social changes and problems such depression and hopelessness. This study aims to investigate the relationship between spiritual well-being, depression, and hope in middle-aged women in Qom, Iran. Methods: This is a descriptive-analytical study with cross-sectional design that was conducted on 100 middle-aged women referred to community health centers in Qom city, who were selected by a convenience sampling method. Data were collected by three questionnaires including Paloutzian and Ellison’s spiritual well-being scale (SWBS), Beck’ depression inventory (BDI), adult hope scale (AHS), which were completed through interview. Data were analyzed in SPSS version 21 software using regression analysis. Results: The Mean±SD total scores of SWBS, BDI, and AHS were 73.43±1.25, 31.10±0.91, and 16.26±0.34, respectively. There was a significant relationship between spiritual well-being and depression and between spiritual health and hope (P≤0.001). Moreover, spiritual well-being and hope had a significant relationship with depression (P≤0.001). Conclusion: Middle-aged women with high spiritual well-being have less depression and more hope. It is recommended to pay more attention to spiritual well-being of these women to maintain their mental health and increase their hope.

Abstract Background As a novel tumor suppressor mediator, activating transcription factor 3 (ATF3) has recently aroused an interest in its possible therapeutic applications in various cancers. In this study, we evaluated the effect of ATF3 overexpression on the cellular level of nuclear factor kappa B (NF-κB) in human papillomavirus (HPV)-infected Ca Ski cells. Further, we examined whether ATF3 could mediate cell cycle arrest and alter the apoptosis level of Ca Ski cells. Methods The biological behavior of Ca Ski cells was evaluated prior and subsequent to the overexpression of ATF3 by MTT assay, fluorescence microscopy, cell cycle and annexin V/PI flow cytometric analysis. The effect of ectopic ATF3 expression on the cellular level of NF-κB in HPV-positive cells was evaluated by western blotting assay. Results The overexpression of ATF3 in Ca Ski cells led to significant apoptosis and cell cycle arrest in the G1 phase. Western blotting assay revealed a discernible reduction of NF-κB p65 level in cervical cancer cells. Conclusion ATF3 acts as a tumor suppressor factor in HPV16-infected Ca Ski cells and exerts anti-cancer effects on HPV16-related cervical cancer cells potentially by hindering cell growth and inducing cell cycle arrest through the down-regulation of NF-κB. Our results suggest that ATF3 induction or NF-κB suppression may be useful targets for HPV16-related cervical cancer prevention and treatment.

Background and aim: The professional ethics of librarianship consist of methods and behaviors that increase client desire for a library. One of the variables that results from professional ethics is social adjustment. The aim of this study was to investigate the relationship between social adjustment and professional ethics of librarians working in the libraries of Tehran Universities of Medical Sciences. Materials and methods: This descriptive survey study was conducted based on correlation method. The statistical population of the study included all librarians working in the libraries of Tehran Universities of Medical Sciences, and 175 persons were selected as a sample using the available sampling method and based on Morgan's table. A social compatibility questionnaire and a professional ethics questionnaire were used to collect data. Data were analyzed using SPSS 22 through one-sample t-tests, independent t-test, ANOVA and regression analysis. Findings: The results showed that there was a positive and significant relationship between social adjustment and professional ethics (Sig

Abstract Background The Quality of Life Enjoyment and Satisfaction Questionnaire-Short Form (Q-LES-Q-SF) is the most frequently used generic quality of life (QOL) measure in many countries and cultures worldwide. However, no single study has been carried out to investigate whether this questionnaire performs similarly across diverse cultures/countries. Accordingly, this study aimed to assess the cross-cultural measurement invariance of the Q-LES-Q-SF across ten different countries. Methods The Q-LES-Q-SF was administrated to a sample of 2822 university students from ten countries: Bangladesh, Brazil, Croatia, India, Nepal, Poland, Serbia, Turkey, the United Arab Emirates, and Vietnam. The Bayesian approximate measurement invariance approach was used to assess the measurement invariance of the Q-LES-Q-SF. Results Approximate measurement invariance did not hold across the countries for the Q-LES-Q-SF, with only two out of 14 items being non-invariant; namely items related to doing household and leisure time activities. Conclusions Our findings did not support the cross-cultural measurement invariance of the Q-LES-Q-SF; thus, considerable caution is warranted when comparing QOL scores across different countries with this measure. Item rewording and adaptation along with calibrating non-invariant items may narrow these differences and help researchers to create an invariant questionnaire for reliable and valid QOL comparisons across different countries.

Abstract Background Retention is an important aspect of orthodontic treatment. This study aimed to analyze the survival of three types of maxillary and mandibular bonded orthodontic retainers. Methods This retrospective cohort study evaluated the records of 118 orthodontic patients (90 females, 28 males, mean age of 22.34 ± 6.44 years) retrieved from a private orthodontic office. Data regarding the retainer failure, dental caries, unwanted tooth movements, maximum pocket depth (PD), and bleeding on probing (BOP) recorded at the follow-up sessions were extracted from patient records. Three types of retainer wires namely Bond-A-Braid, Orthoflex, and Retainium were compared regarding the abovementioned parameters. Data were analyzed by ANOVA, Chi-square, Monte-Carlo Chi-square, and Kruskal Wallis tests, the log rank test, and the Cox regression model. Results The frequency of retainer failure was not significantly different between males and females, different age groups, or different treatment durations (P > 0.05). Wire fracture was the most common failure type in both the maxilla and mandible. Also, the frequency of failure was not significantly different between the maxillary and mandibular retainers (P > 0.05). The frequency of failure, and survival of the three types of retainer wires were not significantly different during a 5-year period (P > 0.05). Conclusions The three types of orthodontic retainers had comparable survival rates. Their failure rate was not correlated with the age or gender of patients or the treatment duration.

Abstract Background The etiopathogenesis of coronavirus disease 2019 (COVID-19) stem partially from the abnormal activation of the innate and adaptive immune systems. Here in the current investigation, the mRNA expression levels of toll-like receptors (TLRs) were evaluated in the nasopharyngeal epithelial cells from COVID-19 patients. Methods Epithelial cells were obtained using nasopharyngeal swab samples from 90 COVID-19 patients and 50 controls. COVID-19 cases were classified into those without symptoms, with symptoms but not hospitalized, and with symptoms and hospitalized. To determine the mRNA expression levels of TLRs, first RNA was extracted and cDNA was synthesized, and finally Real-time PCR was exerted. Results It was seen that the transcript levels of TLR3, TLR7, TLR8, and TLR9 were overexpressed in the COVID-19 patients with clinical symptoms needing hospitalization as well as in those with clinical symptoms without needing for hospitalization compared to controls. Upregulation of TLRs was associated with clinical presentations of the patients. Conclusions Modulation of TLR3, TLR7, TLR8, TLR9 in the epithelial cells of COVID-19 cases may estimate the disease severity and requirement for hospitalization.

Abstract Background This study aimed to assess the effects of digital storytelling on the self-management behavior of adolescents with type 1 diabetes (TID). Methods In this pilot randomized controlled clinical trial, 60 adolescents with TID were randomly allocated into two parallel groups: intervention (training with digital storytelling method, n = 33) or control (training with a conventional method, n = 33). The primary outcome was assessing the Self-Management behavior of adolescents with TID (SMOD-A) at baseline and three months after the intervention. Results The results revealed that digital storytelling could significantly improve self-management behaviors amongst adolescents with TID (P = 0.005). In contrast, in the control group, no significant changes were observed (P > 0.05). Furthermore, the mean score of Collaboration with Parents subscale was significantly higher in the digital storytelling group than in the control group after the intervention (p = 0.022). The results also showed that the level of Collaboration With Parents' subscale scores had a meaningful reverse relationship with the adolescent age after digital storytelling (p = 0.048). Repeated measures ANOVAs showed that there were significant main effects of time and group on collaboration with parents(p = 0.002) and goal subscales (p = 0.035). With respect to HbA1c levels, significant changes were not observed in any of the groups (P > 0.05). Conclusions Digital storytelling is practicable and a potentially beneficial training modality for adolescents with TID. Trial registration This trial was respectively registered. ClinicalTrials.gov Identifier: IRCT20191220045828N1 . Date of registration: Oct 29. 2020.

Background. The crisis caused by the novel coronavirus in 2019 has caused challenges and problems in most organizations and created difficulties for employees who are the most important organizational resource. Accordingly, the purpose of this study was to identify the components of human resources (HR) during the new coronavirus (COVID-19) crisis, based on previous researches in this field. Material. This is a Meta-Synthesis study. Using the 4 keywords of human resources, human resource management, coronavirus, COVID-19, the researchers explored literature databases of Proquest, The Scientific Information Database (SID), Web of Science, Emerald journals as well as Google Scholar, the specialized search engine, in 2019-2021. The number of sources initially found was 1,029, of which 921 articles were rejected because of the title. The total number of screened abstracts was 108, 16 of which we rejected on the basis of the abstracts and 27 of which we rejected in view of content, leaving us with 65 final articles to be reviewed. Three universal themes, three constructive themes, 11 basic themes and 117 codes were extracted. Results. Based on the findings of this study social opportunities and threats are the biggest challenges for human resources. The HR unit should also focus on issues such as virtualization of work and work environment, the degree of external environment support for the organization's employees, how to restructure jobs, health, and psychological challenges, as well as economic and internal challenges. Conclusion. In dealing with the coronavirus, human resource managers should pay special attention to components such as virtualization of work and work environment, support of the external environment for employees of the organization, restructuring of jobs, health and psychological requirements and challenges, whether they be social, economic, or intra-organizational. Extended Abstract Background One of the challenges that the field of management is currently facing, and can cause a crisis in the field of human resource management, if ignored, is the new Corona virus (covid-19). The observations of researchers and human resource managers indicate that since the announcement of the virus worldwide, the overall structure of work has undergone major changes and, consequently, the lifestyle of humans has been affected. The crisis caused by the new coronavirus has caused challenges and problems in most organizations and has caused problems for employees, who are the most important assets and resources of most organizations. Accordingly, the purpose of this study was to identify the components of human resources during the new coronavirus crisis (covid-19), based on previous research in this field, and to extract the relevant components. These components can help managers, especially human resources managers, in advancing goals. Material Topics in this field have recently entered the literature of management and leadership and comprehensive models and theories in the field of research have not been appeared yet. Accordingly, the research method of this article is a qualitative study that has been done by researchers of published articles on human resource management in the new covid-19 crisis, using the meta-synthesis method. The goal is to create a new, integrated interpretation of the findings. This method is for clarifying the concepts, patterns, and results in refining the existing states of knowledge and the emergence of operational models and accepted theories. The use of the meta-synthesis method to identify key factors related to human resource management in the new covid-19 crisis serves to integrate several studies to create comprehensive and interpretive findings. Does the main research question emphasize what the dimensions and components of human resource management are in the new covid-19 crisis according to previous research? To set the research question, Four main parameters have been used, namely: Using the 4 keywords of human resources, human resource management, coronavirus, COVID-19, the researchers explored literature databases of Proquest, The Scientific Information Database (SID), Web of Science, Emerald journals as well as Google Scholar, the specialized search engine, in 2019-2021. The number of 1,029 sources was found, of which 921 articles were rejected because of the title. The total number of screened abstracts was 108, 16 of which we rejected on the basis of the abstracts and 27 of which we rejected in view of content, leaving us with 65 final articles to be reviewed. Three universal themes, three constructive themes, 11 basic themes and 117 codes were extracted. Results COVID-19 pandemic is destroying the global economy, but it also brings different opportunities for organizations. It is time for HR managers to think about how to take advantage of this opportunity. In certain situations, and during a covid-19 crisis, organizational managers need to communicate openly and honestly with employees so that they can perform more effectively, because employee participation has a significant and positive effect on organizational performance. In addition, knowledge sharing in this situation is more important than ever and has a significant and positive effect on the performance of the organization. Therefore, to maintain the high performance of the organization at this time, employee participation and knowledge sharing can be the best way to meet the current human resource challenges. During the outbreak of the covid-19 disease, employee participation is a key element of employee and organizational success, and employee satisfaction leads to better performance, increased creativity, and organizational commitment, which is becoming increasingly important in hospitals and health care organizations. This study indicate that opportunities and social threats are the biggest challenges facing human resources. The HR unit should also focus on issues such as virtualization of work and work environment, the degree of external environment support for the organization's employees, how to restructure jobs, health, and psychological challenges, as well as economic and internal challenges. Human resources managers can observe the characteristics, requirements, and challenges arising from this disease on a component-by-component basis. For example, hospital managers consider issues such as the prevalence of mental disorders such as depression, insomnia and generalized anxiety, fear of not knowing, health crisis, stress in the medical system, negative impact on the physical and mental health of employees, and risk of isolation or loneliness in work environments. Distance, mental health, the loneliness of single and childless employees are the main challenges of the health system employees and identifying these challenges can solve many problems arising at this point. The existence of social norms, on the other hand, can be even more important. Such norms may include the implementation of policies such as social distancing and closure of gathering and interaction centers, combating the phenomenon of social stigma, raising awareness of how the virus might be transmited, care and prevention of pollution through national and social media, highlighting the importance of social responsibility. Among other important norms identified in this study are health care, public governance, education, employment, and socio-economic factors, support for managers to balance life and work, leaving employees to prepare meals, play with children and do housework, staff participation and knowledge sharing, providing a clean and safe work environment, providing personal protective equipment and financial assistance for them and their family members, employees' adaptation to the remote work environment, separation of work and private life. Conclusion Finally, after reading this article, managers and researchers in this field and other related fields can look at human resource issues through a new lens. In dealing with the covid-19, human resource managers should pay special attention to components such as virtualization of work and work environment, support of the external environment for employees of the organization, restructuring of jobs, health and psychological requirements and challenges, social, economic, and intra-organizational factors. One of the limitations of this research is the novelty of the subject and the lack of previous research, especially in Iranian sources. Also, quantitative research addresses aspects that may not be possible to monitor in qualitative research. It is therefore recommended that future research focus on quantitative-qualitative hybrid methods. It is also suggested that future research investigate the impact of human resource processes during covid-19 outbreaks. Practical Implications of Research It is best for HR managers to review the structure and processes of HR and organizational resources and to coordinate the organization to adapt to the changes resulting from COVID-19. Ethical Considerations The researchers have adhered to all ethical principles in the use, presentation, and publication of scientific materials and all the rights of researchers have been observed. Conflict of Interest The authors of this article hereby declare that they have no conflict of interest. Aknowledgment Not applicable.

Background: Balance ability is a crucial component of independent daily activities among the older adultss. Balance impairment is one of the major risk factors for falls and related complications. Objective: The present study aims to investigate and compare the effect of neurofeedback training and balance training on balance and fall risk among older adults.Material and Methods: In this randomized controlled trial, a total of 48 older adults aged more than 65 years were recruited and randomly assigned into two groups, neurofeedback group (n=24) and balance exercise group (n=24). Prior to the intervention, the static balance, dynamic balance, and fall risk were measured using Biodex D balance system and Fullerton Advanced Balance scale. Subjects in neurofeedback group received neurofeedback training for 12 sessions of 30-min, every other day. Moreover, subjects in balance exercise group received balance training for four weeks in 12 sessions (45-minute) every other day. After the intervention, balance measurements were repeated in both groups. The significance level was set at p Results: Static balance and dynamic balance were shown to significantly improve, after the interventions (p

Objectives: Bruising is an important side effect of enoxaparin injection. Comfrey (Symphytum officinale) is used to treat different types of wounds, bone fractures, and bruising in traditional medicine in many countries for centuries. This study aimed to determine the effects of the Comfrey ointment on the bruise size and color following enoxaparin injection. Methods : This double-blind randomized clinical trial was conducted on 80 patients with acute coronary syndrome (ACS). The participants were randomly divided into two groups of 40, namely Comfrey and Placebo. Changes in bruise size and color in both groups were assessed daily before and after the intervention. Results : The Comfrey and Placebo groups were homogeneous in demographic and clinical variables. A downward trend was observed in the bruise size in both groups throughout the study. However, the bruise size was smaller in the Comfrey group than the Placebo group on day 2-5 of the intervention. Moreover, there was a significant difference in bruise color between the groups, with a shorter healing course in the Comfrey group. Conclusion : The Comfrey ointment accelerated the healing process of enoxaparin injection-induced bruising in patients with ACS. It is recommended as a safe and simple approach for these patients.

Abstract Unexpected imbalances between supply and demand during real‐time operation in the wake of high penetration of renewable energy resources necessitate system operators to improve flexibility of the system. Moreover, increasing growth in flexible distributed resources installation in distribution networks with multiple MicroGrids (MGs) such as fuel‐based distributed generators, storage units, and controllable loads makes distribution system operators be able to manage energy imbalances locally through exploiting potentials of aforementioned resources in flexibility enhancement. This paper proposes a receding horizon data‐driven chance‐constrained energy flexibility trading framework for active distribution networks with multiple MGs. Specifically, a distance‐based confidence set is constructed in a data‐driven manner to apply net load uncertainty into this modelling. According to this proposed data‐driven approach, the energy flexibility is modelled using flexibility envelope notion to demonstrate its dynamics in different scenarios in an imminent horizon. Furthermore, MGs' flexibility trading problem is modelled as an exact potential game that possesses a pure strategy Nash Equilibrium (NE). An iterative decentralized algorithm based on alternating direction method of multipliers is developed to achieve the NE strategy of MGs. Numerical results are also represented to show the performance efficiency of the proposed energy flexibility trading framework.

Abstract Regular and irregular variations in total electron content (TEC) are one of the most significant observables in ionospheric studies. During the solar cycle 24, the variability of ionosphere is studied using global positioning system derived TEC at a mid-latitude station, Tehran (35.70N, 51.33E). Based on solar radio flux and seasonal and local time-dependent features of TEC values, a semi-empirical model is developed to represent its monthly/hourly mean values. Observed values of TEC and the results of our semi-empirical model then are compared with estimated values of a standard plasmasphere–ionosphere model. The outcome of this model is an expected mean TEC value considering the monthly/hourly regular effects of solar origin. Thus, it is possible to use it for monitoring irregular effects induced by solar events. As a result, the connection of TEC variations with solar activities are studied for the case of coronal mass ejections accompanying extreme solar flares. TEC response to solar flares of class X is well reproduced by this model. Our resulting values show that the most powerful flares (i.e. class X) induce a variation of more than 20 percent in daily TEC extent.

Background: Repetitive transcranial magnetic stimulation (rTMS) is a novel technique that may improve recovery in patients with stoke, but the role of rTMS as an applied and practical treatment modality for stroke rehabilitation has not been established yet. Objective: This study was conducted to determine the effects of a rehabilitation program (RP) in conjunction with rTMS on functional indices of the paretic upper limb in the subacute phase of stroke. Material and Methods: In this experimental study, twenty patients in the subacute phase of stroke were randomly assigned into two groups: The high frequency rTMS (HF-rTMS) in conjunction with RP (experimental group), and the RP group (control group). The experimental group received 10 sessions of 20 Hz rTMS on the affected primary motor cortex and the other group received 10 sessions of RP. In experimental group, RP for the paretic hand was conducted following rTMS session. Box and block test (BBT), Fugl-Meyer Motor Assessment for upper limb (FMA-UL), grip strength and pinch strength were used to assess motor function before the first session and after the last session of treatment. Results: Significant improvement in BBT, FMA-UL, grip strength and pinch strength was observed in both groups. Improvement of BBT and grip strength was significantly greater in the experimental group rather than the control group (p

Abstract Background Recently, extensive research has been reported the higher rate of depression and anxiety among people living with HIV/AIDS (PLWHAs) as compared to the general population. However, no single study has been carried out to investigate whether this disparity is a real difference or it happens due to lack of measurement invariance. This study aims to assess the measurement invariance of the Beck Anxiety Inventory (BAI) and 10-item Centre for Epidemiological Studies Depression Scale (CESD-10) questionnaires across PLWHAs and healthy individuals. Methods One hundred and fifty PLWHAs and 500 healthy individuals filled out the Persian version of the BAI and CESD-10 questionnaires. Multi-group multiple-indicators multiple-causes model (MG-MIMIC) was used to assess measurement invariance across PLWHAs and healthy people. Results Our findings revealed that PLWHAs and healthy individuals perceived the meaning of all the items in the BAI and CESD-10 questionnaires similarly. In addition, although depression scores were significantly higher in PLWHAs as opposed to the healthy individuals, no significant difference was observed in anxiety scores of these two groups. Conclusions The current study suggests that the BAI and CESD-10 are invariant measures across PLWHAs and healthy people which can be used for meaningful cross-group comparison. Therefore, in comparison to healthy individuals, higher depression score of PLWHAs is a real difference. It is highly recommended that health professionals develop therapeutic interventions and psychological supports to promote the mental health of PLWHAs which alleviate their depressive symptoms.

Background: The role of cytokine storm in the immunopathogenesis of coronavirus disease 2019 (COVID-19) has been implicated. Objective: To determine the association of microRNA (miRNA)-10b and serum levels of IL-2 and IL-8 in patients with COVID-19. Methods: Blood samples were obtained from 33 COVID-19 patients and 29 healthy subjects. After RNA extraction and cDNA synthesis, the transcript level of miR-10b was determined by Real-time PCR. In addition, the serum levels of IL-2 and IL-8 were measured in subjects using ELISA. Results: The patient group comprised of 33 patients with COVID-19 (62.4 ± 3.7 years old), 13 (39%) males and 20 (61%) females. In the control group, 29 subjects (56.6 ± 1.6 years old), 9 (31%) males and 20 (69%) females, were included. The expression of miR-10b was significantly downregulated in the peripheral blood of COVID-19 patients in comparison to the healthy controls (fold change= 0.12, p < 0.0001). The levels of IL-2 (p < 0.001) and IL-8 (p < 0.001) were significantly increased in the serum samples of COVID-19 patients compared to the healthy subjects. The expression level of miR-10b was correlated significantly with the serum levels of IL-2 and IL-8 as well as with the age of patients, ESR and CRP levels. Conclusions: miR-10b is downregulated in the COVID-19 patients and might result in increased levels of IL-2 and IL-8, hence contributing to cytokine storm.

Abstract Risk factors for clinical outcomes of COVID-19 pneumonia have not yet been well established in patients with underlying liver diseases. Our study aimed to describe the clinical characteristics and outcomes of COVID-19 infection among patients with underlying liver diseases and determine the risk factors for severe COVID-19 among them. In a retrospective analytical study, 1002 patients with confirmed COVID-19 pneumonia were divided into two groups: patients with and without underlying liver diseases. The admission period was from 5 March to 14 May 2020. The prevalence of underlying conditions, Demographic data, clinical parameters, laboratory data, and participants' outcomes were evaluated. Logistic regression was used to estimate the predictive factors. Eighty-one (8%) of patients had underlying liver diseases. The frequencies of gastrointestinal symptoms such as diarrhea and vomiting were significantly higher among patients with liver diseases (48% vs. 25% and 46.1% vs. 30% respectively, both P

Abstract Background Discrepancy between child self-report and parent proxy-report has long been documented in the health-related quality of life (HRQoL) measurement of children with chronic health conditions. This study aims to assess whether child and parent reports of the Kinder Lebensqualität fragebogen (KINDL) questionnaire measure the same construct of HRQoL in children with attention-deficit hyperactivity disorders (ADHD). Methods Participants were 122 Iranian children with ADHD and 127 of their parents, who completed the child and parent reports of the KINDL, respectively. Internal consistency of the child and parent reports were assessed by Cronbach's alpha. The intra-class correlation (ICC) coefficient and factor analysis were applied to assess whether the child self-report and the parent proxy-report measured the same construct of HRQoL. Additionally, convergent and discriminant validity were assessed using the Spearman correlation. Results The results of factor analysis revealed that the child self-report and parent proxy-report measure two different aspects of HRQoL. Moreover, both versions of the KINDL instrument showed excellent convergent and discriminant validity. The internal consistency was close to or greater than 0.7 for all domains of both child and parent reports. Conclusions Although the child self-report and the parent proxy-report of the Persian version of the KINDL have good psychometric properties, they are not interchangeable. This finding indicates that Iranian children with ADHD and their parents evaluate children's HRQoL from their own viewpoints.

Background: Knowing about sexual issues and substance abuse is crucial for girls in preventing high-risk behaviors in the medical, social, cultural, and evolutional levels. The aim of this study was to determine the self-care needs of adolescent girls in the domains of knowledge, attitude, and performance with regard to drug use and risky sexual behaviors. Materials and Methods: This cross-sectional study was conducted in the secondary schools located in the third district of Isfahan. Data were collected from 384 female students by systematic random sampling on 2019, and using a four-part questionnaire including demographic characteristics and self-care needs (knowledge, attitude and performance), drug addiction and unsafe sexual behaviors were measured and then were analyzed using descriptive and inferential statistics. Results: According to the adolescents, “familiarity with infectious diseases caused by drug addiction”, “alcohol consumption, drugs and smoking as a way of forgetting problems” and “learning the skills of excitement control,” were their first self-care priorities in terms of awareness, attitude, and performance, respectively. Additionally, “understanding the social and mental effects of relationships with the other sex”, “separating the children's bedrooms from that of parents” and “ways of caring for personal hygiene in menstruation period and travel time” were considered as their first self-care priorities in terms of knowledge, attitude, and performance with regard to sexual behaviors, respectively. Conclusions: Based on the results, more effective interventions to protect the adolescents from being involved in substance use and sexual harmful behaviors are recommended through the training of self-care needs in adolescents.

Background/objective: Irisin is suggested to be an exercise beneficial effects mediator. This study aimed to examine the effects of the aerobic exercise (AE), resistance exercise (RE), and combined exercise (CE) on the plasma levels of irisin and some metabolic and anthropometric indices. Methods: Sixty overweight women with metabolic syndrome were assigned equally into four groups: AE, RE, CE, and control. The study variables were measured before and 24 h after the intervention period. Results: None of the study groups showed statistically significant changes in the serum irisin. However, muscle mass significantly increased in the RE and CE groups. Also, a significant decrease was observed in the body fat percentage in all groups. In addition, compared with the control group, the homeostatic model assessment of insulin resistance in the AE (p = 0.021), RE (p = 0.039), and in the CE (p = 0.003) groups reduced significantly. According to the analysis of indices’ changes, serum irisin was significantly correlated with the body fat percentage (r = 0.532) and HOMA-IR (r = 0.424). Conclusions: The systematic exercise program for 8-weeks did not change circulating irisin and no statistically significant difference was observed between the exercise methods. Also, serum irisin seemed to be associated with the glycemic status, body fat and weight independent of exercise activity. RCT registration code: IRCT20180806040721N2. Registry name: Iranian Registry of Clinical Trials.

Introduction: Breast cancer is the most common cancer among women. Doxorubicin is one of the most important chemotherapy drugs in the treatment of tumors with many side effects. Today, herbal compounds make up about one-third of the total available drugs. Heracleum persicum has anti-cancer effects. Moreover, in recent years, there has been an interest in the study of new drug targets, such as the use of parasitic compounds in cancer treatment. Therefore, this study aimed to investigate the anticancer effects of Heracleum persicum alcoholic extract and Leishmania major promastigute in comparison with doxorubicin in MCF7 breast cancer cell line and HU02 fibroblast. Materials & Methods: Breast and fibroblast cell lines were exposed to logarithmic concentrations of doxorubicin, Heracleum persicum extract, and Leishmania promastigute separately and in combination. The MTT was used to determine the inhibitory concentration of this herb extract, medicine, and the parasite. The data were analyzed in SPSS software. Ethics code: IR.SKUMS.0063-99 Findings: The results showed that an increase in the concentration of doxorubicin, Heracleum persicum extract, and Leishmania promastigute individually and in combination led to a decrease in the percentage of live fibroblast cells and MCF7. The highest percentage of the decreased live cells is observed in the combined application of Heracleum persicum extract, Leishmania promastigute, and doxorubicin. Discussion & Conclusions: Heracleum persicum extract and Leishmania promastigute can have significant inhibitory effects on the percentage of live fibroblast cells and MCF7, which is more pronounced in living cells of MCF7.

Background:Differentiation of Embryonic Stem Cells into Oocyte-like cells in vitro is challenging. Successful derivation of oocyte from stem cells can provide an alternative source for curing ovogenesis problems. The current study aims to demonstrate a new protocol with two different types of media for differentiating embryonic stem cells (ESCs) into oocyte-like cells (OLCs). Methods: After culturing mouse ESCs, embryoid bodies (EBs) were generated from ESCs by hanging drop (HD) method. To final differentiation of oocyte-like cells (OLCs), the EBs were cultured in two different types of media for 12 days (first 7 days EBs were cultured in in vitro maturation diluted in Granulose Cell- Conditioned Medium and Follicular Fluid [1:1:1] followed by 5 days of culture in in vitro maturation diluted in uterine condition medium [1:1] ). Results:According tothe MTT test, the viability rate increased in the experimental group compared to the control EBs cultured alone. Expression of Oct4, as a pluripotency marker, decreased during the differentiation process of EBs in the experimental group. Co-culturing of EBs with our mentioned protocol increased germ cell markers (Stella and Mvh) and increased Oocyte-specific markers (ZP1, Figα and GDF9). Conclusion:Our study introduces a promising in vitro protocol for achieving successful oogenesis through creating interactions of EBs with granulosa cells and uterine condition medium.

Objectives: This study aimed to compare the optical properties of Zolid FX, Katana UTML, and lithium disilicate laminate veneers. Materials and Methods: In this in-vitro experimental study, the maxillary left lateral incisor of a phantom received a laminate veneer preparation. An impression was made, and a die was fabricated using dental stone. The die was scanned using a computer-aided design/computer-aided manufacturing scanner. Ten dies were fabricated from each of the A1, A2, and A3 shades of composite resin. Laminate veneers were fabricated using A1 shade of Katana UTML, Zolid FX, and IPS e.max CAD ceramics (n=10) and placed on composite abutments using bleach and white colors of trial insertion paste (TIP). The optical properties were measured at the incisal, middle, and cervical thirds using a spectrophotometer. Data were analyzed using three-way analysis of variance and Tukey’s test. Results: The effect of laminate material on the L*, a*, and b* parameters was significant in all areas (P

Background. Myasthenia gravis (MG) is a neuromuscular, autoimmune disease that causes weakness by impairing neuromuscular transmission. According to reports, vaccines can lead to autoimmunity in different ways, and COVID-19 vaccines are suggested to trigger MG. We conducted this systematic review to assess MG patients after the COVID-19 vaccination. Methods. We collected 231 studies from four databases from inception to 26 March 2022. Results. 4 case studies were selected from 231 research studies, and data were extracted based on inclusion criteria. In all cases, MG was reported following COVID-19 vaccination. Symptoms such as muscle weakness, numbness, and ptosis were common. The MG was confirmed through RNST, MRC, NCS, and AchR-binding antibody titer tests. Conclusion. Although all cases of MG were diagnosed following appropriate tests, the sample size was small; therefore, further investigation is required to demonstrate the possible association between MG and COVID-19 vaccination.

Background and Objectives: Post-cesarean pain and anxiety is associated with several complications and it is very important for maternal and neonatal health care and breastfeeding. Some Studies are indicative of a relationship between psychological factors and pain. The aim of this research was to investigate the relationship between perfectionism and post-cesarean pain and anxiety. Methods: This correlational descriptive analytical study was carried out on 70 eligible pregnant women who referred to Omolbanin hospital of Mashhad city for elective cesarean section. Sampling was performed using consecutive method. Data were collected using Ahvaz Perfectionism Questionnaire (APS) and the Spielberger State-Trait Anxiety Inventory (2-3 hours before cesarean section). Two hours after cesarean section, Spielberger questionnaire was used and to assess the patients’ pain, short-form McGill Pain Questionnaire (SF-MPQ), was used. Data were analyzed by Chi-square, Spearman, and Pearson correlation tests at the significance level of p

Evaporation is one of the main components of the hydrological cycle, and its estimation is crucial and important for water resources management issues. Access to a reliable estimator tool for evaporation simulation is important in arid and semi-arid areas such as Iran, which lose more than 70% of their received precipitation by evaporation. Current research employs the Bayesian Regularization (BR) and Scaled Conjugate Gradient (SCG) algorithms for training the Multilayer Perceptron (MLP) model (as MLP-BR and MLP-SCG) and comparing their performance with the Levenberg–Marquardt (LM) algorithm (as MLP-LM). For this purpose, 16 meteorological variables were used on a daily scale; including temperature (5 variables), air pressure (4 variables), and relative humidity (6 variables) as input data sets, and pan evaporation as the target variable of the MLP model. The surveys were conducted during the period of 2006–2021 in Fars Province in Iran, which is a semi-arid region and has many natural lakes. Various combinations of input-target pairs were tested by several learning algorithms, resulting in seven input scenarios: (1) temperature-based (T), (2) pressure-based (F), (3) humidity-based (RH), (4) temperature–pressure-based (T-F), (5) temperature–humidity-based (T-RH), (6) pressure–humidity-based (F-RH) and (7) temperature–pressure–humidity-based (T-F-RH). The results indicated the relative superiority of the three-component scenario of T-F-RH, and a considerable weakness in the single-component scenario of RH compared with others. The best performance with a root mean square error (RMSE) equal to 1.629 and 1.742 mm per day and a Wilmott Index (WI) equal to 0.957 and 0.949 (respectively for validation and test periods) belonged to the MLP-BR model. Additionally, the amount of R2 (greater than 84%), Nash-Sutcliff efficiency (greater than 0.8) and normalized RMSE (less than 0.1) all indicate the reliability of the estimates provided for the daily pan evaporation. In the comparison between the studied training algorithms, two algorithms, BR and SCG, in most cases, showed better performance than the powerful and common LM algorithm. The obtained results suggest that future researchers in this field consider BR and SCG training algorithms for the supervised training of MLP for the numerical estimation of pan evaporation by the MLP model.

Background and Objectives: Evaluation of learning and teaching activities is one of the activities that is given emphasis and attention in the educational institutions. One of the diagnostic tools in this context is assessment of educational environment and educational space or, in other words, educational atmosphere. The aim of this study was to investigate the students' viewpoint about the educational atmosphere of Qom University of Medical Sciences. Methods: This study was performed as a descriptive-analytical study 0n all the students studying in Qom University of Medical Sciences in 2018. Based on multi-stage sampling, 306 students were selected. Data collection tool was included a demographic characteristics questionnaire and DREEM standard questionnaire. Data were analyzed by independent t-test, one way ANOVA, Duncan's post-hoc test, and Pearson correlation coefficient at the significance level of p

Background: Stem cell therapy has been developed as an effective treatment method for the heart failure. Also, extracellular matrix has shown the positive effects in stem cell differentiation and myocardial tissue organization. Cardiogel is a native cardiac extracellular matrix (ECM) derived from cardiac fibroblasts. In the present study the role of cardiogel is examined for its cardiomyogenic potential on mouse bone marrow- derived mesenchymal stem cells (BM-MSCs). Method: The BM-MSCs were isolated from six-week-old mice. Cardiac fibroblasts were collected from neonatal heart mice and the cells were seeded on 0.2% gelatin pre-coated plates for up to 21 days. Then, the decellularization was performed via enzymatic digestion. For cardiomyocyte differentiation, the BM-MSCs were plated on matrix-coated plates (Cardiogel, CCP), Matrigel-coated plates (MCP) and gelatin-coated plates (GCP) as a control group at a density of 1 × 104 cells per cm2 in CM containing 3 mM 5-azacytidine. Results: The results proved that cardiogel is capable to promote the cardiomyogenic differentiation of BM-MSCs. Cardiogel had a great influence on cellular adhesion, gene expression and cardiomyocyte differentiation compared to MCP and GCP. Gene expression analysis showed that cardiac specific markers were expressed in BM-MSCs has grown in CCP that represented the cardiac-specific differentiation. Conclusion: Our results suggest that cardiogel is an effective ECM that can improve the cardiomyogenic differentiation of BM-MSCs, and it can be used as a possible therapeutic approach in cardiac tissue regeneration.

Influencing Factors on Patients’ Length of Stay in an Emergency Department of a Training Hospital Bagheri Zahra1, Rafiei Sima*2, Mohebbifar Rafat3 1. MSc Student in Healthcare Management, Student Research Center, Qazvin University of Medical Sciences, Qazvin, Iran 2. Assistant Professor, Social Determinants of Health Research Center, Qazvin University of Medical Sciences, Qazvin, Iran 3. Associate Professor, Department of Healthcare Management, School of Public Health, Qazvin University of Medical Sciences, Qazvin, Iran *Correspondence: School of Public Health Qazvin University of Medical Sciences, Bahonar Blvd., Qazvin, Iran. Tel: 00982833369581 Email: sima.rafie@gmail.com Abstract: Background & Objectives: Patients’ length of stay in emergency departments is one of the key criterion which has been focused by hospital managers recently. This study aimed to assess the influencing factors on patients’ length of stay in an emergency department of a training hospital affiliated by Alborz Medical University of Medical Sciences. Methods: This was a descriptive-analytical study with a cross-sectional design in 2017. Study population consisted of all inpatients in a six month time period from the beginning of the study year. Through the use of Cochrane sample size calculation formula 555 numbers of samples were selected which their related data were obtained from the review of patients’ medical records. To test study hypotheses data were entered to a SPSS version 20 and analyzed through descriptive statistical analysis method, Pearson correlation test, t-test, and ANOVA. Results: Mean of patients’ length of stay was 11.31 hours. Evidence showed that this mean time was correlated with some of the factors including internal or external medical counseling, the necessity to have a medical laboratory test, a medical imaging test or the time interval between triage and the first physician’s visit. Conclusion: Modifying hospital processes and performance procedures in an emergency department with an aim to improve service quality and effective interactions among different hospital units can play a helpful role in solving existing problems. Key­words: Length of Stay, Emergency Department, Training Hospital, Inpatients ­Citation: Bagheri Z, Rafiei S, Mohebbifar R. Influencing Factors on Patients’ Length of Stay in an Emergency Department of a Training Hospital. Journal of Health Based Research 2019; 4(4): 371-81. [In Persian]

BackgroundThe impact of de novo anti-HLA donor-specific alloantibodies (DSA) which develop after long-term liver transplantation (LT) remains controversial and unclear. The aim of this study was to investigate the role of de novo DSAs on the outcome in LT.MethodsWe did a systematic review and meta-analysis of observational studies published until Dec 31, 2019, that reported de novo DSA outcome data (≥1 year of follow-up) after liver transplant. A literature search in the MEDLINE/PubMed, EMBASE, Cochrane Library, Scopus and Web of Science Core Collection databases was performed.ResultsOf 5,325 studies identified, 15 fulfilled our inclusion criteria. The studies which reported 2016 liver transplant recipients with de novo DSAs showed an increased complication risk, i.e. graft loss and chronic rejection (OR 3.61; 95% CI 1.94–6.71, P < 0.001; I2 58.19%), and allograft rejection alone (OR 6.43; 95% CI: 3.17–13.04; P < 0.001; I2 49.77%); they were compared to patients without de novo DSAs. The association between de novo DSAs and overall outcome failure was consistent across all subgroups and sensitivity analysis.ConclusionsOur study suggested that de novo DSAs had a significant deleterious impact on the liver transplant risk of rejection. The routine detection of de novo DSAs may be beneficial as noninvasive biomarker-guided risk stratification.

Abstract Background and Objective Patients with panic disorder (PD) suffer from elevated oxidative stress as a consequence of serotonin metabolism disorder. These patients have elevated serotonin concentration and catabolism of serotonin via monoamine oxidase. The aim of the present study was to evaluate serum homocysteine concentration and its relationship with oxidative stress level in PD patients, regarding homocysteine as a diagnostic biomarker of heart disease. Materials & Method Sixty patients with PD according to the DSM‐5 diagnostic criteria for a panic attack and 60 healthy individuals were included in the present study. Peripheral venous blood samples were taken from patients. Erythrocytes and serum were separated from blood, and RBC hemolysates were prepared to investigate oxidative stress indices including glutathione and glutathione peroxidase. Serum homocysteine and carbonyl groups concentrations were measured in all samples. Data were analyzed using ANOVA, and p

Background/objective: This study aimed to investigate the impacts of a 12-week training of the aerobic exercise (AE), resistance exercise (RE), and combined exercise (CE) on the serum levels of nesfatin-1, irisin-1 and some other metabolic and anthropometric indices in overweight women with metabolic syndrome.Methods: Sixty overweight women with metabolic syndrome were assigned equally into four groups: aerobic exercise (AE, n = 15), resistance exercise (RE, n = 15), combined exercise (CE, n = 15), and control (n = 15). All groups underwent 12 weeks of intervention. The study variables were measured before and 24 h after the intervention period.Results: Twelve weeks of training resulted in an increase of irisin-1 in the AE and CE groups and nesfatin-1 in all the intervention groups. As expected, all the trained groups exhibited a positive alteration in anthropometric indices and lipid profile in comparison with the control group. Besides, compared with the control group, insulin resistance (based on the homeostatic model assessment) in AE (p = 0.022), RE (p = 0.032), and CE (p < 0.001) groups were reduced significantly. According to the observed changes in the measured indices, serum irisin-1 was significantly correlated with body weight, BMI, body fat percentage, fasting insulin, and HOMA-IR. However, with regard to nesfatin-1, only a negative correlation was observed with body fat percentage and LDL-cholesterol.Conclusions: The 12-week systematic training program changed circulating irisin-1 and nesfatin-1. Also, change in the serum irisin-1 and nesfatin-1 were correlated with the change in glycemic and anthropometric indices in addition to LDL-cholesterol. Also, exercise training significantly reduced fasting insulin and HOMA-IR in all the intervention groups.RCT Registration Code: IRCT20180806040721N2.

Background and Objective: Prolonged hospitalization lead to considerable financial burden for patients as well as health care system. This study aimed to identifying important factors resulting in excess hospitalization days in patients undergoing abdominal surgeries using the multilevel zero-inflated Poisson regression model. Methods: In this descriptive - analytic study, 485 patients from five teaching and private hospitals in Shiraz (southern Iran) were selected based on convince sampling method. Multilevel zero-inflated Poisson regression model was used to determine the risk factors of excess hospitalization day. Maximum likelihood method was used to estimate parameters of the model. Moreover, Akaike Information Criterion (AIC) and Bayes Information Criterion (BIC) indices were applied to assess the goodness of fit of the model. Results: The primary analysis of data showed that 81.2% of the patients did not undergo excess hospitalization days. Based on findings, age, respiration rate, blood infusion, fever, smoking and drug abuse did not affect excess hospitalization days. In contrast, gender, renal diseases, operation history, laparoscopic gallbladder removal, prostate surgery and ileus significantly led to excess hospitalization days (P

Abstract Background Human adipose-derived stem cells (hADSCs) are capable of differentiating into many cells such as cardiac cells. Different types of inducers are used for cardiac cell differentiation, but this question still remains to be investigated, which one is the best. The aim of this paper was to investigate the effect of combination of fibrin scaffold and trichostatin A (TSA), for differentiation of hADSCs into cardiomyocyte-like cells. Methods After approval of characteristics of hADSCs and fibrin scaffold, hADSCs were cultured in fibrin scaffold with 10 µM TSA for 72 h and kept in standard conditions for 4 weeks. QRT-PCR and immunostaining assay were performed for evaluating the expression pattern of special cardiac genes and proteins. Results In particular, our study showed that fibrin scaffold alongside TSA enhanced expression of the selected genes and proteins. Conclusions We concluded that the TSA alone or with fibrin scaffold can lead to the generation of cardiac like cells in a short period of time.

Background: This study examined the impacts of an Emotional Focused Intervention on emotional abuse behaviors and marital satisfaction among the elderly married couples. Methods: This randomized controlled trial study was carried out in Shiraz-Iran, during September 2013-2014. The elderly couples were invited to join an emotional focused intervention, following the advertisement and announcement on bulletin boards in the elderly day clinic centers and all governmental primary health care centers. Then, 57 couples (114 participants) who were eligible for study were assigned in two groups by block randomization (29 in the experimental and 28 in the control group(.The couples in the experimental group received intervention twice a week for four weeks. Each session lasted 90 minutes. The control group didn’t receive any intervention and the subjects were put in the waiting list. The outcome measures were evaluated by Multidimensional Measure of Emotional Abuse Questionnaire (MMEAQ) and Marital Satisfaction Questionnaire for Older People (MSQFOP). Repeated measurement ANOVA was used to detect any significant changes between groups in their mean scores of emotional abuse behaviors and marital satisfaction from pre- to post-test, and 3 months after the intervention. Analysis of data was performed using SPSS, version 19, and P≤0.05 was measured as significant. Results: The mean duration of marriage was 39.56±9.64 years. In the experimental group, the abusive behaviors decreased significantly (P

Abstract Background In the first stage of meta-analytic structural equation modeling (MASEM), researchers synthesized studies using univariate meta-analysis (UM) and multivariate meta-analysis (MM) approaches. The MM approaches are known to be of better performance than the UM approaches in the meta-analysis with equal sized studies. However in real situations, where the studies might be of different sizes, the empirical performance of these approaches is yet to be studied in the first and second stages of MASEM. The present study aimed to evaluate the performance of the UM and MM methods, having unequal sample sizes in different primary studies. Testing the homogeneity of correlation matrices and the empirical power, estimating the pooled correlation matrix and also, estimating parameters of a path model were investigated using these approaches by simulation. Results The results of the first stage showed that Type I error rate was well under control at 0.05 level when the average sample sizes were 200 or more, irrespective of the types of the methods or the sample sizes used. Moreover, the relative percentage biases of the pooled correlation matrices were also lower than 2.5% for all methods. There was a dramatic decrease in the empirical power for all synthesis methods when the inequality of the sample sizes was increased. In fitting the path model at the second stage, MM methods provided better estimation of the parameters. Conclusions This study showed the different performance of the four methods in the statistical power, especially when the sample sizes of primary studies were highly unequal. Moreover, in fitting the path model, the MM approaches provided better estimation of the parameters.

Abstract INTRODUCTION: The promising non-clinical antileishmanial effects of gentian violet (GV) encouraged us to evaluate the additive effect of GV on cryotherapy. METHODS: For 8 weeks, 59/161 cutaneous leishmaniasis patients/lesions underwent cryotherapy alone (group 1) or cryotherapy accompanied by 1% GV application (group 2). The primary endpoint was clinical response. RESULTS: Ultimately, 54.7% and 45.3% of the significantly cured lesions belonged to groups 1 and 2, respectively, which was not statistically significant. The clinical response was significantly different between the two groups at the end of the fourth week. CONCLUSIONS: Although the clinical response of the two groups was significantly different at the end of the fourth week, application of GV did not increase the efficacy of cryotherapy.

Background Due to the pivotal role of clinical education in the nursing profession, paying attention to effective approaches in improving the quality of education is of great importance. Objectives The current study aimed at determining the effect of mentorship with senior students or nurses on knowledge and clinical self-efficacy of nursing students. Methods The current trial was conducted on 72 nursing students in Lorestan University of medical sciences in academic year 2012 - 2013. The participants selected by convenience sampling method and assigned, using stratified random blocks, to one control group which supervised by a faculty member only and two intervention groups supervised by a faculty member and a senior student or nurse as mentor. Clinical self-efficacy scale and a researcher-made questionnaire were used to measure the participants’ knowledge and self-efficacy before and after the educational intervention. ANOVA and paired samples test and chi square were used to analyze the data. Results The mean score of knowledge and clinical self-efficacy increased in all the three groups, but the increase was significantly higher in the third group (the group supervised by a faculty member and a qualified nurse as mentor) than the others. Conclusions Due to the positive effects of mentorship with a qualified nurse, it is suggested that mentorship programs be included in the curriculum of nursing students.

Objective: Vascular endothelial growth factor (VEGF) and VEGF receptors (VEGFRs) play important roles in angiogenesis of different developmental mechanisms such as wound healing, embryogenesis and diseases, including different types of cancer. VEGFR2 is associated with cell proliferation, migration, and vascular permeability of endothelial cells. Blocking VEGF and its receptors is suggested as a therapeutic approach to prevent tumor growth. In this study, we aim to block VEGF signaling via small interfering RNA (siRNA) inhibition of VEGFR2. Materials and Methods: In this experimental study, we used the RNA interference (RNAi) mechanism to suppress expression of the VEGFR2 gene. We conducted the 3-(4,5-dimethylthiazol- 2-yl)-2,5-diphenyl-tetrazolium bromide (MTT) assay, real-time polymerase chain reaction (PCR), Western blot, and flow cytometry analyses of VEGFR2 expression. Results: Real-time PCR and Western blot results showed that VEGFR2 expression significantly downregulated. This suppression was followed by inhibition of cell proliferation, reduction of viability, and induction of apoptosis in the cancer cells. Conclusion: These findings suggest that VEGFR2 has a role in cell proliferation and tumor growth. Accordingly, it is suggested that VEGFR2 can be a therapeutic target for controlling tumor growth and proliferation.