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Background and Objective: Colorectal cancer is the third most common cancer in men and the second most common in women. The use of parasites or parasite antigens is one of the newest therapeutic approaches for cancer, although it has not yet been used or approved in human trials. This study aimed to determine the cytotoxic effects of purified carbohydrates from the hyaline layer, fluid, and protoscolices of hydatid cysts on the human colorectal cancer cell line (LS174T). Methods: This descriptive-analytical study was conducted on two sheep and two cow livers infected with hydatid cysts, and the human colorectal adenocarcinoma cell line (LS174T) purchased from the Pasteur Institute of Iran at the Faculty of Veterinary Medicine, Shahid Chamran University of Ahvaz, Iran during 2022. Cyst fluid, protoscolices, and the hyaline layer were isolated from the hydatid cyst-infected livers, and glycoproteins and glycolipids from different parts of the cyst were extracted using the chloroform-methanol method. Carbohydrates were purified using the beta-elimination method and their presence was confirmed using the phenol-sulfuric acid method. The cytotoxicity of purified carbohydrates on the LS174T cell line was evaluated using the methyl tetrazolium (MTT) assay for 24 hours. Results: Concentrations of 0.5 and 0.25 of purified carbohydrates from glycoproteins and glycolipids of hydatid cysts significantly inhibited the growth of LS174T cells (P

Abstract Background Gastric intestinal metaplasia (GIM) is a precancerous lesion that increases the risk of gastric cancer. Several preliminary studies have examined the prevalence of GIM. The present systematic review and meta-analysis were conducted aimed estimating the global prevalence of GIM. Methods The present systematic review and meta-analysis was conducted based on the PRISMA reporting guidelines in the range of 1988–2022. Articles related to the purpose of the study were obtained from Embase, PubMed, Scopus, Web of Science (WOS), MagIran, SID databases, and Google Scholar search engine using relevant and validated keywords in MeSH/Emtree. Inclusion criteria were observational articles, access to the full text of the article, and articles that reported prevalence. Heterogeneity among studies was examined using the I 2 index. The random effects model was used in this review due to the high heterogeneity between the results of the studies. Data were statistically analyzed using the Comprehensive Meta-Analysis (CMA) software. Results In the initial search, 4946 studies were found, of which 20 articles with a sample size of 57,263 met all the criteria for inclusion in the study. The global prevalence of GIM was 17.5% (95% confidence interval: 14.6–20.8%). The highest percentage of prevalence of GIM belonged to American continent with 18.6% (95% confidence interval: 13.8–24.6%) and patients with gastroesophageal reflux with 22.9% (95% confidence interval: 9.9–44.6%). Conclusion The results of this study showed that the prevalence of GIM in the world is high and needs further investigation. Therefore, it is recommended to be given more attention by experts, officials, and health policymakers.

The genus Pistacia, with its species having notable ecological, economic, and medicinal implications, demonstrates remarkable environmental adaptability. The central objective of the study is to analyze interspecific variations between Pistacia atlantica subsp. atlantica and Pistacia terebinthus across three distinct bioclimatic zones in the Middle Atlas region of Morocco. The methodology includes collecting dendrometric measurements and conducting macromorphological examinations on these two taxa, with a detailed analysis of 27 qualitative and quantitative variables. A micro-morphological analysis of leaves, using scanning electron microscopy (SEM), is employed to explore specific features such as size and stomatal density, as well as qualitative aspects like epidermal cell shape and trichomes. Dendrometric measurements have revealed that the canopy surface and the number of trunks per tree can serve as distinctive features between the two species. Regarding the sex ratio of Pistacia atlantica subsp. atlantica, 59% of the examined trees are males, primarily associated with the jujube tree in arid zones and the dwarf palm in humid areas. In contrast, female Pistacia terebinthus exhibit a similar percentage, predominantly associated with oak groves and cade juniper in their distribution areas. Principal component analysis of biometric measurements emphasized a significant disparity between the two species, representing 60.25% of the total variance. The use of SEM unveiled new features facilitating the identification of the two species. By leveraging the macromorphological and micromorphological variability of pistachio trees, we can qualify those best suited to diverse bioclimates. In this regard, we suggest incorporating them into reforestation and rehabilitation programs aimed at restoring our declining ecosystems.

Aims: The aims of this study were to describe the demographic, socioeconomic, and educational factors associated with core surgical trainees (CSTs) who apply to and receive offers for higher surgical training (ST3) posts in Trauma & Orthopaedics (T&O). Methods: Data collected by the UK Medical Education Database (UKMED) between 1 January 2014 and 31 December 2019 were used in this retrospective longitudinal cohort study comprising 1,960 CSTs eligible for ST3. The primary outcome measures were whether CSTs applied for a T&O ST3 post and if they were subsequently offered a post. A directed acyclic graph was used for detecting confounders and adjusting logistic regression models to calculate odds ratios (ORs), which assessed the association between the primary outcomes and relevant exposures of interest, including: age, sex, ethnicity, parental socioeconomic status (SES), domiciliary status, category of medical school, Situational Judgement Test (SJT) scores at medical school, and success in postgraduate examinations. This study followed STROBE guidelines. Results: Compared to the overall cohort of CSTs, females were significantly less likely to apply to T&O (OR 0.37, 95% CI 0.30 to 0.46; n = 155/720 female vs n = 535/1,240 male; p < 0.001). CSTs who were not UK-domiciled prior to university were nearly twice as likely to apply to T&O (OR 1.99, 95% CI 1.39 to 2.85; n = 50/205 vs not UK-domiciled vs n = 585/1,580 UK-domiciled; p < 0.001). Age, ethnicity, SES, and medical school category were not associated with applying to T&O. Applicants who identified as ‘black and minority ethnic’ (BME) were significantly less likely to be offered a T&O ST3 post (OR 0.70, 95% CI 0.51 to 0.97; n = 165/265 BME vs n = 265/385 white; p = 0.034). Differences in age, sex, SES, medical school category, and SJT scores were not significantly associated with being offered a T&O ST3 post. Conclusion: There is an evident disparity in sex between T&O applicants and an ethnic disparity between those who receive offers on their first attempt. Further high-quality, prospective research in the post-COVID-19 pandemic period is needed to improve equality, diversity, and inclusion in T&O training. Cite this article: Bone Jt Open 2024;5(8):697–707.

Abstract Antimicrobial photodynamic therapy (aPDT) is a promising approach to combat antibiotic resistance in endodontic infections. It eliminates residual bacteria from the root canal space and reduces the need for antibiotics. To enhance its effectiveness, an in silico and in vitro study was performed to investigate the potential of targeted aPDT using natural photosensitizers, Kojic acid and Parietin. This approach aims to inhibit the biofilm formation of Enterococcus faecalis, a frequent cause of endodontic infections, by targeting the Ace and Esp proteins. After determining the physicochemical characteristics of Ace and Esp proteins and model quality assessment, the molecular dynamic simulation was performed to recognize the structural variations. The stability and physical movement of the protein-ligand complexes were evaluated. In silico molecular docking was conducted, followed by ADME/Tox profiling, pharmacokinetics characteristics, and assessment of drug-likeness properties of the natural photosensitizers. The study also investigated the changes in the expression of genes (esp and ace) involved in E. faecalis biofilm formation. The results showed that both Kojic acid and Parietin complied with Lipinski’s rule of five and exhibited drug-like properties. In silico analysis indicated stable complexes between Ace and Esp proteins and the natural photosensitizers. The molecular docking studies demonstrated good binding affinity. Additionally, the expression of the ace and esp genes was significantly downregulated in aPDT using Kojic acid and Parietin with blue light compared to the control group. This investigation concluded that Kojic acid and Parietin with drug-likeness could efficiently interact with Ace and Esp proteins with a strong binding affinity. Hence, natural photosensitizers-mediated aPDT can be considered a promising adjunctive treatment against endodontic infections.

Objective(s): Early effective treatment and appropriate coverage are vital for full-thickness wounds. Amnion membrane-derived products have recently emerged in tissue engineering. However, the optimal concentration, carrier for controlled release, and handling have remained challenges. This study aims to develop and optimize an in situ forming, amniotic-based hydrogel for wound healing.Materials and Methods: Here, a composite matrix was fabricated with gelatin hydrogel modified with methacrylate functional group conjugated (GelMA) and keratose (wt.1%), loaded with mesenchymal stem cells (MSCs, 1×105 cell/ml) and optimized soluble amniotic membrane (SAM, 0.5 mg/ml). The physicochemical properties of the final subject were evaluated in vitro and in vivo environments. Results: The results of the in vitro assay demonstrated that conjugation of the methacryloyl group with gelatin resulted in the formation of GelMA hydrogel (26.7±1.2 kPa) with higher mechanical stability. Modification of GelMA with a glycosaminoglycan sulfate (Keratose) increased controlled delivery of SAM (47.3% vs. 84.3%). Metabolic activity (93%) and proliferation (21.2 ± 1.5 µg/ml) of MSCs encapsulated in hydrogel improved by incorporation of SAM (0.5 mg/ml). Furthermore, the migration of fibroblasts was facilitated in the scratched assay by SAM (0.5 mg/ml)/MSCs (1×105 cell/ml) conditioned medium. The GelMA hydrogel groupes revealed regeneration of full-thickness skin defects in rats after 3 weeks due to the high angiogenesis (6.3 ± 0.3), cell migration, and epithelialization. Conclusion: The results indicated in situ forming and tunable GelMA hydrogels containing SAM and MSCs could be used as efficient substrates for full-thickness wound regeneration.

Abstract Background and Objectives Zygomycosis, a severe form of fungal infection, is classified into two categories: Mucorales and Entomophthorales. Within the Entomophthorales category, Basidiobolomycosis is a rarely recognized genus that can have significant health implications. Prompt diagnosis and appropriate treatment, which includes the use of antifungal medication and surgical procedures, are vital for enhancing the prognosis of patients. The objective of this study is to investigate the response to treatment in patients hospitalized due to basidiobolomycosis. Methods We carried out a retrospective study, in which we analyzed data from 49 patients who were diagnosed with Entomophthorale, Zygomycosis, and Basidiobolomycosis at Namazi Hospital, Shiraz, between the years 1997 and 2019. The data included parameters such as demographic information, clinical symptoms, imaging findings, treatment methods, and patient outcomes. Results Out of 49 patients, 24 children, predominantly male (83.3%), were definitively diagnosed with basidiobolomycosis. The ages of the patients ranged from 1 to 16 years, with an average of 5.75 years. The most frequently observed clinical manifestations included abdominal pain (70.8%), fever (54.2%), hematochezia (41.7%), vomiting (20.8%), and anorexia (16.7%). Half of the patients exhibited failure to thrive (FTT), while abdominal distension was present in 25% of the cases, and a palpable abdominal mass was found in 37% of the patients. The primary treatment strategy incorporated surgical interventions complemented by a comprehensive antifungal regimen. This regimen included medications such as amphotericin B, cotrimoxazole, itraconazole, potassium iodide, and voriconazole. These were mainly administered in a combination therapy pattern or as a monotherapy of amphotericin B. Twenty-two patients were discharged, while two patients died due to complications from the disease. Conclusion Our findings indicate that the prevailing treatment modalities generally involve surgical intervention supplemented by antifungal regimens, including Amphotericin B, Cotrimoxazole, Potassium Iodide, and Itraconazole.

Abstract Cardiometabolic risk factors increase the chance of developing cardiovascular disease (CVD) and type 2 diabetes. Most CVD risk factors are influenced by total and regional obesity. A higher risk of developing CVD may be linked to vitamin D deficiency, which is more prevalent in the older population. With the goal of evaluating the association between vitamin D and cardiometabolic risk factors and total and regional obesity in older adults, this research included 25 (OH) vitamin D3 concentrations and biochemical markers associated with cardiometabolic diseases, as well as total and regional adiposity, which was measured by DXA. A total of 1991 older participants in the PoCOsteo study were included. Overall, 38.5% of participants had vitamin D deficiency. After adjusting for confounders, the results of multiple linear and logistic regression suggested an inverse association between vitamin D and body mass index (P = 0.04), waist circumference (P = 0.001), total fat (P = 0.02), android fat (P = 0.001), visceral fat (P

Background: Parkinson's disease (PD) is a complex neurodegenerative disorder characterized by dopamine depletion and severe motor impairments. Preladenant, an adenosine A2 receptor antagonist, is an investigational treatment for PD. This systematic review and meta-analysis aimed to critically evaluate the efficacy of Preladenant in improving motor symptoms in patients with PD. Methods: A comprehensive literature search was conducted in PubMed, Embase, and Cochrane Central Register of Controlled Trials from inception to March 2023, following the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines. Randomized controlled trials (RCTs) comparing Preladenant with placebo in PD patients were included. The primary outcome was the change in daily ON time without troublesome dyskinesia. Secondary outcomes included the change in daily OFF time and adverse events. The risk of bias was assessed using the Cochrane Risk of Bias tool. Results: Four RCTs with a total of 2097 PD patients were included. Pooled analysis showed that Preladenant could generally increase daily ON time (pooled effect 0.15 and 95 % CI: −0.19–0.48) and reduce daily OFF time (pooled effect −0.04 and 95 % CI: −0.43–0.36) compared to placebo, however it was not significant. The included studies had moderate to high heterogeneity. No significant differences in adverse events were observed between Preladenant and placebo. Conclusion: This meta-analysis suggests that Preladenant may improve motor fluctuations in PD patients by increasing ON time and reducing OFF time. However, the high heterogeneity among studies warrants further large-scale, high-quality RCTs to confirm these findings and establish the long-term safety and efficacy of Preladenant in PD management.

Background: Osteopenia is a relatively common disorder in premature infants. If this disease is not diagnosed and treated timely, it would be impaired growth in infancy. Objectives: Present study was performed for assessment relationship between osteopenia and neonatal/maternal factors among premature neonates that hospitalized in neonatal intensive care unit of Afzalipour Medical Center. Methods: Present cross-sectional study was performed on 100 premature infants, who were admitted to the NICU of Afzalipour Medical Center in Kerman during 2017-2018. Alkaline phosphatase a screening criterion for osteopenia was measured in infants aged one month and its relation with factors such as birth weight, weight gaining, duration of hospitalization, duration of intravenous feeding, type of nutrition, volume of formula and food supplement consumption were evaluated. Results: Of the total 100 preterm babies, based on the criterion utilized for diagnosis of osteopenia (alkaline phosphatase above 900 units/L), 41 infants had osteopenia of prematurity Prevalence of osteopenia was 41%. Infants who used breastmilk alone has mostly osteopenia of prematurity. Prevalence of osteopenia was higher among girls in compare with boys. Mean length of hospitalization, Total parenteral nutrition venous feeding in neonates with osteopenia were higher among in compare with other neonates. Mean of maternal serum level of vitamin D in mothers of premature neonates with osteopenia was significantly lower in compare with others. Conclusions: Infants that intake exclusively breast milk was more vulnerable to osteopenia, and supplement should be considered in these infants.

Abstract Suicide is a major public health challenge worldwide with an increasing trend. Identifying risk factors for suicide attempts and suicide deaths may help find useful ways to prevent suicide. We aimed to determine the trend and related factors of suicide attempts and suicide deaths in Rafsanjan. This retrospective study included all suicide cases from 2018 to 2022 in Rafsanjan, a city in the southeast of Iran. The information was extracted from the suicide registration system of Rafsanjan University of Medical Sciences. Univariable and multivariable logistics regression models were used to investigate factors affecting suicide death. A total of 2039 cases of suicide, including 1932 cases (94.75%) of suicide attempts and 107 cases (5.25%) of suicide deaths were recorded during the study period. The frequency of suicide deaths and suicide attempts per 100,000 people increased in 2022 compared to 2018 in both genders. In the adjusted model, the odds of suicide deaths in males was 6.48 (95% CI 3.39–12.42) times higher than in females. Also, the odds of suicide deaths in unemployed subjects and housewives were 2.64 (95% CI 1.50–4.67) and 7.45 (95% CI 3.08–18.07) times higher than employed subjects respectively. Finally, people with education less than a diploma had 10.85 (95% CI 1.48–79.54) times higher odds of suicide deaths compared to people with university education. The present research showed that the pattern of suicide has been increasing since 2018, and we may see an upward trend in the coming years, which requires further investigation and preventive measures. Male gender, low education level, unemployment, and being a housewife were associated with the highest frequency of suicide death.

Abstract Gene manipulation of hematopoietic stem cells (HSCs) using the CRISPR/Cas system as a potent genome editing tool holds immense promise for addressing hematologic disorders. An essential hurdle in advancing this treatment lies in effectively delivering CRISPR/Cas to HSCs. While various delivery formats exist, Ribonucleoprotein complex (RNP) emerges as a particularly efficient option. RNP complexes offer enhanced gene editing capabilities, devoid of viral vectors, with rapid activity and minimized off-target effects. Nevertheless, novel delivery methods such as microfluidic-based techniques, filtroporation, nanoparticles, and cell-penetrating peptides are continually evolving. This study aims to provide a comprehensive review of these methods and the recent research on delivery approaches of RNP complexes to HSCs.

Abstract Background Endometriosis is a chronic and debilitating disease that can affect the entire reproductive life course of women, with potential adverse effects on pregnancy. The aim of the present study is to investigate the association between hypertensive disorders in pregnancy and endometriosis. Method Relevant articles were searched from the Cochrane Library, PubMed, Scopus and Web of Science from inception up to December 2023. The full-text observational studies published in English that had a confirmed diagnosis of endometriosis were included. The case group included pregnant women diagnosed with endometriosis at any stage, while the control group consisted of pregnant women who had not been previously diagnosed with endometriosis. Two authors extracted and analyzed the data independently. Disagreements were reconciled by reviewing the full text by a third author. Endnote X9 was used for screening and data extraction. We used fixed and random effects models in Review Manager 5.3 to analyze the pooled data. The quality of the included studies was assessed using the Downs and Black checklist. Results Out of the 9863 articles reviewed, 23 were selected for meta-analysis. According to the results of this study, there was an association between endometriosis and gestational hypertension (OR = 1.11, 95% CI: 1.06, 1.16; I 2 = 45%, P

Abstract Background Colorectal cancer has created a significant burden worldwide, including in Iran. Open and laparoscopic surgery are important treatment methods for this disease. The aim of this study is to compare postoperative outcomes of laparoscopic versus open surgery in Iran, with a particular emphasis on controlling confounding factors. Methods To control confounding factors in between-group comparisons of observational studies, a method based on propensity scores was used. The current study was conducted on 916 patients with colorectal cancer in the city of Shiraz between the years 2011 to 2022. The required data regarding treatment outcomes, type of surgery, demographic characteristics, and clinical factors related to cancer was extracted from the Colorectal Cancer Research Center of Shiraz University of Medical Sciences. To control confounding factors, we used the Inverse Probability of Treatment Weighting (IPTW) as one of the analytical approaches based on Propensity Score analysis. After IPTW analysis, univariate logistic regression was used for treatment effect estimation. Stata 17 was used for statistical analysis. Results After controlling for 24 clinical and demographic covariates, negative post-operative outcomes were significantly lower in laparoscopic than open surgery. There were significant differences between the two groups of surgery in the percentages of death due to cancer (P

Abstract Studies on the beneficial role of dietary antioxidants in preventing or managing hypertension in postmenopausal women are infrequent. The present cross-sectional study aimed to assess the association between dietary antioxidants and hypertension among menopausal women in Rafsanjan, a city located in the southeast of Iran. This study was based on data from the Rafsanjan Cohort Study (RCS), as part of the Prospective Epidemiological Research Studies in IrAN (PERSIAN). Among 2359 postmenopausal women, finally, 1936 women were included in this study. Participants were grouped as having normal blood pressure (BP), elevated BP, stage 1 hypertension, or stage 2 hypertension as defined by the 2017 American College of Cardiology (ACC)/American Heart Association (AHA) BP guideline. A food frequency questionnaire (FFQ), was utilized to ascertain the levels of various nutrients and dietary antioxidants in the diet. The association between dietary intakes of antioxidants and blood pressure groups was evaluated by crude and adjusted models in the multinominal logistics regression analysis. Normal BP, elevated BP, stage 1 hypertension, and stage 2 hypertension were observed in 35.69%, 3.62%, 10.59%, and 50.10% of postmenopausal women respectively. In the adjusted model, in subjects with higher consumption of β-carotene, the odds ratios of elevated BP in the 3rd quartile was about 2 times (OR: 2.04 (1.06–3.93) higher than 1st quartile. Also, in subjects with medium quality of DAQS, the odds ratios of elevated BP and stage 1 blood pressure were about 2 times (OR: 2.09 (1.05–4.17) and 1.69 times (OR: 1.69 (1.09–2.63) higher than subjects with low quality respectively. Furthermore, we did not find any statistically significant association between increased intake of dietary antioxidants and decreased odds of hypertension. After controlling the effects of confounding variables, increased dietary intake of selenium, carotenoids, vitamin A, vitamin C, and vitamin E did not decrease the odds of hypertension in postmenopausal women. Accordingly, it is suggested that this association be further investigated in the follow-up phase of this prospective study.

Background: Coronavirus disease 2019 (COVID-19) is a pandemic outbreak of RNA coronaviruses (SARS-CoV-2), associated with acute respiratory distress syndrome, multiple organ failure, and death. The surface electrocardiogram is the first line assessment of cardiac electrical system. We aimed to interpret classically the electrocardiographic parameters at admission and during hospital course and association of them with prognosis in patients admitted with diagnosis of infection with SARS-CoV-2. Methods: Surface electrocardiograms (ECG) were obtained from 180 patients with SARS-CoV-2 infection at a large tertiary referral university hospital at north of Iran in Babol. The electrocardiographic waves, intervals and segments in addition to supraventricular and ventricular arrhythmias were depicted. Our cohort included two groups: discharged alive and dead during the hospital course. We compared the ECG characteristics of patients who died vs. survived ones. Results: Some ECG parameters of 180 hospitalized patients were significantly associated with mortality, like heart rate (p< 0.001), bundle branch block (P= 0.035), fragmented QRS (P= 0.015), ST elevation (P= 0.004), T p-e duration (P= 0.006), premature atrial and ventricular complexes (P= 0.030, P= 0.004) and atrial fibrillation (P= 0.003). Conclusion: The SARS-CoV-2 infection had several impacts on cardiac electrical system which may monitored with a simple and easily accessible tool like ECG. This tool also helpful in the risk stratification of patients.

Background: Healthcare-associated infections (HAIs) in intensive care unit (ICU) patients significantly complicate the normal hospitalization process and affect patients’ condition, length of hospitalization, mortality, and treatment cost. In this study, we aimed to determine the prevalence and economic burden of HAIs. Methods: The study involved all patients with a confirmed HAIs (based on CDC/NHSN case-definitions); in the general ICU of a tertiary university hospital in Tehran, from April 2020 to March 2021. The patients’ information, including length of hospitalization, outcome, type and cost of prescribed antibiotics, were recorded. Results: During the study period, 119 HAIs were found in 1395 (43% F / 57% M) patients. The prevalence of nosocomial infections was 8.53%. The mean duration of hospitalization in all ICU patients was 4.7 ± 3.1 days, and 31.85 ± 18.96 days in patients with HAIs. The most common organisms involved in HAIs are Acinetobacter baumannii (54.6%), Klebsiella pneumoniae (30.3%), E. coli (15.1%), and Enterococcus spp. (12%). Incidence density of ventilator-associated pneumonia (VAP), central line-associated bloodstream infection (CLA-BSI), and catheter-associated urinary tract infection (CA-UTI) per 1000 device-days were 36.08, 17.57, and 8.86, respectively. The total cost of antibiotics for HAIs was € 105,407. Among these, the highest consumption costs were for carbapenems, followed by colistin and caspofungin. Conclusion: This study showed the high burden of nosocomial infections in ICUs. Strategies for more strict infection prevention and control are necessary to reduce this burden.

Background: The role of mathematics in the present digital world is very important. Due to its nature, mathematics is mostly disliked by students, especially those with learning disorders. Using e-learning in mobile environments and new teaching methods, the complementary sessions needed for students with learning disorders can be enriched. This group of students is most of the time forgotten. This study investigated the impact of adaptive game-based instruction on the mathematical performance of students with mathematics learning disorders. Aims: The present study was conducted to investigate the impact of adaptive game-based instruction on the mathematical performance of students with learning difficulty in a mobile learning environment. Methods: The current research design was the quasi-experimental type of pre-test-post-test and control group. The statistical population of the research included the students with a mathematics learning disorder in Malard, Tehran, in the second grade of primary school, in the academic year of 2022-2023 from which 10 samples were available that randomly were divided into two groups: experimental (5 people) and control (5 people). The experimental group attended 8 educational sessions in the Shad mobile environment in June 2023 using Shad facilities including messenger and games which are proposed by the experts of the Ministry of Education. For the pre-test and post-test, the questions from the Kangaroo Mathematics Competition 2021 were used and the data were analyzed using SPSS26 and univariate analysis of variance. Results: The research findings show that there is a meaningful difference between pre-test and post-test (F= 25.878, p= 0.001). There is also a meaningful difference between the control group and the experimental group in the post-test (F= 6.392, p= 0.039). According to the obtained results, it was concluded that adaptive game-based instruction has a positive impact on the mathematical performance of students with learning disorders in a mobile learning environment. Conclusion: The results showed that using game-based adaptive learning in a mobile learning environment for students with mathematics learning disorder can help these students improve their mathematical performance at their preferred pace and content with educational support. As Shad environment facilities are available for all students in Iran, schools and learning disorder centers can use game-based adaptive instruction in Shad environment to help the students improve their performance through ongoing learning.

Abstract This review examines various methods of reducing acrylamide levels in processed foods, focusing on thermal and nonthermal methods. Acrylamide, which is mainly formed by the Maillard reaction, poses a health risk and therefore requires the implementation of successful mitigation strategies. The processes by which acrylamide is formed, particularly at temperatures above 120°C, such as frying, roasting, and cooking (however, the practical temperature in the inner of foods does not exceed 120°C), serve as a basis for understanding intervention methods. The effectiveness of thermal technologies, including optimization of time and temperature as well as pretreatment and posttreatment techniques, will be studied in detail. In addition, vacuum‐based technologies such as baking, predrying, frying, deep‐frying, and impregnation are examined to shed light on their underlying mechanisms. Advanced thermal techniques such as microwaves and irradiation will be investigated to evaluate their effectiveness in reducing acrylamide. Furthermore, nonthermal methods, including pulsed electric fields, ultrasound treatments, and novel combinations such as pulsed electric fields and blanching, are being investigated. Various enzymatic interventions with asparaginase and glucose oxidase as well as yeast treatments and fermentations offer a wide range of intervention possibilities. The use of additives/coatings and plant extracts, such as edible coatings, polyphenols, and specific ingredient formulations, has shown promise for acrylamide reduction. This paper highlights the commercial implications, future prospects, and barriers to implementation of these methods. By examining different approaches, this comprehensive analysis emphasizes the importance of using different strategies to successfully reduce acrylamide levels in processed foods and provides guidance to the food industry to improve product safety and quality.

Purpose: To build, train, and assess the artificial neural network (ANN) system in estimating the residual valve rate after endoscopic valve ablation and compare the data obtained with conventional analysis. Methods: In a retrospective cross-sectional study between June 2010 and December 2020, 144 children with a history of posterior urethral valve (PUV) who underwent endoscopic valve ablation were enrolled in the study. MATLAB software was used to design and train the network in a feed-forward backpropagation error adjustment scheme. Preoperative and postoperative data from 101 patients (70%) (training set) were utilized to assess the impact and relative significance of the necessity for repeated ablation. The validated suitably trained ANN was used to predict repeated ablation in the next 33 patients (22.9%) (test set) whose preoperative data were serially input into the system. To assess system accuracy in forecasting the requirement for repeat ablation, projected values were compared to actual outcomes. The likelihood of predicting the residual valve was calculated using a three-layered backpropagating deep ANN using preoperative and postoperative information. Results: Of 144 operated cases, 33 (22.9%) had residual valves and needs to repeated ablation. The ANN accuracy, sensitivity, and specificity for predicting the residual valve were 90.75%, 92.73%, and 73.19%, respectively. Younger age at surgery, hyperechogenicity of the renal parenchyma, presence of vesicoureteral reflux (VUR), and grade of reflux before surgery were among the most significant characteristics that affected postoperative outcome variables, the need for repeated ablation, and were given the highest relative weight by the ANN system. Conclusions: The ANN is an integrated data-gathering tool for analyzing and finding relationships among variables as a complex non-linear statistical model. The results indicate that ANN is a valuable tool for outcome prediction of the residual valve after endoscopic valve ablation in patients with PUV.

Abstract The association between personal habits and metabolic syndrome (MetS) remains controversial. This study aimed to assess the prevalence of MetS among youths and its association with cigarette, tobacco, opium, and alcohol consumption in the Rafsanjan Youth Cohort Study (RYCS). The current cross-sectional study was based on data from RYCS, as part of the Rafsanjan Cohort Study (RCS). RCS is a branch of the prospective epidemiological research studies in Iran (PERSIAN). In the present study, 2843 youths aged 15–35 were included. MetS was diagnosed using the international diabetes federation (International IDF), National Cholesterol Education Panel- Adult Treatment Panel III (NCEP-ATPIII), and Iranian criteria (IDF Iranian). Binary logistic regression models were performed to estimate odds ratios (ORs) and confidence intervals (CIs). The prevalence of MetS was 7.67%, 7.14%, and 10.13% based on NCEP-ATPIII, IDF Iranian, and International IDF criteria respectively. The odds of MetS according to international IDF and Iranian IDF in the alcohol-drinking group in the last 12 months (OR: 1.51, 95%CI 1.02–2.21, OR: 1.66, 95%CI 1.11–2.48 respectively) were greater compared with the non-drinking group. The odds of having high TG in the alcohol-drinking group in the last 12 months was 1.53 times higher than the control group (OR = 1.53, 95% CI: 1.20–1.94). Furthermore, the odds of having high waist circumference (WC) according to IDF International was significantly higher in the tobacco-smoking group in the last 12 months and in the tobacco-smoking group in the last 12 months daily (OR: 1.23, 95%CI 1.01–1.49 and OR: 1.41, 95%CI 1.01–1.98 respectively) compared to the control groups. The prevalence of MetS was 7.67%, 7.14%, and 10.13% based on NCEP-ATPIII, IDF Iranian, and International IDF criteria respectively. The odds of MetS and high TG were greater in the alcohol-drinking group in the last 12 months compared with the non-drinking group. The odds of high WC in the last 12 months, were greater in the tobacco-smoking group compared with the non-smoking group. However, more longitudinal studies are needed to verify the associations observed in the current study.

The purpose of this research is the evaluation of effective criteria for the desirability of financial stability integration based on the comparison of metaheuristic algorithms in banks listed on the Tehran Stock Exchange. Initially, through a systematic content screening process, the effective criteria for the desirability of financial stability integration are used to evaluate banks listed on the Tehran Stock Exchange. Then, relying on two algorithms of Particle Swarm Optimization and Gray Wolf, the study reveals that both innovative algorithms used in this study have the necessary capability to determine the desirability of the financial stability of banks listed on the Tehran Stock Exchange.Metaheuristic Algorithms, Financial Stability Integration, The Desirability of Banks' Efficiency. IntroductionOne of the most important changes in the economic systems of societies is the increasing focus on the functions of financial stability in the banking systems of countries, which has been increasingly taken into account in macroeconomic policies. It is important to note that, due to reasons such as international sanctions, the banking system in developing countries faces many challenges, including disruptions in the banking system and financial exchanges as a result of the reduced foreign trade. This can lead to increased financial costs and risks, reduce public trust in the banking system, diminish international interactions with foreign banks, and disrupt the economic balance. The purpose of this research is the evaluation of effective criteria for the desirability of financial stability integration based on the comparison of metaheuristic algorithms in banks listed on the Tehran Stock Exchange. Literature ReviewFinancial stability in the banking system is defined as a low level of vulnerability to possible risks, which creates a level of balance and stability in banking systems through the ability to resist economic challenges. Elsa et al. (2018) also considered the financial stability of banks as a basis for economic growth functions in a definition and stated that a dynamic banking system needs to control the risks and costs of commercial transactions in a balanced economy to achieve stable financial stability. On the other hand, Verma and Chakarwarty (2023) suggested that if financial stability does not govern the banking systems of countries and they do not have the necessary efficiency, the optimal direction of resources to industries faces a serious challenge, and this issue can affect the country's economic growth in a short period. MethodologyThis study employs a combined and applied methodology. Initially, through a systematic content screening process, the effective criteria for the desirability of financial stability integration are used to evaluate banks listed on the Tehran Stock Exchange. Then, relying on the two algorithms of Particle Swarm Optimization and Gray Wolf and extracting data related to the criteria identified between 2017 and 2018, efforts are made to determine the optimal point of desirability of financial stability integration for banks listed on the Tehran Stock Exchange. In this process, based on the expansion of the mathematical equations of each metaheuristic algorithm and the command codes of the MATLAB software, necessary actions are taken to answer the research questions. ResultThe results showed that both innovative algorithms used in this study have the necessary capability to determine the desirability of the financial stability of banks listed on the Tehran Stock Exchange. However, based on the Wilcoxon Signed-Rank Test coefficients, the Gray Wolf algorithm is more accurate than the Particle Swarm Optimization algorithm for predicting the function of the identified criteria in determining the desirability of financial stability of banks listed on the Tehran Stock Exchange. The results after executing command processes in MATLAB software indicated that both algorithms have the necessary capability to determine the desirability of the financial stability of banks admitted to the Tehran Stock Exchange. However, based on the coefficients of the Wilcoxon test, the Gray Wolf algorithm has a higher accuracy than the Particle Swarm Optimization algorithm for predicting the performance of the identified criteria in determining the desirability of the financial stability of accepted banks. It is also found that the most effective criterion in strengthening the determination of the desirability of financial stability of banks is the liquidity circulation "ϑ3" in the Gray Wolf algorithm. DiscussionIt is also found that the most effective criterion in strengthening the determination of the desirability of banks' financial stability is the Turnover Ratio in the Gray Wolf algorithm. The coefficients obtained in the Gray Wolf algorithm indicate a more effective optimization of effective criteria in determining the financial desirability of the country's banking system. This issue provides an explanation for the interpretation that banks can benefit from this algorithm for financial planning and covering their weaknesses in preserving resources even in the risky conditions of today's economy. ConclusionThe results show that the banks whose total value of transactions in the capital market is higher than the average value of their total shares over a certain period have higher capacities for liquidity circulation. Furthermore, in providing banking services in current and investment matters in competitive projects, these banks have the upper hand compared to other banks. The existence of such added value of shares in the capital market can be considered as contributing to higher returns and lower risk for investing in these banks. Therefore, as the basics of determining the comparative evaluation between algorithms, i.e., the constant return to scale (CRS) and the variable return to scale (VRS) showed banks with higher liquidity circulation and relying on the Gray Wolf algorithm reach the optimal point faster. This finding illustrates the flexibility of financial resources in timely allocation to the market and industries, which can bring higher returns for their shareholders in the long run.

Introduction: Although currently assisted reproductive methods are widely used in the treatment of human infertility, there are still contradictory results of studies on the growth of children after treatment with these methods, including IVF. Therefore, the present study was performed with aim to determine the growth parameters (weight, height and head circumference) in neonates born by IVF in Motazedi and Jahad University Infertility Treatment Centers in Kermanshah city. Methods: This analytical study was conducted on 105 term neonates born in two groups of IVF infertility treatment and normal pregnancy during 2021-2022. All stages of IVF were performed in Motazedi and Jahad University Infertility Treatment Centers in Kermanshah, and then the mothers and their neonates were followed up until after birth. The information of newborns was checked in terms of height, weight and head circumference and recorded in a checklist which was the main and exclusive tool for collecting the study information. Data analysis was done using SPSS statistical software (version 20) and chi-square and Mann-Whitney U tests. P

Background. Having problems in regulating the emotions is considered as the main core of depression disorder and rumination is one of the cognitive components in individuals with depression disorder. The objective of this study was to consider the effect of mindfulness training on rumination and cognitive regulation of emotion in students with depressive symptoms. Methods. This study was a semi-experimental method with a pre-test-post-test design with a control group. The statistical population included all 350 students of the Faculty of Nursing of Tabriz University of Medical Sciences in 2023-2022, among whom the Beck Depression Questionnaire was administered. Among them, 30 students with symptoms of depression (15 as experimental and 15 as control) were selected by purposive sampling method. The emotion regulation scale and rumination questionnaire were used to collect data. Results. The findings showed a significant difference between the experimental and control groups in terms of rumination and cognitive regulation of emotion (P

Abstract Background Infants who are born from mothers with substance use disorder might suffer from neonatal abstinence syndrome (NAS) and need treatment with medicines. One of these medicines is phenobarbital, which may cause side effects in long-term consumption. Alternative drugs can be used to reduce these side effects. This study seeks the comparison of the effects of phenobarbital & levetiracetam as adjuvant therapy in neonatal abstinence syndrome. Methods This randomized clinical trial was performed in one year from May 2021 until May 2022. The neonates who were born from mothers with substance use disorder and had neonatal abstinence syndrome in Afzalipoor Hospital of Kerman were studied. The treatment started with morphine initially and every four hours the infants were checked. The infants who were diagnosed with uncontrolled symptoms After obtaining informed consent from the parents were randomly divided into two groups and treated with secondary drugs, either phenobarbital or levetiracetam. Results Based on the obtained results, it was clear that there was no significant difference between the hospitalization time of the two infant groups under therapy (phenobarbital: 18.59 days versus Levetiracetam 18.24 days) (P-value = 0.512). Also, there was no significant difference between both groups in terms of the frequency of re-hospitalization during the first week after discharge, the occurrence of complications, and third treatment line prescription (P-value = 0.644). Conclusions Based on the obtained results, like hospitalization duration time (P-value = 0.512) it seems that levetiracetam can be used to substitute phenobarbital in treating neonatal abstinence syndrome. Trial registration The current study has been registered in the Iran registry of clinical trials website (fa.irct.ir) on the date 25/2/2022 with registration no. IRCT20211218053444N2.

Abstract Colorectal cancer (CRC) is deadly anaplastic changes in the gastrointestinal tract with high-rate mortality. In recent years, the application of phytocompounds has been extended along with different therapeutic protocols. Here, we monitored the effects of Thymoquinone (TQ) on autophagy via mitochondrial function after modulation of the Wnt/β-catenin signaling pathway. Human colorectal adenocarcinoma HT-29 cells were treated with TQ (60 µM) and 15 µM Wnt3a inhibitor (LGK974) for 48 h. The survival rate was evaluated using an MTT assay. The expression of Wnt-related factors (c-Myc, and Axin), angiogenesis (VE-Cadherin), and mitophagy-related factors (PINK1, OPTN) was assessed using real-time PCR assay. Protein levels of autophagy factors (Beclin-1, LC3, and P62) were monitored using western blotting. Using flow cytometry analysis, the intracellular accumulation of Rhodamine 123 was evaluated. The migration properties were analyzed using a scratch wound healing assay. Data indicated that TQ can reduce the viability of HT-29 cells compared to the control cells (p

Abstract Background Predicting and finding the viral agents responsible for neonatal late-sepsis has always been challenging. Method In this cross-sectional study, which has been done from September 2020 to December 2022, 145 hospitalized neonates suspected to late-onset sepsis alongside routine sepsis workup, were also evaluated for severe acute respiratory syndrome-coronavirus-2 (SARS-COV-2) infection, by nasopharyngeal real-time polymerase chain reaction (RT-PCR) or serological tests. Result 145 neonates including 81 girls and 64 boys with a mean age of 12.3 ± 5.9 days and an average hospitalization stay of 23.1 ± 15.4 days were enrolled in the study. While 76.6% of them had negative bacterial culture, 63 patients (43.4%) showed evidence of SARS-COV-2 infection in RT-PCR or serology tests. None of the underlying factors including gender, age, and laboratory investigation had a significant relationship with SARS-COV-2 infection. Similarly, the outcomes of death and length of hospitalization were not different between the two groups with positive and negative SARS-COV-2 RT-PCR (P

Objective: Asthma is a common disease and curcumin has modest effect in inflammatory disorders. This study investigated the efficacy of nano-curcumin on asthma.Materials and Methods: In this double-blinded randomized clinical trial, 60 patients with non-atopic bronchial asthma were randomly stratified in two groups of intervention (N=30) and control (N=30) groups. Apart from their standard treatment, the intervention group received 40 mg nano-curcumin (soft gel) three times daily while the control group received placebo. During the 60-day study, patients were assessed using spirometry to measure Forced expiratory volume in first second (FEV1). Asthma control test (ACT) was completed every 30 days and asthma quality of life questionnaire (AQLQ) was completed at the first and end of the study.Results: Totally, 31 patients (51.7%) were male and the mean age was 51.45±12.58 years. FEV1 was improved but there was no significant difference between intervention and control groups. ACT and AQLQ domains scores significantly improved. However, it was not statistically different between control and intervention groups.Conclusion: Nano-curcumin at administered dosage had no additive effect on the standard treatment in asthmatic patients.

Background: Anaerobic co-digestion (AcoD) of various wastes is a suitable method for the removal of contaminants and biogas production. The first aim of this study was to determine the optimal ratio of landfill leachate (LL) and sewage sludge (SS) for AcoD, and the second one was to evaluate the effect of pre-ozonation of the mixture on AcoD. Methods: The LL and SS samples were taken from landfill sites and municipal wastewater treatment plants (MWTPs), respectively. In the first step, five reactors were used and named R1 (100% SS), R2(100% LL), R3 (15% LL/85% SS), R4 (25% LL/75% SS), and R5 (45% LL/55% SS). Mesophilic anaerobic digestion (AD) was performed on the reactors and the optimal ratio was determined. In the second stage, the optimal mixtures were subjected to an ozonation process before AcoD. Results: The results of the first stage showed that the highest efficiency removal of the total solids (TS), volatile solids (VS), and chemical oxygen demand (COD), and the highest biogas production belonged to R3 digester, containing 15% LL and 85% SS. In the second stage, the results showed that the removal efficiency of COD and VS in the ozonated sample at the dosage of 7.6 gO3/h were 29.8% and 36.6% higher than the non-ozonated sample, respectively. Furthermore, in the ozonated sample, the biogas yield and the content of methane in the gas mixture were 27% and 9% higher respectively, compared to the non-ozonated sample. Conclusion: According to the results, the appropriate ratio of LL to SS and pre-ozonation of LL/SS mixture have a great impact on the performance of AcoD.

Background: A healthy organization is a place which is productive, capable, and efficient enough to deal with the competitive world. The quality of work life is important, not only to improve life at working environment but also the life outside work place; there the present study examines the relationship between organizational happiness and work life in teaching hospitals in Yazd city in 2023. Methods: This cross-sectional study was conducted in the form of a multi-stage random sampling on 215 people and among the personnel of teaching hospitals in Yazd city. Data collection tool included two standard questionnaires regarding an organizational happiness and the quality of work life. Data were analyzed using descriptive statistics and independent t-student test, one-way ANOVA and Pearson's correlation coefficient test with SPSS 26 software. Results: The findings indicated that there was no significant relationship between organizational happiness and any of the demographic variables. In addition, only the education variable (p = 0.011) had a significant relationship with the quality of life variable. Pearson's correlation test also showed that there was a positive and significant relationship between all the components of organizational happiness and the quality of work life. Conclusion: According to the results of this study, it is necessary for managers and officials to consider organizational happiness and its important components in organizations by adopting appropriate strategies and providing necessary conditions for its promotion.

Abstract Hypothyroidism has been linked to reduced mortality rate and increased lifespan and health span. Telomere shortening, enhanced oxidative stress, and reduced cellular mitochondrial content are important hallmarks of aging shown to be related to age-associated diseases. It was proposed that the status of these markers in early life can be predictive of lifespan and the predisposition to certain age-associated disease in adulthood. Animal studies indicated that prenatal injection of thyroid hormones affects postnatal telomere length. Here, we sought to determine whether thyroid hormones TSH and fT4 are related to the telomere length, mitochondrial DNA copy number (mtDNAcn), and oxidative stress resistance marker GPX in the cord blood of newborns. In this study, we analyzed 70 mothers (18–42 years) and neonate dyads born in 2022 at the Nik Nafs maternity Hospital in Rafsanjan. The relative telomere length (RTL) and mtDNAcn were measured in the genomic DNA of cord blood leukocytes using real-time PCR. GPX enzyme activity was measured in the serum using colorimetric assays. In this study the correlation between these markers and the cord blood TSH and fT4 hormones were assessed using regression models. We found a reverse relationship between TSH levels and RTL in the cord blood of neonates. Additionally, our results displayed increased TSH levels associated with enhanced GPX activity. Regarding the mitochondrial DNA copy number, we found an indirect relationship between fT4 level and mtDNAcn only in male newborns. Future analyses of various oxidative stress markers, mitochondrial biogenesis status, telomerase activity, and the level of DNA damage are warranted to demonstrate the underlying mechanism of our observations.

Abstract In this paper, an automatic design method is proposed for unit cell in spoof surface plasmon polaritons (SSPP) with an almost arbitrary dispersion curve. In this method, the pixel configuration is considered for the unit cell and, by using the binary particle swarm optimization method, the proper topology of the unit cell is explored so as to reach the target dispersion curve. Unlike the traditional method of controlling the dispersion curve, which is performed based on changing the geometric parameters of the predetermined unit cell, in this method, there is no need to know the shape of the unit cell, and the dispersion curve of the modes of SSPP unit cell can be controlled independently with more freedom. Two unit cell samples are designed in order to show the efficiency of the procedure. In the first sample, the dispersion curve is designed to have the lowest asymptotic frequency; in the second sample, the dispersion curve of the second mode is controlled independently from the first mode and is changed arbitrarily. SSPP transmission lines which are related to the unit cells of the two samples are designed, and it is demonstrated that measurement and simulation results are greatly in line with each other.

Abstract Background The origins of pyocele are primarily idiopathic, with reports suggesting the spread from intraperitoneal or hematogenous infection. However, we found no information in the literature regarding the pathogen’s spread from the urinary tract. Case presentation We report here a case of a 23-day-old term Iranian boy (Fars ethnicity) with complaints of new-onset fever, irritability, poor feeding, right hemiscrotal erythema, and edema. Moreover, the physical examination revealed an enlarged, erythematous, tender right hemiscrotum and edematous scrotal walls. Along with leukocytosis and elevated C-reactive protein levels, the urine culture indicated an infection with Escherichia coli. However, as the color Doppler ultrasonographic examination was inconclusive, he underwent surgical exploration on which a hydrocele sac with reddish cloudy pus fluid was noted, with its culture indicating growth with the same mentioned pathogen. Therefore, an appropriate antibiotic regimen was administered, and the patient was discharged a few days later after achieving full recovery and demonstrating no urinary tract structural abnormalities. Conclusion In neonatal pyocele, the spectrum of evaluating the source of the infection should also be extended to the urinary tract. Moreover, administering suitable antibiotics would produce favorable results in cases with no structural abnormalities.

Metronidazole (MTZ) is a vital antimicrobial agent widely used in the treatment of various infections. However, its limited bioavailability and associated side effects necessitate the development of efficient drug delivery systems to enhance therapeutic efficacy and minimize adverse reactions. The field of nanotechnology and nanomaterials presents promising solutions for delivering MTZ, leveraging their unique properties to overcome these challenges. This comprehensive review explores a variety of nanomaterial-based approaches for MTZ delivery, emphasizing the benefits such as improved drug stability, targeted release, and enhanced bioavailability. Various nanocarrier systems, including polymeric nanoparticles, lipid-based nanocarriers, and inorganic nanoparticles, are evaluated for their potential in MTZ delivery applications. The review underscores strategies aimed at reducing MTZ's side effects through controlled release and targeted delivery, with nanocarriers facilitating sustained drug release to minimize fluctuations in drug concentrations and potentially mitigate adverse reactions linked to MTZ administration. Furthermore, innovative combination therapies involving MTZ and other drugs are investigated for their ability to enhance therapeutic outcomes and combat drug resistance. Co-delivery systems show promise in synergistically targeting infections while reducing overall dosage and associated side effects. By summarizing the latest advancements in MTZ delivery, this review provides valuable insights into the potential of nanotechnology-based strategies for optimizing MTZ therapy. These approaches have the potential to transform drug delivery, offering safer and more effective treatments for infectious diseases, and improving patient outcomes by reducing adverse effects.

Background: Clinical, radiological, and laboratory findings characteristic of the coronavirus disease 2019 (COVID-19) infection have already been investigated and identified; however, data on pregnant women infected with COVID-19 are limited. This study aims to examine the clinical, radiological, and laboratory characteristics of pregnant women compared to non-pregnant women with COVID-19 disease. Method: This hospital-based retrospective age-matched case-control study included two groups, pregnant and non-pregnant women, each consisting of 51 patients hospitalized with COVID-19 in Bushehr, Iran. Demographic, clinical, and laboratory information was extracted from medical records using a predefined checklist. Results: Except for cough, there were no statistically significant differences in clinical signs and symptoms between pregnant and non-pregnant women. Although hemoglobin oxygen saturations are statistically significant among the two groups, this difference is not clinically significant (95% vs 93%). There were no statistically significant differences between pregnant and non-pregnant women in the pattern of pulmonary involvement in chest CT findings. Laboratory factors such as serum hemoglobin, red blood cell count, absolute lymphocyte count, prothrombin time and partial thromboplastin time, serum creatinine, serum potassium, and lactate dehydrogenase had statistically significant differences between the two groups. However, these differences were not clinically significant. Conclusion: In a few aspects, the clinical characteristics and laboratory test results of COVID-19 in pregnant patients seem to be distinctive from their nonpregnant controls. We believe our findings can guide the prenatal and postnatal considerations for COVID-19 pregnant patients.

Background:. Open fractures, a common consequence of road traffic collisions, are associated with a high risk of complications. The introduction of standard guidelines has been shown to improve patient care and reduce the risk of complications in several countries. In September 2021, the Malawi Orthopaedic Association/Arbeitsgemeinschaft für Osteosynthesefragen Alliance (MOA/AOA) guidelines and standards for open fracture management were introduced in Malawi. This study aimed to assess the management of open fractures in hospitals in Malawi, before and after implementing a training course on the MOA/AOA open fracture guidelines. Methods:. This was a descriptive and quantitative, before-and-after study that reviewed the medical files of patients with open fractures at Zomba Central Hospital and Mulanje, Salima, and Mangochi district hospitals over two 3-month periods. Variables included initial assessment; antibiotic prophylaxis; place of debridement; type of anesthesia; treatment of the open fracture in the emergency department, operating room, and wards; and short-term complications requiring hospital treatment. Results:. A total of 88 open-fracture case files were reviewed; 43 were prior and 45 were subsequent to the implementation of the open fracture guidelines. The overall median patient age was 36 years (interquartile range, 27 to 45 years), and 91% (80) were male. Limb neurovascular status assessment and documentation improved from 26% (11) of the patients before the guidelines to 62% (28) afterward (p = 0.0002). The percentage who underwent debridement in the operating room significantly increased from 19% (8) to 69% (31) (p = 0.01). The percentage who underwent debridement under general or spinal anesthesia significantly increased from 5% (2) to 38% (17) and from 12% (5) to 29% (13), respectively (p= 0.001). The wound infection rate decreased from 21% to 11%, but this was not significant, and there was no change in the overall complication rate (p = 0.152). Conclusions:. This study suggests that training on the MOA/AOA open fracture management guidelines followed by their implementation can lead to at least temporary improvement in the management of open fractures. Nevertheless, additional studies need to be performed to understand the effect on long-term patient outcomes. Levels of Evidence:. Therapeutic Level III. See Instructions for Authors for a complete description of levels of evidence.

Abstract Aim University start‐ups have gained significant popularity as a means of translating knowledge and research into practical applications. However, there is a lack of understanding regarding the experiences and perspectives of nursing faculties engaged in start‐up ventures. The objective of this study was to explore valuable insights into the barriers and facilitators within this context for promoting success, generating entrepreneurial attitudes, as well as enhancing the sustainability of nursing faculty‐led start‐ups. Design We employed a content analysis methodology to capture the real‐life experiences of nursing faculties involved in university start‐ups. This approach is an effective way to gain a comprehensive understanding of the subject. Methods Data were collected using semi‐structured interviews. Graneheim and Lundman's step was used for analysis and to identify recurring patterns and themes within the collected data. Sampling was done purposefully, with convenience and snowball techniques until data saturation. The MAXQDA version 10 software was utilised to easily analyse, code and present data. Results The analysis revealed four major themes encompassed: motivational factors, personal attributes, limited entry support and barriers to scaling. These themes shed light on factors, support systems, challenges faced during growth as well as personal characteristics highlighted by the participants. Our study highlighted the factors influencing entrepreneurship in nursing faculties. Addressing the challenges of this study requires enhancing support systems and fostering personal development for entrepreneurial success in healthcare innovation. Policymakers can promote university education to expand the entrepreneurship process using more facilities and make more services accessible.

Abstract Background Although primary headaches are common disorders, there is little research on the possible relationship between primary headaches and oral health (decayed, missing, and filled teeth: DMFT). The present study aims to investigate the relationship between the DMFT index and primary headaches. Method This descriptive study was performed on 8682 cases from the Rafsanjani cohort population based on the Rafsanjani cohort study (RCS) and Oral Health Branch of the Rafsanjan Cohort Study (OHBRCS). Episodic primary headache (EPH) and chronic primary headache (CPH) of RCS patients who participated in OHBRCS were studied according to their DMFT score in comparison to nonprimary headache patients. Demographic characteristics and risk factors were compared in different groups. We used crude and multiple logistic regression analyses in this study. Results The missing teeth were significantly higher in the CPH group than in the no CPH group (P 5 filled teeth, and after adjusting for confounders, this relationship remained significant. The odds ratios of CPH were not associated with DMFT or its components in the adjusted models. Conclusion Our study found a correlation between filled teeth and EPH cases, but no correlation between CPH and DMFT or its components.

Deep learning models are widely used in healthcare systems. However, deep learning models are vulnerable to attacks themselves. Significantly, due to the black-box nature of the deep learning model, it is challenging to detect attacks. Furthermore, due to data sensitivity, such adversarial attacks in healthcare systems are considered potential security and privacy threats. In this paper, we provide a comprehensive analysis of adversarial attacks on medical image analysis, including two adversary methods, FGSM and PGD, applied to an entire image or partial image. The partial attack comes in various sizes, either the individual or combinational format of attack. We use three medical datasets to examine the impact of the model’s accuracy and robustness. Finally, we provide a complete implementation of the attacks and discuss the results. Our results indicate the weakness and robustness of four deep learning models and exhibit how varying perturbations stimulate model behaviour regarding the specific area and critical features.

Introduction: Morphine induces ovarian cysts that cause obesity and disrupt sex hormone secretion. Baclofen, a gamma-aminobutyric acid receptor agonist, can help regulate sex hormones and reduce harmful blood lipids by protecting against morphine-induced gamma-aminobutyric acid inhibition. We investigated the prophylactic effect of baclofen in rats receiving morphine by comparing with the untreated groups. Materials and Methods: Forty eight female Wistar rats were randomly divided into several groups, including control (saline 1 mL/kg, i.p.), morphine (5 mg/kg, i.p.), baclofen (10, 20, and 30 mg/kg, i.p.), and baclofen (10, 20, and 30 mg/kg) before morphine (5 mg/kg). Twenty four hours after the treatment, blood and serum samples were taken to check the levels of gonadotropins (LH & FSH) and lipid profile. The ovaries and uterus were also studied, and a proinflammatory nitric oxide (NO) diagnostic test was completed. The results were analyzed using analysis of variance (α = 0.05). Results: In comparison with the control group, the levels of LH and not FSH decreased in the morphine group and the number of ovarian cysts was more in the morphine group. These problems were not observed in the group of baclofen alone and baclofen + morphine. However, the triglyceride level increased slightly in the baclofen 30 mg/kg + morphine group. But the LDL level somewhat decreased. The proinflammatory NO system did not show significant activation in the ovary and uterus, except for the baclofen 10 mg/kg + baclofen group. Conclusion: Morphine can cause ovarian cysts by lowering LH but baclofen prophylaxis can protect reproductive properties by adapting major metabolic changes.

Abstract For more than one billion people living in coastal regions, coastal aquifers provide a water resource. In coastal regions, monitoring water quality is an important issue for policymakers. Many studies mentioned that most of the conventional models were not accurate for predicting total dissolved solids (TDS) and electrical conductivity (EC) in coastal aquifers. Therefore, it is crucial to develop an accurate model for forecasting TDS and EC as two main parameters for water quality. Hence, in this study, a new hybrid deep learning model is presented based on Convolutional Neural Networks (CNNE), Long Short-Term Memory Neural Networks (LOST), and Gaussian Process Regression (GPRE) models. The objective of this study will contribute to the sustainable development goal (SDG) 6 of the united nation program which aims to guarantee universal access to clean water and proper sanitation. The new model can obtain point and interval predictions simultaneously. Additionally, features of data points can be extracted automatically. In the first step, the CNNE model automatically extracted features. Afterward, the outputs of CNNE were flattened. The LOST used flattened arrays for the point prediction. Finally, the outputs of the GPRE model receives the outputs of the LOST model to obtain the interval prediction. The model parameters were adjusted using the rat swarm optimization algorithm (ROSA). This study used PH, Ca + + , Mg2 + , Na + , K + , HCO3, SO4, and Cl− to predict EC and TDS in a coastal aquifer. For predicting EC, the CNNE-LOST-GPRE, LOST-GPRE, CNNE-GPRE, CNNE-LOST, LOST, and CNNE models achieved NSE values of 0.96, 0.95, 0.92, 0.91, 0.90, and 0.87, respectively. Sodium adsorption ratio, EC, magnesium hazard ratio, sodium percentage, and total hardness indices were used to evaluate the quality of GWL. These indices indicated poor groundwater quality in the aquifer. This study shows that the CNNE-LOST-GPRE is a reliable model for predicting complex phenomena. Therefore, the current developed hybrid model could be used by private and public water sectors for predicting TDS and EC for enhancing water quality in coastal aquifers.

This study aimed to assess the role of D2 receptor A-241G (rs1799978) genetic polymorphism and olanzapine response and safety in Iraqi schizophrenic patients. The case-control study composed of 100 schizophrenic patients consisting of both genders were recruited from the Psychiatry Outpatient Department and 50 apparently healthy volunteers, served as a control group. Patient response to olanzapine was evaluated with the aiding of the PANSS and genotyping of D2 receptor A-241G (rs1799978) polymorphisms was detected using the nested PCR method. The heterozygous (AG) and mutant (GG) alleles of D2 receptor A-241G (rs1799978) were significantly predominated in schizophrenic patients and absent in healthy volunteers. Schizophrenic patients with the G allele of D2 receptor A-241G (rs1799978) and who were administered olanzapine exhibited a notable resistance to olanzapine. In conclusion, the genetic polymorphism of D2 receptor A-241G (rs1799978) was significantly associated with resistance to olanzapine in Iraqi schizophrenic patients.

In recent years, the use of propolis in food products has received attention owing to its functional role. This study was conducted to investigate the effect of different concentrations of propolis extract on the total polyphenol content and antioxidant activity of raw milk. For this purpose, an aqueous extract of dry propolis was prepared and stored in dark-colored bottles at 4 °C until the day of experiments. The propolis extract was added to raw milk in concentrations of 0, 4.7, 9.1, 16.6, and 28.5%. Total phenolic content and antioxidant activity were measured using the colorimetric Folin-Ciocalteu method and DPPH assay, respectively. Measurements were performed on the first day at zero hour and after 6 and 24 h of treatment, and the storage temperature was maintained at 5°C until analyzed. The amount of total polyphenol increased with the increase in the concentration of propolis extract in the treated milk in 0 hour; accordingly, the lowest and the highest amounts of total polyphenol were related to control milk and milk containing 28.5% propolis extract, respectively. A decreasing trend was observed in total polyphenol in the control sample and raw milk containing 4.7% propolis extract during 24 hours. There was an increase in total polyphenol content in raw milk containing 9.1% and 16.6% propolis extracts, the trend of changes in raw milk containing 28.5% extract was insignificant. The addition of propolis extract caused an increase in the antioxidant activity and total phenolic content in raw milk. According to the results, it is recommended to carry out more studies to clarify the functions of propolis's total polyphenol content and its interaction with milk proteins.

Olanzapine is commonly prescribed for the management of schizophrenia and is associated with many adverse effects like weight gain, hyperglycemia, and hyperprolactinemia, which may increase the risk of other diseases like diabetes mellitus and cardiovascular diseases. Genetic polymorphism of the D2 receptor may be responsible for the incidence of such adverse effects. This study aimed to assess the role of D2 receptor–141 C Ins/Del (rs1799732) genetic polymorphism and olanzapine-induced adverse effects in Iraqi schizophrenic patients. The case-control study was performed from October 2022 to April 2023 in Al-Hassan Al-Mojtaba Hospital. A total of 100 schizophrenic patients consisting of both genders, aged between 20 and 65 years, were recruited from the Psychiatry Outpatient Department, and 50 apparently healthy without any disease comprising both genders aged 20 to 63 years, served as a control group and were also enrolled in this study. Plasma level of FBS, HbA1c, lipid profile, and prolactin were measured, and genotyping of D2 Receptor–141 C Ins/Del (rs1799732) Polymorphisms was detected using the RFLP method. The heterozygous (Ins/Del) and mutant (Del/Del) alleles of D2 receptor–141 C Ins/Del (rs1799732) was significantly predominated in schizophrenic patient and absent in healthy volunteers. Schizophrenic patients with the deletion allele of D2 receptor–141 C Ins/Del and who were administered olanzapine (rs1799732) exhibited notably higher susceptibility to metabolic adverse effects induced by olanzapine, such as weight gain, hyperglycemia, dyslipidemia, and hyperprolactinemia. In conclusion, the genetic polymorphism of D2 receptor–141 C Ins/Del (rs1799732) was significantly associated with olanzapine induce metabolic adverse effects in Iraqi schizophrenic patients.

Objective: Baicalin and baicalein are natural flavonoids reported for the first time from Scutellaria baicalensis Georgi. Recently, attention has been paid to these valuable flavonoids due to their promising effects. This paper aims to have a comprehensive review of their pharmacological effects.Materials and Methods: An extensive search through scientific databases including Scopus, PubMed, and ISI Web of Science was established.Results: According to literature, these compounds have been mainly effective in the treatment of neurological and neurodegenerative diseases, hepatic and cardiovascular disorders, metabolic syndrome, and cancers through anti-inflammatory and antioxidant pathways. Induction of apoptosis and autophagy, and inhibition of migration and metastasis are the main mechanisms for their cytotoxic and antitumor activities. Decreasing inflammation, reducing oxidative stress, regulating the metabolism of lipids, and decreasing fibrosis, apoptosis, and steatosis are their main hepatoprotective mechanisms. Inhibiting the development of cardiac fibrosis and reducing inflammation, oxidative stress, and apoptosis are also the mechanisms suggested for cardioprotective activities. Decreasing the accumulation of inflammatory mediators and improving cognitive function and depressive-like behaviours are the main mechanisms for neurological and neurodegenerative activities.Conclusion: The findings suggest the therapeutic potential of baicalin and baicalein. However, complementary research in different in vitro and in vivo models to investigate their mechanisms of action as well as clinical trials to evaluate their efficacy and safety are suggested.

Criticizing texts based on structuralist theory is something that has recently become popular in scientific circles, and according to it, from the smallest audio and musical signs to the biggest, which are words and how they are put together, is effective in meaning. On this basis, there is a significant coherence between form and meaning. Undoubtedly, the application of such theories about the Qur'an, which is a highly literary text, makes its long concepts more and more clear. Dealing with the Holy Qur'an and its semantic field is something that has a long history and religious scholars and linguists have dealt with it since the beginning of the revelation until today, by creating various sciences and writing various books such as Rhetoric, Erabs, Qur'an Vocabulary. In the beginning, Quranic studies had an interpretive approach, and it has continued until today, and the existing mystical, jurisprudential, literary, and theological interpretations confirm it. With the emergence of new linguistic theories, which include cognitive linguistics and structural analysis, a new chapter in Quranic studies began and the coherence and harmony of Quranic verses became more apparent. With the emergence of new linguistic theories, which include cognitive linguistics and structural analysis, a new chapter in Quranic studies began and the coherence and harmony of Quranic verses became more apparent. Because structural criticism is one of the critical methods of literary texts, by means of which, with the benefit of rules and principles, the relationship between audio, musical, and lexical signs, and syntactic and rhetorical points of words can be explored. Surah Nazeat is an example of chapter 30 for the news of the truth of the hereafter, and it brings the hereafter to the heart of mankind with its fear and concentration of events and its seriousness and originality in divine destiny and in the way of informing about that great truth, the style and context of the Surah plays various musical songs on the depths of being and creates various emotions around that great truth. This article tries to show as much as possible the existing order in Surah Nazeat according to the structuralist theory, at different sound, lexical, syntactic, and rhetorical levels. With this aim, the question is, in what language structure is the text of Surah Nazeat expressed and in what structure are the concepts derived from it presented? The research method is a descriptive-analytical method. At first, the structuralist theory is explained, and then the different parts of the Surah are explained according to this theory, and finally, the research results are presented. The findings indicate that the elements of the linguistic structure of Surah Nazeat are in the direction of complete coherence with regard to the subject of the Surah, that is, the truth of the Hereafter and its terrifying events. The initial short and shocking passages are consistent with the induction of fear and dread of the Day of Resurrection and the long and gentle sections at the end are in harmony with its constructive content, that is, the end of the believer and the unbeliever. The middle structure of the verses is sometimes with a short section and sometimes with a longer section, which is in complete harmony with the content of the verses. The final sections of the verses "A" and "Ha" are also completely consistent with the prevailing atmosphere of the verses and have increased the fear of the great events of the hereafter and have doubled the meanings of the verses and their impact. This harmony and order has been seen in other levels of speech, such as the phonetic, lexical, syntactic and rhetorical levels, and has doubled the effect of the verses. Using verbal and spiritual arrays, such as contrasting words and synonyms of verbs and complete and incomplete puns, and observing the rhetorical points in the Surah, such as removing the answer to oath, contrasting words, The use of negative interrogatives, interpretive sentences, nominal and actual sentences, present participle verbs, adverbs of description and present tense, the use of the letters "enna" and "ennama" have also added to the impact of the text and intensified its meaning. And all of them are in the service of the topic of the Surah, that is, the truth of the hereafter and its extensive events. In other words, the elements in this surah at different phonetic, lexical, syntactic, and rhetorical levels, in the form of a general structure and an interconnected collection, serve the truth of the hereafter and its terrifying events. And between the beginning and the end of the surah, there is also a thematic proportionality because the surah begins with the angels of taking soul and ends with the Resurrection

Abstract Background The benefit of surfactant replacement therapy for respiratory distress syndrome (RDS) has been demonstrated. However, some surfactants are expensive and usually inaccessible. Consequently, the Iranian Survanta was produced, but its effect on complications and mortality of RDS is unknown. This study aimed to compare the therapeutic outcomes of Iranian surfactant (beraksurf) and BLES (bovine lipid extract surfactant) on RDS treatment among preterm neonates. Methods This triple blinded randomized controlled trial study was performed on 128 eligible neonates diagnosed with RDS in Afzalipour hospital in Kerman, Iran. Diagnosis of RDS, gestational age of 28–34 weeks and weight ≥ 1 kg were considered as inclusion criteria. Congenital anomalies such as congenital cyanotic heart diseases, digestive system anomalies and chromosome abnormalities were the exclusion criteria Neonates were randomly assigned into two equal groups: (1) those treated with BLES (n = 64) and (2) those treated with beraksurf (n = 64). Complications including patent ductus arteriosus (PDA), sepsis, intraventricular hemorrhage (IVH), pneumothorax, pulmonary hemorrhage, mortality, and also, the number of days required for invasive mechanical ventilation (using ventilator) and non-invasive continuous positive airway pressure (CPAP) were evaluated for all neonates. The risk ratio (RR) was calculated at 95% of confidence intervals (CI). Results Compared with BLES group, the RR estimate among neonates in beraksurf group was 0.89 (0.66–1.20) for PDA, 0.71 (0.23–2.13) for IVH, 0.44 (0.14–1.36) for sepsis, 0.35 (0.13–0.93) for pneumothorax, 0.33 (0.12–0.86) for pulmonary hemorrhage, and 0.55 (0.28–1.05) for mortality. Conclusions Despite advances in the use of exogenous surfactants for the treatment of neonatal respiratory distress syndrome; There are still some controversial topics in this field. The results obtained in the present study showed that the two types of surfactant (BERAKSURF and BLES) have similar efficacy for the treatment and short-term outcomes in preterm infants with respiratory distress syndrome. Therefore, due to the cost-effectiveness of BRAKSURF compared to BLES, We recommend choosing BERAKSURF in terms of treatment.

Background: Assessment is an important issue in the education process that must be present in all stages of education, which include: initial assessment, formative assessment and final assessment. By selecting and adding virtual education learning tools and facilities to the teaching and learning process and turning it into an interactive and constructive educational activity, as well as using active learning environment design patterns such as 5E in schools, learning can be increased in students. Aims: The purpose of this research is to design a learning environment for virtual education based on creative methods of assessment and to determine its impact on the learning of second grade elementary school students. Methods: The current research design was carried out in two stages by using the combined or mixed research method. The first stage of the research was conducted using the content analysis method, using the literature of the virtual education learning environment based on the creative methods of measuring and learning students, along with the latest domestic and foreign written articles through databases. The second stage of the research was conducted using a quasi-experimental method in the form of a pre-test and post-test design with a control group. The statistical population of this research was elementary school students of Hefde district of Tehran. In this research, purposeful sampling was used. The sample of this research included sixth grade students of 17 Shahrivar primary school in the academic year of 1401-1402. The number of these students was 60, and in this research, they were randomly replaced in the test and control groups (30 people in each group). Results: The results show that the difference between the post-test scores in the two experimental and control groups is significant. The significance level of the findings is 95% confidence. In this research, creative and new measurement methods that have been less used so far were used in the design of the 5E learning environment and it was observed that these creative and new measurement methods have an effect on learning. Conclusion: Therefore, the design of the learning environment based on creative assessment methods has an effect on learning and its dimensions, including involvement, exploration, explanation, expansion of the subject and reporting of the students of the second year of elementary school.

Abstract Ellagic acid (EA) is a polyphenol extracted from many plants. EA modulates inflammatory mediators via antioxidant mechanisms, such as catalase (CAT) activities, superoxide dismutase (SOD), enhancement, increase in glutathione (GSH), and lipid peroxidation (LPO) suppression. EA has anti‐apoptotic properties that are thought to be mediated by regulating the expression of B‐cell lymphoma 2 (Bcl‐2), Bcl‐2‐associated X protein (Bax), and caspase‐3. In this article, we surveyed the literature dealing with the protective effects of EA against different heavy metals, drugs, and natural toxins. The findings indicated that EA has remarkable protective properties against various toxicants. Its protective effects were mostly mediated via normalizing lipid metabolism, oxidative stress, and inflammatory mediators, for example, tumor necrosis factor‐α (TNF‐α), interleukin‐6 (IL‐6), and IL‐1β. The results of this study showed that EA has significant protective effects against a varied range of compounds, either chemical or natural. These effects are mainly mediated via intensifying the antioxidant defense system. However, other mechanisms such as inhibition of inflammatory responses and suppression of apoptosis are important.