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Purpose: One of the most obvious functional effects of aging on the cognitive and processing processes of spatial hearing is the localization problem and the disorder of speech perception in noise. The purpose of the present study is to investigate the performance of dynamic spatial auditory processing in the elderly. Methods: This descriptive and analytical study was conducted on 60 young participants aged from18 to 25 years old and 60 elderly participants aged from 60 to 75 old years, using speech, spatial, and qualities of hearing scale (SSQ) questionnaire, binaural masking level difference (BMLD) and dynamic quick speech in noise (DS-QSIN) tests. Results: Comparing the average scores of the tests and the questionnaire using the independent t test showed a significant difference between the two groups (p < 0.001). It was also found that gender had no effect on the results (p > 0.05). Conclusions: Aging is accompanied by different structural and functional changes in the auditory central nervous system, which leads to a decrease in speech perception in challenging listening environments, as well as a decrease in sound localization abilities, due to the reduction of temporal and spectral information. This problem affects the determination of the source of sound and the spatial cognition of the elderly and leads to a disturbance in the awareness of the auditory environment. Therefore, auditory rehabilitation programs can cause the improvement of spatial auditory processing performance and improve speech perception in noise in the elderly. [ABSTRACT FROM AUTHOR]

Introduction: This retrospective descriptive study evaluated the Scopus-indexed dental journals and their most-cited documents affiliated with the Middle East and North Africa (MENA) countries from 2011 to 2021. Methods: Dental journals affiliated with MENA countries, their bibliometric indicators (SJR, CiteScore, SNIP, and H-index), and the 101 most cited articles of the considered journals were extracted and studied through descriptive statistics. In addition, the "citation per year" of each top 101 articles was calculated. Spearman's rho test was used for pairwise comparisons of the correlation coefficient values between each two of the considered bibliometric indicators. Results: The number of citations of the 101 most-cited papers ranged from 35 to 203. The mean (SD) citations of studied articles were 61.33 (37.58) and the median was 46. Furthermore, CiteScore had the highest significant correlation with SJR (r = 0.828, P < 0.001). Moreover, the citation per year of the top 101 documents had no significant relationship with any of the journals' bibliometric indicators. Conclusion: Because journal performance and citation rate are multi-dimensional concepts, a single metric cannot express them thoroughly despite correlations between indices. "European Journal of Dentistry" from Turkey, "Saudi Dental Journal" from Saudi Arabia, and "Iranian Endodontic Journal" and "Journal of Lasers in Medical Sciences" both from Iran had the highest ranks in the SCImago portal and the highest scores in bibliometric indices amongst the MENA dental journals. [ABSTRACT FROM AUTHOR]

Background and Objective: The most common index in dental studies is the decayed, missing or filled teeth (dmft)/DMFT. Risk factor evaluation in order to investigate the significant factors that affected this dmft in children has an important role in dental epidemiological studies. This study aims to use a zero inflated binomial model for investigating the risk factors that affected the dmft in children aged 5 - 6 years in Tehran, Iran. Methods: This cross - sectional study was a part of a national survey for assessing the oral health status of Iranian citizens in 2012. The target population was children aged 5 - 6 years. The information and oral examination were collected by the WHO recommended clinical examination form and a trained calibrated dental team (dentists and hygienists). A binomial zero inflated model (ZIB) with random effect was used for evaluating the effect of all variables on dmft. Results: In general, 593 subjects were studied. From the entire subject in this study the frequency of zero was 1071 (45%). The result of ZIB model with random effect in zero part showed that brushing the teeth (OR = 3.5; P value = 0.012) and mothers with university education (OR = 11.24; P value = 0.016) had significant relation with zero dmft. The variance component of random intercept in zero part was significant too (σ²=4.68, P < 0.001). Conclusions: Zero inflated binomial model with random effect in zero part fitted better to this data. Brushing the teeth and high education of mothers had protective effect for dmft in children aged 5 - 6 years in Tehran. [ABSTRACT FROM AUTHOR]

Background: Hypothermia is an important determinant of the survival of newborns, especially among low-birth-weight babies. Prolonged hypothermia leads to edema, general hemorrhage, jaundice and death. So this study has afforded to examine effective factors on passing the hypothermia state. Materials and Methods: Our sample consists of 439 neonates that were hospitalized in NICU, at Emam Khomeini hospitals of Tehran. The neonate's rectal temperature was measured immediately after birth and every 30 minutes after that, until neonate passed hypothermia stage. In order to estimate the rate of transition from state of neonatal hypothermia, we used multi-state Markov model with two covariates, newborn baby birth weight and environmental temperature. We used R package to fit the model. Results: Estimated transition rates from severe hypothermia and mild hypothermia were 0.1192 per minute and 0.0549 per minute, respectively. Weight had a significant effect on transition from hypothermia stage to normal stage (%95 confidence interval (0.1364, 0.4165), (p-value<0.001). Environmental temperature affected the transition from hypothermia stage to normal stage; significantly %95 confidence interval for parameter of Environmental temperature is (0.0439, 0.4963), (p-value<0.001). Conclusions: Results showed that, the neonates with normal weight and neonate in an environmental temperature higher than 28o C had a bigger transition rate from hypothermia stage. [ABSTRACT FROM AUTHOR]

Background: Stroke is a prevalent cause of disability in adults. The fall is the most common balance and motor impairments, which affects the quality of life in stroke patients. This study aims to employ random effects hurdle model for evaluating the balance improvement in stroke patients under the occupational therapy. Methods: In this longitudinal study with repeated measurement during one year between 2013 and 2014, the data was collected using non-random sampling method from three occupational therapy clinics. For a total of 38 stroke patients, the number of falls was recorded every two weeks. The random effects hurdle model and random effects zero inflated Poisson (ZIP) model were fitted to the data and were compared together. Data analysis was carried out using SAS Software version 9.2. Results: The results of random effects ZIP model showed that the covariates of sex and age and affected side of stroke and follow up duration had statistically significant effect on balance improvement (p< 0.05). The occupational therapy has been effective on balance improvement more than 40% during one year. Conclusion: The ZIP model with random effects can capture zero inflation and correlation structure in longitudinal count data simultaneously. Older patients, women and patients with left-side impairments were more at risk of fall and balance impairment, so they need more care and therapy. [ABSTRACT FROM AUTHOR]

Background and Objectives. In recent years, hepatitis C virus (HCV) infection represents a major public health problem. Evaluation of risk factors is one of the solutions which help protect people from the infection. This study aims to employ zero-inflated Poisson mixed models to evaluate prognostic factors of hepatitis C. Methods. The data was collected from a longitudinal study during 2005-2010. First, mixed Poisson regression (PR) model was fitted to the data. Then, a mixed zero-inflated Poisson model was fitted with compound Poisson random effects. For evaluating the performance of the proposed mixed model, standard errors of estimators were compared. Results. The results obtained from mixed PR showed that genotype 3 and treatment protocol were statistically significant. Results of zero-inflated Poisson mixed model showed that age, sex, genotypes 2 and 3, the treatment protocol, and having risk factors had significant effects on viral load of HCV patients. Of these two models, the estimators of zero-inflated Poisson mixed model had the minimum standard errors. Conclusions. The results showed that a mixed zero-inflated Poisson model was the almost best fit. The proposed model can capture serial dependence, additional overdispersion, and excess zeros in the longitudinal count data. [ABSTRACT FROM AUTHOR]

Background: Hypothermia is an important determinant of survival in newborns, especially among low-birth-weight ones. Prolonged hypothermia leads to edema, generalized hemorrhage, jaundice and ultimately death. This study was undertaken to examine the factors affecting transition from hypothermic state in neonates. Methods: The study consisted of 439 neonates hospitalized in NICU of Valiasr in Tehran, Iran in 2005. The neonates' rectal temperature was measured immediately after birth and every 30 minutes afterwards, until neonates passed hypothermia stages. In order to estimate the rate of transition from neonatal hypothermic state, we used multistate Markov models with two covariates, birth weight and environmental temperature. We also used R package to fit the model. Results: Estimated transition rates from severe hypothermia and mild hypothermia were 0.1192 and 0.0549 per minute, respectively. Weight had a significant effect on transition from hypothermia to normal condition (95% CI: 0.1364-0.4165, P<0.001). Environmental temperature significantly affected the transition from hypothermia to normal stage (95% CI: 0.0439-0.4963, P<0.001). Conclusion: The results of this study showed that neonates with normal weight and neonates in an environmental temperature greater than 28 °C had a higher transition rate from hypothermia stages. Since birth weight at the time of delivery is not under the control of medical staff, keeping the environmental temperature in an optimum level could help neonates to pass through the hypothermia stages faster. [ABSTRACT FROM AUTHOR]

Purpose: The objective of this randomized controlled trial was to investigate the impact of manual therapy (friction massage) and pelvic floor muscle (PFM) training on erectile dysfunction (ED), pelvic floor muscle thickness, and blood flow in the penile arteries and veins in men who have undergone prostatic adenectomy (PA). Materials and Methods: This study employed a randomized, double-blinded, controlled trial design. Forty patients participated and were divided into two groups: intervention and control (n=20 per group). The intervention group received 10 sessions of pelvic floor muscle training and manual therapy, while the control group solely underwent pelvic floor muscle training. The recovery rate was measured using the International Index of Erectile Function 15 (IIEF-15) questionnaire and Erection Hardness Score (EHS). Sonographic factors were assessed using simple and Doppler ultrasound. Results: The intervention group exhibited significantly higher erectile function scores (F(1,37)=158.04, P < 0.001, η2 P = 0.810) and a higher average total (IIEF-15) score (20.52) (F(1,37)=136.76, P < 0.001, η2 P = 0.787) com- pared to the control group in the post-test assessment. Comparison between the two groups revealed an increase in ultrasonic parameters such as the thickness of the ischiocavernosus and bulbospongiosus muscles, maximum systolic velocity, and minimum diastolic velocity of the cavernosal artery in the intervention group. However, the maximum blood flow velocity in the posterior vein decreased. Conclusion: PFM training and friction massage play a significant role in managing ED following PA, positioning them as the primary treatment approach for men experiencing ED post-prostatectomy. [ABSTRACT FROM AUTHOR]

Introduction: The amount of thoracic kyphosis and its mobility may be affected by gender in older adults. This study investigates gender differences in thoracic kyphosis and thoracic spine mobility in healthy older adults. Materials and Methods: In this cross-sectional study, 36 participants among which 21 were female and 15 were male with an age range of 65-80 years participated. The amount of thoracic spine kyphosis was measured in a relaxed standing position and the position of maximum correction of thoracic kyphosis using a flexible ruler between the spinous processes of T12 and C7. The difference between the thoracic kyphosis of the relaxed state and the condition of the maximum correction is used to determine the degree of thoracic spine mobility. Finally, men and women were compared in terms of thoracic kyphosis and thoracic spine mobility. The student t-test was employed to compare kyphosis and spinal mobility between men and women, and the paired student t-test was used to compare kyphosis angle in a relaxed posture and maximum kyphosis correction status. Meanwhile, the Pearson test was utilized to evaluate the relationship between variables. Results: Although there was no statistically significant difference in the mean thoracic kyphosis of relaxation (P=0.13) and maximal correction (P=0.18) status of healthy old men and women, there was a significant positive relationship between the rate of kyphosis angle and the amount of mobility of thoracic kyphosis (P=0.003; r=0.48). Conclusion: There is no difference in the degree of kyphosis and thoracic spine mobility in older men and women. In addition, people with more thoracic kyphosis had more spinal mobility. [ABSTRACT FROM AUTHOR]

Background and Aim: The Acceptable Noise Level (ANL), which is an effective clinical tool for quantitative assessment of noise tolerance, is affected by some known variables related to both subject and testing materials. The present study examined how the characteristics of different babble noises may affect the ANL results in normal adult listeners. Methods: Forty Persian listeners with normal hearing participated. In addition to typical ANL testing with 12-talker noise, the ANL was obtained in 8 different conditions varying in number of talkers from 2 to 10 in the babble noises presenting forward and backward. Results: There was a significantly lower ANL for 2-talker babble compared to 4, 8, 10, and 12-talker babble in both forward and backward noise conditions. With the increase in talkers in noise, the ANL becomes worse but reaches almost a plateau with more than 4 talkers in babble noise. There was a statistically significant difference between 2-talker forward and 2-talker backward noises, with no difference for the other conditions. Conclusion: This finding that the ANL is affected by the number of talkers in babble noise and by the forward and backward background noise suggests that informational masking and listening in dip mechanisms are involved in ANL for normal hearing people at least. [ABSTRACT FROM AUTHOR]

Fatigue and balance disorders are common challenges experienced by Multiple Sclerosis (MS) individuals. The purpose of this study was to compare the concurrent effects of cerebellar and prefrontal anodal trans-cranial direct current stimulation (a-tDCS) with postural training on balance and fatigue in MS patients. 51 patients were evaluated to randomly allocation to a-tDCS over cerebellum, a-tDCS over dorsolateral prefrontal cortex (DLPFC) and sham group. 46 individuals (n = 16 in experimental groups and n = 14 in control group) followed treatment. All the groups received 10 sessions of postural training. The experimental groups underwent a-tDCS with a current of 1.5 mA for a period of 20 min. While, in the sham group, tDCS was only activated for 30 s and then turned off. The treatment included 10 sessions for four weeks. Before and after intervention, fatigue and balance were assessed using Fatigue Severity Scale (FSS), Timed Up and Go (TUG) test and Berg Balance Score (BBS), respectively. There was found a significant reduction in fatigue in the group receiving a-tDCS over the prefrontal cortex with postural training compared to the other two groups (P < 0.001). Additionally, a significant improvement was found in balance in the group receiving a-tDCS over the cerebellum concurrent with postural training in comparison to the other two groups (P < 0.001). Besides, in the sham group, the significant results were not reported in the variables. (P > 0.001). The results demonstrated that a-tDCS enhances the effects of postural training on balance and fatigue in MS patients. [ABSTRACT FROM AUTHOR]

Introduction: Stroke is one of the most debilitating diseases among adults worldwide and leads to persistent rehabilitation needs even at the chronic stage. Achieving good postural control is a critical requirement for daily activities which enhances quality of life (QoL) in patients with stroke. There is increasing evidence that transcranial direct current stimulation (tDCS) can be considered a promising adjunct technique to improve motor recovery after stroke. Evidence of augmented neuroplasticity after tDCS suggests that paired rehabilitation followed by consecutive use of tDCS may optimize recovery outcomes. Although a few randomized controlled trials have been conducted on upper limb rehabilitation in chronic stroke using tDCS, no study focused on balance training in chronic stroke patients. The present randomized, sham-controlled, double-blinded clinical study addresses brain stimulation targeting postural control using tDCS in chronic stroke. Methods: The study participants included chronic ischemic stroke individuals with postural control impairments who passed the exclusion criteria. Active or sham anodal tDCS was delivered to the lesioned leg motor cortex combined with balance training. The experimental group received active anodal tDCS stimulation (2 mA) for 20 min, daily for 5 days paired with balance training. Linear and nonlinear approaches were used to analyze postural sway changes pre-and post-intervention. Postural sway fluctuation, functional balance assessment using the Berg balance scale, and timed up-and-go test were conducted to compare the active and sham groups. Conclusion: This trial could have significant implications for balance rehabilitation after stroke in the ambulatory setting. If effective, this novel approach may improve rehabilitation protocol in this population. [ABSTRACT FROM AUTHOR]

Background and Aim: Experiencing dizziness/vertigo is often an indication of dysfunction in the vestibular system. Recent findings show a connection between peripheral vestibular dysfunction and cognitive impairments. The Neuropsychological Vertigo Inventory (NVI) can assess physical, emotional, and cognitive issues in individuals with dizziness/vertigo. The aim of this research was to translate, cultural adaptation and evaluation of the reliability and validity of NVI to Persian. Methods: In this descriptive-analytical study, the NVI scale was translated and adapted to the Iranian cultural context following the international quality of life assessment protocol for translation and equivalence. After obtaining face validity, the scale was administered to 140 patients with peripheral vestibular system dysfunction and 70 control group (age between 25 and 80 years). After one week, 50 participants were asked to complete the questionnaire again. Eventually, reliability was evaluated with both methods of internal consistency and test-retest reproducibility. Results: Out of the 28 items in the NVI scale, 3 items were modified to better align with the cultural conditions of Iranians. The impact scores for most items in this scale were found to be higher than 1.5. The Cronbach's alpha coefficient values for the overall scale (0.90) and test-retest reliability with intra-class correlation coefficient for the overall scale (0.91) were confirmed. Conclusion: The Persian version of NVI scale demonstrates excellent validity and reliability, and it exhibits a high level of content alignment with the original version. Therefore, it can be a useful tool to better understand the physical, emotional and cognitive disturbances in patients with vertigo/dizziness. [ABSTRACT FROM AUTHOR]

Background: To our knowledge, there is scant research on the use of rehabilitative ultrasound imaging (RUSI) method for evaluating bladder base displacement in pregnant women. The RUSI is a non-invasive and simple method that assesses the function of pelvic floor muscles (PFM) based on the movement of the bladder base. Objectives: This study aims to assess the reliability of the RUSI for the assessment of PFM function in pregnant women during voluntary muscle contractions. Materials & Methods: In this cross-sectional study, 18 pregnant women with different gestational ages participated. The amount of bladder base displacement during PFM contraction was assessed in all women and considered an indicator of PFM function. The test re-test reliability was evaluated using the intraclass correlation coefficient (ICC) and Bland-Altman plot. The percentages of standard error of measurement (SEM%) and minimal detectable change (MDC%) were also calculated. Results: The mean amount of bladder base displacement during PFM contraction at time points 1 and 2 was 4.89±1.43 and 4.81±1.41, respectively. The ICC was 0.989 (95% CI, 0.969%, 0.996%), which indicates excellent reliability. The Bland-Altman plot showed that all the points were within the 95% limits of agreement with no considerable trend or bias. The SEM% and MDC% were 3.09% and 8.41%, respectively. Conclusion: The intra-rater reliability of the RUSI to assess PFM function in pregnant women is high, and can be useful for further studies on the PFMs in pregnant women. [ABSTRACT FROM AUTHOR]

Background and Aim: Amblyaudia is a diagnostic issue in central auditory processing disorder (CAPD), which is characterized by asymmetry in dichotic listening performance. This disorder negatively affects the academic performance of children by influencing their information processing, reading, attention, etc. The present study aimed to investigate the effect of the dichotic interaural intensity difference (DIID) training on all auditory processing categories of the Buffalo Model using the Persian staggered spondaic word (P-SSW) test. Methods: The study was conducted on 17 children (11 girls and 6 boys) aged 8-12 years old diagnosed with amblyaudia. All children were first evaluated by the P-SSW test, and then participated in 10-12 sessions of the DIID training. The P-SSW test was taken again after completing the training program in order to evaluate the training effect. Results: The paired t-test results showed a significant reduction in the mean scores of decoding (p < 0.001) and tolerance fading memory (p < 0.004) categories as well as the total mean score of P-SSW test after training. The Wilcoxon test also showed the effect of this training on the integration category (p < 0.025). The McNemar test, however, showed no statistically significant effect of the DIID training on the organization category. Conclusion: The DIID training causes significant improvement in some central auditory processing categories of the Buffalo Model, including decoding, tolerance fading memory and integration. [ABSTRACT FROM AUTHOR]

Introduction: Diverse microbiotas which have some contributions to gene expression reside in human skin. To identify the protective role of the skin microbiome against UV exposure, proteinprotein interaction (PPI) network analysis is used to assessment gene expression alteration. Methods: A microarray dataset, GEO accession number GSE117359, was considered in this respect. Differential expressed genes (DEGs) in the germ-free (GF) and specific pathogen-free (SPF) groups are analyzed by GEO2R. The top significant DEGs were assigned for network analysis via Cytoscape 3.7.2 and its applications. Results: A total of 28 genes were identified as significant DEGs and the centrality analysis of the network indicated that only one of the seven hub-bottlenecks was from queried genes. The gene ontology analysis of Il6, Cxcl2, Cxcl1, TNF, Il10, Cxcl10, and Mmp9 showed that the crucial genes were highly enriched in the immune system. Conclusion: The skin microbiome plays a significant role in the protection of skin against UV irradiation and the role of TNF and IL6 is prominent in this regard. [ABSTRACT FROM AUTHOR]

Background: Congenital Hypothyroidism (CH) is one of the reasons for mental retardation and defective growth in neonates. It can be treated if it is diagnosed early. The congenital hypothyroidism can be diagnosed using newborn screening in the first days after birth. Disease mapping helps to identify high-risk areas of the disease. This study aimed to evaluate the pattern of CH using the Poisson Spatio-temporal model in disease mapping under the Bayesian paradigm. Methods: The recorded data of all infants diagnosed with CH between 2011 and 2018 in Guilan, Iran were used in this study. The Poisson Spatio-temporal model under the Bayesian paradigm was run using the Markov Chain Monte Carlo method in Open BUGS software. Moreover, the maps of the towns in Guilan were prepared via Arc GIS software. Results: Out of 219800 live births in Guilan, Iran, the incidence of CH was 2:1000 in this time period. The pattern of disease mapping for the posterior mean of relative risk for CH was identical in this 7-year period. Furthermore, the pattern of disease mapping with spatial model excluding time dependence was similar to the maps of the Spatiotemporal model. Conclusion: The incidence rate of CH was approximately constant during this time, and disease mapping revealed no rising trends in this period. This probably can be due to resolving iodine deficiency as one of the main causes of CH incidence by consuming kinds of seafood and iodized salt in Guilan province. [ABSTRACT FROM AUTHOR]

Background and Aim: Questionnaires are useful tools for clinicians. This study aimed to translate the Dizziness Handicap Inventory for Patient Caregivers (DHI-PC) into Persian (DHI-PC-P) and assess its psychometric properties for children aged 5-12 years. Methods: This is a descriptive-analytical psychometrics study. After obtaining permission from the developers of the DHI-PC, translation into Persian and cross-cultural adaptation were done according to the international guidelines for self-assessment tools recommended by the American Association of Orthopedic Surgeons. Participants were 21 parents (mean age: 38.05 years, SD=6.1 years, 18 female) and their children with dizziness (mean age 8.69 years, SD=2.41 years, 9 female) between the ages of 5-12 years old. Face validity, content validity, and test-retest reliability at an interval of 14-21 days were evaluated for the DHI-PC-P. Results: The face validity was confirmed qualitatively by the experts' opinions and quantitatively by calculating the item impact score. Content validity was confirmed by calculating the content validity index and the content validity ratio (0.97 and 0.86, respectively). The internal consistency was good (Cronbach's alpha=0.90). For the testretest reliability, the intraclass correlation coefficient was obtained 0.94, indicating an excellent reliability. Conclusion: The DHI-PC-P can be used clinically as a valid and reliable tool for children with dizziness aged 5-12 years. [ABSTRACT FROM AUTHOR]

The Franssen illusion, or Franssen effect (FE), is one of the auditory spatial illusions. Few studies have explored the FE, and the mechanisms underlying it remain unknown. The present study was conducted to clarify the FE occurrence with different tasks and presentation modes in young adults. It also sought to investigate possible neurophysiological similarities between interaural time difference (ITD) cue processing and FE perception. FE perception was evaluated using two different tasks and two presentation modes (i.e., insert phones and loudspeakers). Sound reflections (reverberation) were presented in the diffuse field (loudspeaker mode). ITD performance was investigated using different stimuli delivered via insert phones. No significant difference between the two FE perception tasks was found (F1;25 = 0:138, p = 0:713). However, the FE perception showed a significant difference between the two presentation modes (F1;25 = 434:03, p < 0:001). Spearman's correlation did not reveal a significant relationship between FE perception and ITD scores (p > 0:05). The current findings show the importance of reverberation in the FE occurrence. Also, the non-significant correlation between the results of the behavioral binaural temporal resolution test and FE perception in young people with normal temporal resolution may indicate that room reflections (reverberation) complicate the ability to process ITDs (rather than poor ITD processing for the "steady state" portion of signal). [ABSTRACT FROM AUTHOR]

Objectives: To evaluate a modified two-step buccal infiltration (MBI) of 1.7 mL 4% articaine as primary or supplemental anesthesia in mandibular first and second molars diagnosed with symptomatic irreversible pulpitis (SIP). Materials and methods: One hundred and eight patients with SIP were randomly assigned to one of three groups (n = 36). They were given an inferior alveolar nerve block (IANB) of 2% lidocaine with 1:80.000 epinephrine or a primary MBI of 4% articaine with 1:100.000 epinephrine in the IANB and MBI groups, respectively. Patients in the IANB + MBI group received an IANB followed by an MBI. Pain levels during the injection, access cavity preparation, and initial filing were recorded on the Heft-Parker visual analog scale (HP-VAS). No or mild pain (HP-VAS ≤ 54) upon access cavity preparation and initial filing was considered a success. Chi-square and Kruskal–Wallis tests were used to analyze the data. Results: MBI (77.8%) and IANB + MBI (94.4%) had both significantly higher success rates than IANB (50.0%) (P <.001). However, when the Bonferroni adjustment was applied, there was no statistically significant difference between the MBI and IANB + MBI techniques (P =.041 >.017). MBI was associated with significantly less injection pain than IANB (P <.001). Conclusions: Both primary and supplemental MBI with 4% articaine were superior to IANB with 2% lidocaine in mandibular first and second molars diagnosed with SIP. Further research may be needed to confirm the findings of this study. Clinical relevance. The findings of this study suggest that supplemental or primary MBI can be a clinically viable alternative to IANB, which has a relatively low success rate when managing mandibular molars diagnosed with SIP. [ABSTRACT FROM AUTHOR]

Background/Aims: Muscle imbalance in patella stabilisers leads to patellar lateral glide and can cause patellofemoral pain syndrome. This study investigated the effect of progressive strengthening exercises of the vastus medialis oblique on pain and patellar alignment in patients with patellofemoral pain syndrome and patellar lateral glide. Methods: A double-blind, randomised controlled trial was conducted with 40 individuals with patellofemoral pain syndrome with patellar lateral glide aged 20–40 years. The study group received vastus medialis oblique-specific strengthening exercises and routine physiotherapy treatment, and the control group received routine physiotherapy treatment only (stretching exercises, gluteal and quadriceps isometric exercises and conventional transcutaneous electrical nerve stimulation). Participants performed these exercises three times a week for 8 weeks. Pain intensity was measured before and after the intervention using a visual analogue scale and patellar alignment was measured using ultrasonographic parameters, including the trochlear angle, patella offset angle and distance between patellar tip and trochlear groove. Results: In the between-groups comparison, there was a significant decrease in pain intensity in both the study and control groups, although the study group had a greater decrease (study group before intervention: 71.15 ± 1.54, study group after intervention: 22.21 ± 0.35, P=0.001); control group before intervention: 70.09 ± 1.22, control group after intervention: 31.82 ± 0.36 (P=0.001)) and patella offset angle (in the study group compared to the control group after 8 weeks of intervention. In within-groups comparison, a significant decrease of the patella offset angle in the study group was observed (before intervention: 16.2 ± 1.53; after intervention: 13.2 ± 1.87, P=0.001). No significant differences were found for the other parameters. Conclusions: Specific strengthening of the vastus medialis oblique muscle in patients with patellofemoral pain syndrome and patellar lateral glide can lead to pain reduction and improvement of patellar alignment to correct lateralisation. This change may delay the process of patellofemoral joint degeneration. Including vastus medialis oblique-specific strengthening exercises in standard physiotherapy treatments may help to reduce pain levels in people with patellofemoral pain syndrome. Implications for practice: Investigating the main cause of patellofemoral pain syndrome could have an essential role in the rehabilitation treatment of patients. [ABSTRACT FROM AUTHOR]

Objective. B lymphocyte infiltration in the tumor microenvironment has been proposed to play pivotal roles in tumor progression. Heat shock protein 70 (HSP70) expressed by tumor cells can induce antitumor immune response. Few studies have examined the clinicopathologic relationship between tumor infiltrating B lymphocyte and HSP70 expression in human cancer. So far, there is no complete knowledge on the relationship in oral squamous cell carcinoma (OSCC). The present study was conducted to evaluate the relationship between tumor infiltrating B lymphocyte and HSP70 expression in OSCC, as well as the clinical outcome. Materials and Methods. In this retrospective study, the immunohistochemical analysis of 50 OSCC specimens was performed using CD20 and HSP70 antibodies. The relationship between markers’ expression and clinicopathologic data was evaluated using Mann–Whitney test, Chi-square test, logistic regression model, and Spearman’s correlation coefficient. Results. The data analysis showed significant correlation between peritumoral CD20+ B lymphocyte infiltration and lymph node metastasis (P=0.047). Furthermore, HSP70 expression was significantly correlated with stage (P=0.003), lymph node metastasis (P<0.001), and tumor size (P=0.044). However, no relationship was observed between B lymphocyte infiltration and HSP70 expression. Conclusion. The results suggest that peritumoral B lymphocyte infiltration and HSP70 expression level have significant association with OSCC and may be considered as prognostic indicators in OSCC. Thus, evaluation of B cells as therapeutic targets in OSCC patients is recommended. [ABSTRACT FROM AUTHOR]

Introduction: Some accurate tools exist to assess fear-avoidance behavior, such as the Tampa scale for kinesiophobia (TSK) in individuals with musculoskeletal problems. The current research aims to compare the psychometric characteristics of the original 17-items TSK questionnaire and its 11-item brief version in chronic non-specific low-back pain (CNSLBP). Materials and Methods: In this test development study, 295 patients with CNSLBP referred to the physiotherapy clinic of Milad Hospital in Tehran city, Iran were evaluated. Confirmatory factor analysis (CFA) and α Cronbach was conducted to assess the validity and reliability of the original and brief version of the TSK, respectively. For goodness-of-fit, the Χ²/df, root mean square error of approximation (RMSEA), goodness-of-fit index (GFI), and comparative fit index (CFI) indices were used. Results: Internal consistency specified by Cronbach's α was 0.949 for the original version of the questionnaire and 0.927 for the brief one. Based on the CFA findings, the goodness-of-fit indices for the brief version were GFI=0.921, RMSEA=0.078 (90% confidence interval (CI), 0.062%-0.094%), comparative fit index (CFI)=0.981, and Χ²/df=2.791. These indices for the original one were 0.882, 0.066 (90% CI, 0.055%-0.076%), 0.983, and 2.270, respectively. A significant correlation was found between these two versions (P<0.001). These findings confirm the adequacy of the brief version of the TSK. Conclusion: The brief version of TSK can be considered a reliable and valid tool to evaluate somatic focus and activity avoidance in patients with CNSLBP. [ABSTRACT FROM AUTHOR]

Background and Aim: The Acceptance Noise Level (ANL) which determines the tolerable noise level while listening to running speech, is related to factors such as hearing loss and speech presentation level. This study aims to investigate the effect of speech presentation level on the ANL in people with unilateral Meniere's Disease (MD) compared to the normal-hearing people. Methods: In this study, 33 people aged 32-60 years with unilateral MD and 38 normal-hearing people aged 20-46 years participated. The ANL growth was evaluated unilaterally at four different speech presentation levels: Most Comfortable Level (MCL), -10 dB lower than the MCL, +10 dB higher than the MCL, and a range between MCL and uncomfortable level. Results: In MD patients, the ANL of the affected ear was significantly different from that of the contralateral ear (p<0.010). Compared to the normal-hearing people, the pattern of ANL growth in MD patients was significantly different, but the ANL growth patterns were similar between the affected and contralateral ears. Conclusion: ANL and its growth pattern are different between the affected and contralateral ears of patients with unilateral MD, but are similar compared to normal-hearing people. Despite the apparently normal hearing thresholds, the performance of the contralateral ear in noise at various speech presentation levels in patients with unilateral MD seems to be similar to that of the affected ear. [ABSTRACT FROM AUTHOR]

Introduction: Immobility and limited usage of operated limbs lead to weakness and atrophy of the muscle after anterior cruciate ligament (ACL) reconstruction. However, training programs for preventing biomechanical risk factors such as lower limb alignment and increased muscular contraction are very limited. Thus, the current study was carried out to evaluate the recovery of quadriceps muscle strength and the improvement of knee function using adjuvant electromyographic biofeedback (EMG-BF) after ACL reconstruction. Methods: This prospective randomized controlled trial was conducted among 40 patients (20 = EMGBF group, 20 = Control group) with ACL reconstruction, who were referred to Akhtar Hospital from 2021 to 2022. In the EMG-BF group, EMG BFB was added to the standard rehabilitation protocol, and in the control group, the standard rehabilitation protocol with full postoperative weightbearing, knee brace (zero degree of extension, 90 degrees of flexion), and electrical stimulation with maximal voluntary isometric knee extension was performed. Each group was intervened for 4 weeks and three sessions of 30 minutes per week. It should be noted that each patient participated in 16 outpatient physiotherapy sessions after surgery. Nicholas Hand-Held Dynamometer (HHD) was used for measuring quadriceps strength, and Knee Outcome Survey-Activities of Daily Living (KOS-ADLs) and Knee Outcome Survey Sports Activities Scale (KOS-SAS) questionnaires were used for assessing the knee function. Results: Four weeks after the treatment, the EMG-BF group showed a significant increase in quadriceps strength (P = 0.0001). Quadriceps strength had a significant difference before and after 4 weeks of intervention (P = 0.0001), but in the control group, no significant difference was observed (P = 0.368). The EMG-BF group had a significant increase in KOS-ADLs and KOS-SAS scores after 4 weeks of intervention (P = 0.0001). Conclusion: In our study, isometric strengthening of quadriceps with adjuvant EMG-BF significantly increased the strength of quadriceps and knee function during 4 weeks. EMG-BF is a low risk, low cost, and less invasive intervention and has high safety and adjustment ability. It is a valuable adjuvant method for achieving better functional recovery in a shorter time. [ABSTRACT FROM AUTHOR]

Background and Aim: Each year, millions of older people experience falling which can cause serious injuries such as broken bones, head injuries, or even death. Since Diabetes Mellitus can disrupt the balance system and increase falling, and given that fear of falling and balance confidence are critical fall-related psychological concerns that can be the risk factors of falls in the diabetic elderly, this study aimed to compare fear of falling and balance confidence of diabetic and non-diabetic older adults in Iran. Methods: Participants were 63 diabetic older patients and 59 non-diabetic peers aged 60 years and over. Data were collected using the Persian versions of falling efficacy scale-international and activities-specific balance confidence-short form questionnaires. In addition, modified Romberg and timed up and go tests were performed to assess subjective balance performance. Results: The scores of falling efficacy scale-international questionnaire and timed up and go test were significantly higher in diabetic group while the scores of activities-specific balance confidence-short form questionnaire were lower (p<0.001). No significant differences were observed in the modified Romberg test scores between two groups. Conclusion: Fear of falling and low balance confidence are more common in diabetic older adults compared to non-diabetic peers. They have poor performance in timed up and go test and have more falls during the last 12 months. [ABSTRACT FROM AUTHOR]

Background: Childbirth is one of the important and most painful phenomena that mothers experience in their lifetime. Acupressure and Reflexology are complementary therapy approaches and techniques that are simple, easy, inexpensive, non-invasive and non-pharmacological methods of pain relief. The aim of the research was to detrmine and compares the effect of acupressure at the SP6 point and reflexology on pain intensity and duration of first stage of labor Materials and Methods The present study was a randomized clinical trial. It was done on 92 pregnant women in the delivery room of Shahid Akbar Abadi Hospital. They were categorized into 35 women in the acupressure group, 35 in the reflexology group and in the third group 36 samples received routine care. The three groups were as same as each other in the point of view of demographic and obstetrical characteristics. The data gathering tools were included a demographic questionnaire and an examination checklist. In addition, the severity of pain was evaluated with the visual analogue scale (0 to 10cm). In all groups pregnant women were asked to evaluate the severity of pain experienced at the start of the study, before and after the first (dilatation 4-5) and second (dilatation 7-8) intervention. Results: Kruskal Wallis test has showed no significant difference for pain severity at the start of study and before the first intervention among these three groups, however, the statistical test has shown significance differences after the first intervention, before and after the second intervention among them. The intensity of pain has increased significantly in the routine care group (P= 0.001). Our finding has indicated that the average pain score in the acupressure group was lower than reflexology group, but the Mann-Whitney test has shown no significant differences. The pain intensity of labor before and after of intervention with the Wilcoxon test in both stages has indicated that there were no significant differences after intervention in comparison with before the intervention in acupressure and reflexology group. However, in the routine care group the intensity of pain has significantly increased (P=0. 001). Conclusion: This study showed that foot reflexology and acupressure at the SP6 pain are effective in reducing labor pain. Application of no pharmacologic pain reduction technique instead of the pharmacological methods to relieve labor pain recommends. [ABSTRACT FROM AUTHOR]

Background: Autism spectrum disorder (ASD) is a neurodevelopmental disorder with 2 main symptoms of social and communication deficits and stereotyped behaviors. Pretend play and theory of mind (ToM) have an essential role in a child's cognitive and social development. Objectives: In this study, different variables of pretend play with levels of ToM were examined in 2 groups of typical children and children with autism. Methods: In this case-control observational study, 45 typical children and 18 children with autism aged 5 to 7 years participated. For both groups, the ToMtest was performed to measure the levels of ToM, and the child-initiated pretend play assessment (ChIPPA) was performed to analyze the pretend plays in both groups. Both tests were performed directly on children, and the scores were recorded by the examiner. Results: The results showed a significant positive relationship between the total score of ToM and pretend play. In children with autism, there was no difference between the ToM scores regarding age (P > 0.05). There was also a significant relationship between the levels of ToM, percentage of elaborate pretend actions (PEPA), and the number of object substitutions (NOS; P < 0.001). The scores of the ToM and pretend play levels of children with autism and typical children were significantly different (P < 0.001). Conclusions: Basedonthe findings, the ToMandpretend play levels were lower inASDchildren than in typical children. In addition, children who had higher PEPA scores and better NOS had higher ToM scores. [ABSTRACT FROM AUTHOR]

Introduction: Identifying the contributing factors to a specific learning disorder and comparing these factors in different types of this disorder will lead to using more proper interventions in the future. Therefore, this study aimed to compare sensory processing skills and perceived motor competence between three groups of students with specific learning disabilities (reading and writing disorders, math disorders, and combination disorders). Materials and Methods: The present study was a cross-sectional descriptive-analytical study. The participants were 48 children (16 in each group, aged 8-12 years). They were selected from Chaharmahal and Bakhtiari Province, Iran, by the simple convenience sampling method. The participants’ sensory processing was measured with sensory profile 2 and their perceived motor competency with Marsh perceived motor competence questionnaire. Results: The results showed a significant difference between the three groups in the sensory sensitivity, low registration sensory patterns and processing of tactile, and body position senses (P <0.05). However, no significant differences were observed between groups in other components of sensory processing and perceived motor competence (P> 0.05). Conclusion: The results indicate that therapeutic interventions in the group with reading and writing disorders should focus on increasing sensory registration and processing of tactile and body position senses and reducing sensory sensitivity in the mathematical group. [ABSTRACT FROM AUTHOR]

Background: Nipple fissure is a common disorder during breastfeeding. With high prevalence of nipple fissures and its impacts on M breastfeeding, as well as the existence of evidence in favor of the application of peppermint as an antiinflammatory and antiinfection PH herb, the purpose of this study is to determine the effect of Menthol essence on improving nipple fissures in the primiparous 0 breastfeeding women. Materials and Methods: This study was conducted using a clinical trial method. Samples were divided randomly into two groups of 55 women. The women in the peppermint group applied four drops of Menthol essence on their nipple and areola after each feeding. The control group applied four drops of their own milk on the nipple and areola after each feeding. Then, the two groups were studied on days 10 and 14 postpartum. For intensity of pain, the visual analog scale (0-10 cm) and to measure the severity of damage, Amir scale (1-10 cm) were applied and the existence or lack of nipple discharge was also recorded. The data were analyzed using SPSS 17 software. Results: The mean intensity of pain and nipple fissure before treatment (8.55 ± 1.74) and day 10 after delivery (4.26 ± 1.57) and before treatment and day 14 after delivery in the case group (1.32 ± 1.02) had a significant difference (P < 0.001). Nipple discharge between the two groups, before treatment (%75.2) and day 10 after delivery (%31.6) and before treatment and day 14 after delivery (%15.7), the case group had a significant difference (P < 0.001). Conclusion: Menthol essence can improve nipple fissures in the primiparous breastfeeding women. [ABSTRACT FROM AUTHOR]

Objective: The concept of minimally invasive endodontics recommends less-invasive vital pulp therapy (VPT) modalities over more aggressive traditional endodontic approaches in mature permanent teeth with carious pulp exposure, including irreversible pulpitis (IP) cases. Consequently, VPT needs to be compared with root canal therapy (RCT) in terms of treatment outcomes. This randomized clinical trial compares the results of full pulpotomy using two calcium-silicate cements, i.e., mineral trioxide aggregate (MTA) and calcium-enriched mixture (CEM) cement, with RCT in mature permanent teeth. Materials and methods: A total of 157 carious pulp exposure cases in two academic centers with/without established IP were selected/included/randomly appointed to three study arms; (i) RCT (n = 51) as the reference treatment, (ii) pulpotomy with ProRoot MTA (PMTA; n = 55), and (iii) pulpotomy with CEM cement (PCEM; n = 51) as two alternative VPT treatments. Two-year clinical/radiographic results were the outcomes of interest. Data were statistically analyzed through the analysis of variance, chi-square, Fisher exact test, and Kruskal–Wallis. Results: At 2-year recall, 147 teeth were examined (6.4% dropout). All molars, except for one, were clinically functional/symptom-free, and there was no statistical difference between the three study arms (p = 0.653). The radiographic success rates in RCT, PMTA, and PCEM arms were 98%, 100%, and 97.9%, respectively, without statistically significant differences (p = 0.544). Conclusion: In the management of mature permanent teeth with/without established IP, all experimental groups exhibited equivalent/comparable results. Clinical relevance: Simple VPT using MTA/CEM can be suggested/recommended as a viable advantageous alternative to RCT for the management of carious pulp exposures with/without sign/symptoms of IP. [ABSTRACT FROM AUTHOR]

Background and Aim: Many aspects and features of auditory system can be improved by musical training. This study aimed to investigate the effects of a stringed musical instrument playing course on temporal resolution and temporal fine structure (TFS) processing. Methods: This analytical cross-sectional study was conducted on 44 normal-hearing adults aged 20-40 years divided to two groups. The first group included 22 stringed musical instruments players (13 males) with at least three years of experience, and the second group were 22 non-players (13 males). The random gap detection test (RGDT) was used to measure temporal resolution aspect of hearing. For TFS processing, latest version of temporal fine structure-adaptive frequency (TFS-AF) test was used. Results: The TFS-AF results showed no statistically significant difference between groups in different interaural phase differences (IPDs). The RGDT results showed significant differences between groups at 500, 1000 and 2000 Hz, but not at 4000 Hz. Spearman correlation test results showed no statistically significant correlation between the results of TFS-AF and RGDT. Conclusion: Musical training has no effect on TFS processing but considerably enhances gap detection ability. Their underlying mechanisms for TFS processing and gap detection are different. [ABSTRACT FROM AUTHOR]

Background and Aim: Spatial hearing is a prerequisite for the proper function of the listener in complex auditory environments. In the present study, a Persian version of the dynamic spatial-quick speech in noise (DS-QSIN) has been developed with respect to all possible factors affecting the test and to run five lists for normal hearing subjects and assessment of reliability. Methods: To construct five new lists according to the original quick speech in noise (QSIN) test, we used frequent, familiar, and difficult words to construct unpredictable sentences. After determining the content and face validity of the sentences, 30 selected sentences were played using a DS-QSIN software for 35 subjects aged 18-25 years. The reliability of the test was assessed after repeating the test after two weeks. Results: According to expert judges, these 30 sentences showed acceptable content and face validity with the changes. The average signal-to-noise ratio (SNR) loss of five lists was -5.2 dB. No significant difference was seen between men and women in all lists. The results indicate no difference in the average SNR loss between the five lists. Regarding the reliability assessment, the test-retest correlation coefficient was 0.5 to 0.7 (p<0.05). The intra-class correlation coefficient between test-retest was statistically significant (p>0.001) and confirmed that the lists have high reliability and repeatability. Conclusion: DS-QSIN test showed good validity and reliability and can be helpful in diagnosis and selecting the best method for rehabilitation of people with a spatial hearing disorder. [ABSTRACT FROM AUTHOR]

Background and Aim: Noise tolerance and performance in noisy environments are influential factors of hearing aid use in people with hearing loss. One of the causes of hearing loss is Meniere's disease (MD), which affects speech perception in noise. Acceptable noise level (ANL) is a test that measures the maximum tolerated background noise level (BNL) while listening to the running speech. Since the effect of MD on ANL needs further study, the present study aims to examine the ANL test results in people with unilateral MD, and compare the results between the two ears. Methods: This cross sectional study conducted on 33 individuals with unilateral MD (21 females and 12 males) aged 32-60 years who had the disease for at least one year, who participated in this study. Their most comfortable level (MCL), BNL, and ANL in both ears were then evaluated. Results: The mean MCL and BNL were significantly different between the two ears, where they were higher in the affected ear than in the contralateral ear. There was also a significant difference in the ANL results between the two ears. In the affected ear, a statistically significant relationship was reported between the ANL and the average hearing thresholds at frequencies of250, 500, and 1000 Hz. Conclusion: MD affects the ANL in the affected ear and causes a deterioration in its level and speech perception in noise. [ABSTRACT FROM AUTHOR]

Objectives: Finding the best voxel size for the detection of vertical periodontal bone defects with minimum patient radiation dose is a priority. This study sought to assess the effect of cone-beam computed tomography (CBCT) voxel size on the detection of vertical bone defects.Materials and Methods: In this in vitro, experimental study, 31 vertical defects including 2 one-wall, 12 two-wall, and 17 three-wall defects were randomly created in the maxilla and mandible of four sheep skulls with the associated soft tissue using round and needle burs. Forty sound sites were considered as the control group. The CBCT scans were obtained from the skulls with 0.150 and 0.300 mm3 voxel sizes and 8 x 11 cm2 field of view (FOV). The images were randomly evaluated by two oral and maxillofacial radiologists and two periodontists, and their findings were recorded. The inter-rater observer agreement (weighted kappa), sensitivity and specificity values were calculated for each voxel size. Comparisons were made using paired t-test. Results: The two voxel sizes had no significant difference in detecting one-wall and twowall defects (P>0.05). But the smaller voxel size was significantly superior for detecting three-wall defects (P=0.001). The inter-rater observer agreement was unfavorable (kappa < 0.6) for the detection of all three defect types. Conclusion: In general, increasing the image resolution by decreasing the voxel size increased the sensitivity and reduced the specificity of CBCT for detection of vertical bone defects, and is only recommended for detection of three-wall defects. [ABSTRACT FROM AUTHOR]

Objectives: Diminished proprioception after an anterior cruciate ligament (ACL) rupture causes disabilities following injury. The aim of this study was to investigate the trend of this change during six months following an isolated unilateral complete ACL rupture. Materials and Methods: In this cohort study, a total of 58 male and female athletes, aged 20-40 years, were surveyed in equal groups with 29 subjects. The healthy (first) and ACLD (second) groups included athletes with isolated unilateral complete ACL ruptures (the ACL-deficient knee group). Knee proprioception was investigated in both groups in three stages, namely, at the beginning of the study (two months after the injury in the ACL-D group) and the intervals of two and four months after the first assessment. The active reproduction of passive positioning (ARPP) method was used in this study. The selected angles were 45° and 60° of knee flexion, and an isokinetic device was the measuring instrument. Three reproduction angular errors were compared between three measurements in each test, including constant error (CE), absolute error (AE), and variable error (VE). Results: The results showed that AE and VE, unlike CE, significantly changed within both groups. AE (P ≤ 0.002, P ≤ 0.001 for 45° and 60°, respectively) and VE (P ≤ 0.043 for 45°), as well as AE (P ≤ 0.002, P ≤ 0.001 for 45°and 60°, respectively) and VE (P ≤ 0.005, P ≤ 0.016 for 45° and 60°, respectively) were significant in the healthy and ACL-D groups, respectively. In addition, a significant difference was observed between healthy and ACL-D groups regarding knee proprioception. At 45°, CE, AE, and VE were significant in the first (P ≤ 0.024), the third (P ≤ 0.014), and all three (P ≤ 0.001, P ≤ 0.027, & P ≤ 0.001) tests, respectively. Finally, AE, VE, and CE were found to be significant in the second (P ≤ 0.001), second (P ≤ 0.004), and third (P ≤ 0.026) tests, at 60°, respectively. Conclusions: In general, ACL rupture reduced knee proprioception after the injury in athletes compared to healthy individuals. Within-group differences, as well as differences between healthy and injured athletes diminished over time within six months after the injury. Eventually, knee proprioception improved in individuals with ACL rupture although the exact mechanism of these changes remains unknown. [ABSTRACT FROM AUTHOR]

Background: Congenital hypothyroidism (CH) is one of the most prevalent preventable causes of mental retardation. Studies show that the incidence rate of CH is very high in Iran. Disease mapping is a tool for visually expressing the frequency, incidence, or relative risk of illness. The present study aimed to model CH counts considering the effects of the neighborhood in towns and perform mapping based on the relative risk. Methods: In this historical cohort study, data of all neonates diagnosed with CH with TSH level =5 mIU/L between March 21, 2017, and March 20, 2018, in health centers in Guilan, Iran were used. The number of neonates with CH was zero in most towns of Guilan Province. The Bayesian spatial zero-inflated Poisson (ZIP) regression model was employed to investigate the effect of the town's neighborhood on the relative risk of CH incidence. Then, the map of the posterior mean of the relative risk for CH incidence was provided. The analysis was performed using OpenBUGS and Arc GIS software programs. Results: The relative risk of CH incidence was high in the West of Guilan. Moreover, the goodness-of-fit criterion indicated that it is more appropriate to fit the Bayesian spatial ZIP model to these data than the common model. Conclusions: Considering the high relative risk of CH in the Western towns of Guilan Province, it is better to check important risk factors in this region. [ABSTRACT FROM AUTHOR]

Background: The risk of falling in patients with chronic obstructive pulmonary disease (COPD) is higher than healthy people, imposing a great financial burden on patients due to clinical diagnosis and treatment. This study aimed to compare static balance between two groups of healthy people and COPD patients, based on cognitive tasks and vision tests, using linear and non-linear analyses. Materials and Methods: A total of 15 patients with COPD and 14 age- and gender-matched healthy individuals were recruited in this study. Variations in the center of pressure were recorded in both medial-lateral (ML) and anteriorposterior (AP) directions by implementing visual feedback and cognitive tasks, with the subject standing on a force plate. Data related to the center of pressure were analyzed in the AP and ML directions by linear methods (i.e., standard deviation of displacement, standard deviation of maximum velocity, average velocity, and phase plane). Also, the nonlinear method (Lyapunov exponents) was used in both directions. Results: The cognitive tasks improved the center of pressure variables in both groups. In association with the vision tests, only lack of vision had a significant effect on the patients. The results of the linear analysis in the ML direction were significantly higher in the COPD group as compared to the healthy group; however, the results were not significant in the AP direction. Also, the nonlinear analysis showed significant differences between the groups. Conclusion: Use of both linear and non-linear analyses is necessary for evaluating the balance of patients with breathing difficulties. Balance disorders in COPD patients were mostly in the ML direction; therefore, postural deformities might be one of the reasons for balance problems in the AP direction. [ABSTRACT FROM AUTHOR]

Background/Aims: The participation of children and adolescents with cerebral palsy in leisure activities is associated with their preferences. A better understanding of their leisure preferences and the factors that influence them can help therapists to promote young patients' participation in leisure activities. The aim of this study was to describe the role of individual factors in the prediction of leisure preferences of children and adolescents with cerebral palsy in Iran. Methods: A cross-sectional study design was used. A total of 152 children and adolescents with cerebral palsy were selected to complete the Preferences for Activities of Children questionnaire. Simple and multiple linear regression analyses were performed to assess the role of individual factors in the prediction of preferences for leisure activities. Results: Individual factors played a significant role in the prediction of leisure preferences. Their influence on the preferences for recreational, physical and self-improvement domains (r2=0.215; 0.154; 0.127, respectively) were greater than for social and skill-based domains (r2=0.045; 0.052, respectively). Conclusions: Preferences for physical activities need to be augmented while a high preference for social and recreational activities could be used to promote participation in leisure activities. Therapists and other healthcare professionals should consider individual factors relating to leisure preferences when devising therapeutic plans that aim to promote participation in leisure activities. [ABSTRACT FROM AUTHOR]

Background and Aim Lip reading is extraction of speech data from the activity of the lower part of face, particularly jaws, lips, tongue, and teeth that is a natural skill in people with hearing loss. The main purpose of lip reading is to increase the independence of people with hearing loss. Looking at the speakers facial movements significantly increase the ability to understand the spoken words, particularly in the environments where noise is present. In fact this reflects the important role of visual signals. In current study we consider the effects of education on lip reading ability by planning and instructing a lip reading program in male subjects. Methods & Materials Sara lip reading test 1 and 2 were used for the assessment of lip reading skills and for studying the effects of lip reading training on recognition of speech. This intervention as a semi-experimental study, was conducted on 27 male students, selected by available sampling. For data analysis, statistical analysis of variance with repeated measurements and Mcnemar was used. Ethical Considerations This research with the code IR.SBMU.REC.1394.144 has been approved by the ethics committee of Shahid Beheshti University of Medical Sciences. Results There were significant differences between Sara lip reading test 1 scores in 2 positions (P=0.000). Lip reading test scores also showed significant differences in Sara lip reading test 2 in 2 positions (P=0.000). Also between the scores of Consonant-vowel, consonant-vowel syllables, in the position before teaching lip-reading and then,was significant difference (P<0.05). Conclusion The findings of this study showed that instructing lip reading has a positive effect on lipreading ability in people. [ABSTRACT FROM AUTHOR]

Aim: To understand the molecular difference between H.pylori negative and positive gastric cancer, a regulatory network analysis is investigated. Background: Helicobacter pylori as the one of the most leading causes of gastric cancer is yet to be studied in terms of its molecular pathogenicity. Methods: Cytoscape version of 3.7.2 with its applications was employed to conduct this study via corresponding algorithms. Results: A total of 161 microRNAs were identified differentially expressed in the comparison of two groups of gastric cancer including negative and positive with H.pylori infection. CluePedia explored the regulatory network and found down-regulation dominant while considering the linked hub genes. Conclusion: It can be concluded that the presented microRNAs and target genes could have associations with H.pylori carcinogenesis in gastric cancer through dysregulation of some vital biological processes. These microRNAs and target genes include hsa-miR-943, hsa-miR-935, hsa-miR-367, hsa-miR-363, hsa-miR-25, and hsa-miR-196b and ADRA1A, KCNA4, SOD1, and SESN3, respectively. However, verification analysis in this regard is required to establish these relationships. [ABSTRACT FROM AUTHOR]

Aim: To assess the immunological reactions and gene expression level in the celiac disease (CD) patients under a gluten-free diet (GFD). Background: CD is an autoimmune disorder in genetic susceptible individuals and lifelong gluten free diet is the effective treatment method. It seems that treated patients will experience a normal life style though there are documents about some potential damages. Methods: Gene expression profiles of treated CD patients and healthy samples were obtained from Gene Expression Omnibus (GEO) and compared to find the differentially expressed genes (DEGs). The identified DEGs were introduced in the network and gene ontology (GO) analysis. Results: Ten differentially expressed genes (DEGs) including CCR2, IRF4, FASLG, CCR4, ICOS, TNFSF18, BACH2, LTF, PRM1, and PRM2 were investigated via network analysis. Seven clusters of biological processes (BP) were determined as the affected BP. PThe finding led to introduction of CCR2, IRF4, FASLG, CCR4, and ICOS as the potential immunological markers that are still active despite GFD in the treated CD patients. Conclusion: The results of this study indicated that the immune system is already active in treated CD patients despite GFD treatment and exposure to gluten causes potential immunological reactions in these patients. [ABSTRACT FROM AUTHOR]

OBJECTIVES: The Flexi-Bar and Bodyblade are oscillatory tools used in rehabilitation centers worldwide to enhance muscle activity. Because of a lack of reports on the Flexi-Bar, this study focused on erector spinae (ES) muscle activation under different conditions. METHODS: Twelve university students (age 21 ± 2.5 years old) were recruited in this study and were tested while using a loaded Flexi-Bar for 10 seconds. Comparison between muscle activation on the right and left sides in the cervical, thoracic, and lumbar regions was measured by electromyography during two-leg and one-leg (left and right) standing. RESULTS: The results showed that during oscillation using the right hand, the right cervical muscles showed significantly higher activation levels than the left cervical muscles, while the thoracic and lumbar regions showed significantly higher muscle activities on the left side. CONCLUSION: The current study showed that the Flexi-Bar might be used for muscle activation and reeducation, as well as for specific exercise therapy in spinal muscle imbalance. [ABSTRACT FROM AUTHOR]

Background/Aims: This study evaluated the role of individual factors of children and adolescents with cerebral palsy in the prediction of leisure participation. Methods: A cross-sectional study design was used. A group of children and adolescents with cerebral palsy were selected to complete the Children's Assessment of Participation and Enjoyment. Participants' cognitive levels were assessed based on the Study of Participation of Children with Cerebral Palsy Living in Europe estimated cognitive levels. Findings: The models could best predict up to 31.8% of the variance in the participation rates, 28.4% of the variance in the frequency scores and 33.5% of the variance in the enjoyment scores of leisure domains. The type of cerebral palsy was one of the most significant predictive factors of leisure participation (β ranged from −0.177 to −0.525 for quadriplegia). Conclusions: Therapists and rehabilitation specialists may consider individual factors to predict a proportion of leisure participation subscales before planning for interventions aimed at promoting the leisure participation of children and adolescents with cerebral palsy. [ABSTRACT FROM AUTHOR]

Objective(s): As the most prevalent endocrine system malignancy, papillary thyroid carcinoma had a very fast rising incidence in recent years for unknown reasons besides the fact that the current methods in thyroid cancer diagnosis still hold some limitations. Therefore, the aim of this study was to improve the potential molecular markers for diagnosis of benign and malignant thyroid nodules to prevent unnecessary surgeries for benign tumors. Materials and Methods: In this study, 1H-NMR metabolomics platform was used to seek the discriminating serum metabolites in malignant papillary thyroid carcinoma (PTC) compared to benign multinodular goiter (MNG) and healthy subjects and also to better understand the disease mechanisms using bioinformatics analysis. Multivariate statistical analysis showed that PTC and MNG samples could be successfully discriminated in PCA and OPLS-DA score plots. Results: Significant metabolites that differentiated malignant and benign thyroid lesions included citrate, acetylcarnitine, glutamine, homoserine, glutathione, kynurenine, nicotinic acid, hippurate, tyrosine, tryptophan, β-alanine, and xanthine. The significant metabolites in the PTC group compared to healthy subjects also included scyllo- and myo-inositol, tryptophan, propionate, lactate, homocysteine, 3-methyl glutaric acid, asparagine, aspartate, choline, and acetamide. The metabolite sets enrichment analysis demonstrated that aspartate metabolism and urea cycle were the most important pathways in papillary thyroid cancer progression. Conclusion: The study results demonstrated that serum metabolic fingerprinting could serve as a viable method for differentiating various thyroid lesions and for proposing novel potential markers for thyroid cancers. Obviously, further studies are needed for the validation of the results. [ABSTRACT FROM AUTHOR]

Background and purpose: Vestibular Schwannoma (VS) is a lesion in peripheral vestibular system that leads to reduction of Vestibulo Ocular Reflex (VOR) gain and incidence of corrective saccades. Researches showed that the result of Video Head Impulse Test (VHIT) is positive in peripheral vestibular system disorders and negative in central vestibular system disorders. The aim of this study was to evaluate and compare the results of VHIT in patients with vestibular schwannoma and patients with central vestibular system tumors. Materials and methods: A descriptive-analytic study was conducted in 12 patients with unilateral VS tumor and 15 patients with unilateral central vestibular system tumors in Iran Gamma-Knife Center (December 2014-September 2015). The patients were selected based on diagnosis of neurosurgeon and their complaints from vertigo, imbalance, and dizziness. Assessment of VHIT was performed using horizontal and vertical head impulses. Finally, the amount of VOR gain and the corrective saccade ratio were evaluated in two groups of patients with tumors. The gain of VOR ≤0.80 was considered as abnormal criterion. Results: Mean VOR gain in effective side was 0.38 in patients with VS tumor, and 0.96 in patients with central vestibular system tumors (P= 0.001). Also, corrective saccades ratio was 30.34 in patients with VS and 3.44 in patients with central vestibular system tumors (P= 0.007). Conclusion: The results of VHIT improved differential diagnosis of peripheral vestibular system tumors from central vestibular system tumors. [ABSTRACT FROM AUTHOR]

Diabetes is a highly prevalent metabolic disease with macrovascular and microvascular complications. Insulin resistance plays a major role in the pathogenesis of atherosclerosis in type 2 diabetes patients. The risk of atherosclerosis progress in diabetes is of 2-4 orders of magnitude. Early atherosclerosis can be detected by carotid intima-media thickness (cIMT) ultrasonography. There is an inverse relationship between intima-media thickness and physical activity. The aim of this study was to investigate the effects of an 8-week aerobic exercise program on the vascular structure in different segments of the carotid artery. This study was a randomized control trial. Thirty individuals were selected out of 642 volunteers who fulfilled the inclusion criteria. They were randomly divided into aerobic exercise and control groups by a block randomization method. This study was carried out during May-October 2016 in Iran. The aerobic protocol comprised of 24 sessions of aerobic exercise on a treadmill for 30 min per session, 3 days a week. The intensity of the training protocol was 50-70% of the patient’s max heart rate. Measurements of vascular parameters were evaluated by the same person, before and after the 24-session intervention. There were no significant differences between anthropometric, sex, age, diabetic history, and cardiac ejection fraction, compared to baseline characteristics. Intima-media thickness (0.52 ± 0.12), intima-media/lumen (0.07 ± 0.02) in bulb carotid, common carotid, and internal carotid, as well as bulb wall, were reduced significantly in the training group compared to the control group after 8 weeks (p < 0.05). Twenty-four sessions of aerobic exercise improved vascular parameters in type 2 diabetics. [ABSTRACT FROM AUTHOR]

Forward head posture (FHP) is considered to be one of the most common postural disorders in the spinal column. Recently studies have reported impaired proprioception to be one of the results of prolonged FHP. Studies have suggested that vibration stimulus is capable of improving joint proprioception. Thus the aim of this study was to investigate the effects of one session of whole body vibration (WBV) training in standing position on cervical joint position sense in individuals with FHP. Thirty (12 females and 18 males) individuals with FHP were randomly assigned to a vibration (experimental) or non-vibration (control) group. The vibration group experienced 5 sets of WBV while holding the head and neck in retraction. The non-vibration group held the same position for the same time without any vibration. Four target angles were established to assess the absolute and constant joint position sense (JPS) errors for each individual. Results showed significant reduction (P<0/05) in JPS absolute errors in 2 target angles in the vibration group when compared to the non-vibration group. It was concluded that relative improvement in cervical JPS could be achieved when adding additional sensory input from WBV stimulus to the head and neck retraction exercise. [ABSTRACT FROM AUTHOR]