Search

Abstract Background Numerous studies have explored the effects of L-arginine, whether administered in the form of a supplement or through infusion during cardioplegia, on cardiac and inflammatory markers in individuals undergoing coronary artery bypass grafting (CABG). However, these studies presented contradictory findings. Consequently, the objective of this study was to investigate the impact of l-arginine on these markers by analyzing available randomized controlled trials (RCTs). Methods We performed an extensive search across various databases, including Embase, Medline/PubMed, Web of Science, Scopus, Cochrane Library, and Google Scholar, covering research published until December 2023. To analyze the mean changes in inflammatory and cardiac markers between the L-arginine and control groups, we calculated the weighted mean difference (WMD) along with the corresponding 95% confidence interval (CI) using a random-effects model. Results A total of 393 RCTs were identified during the initial search. After screening and selection, 7 trials were included. In a meta-analysis of three trials that reported troponin T levels, we found a significant impact of L-arginine on reducing troponin T levels (WMD = -0.61 ng/ml; 95% CI: -1.07, -0.15). Our analysis also showed that L-arginine had a noticeable impact on decreasing interleukin-6 (IL-6) levels (WMD = -7.72 pg/ml; 95% CI: -15.05, -0.39). However, we found no considerable impact of L-arginine treatment on creatine phosphokinase-MB (CPK-MB), tumor necrosis factor-alpha (TNF-α), and troponin I compared to the placebo groups. Conclusions Our findings suggest that L-arginine may benefit patients undergoing CABG, as it helps reduce inflammatory reactions and limits myocardial ischemia. This study registered in the PROSPERO database (Registration No. CRD42024508341).

Abstract Background Drug-drug interactions (DDIs) between antiretroviral therapy (ART) and commonly used co-medications in HIV patients, especially women, impact treatment efficacy and patient safety. Objective This study aimed to study the prevalence and types of drug-drug interactions (DDIs) between antiretroviral therapy drugs (ARTs) and comedications among a female population with HIV. Additionally, the study investigates the association of these DDIs with ART medication changes and treatment adherence. Methods This cross-sectional study included 632 adult women living with HIV (WLHIV). Data was retrospectively extracted from patient files. Drug.com interaction checker website was used to assess DDIs between ART and non-ART medications. Changes to the ART regimen previously attributed to ART side effects or patient non-adherence were considered drug changes. Results A total of 429 WLHIV (mean age: 44.05 ± 9.50) were eligible. The prevalence of DDIs between ART and non-ART medications was 21.4%, with 4.7% minor, 18.4% moderate, and 8.9% major interactions. The highest prevalence of DDI was among cardiovascular medication users (71.7%), followed by central nervous system drugs (69.2%). Changing medications resulted in a decrease in DDIs, with significant reductions in total and minor interactions. Participants without DDIs had better adherence to ART. DDI between ART and non-ART medications was significantly associated with ART drug change, even after accounting for side effects attributed to ARTs, indicating an independent twofold association (OR = 1.99, CI 1.04–3.77). Moreover, further adjustments for HIV viral load and CD4 + cell count did not change the significance of the association (OR = 2.01, CI 1.03–3.92). Conclusion DDIs in WLHIV impact adherence to ART. Altering ART may not be directly related to ART side effects, but rather primarily due to interactions with non-ART medications. Modifying non-ART drug regimens can reduce the likelihood of DDIs.

Abstract Introduction The accurate prediction of COVID-19 mortality risk, considering influencing factors, is crucial in guiding effective public policies to alleviate the strain on the healthcare system. As such, this study aimed to assess the efficacy of decision tree algorithms (CART, C5.0, and CHAID) in predicting COVID-19 mortality risk and compare their performance with that of the logistic model. Methods This retrospective cohort study examined 5080 cases of COVID-19 in Babol, a city in northern Iran, who tested positive for the virus via PCR from March 2020 to March 2022. In order to check the validity of the findings, the data was randomly divided into an 80% training set and a 20% testing set. The prediction models, such as Logistic regression models and decision tree algorithms, were trained on the 80% training data and tested on the 20% testing data. The accuracy of these methods for the test samples was assessed using measures like ROC curve, sensitivity, specificity, and AUC. Results The findings revealed that the mortality rate for COVID-19 patients who were admitted to hospitals was 7.7%. Through cross validation, it was determined that the CHAID algorithm outperformed other decision tree and logistic regression algorithms in specificity, and precision but not sensitivity in predicting the risk of COVID-19 mortality. The CHAID algorithm demonstrated a specificity, precision, accuracy, and F-score of 0.98, 0.70, 0.95, and 0.52 respectively. All models indicated that factors such as ICU hospitalization, intubation, age, kidney disease, BUN, CRP, WBC, NLR, O2 sat, and hemoglobin were among the factors that influenced the mortality rate of COVID-19 patients. Conclusions The CART and C5.0 models had outperformed in sensitivity but CHAID demonstrates a better performance compared to other decision tree algorithms in specificity, precision, accuracy and shows a slight improvement over the logistic regression method in predicting the risk of COVID-19 mortality in the population under study.

Land use change is a critical factor affecting the structure and functioning of biological communities, particularly forest birds. The Hyrcanian forests in northern Iran are undergoing significant transformations due to increasing agricultural expansion and the growth of orchards encroaching upon forest edges. While research often suggests that the edge effect can enhance species diversity in heterogeneous agricultural-forest landscapes, the effects of different agricultural practices have received less attention. In this study, we integrated remote sensing, landscape ecology, and statistical analysis, and served bird communities as ecological indicators aiming to identify the impact of various land use modification on biological communities of an agricultural-forest landscape. We used Sentinel-2 images to generate a land use map of the region based on the random forest classification method. Explanatory variables extracted from the derived land use were measured in 75 cell grids (1200 × 1200 m) and bird information in 400 × 400-meter units. We calculated 15 landscape metrics for each 1200-meter landscape unit cell and combined them with residential area and road length data for statistical analysis. The Redundancy Analysis (RDA) method was employed to examine the effects of environmental variables on bird community composition. We identified a total of 38 breeding bird species belonging to 21 families in the region. The RDA variance partitioning accounted for 0.554 as the constrained fraction, indicating that 54 % of the bird community variance was explained by the explanatory variables. Generalist and urban-dwelling birds were mainly dispersed across negative values of canonical axis 1 (RDA1). Conversely, forest specialist birds were scattered along positive values of RDA1. Less specialized understory birds, depending on more open woods with higher species diversity, were mostly illustrated with shorter projections across RDA2 extremes, correlated with orchards. Our findings demonstrate that the marginal habitats of Hyrcanian forests, predominantly consisting of orchard plantations, exhibit greater bird community diversity compared to dense forests or croplands. Although species diversity has been observed to increase initially, the ongoing trend of orchard encroachment on forest patches may result in heightened edge effects, an increased presence of generalist species, and a decline in specialized forest species. These results can help guide land use planning to achieve biodiversity goals in heterogeneous agricultural-forest landscapes.

Abstract Background and Aims Before performing any surgical or endovascular procedure, the anatomical classification of the patient is essential for treatment planning. Computed Tomographic Angiography (CTA) is a standard method to evaluate thoracic aortic anatomy and associated variations. Methods This cross‐sectional, descriptive study was performed among adult participants without any peripheral vascular diseases undergoing thoracic CTA. Demographic data were collected along with factors retrieved from the patients CTA, such as the type of aortic arch, length, and diameter of ascending and descending aorta, the diameter of the main branches and the distance between branches, the angles by which the main arteries rise from their origins, and left anterior oblique angle of the aortic arch. Results 164 patients, with a mean age of 57 ± 19.3 years, entered the study. 53 (33.8%) had a bovine arch, which was mostly observed among males. A decrease in the frequency of type I arch and also an increase in the frequency of type 2 and 3 arches was observed with the increase in age (p

The epidemiology of pandemics is classically viewed using geographical and political borders; however, these artificial divisions can result in a misunderstanding of the current epidemiological state within a given region. To improve upon current methods, we propose a clustering algorithm which is capable of recasting regions into well-mixed clusters such that they have a high level of interconnection while minimizing the external flow of the population towards other clusters. Moreover, we analyze and identify so-called core clusters, clusters that retain their features over time (temporally stable) and independent of the presence or absence of policy measures. In order to demonstrate the capabilities of this algorithm, we use USA county-level cellular mobility data to divide the country into such clusters. Herein, we show a more granular spread of SARS-CoV-2 throughout the first weeks of the pandemic. Moreover, we are able to identify areas (groups of counties) that were experiencing above average levels of transmission within a state, as well as pan-state areas (clusters overlapping more than one state) with very similar disease spread. Therefore, our method enables policymakers to make more informed decisions on the use of public health interventions within their jurisdiction, as well as guide collaboration with surrounding regions to benefit the general population in controlling the spread of communicable diseases.

Thought is a fundamental and intrinsic characteristic of humans, setting them apart from other beings. For this reason, one of the influential factors in education is the cultivation and strengthening of the rational faculty. In Islamic philosphy, rational education has also been given serious attention. The main purpose of this research is to explain the methods of rational education in Ibn Sina's philosophical system. To achieve this goal, a descriptive-analytical method has been used. The research population includes the works of Ibn Sina, from which materials related to philosophical and educational foundations and methods of rational education have been purposefully selected. The findings indicate that the methods of rational education should be in line with the goals and principles and in accordance with them, and should guide the learners to choose the correct rational path and enrich the levels of reason until they reach the ultimate goal of rational education -which is divine proximity. These methods include cultivating creativity (creating a creative space), cultivating reason (through play and argumentative dialogue), question-based dialogue, participation, controlling the excesses of the soul, intellectual intuition, and the method of asceticism, which have been identified and explained. The application of the aforementioned methods can be effective in creating a foundation and smoothing the path for rational education in the educational system.

Abstract Background Rubella and measles are two highly contagious viral childhood diseases. However, the high possibility of brutal effects of both microorganisms during pregnancy has kept them emerging as a major public health issue. The current study aimed to investigate the seroprevalence of rubella and measles among 15–25‐year‐old females in southwest Iran. Method This descriptive study was performed in Jahrom, southern west Iran during 2012. Serum samples from female individuals with an age of 15–25 years visiting main laboratories in our study location were collected and evaluated by a commercial ELISA kit for anti‐rubella and measles IgG antibodies. Results Among the 179 participants, regarding anti‐rubella antibodies, 171 (95.0%) were positive, 3 (1.7%) were negative, and 6 (3.3%) were borderline. Regarding anti‐measles antibodies, 166 (92.2%) of the subjects were positive, 1 (5.6%) was negative, and 13 (17.2%) were borderline. By assuming a positive value for the borderline cases, the ultimate findings demonstrated that 98.3% and 99.4% of the participants were immune against rubella and measles, respectively. There was no statistically significant association between measles and rubella immunity with age or the use of immunosuppressor medication. Conclusion Implementation of vaccine program has obtained significant immunity level in inhabitants, particularly women of childbearing age who play a more important role in herd immunity. Therefore, maintaining the national immune screening against rubella and measles is needed to take into consideration to maintain the current satisfactory level of immunization.

BackgroundProper nutrition is a crucial factor in preventing osteoporosis, a significant pathological cause linked to skeletal weakness; this study investigated the relationship between dietary diversity score and food group diversity score with osteoporosis in postmenopausal women.MethodsThis case-control study was conducted on 378 menopausal women aged 45–85 in Tehran, Iran. The age-matching method to control the confounding effect of age was used. The method of dual-energy X-ray absorptiometry (DXA) was used for assessing the bone mineral density of lumbar vertebrae and femoral neck. The bone mass status was evaluated with WHO criteria. All subjects were divided into the osteoporosis group and the non-osteoporosis group according to their T-score. A convenience sampling method was utilized to select the participants, which included two groups: case (n = 189) and control (n = 189). Data was collected using demographic and anthropometric information questionnaires, a valid 147 item food frequency questionnaire, and a physical activity questionnaire. Statistical analyses were conducted using SPSS-26, and p-values less than 0.05 were deemed to be statistically significant.ResultsThe results indicated significant differences in weight, body mass index, physical activity, smoking, and alcohol use between the two groups. The mean ± standard deviation of dietary diversity score (DDS) was lower in participants with osteoporosis (case) (3.31 ± 1.26) than in control (4.64 ± 1.33) (p

Introduction: Artificial intelligence (AI), particularly ChatGPT developed by OpenAI, has shown the potential to improve diagnostic accuracy and efficiency in emergency department (ED) triage. This study aims to evaluate the diagnostic performance and safety of ChatGPT in prioritizing patients based on urgency in ED settings. Methods: A systematic review and meta-analysis were conducted following PRISMA guidelines. Comprehensive literature searches were performed in Scopus, Web of Science, PubMed, and Embase. Studies evaluating ChatGPT's diagnostic performance in ED triage were included. Quality assessment was conducted using the QUADAS-2 tool. Pooled accuracy estimates were calculated using a random-effects model, and heterogeneity was assessed with the I² statistic. Results: Fourteen studies with a total of 1,412 patients or scenarios were included. ChatGPT 4.0 demonstrated a pooled accuracy of 0.86 (95% CI: 0.64-0.98) with substantial heterogeneity (I² = 93%). ChatGPT 3.5 showed a pooled accuracy of 0.63 (95% CI: 0.43-0.81) with significant heterogeneity (I² = 84%). Funnel plots indicated potential publication bias, particularly for ChatGPT 3.5. Quality assessments revealed varying levels of risk of bias and applicability concerns. Conclusion: ChatGPT, especially version 4.0, shows promise in improving ED triage accuracy. However, significant variability and potential biases highlight the need for further evaluation and enhancement.

Background: Concomitant inflammation may boost the cardiovascular complications in end-stage renal disease (ESRD) patients undergoing hemodialysis (HD). Omega-3 fatty acids may have certain health benefits in HD patients. The aim of this study was to investigate the effects of omega-3 fatty acids supplementation on hematocrit (HCT), hemoglobin (HB) level and platelet (PLT) counts of HD patients. Methods: A randomized controlled trial was conducted on HD patients at a private dialysis center in Rasht, Iran. Three omega-3 fatty acid supplement capsules (3 g/d) were administered daily for two months to patients in the intervention group (n = 55). The control group (n = 60) were given three placebo capsules containing medium chain triglyceride (MCT) oil, similar to the supplemental dose of the intervention group at the same period. Three parameters of HCT, HB and PLT were measured at baseline and after the intervention. Results: The PLT count decreased in the intervention group compared to the control group (173.38 ± 74.76 vs. 227.68 ± 86.58 103/mm3, F = 4.83, P = 0.03). No significant change was found on the levels of HCT and HB parameters between the two groups after the intervention. Conclusion: Omega-3 supplementation in HD patients may decrease the risk of forming blood clots in the blood vessels. Further studies are warranted.

Introduction: Feeling alone and enduring distress are risk factors for suicidal thoughts, while parental bonds are protective factors. However, the complex mechanisms behind these factors have not been identified among people with a history of suicide attempts. Therefore, the present study aimed to predict suicide attempts through distress tolerance, feeling alone, and parental bonds in people with a history of suicide attempts. Material & Methods: The current research is a descriptive-correlational study, and the statistical population included all people with a history of suicide attempts in Isfahan, Iran, from among whom 120 people were selected through convenience sampling. The research tools included parental bond questionnaires by Parker et al. (1979), distress tolerance by Simmons and Gaher (2005), feelings of loneliness by Russell et al. (1980), and attempted suicide was made by the researcher. The collected data was analyzed using descriptive methods, including Mean and Standard deviation and inferential statistics (e.g., Pearson's correlation coefficient and stepwise regression analysis) using the SPSS software (version 27) and PLS3 statistical software. Results: The results showed that among the predictor variables, feeling alone had the highest predictive power (64.7%), and in the second step, with the addition of parental bond with the mother, it increased to 0.701%, and in the third step, with the addition of Parenting bond with father reached 0.729%, and in fourth step with the addition of distress tolerance, it reached 0.743%, all of which are statistically significant. Discussion & Conclusion: Based on the findings of the present research, we can point out the influential role of feeling alone in predicting suicide attempts, and the need for families and policy-makers to pay attention to this prominent factor can play a major role in reducing suicide rate.

BACKGROUND: As nurses are in close contact with patients with coronavirus disease 2019 (COVID-19), they are more susceptible to infection and spread of the virus. Limited clinical knowledge of the COVID-19 virus and the lack of adequate supply of personal protective equipment (PPE) and lack of medical and personal protective equipment may lead to low work morale, absenteeism, apathy, and poor performance in nurses. Therefore, the emotional problems of nurses during the COVID-19 epidemic deserve more attention. This study was conducted to investigate self-efficacy and its relationship with health hardiness and quality of work life in nurses. METHODS: This was a descriptive cross-sectional study conducted on 219 nurses working in hospitals (Tohid, Kowsar, and Be’sat hospitals) of Sanandaj City, Iran, in November 2021. The sampling method was proportional stratified random method. Questionnaires of demographic information, self-efficacy, health hardiness, and quality of work life were completed by nurses. Data analysis was performed using descriptive statistics tests, independent t-test, analysis of variance (ANOVA), Pearson correlation, and simple linear regression. The data were analyzed in SPSS software. RESULTS: The quality of work life of 81.3% of participants was reported as moderate and 18.7% was reported as very good. Pearson's correlation coefficient showed that the relationship between self-efficacy and health hardiness was significant and there was a positive correlation between the two variables (P < 0.001, r = 0.539). CONCLUSION: Given the low level of nurses' self-efficacy and its relationship with health hardiness, there is a need to promote nurses' self-efficacy and health hardiness for health professionals.

Abstract Colorectal cancer is a prevalent malignancy with global significance. This retrospective study aimed to investigate the influence of stage and tumor site on survival outcomes in 284 colorectal cancer patients diagnosed between 2001 and 2017. Patients were categorized into four groups based on tumor site (colon and rectum) and disease stage (early stage and advanced stage). Demographic characteristics, treatment modalities, and survival outcomes were recorded. Bayesian survival modeling was performed using semi-competing risks illness-death models with an accelerated failure time (AFT) approach, utilizing R 4.1 software. Results demonstrated significantly higher time ratios for disease recurrence (TR = 1.712, 95% CI 1.489–2.197), mortality without recurrence (TR = 1.933, 1.480–2.510), and mortality after recurrence (TR = 1.847, 1.147–2.178) in early-stage colon cancer compared to early-stage rectal cancer. Furthermore, patients with advanced-stage rectal cancer exhibited shorter survival times for disease recurrence than patients with early-stage colon cancer. The interaction effect between the disease site and cancer stage was not significant. These findings, derived from the optimal Bayesian log-normal model for terminal and non-terminal events, highlight the importance of early detection and effective management strategies for colon cancer. Early-stage colon cancer demonstrated improved survival rates for disease recurrence, mortality without recurrence, and mortality after recurrence compared to other stages. Early intervention and comprehensive care are crucial to enhance prognosis and minimize adverse events in colon cancer patients.

Objective(s): The healthcare environment should provide the highest level of safety for staff and clients. This study aimed to assess the structural and non-structural safety status of Tabriz primary health care centers. Methods: This cross-sectional study assessed 40 comprehensive healthcare centers in Tabriz, Iran in 2019. The data collection instrument was a self-designed questionnaire We assessed the compliance of comprehensive healthcare centers with the standards checklist through conducting interviews, considering observations, and reviewing the documents. The descriptive results for qualitative data were reported as frequency (percentage) and for quantitative data as mean (standard deviation). Furthermore, to evaluate the association between contextual variables and physical safety status of centers, t-test, ANOVA, and Tukey’s post hoc tests were used as appropriate (structural or non-structural). Results: The results of the study showed that the level of structural, non-structural, and total safety for the physical space of the centers was 48.2%, 37.4%, and 43%, respectively. Accordingly, based on cutting points, the level of structural safety and total safety was identified as moderate, and the level of non-structural safety was identified as low. In addition, descriptive results showed that there is a statistically significant relationship between urban area and non-structural safety so that non-structural safety of centers located in zone 4 was significantly higher than the safety of centers located in zone 10 (P = 0.011). Conclusions: Based on the findings, the safety status of Tabriz health centers was identified as unfavorable and will not able to provide proper services to their covering population in serious hazards.

Abstract Background Gastroesophageal Reflux Disease (GERD) is a common chronic condition. Its chronic nature may affect the pattern of medication use. This study aimed to investigate the prevalence, associated factors, and patterns of polypharmacy and medication use among GERD patients in southwestern Iran. Methods We used data from the Pars Cohort Study. We classified drugs using the Anatomical Therapeutic Chemical classification system. The Lexicomp® database was used to assess potential drug-drug interactions. Multivariable Poisson regression was applied. Adjusted prevalence ratio (PR) and its 95% confidence interval (CI) were estimated. Results A total of 9262 participants were included. Among 2,325 patients with GERD, age-standardized prevalence of polypharmacy was 9.5% (95% CI: 7.5%, 11.6%) in males, and 19.3% (95% CI: 17.2%, 21.4%) in females. The PR of experiencing Polypharmacy by GERD patients compared to non-GERD patients was 1.82 (95% CI: 1.61, 2.05%). Multimorbidity (PR: 3.33; CI: 2.66, 4.15), gender (PR: 1.68; CI: 1.30, 2.18), and metabolic syndrome (PR: 1.77; CI: 1.45, 2.15) were associated with polypharmacy among GERD patients. Drugs for acid-related disorders were the most common used drugs among men, women and elders. We found that 13.9%, 4.2%, and 1.1% of GERD patients had type C, D and X drug interactions, respectively. Conclusion GERD is correlated with a higher prevalence of polypharmacy. Among GERD patients, females, those with multi-morbidities, and those with metabolic syndrome may be affected more by polypharmacy. Considering the fairly high rate of interactions identified, a review of the medication list is essential when approaching GERD patients, and physicians must check for medications that may worsen GERD.

Introduction: In this study, we examined the impact of a hydroethanolic extract derived from ajwain and carvone (a compound present in ajwain), on learning, spatial memory, and anxiety levels in adult male rats that were chronically immobilized. Methods: There were 60 rats used in this study, divided into six groups of 10 rats each. To expose stress, 30 rats (in 3 groups including Stress, Stress-Carvone, and Stress-Ajwain groups) were placed in a restrainer for 6 hours every day for 21 consecutive days. Stress-Carvone and Stress-Ajwain groups received carvone (20 mg/kg) and ajwain extract (500 mg/kg) by gavage respectively. Thirty rats were also used in three groups (Control, Carvone, and Ajwain groups). Spatial learning and memory were studied using the Morris water maze, and anxiety was assessed by the elevated-plus maze. Results: Compared to the control group, chronic immobilization caused the rats to swim a longer time (P < 0.01) and distance (P < 0.05) to reach the hidden platform, and a shorter time and distance to swim in the target quarter (P < 0.05) in the Morris water maze. The percentage of entering the open arm in the elevated plus maze (P < 0.001) and the percentage of time staying in this arm (P < 0.01) were lower than the control group. The carvone improved the performance of stressed animals in the Morris maze, but the ajwain extract had no effect on the memory deficit of stressed animals. Furthermore, treating ajwain extract and carvone increased the percentage of entry into the open arm and the percentage of time spent in the open arm in animals exposed to stress. Conclusion: Ajwain extract and carvone reduce anxiety behavior in rats exposed to chronic immobility stress; carvone treatment prevents memory impairment in these animals. It is possible that the extract of ajwain (partially through carvone) is effective in reducing damage caused by stress in the nervous system.

Background and purpose: Nurses working in the intensive care unit (ICU) face more ethical conflicts in caring for COVID-19 patients. The present study aimed to assess the relationship between moral disengagement and the quality of nursing care in nurses caring for Covid-19 patients hospitalized in the special ICU department of medical-educational centers affiliated with Mazandaran University of Medical Sciences. Materials and methods: This descriptive cross-sectional study was conducted on 150 nurses caring for COVID-19 patients hospitalized in the ICU of Mazandaran University of Medical Sciences from 2021 to 2022. Date collection tools included demographic information questionnaires, Fida et al.'s moral disengagement, and nursing care quality. Data analysis was performed using descriptive (frequency, percentage, mean, standard deviation) and inferential (Pearson correlation coefficient and linear regression) statistics. Results: The moral disengagement score of nurses was 40.58±8.64. The mean scores of quality of nursing care in total, psychosocial dimension, communication dimension, and physical dimension were 177.3±13.25, 74.92±6.50, 36.80± 2.82, and 66.73±5.45, respectively. No significant relationship was observed between the quality of nursing care and moral disengagement (P>0.05). Conclusion: The lack of a significant relationship between the quality of nursing care and moral disengagement in the present study was in the condition of the COVID-19 pandemic when people were under high organizational and psychological pressures. Therefore, for a better conclusion, it is suggested that this research be carried out in non-emergency conditions and after the pandemic again in the inpatient wards of infected patients.

ObjectiveTraumatic experiences are a significant risk factor for psychological disturbances, including disorders such as complex posttraumatic stress disorder, emotion-processing problems, and trauma-related dissociative experiences. The present investigation examined the coexistence of these symptoms using a network analysis model.MethodThis study included a sample of 406 people referred to comprehensive health centers in Tehran from September to December 2023 with psychopathological syndromes. Variables were assessed using The International Trauma Questionnaire, International Measurement of Exposure to Traumatic Event checklist, Baker Emotional Processing Questionnaire, and Dissociative Experiences. A regularized partial correlation network and Glasso algorithm, in combination with Extended Bayesian information criteria, were applied to estimate the network structure.ResultsSigns of unprocessed emotions and disturbance in self-organization symptoms were the most important symptoms in the symptom network, forming strong connections with other nodes. Thereby, these two symptoms can be regarded as the most important clinical manifestations in the symptom network following traumatic experiences. Three distinct symptom communities were identified: the community of traumatic experiences (childhood, adolescence, adulthood), the community of dissociative experiences (amnesia, depersonalization/derealization, and absorption), and the community of emotional processing (suppression, unpleasant emotional experience, Signs of unprocessed emotions, avoidance, and emotional control, posttraumatic stress disorder symptoms and disturbance in self-organization symptoms). The strongest edges observed were between childhood trauma-adolescence trauma (0.473) in the community of traumatic experiences, between amnesia and depersonalization/derealization (0.644) in the community of dissociative experiences, and between disturbance in self-organization symptoms and unprocessed emotions (0.324) in the community of emotional processing, indicating the recurrent occurrence of these symptoms.ConclusionIn this study, disturbance in self-organization symptoms was identified as the central psychopathologic symptom in individuals experiencing traumas at different developmental stages. It seems that adolescent trauma and not childhood trauma plays a more decisive role in the symptoms that a person manifests after traumatic experiences. Also, posttraumatic stress disorder symptoms and disturbance in self-organization symptoms were recognized in the cluster of emotional processing symptoms and can have substantial roles in prioritizing therapeutic measures.

Intellectual education cultivates the power of reason. Intellect plays a crucial role in reasoning, analysis, and combining information within the education system. Therefore, this article aims to identify and explain the obstacles to rational education from Ibn Sina's perspective, proposing educational solutions to address them within the education system. The research employs a qualitative method with the Claysey model for data analysis. Data collection involved analyzing books, descriptions, and articles on Avicenna's views. Ibn Sina defines intellectual education as cultivating the intellectual power to reach divine proximity. By understanding and overcoming obstacles, this approach strengthens the educated mind. The article identifies these obstacles within three axes: cognitive, attitudinal, and practical. The cognitive axis includes elements like illusion, conflict with truth, sensory disorder, and emotional outbursts. The attitudinal axis encompasses components such as difficulty distinguishing good from bad (virtues and vices), anger, rage, lack of pure intention, and dependence on worldly affairs. Finally, the practical axis includes elements like disobeying God's commandments, satanic temptations, excessive desires (greed), and lust. Following the description of each element, the article proposes new educational solutions to address these obstacles to rational education.

Background: Obesity is associated with developing polycystic ovary syndrome (PCOS). The present study investigated whether weight loss after bariatric surgery could improve symptoms and related hormones in women with morbid obesity.Methods: In a retrospective observational study, 50 women aged 18-40 years with body mass index (BMI)=42.3 kg/m2 who underwent laparoscopic Roux-en-Y gastric bypass (RYGB) were enrolled. Evaluation of anthropometric data, serum testosterone, luteinizing hormone (LH), follicle-stimulating hormone (FSH), prolactin (PRL), fasting plasmaglucose (FPG), and lipid profile were measured preoperatively and at 1-year follow-upResults: Of 50 women, 32 (64%) women were diagnosed to have PCOS. The mean BMI at 1-year follow-up was 27.05 kg/m2. Hirsutism and irregular menstruation resolved entirely among 68.8% (11/16) and 100% (18/18) at 1-year follow-up. There was a significant decrease in total serum testosterone (2.1±0.2 to 0.9±0.1 ng/mL) and LH (8.5±3.36 to 5.02±2.4 mIU/mL) at 1-year follow-up, whether changes in levels of serum FSH, PRL were not significant.Conclusion: Bariatric surgery was effective in weight loss and improvement of PCOS symptoms and related hormones in women with morbid obesity. Thus, women with PCOS and morbid obesity should be eligible for bariatric surgery.

Due to the specific features of the adrenal glands, traumatic adrenal injury is a rare phenomenon. Themajority of these rare types of traumas are caused by blunt force injuries and rarely by penetratingmechanisms. In such cases, a whole-body computed tomography scan is essential for early diagnosis.This paper describes an uncommon case of adrenal hematoma and contusion followed by blunt abdominaltrauma. A 35-year-old woman was admitted to the emergency department after a high-speed vehicle-pedestriancollision. She presented with decreasing level of consciousness. Additionally, a thoracoabdominal CT scanrevealed a left flank hematoma. Blunt adrenal injury, often accompanied by multiorgan damage, is a rareoccurrence resulting from severe accidents. Accurate diagnosis based on clinical symptoms requires highclinical suspicion, particularly in isolated cases, and treatment depends on the patient’s condition.

Background and Purpose: Endothelial dysfunction plays an important role in the development of cardiovascular diseases. Exercise training may lead to improved endothelial function. However, the effect of resistance training on endothelial function is not clearly understood. In addition, the age and health status of individuals may also play a role in endothelial function, and these factors have not been investigated in endothelial response to resistance training. Therefore, the aim of the present meta-analysis is to investigate the effect of resistance training on endothelial function in young and older adults with and without chronic diseases.Materials and Methods: Main databases including PubMed and Web of Science were searched through January 13, 2023, for resistance training studies on the FMD index. The inclusion criteria for the current research included studies with an exercise training group, human subjects with an average age older than 18 years, measuring endothelial function using FMD, and published in English and Persian language journals. Weighted mean difference (WMD) and 95% confidence interval were used to determine the effect size using CMA2 software. The level of heterogeneity was assessed using the I2 test and the publication bias was also assessed with Egger's test. Subgroup analyses were performed for age (elderly adults including people over 50 years old and young adults including people under 50 years old), health status (with chronic disease and healthy), and type of study (one-group and two-group). All analyzes were performed using CMA2 software.Results: Twenty-one studies including 701 participants were included in the meta-analysis. The results of data analysis showed that resistance training resulted in a significant increase in FMD [2.07, (CI: 1.26 to 2.88) P = 0.001]. Examination of heterogeneity using the I2 test showed that there was a significant heterogeneity (I2=82.92, p=0.001), while Egger's test results (p=0.73) did not confirm the publication bias. Subgroup analysis based on age showed that resistance training in both groups of young [WMD: 2.06, P = 0.001] and older [WMD: 1.87, P = 0.001] individuals leads to an increase in FMD. In addition, resistance training in both groups of healthy [WMD: 1.770 P = 0.001] and patients [WMD: 2.406 P = 0.001] individuals lead to an increase in FMD. In addition, the analysis based on the type of study showed that FMD is increased in both single-group [WMD: 1.18, P = 0.029] and two-group [WMD:2.51, P =0.001] studies.Conclusion: In general, the main findings of the present meta-analysis show that resistance training is an effective exercise intervention for improving endothelial function, whose beneficial effects occur independently of the age and health status of adults. Therefore, resistance training should be included in the exercise program for adults.

In this study, four identical laboratory-scale sequencing batch reactors (SBRs) were continuously operated with different concentrations of microbeads (MBs) (5,000–15,000 MBs/L) to investigate the stress-responses of activated sludge under the MB exposure. It was found that the overall treatment performance (organic removal) of SBRs was fairly affected by short-term exposure to low levels of MBs; however, it was adversely affected as the concentration of MBs increased. The average concentration of mixed liquor suspended solids and heterotrophic bacteria in the reactor fed with 15,000 MBs/L were 16 and 30% less than in the pristine control reactor, respectively. Batch experiments further demonstrated that fairly low concentrations of MBs favored the development of dense microbial structures. Further increasing the MB concentrations to 15,000 MBs/L, however, distinctly weakened the settling performance of sludge. Morphological observations revealed suppressed uniformity, strength, and integrity of flocs reactors with the addition of MBs. Microbial community analyses revealed that the abundance of protozoan species declined 37.5, 58, and 64%, respectively, when SBRs were exposed to 5,000; 10,000; and 15,000 MBs/L as compared with the control reactor. The present work provided new insight into the possible effects of MBs on the performances and operational parameters of activated sludge. HIGHLIGHTS Plastic microbeads were extracted from facial scrubs and their characteristics were determined.; Responses of activated sludge upon exposure to microbeads (MBs) were elucidated.; The effect of MBs on operating indicators of the activated sludge process including sludge settleability bacterial and higher-life population were investigated.; The effect of MBs on treatment performance was studied.;

Abstract Background and Aims Obesity is considered a major growing threat to public health which could negatively affect the quality of life. The current cross‐sectional study was conducted to investigate the population‐based prevalence of metabolically healthy obesity (MHO) and healthy overweight (MHOW) and associated factors in southern Iran. Methods Baseline data from the Pars Cohort Study was analyzed. Metabolically healthy participants were identified based on the definition of the American Heart Association for the metabolic syndrome. The prevalence of MHOW and MHO and their 95% confidence intervals were estimated. Poisson regression was applied for the calculation of prevalence ratios (PRs). Results Gender‐ and age‐standardized prevalences of MHOW and MHO were 6.3% (6.0%–6.6%) and 2.3% (2.1%–2.5%), respectively. The following factors were associated with being MHOW compared with those with normal weight: Being younger, female gender (1.31, 1.20–1.43), higher socioeconomic status, being noncurrent cigarette smoker (1.27, 1.11–1.45), low level of physical activity (1.14, 1.03–1.25), having normal overweight during adolescence, and overweight (1.35, 1.24–1.48) or obesity (1.68, 1.53–1.86) during young adulthood. We also found strong associations between MHO and younger age groups, female gender (2.87, 2.40–3.42), being married (1.57, 1.08–2.27), Fars ethnicity (1.25, 1.10–1.43), higher socioeconomic status, ever use of tobacco (1.14, 1.00–1.30), never use of opium (1.85, 1.19–2.86), lower physical activity (1.45, 1.20–1.72), being normal weight in 15‐year body pictogram and being overweight (1.87, 1.59–2.20) or obese (3.20, 2.74–3.72) in 30‐year body pictogram when considering those with normal weight or MHO. Conclusion Potentially modifiable factors including physical activity should be more emphasized. Furthermore, our study issued that it would be more reasonable that the prevention of unhealthy obesity be initiated before the development of MHO, where there are more protective factors and they could be more effective.

Objectives: Antibacterial activity against endodontic pathogens is a desirable feature for root canal sealers. The objective of this study was to compare the antibacterial effect of three resin-based endodontic sealers (AH26, Adseal, and Beta RCS) against Enterococcus faecalis in vitro. Materials and Methods: The antibacterial properties of the sealers were assessed against E. faecalis using agar diffusion test (ADT) for fresh state (N=10) and direct contact test (DCT) for freshly-mixed and set states of the materials (N=10). In ADT, the diameter of the zones of inhibition was measured after 24h of contact. In DCT, the colony-forming units of the bacteria were counted after 30 minutes and 180 minutes of exposure. The results were analyzed with two-way ANOVA and independent sample t-test. P0.05). According to ADT, AH26 and Adseal represented the widest and the smallest inhibition zones, respectively (P

Abstract Objectives The significance of T helper 17 (Th17) cells in the pathogenesis of rheumatoid arthritis (RA) has recently been demonstrated in many studies. Retinoic acid receptor‐related orphan receptor γt (RORγt) is a transcription factor that is specifically involved in the generation of Th17 cells. Besides, the chemokine receptor CCR6, the receptor for CCL20, is characteristically expressed by these cells. Considering the pivotal roles of Th17 cells in RA pathogenesis, in this study, we assessed the gene expression of CCR6 and RORγt in the peripheral blood leukocytes of new case RA patients. Also, we evaluated their association with anticyclic citrullinated peptide (anti‐CCP) antibodies and disease activity. Methods Forty‐five new case RA patients and 45 healthy persons have been recruited in this investigation. The gene expression of CCR6 and RORγt was evaluated by quantitative real‐time PCR (qRT‐PCR), and anti‐CCP antibodies plasma levels were measured using the enzyme‐linked immunosorbent assay (ELISA) technique. Disease activity was measured according to the disease activity score‐28 (DAS‐28) formula. Results The gene expression of CCR6 and RORγt increased remarkably in new case RA patients compared to healthy controls (p

Background: As a public health priority, health-related quality of life (HRQoL) is associated with some factors like sleep disorders. Taking this into consideration, this study aimed at investigating the relationship between sleep duration and sleep quality with HRQoL in patients on hemodialysis. Methods: This cross-sectional study was carried out among 176 patients on hemodialysis who were admitted to the dialysis ward of 22 Bahman hospital and a private renal clinic in Neyshabur (a city in North-East of Iran) in 2021. Sleep duration and quality were measured using an Iranian version of Pittsburgh Sleep Quality Index (PSQI) and HRQoL was evaluated with the Iranian version of a 12-Item Short Form Survey (SF-12). To analyze the data and examine the independent association of sleep duration and quality with HRQoL, multiple linear regression model was performed. Results: The mean age of the participants was 51.6 ± 16.4 and 63.6% were male. Moreover, 55.1% and 5.7% of subjects reported a sleep duration shorter than 7 h and equal to or more than 9 h, respectively, and the value prevalence of poor sleep quality was reported as 78.2%. Furthermore, the reported overall score of HRQoL was 57.6 ± 17.9. According to the adjusted models, poor sleep quality was negatively associated with the total HRQoL score (B = −14.5, P

Introduction: Multifunctional of cancer-specific tumor biomarkers is a potent therapeutic approach to treat cancer diseases with high efficacy. Among these methods that can be mentioned are the composition and design of nanoparticles and photosensitizers (PS). The purpose of this study is to investigate the effect of gold nanoparticles (GNPs) coated thioglucose (Tio) combined with methylene blue photosensitizer to enhance the efficacy of hybrid therapy (photodynamic and radiation therapy).Material and Methods: First, GNPs-Tio was synthesized. Next, the toxicity of GNPs-Tio, MB, and their combinations was determined on the MCF-7 cell line to achieve their optimal concentrations. In the next step, the efficacy of combination therapy was evaluated using hybrid therapy. For this purpose, an optical dose of 15.6 J/cm2 and 2 Gy for radiation therapy were delivered. Cell viability was evaluated using MTT and colony assays.Results: According to the MTT assay, the combined photodynamic and radiation treatment of GNPs-Tio did not cause significant cell death. But this induced significant cell death by using GNPs-Tio + MB while the cell survival rate was almost zero. Combined therapy caused significant cell death in the presence of each of the pharmacological agents alone and their combination in colony assay.Conclusion: The difference in treatment results between the MTT and the colony assay can be due to the more accurate colony assay for cell death detection. Significant cell death was achieved in the combination of photodynamic and radiotherapy in the presence of MB and MB + GNP-Tio.

Purpose: New lethal coronavirus disease 2019 (COVID-19), currently, has been converted to a disastrous pandemic worldwide. As there has been found no definitive treatment for the infection in this review we focused on molecular aspects of coenzyme Q10 (CoQ10) and possible therapeutic potencies of CoQ10 against COVID-19 and similar infections. Methods: This is a narrative review in which we used some authentic resources including PubMed, ISI, Scopus, Science Direct, Cochrane, and some preprint databases, the molecular aspects of CoQ10 effects, regarding to the COVID-19 pathogenesis, have been analyzed and discussed. Results: CoQ10 is an essential cofactor in the electron transport chain of the phosphorylative oxidation system. It is a powerful lipophilic antioxidant, anti-apoptotic, immunomodulatory and anti-inflammatory supplement which has been tested for the management and prevention of a variety of diseases particularly diseases with inflammatory pathogenesis. CoQ10 is a strong anti-inflammatory agent which can reduce tumor necrosis factor-α (TNF-α), interleukin (IL)- 6, C-reactive protein (CRP), and other inflammatory cytokines. The cardio-protective role of CoQ10 in improving viral myocarditis and drug induced cardiotoxicity has been determined in different studies. CoQ10 could also improve the interference in the RAS system caused by COVID-19 through exerting anti-Angiotensin II effects and decreasing oxidative stress. CoQ10 passes easily through blood–brain barrier (BBB). As a neuroprotective agent CoQ10 can reduce oxidative stress and modulate the immunologic reactions. These properties may help to reduce CNS inflammation and prevent BBB damage and neuronal apoptosis in COVID-19 patients. Conclusion: CoQ10 supplementation may prevent the COVID-19-induced morbidities with a potential protective role against the deleterious consequences of the disease, further clinical evaluations are encouraged.

Accurate spatiotemporal monitoring and modeling of soil moisture (SM) is of paramount importance for various applications ranging from food production to climate change adaptation. This study deals with modeling SM with the random forest (RF) algorithm using datasets comprising multispectral data from Sentinel-2, Landsat-8/9, and hyperspectral data from the CoSpectroCam sensor (CSC, licensed to AgriWatch BV, Enschede, The Netherlands) mounted on an unmanned aerial vehicle (UAV) in Iran. The model included nine bands from Landsat-8/9, 11 bands from Sentinel-2, and 1252 bands from the CSC (covering the wavelength range between 420 and 850 nm). The relative feature importance and band sensitivity to SM variations were analyzed. In addition, four indices, including the perpendicular index (PI), ratio index (RI), difference index (DI), and normalized difference index (NDI) were calculated from the different bands of the datasets, and their sensitivity to SM was evaluated. The results showed that the PI exhibited the highest sensitivity to SM changes in all datasets among the four indices considered. Comparisons of the performance of the datasets in SM estimation emphasized the superior performance of the UAV hyperspectral data (R2 = 0.87), while the Sentinel-2 and Landsat-8/9 data showed lower accuracy (R2 = 0.49 and 0.66, respectively). The robust performance of the CSC data is likely due to its superior spatial and spectral resolution as well as the application of preprocessing techniques such as noise reduction and smoothing filters. The lower accuracy of the multispectral data from Sentinel-2 and Landsat-8/9 can also be attributed to their relatively coarse spatial resolution compared to the CSC, which leads to pixel non-uniformities and impurities. Therefore, employing the CSC on a UAV proves to be a valuable technology, providing an effective link between satellite observations and ground measurements.

Background: Urinary tract infection (UTI) is one of the most important health care issues with a major role in occurrence of nosocomial infections. Rise in antibiotic resistance rate by UTIs not only lead to morbidity and mortality, but also impose a remarkable financial burden on health care infrastructure. This study was undertaken to evaluate the prevalence of UTIs and identify common microorganisms responsible for infection and their antibiotic resistance profile in our Intensive Care Unit (ICU). Methods: In this perspective cross-sectional study, data from patients admitted to the ICU of two main referral hospitals in Yasouj, Southern-west Iran from 2015- 2016 was collected. Patients were selected in a subsequent manner and were asked to provide a midstream urine sample. Positive cultures were subsequently placed in differential culture medium for the diagnosis of the causative pathogen, while also evaluating with Muller Hinton Agar culture for antibiogram through disc diffusion method, to evaluate the pathogens sensitivity and resistance towards the tested antibiotics. Results: Based on bacterial culture results among a total of 112 obtained urine samples, 100 (89.2%) were negative while 12 (10.8%) were positive, in which the majority were gram-negative (6.25%) and the most frequent pathogen was Escherichia coli (5.3%). All cases of UTI in our population were fully resistant to cephalexin, ampicillin, and amoxicillin. Also, all gram-negative cultures were sensitive to amikacin. There was also no significant association between the antibiogram results with age, gender, and gram results. Conclusion: we report actual data on the resistance patterns of uro-pathogens in a public hospital in Iran. Escherichia coli showed a high prevalence among all UTIs with lower resistance rates to the antibiotics. Resistance to nalidixic acid and trimethoprim-sulfamethoxazole were significantly lower than other oral antibiotics, making both a suitable and cheap alternative for the empirical treatment.

This in-vitro study aimed to evaluate the physical properties of three resin-based root canal sealers (BETA RCS, AH26, and Adseal) in terms of flow and film thickness as per ISO 6876/2012. The results revealed that the flow values of BETA RCS, Adseal, and AH26 sealers were 23.06±1.58, 22.5±4.23, and 21.85±1.71, respectively. Moreover, film thickness values for BETA RCS, Adseal, and AH26 sealers were 52.33±2.51, 18.66±0.57, and 52±2, respectively. No significant difference was observed regarding film thickness between AH26 and BETA RCS sealers (P>0.05), while Adseal showed better result in terms of film thickness than other sealers (P˂0.05). The highest solubility was related to BETA RCS (0.6%), and the lowest to Adseal (0.07%). However, all sealers had acceptable solubility and radiopacity. The findings of the current study suggested that all tested root canal sealers had similar properties based on ISO 6876 standard criteria.

Background: Cancer stem cells (CSCs) are the most challenging issue in cancer treatment, because of their high resistance mechanisms, that can cause tumor recurrence after common cancer treatments such as drug and radiation based therapies, and the insufficient efficiency of common treatments in CSCs removal and the recurrence of tumors after these treatments, it is essential to consider other methods, including non-ionizing treatments likes light-based treatments and magnetic hyperthermia (MHT). Method and material: After synthesis, characterization and investigation, the toxicity of novel on A375 and MAD-MB-231 cell lines, magnetic hyperthermia and light-based treatments were applied. MTT assay and flow cytometry was employed to determine cell survival. the influence of combination therapy on CD44 + CD24−and CD133 + CD44+ cell population, Comparison and evaluation of combination treatments was done respectively using Combination Indices (CIs). Result: The final nanoparticle has a high efficiency in producing hydroxyl radicals and generating heat in MHT. According to CIs, we can conclude that combined using of light-based treatment and MHT in the presence of final synthesized nanoparticle have synergistic effect and a high ability to reduce the population of stem cells in both cell lines compared to single treatments. Conclusion: In this study a novel multi-functional nanoplatform acted well in dual and triple combined treatments, and showed a good performance in the eradication of CSCs, in A375 and MAD-MB-231 cell lines.

Introduction: Atopic dermatitis (AD) is a chronic inflammatory skin disease for which there is no adequate treatment. Mesenchymal stem cells have already been used to treat inflammatory diseases. The present study investigated the effect of the administration of human mesenchymal stem cells-conditioned medium (MSC-CM) on the AD model and its relationship with central pain, the level of oxidative, and inflammatory stress factors in the skin. Material & Methods: The AD model was established by topical administration of a 2% 4,2-dinitrochlorobenzene (DNCB) solution on the dorsal and ear skin of mice. Mice received topical MSC-CM and betamethasone ointment as a positive control three times a day for 2 weeks. Skin interleukin-4 (IL-4) and malondialdehyde (MDA) levels were measured by the ELISA method in all groups. Changes in nociception were assessed by the tail flick test. Histological changes in the body and ear skins were evaluated after hematoxylin-eosin (H&E) staining, and mast cells number in toluidine blue-stained sections were counted in this study. (Ethic code: IR.SHAHED.REC.1399.095) Findings: Topical administration of MSC-CM and betamethasone was able to reduce pain, inflammation, and changes of dermis thickness in the dorsal and ear skins, as well as the infiltration of mast cells in the skin of groups treated with DNCB. Moreover, MSC-CM, similar to betamethasone, decreased the level of IL-4 and MDA levels in the skin of DNCB receiving groups. Discussion & Conclusion: The increase in IL-4 levels and lipid peroxidation play an important role in inducing AD-like lesions in the skin of the mouse in the DNCB model; in addition, the topical application of the MSC-CM is a potential therapeutic agent for AD.

Background: Microbial infections and the resistance to antibacterial drugs are on the rise, and scientists are in search of the safest and most effective approach to overcome them. Medicinal plants are potentially effective against many microorganisms. Therefore, this study was planned to examine the antibacterial properties and cytotoxicity of the extracts of Allium sativum and Myrtus communis against bacteria that cause nosocomial infections. Methods: A. sativum and M. communis were collected from the northern regions of Iran during the spring. After preparing the hydroalcoholic extracts of A. sativum and M. communis, the minimum inhibitory and bactericidal concentrations (MIC & MBC) were determined. The cytotoxicity of the extracts was asseyed in normal cells and Hu02 fibroblast cell line. Results: The MIC and MBC of A. sativum (62.5 mg/mL) against Salmonella enterica were similar. Also, the MIC of A. sativum and M. communis against Acinetobacter baumannii and Pseudomonas aeruginosa were similar (62.5 & 15.6 mg/mL), respectively. The viability percentage of skin fibroblasts after treatment for 48 hours with the extract of A. sativum was significantly higher than that of M. communis. Conclusion: Both extracts from A. sativum and M. communis demonstrated good antimicrobial properties. Based on the results, the safe antibacterial potential of the extracts may be used as alternative agents to fight against nosocomial bacterial infections.

Abstract Background Polypharmacy in patients with cardiovascular diseases (CVDs) has been linked to several adverse outcomes. This study aimed to investigate the pattern of medication use and prevalence of polypharmacy among CVDs patients in Iran. Method We used the baseline data of the Pars cohort study (PCS). The participants were asked to bring their medication bags; then, the medications were classified using the Anatomical Therapeutic Chemical classification. Polypharmacy was defined as using five or more medications concurrently. Poisson regression modeling was applied. The adjusted prevalence ratios (PR) and its 95% confidence interval (CI) were estimated. Results Totally, 9262 participants were enrolled in the PCS, of whom 961 had CVDs. The prevalence of polypharmacy in participants with and without CVDs was 38.9% and 7.1%, respectively. The highest prevalence of polypharmacy (51.5%) was among obese patients. Abnormal waist-hip ratio (PR: 2.79; 95% CI 1.57–4.94), high socioeconomic status (PR: 1.65; 95% CI 1.07–2.54), tobacco-smoking (PR: 1.35; 95% CI 1.00–1.81), patients with more than three co-morbidities (PR: 1.41; 95% CI 1.30–1.53), high physical activity (PR: 0.66; 95% CI 0.45–0.95), use of opiate ever (PR: 0.46; 95% CI 0.26–0.82), and healthy overweight subjects (PR: 0.22; 95% CI 0.12–0.39) were associated with polypharmacy. Cardiovascular drugs (76.1%), drugs acting on blood and blood-forming organs (50.4%), and alimentary tract and metabolism drugs (33.9%) were the most frequently used drugs. Agents acting on the renin-angiotensin system were the mostly used cardiovascular system drugs among men and those above 60 years old, while beta-blocking agents were mostly prevalent among cardiovascular system drugs in women with CVDs. Conclusion Given the high prevalence of polypharmacy among CVDs patients, and subsequent complications, programs to educate both physicians and patients to prevent this issue is crucial.

IntroductionMothers with disabled children are among the most critical groups exposed to domestic violence. Although domestic violence strongly affects these mothers’ physical and mental health, it subsequently affects their drug addiction and resilience to suicide. Based on this, it is crucial to investigate domestic violence, drug addiction, and resilience against suicide in mothers with disabled children. This study investigated the relationship between domestic violence, substance dependence, and resilience against suicide in mothers with disabled children in Iranian society.MethodsFrom January to April 2023, a cross-sectional study was conducted in central and western Iran with the participation of 267 mothers with disabled children. The mothers of disabled children were selected through convenience and snowball sampling. Then they completed questionnaires included domestic violence, substance dependence and resilience against suicide. The collected data were analyzed using SPSS version 22 with descriptive statistics, such as prevalence, percentage, mean, and standard deviation, and expository measurements, including ANOVA, independent t, and regression tests.ResultsThe study revealed that there was a strong direct correlation between domestic violence and substance abuse (r = 0.89, p

Background: Breast cancer (BC) is the most common malignancy in women worldwide. The methylation status of MyoD1, a tumor suppressor gene, is enrolled in various cancers, i.e., BC. Various studies showed the impact of MyoD1 epigenetic dysregulation in BC. This study aimed to investigate the methylation status and expression level of MyoD1 in BC patients and its association with the expression of DNMT1. Materials and Methods: This case-control study was conducted on 30 cases (pathology-confirmed ductal carcinoma) and 18 controls (fibroadenoma and fibrocystic masses), referred to Velayat Hospital, Qazvin, Iran. The expression of the MyoD1 and DNMT1 and the promoter methylation of the MyoD1 were evaluated in tissue blocks of BC patient masses using qRT-PCR and MS-PCR assays, respectively. SPSS 24.0 was used to analyze the data. Results: The MyoD1 promoter is hypermethylated in BC patients compared to controls (p =0.001). The expression level of MyoD1 in BC patients was significantly reduced compared to controls (fold change =0.13, p =0.042). In addition, in BC patients, the reduced expression level of MyoD1 was significantly associated with methylation of the MyoD1 promoter (p =0.001). There is no significant difference between the expression level of DNMT1 in BC patients and controls (p =0.197). A significant association is found between the expression of DNMT1 and the methylation status of the MyoD1 promoter (p =0.038). Discussion: The expression level of MyoD1 is affected by the methylation status of the promoter of this gene. Moreover, the expression level and methylation status of MyoD1 are correlated with clinical parameters.

Background: Cancer development is aided by the role of long noncoding RNAs (lncRNAs) that act as competing endogenous RNAs (ceRNAs) absorbing microRNAs (miRNAs). We aimed to discover a novel regulatory axis in colorectal cancer (CRC) and potential biomarkers based on miR-616-3p. Materials and Methods: The gene expression omnibus database was mined for differentially expressed lncRNAs (DELs) and mRNAs. LncRNAs and mRNAs were predicted using the RegRNA and TargetScan databases. A combination of the ciBioPortal and Ensemble databases was used to locate the mRNAs. Cytoscape 3.7.1-built CeRNA networks. A quantitative real-time polymerase chain reaction (qRT-PCR) was utilized to confirm the expression levels of these RNA molecules. Statistical analyses were implemented by GraphPad Prism 9. Results: qRT-PCR showed (Linc01282, lnc-MYADM-1:1, and Zinc Finger Protein 347 [ZNF347]) were overexpressed whereas, (salt-inducible kinases 1 [SIK1], and miR-616-3p) were down regulated. Conclusion: These results identify unique, unreported lncRNAs as CRC prognostic biomarkers, as well as prospective mRNAs as new treatment targets and predictive biomarkers for CRC. In addition, our study uncovered unexplored ceRNA networks that should be studied further in CRC.

This study aimed to assess the relationship between skeletal malocclusion and radiomorphometric indices of the mandible in long face patients. This cross-sectional study evaluated 174 lateral cephalograms and panoramic radiographs of long face patients between the ages of 17 and 30 presenting at the Orthodontics Department of Qazvin Dental School. The gonial angle, antegonial angle, type of antegonial notch, and depth of antegonial notch were measured bilaterally on panoramic radiographs. The correlation between the radiomorphometric parameters and the type of occlusion was analyzed using one-way ANOVA, independent t-test, Chi-square test, and Fisher’s exact test (alpha = 0.05). The mean size of gonial angle was significantly different among the three classes of occlusion (p = 0.046), while the difference was not significant regarding the antegonial angle size and antegonial notch depth (p > 0.05). An independent t-test showed that the mean sizes of gonial angle (p = 0.026) and antegonial angle (p = 0.036), and the antegonial notch depth (p = 0.046) in males, were significantly greater than the values in females. According to the Chi-square and Fisher’s exact test, the right antegonial notch type was significantly different among the three classes of malocclusion (p = 0.006), while this difference was not significant in the left side (p = 0.318). The right antegonial notch type II was more common in males, while the right antegonial notch type I was more common in females (p = 0.014). According to the results, the indices of gonial angle and type of antegonial notch can be clinically useful for predicting the growth rate of the mandible and designing the appropriate treatment in long face patients.

Background: Nephropathic cystinosis (NC) is an uncommon autosomal recessive disease with abnormality in lysosomal storage that appearances in patients with mutations in the CTNS gene encoding a lysosomal transporter cystinosin. Disrupted function of this transporter is followed by accumulation of cysteine crystals in cells of many various organs. This study aimed to investigate the mutations of the CTNS gene in 20 Iranian patients suffering from NC. Materials and Methods: Twenty Iranian cystinosis patients referring to Imam Hossein Hospital of Isfahan were employed in this case-series study. After extraction of genomic DNA, the promoter and entire coding regions of CTNS were analysed using sanger sequencing in all patients. Gap–Polymerase Chain Reaction was used to detect 57 kb deletion in the CTNS gene. In silico study was performed to analyse variants. Results: The large deletion was not seen in any NC patients. Molecular analysis which conducted to screen the CTNS gene of patients, identified eight different mutations, including two new mutations, c.971_972insC and c.956_956delA, which have not been reported before, and c.681G>A mutation, which was identified as a frequently founded mutation in the Middle East and was observed in 35% of patients. In this study, five other mutations including c.1015G>A, c.922G>A, c.323_323delA, c.433C>T, and c.18_21delGACT were also observed, which have been reported in previous studies. Conclusion: The mutational spectrum in the Iranian patients is the same as previously reported mutations except that two new mutations were found. The present findings will present suggestions for regular molecular diagnosis of cystinosis in Iran.

Abstract Background The outbreak of Coronavirus disease, which originated in Wuhan, China in 2019, has affected the lives of billions of people globally. Throughout 2020, the reproduction number of COVID-19 was widely used by decision-makers to explain their strategies to control the pandemic. Methods In this work, we deduce and analyze both initial and effective reproduction numbers for 12 diverse world regions between February and December of 2020. We consider mobility reductions, mask wearing and compliance with masks, mask efficacy values alongside other non-pharmaceutical interventions (NPIs) in each region to get further insights in how each of the above factored into each region’s SARS-COV-2 transmission dynamic. Results We quantify in each region the following reductions in the observed effective reproduction numbers of the pandemic: i) reduction due to decrease in mobility (as captured in Google mobility reports); ii) reduction due to mask wearing and mask compliance; iii) reduction due to other NPI’s, over and above the ones identified in i) and ii). Conclusion In most cases mobility reduction coming from nationwide lockdown measures has helped stave off the initial wave in countries who took these types of measures. Beyond the first waves, mask mandates and compliance, together with social-distancing measures (which we refer to as other NPI’s) have allowed some control of subsequent disease spread. The methodology we propose here is novel and can be applied to other respiratory diseases such as influenza or RSV.

Abstract Background The first large serosurvey in Iran found a SARS-CoV-2 antibody seroprevalence of 17.1% among the general population in the first wave of the epidemic by April, 2020. The purpose of the current study was to assess the seroprevalence of COVID-19 infection among Iranian general population after the third wave of the disease. Methods This population-based cross-sectional study was conducted on 7411 individuals aged ≥10 years old in 16 cities across 15 provinces in Iran between January and March, 2021. We randomly sampled individuals registered in the Iranian electronic health record system based on their national identification numbers and invited them by telephone to a healthcare center for data collection. Presence of SARS-CoV-2-specific IgG and IgM antibodies was assessed using the SARS-CoV-2 ELISA kits. The participants were also asked about their recent COVID-19-related symptoms, including cough, fever, chills, sore throat, headache, dyspnea, diarrhea, anosmia, conjunctivitis, weakness, myalgia, arthralgia, altered level of consciousness, and chest pain. The seroprevalence was estimated after adjustment for population weighting and test performance. Results The overall population-weighted seroprevalence adjusted for test performance was 34.2% (95% CI 31.0-37.3), with an estimated 7,667,874 (95% CI 6,950,412-8,362,915) infected individuals from the 16 cities. The seroprevalence varied between the cities, from the highest estimate in Tabriz (39.2% [95% CI 33.0-45.5]) to the lowest estimate in Kerman (16.0% [95% CI 10.7-21.4]). In the 16 cities studied, 50.9% of the seropositive individuals did not report a history of symptoms suggestive of COVID-19, implying an estimation of 3,902,948 (95% CI 3,537,760-4,256,724) asymptomatic infected individuals. Conclusions Nearly one in three individuals were exposed to SARS-CoV-2 in the studied cities by March 2021. The seroprevalence increased about two-fold between April, 2020, and March, 2021.

Abstract In this cross-sectional population-based study, we used the baseline data of the Prospective Epidemiologic Research Studies in IrAN cohort study collected in Iran from 2014 to 2020. The main outcomes were the prevalence of hypertension and proportion of awareness, treatment, and control based on the 2017 ACC/AHA guideline compared to the seventh report of the Joint National Committee (JNC7). Of the total of 163,770 participants, aged 35–70 years, 55.2% were female. The sex-age standardized prevalence of hypertension was 22.3% (95% CI 20.6, 24.1) based on the JNC7 guideline and 36.5% (31.1, 41.8) based on the ACC/AHA guideline. A total of 24,312 participants [14.1% (10.1, 18.1)] were newly diagnosed based on the ACC/AHA guideline. Compared to adults diagnosed with hypertension based on the JNC7 guideline, the newly diagnosed participants were mainly young literate males who had low levels of risk factors and were free from conventional comorbidities of hypertension. About 30.7% (25.9, 35.4) of them (4.3% of the entire population) were eligible for pharmacologic intervention based on the ACC/AHA guideline. Implementation of the new guideline may impose additional burden on health systems. However, early detection and management of elevated blood pressure may reduce the ultimate burden of hypertension in Iran.

Objectives The rapid growth of the elderly population has led to more problems, such as declining independence. Due to the importance of doing independent daily living activities in the elderly, this study was conducted to determine the relationship between social support, cognitive status, and depressive symptoms with daily activities in the elderly in Amirkola City. Methods & Materials This matched case-control study is part of the first phase of the cohort project for the elderly in Amirkola City, which was conducted on all people aged 60 years and more in Amirkola City. To collect the data, various questionnaires, including demographic characteristics, mental brief assessment (MMSE), duke social support index (DSSI), elderly depression index (GDS), activity of daily living (ADL), and instrumental activity of daily living (IADL) were used. Statistical analysis of variables was performed using descriptive (frequency, mean and standard deviation) and analytical tests (independent t-test, conditional logistic regression) and at a significant level (P

Abstract Background The coronavirus disease (COVID-19) hospitalized patients are always at risk of death. Machine learning (ML) algorithms can be used as a potential solution for predicting mortality in COVID-19 hospitalized patients. So, our study aimed to compare several ML algorithms to predict the COVID-19 mortality using the patient’s data at the first time of admission and choose the best performing algorithm as a predictive tool for decision-making. Methods In this study, after feature selection, based on the confirmed predictors, information about 1500 eligible patients (1386 survivors and 144 deaths) obtained from the registry of Ayatollah Taleghani Hospital, Abadan city, Iran, was extracted. Afterwards, several ML algorithms were trained to predict COVID-19 mortality. Finally, to assess the models’ performance, the metrics derived from the confusion matrix were calculated. Results The study participants were 1500 patients; the number of men was found to be higher than that of women (836 vs. 664) and the median age was 57.25 years old (interquartile 18–100). After performing the feature selection, out of 38 features, dyspnea, ICU admission, and oxygen therapy were found as the top three predictors. Smoking, alanine aminotransferase, and platelet count were found to be the three lowest predictors of COVID-19 mortality. Experimental results demonstrated that random forest (RF) had better performance than other ML algorithms with accuracy, sensitivity, precision, specificity, and receiver operating characteristic (ROC) of 95.03%, 90.70%, 94.23%, 95.10%, and 99.02%, respectively. Conclusion It was found that ML enables a reasonable level of accuracy in predicting the COVID-19 mortality. Therefore, ML-based predictive models, particularly the RF algorithm, potentially facilitate identifying the patients who are at high risk of mortality and inform proper interventions by the clinicians.

Abstract Background Inappropriate medication use among individuals with depressive disorders (DD) is a rising public health challenge. We aimed to investigate the polypharmacy and its determinants among individuals with DD in a less developed region, and evaluate the pattern of medication use in this population. Methods Data was extracted from Pars Cohort Study (PCS) between 2016 and 2019. Participants were asked to bring all the medication they were using regularly, and history of DD during the last 12 months prior to study was obtained. The Anatomical Therapeutic Chemical classification was applied and polypharmacy was defined as concurrent use of five or more medications. Logistic regression models were developed to estimate the associations between polypharmacy and DD, adjusted for relevant covariates. The prevalence of consumption of each drug class was estimated among males, females, and elders. Logistic regression was applied and the adjusted odds ratio (OR) and its 95% confidence interval (CI) were estimated. Results A total of 9264 participants with a mean age of 52.6 (SD: 9.7) were enrolled. The prevalence of polypharmacy was 22.6% [95% CI (20.7–24.6)]. The most common drug classes were genitourinary system (55.4%) and nervous system (29.1%) medication, respectively. Recent history of DD was reported among 19.4% (n = 1795) participants, the majority of whom were females. Factors associated with polypharmacy include female gender (OR: 1.51), Fars ethnicity (OR: 1.52), lower physical activity (OR: 1.74), and higher socioeconomic status (OR: 1.40). The prevalence of antidepressant use among males was higher than females (P

Abstract Background Despite all recent health-related improvements, anemia remains an extensive global public health issue affecting the lives of about one-fourth of the world population in a geographically heterogeneous pattern. We, therefore, aimed to illustrate the prevalence, severity, most common types, and major determinants of anemia among adults in Khuzestan, Iran, from 2016 to 2019. Methods In a large population-based cross-sectional study comprising of a diverse population, each participant underwent a questionnaire-based interview and laboratory testing for hematological analysis. A hemoglobin (HGB) concentration of

Objectives Access to maternal and neonatal care services (MNCS) is an important goal of health policy in developing countries. In this study, we proposed a 3-level hierarchical location-allocation model to maximize the coverage of MNCS providers in Iran. Methods First, the necessary criteria for designing an MNCS network were explored. Birth data, including gestational age and birth weight, were collected from the data bank of the Iranian Maternal and Neonatal Network national registry based on 3 service levels (I, II, and III). Vehicular travel times between the points of demand and MNCS providers were considered. Alternative MNCS were mapped in some cities to reduce access difficulties. Results It was found that 130, 121, and 86 MNCS providers were needed to respond to level I, II, and III demands, respectively, in 373 cities. Service level III was not available in 39 cities within the determined travel time, which led to an increased average travel time of 173 minutes to the nearest MNCS provider. Conclusions This study revealed inequalities in the distribution of MNCS providers. Management of the distribution of MNCS providers can be used to enhance spatial access to health services and reduce the risk of neonatal mortality and morbidity. This method may provide a sustainable healthcare solution at the policy and decision-making level for regional, or even universal, healthcare networks.