Search

Abstract Congenital aniridia is a rare eye disease characterized by loss of PAX6 protein leading to aniridia-associated keratopathy that significantly reduces vision. The miR-204-5p is a possible regulator of PAX6 function and here we evaluate its effect in multiple in vitro and in vivo models. In vitro, miR-204-5p overexpression suppressed vascular factor ANGPT1 in human limbal stem cells (T-LSC) and Pax6-knockdown LSC (mut-LSC), and in primary human limbal epithelial cells (LEC) at the gene and protein levels and following LPS stimulation. However, miR-204-5p inhibited VEGFA expression only in mut-LSCs and LPS-stimulated LEC. Also, miR-204-5p increased PAX6 expression in mut-LSC and differentiated corneal epithelial cells, but not in LEC. Topical miR-204-5p after LPS-induced keratitis in mice failed to suppress Vegfa, Angpt1, Il-1β, and Tnf-α or rescue Pax6 levels in contrast to in vitro results, although it significantly reduced the inflammatory infiltrate in the cornea. In Pax6 Sey/+ aniridia mice, miR-204-5p did not rescue PAX6 levels or suppress Vegfa, Angpt1, or inhibit the ERK1/2 pathway. While short-term miR-204-5p treatment effectively suppresses VEGFA and ANGPT1 and enhances PAX6 expression in multiple corneal epithelia, effects are variable across primary and immortalized cells. Effects of longer-term in vivo treatment, however, require further study.

Abstract Background Mild cognitive impairment (MCI) and Alzheimer’s disease (AD) are significant neurodegenerative disorders with increasing prevalence worldwide. Lifestyle and dietary factors, including micronutrients, have been suggested as modifiable risk factors for disease development. This study aims to investigate the association between micronutrients and cognitive ability in these diseases. Methods A cross-sectional study involving 105 participants with MCI and AD was conducted. Dietary assessments were performed using a validated food frequency questionnaire (FFQ), and micronutrient intake was calculated based on nutrient content. Disease severity was evaluated using the Functional Assessment Staging Tool (FAST). Statistical analyses, including correlation coefficients and multiple regression models, were employed to examine the association between micronutrients and disease progression. Results The results revealed significant correlations between disease severity and several micronutrients, including omega-3 fatty acids (B = -0.2, P = 0.01), carotenoids (B = -0.19, P = 0.02), dietary antioxidant compounds, including vitamins A, C, D, E (B = -0.19, P = 0.02), selenium (B = -0.17, P = 0.03), alpha-carotene (B = -0.16, P = 0.04), beta-carotene (B = -0.17, P = 0.03), and lycopene (B = -0.16, P = 0.04). Multivariate regression analysis showed that higher intake of omega-3 fatty acids was associated with slower disease progression. Furthermore, the levels of these micronutrients declined in advanced stages of the disease. Conclusion Omega-3 fatty acids and carotenoids may affect the cognitive ability and disease progression. Further longitudinal studies are warranted to establish causality and explore the therapeutic implications of these findings for the prevention and management of MCI and AD.

Abstract Introduction In congenital aniridia caused by mutations in paired box 6 (PAX6), PAX6 influences the migration and differentiation of limbal epithelial cells (LECs), thereby playing a pivotal role in aniridia-associated keratopathy. The antidepressants ritanserin and duloxetine affect PAX6 expression in LECs. Limbal stromal cells, which support limbal epithelial stem cells, are crucial in the limbal stem cell niche. This study explores how ritanserin and duloxetine influence gene expression in primary human limbal stromal cells from subjects with congenital aniridia and from healthy subjects, in vitro. Methods Primary human limbal stromal cells from corneas affected by aniridia (AN-LSCs) (n = 8) and from healthy corneas (LSCs) (n = 8) were isolated and cultured in either low-glucose serum-free (LGSF) or normal-glucose serum-containing (NGSC) media. Cells were treated with 4 µM ritanserin or duloxetine for 24 h. Quantitative PCR (qPCR) and western blot were used to assess the expression of PAX6, FOSL2, TGF-β1, ACTA2A1, LUM, COL1A1, COL5A1, DSG1, FABP5 and ADH7. Results In AN-LSCs with LGSF-medium, ritanserin increased PAX6 messenger RNA (mRNA) (p = 0.007) and decreased TGF-β1 and FOSL2 mRNA levels (P = 0.005, P = 0.038). In addition, TGF-β1 protein levels decreased with both treatments (P = 0.02, P = 0.007), and FABP5 protein level increased, using ritanserin (P = 0.019). In LSCs with LGSF-medium, ACTA2A1 mRNA levels decreased using ritanserin and duloxetine (P = 0.028; P = 0.031), while FABP5 mRNA levels increased with ritanserin treatment (P = 0.003). Also, duloxetine use reduced α-SMA protein (P = 0.013) and increased FABP5 protein levels (P = 0.029). In LSCs with NGSC-medium, ritanserin elevated LUM, FABP5 and ADH7 mRNA and protein levels (P = 0.025, P = 0.003, P = 0.047, P = 0.024, P = 0.013, P = 0.039). Conclusions The results of our study confirmed that the antipsychotropic drugs ritanserin and duloxetine alter PAX6 and TGF-β1 gene expression in AN-LSCs cultured in LGSF-medium. These drugs were found to have an impact on retinoic acid signaling pathways and keratocyte characteristic markers both in LSCs and AN-LSCs, using different culture media.

BackgroundThe COVID-19 pandemic, which emerged in late 2019, influenced nearly all aspects of human life, including food choices and dietary habits.MethodologyA web-based search was conducted from March to April 2024 in MEDLINE/PubMed, CINAHL, Embase, and the Cochrane Library for published reports of large-scale surveys of dietary changes during or shortly after the coronavirus pandemic lockdown in Iran. The keywords used were coronavirus OR COVID-19, diet OR nutrition, household, and Iran. Studies that focused on specific areas, subgroups (such as students), or just one city or province were not included. To monitor dietary changes from the years before the lockdown, we used and plotted data from the Household Income and Expenditure Survey (HIES), as provided by the Statistical Center of Iran.ResultsThe overall results of the nationwide studies conducted during the lockdown period in Iran revealed that a significant proportion of the households reduced their consumption of milk, yogurt, cheese, red meat, white meat, eggs, and rice/bread. In approximately 47% of the households where weekly consumption of animal protein sources decreased, the consumption of rice and bread increased. Accordingly, 35 and 44% of households reported a decrease in the consumption frequency of fruits and snacks, respectively. Additionally, 21% of those who reduced their fruit consumption completely removed fruits from their food basket. Meanwhile, the use of dietary supplements, especially vitamin D, vitamin C, zinc, and multivitamins, had increased in households, particularly among those with higher incomes. Decreased income was a common reason for all of these dietary changes, which can have major health consequences in the long term.ConclusionThis review provides evidence that the observed changes had already begun years before the pandemic and presumably have not yet returned to the pre-pandemic situation. Finally, we suggest some strategies for policymakers to overcome the crisis and enhance community the nutrition and health of general population.

Abstract Background Inadequate fruits and vegetables intake is associated with several diseases. This study aimed to explore changes in fruits and snack consumption during the COVID-19-related lockdown in Iran. Methods An online cross-sectional survey among Iranian households was conducted from the 4th to 25th April 2020, during the COVID-19 lockdown. Data were collected about any changes in frequency consumption of the fruits and snacks and the reasons for the changes. Ordinal logistic regression was performed to examine which factors contributed to changes in consumption. To account for the complex sampling design and allow inferences valid for the population, sampling weights were used in all analyses. Results A total of 21,290 households took part in the survey. During the epidemic, consumption of fruits and snacks decreased by 35% and 44%, respectively. Among the households whose fruit intake was decreased, about 21% fully omitted it from their food baskets. Residing in rural areas, having more than six members in the household, income loss, and residing in deprived provinces were directly associated with decreased consumption of fruits and snacks. Being a female-headed household was positively associated, and having persons with COVID-19 in the households was inversely associated, with decreased consumption of fruits. The main reason for reducing fruit and snack consumption was income loss. Conclusions A significant decline in fruit and snack consumption because of COVID-19 lockdown was seen among the Iranian households. It is likely that these changes in dietary habits will become longstanding with consequent adverse health outcomes.

Background: Childhood obesity and overweight have become major public health problems worldwide. To combat this problem, effective, sustainable, and consistent strategies are needed. In this study, the long-term effect of a school-based intervention for weight reduction was evaluated in primary school students in Tehran, Iran. Methods: This was a cluster randomized controlled trial (RCT) conducted in 12 primary schools in a low- to middle-class district in Tehran, Iran. The participants were 334 overweight or obese primary school students (girls =164) based on World Health Organization standards, equally distributed in the intervention (n=167) and comparison (n=167) groups. It was a multi-component intervention and included nutrition education and increased physical activity (PA), a lifestyle modification program for parents, and changing the food items sold in canteens of the schools. Body mass index Z-score [BMI-Z] was determined as the primary outcome and measured at baseline, three months after baseline, at post-test (after 18 weeks), and follow-up (13-month). In total, 205 students (59.5%) completed the follow-up. Analyses were carried out based on the intention-to-treat principle using linear mixed models. Results: After 13 months, the BMI Z-score decreased in both intervention and comparison groups. However, the change was more significantly observed in the intervention group (adjusted change: 0.098, 95% CI: (0.03-0.16) compared with comparison group (P=0.003(. The intervention had a more significant effect on BMI Z-score among girls (adjusted change: 0.36, 95% CI: (0.27-0.45) compared with the comparison group (P

From an economic point of view, the tourism industry has a special place. Especially in the single-product economy of Iran, it can be used as the best and most optimal alternative to oil. Augmented reality technology is one of the world's newest and most up-to-date applied technologies, highly regarded today. This research focuses on augmented reality and its patterns. This research aims to investigate and develop a practical pattern identification of augmented reality (ar) and its tracking in the tourism industry. Designs are provided by capturing the position and orientation of the device and its location using sensors and Computer vision with screen technology (augmented reality guide). A guide is designed, implemented, and evaluated as an augmented reality application on a mobile phone. The proposed solution has been using deep learning in marker identification. The deep learning architecture used is Yolo, and the proposed method's marker identification results have an accuracy of 68.73 maps

Abstract Background An increasing number of studies in Western countries have shown that healthy eating patterns have a protective effect against cognitive decline and dementia, however, information about this relationship among non-western populations with different cultural environments is scarce. The present study investigated the association between dietary patterns (DPs) and cognitive function in the Iranian elderly. Methods In this case–control study, the data of 290 elderly people in two groups of case and control (Mean age in case: 74.2 ± 8.6, in control: 67.3 ± 7.3 year) were analyzed. Two DPs of healthy and unhealthy were extracted from a 142-item dish-based food frequency questionnaire, and patterns driven by principal components analysis (PCA) of 25 food groups. Multivariate binary logistic regression calculated the odds ratio (OR) of cognitive impairment with adjustment for potential confounding factors. Results A healthy DP, characterized by high consumption of fruits and vegetables, legumes, and nuts, was related to a decrease in the odds of Alzheimer’s disease in Iranian elderly people. Also, moderate adherence to an unhealthy food pattern was associated with an increase in the probability of the disease; however, the association was not statistically significant. Conclusion In this elderly population, a healthy eating pattern was associated with reducing the risk of Alzheimer’s disease. Further prospective studies are recommended.

Background: Diabetic foot ulcer and potential subsequent lower extremity amputation are major complications of diabetes mellitus and are also prominent morbidity factors that could affect patients’ quality of life. Objectives: This study aimed to assess the prevalence of diabetic foot amputation and explore correlates of amputation cause and type among subjects with diabetes mellitus in Tehran, Iran. Methods: A descriptive cross-sectional study was conducted to assess the demographic, sociological, and clinical characteristics of subjects who had undergone lower extremity amputation due to diabetic foot ulcers, from 2011 to 2020, in two educational medical centers in Tehran, Iran. We examined the medical records of 4676 individuals who were admitted to Shariati and Sina hospitals due to diabetic foot issues. Information related to patient demographics (age, gender, marital status), social factors (education level, insurance), and clinical data (medical history, laboratory results, and characteristics of diabetic foot ulcers) was collected for subjects who had undergone lower extremity amputation due to diabetic foot ulcer. The collected data was reported using average values, standard deviations and proportions and analyzed using statistical tests. Results: During one decade, 882 out of 4676 (18.8%) patients with diabetic foot ulcers underwent lower extremity amputations of various types in Sina and Shariati hospitals in Tehran, Iran. Of these, 692 (14.5%) were included for further analysis in the study and the rest were excluded due to lack of sufficient recorded data. About 75.9% of the study population was male, and the average age including both sexes was 60 years. About 92.7% were married, and on average, subjects had been afflicted with diabetes mellitus for 15.1 years. Statistical analysis using Pearson’s chi-square test showed there was a significant association between the treatment regimen for diabetes mellitus and the type of amputation ( P = .01), as well as between the duration of the disease and the cause of amputation ( P = .01) and its type ( P = .04). Conclusion: diabetes mellitus related treatment regimen and duration of disease are significantly associated with amputation cause and type.

Background and aims: Phenylketonuria (PKU) is an autosomal recessive disorder of phenylalanine (Phe) metabolism. Mutations in the phenylalanine hydroxylase (PAH) gene are the main reason for the incidence of PKU. To date, more than 1180 variants have been detected in the PAH gene. Given that the distribution pattern of mutations in the PAH gene is specific to each population, the present study was conducted to detect exon 4 mutations and adjacent flanking regions of the PAH gene in northern Iran. Methods: This is a descriptive cross-sectional study, in which 24 unrelated PKU patients in Taleghani Hospital in Gorgan were enrolled for a one-year period. After extraction of genomic DNA from leukocytes, identification of exon 4 mutations and adjacent flanking regions was performed using polymerase chain reaction (PCR) and sequencing techniques. Results: In this study, IVS4+1G>A mutation was detected in one allele (2.08%) among 48 alleles. Moreover, IVS4+47C>T and IVS3-22C>T polymorphisms were observed in 12 alleles (25%) and eight alleles (16.7%), respectively. Conclusion: In the present study, IVS4+1G>A mutation was only found in 2% of chromosomes. Hence, different mutations are responsible for PKU disease in the north of Iran, and further studies are recommended to identify all mutations in the PAH gene in the region.

Background: The relation between long-term dietary intake and diseases is well known. There are several methods to determine long-term dietary intake. The food frequency questionnaire (FFQ) is used in studies to assess habitual dietary intake over a long term period. Dietary intake varies according to cultural differences, so an FFQ must be designed and validated for the target population. This protocol study aims to explain the development and validation of a semi-quantitative FFQ for the Iranian population that includes mixed dishes and single food items. Methods: The initial list of food items were extracted from interviews and expert opinion. An expert panel of ten nutritionists calculated the content validity ratio (CVR) and content validity index (CVI) of food items to finalize the FFQ. One hundred twenty eligible participants were included in the study. They completed the FFQ two times, with a ten month interval. They recorded their food intake for three days in the 2nd and 10th months of the study. In the 4th and 10th months, serum retinol and alpha-tocopherol, and 24-hour urinary potassium and nitrogen were measured. Result: Covering typical Iranian mixed dishes is the main advantage of this study. Given that the questionnaire is valid and reproducible, it can be used in epidemiologic studies. Conclusion: The current study developed a dish-based Iranian FFQ based on mixed food.

Abstract Background Anaplastic thyroid carcinoma (ATC) is the most aggressive subtype of thyroid cancer. In this study, we used a three-dimensional in vitro system to evaluate the effect of a dual MEK/Aurora kinase inhibitor, BI-847325 anticancer drug, on several cellular and molecular processes involved in cancer progression. Methods Human ATC cell lines, C643 and SW1736, were grown in alginate hydrogel and treated with IC50 values of BI-847325. The effect of BI-847325 on inhibition of kinases function of MEK1/2 and Aurora kinase B (AURKB) was evaluated via Western blot analysis of phospho-ERK1/2 and phospho-Histone H3 levels. Sodium/iodide symporter (NIS) and thyroglobulin (Tg), as two thyroid-specific differentiation markers, were measured by qRT-PCR as well as flow cytometry and immunoradiometric assay. Apoptosis was assessed by Annexin V/PI flow cytometry and BIM, NFκB1, and NFκB2 expressions. Cell cycle distribution and proliferation were determined via P16, AURKA, and AURKB expressions as well as PI and CFSE flow cytometry assays. Multidrug resistance was evaluated by examining the expression of MDR1 and MRP1. Angiogenesis and invasion were investigated by VEGF expression and F-actin labeling with Alexa Fluor 549 Phalloidin. Results Western blot results showed that BI-847325 inhibits MEK1/2 and AURKB functions by decreasing phospho-ERK1/2 and phospho-Histone H3 levels. BI-847325 induced thyroid differentiation markers and apoptosis in ATC cell lines. Inversely, BI-847325 intervention decreased multidrug resistance, cell cycle progression, proliferation, angiogenesis, and invasion at the molecular and/or cellular levels. Conclusion The results of the present study suggest that BI-857,325 might be an effective multi-targeted anticancer drug for ATC treatment.

The transparent corneal epithelium in the eye is maintained through the homeostasis regulated by limbal stem cells (LSCs), while the nontransparent epidermis relies on epidermal keratinocytes for renewal. Despite their cellular similarities, the precise cell fates of these two types of epithelial stem cells, which give rise to functionally distinct epithelia, remain unknown. We performed a multi-omics analysis of human LSCs from the cornea and keratinocytes from the epidermis and characterized their molecular signatures, highlighting their similarities and differences. Through gene regulatory network analyses, we identified shared and cell type-specific transcription factors (TFs) that define specific cell fates and established their regulatory hierarchy. Single-cell RNA-seq (scRNA-seq) analyses of the cornea and the epidermis confirmed these shared and cell type-specific TFs. Notably, the shared and LSC-specific TFs can cooperatively target genes associated with corneal opacity. Importantly, we discovered that FOSL2, a direct PAX6 target gene, is a novel candidate associated with corneal opacity, and it regulates genes implicated in corneal diseases. By characterizing molecular signatures, our study unveils the regulatory circuitry governing the LSC fate and its association with corneal opacity.

Abstract Sterilization of saffron packaging and maintaining the quality of saffron content are the main priorities in saffron preservation. Common modalities do not offer lasting saffron preservation and it is urgent to develop novel packaging approaches from renewable resources and prevent packaging waste. Here, simultaneous decontamination and quality maintenance of saffron is demonstrated, for the first time, through the synergistic application of nano-clay-loaded carboxymethyl cellulose (CMC)/polyvinyl alcohol (PVA) nanocomposites (CNCs) and cold plasmas (CP). Compared to the separate uses of CP and CMC/PVA/nano clay, our results confirm the synergies between CP and CMC/PVA/nano clay cause complete inactivation of Escherichia coli bacteria, while not significantly affecting the concentrations of the essential saffron components (safranal, crocin, and picrocrocin). Overall, the CP-treated CMC/PVA/nano clay fosters saffron preservation, through contamination removal and quality maintenance of the food product. The synergistic application of CP and CMC/PVA/nano clay thus represents a promising strategy for packaging, sterilization, and preservation of high-value food products.

Abstract Background The pandemic of the newly emerged coronavirus infection and its related disease, Covid-19, has influenced various aspects of human life including dietary habits. This study aimed to examine changes in dairy products consumption during Covid-19 lockdown period in a huge sample of Iranian households. Methods A cross-sectional descriptive-analytical study using a web-based electronic self-administered questionnaire designed to detect any changes in the consumption frequency of dairy products in the Iranian households during Covid-19 lockdown. Results A total of 21,290 households were enrolled. During Covid-19 epidemic lockdown, about 29%, 26% and 7% of the households had decreased their consumption frequency of milk, yogurt and cheese, respectively. The female-headed households were 21% more likely to decrease their consumption of milk, compared with male-headed households (OR = 1.21, 95% CI: 1.05–1.4). The households residing in food insecure provinces were 29%, 20% and 45% more likely to decrease their consumption of milk, yogurt and cheese as compared with those living in the food secure provinces. About 37%, 25.3%, 19.4% of those households who reported a decrease in consumption of dairy products had fully omitted them. Conclusion We found considerable decrement of dairy products consumption, especially milk and yogurt, in a high proportion of the studied households. Inadequate intake and, in some households, omission of dairy products can potentially bring about serious health outcomes with heavier economic burden. Further studies to track these changes over time and to evaluate their health consequences are warranted.

Abstract Background Nutritional inadequacy, especially micronutrients, is still a serious concern among children in developing countries. Dietary diversity score (DDS) has been recommended as a proxy for nutritional adequacy. The present study aims to develop a questionnaire to assess the dietary diversity among 24–59 months children in Iran; also, the validity of the dietary diversity score as an indicator of nutritional status among the children will be assessed. Methods In order to design the questionnaire, the Food and Agriculture Organization Guideline for measuring individual dietary diversity will be applied. According to the guideline, foods are categorized into nine groups, then dietary diversity score will be calculated by summing the number of food groups. In order to evaluate the efficacy of this questionnaire in predicting the nutritional status of the children, the relationship between dietary diversity score calculated by the questionnaire with nutritional adequacy, serum retinol and anthropometric indicators will be compared. Discussion DDS can be a valuable indicator for predicting the adequacy of macronutrients and micronutrients specially in children. It is also significantly related to the mean probability of adequacy (MPA).

Abstract Background This study aimed to develop a conceptual framework to better understand food and nutrition literacy and its dimensions and components among Iranian children. Methods The study included three sub-studies. First, two qualitative studies were conducted to explore experts’ and students’ perspectives and experiences regarding the topic. A comprehensive qualitative literature review was then conducted to identify food/nutrition literacy definitions and its components in the relevant literature. The data of the above three sub-studies were compiled as text data and were analyzed utilizing MAXQDA2010 software. Results Two main domains, including cognitive and skill domains, emerged from the data analysis. The cognitive domain consisted of food- and nutrition-related knowledge included four subcategories “nutrition knowledge”, “lifestyle knowledge”, “food safety knowledge”, and “knowledge of food and its preparation”) as well as “food and nutrition understanding”. The skill domain consisted of three dimensions: “functional”, “interactive”, and “critical” food and nutrition literacy. Conclusions The developed framework highlights the importance of integrated application of all dimensions of food and nutrition literacy among this population group. It can assist policymakers and curriculum developers in assessing education curricula and developing effective strategies for teaching and learning to increase students’ food and nutrition literacy.

Background and aims: To identify the pattern and causes of death and to deal with them are among the most appropriate strategies to increase human life expectancy. The pattern of death in society must be identified to cope with the causes of premature deaths. The aim of this study was to epidemiologically investigate the causes of death in people aged 5-14 years in northeastern Iran. Methods: Data on the deaths of people aged 5-14 years from Khorasan Razavi province during 2013- 2019, drawn from the Causes of Mortality Classification System of the Ministry of Health and Medical Education, were used to conduct the study. Results: Data on 2084 deaths were examined, of which 824 (40.04%) occurred in girls. The number of deaths was 976 (53.83%) and 1108 (46.17%) in the age group of 5-9 and 10-14, respectively. Traffic accidents, cancers, external causes (unexpected events), and circulatory system diseases were found as the main causes of death. Among the cancers, lymphoid leukemia, malignant brain tumors, and myeloid leukemia (18%, 12%, and 7%, respectively) were the most common cancers, leading to death. In rural areas, unexpected events (20%) were the leading cause of death, followed by traffic accidents and cancers (19% and 13%, respectively). Conclusion: Overall, the mortality rate in children aged 5-14 years due to traffic accidents and unexpected events (suffocation, burns, and the like) seems to be substantially higher in Iran compared to some developing countries and some neighboring countries such as Turkey. Given the possibility of taking preventive measures in this regard, it is necessary to develop policies to reduce the mortality rate in the age group.

Type 2 Diabetes Mellitus (T2DM) has been the main category of metabolic diseases in recent years due to changes in lifestyle and environmental conditions such as diet and physical activity. On the other hand, the circadian rhythm is one of the most significant biological pathways in humans and other mammals, which is affected by light, sleep, and human activity. However, this cycle is controlled via complicated cellular pathways with feedback loops. It is widely known that changes in the circadian rhythm can alter some metabolic pathways of body cells and could affect the treatment process, particularly for metabolic diseases like T2DM. The aim of this study is to explore the importance of the circadian rhythm in the occurrence of T2DM via reviewing the metabolic pathways involved, their relationship with the circadian rhythm from two perspectives, lifestyle and molecular pathways, and their effect on T2DM pathophysiology. These impacts have been demonstrated in a variety of studies and led to the development of approaches such as time-restricted feeding, chronotherapy (time-specific therapies), and circadian molecule stabilizers.

Purpose: This study examines what makes elite sports and how it affects Iran's sports business and industry. An integrated approach was used to achieve this goal.Methodology: We segmented the data analysis procedure into three stages. For the fuzzy Delphi method, experts and academics were asked for their opinions on what was most important. After that, we used interpretative structural modeling (ISM) to classify the components and create a hierarchical model. The MICMAC analysis was also used to determine how the factors drive and depend on each other.Findings: This study has identified 14 factors related to ES in Iran. The model that was developed has six levels. Also, the MICMAC analysis found that three variables were independent, two were dependent, three were linked, and one was found to be autonomous.Originality: According to our knowledge, the research design presented in this article represents the first attempt to hierarchically analyze these factors and develop a model for ES in Iran, which can lead to the promotion of the sports business industry. Using the model that was made for the future of Iran's ES, preparations will need to be made, such as the following: Active diplomacy in sports (with a focus on championships and professional sports) by those who are involved and responsible for the problem; redesigning the country's sports structure for excellence and success in international arenas; There is a need to modify the goals and policies of ES to make them more coordinated with the specific goals and programs that correspond to the different scenarios that could occur: alterations to budget allocation and distribution to medal-rich and medal-prone sports; A talent search system that is built in and can be used to look for talents is also needed.

Abstract Background The COVID-19 epidemic has affected diverse issues of life including economy, health and nutrition. This nationwide study was conducted to evaluate the effects of the epidemic lockdown-induced socio-economic changes on animal source proteins and cereals intakes of Iran population for the first time. Methods This was a cross-sectional descriptive-analytical study using a web-based electronic self-administered questionnaire. A questionnaire was designed with the aim of detecting any changes in the dietary pattern of the Iranian household following coronavirus epidemic. Results A total of 21,290 households participated in the study. Approximately 33%, 24%, 14.2% and 7% of the households had decreased the weekly consumption of red meat, white meat, eggs and rice/bread, respectively, following COVID-19 epidemic. The results of ordered logistic regression showed that the female-headed households, as compared with male-headed ones, were 30% more likely to decrease their weekly consumption of white meat (OR = 1.3, 95% CI: 1.1–1.5). About 8.6% of the households had reduced all three major dietary sources of animal protein. Close to half of the households (46.9%) who decreased their intake of the animal protein sources had increased their intake of rice or bread, too. The major reasons for these changes were decrease of income and job loss. Conclusion In conclusion, animal protein food consumption decreased during epidemic lockdown but the amounts of rice and bread, as the major sources of dietary energy, have increased. These changes, if persist long enough, can seriously affect micronutrient status of the whole population. Early nutritional interventions for needy families are warranted.

Abstract Background Food and nutrition literacy is a key factor in shaping healthy dietary behaviors and may result in decreasing decrease the prevalence of overweight. Empirical research on food and nutrition literacy and its outcomes is limited, especially among children and adolescents. Thus, this study investigates the link between Food and Nutrition Literacy (FNLIT) with eating behaviors, academic performance, and overweight in 10–12 years old students in Tehran, Iran. Methods This study was performed through two phases: 1) Proposing a conceptual model of the relationship between FNLIT and its determinants and outcomes, based on the existing evidence and previous models, and 2) Testing the proposed FNLIT model through a cross-sectional study on 803 primary school students (419 boys and 384 girls, from 34 public and 10 private primary schools), aged 10–12 years using structural equation modeling. Demographic, socio-economic, and household food security characteristics were collected by interviewing the students and their mothers/caregivers using a questionnaire. FNLIT was measured by a self-administered, locally designed, and validated questionnaire. Results The fit indices suggested a reasonably adequate fit of the data to the hypothesized model (χ2/df = 2.03, p

Background: To improve dairy consumption among children, it is crucial to explore probable barriers and facilitators toward it. The current qualitative study aims to discover barriers and facilitators of dairy intake among school-age children in Tehran to suggest strategies to improve it based on the optimal components of social marketing. Methods: In a qualitative study, 111 school-age children (mean age 10.08±0.57 years) were selected by purposive sampling with maximum diversity from primary schools in three areas of Tehran. Sixteen focus group discussions (FGDs) were separately conducted among students in different grades. Contents of the FGDs were analyzed using MAXQDA 2010. Results: Food and nutrition literacy, improvement of attitude and trust-building, training taste and food preferences were the main facilitators to increase dairy products among school-age children. Barriers related to dairy products consumption included negative attitudes toward dairy products, unsound tastes, and unhealthy food preferences. The main suggested strategies to increase dairy consumption were improvement of the products' sensory and non-sensory characteristics, providing the milk and dairy products consumption experience for free, improvement of the quality of preserving places, enhancing physical and economic availability of dairy products. Dairy stores and school buffets were mentioned as the best places for supply. Encouragement and motivation, education and information, modeling and promoting appropriate culture were suggested as the main promotion strategies. Conclusion: To provide practical strategies for increasing dairy consumption among children, the perceived barriers and facilitators mentioned by them should be addressed.

Obesity is a public health issue, leading to many medical and socially unacceptable complications. To combat obesity, going on a diet is a routine prescription by dieticians. Although men and women with obesity are equally advised to lose their body weight, almost in all societies women are more adhered to their prescribed diets. However, some of weight reducing diets seems neither effective nor long lasting. This study aimed to assess perceived barriers to weight-loss programs among women with obesity in Shiraz. Methods: This qualitative study was conducted in 2017 in Shiraz. To fulfill the objectives of the study, eight semi-structured focus group discussions (FGDs) and seven in-depth interviews with key informants were performed. The eligible participants for FGDs were women with obesity who were not satisfied with their diet and were selected through a public call in Shiraz. Results: A total of 1429 initial codes were obtained from FGDs, and after categorizing, four main barriers were resulted. Dietary, socio-cultural, supportive- psychological, and economic issues were identified as the main perceived barriers to weight-loss programs. Conclusion: The study findings provided comprehensive information about the probable causes of diet prescriptions failure, which can assist dietitians to improve the efficacy of their weight management advice in clinics

Background & Aims Pregnancy is associated with physiological and psychological changes. Pregnancy in adolescence may affect the quality of life (QoL) of young women. This study aims to investigate the QoL of adolescent pregnant women in Arak, Iran. Materials & Methods This cross-sectional study was conducted on 217 adolescent pregnant women referred to comprehensive health centers in urban areas of Arak city in 2020 who were selected by a multi-stage sampling method. A demographic form and the QoL gravidarum questionnaire (QoL-GRAV) were used to collect information. Descriptive statistics were used to describe the data and independent t-test, analysis of variance, and Pearson correlation test were used to examine the relationship between the study variables in SPSS software, version 22. Significance level was set at 0.05. Results The mean age of participants was 17.86±1.42 years. Their mean total score of QoL was 1.83±0.56, which was higher than average. They had the highest score in the psychological health domain (Mean=2.01) and the lowest score in the social functioning domain (Mean=1.5). Mother's educational level, husband's educational level, economic status , and pregnancy status (unplanned/planned) according to women and their husbands had a statistically significant relationship with the QoL. Conclusion The QoL of adolescent pregnant women in Arak is higher than the average. Those with higher educational level, those with husbands having higher educational level, those with better economic status, and those with planned pregnancy have better QoL.

Introduction: Food waste reflects inadequate food intake and is of economic and environmental importance. Therefore, understanding the underlying factors is a must to combat food waste. Methods: A qualitative study was conducted using semi-structured interviews with managers, nurses, nutritionists, food providers, kitchen staff, and inpatients at three hospitals in Tehran. Responses were recorded, coded, and analyzed thematically. Results: Forty-eight face-to-face interviews led to three core categories: 1. opinions/performance; 2. causes, related factors, and characteristics; and 3. rooting and suggestions. We found that the majority of the hospitalized patients did not consume their entire food. In spite of overall satisfaction with the quantity and quality of food, anorexia, personal taste, and poor quality of raw materials prohibited patients from eating. Also, rice was the most discarded food. Economic barriers were the most important hindrance to elevate the quality, and some strategies, like the supply of high-quality materials and recruiting skillful cooking team, were proposed to improve it. Conclusions: Our findings delineated a limited budget as the main barrier to improve the quality. Nevertheless, the low quality of hospital foods may actually impose a heavier economic burden due to food waste.

Repeated Transcranial Magnetic Stimulation (RTMS) therapy is one of the modern treatment methods for various neurological and psychiatric diseases. With the clinical advancement of new therapies, there is a need to increase nursing knowledge, various practical skills, and new ways of organizing care. This study aims to review the rTMS, and the role of psychiatric nurses before, during and after rTMS. The search was conducted in IranMedex, PubMed, Elsevier, Google Scholar, Ovid, and SID databases using the keywords: Repeated transcranial magnetic stimulation, long-term potential, mental nerve, psychiatric nursing both in English and Persian. Initial search yielded 42 articles, of which 24 were selected for the review. Treatment with rTMS can cause significant treatment effects. It has low complications, and is non-invasive and painless. The patient is conscious during the treatment process and is safe from the effects of anesthetic drugs. This method is also effective for people who are resistant to treatment. The psychiatric nurses play an important role in rTMS and teach patients on the formation of realistic expectations and the establishment of systems that ensure the continuity of safety and care. Moreover, they can assess clinical problems and work with the patients to create a therapeutic environment.

Summary: Background & aims: Vitamin D is being increasingly recognized for its important non-skeletal functions including endocrine actions. This study investigated if a single, large, intramuscular postpartum injection of vitamin D improve adiponectin levels among women with gestational diabetes mellitus (GDM). Methods: A total of 45 pregnant women with GDM participated in this randomized clinical trial. They were randomly divided into intervention and control group. The intervention group received an intramuscular injection of 300,000 IU of vitamin D during 3–10 days after their child delivery, but controls did not. Serum 25-hydroxyvitamin D, fasting plasma glucose (FPG), hemoglobin A1c (HbA1c) and serum adiponectin were measured at baseline and after 3 months of intervention. Results: Serum 25 OH vitamin D increase significantly in the intervention but not in the control group from 24.25 to 62.10 (nmol/L) (p-value

Abstract Objective The aim of this study was to assess the relationship between household food insecurity (HFI) with food and nutrition literacy (FNLIT) in a sample of Iranian children. This cross sectional study was performed on 315 children aged 9 to 12 years recruited from the primary schools throughout Mashhad, Iran. The Household Food Insecurity Access Scale (HFIAS) was used to assess the HFI. Also, overall FNLIT score and its sub-categories were evaluated using a validated 40-item questionnaire. Results The prevalence of HFI in the total sample was about 56%. Also, almost 14% of students had a low FNLIT score. Food insecure children had significantly lower levels of FNLT and some subscales including nutrition knowledge, food choice literacy, and food label literacy than the food-secure subjects, moreover, they had a higher likelihood of having low FNLIT score (OR = 2.89, CI 1.03–8.09; p = 0.04). In conclusion, there is a negative association between HFI and FNLIT in children. Further studies to confirm this finding are needed.

Abstract Background Depression is a major contributor to disability-adjusted life years (DALY) lost in the world. Dietary patterns are widely used to investigate diet–disease relations. In the current study, the relationship between dietary patterns and depression was investigated. Besides, the role of serum vitamin D, zinc, magnesium, and total antioxidant capacity as potential mediatory variables was studied. Methods It was an individually matched case–control study in which 330 depressed and healthy subjects were recruited for the extraction of dietary patterns; psychiatrists diagnosed major depressive disorder, using the criteria of the Diagnostic and Statistical Manual of Mental Disorders. Serum vitamin D and aforementioned biomarkers were measured for a number of randomly selected depressed and healthy individuals. We conducted mediatory analysis by regression models. Results Healthy and unhealthy dietary patterns were associated with the lower and higher odds of depression (OR 0.39, CI 0.17–0.92 and OR 2.6, CI 1.04–6.08), respectively. A significant relationship between serum vitamin D with depression after adjusting for potential confounders was observed as well (OR 0.93, CI 0.87–0.99). According to the mediatory analysis the unhealthy dietary patterns were related to depression via altering the serum vitamin D concentration. Conclusion This study showed that vitamin D deficiency mediates the relationship between unhealthy dietary patterns and depression. However, to get a clearer result further prospective studies are required.

Abstract Objective This study aims to assess the relationship between Food and Nutrition Literacy (FNLIT) and dietary diversity score (DDS); FNLIT and nutrient adequacy (NAR%, MAR%) in school-age children in Iran. Results This cross-sectional study was undertaken on 803 primary school students in Tehran, Iran. Socio-economic, as well as three 24-h dietary recalls were collected through interviewing students and their mothers/caregivers. FNLIT was measured by a self-administered locally designed and validated questionnaire. Low level of FFNL was significantly associated with higher odds of low DDS (OR = 2.19, 95% CI 1.32–3.62), the first tertile of fruit diversity score (OR = 3.88, 95% CI 2.14–6.99), and the first tertile of dairy diversity score (OR = 9.60, 95% CI 2.07–44.58). Low level of IFNL was significantly associated with probability of lower meat diversity score (OR = 1.73, 95% CI 1.07–2.81). Low level of FLL was also significantly associated with probability of lower DDS (OR = 1.81, 95% CI 1.11–2.94), dairy diversity score (OR = 2.01, 95% CI 1.02–3.98), and meat diversity score (OR = 2.14, 95% CI 1.32–3.45).Low FNLIT and its subscales were associated with higher odds of low level of NAR of protein, calcium, vitamin B3, B6, B9, as well as the probability of lower level of MAR.

Abstract Background Major depressive disorder is among main worldwide causes of disability. The low medication compliance rates in depressed patients as well as the high recurrence rate of the disease can bring up the nutrition-related factors as a potential preventive or treatment agent for depression. The aim of this study was to investigate the association between dietary patterns and depression via the intermediary role of the serum folate and vitamin B12, total homocysteine, tryptophan, and tryptophan/competing amino acids ratio. Methods This was an individually matched case-control study in which 110 patients with depression and 220 healthy individuals, who completed a semi-quantitative food frequency questionnaire were recruited. We selected the depressed patients from three districts in Tehran through non-probable convenience sampling from which healthy individuals were selected, as well. The samples selection and data collection were performed during October 2012 to June 2013. In addition, to measure the serum biomarkers 43 patients with depression and 43 healthy people were randomly selected from the study population. To diagnose depression the criteria of Diagnostic and Statistical Manual of Mental Disorders, fourth edition, were utilized. Results The findings suggest that the healthy dietary pattern was significantly associated with a reduced odds of depression (OR: 0.75; 95% CI: 0.61–0.93) whereas the unhealthy dietary pattern increased it (OR: 1.382, CI: 1.116–1.71). The mediation analysis showed that the healthy dietary pattern was associated with a reduced risk of depression via increased serum levels of the folate and vitamin B12; however, the unhealthy dietary pattern was associated with increased risk of depression via decreased serum levels of folate and vitamin B12, based on tree adjusted logistic regression models. Conclusion Dietary patterns may be associated with depression by changing the serum levels of folate and vitamin B12. Further studies are required to confirm the mechanism.

Abstract Objective This study aimed to assess the validity and reliability of a dish-based, semi-quantitative food frequency questionnaire (DFFQ) for epidemiological studies in Iran. The DFFQ included 142 items (84 foods and 58 mixed dishes) which was filled in by 230 adults (110 men). All participants completed two separate DFFQs with a 6 months interval as well as six 24-h recalls, each month. Dietary biomarkers and anthropometric measurements were made. The validity was evaluated by comparing the DFFQ against 24-h dietary recalls and dietary biomarkers, including serum retinol and beta-carotene. Reliability was evaluated using intra-class correlation coefficient (ICC) and validity was determined by unadjusted and energy adjusted correlation coefficients (CC), de-attenuated CC, and cross-classification analyses. Results ICC for reliability ranged between 0.42 and 0.76. De-attenuated CC for the FFQ and the 24-h recalls ranged between 0.13 and 0.54 (Mean = 0.38). The de-attenuated CC between the DFFQ and plasma levels of retinol and beta-carotene were 0.58 (P = 0.0001) and 0.40 (P = 0.0001), respectively. Cross-classification analysis revealed that on average 73% were correctly classified into same or adjacent quartiles and 5% were classified in opposite quartiles.

Objective Assessing safety and immunogenicity of an inactivated whole virus particle vaccine.Design Single-centre, double-blind, randomised, placebo-controlled, phase I (stage I: 18–50, stage II: 51–75 years), phase II (18–75 years) clinical trials.Setting 29 December 2020 to 22 April 2021.Participants Stage I-phase I: 56 participants; stage II-phase I: 32; phase II: 280.Intervention During stage I, participants randomly (3:3:1) received 3 µg, 5 µg vaccine or placebo in a 14-day interval. Participants in stage II received two shots of 5 µg vaccine or placebo (3:1). In phase II, participants received 5 µg vaccine or placebo (4:1) in a 28-day interval.Primary and secondary outcome measures Safety assessment and immunogenicity assessment via antibody response and conventional virus neutralisation test (cVNT).Results All adverse events (AEs) were mild or moderate and transient in both phase I and phase II, and no AEs of special interest were reported. The seroconversion-rate of neutralising, antireceptor binding-domain (RBD) and anti-spike-glycoprotein (anti-S) antibodies 14-days after second dose of 5 µg vaccine in stage I was 70.8% (95% CI 48.9% to 87.4%), 87.5% (95% CI 67.6% to 97.3%), 91.7% (95% CI 73.0% to 99.0%). The antibody titres increased more among 5 µg than 3 µg. The corresponding rates for 3 µg vaccine were 45.8% (95% CI 25.6% to 67.2%), 54.2% (95% CI 32.8% to 74.5%) and 70.8% (95% CI 48.9% to 87.4%), respectively. In stage II, 100% (95% CI 84.6% to 100%), 86.4% (95% CI 65.1% to 97.1%) and 86.4% (95% CI 65.1% to 97.1%) of participants seroconverted for neutralising, anti-RBD and anti-S antibodies. In phase II, the seroconversion rate of neutralising-antibody was 82.8% (95% CI 77.0% to 87.6%), anti-RBD 77.0% (95% CI 70.7% to 82.6%) and anti-S 79.9% (95% CI 73.8% to 85.1%) on day 42. In the cVNT, the sera at 1/64 times dilution would neutralise SARS-CoV-2 among 91.7%, 77.3% and 82.5% of vaccinated participants in phase I-stage I, phase I-stage II and phase II clinical trials, respectively.Conclusions These results support further evaluation of this inactivated whole virus particle vaccine.Trial registration numbers IRCT20201202049567N1 and IRCT20201202049567N2 for phase I and IRCT20201202049567N3 for phase II.

INTRODUCTION ... [1-4]. The primary infection and pathogenesis of Covid-19 are still unknown, but in most patients, it causes lung involvement and mainly respiratory disease [5]. ... [6]. Currently, the gold standard for the diagnosis of Covid-19 patients is the detection of SARS-CoV-2 nucleic acid by real-time reverse transcription polymerase chain reaction (RT-PCR) from respiratory samples (oral and nasopharyngeal swabs) [7, 8]. Based on studies conducted in China and elsewhere, clinical hematology tests play an essential role by providing useful prognostic markers to the clinical team, so they can be helpful in the triage and management of affected patients [9]. Some laboratory abnormalities include decrease in the number of white blood cells and lymphocytes, neutrophilia, thrombocytopenia, C-reactive protein (CRP), erythrocyte sedimentation rate (ESR), and abnormal procalcitonin (PCT) in most patients. Also, the blood count of patients with covid-19 infection at the time of diagnosis shows changes related to the disease's stage and severity [6, 10]. AIM(S) This study aimed to compare the findings of the first CBC-Diff in discharged patients with a diagnosis of Covid-19 compared to those who died in Shahid Mostafa Khomeini Hospital. RESEARCH TYPE This is a cross-sectional study. RESEARCH SOCIETY, PLACE & TIME Using the census sampling method, the files of all patients hospitalized in the adult department of Mustafa Khomeini Hospital with a definite diagnosis of Covid-19 who were hospitalized between March 2019 and October 2021 were collected, and the survival of the patients was followed up to one month after discharge. USED DEVICES & MATERIALS In terms of net and composite results, the first CBC-Diff laboratory finding was evaluated, and the survival time was one month after discharge, personally followed by the researcher. The CBC-Diff test was performed by the Sysmex kx21 cell counter made in Japan after calibration according to the manufacturer's standard, and a laboratory science expert reported all the results of the CBC-Diff test. Definite diagnosis of covid-19 was done by RT-PCR test and SARS-CoV-2 IgG Detection kit in ELISA test of Pishtaz Co with the license of Ministry of Health ISO13485. METHOD By referring to the medical record archive section of the hospital, demographic information and the first CBC-Diff laboratory finding of all patients with a definite diagnosis of Covid-19 were extracted. Then, the information of the patients who met the conditions for entering the study was extracted, and the files that were incomplete in this respect were excluded from the study. Based on the form, information including items such as age, sex, body mass index, hospitalization date, discharge or death date, underlying diseases, and the results of the first laboratory findings (CBC-DiffWBC, HBG, MCV, RDW, MCH, Eosinophil, Neutrophil, Lymphocyte, Monocyte, Platelet NLR, PLR, SII) was prepared, and finally, the information included two general sections of demographic questions and laboratory results related to the research objectives. The normal level of measured parameters is as follows: WBC=4.8-10.8×1000/MICL, Hemoglobin=12-16 g/dl, RDW-CV=11.5-16%, Neutrophil=55-75%, Lymphocyte=20-40%, Monocytes=1-8%, EOSINOPHIL=1-5%) ETHICAL PERMISSION This study was conducted after obtaining the code of ethics as IR.SHAHED.REC.1400.173. STATISTICAL ANALYSIS All the obtained data were collected in Excel 2013 software. Data were analyzed using Medcalc 2013 statistical software. Combined data were calculated based on standard formulas (PLR=Platelet/Lymphocyte, NLR=Neutrophil/Lymphocyte, SII=Platelet×NLR). The normality of the distribution of the variables was checked based on the Shapiro-Wilk test. Due to the fact that the dependent variable was quantitative, the binomial logistic regression model was used considering the assumptions of the above test (the dependent variable is two-state, the quantitative data should have a linear relation with the independent variables based on the Box-Tidwell test). First demographic variables were measured from the confounding by Multivariate regression analysis. The chance or survival event was then calculated based on the absolute and composite results of the first CBC-Diff laboratory finding. The fit of the model was measured based on the Hosmer-Lemeshow test. Also, the number of changes in the independent variable (parameters of the first laboratory finding CBC-Diff) on the dependent variable (survival) was measured using the Cox & Snell R2 and Nagelkerke R² tests. The p-value was less than 0.05 as the significance criterion. FINDING by TEXT Finally, after removing the incomplete files, the data of 213 adult patients were analyzed. In the discharged group of this study, 77 women (55.6%), 61 men (44.4%) with an average age of 60.96±17.37 years, and in the dead group, 34 women (45.7%) and 41 men (54.3%) with an average age of 57.71±14.74 years were studied. Demographic indicators and the first CBC-Diff laboratory findings of the study population are summarized in Table 1. The dispersion distribution of demographic indicators and laboratory findings was statistically evaluated using the Shapiro-Wilk test. Other indices did not have a normal distribution except for the hemoglobin index. In the dead group, 16 patients had no body mass index. One patient did not have neutrophils, lymphocytes, Eosinophils, and monocytes indicators. In the discharged group, 20 patients had body mass index, six had RDW index, and one did not have neutrophils, lymphocytes, Eosinophils, and monocytes indicators. Of the 138 discharged patients, 32% had a history of diabetes, 28% had a history of heart disease, 12% had a history of other diseases (addiction, thyroid, respiratory, kidney), and 28% had no underlying diseases. Of the 75 dead patients, 56% were women, 31% had a history of diabetes, 36% had a history of heart disease, 12% had a history of other underlying diseases (addiction, thyroid, respiratory, kidney), and 21% had no underlying diseases (Table 1). For the correlation of demographic factors (gender, underlying disease, age, and body mass index) of hospitalized patients diagnosed with covid-19 using the logistic regression model, it can be said that none of the demographic factors affected the chance of survival. Cox-Snell's coefficients and Nagelkerk's test showed that demographic factors affected the chance of survival from 16.9 to 23.5%, which was not significant. Also, the Box-Tidwell test showed a linear relationship between the quantitative independent variable (age and body mass index) and did not need to be categorized. In general, it can be said that none of the demographic factors were confounding (Table 2). To relate the first hematology findings on the survival of patients with covid-19 infection (WBC, HGB, MCV, RDW, MCH, PLT, Eosinophils, Neutrophils, Lymphocyte, Monocytes) hospitalized patients diagnosed with covid-19. Using a logistic regression model simultaneously, it can be said that the increase of WBC with a cut-off point higher than 9×1000/micl was adequate. Its detection power was weak (ROC=0.66, p=0.001, X²=21.82). Hemoglobin decrease with a cut-off point of 11.1g/dl was effective and lacked diagnostic power (ROC=0.58, p=0.03, X²=4.33). The increase in RDW with a cut-off point higher than 14.6% was effective, and its diagnostic power was weak (ROC=0.66, p=0.002, X²=13.83). The increase of MCH with a cut point higher than 27.1 pg was ineffective and lacked diagnostic power (ROC=0.54, p=0.12, X²=2.35). MCV increase with a cut point higher than 83.3 fl was effective, and its diagnostic power was weak (ROC=0.60, p=0.02, X²=4.94). Platelet increase with a cut-off point of less than 259×1000/micl was ineffective and lacked diagnostic power (ROC=0.50, p=0.60, X²=0.26) (Figure 1). Eosinophil increase with a cut-off point of less than 1% was ineffective and had no diagnostic power (ROC=0.54, p=0.71, X²=0.13). The increase of neutrophils with a cut-off point of more than 79% was effective and had good diagnostic power (ROC=0.70, p=0.001, X²=19.66) (Figure 2). Lymphocyte reduction with a more than 14% cut-off point was effective and had good diagnostic power (ROC=0.70, p=0.001 X²=24.16). The reduction of monocytes with a cut-off point of less than 3% was ineffective and had no diagnostic power (ROC=0.55, p=0.13, X²=2.24) (Figure 3). Increasing the ratio of neutrophils to lymphocytes with a cut-off point of more than 5.6% was effective and had good diagnostic power (ROC=0.70, p=0.001, X²=28.78). The increase in the ratio of platelets to lymphocytes with a cut-off point of more than 10.16 was effective and had poor diagnostic power (ROC=0.67, p=0.001, X²=16.50). An increase in the immune-inflammatory system index with a cut-off point of more than 945 was effective and had poor diagnostic power (ROC=0.68, p=0.001, X²=17.72) (Figure 4). Based on the study's findings, the table of sensitivity and specificity of hematology markers was extracted (Table 3). MAIN COMPARISION to the SIMILAR STUDIES This study showed that the first hematology findings for prognosis and predicting the survival of patients with covid-19 infection are the increase of neutrophils and the increase of neutrophil to lymphocyte ratio. These markers had good diagnostic power. Lanini et al.'s 2020 study titled "Covid-19 disease, temporal analysis of complete blood count parameters during illness and association with patient demographics and management outcomes in survivors and deaths. A longitudinal descriptive cohort study" conducted in Italy on CBC laboratory results of 379 patients with Covid-19 for 21 consecutive days shows that 10.8% of patients died and 89.2% of patients were discharged. Gender (245 men, 93 women in the discharged group and 28 men, 13 women in the deceased group) does not affect the frequency of death, but age (over 60 years vs. 60 years or less) affects the frequency of death. Underlying diabetes and heart disease (34 people vs. 11 people, 102 people vs. 27 people) affects the frequency of death. The first laboratory results of CBC showed that high neutrophils and low lymphocytes affect the frequency of death. The decrease of monocytes has no effect, the decrease of hemoglobin has no effect, the increase of MCV has no effect, the increase of RDW has an effect, and the increase of platelets has an effect [15, 16]. Regarding gender, high neutrophil, low lymphocyte, and increased RDW were consistent with the present study. However, the results of the underlying disease and increased platelets were not consistent with the present study [17]. The difference can be in the type of race and the severity of the disease. The death rate of the present study was 35.2%. Liu et al.'s 2020 study titled "Development and Validation of a Risk Score Using Complete Blood Count to Predict Hospital Mortality in Covid-19 Patients” conducted in Italy and China on 9084 infected patients shows that based on the first findings of the CBC test, the five risk factors for death are platelets, white blood cells above 9.5, neutrophils and lymphocytes, and old age. This result was consistent with the current study regarding white blood cells, neutrophils, and lymphocytes (both from the cut-off point of death estimation and the type of relationship). However, it was not consistent in terms of platelets. In the case of platelet incompatibility, it can be said that the cut-off point is selected in the estimation of death. In the mentioned study, the cut-off point was less than 125, but in the present study, it was less than 259,000 micro/liter, and the frequency of death was 8.5% in the above study and 35% in the present study [18]. Mousavi et al.'s study was conducted in Tehran on 225 patients with covid-19, which shows that 24.4% of patients died, and based on the first findings of the CBC test, three risk factors have been identified for death, high lymphocytes, low neutrophils, and decreased hemoglobin [19]. In terms of demographic indicators, gender was not influential. However, age was influential, entirely consistent with the present study regarding lymphocytes and neutrophils, but not in hemoglobin reduction. In case of inconsistency, it can be said that it is a particular cut-off point in the estimation of death. In the above study, the cut-off point was less than 12g/dL, but in the present study, it was less than 11.1 g/dL. Bahl et al.'s study in 2020 was conducted on 1461 patients with covid-19 and showed that 22.4% of patients died due to covid-19. Age and body mass index affect the frequency of death. However, gender has no effect, and based on the first findings of the CBC test, the four risk factors of death are high platelets, white blood cells, lymphocytes, and low hemoglobin [20] in terms of gender, age, high white blood cell, high lymphocyte was consistent with the present study. However, it was not consistent in high platelet and low hemoglobin. The inconsistency can be attributed to the large sample size of the above study. In the present study, hemoglobin drop and platelet increase were more observed in deceased people, but it was not significant. LIMITATIONS The most important limitation of this study was the incompleteness of the information in the patients' files. Although the intended study was cross-sectional, due to space and time limitations, it was only possible to examine some of the causes of intervention. SUGGESTIONS Future studies with a larger statistical population and broader geographical survey will lead to the possibility of obtaining accurate results. CONCLUSIONS The three factors of increasing neutrophils, decreasing lymphocytes, and increasing the ratio of neutrophils to lymphocytes are good predictors for detecting death in Covid-19. CLINICAL & PRACTICAL TIPS in POLICE MEDICINE In this study, an attempt was made to gather valuable and brief information about covid-19 by examining hematological factors. Considering the spread of Covid-19 in high-density environments such as military barracks, this article emphasizes quick recognition of the mentioned cases. Considering the predictive cases of death in those suffering from covid-19, equipping the laboratories of military centers for the rapid preparation of laboratory results according to the cases explained above can play an essential role in the rapid recognition and treatment of high-risk individuals. ACKNOWLEDGMENTS The cooperation of Mustafa Khomeini Hospital staff in completing this project is appreciated. CONFLICT of INTEREST The authors state that the present study has no conflict of interest. FUNDING SOURCES This project was done with the financial support of Shahed University.

INTRODUCTION Nosocomial infections is one of the problems of hospital environments, which in addition to economic costs, sometimes prolongs the patient's hospitalization [1]. .... [2-10]. 90% of nosocomial infections are caused by bacteria; Klebsiella pneumoniae, Staphylococcus aureus, Pseudomonas and Proteus mirabilis are among the most important causes of nosocomial infections [10]. Prescribing antibiotics is the first way to treat the disease due to the important role of bacteria in causing nosocomial infections but the challenge in the treatment of these infections is the occurrence of antibiotic resistance [11]. Vancomycin is one of the antibiotics that is frequently used in the hospital environment, especially in the case of methicillin-resistant staphylococci. Although a few cases of vancomycin-resistant Staphylococcus aureus have been reported, with the emergence of resistance to vancomycin in enterococcus and the emergence of methicillin-resistant staphylococci with reduced sensitivity to vancomycin, the treatment problems of these bacteria have increased [12-14]. Excessive antibiotic consumption has caused this resistance. This consumption in Iran is 16 times the world standard and approximately equal to the entire Europe [15]. Timely recognition and diagnosis of antibiotic resistance, proper use of antibiotics to reduce the creation of drug resistance is one of the most important principles in any hospital which the results are effective in reducing patients' long -term hospitalization and reducing mortality and heavy economic costs for patients. Since the use of antibiotics in various infections has increased, examining antibiotic resistance is a research priority in each region. AIM(s) In this study, frequency and risk factors and antibiotic resistance of nosocomial infections caused by gram positive bacteria were investigated during 6 years in Mustafa Khomeini Hospital in Iran RESEARCH TYPE The present study is a retrospective cross -sectional and descriptive analytical study. RESEARCH SOCIETY, PLACE & TIME This study was conducted on patients with the diagnosis of nosocomial infection during the years 2014 to 2019 at Shahid Mustafa Khomeini Hospital in Tehran, Iran. SAMPLING METHOD AND NUMBER Based on the census sampling method, 263 patients were identified by diagnosing infection at the time of the study (4 people have two different nosocomial infections and 2 have a common nosocomial infection with different risk factors). Those whose nosocomial infection was not mentioned in their file were excluded from the study. METHOD The information required for each patient (based on the Clinical Guidebook of nosocomial Infection in Iran) in the information form including: age, gender, hospitalization department, performing invasive procedures (endotracheal intubation, cathetering, venous catheter, arterial catheter) culture samples, sensitivity and resistance to antibiotics, type of antibiotic, type of infection and type of bacteria were recorded. In the studied patients, drug sensitivity was determined by the disk diffusion method. The first step of this method includes the preparation of yeast suspension according to McFarland standard turbidity of 0.5. Dip a sterile swab in the suspension and after taking the excess liquid by pressing the swab against the inner wall of the tube, wet the swab on the surface of the 9 cm plate containing Mueller Hinton's medium that has already reached room temperature, 3 times completely at an angle of 60 degree and is uniformly inoculated on the surface of the plate. Then the plates are placed in a suitable place for 3 to 5 minutes (maximum 15 minutes) so that the excess liquid is absorbed and penetrates into the agar. In the next step, the antibiotic discs are removed by fine forceps, previously soaked in alcohol and then cooled with a sterile flame, and placed on the surface of the plate. The discs should be pressed briefly with the help of pliers. According to the McFarland standard, to transfer other discs, the forceps must be re-sterilized; because immediately after placing the discs, the antibiotic penetrates into the agar, therefore, discs should not be moved after they are placed on the environment. The plates are kept inverted for 24 hours at 35-37°C. After 24 hours, the plate is checked under the lamp and the diameter of the no growth halo is measured with a ruler and according to the table with the discs, the antibiogram test report is prepared as resistant, semi-sensitive and sensitive. ETHICAL PERMISSION This study was conducted after obtaining the code of ethics IR.SHAHED.REC.1399.147 from Shahed University. STATISTICAL ANALYSIS Data were analyzed using MedCalc 20 statistical software. Mean and standard deviation were used to describe quantitative variables with normal distribution, median and range were used for quantitative variables with non-normal distribution, number and percentage were used to describe qualitative variables. In order to measure the relationship between the demographic factors of patients and the risk factors of contracting enterococcus isolates, staphylococcus aureus isolates, and coagulase-negative staphylococcus isolates, logistic regression model was used with a type 1 error rate of 0.05. FINDING by TEXT In this study, 269 gram-positive cocci isolates from 263 patients were identified during 6 years (from April 2014 to March 2019). In total, 36% of nosocomial infections belonged to coagulase-negative Staphylococcus isolates, 33% to Staphylococcus aureus isolates, 25% to Enterococcus isolates, and 6% to other Gram-positive cocci isolates (Group A Streptococcus, Group B Streptococcus, Staphylococcus Saprophyticus, and Viridans Streptococcus). (Table 1). In this study, the sensitivity of antibiotics erythromycin, amikacin, piperacillin-tazobactam, cefoxitin, clindamycin, vancomycin, ampicillin, ampicillin-sulbactam, gentamicin, ciprofloxacin, chloramphenicol, cholestin, trimethoprim-sulfamethoxazole, linezolid, nitrofurantoin, meropenem, ofloxacin, cefepime was checked with cocci isolates Gram positive (Table 2). The logistic regression model was used to measure the relationship between demographic factors of patients and risk factors with Enterococcus isolate (p= 0.001, X²(7)= 41.67), Staphylococcus aureus isolate (p= 0.001, X²(8)= 42.12) and coagulase-negative Staphylococcus isolates (p=0.01, X²(8)= 18.48) were used. The results of this comparison showed that there was a significant and direct relationship between the inpatient department (special care to the normal department) and the underlying disease (having or not having an underlying disease) with the infection of Enterococcus isolate. Out of 263 patients, 209 had a urinary catheter and 147 had an endotracheal tube, 16 of the patients with a tracheal tube had this isolate, which were not included in the model to avoid errors (Tables 3 and 4). Also, there was a significant and direct relationship between the inpatient department (special care to the normal department) and the length of time the endotracheal tube remained with the infection of Staphylococcus aureus isolate. Also, there was a significant and direct relationship between the duration of hospitalization and coagulase-negative Staphylococcus isolates (Tables 5, 6, 7, 8). MAIN COMPARISON to the SIMILAR STUDIES The results of this study showed that the coagulase-negative Staphylococcus isolate ranked first with 36% infection. The most dangerous factor of this bacterium was the vascular catheter. Staphylococcus aureus ranked second with 33% of infections and the most common cause was endotracheal tube. Enterococcus isolates ranked third with 25% of cases, and the most common cause was urinary catheters. The best drugs affecting gram-positive cocci were vancomycin and ciprofloxacin, and the most resistance was seen in erythromycin, amikacin and clindamycin. High length of hospitalization and hospitalization department were effective risk factors. The results of the Asghar study, which was conducted in 2008-2009 titled “Prevalence and antibiotic sensitivity of Gram-positive bacteria in Mecca hospitals” are consistent with the results of the present study and show that ampicillin and erythromycin are resistant to streptococci [16]. The results of Mosadegh Rad's meta-analysis show that suction, tracheal tube, urinary catheter, history of surgery and ventilator were the most common causes of nosocomial infection in Iranian hospitals, and in this study, vascular catheter is known as the most important risk factor [17]. History of surgery and urinary catheter in Rahmanian's study constitute 20.9% and 20.3%, respectively, of the cause of nosocomial infection [18]. In the Bijari’s study, urinary catheter dislodgement, suction and endotracheal tube are known as the most important risk factors for nosocomial infections [19]. Ahmed Khan's study on 13 types of nosocomial infections shows that vancomycin has a high sensitivity on enterococcus of most gram-positive cocci infections, which was consistent with the present study [20]. In the study of Mossadegh Rad, Escherichia coli was the most common microorganism causing nosocomial infection, which can indicate its drug resistance to antibiotics. Pseudomonas, Staphylococcus and Klebsiella are in the next categories [17]. ... [21]. The study of Vahdat of Bushehr shows that ampicillin is 94% resistant in Staphylococcus aureus, Vancomycin is 11.7 resistant in Staphylococcus aureus, Gentamicin is 76.5% resistant in Staphylococcus aureus, Amikacin is 76.5% resistant in Staphylococcus aureus, Zoxim hardness is 59% resistant percentage was consistent with the present study and indicates the accuracy of antibiotic selection [22]. Zamanian's study also shows that Staphylococcus aureus has the highest resistance to amoxicillin, nalidixic acid, and penicillin, the lowest resistance to vancomycin, and the highest sensitivity to vancomycin, nitrofurantoin, amikacin, and co-trimoxazole, respectively; this difference in the results of different studies may be due to the difference in the sample size of the studies [23]. LIMITATIONS The limitations of this study include the retrospective nature of the research and the insufficient accuracy of the information based on the files and also conducting this study in only one hospital. SUGGESTIONS Conducting similar studies in a multi-centered manner can most likely determine the pattern of antibiotic resistance at a higher level and based on that, it is possible to plan for the appropriate treatment of patients. CONCLUSIONS Coagulase-negative Staphylococci with 36 % has the most frequent and vascular catheter is the most risk factor in this bacterium. Staphylococcus aureus with 33 % infection in the second place and the Enterococcus isolate with 25 % infection.is in the third place. If the use of resistant antibiotics is limited and antibiotics sensitive to microorganisms are used as much as possible, the occurrence of more microbial resistances will be prevented. The insertion of various catheters, including urinary and vascular catheters can provide the basis for nosocomial infection and has been identified as a risk factor in various studies. Therefore, it is better to limit the use of catheters to very essential materials. According to the results of the study, the use of effective antibiotics according to the patient's antibiogram can be useful in improving the effectiveness of the treatment. CLINICAL & PRACTICAL TIPS in POLICE MEDICINE Given that gram -positive bacteria such as negative coagulase staphylococcus and staphylococcus aureus are very important pathogens in the hospital environment, including urban hospitals and field hospitals during war and natural crises. The use of effective antibiotics according to antibiogram is emphasized for better treatment, especially during war and crises. Equipping military centers laboratories with antibiogram kits, to quickly prepare samples to prescribe antibiotics selectively, will have better therapeutic results in the above conditions. ACKNOWLEDGMENTS The cooperation of the respected personnel of Mustafa Khomeini Hospital in completing this project is appreciated. CONFLICT of INTEREST The authors state that there is no conflict of interest in the present study. FUNDING SOURCES The project was carried out with the financial support of the Shahed University.

Background: Celiac disease (CD) is an autoimmune condition caused by gluten in genetically predisposed people. This study aims to identify potential biomarkers of CD by using bioinformatics approaches. Materials and methods: The microarray dataset (GSE113469) was selected from the GEO database and reanalyzed in this study. Differentially expressed genes (DEGs) of CD patients and healthy individuals were obtained through the LIMMA package of the R software. By using the STRING online database, the protein-protein interaction (PPI) network were established and visualized via Cytoscape. Hub genes were identified by the Cytoscape's cytoHubba plugin using different methods. Receiver operating characteristic (ROC) analysis was employed to assess the diagnostic precision of hub genes. The association of hub genes with related transcription factors (TFs) and microRNAs (miRNAs) was evaluated, and candidate drugs that interacted with the hub genes were subsequently identified using the DGIdb database. Results: Ninety-nine DEGs were identified through the LIMMA package of R software from the GSE113469 dataset. Then, by using the STRING online database, the PPI network of DEGs was established and visualized via Cytoscape. The five hub genes (PTPRC, HIF1A, CXCL8, CCL2, and CXCR4) were identified by cytoHubba using different methods. The ROC analysis revealed that all of the hub genes had a good diagnostic value. Moreover, the miRNA; miR-155–5p, and the TFs; SMAD4, MYC, and BACH1 were screened to have the most correlation with the hub genes. Ultimately, 87 candidate drugs that interacted with the hub genes were found by using the DGIdb database. Conclusion: Eventually, it can be concluded that identifying genes and molecular pathways in CD can contribute to a better understanding of disease pathogenesis and designing therapeutic methods.

Background: The prevalence of non-communicable diseases (NCDs) and the status of nutritionally high-risk behaviors in the country are not promising. Because of undeniable impact of media advertising on food choices, to combat the problem some regulations on food advertisements are developed in the country. However, the high prevalence of NCDs warns of the possibility that either the laws are not given the necessary attention or they are not implemented properly. Therefore in the present review, all studies on how the country's visual and written mass media comply with regulations related to food product advertisement were systematically reviewed. Methods: We searched all studies, including Persian and English articles, dissertations, and research projects, published and unpublished reports in eight domestic and international databases and search engines during the years 1996 to December of 2020 (25 years). Then, the content of the eligible studies was extracted, evaluated, and reported. Results: A total of 18 eligible studies (articles and reports) were included in the review. The results indicated violations of rules and regulations including displaying food products of low nutritional value and obese people, misleading/exaggerating claims, award offers, induction of gluttony, consumerism, and inconsistency with scientific facts. Most of the studies (55%) had, implicitly or explicitly, targeted children and adolescents. Conclusions: The results of this study indicated a violation of the rules and regulations of health policies, mainly in the field of promoting foods of low nutritional value during the study period. Violations of the ban on advertising for children were also reported in more than half of the studies.

Background: The coronavirus disease 2019 (COVID-19) pandemic elicited the general population to use various dietary supplements (DSs) and nutraceuticals as a protective means against the disease. The present study aimed to evaluate changes and certain determinants of DS intake during the COVID-19 lockdown among Iranian households. Methods: This nationwide cross-sectional study was conducted from April 4 to April 25, 2020, during which Iran was in lockdown. To collect data, a web-based electronic self-administered questionnaire was created. The data were compared among provinces based on their food security situations. Results: A total of 21,290 households were included in the analyses. Approximately 27% of the households were using DSs after the epidemic. The most common DSs used were vitamin D (42%) and vitamin C (20%), followed by multi-vitamin (16%), zinc (9%), omega-3 (6%), vitamin A (4%), and probiotics (3%). Logistic regression analysis revealed that DS intake was directly associated with the household income but inversely with household size and the food security status of the provinces. DS intake was positively associated with the presence of high-risk persons in the households, the education of the households' head, and the presence of a person with a history of COVID-19 within the household. Conclusions: During epidemic lockdown, DS use was remarkably increased among the Iranian households. Apart from the debatable usefulness of DSs against COVID-19, the inverse association of DS use with a household's income and provincial food security well indicates inequity in accessibility to DS. Actions to improve the nutritional status of the under-privileged populations including targeted supplementation are strongly recommended.

Background and Aim: Patient participation is a widespread concept and is considered as an important issue for improving the quality of patient care and patient safety, which has been considered by health managers. Therefore, this study aimed to investigate the effect of nurseschr('39') characteristics on their willingness to patient participation in patient safety in hospitals affiliated to Tehran University of Medical Sciences using PaCT-HCW questionnaire. Materials & Methods: This was a descriptive-analytic study. Cross-sectional information was gathered on 220 nurses working in teaching and non-teaching hospitals affiliated to Tehran University of Medical Sciences, year of 2017-2018. For sampling, nurses were randomly selected from eligible wards. To collect information validated Malfait and et al questionnaire by named PaCT-HCW was used. The data were analyzed with SPSS 22 software using descriptive statistics and regression test at P-value less than 0.05. Results: The nurseschr('39') two characteristics including the length of work experience in the hospital (P=0.043, B=0.323), and the length of work experience in the ward (P=0.006, B=0.604) The direct effect and type of hospital (P=0.001, B =-8.182) had a reverse effect on nurseschr('39') willingness to patient participation in patient safety Conclusion: Health managers can consider The length of nurseschr('39') experience, as well as the type of hospital and the type of specialized ward, by creating the necessary facilities and developing educational programs for patient participation in patient safety.

Introduction: The anterior cruciate ligament (ACL) is one of the supporting structures of the knee joint. ACL injuries are very common, and rapid postoperative return to exercise is the most important goal for athletes. Considering the different available surgical approaches, the purpose of the present study was to compare the knee range of motion (ROM) and spatio-temporal parameters during gait after ACL reconstruction using two different surgical methods in elite men athletes. Materials and Methods: In this quasi-experimental study, 25 elite athletes participated, ten subjects in the healthy group, eight in the allograft group, and seven in the autograft group. They were asked to walk along a walkway at preferred speed. Qualisys motion analysis system (eight camera) at a sampling frequency of 100 Hz was used to measure gait kinematic. Spatio-temporal and ROM parameters were extracted in three groups. One-way analysis of variance was performed to compare these variables at a significance level of P < 0.05. Results: There was no significant difference between the groups in terms of spatio-temporal parameters of step length, step time, stride length, stride time, cadence, velocity, stance phase, and swing phase of gait (P > 0.05 for all); however, the allograft group had lower mean values in all variables except for the cadence. In terms of knee ROM, with the exception of the minimum swing flexion that was significantly less in control group (P = 0.01), there was no significant difference between groups (P > 0.05). Conclusion: It seems that there is no functional difference between the two reconstruction types; therefore, it is not possible to make decision about knee reconstruction with regard tospatio-temporal parameters and kinematic pattern. We suggest that knee reconstruction be assessed from different viewpoints such as coordination pattern and muscle coordination.

Developing an effective phycoremediation system, especially by utilizing microalgae, could provide a valuable approach in wastewater treatment for simultaneous nutrient removal and biomass generation, which would help control environmental pollution. This research aims to study the impact of low-voltage direct current (DC) application on Chlorella vulgaris properties and the removal efficiency of nutrients (N and P) in a novel electrokinetic-assisted membrane photobioreactor (EK-MPBR) in treating synthetic municipal wastewater. Two membrane photobioreactors ran in parallel for 49 days with and without an applied electric field (current density: 0.261 A/m2). Mixed liquid suspended soils (MLSS) concentration, chemical oxygen demand (COD), floc morphology, total phosphorus (TP), and total nitrogen (TN) removals were measured during the experiments. The results showed that EK-MPBR achieved biomass production comparable to the control MPBR. In EK-MPBR, an over 97% reduction in phosphate concentration was achieved compared to 41% removal in the control MPBR. The control MPBR outperformed the nitrogen removal of EK-MPBR (68% compared to 43% removal). Induced DC electric field led to lower pH, lower zeta potential, and smaller particle sizes in the EK-MPBR as compared with MPBR. The results of this novel study investigating the incorporation of Chlorella vulgar is in an electrokinetic-assisted membrane photobioreactor indicate that this is a promising technology for wastewater treatment.

Background: The aim of the present study was to determine the association between body image and psychological wellbeing during pregnancy. Materials and Methods: This descriptive correlational study was conducted on 320 pregnant women who were referred to health centers in Isfahan, Iran, during 2016 and had the inclusion criteria. They were selected by nonprobability convenient sampling. Data were gathered using standard psychological wellbeing and body image satisfaction questionnaires. The data were analyzed using Statistical Package for the Social Sciences software by descriptive and inferential statistical methods. Results: The results showed that the mean (SD) score of psychological wellbeing among participants was 77.50 (10.10) and their mean (SD) score of satisfaction with body image was 89.30 (14.60). Moreover, the results revealed a positive and significant relationship between the scores of psychological wellbeing and body image satisfaction (r=0.354, p

Background and purpose: Coronary artery disease is a major cause of death and disability in any society. The aim of this research was to evaluate the factors causing delay in admission of patients who need cardiac care. Materials and methods: In this descriptive analytic study, we used the files of patients attending a heart hospital affiliated with Mazandaran University of Medical sciences within 6 months (March-September 2015). Data analyses were done applying Quantile regression in STATA V13 and SPSS V20. Results: from 401 patients, 59.35% referred to hospital within the first 3 hours after imitation of pain, while 20.45% and 20.2% attended the hospital after 3 hours and 6 hours following the onset of pain, respectively. The average hospitalization waiting time was 238 min (almost 4 hr). Our results showed that waiting time was lower for male patients, people with higher education, those with health insurance, individuals with history of cardiac diseases, married cases and urban patients. These variables had significantly affected the hospitalization waiting time (P

Background and Objectives: This study was conducted to compare the health literacy of Tehran University and Tehran University of Medical Sciences due to the impact of librarians' role on health and in disseminating health information that promote health and empower the identification and controlling the factors that affect the society. Material and Methods: This was a descriptive survey. Study population consisted of librarians working on campus in libraries of Tehran university and Tehran university of Medical Sciences. Data were collected using the standard questionnaire TOFHLA (Test of Functional Health Literacy of Adults) In January 2015. For data analysis, descriptive (the mean SD) and analytical statistics (One-sided t-test, Friedman test) were applied. Results: The mean age of participants was 39.21±7.75 years, 74.7% of the participants were female and 69.3% had library science education. Health literacy scores were calculated as 83.7 ± 16.6. Among the participants, 82.3% had adequate health literacy, 3.8% marginal health literacy and 13.9% had inadequate health literacy. Health literacy of the librarians in both universities had no significant differences. Conclusion: Academic librarians have adequate level in health literacy. They can play an important role as trainers of health literacy in university and community. This is suggested to be one of the academic librarian's duties and be mentioned in their organizational position.

Background: Pain is a degenerative and disabling condition which is accompanied by several psychological variables. Therefore, this study aimed to investigate the effectiveness of dialectical behavior therapy techniques in reducing the catastrophizing, fear of movement, pain-induced disability, and pain intensity in patients with preoccupied attachment style suffering musculoskeletal chronic pain. Materials and Methods: The Study was conducted as a single subject research based on multiple-baseline design. The participants were two women patients suffering chronic back pain that were selected through purposive method from among clients of Pain Clinic of Tabriz, based on pain specialist diagnosis, clinical interview and screening tools. Pain Catastrophizing Questionnaire, Tampa Scale for Kinesiophobia, Pain Disability Questionnaire, Visual Analogue Scale, and also relationships scales Questionnaire were filled by subjects in 5th, 7th, 9th, 11th, 14th baseline sessions and the follow up session. In order to study the treatment results drawing symptom severity diagram and mean base line reduction related to single subject studies. Results: Results indicate that average score of catastrophizing, fear of movement, pain disability, and pain intensity were decreased in both patients from baseline to follow up (33.25 to 16.5), (45.75 to 21), (17.5 to 7), and (213.75 to 90), respectively. In addition, during the treatment the average score of attachment security in both patients was increased from 1.25 to 2.3. Conclusion: Dialectical behavior therapy was effective in increasing secure attachment and decreasing pain-related problems in patients with musculoskeletal pain. Thence, it is recommended that the study be done with larger samples in future.

An amendment to this paper has been published and can be accessed via the original article.

Purpose: The general aim of the present study is to evaluate the level of user loyalty in library of Tehran University Faculty of Literature and Humanities’s services and to determine their affecting factors. Originality: In Iran, there has been no research on the university library user loyalty measurement with the present study conditions. Findings: Loyalty level in 60/1% of library users in Tehran University Faculty is high, in 39/4% of them is average and in 0/5% of them is low. "cost of services" and "quality of service" indicators respectively showing (SD =0/87) 4/08 and (SD =0/82) 4/05 were allocated the best score in relation to the factor of “Loyalty level”level . Methodology: This research is descriptive. The study population consisted Faculty of Literature and Humanities of Tehran University student with 2150 students in bachelor, master and PhD degree. The means of data collection was a questionnaire about evaluation of customer loyalty and its Cronbach's alpha is estimated as 0/7.

To determine the status (number, subject, changes, release period, websites, Scientific-Research) of the journals published in the Tehran University since the establishment until the end of year 2016. The present survey method is descriptive. The population includes approximately 600 academic and student magazines published in Tehran University since the establishment (1935) until the end of 1394. Sampling of the census and the entire population are included. Collecting process data and logs were taken using library studies and information gathered in the table include the title, the beginning and the end [of publication, the publication period, subject, attachment, language, website addresses, location and other explanations. Data analysis using SPSS software and descriptive statistics are presented in the form of graphs. 256 academic and 306 student journals were identified at Tehran University. From 185 journals that were published, 48/8 percent are about human sciences and the other half is devoted to other topics. More than 52 percent of the published university journals are scholarly scientific and 8/32 percent of approved research forms the scientific publications. The dominant language is Farsi and the publication half of the magazines are bi-quarterly Journals and the other half are quarterly ones. The oldest university magazine belongs to the Faculty of Veterinary Medicine, which is now published under the title of Journal of Veterinary Researches. The oldest magazine (without change) has about 30 years from the 50s. 76 percent of active journals, present their information via websites. During 1976-1985 the number of journals decreased because of social circumstances after the Islamic Revolution, imposed war and the years after the war. During the years 1986-2016 the number of published magazines increased greatly thanks to new technologies and ease of online publishing due to the technical development and possibility of using academic institutions facilities and public budget and because of the importance of publishing scientific results for researchers, it is necessary to pay special attention to make websites for all journals.

Myrosinase is a β-thioglucoside glucohydrolase enzyme which catalyzses the separation of glucose from glucosinolates and produces an unstable intermediate, aglycone. This intermediate will be rearranged and then converted to different compound such as thiocyanate, isothiocynate and nitrile, depending on the environmental conditions. Among them, isothiocyanates are more important compounds due to the pharmaceutical applications. Sulforaphane is the most isothioyanates which produces from glucosinolate glucoraphanin through myrosinase hydrolysis. In this study, in order to investigate the effects of Cu and Zn ions on myrosinase activity and rearrangement of aglycone fragment in Lepidium draba, glucose and sulforaphane content were measured respectively. The results showed that myrosinase activity significantly promoted at treatment with 8 µM Zn2+ in compared to the control and significantly reduced by the increase Zn2+ concentration in media. Elevated of the enzyme activity was seen at all Cu concentration which was more significant at 4 µM. On the other hand, sulforaphane content was reduced at presence of all concentrations of the both ions especially Zn ions. Overall, it deduced that the mentioned ions, especially Cu at low concentrations have stimulatory effects on myrosinase activity. These ions also affected rearrangement of the aglycone fragment particularly Zn which turned the rearranged pathway into other compound except isothiocyanates, therefore the sulforaphane content reduced at presence of these metals.