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The impact of a sense of belonging (SOB) on life satisfaction is acknowledged. However, research focusing on this dynamic within higher education is sparse. Additionally, the mechanisms underlying this association warrant further investigation. This study aimed to determine the serial mediation effects of loneliness and depression on the relationship between SOB and life satisfaction among college students. A cross-sectional survey was conducted with 345 college students (M age  = 22.16, SD = 4.48). The survey instruments included the Satisfaction with Life Scale (SWLS), the Social and Emotional Loneliness Scale for Adults (SELSA-S), the Depression, Anxiety, and Stress Scale (DASS), and the Institutional Integration Scale (IIS). The serial mediation effects were analyzed utilizing Model 6 of Hayes' PROCESS macro in SPSS. The results showed that the sense of belonging to the university had no direct effect on life satisfaction (Effect = 0.105, 95 % CI: -0.076 to 0.286). Loneliness and depression serially mediated the relationship between a sense of belonging to the university and life satisfaction (Effect = 0.029, 95 % CI: 0.012 to 0.051). Depression independently mediated the association between SOB and life satisfaction (Effect = 0.160, 95 % CI: 0.10 to 0.221), whereas loneliness did not serve as a significant independent mediator in the relationship between belonging to the university and life satisfaction (Effect = 0.014, 95 % CI: -0.006 to 0.039). This research enhances comprehension of the fundamental processes linking students' sense of belonging (SOB) with their life satisfaction, offering valuable perspectives for academic institutions to develop strategies to elevate university students' well-being., Competing Interests: Declaration of competing interest The authors declare that they have no known competing financial interests or personal relationships that could have appeared to influence the work reported in this paper., (Copyright © 2024 The Author(s). Published by Elsevier B.V. All rights reserved.)

Background: In developing nations, myocardial infarction (MI) remains a significant contributor to deaths from sudden cardiac arrest, with diet playing a key role in its incidence through oxidative stress mechanisms. Although the connection between the Dietary Antioxidant Index (DAI) and cardiovascular diseases has been demonstrated in some studies, the relationship between DAI and MI has not been extensively explored. Therefore, this research aims to investigate this association., Methods: We conducted a nested case-control study involving 156 MI cases and 312 healthy controls, utilizing data from the Fasa Adults Cohort Study (FACS), a population-based study of individuals aged 35-70 residing in Fasa, Iran, with 11,097 participants included at baseline. The DAI was determined by normalizing the intake values of six dietary vitamins and minerals, adjusting by subtracting the global mean, and then dividing by the global standard deviation. MI diagnosis was established by an experienced cardiologist using electronic medical records. Conditional logistic regression was employed to examine the association between DAI and MI., Results: There were no significant differences between the case and control groups in terms of age (P = 0.96), gender distribution (P = 0.98), and education level (P = 0.38). In a multiple conditional logistic regression analysis, after adjusting for key variables-including body mass index (BMI), smoking status, education level, and serum levels of triglycerides (TG), low-density lipoprotein (LDL), high-density lipoprotein (HDL), total cholesterol (TC), fasting blood sugar (FBS), saturated fatty acids (SFA), and polyunsaturated fatty acids (PUFA)-an inverse association was found between DAI and the risk of myocardial infarction (MI) [adjusted Odds Ratio (Adj OR) = 0.88, 95% Confidence Interval (CI): 0.85-0.92; P < 0.001]., Conclusions: This study highlights the crucial role of the DAI in reducing the risk of myocardial infarction. Promoting diets rich in antioxidants presents a straightforward and effective strategy for MI prevention and the promotion of cardiovascular health, underscoring the novelty and significance of this research in dietary approaches to disease prevention., (© 2024. The Author(s).)

Background and Aim: One of the leading reasons that patients, particularly older persons, are brought to the orthopedic emergency room is a fracture at the end of the radius. In this study, a new traction method for distal radius fractures was compared with manual reduction., Methods: The census method was used in this clinical trial to study 45 patients (46 hands) who were referred to Hamedan Besat Hospital in 2021. Patients were randomly assigned to two groups. The manual reduction (pressure and traction by an assistant and a doctor) method was implemented in Group A, and the new traction procedure (pressure and traction by hardware or a device) was performed in Group B. The radiographic results of reduction in both groups were investigated and compared immediately and in the first and 6 weeks after surgery., Results: The following results were observed in the new and manual groups in the sixth week after surgery: average volar tilt: 4.19 ± 3.79 and 4.08 ± 3.88 ( p  = 0.926), radial angulation: 2.18 ± 1.27 and 2.21 ± 1.35 ( p  = 0.934), radial shortening: 10.52 ± 0.65 and 10.56 ± 0.68 ( p  = 0.828), radial inclination: 22.52 ± 2.46 and 22.71 ± 2.01 ( p  = 0.787), dorsal angulation: -5.89 ± 0.33 and 5.22 ± -1.91 ( p  = 1.00), ulnar variance: 1.66 ± 0.90 and 1.67 ± 0.81 ( p  = 0.958), and average pain score: 2.40 ± 0.68 and 2.47 ± 0.73 ( p  = 0.737)., Conclusion: The new reduction procedure with hardware in patients with distal radius fractures showed the same effect as the traditional method based on pressure and traction by the assistant and doctor in terms of radiographic changes and pain score of the fracture site., Competing Interests: The authors declare no conflict of interest., (© 2024 The Authors. Health Science Reports published by Wiley Periodicals LLC.)

Background: The global phenomenon of population aging requires an understanding of the factors influencing the health of the elderly becomes imperative. We aimed to focus on South Korea, a nation set to become an aging society by 2025. The study examined the influence of regular exercise and exercise types on the health of the elderly with particular attention to South Korea's unique sociodemographic context., Methods: We targeted individuals aged 50 yr and above. The study was conducted through online surveys from August to September 2023. Utilizing Logistic Regression analysis and Chi-Square tests, the research explored correlations, trends, and influencing factors affecting elderly exercise behaviors, encompassing demographic variables, health status, and exercise types., Results: The analysis of demographic characteristics revealed that marital status, education level, and financial status displayed diverse representations within the sample. Comparisons between health status and exercise groups suggested potential health benefits for the Regular Exercise group. Logistic Regression analysis identified significant influences of gender and financial status on regular exercise engagement. Additionally, a strong relationship between health status and exercise preferences, notably strength training, emerged., Conclusion: Regular exercise and exercise types benefit elderly individuals. Men and those with better financial status are more likely to exercise regularly. Strength training emerges as a significant contributor to better health across various health status categories. Policymakers and healthcare professionals should consider these insights to develop targeted interventions for promoting healthy aging, acknowledging the cultural and socioeconomic factors of South Korea's aging population., (Copyright© 2024 Yi et al. Published by Tehran University of Medical Sciences.)

Transcranial direct current stimulation (tDCS) is a promising treatment for post-traumatic stress disorder (PTSD). However, not all patients respond to this type of treatment. The first aim of present study was to examine efficacy of tDCS for PTSD, depression, anxiety, and anhedonia in patients with PTSD. The second aim of this study was to examine the demographic, clinical, and psychological factors that may predict response to tDCS. In this open-label study, 103 PTSD patients underwent 10 sessions of tDCS (2 mA, 20 min). The anodal and cathodal electrodes were placed over the left dorsolateral prefrontal cortex (DLPFC; F3) and right supra-orbital (FP2) Respectively. Clinical outcome measures included Posttraumatic the Stress Disorder Checklist for DSM-5 (PCL-5), the Beck Depression Inventory (BDI-II), the Beck Anxiety Inventory (BAI), and the Snaith-Hamilton Pleasure Scale (SHAPS). There was an overall significant improvement in symptoms of PTSD, depression, anxiety, and anhedonia from pre- to post-treatment. Results also revealed that non-responders had higher severity at baseline for depression, anxiety, and anhedonia. However, higher severity of depression and anhedonia at baseline predicted response status, with higher severity associated with greater likelihood of non-response. tDCS of the left dLPFC and right supra-orbital appears to have a positive effect in reducing PTSD and related symptoms. These initial results could have an important influence on the adoption of anodal tDCS over the left DLPFC for PTSD, by enabling the early identification of patients who respond to tDCS., (Copyright © 2023 Elsevier B.V. All rights reserved.)

Purpose: Despite to high burden of road traffic injuries (RTIs), the RTI epidemiology has received less attention with rare investments on robust population cohorts. The PERSIAN Traffic Safety and Health Cohort (PTSHC) was designed to assess the potential causal relationships between human factors and RTI mortality, injuries, severity of the injury, hospitalised injury, violation of traffic law as well as offer the strongest scientific evidence., Participants: The precrash cohort study is carried out in four cities of Tabriz, Jolfa, Shabestar and Osku in East Azerbaijan province located in northwest Iran. The participants were people who sampled among the general population. The cluster sampling method was used to enrol the households in this study. The PTSHC encompasses a wide and comprehensive range and types of data. These include not only the common cohort data collections such as medical examination measures, previous medical history, bio assays and behavioural assessments but also includes data obtained using advanced novel technologies, for example, electronic travel monitoring, driving simulation and neuro-psycho-physiologic laboratory assessments specifically developed for traffic health field., Findings to Date: A total of 7200 participants aged 14 years and above were enrolled at baseline, nearly half of them being men. The mean age of participants was 39.2 (SD=19.9) years. The majority of participants (55.4%) belonged to the age group of 30-56 years. Currently, approximately 1 200 000 person-measurements have been collected., Future Plans: PSTHC will be used to determine the human-related risk factors by adjusting for the vehicle and land-use-related factors. Therefore, a lot of crashes can be prevented using effective interventions. Although this cohort provides valuable data, it is planned to increase its size to achieve the highest level of evidence with higher generalisability. Also, according to the national agreement this cohort is going to be extended to several geographical regions in second decade., Competing Interests: Competing interests: None declared., (© Author(s) (or their employer(s)) 2024. Re-use permitted under CC BY-NC. No commercial re-use. See rights and permissions. Published by BMJ.)

Background and Aims: Chronic obstructive respiratory diseases (COPD) not only cause damage to the respiratory system as well as the heart and blood vessels of the patient but also have a direct effect on the condition of the musculoskeletal system. The risk of falling is increasing due to dysfunction of the joints as well as aging, which occurs frequently in this population. Gait deficits are known as an important risk factor for falls. This research aimed to investigate the gait of COPD patients compared to healthy people to gain a better understanding of the reasons for falls., Methods: Twenty patients with COPD and 20 age and BMI-matched healthy individuals were included in this study. Sixteen markers were applied to the lower body of the subjects. Spatio-temporal, kinematic, and maximum moment parameters were measured in different phases in three lower body joints, including the hip, knee, and ankle., Results: The results showed that all spatio-temporal parameters in patients were significantly lower than in healthy people. The ankle angle in the sagittal plane at initial contact was significantly difference ( p  = 0.03). As well as, in the frontal plane the hip angle in the mid-stance showed a significant difference ( p  = 0.02). There was also a significant difference in maximum hip moment in the sagittal plane between the two groups ( p  = 0.01)., Conclusion: The larger hip angle of the patients can be related to the balance problems in the mediolateral direction. The moment showed a significant difference in the hip joint. Since the hip muscles are directly in a synergistic relationship with the trunk muscles, it seems the performance of these muscles is likely to be seriously damaged due to respiratory diseases., Competing Interests: The authors declare no conflict of interest., (© 2024 The Authors. Health Science Reports published by Wiley Periodicals LLC.)

This meta-analysis aimed to evaluate the effects of flaxseed supplementation on weight loss, lipid profiles, high-sensitivity C-reactive protein (hs-CRP), and glucose levels in patients with coronary artery disease (CAD). A systematic search was performed using various online databases, including Scopus, PubMed, Web of Science, EMBASE, and Cochrane Library, to identify relevant randomized controlled trials (RCTs) until June 2023. To evaluate heterogeneity among the selected studies, the Q-test and I 2 statistics were employed. Data were combined using either a fixed- or random-effects model and presented as a weighted mean difference (WMD) with a 95% confidence interval (CI). Of the 428 citations, six RCTs were included. The pooled results did not show significant changes in the WMD of lipid factors (high-density lipoprotein cholesterol, triglycerides (TG), low-density lipoprotein cholesterol, and total cholesterol) following flaxseed intake. However, after performing a sensitivity analysis to determine the source of heterogeneity, flaxseed supplementation resulted in a significant decrease in TG levels (WMD = -18.39 mg/dL; 95% CI: -35.02, -1.75). Moreover, no significant differences were observed in either weight or BMI following flaxseed intake. However, the circulating levels of fasting blood glucose (WMD = -8.35 mg/dL; 95% CI: -15.01, -1.69, p = .01) and hs-CRP (WMD = -1.35 mg/L; 95% CI: -1.93, -0.77, p < .01) significantly decreased after the intervention. Flaxseed supplementation was associated with lowering FBS, hs-CRP, and TG levels but did not affect weight loss parameters and other lipid markers in CAD., (© 2024 The Authors. Clinical Cardiology published by Wiley Periodicals, LLC.)

Background: Anhedonia and rumination are mental disorders' transdiagnostic features but remain difficult to treat. Transcranial direct current stimulation (tDCS) is a proven treatment for depression, but its effects on anhedonia and rumination and whether anhedonia and rumination can be used as a predictive biomarker of treatment response is not well known. This study aimed to investigate the tDCS efficacy and identify the predictive role of anhedonia and rumination in response to tDCS in patients with MDD., Methods: 182 patients received 10 tDCS sessions delivered at 2 mA to left (anode) dorsolateral prefrontal cortex (DLPFC). Hamilton Rating Scale for Depression (HRSD-17), Snaith-Hamilton Pleasure Scale (SHAPS), and the 10-item Ruminative Response Scale (RRS-10) was administered to patients with MDD before treatment, following it, and after two weeks of tDCS., Results: There was an overall significant improvement in anhedonia from pre- to post-treatment. Regression analyses revealed that responders had higher baseline anhedonia and rumination (reflective pondering) scores. We found that the reduction in HRSD scores after tDCS was significantly associated with anhedonia's baseline values while no relation was found between baseline rumination and tDCS treatment response., Conclusion: These results provide new evidence that pronounced anhedonia may be a significant clinical predictor of response to tDCS. Patients with severe or low baseline rumination had an equal chance of achieving clinical response. Prospective tDCS studies are necessary to validate the predictive value of the derived model., Competing Interests: Declaration of competing interest None., (Copyright © 2023 Elsevier B.V. All rights reserved.)

Background: Diabetic cardiomyopathy is defined as an independent entity with a specified pathological progression from diastolic dysfunction with preserved ejection fraction to overt heart failure. Myocardial perfusion imaging (MPI) with gated-single-photon emission computed tomography (G-SPECT) has been introduced as a feasible tool to evaluate left ventricular (LV) diastolic function. The aim of this study was to investigate the characteristics of diastolic parameters derived from G-SPECT MPI in diabetic patients compared to patients at very low risk of coronary artery disease (CAD) and with no other CAD risk factors., Methods: This cross-sectional study was performed on patients referred to the nuclear medicine department for G-SPECT MPI. Demographic and clinical data, as well as medical history, were extracted from a digital registry system including 4447 patients. Then, two matched groups of patients with only diabetes as cardiac risk factor ( n  = 126) and those without any identifiable CAD risk factors ( n  = 126) were selected. Diastolic parameters of MPI, including peak filling rate, time to peak filling rate, mean filling rate at the first third of diastole and second peak filling rate, were derived using quantitative software for eligible cases., Results: The mean age of the diabetic and nondiabetic groups was 57.1 ± 14.9 and 56.7 ± 10.6 years, respectively ( P  = 0.823). Comparison of quantitative SPECT MPI parameters between the two groups showed a statistically significant difference only in total perfusion deficit scores, whereas none of the functional parameters, including diastolic and dyssynchrony indices and the shape index, were significantly different. There were also no significant differences in diastolic function parameters between diabetes and nondiabetes patients in the age and gender subgroups., Conclusion: Based on the G-SPECT MPI findings, there is a comparable prevalence of diastolic dysfunction in patients with only diabetes as a cardiovascular risk factor and low-risk patients with no cardiovascular risk factors in the setting of normal myocardial perfusion and systolic function., (Copyright © 2023 Wolters Kluwer Health, Inc. All rights reserved.)

Objective: This study was aimed to determine the relationship between job stress and work-related quality of life (WRQoL) among emergency medical technicians (EMTs) in Lorestan province, Western Iran., Design: This was a cross-sectional study., Methods: Totally 430 EMTs who had been engaged in their respective units for more than 6 months from all emergency facilities in Lorestan province were selected using single stage cluster sampling method. Data were collected from April to July 2019 using two standard questionnaires: job stress (Health and Safety Executive (HSE)) and WRQoL. The OR with 95% CI was used to declare the statistical association (p≤0.05)., Results: All participants were exclusively males, with a mean age of 32±6.87 years. The overall average score of job stress using the HSE scale was 2.69±0.43; while the overall quality of working life score was 2.48±1.01. The type of working shift was found to have a significant impact on the HSE-average score (F(3,417)=5.26, p=0.01); and on the WRQoL-average score (F(3,417)=6.89, p<0.01)., Conclusion: Two-thirds of EMTs working in governmental hospitals had job stress and a low quality of work-related life. Additionally, work shift was statistically significant associated with EMTs' job stress and WRQoL., Competing Interests: Competing interests: None declared., (© Author(s) (or their employer(s)) 2023. Re-use permitted under CC BY-NC. No commercial re-use. See rights and permissions. Published by BMJ.)

Background: Concerns about the role of chronically used medications in the clinical outcomes of the coronavirus disease 2019 (COVID-19) have remarkable potential for the breakdown of non-communicable diseases (NCDs) management by imposing ambivalence toward medication continuation. This study aimed to investigate the association of single or combinations of chronically used medications in NCDs with clinical outcomes of COVID-19., Methods: This retrospective study was conducted on the intersection of two databases, the Iranian COVID-19 registry and Iran Health Insurance Organization. The primary outcome was death due to COVID-19 hospitalization, and secondary outcomes included length of hospital stay, Intensive Care Unit (ICU) admission, and ventilation therapy. The Anatomical Therapeutic Chemical (ATC) classification system was used for medication grouping. The frequent pattern growth algorithm was utilized to investigate the effect of medication combinations on COVID-19 outcomes., Findings: Aspirin with chronic use in 10.8% of hospitalized COVID-19 patients was the most frequently used medication, followed by Atorvastatin (9.2%) and Losartan (8.0%). Adrenergics in combination with corticosteroids inhalants (ACIs) with an odds ratio (OR) of 0.79 (95% confidence interval: 0.68-0.92) were the most associated medications with less chance of ventilation therapy. Oxicams had the least OR of 0.80 (0.73-0.87) for COVID-19 death, followed by ACIs [0.85 (0.77-0.95)] and Biguanides [0.86 (0.82-0.91)]., Conclusion: The chronic use of most frequently used medications for NCDs management was not associated with poor COVID-19 outcomes. Thus, when indicated, physicians need to discourage patients with NCDs from discontinuing their medications for fear of possible adverse effects on COVID-19 prognosis., Competing Interests: The authors declare that the research was conducted in the absence of any commercial or financial relationships that could be construed as a potential conflict of interest., (Copyright © 2023 Malekpour, Abbasi-Kangevari, Shojaee, Saeedi Moghaddam, Ghamari, Rashidi, Namazi Shabestari, Effatpanah, Nasehi, Rezaei and Farzadfar.)

Wild pomegranate is a valuable edible species in the plant ecosystem of the Hyrcanian forests and the northern plains of the Caspian coast in Iran. The genetic diversity of these wild pomegranates can be effective in pomegranate breeding programs and germplasm conservation. In the present study, morphological diversity in 103 wild pomegranates ( Punica granatum L . var. spinosa ) in the northeastern area of Iran was studied using 46 traits related to trees, flowers, and fruits. The results showed that the fruit weight ranged from 17.93 to 99.9 g with an average of 48.92 g, the total aril weight ranged from 0.54 g to 64.78 g with an average of 24.25 g, and the weight of 100 arils was between 4.89 and 46.21 with an average of 13.79. The fruit cracking percent, crown shape, aril juiciness, calyx, and corolla colors show a high coefficient of variation (CV > 70%). Based on PCA results, fruit weight and total aril weight, peel weight, and fruit length and diameter were important on determining differences among accessions. In biplot analysis, genotype distribution was determined by two main factors. In cluster analysis, the studied accessions were divided into two different major clusters and two subclusters in each one. The results showed a high diversity of important pomological traits in wild pomegranates such as fruit weight, fruit cracking percent, crown shape, total aril weight, aril juiciness corolla, and calyx color that can be used in breeding programs to improve pomegranate juice quality and marketability., Competing Interests: The authors have no conflict of interest., (© 2022 The Authors. Food Science & Nutrition published by Wiley Periodicals LLC.)

Background: Urban parks play a noticeable role in city areas for making connections between nature and the residents of cities, especially from a mental health perspective. This paper investigated how the number and types of urban parks impact city residents' mental health., Method: This study used the data collected by the Community Health Survey in Seoul, South Korea in 2020 (n=22915). The type and number of local parks were categorized based on each district, and three variables of mental health were selected, including 'subjective health awareness', 'stress awareness' and 'depression rate'. Correlation and interaction analyses were conducted to explore the relationship between variables., Result: The data indicated that both the quantity and types of the urban parks were associated with mental health of the residents. Positive mental health is likely to be associated with higher density of local parks in a district. It seems that parks characterized by children's activity and have nature-focused design, are more effective in changing the mental health of residents., Discussion: The research demonstrates a positive relationship between the quantity of urban parks and mental health in the scale of city districts. However, such a correlation can differ based on the type of parks, as well as the quantity of greenery in an area., (Copyright © 2022 Choi et al. Published by Tehran University of Medical Sciences.)

The knee unloader brace can change loading on knee which may be effective in reducing symptoms and progression of disease in people with knee osteoarthritis. The purpose of this study was to evaluate the effect of a new knee brace during walking in a patient with medial compartment knee osteoarthritis. Two brace types were used: new brace and conventional brace. A pneumatic cuff of novel brace was fitted in the bottom of the medical slipper that was connected to the cuff section of the knee through the tube. After the knee brace is deployed, its force can vary in different stages of the gait. During the heel strike, the weight of the cuff is compressed on the floor, causing the air to flow inside it and entering the volume of air into the knee pad. The results of using this pneumatic knee brace compared with conventional knee braces on a patient showed that in both cases, the open and closed palatal pump, the adduction moment and ROM was decreased in the stance phase. But the three-point knee pressure, however, was less effective in reducing the adduction moment but also reduced the knee ROM. Using novel brace can eliminate the patient's need for painful and costly surgery to reduce the symptoms of osteoarthritis., Competing Interests: None, (Copyright: © Journal of Biomedical Physics and Engineering.)

Background: Cystic echinococcosis (CE) is one of the most important parasitic infections in subgroup seven common neglected diseases of humans and animals. It is in the list of 18 neglected tropical diseases of the WHO. We aimed to analyze the situation of the disease in Iran using Geographical Information System (GIS) and satellite data analysis., Methods: The data obtained from the Ministry of Health and Medical Education, Tehran, Iran and other related centers from 2009 to 2018 were analyzed using GIS. Then, the spatial distribution maps of the disease were generated, and the hot spots of the disease in Iran were determined using spatial analysis of ArcGIS10.5 software. Geographically weighted regression (GWR) analysis in ArcGIS10.5 was used to correlate the variables affecting the disease including temperature, relative humidity, normalized different vegetation index (NDVI) and incidence of hydatidosis. Data analysis was performed by Linear regression analysis and SPSS 21 software using descriptive statistics and chi-square test., Results: Zanjan, Khorasan Razavi, North Khorasan, Chaharmahal Bakhtiari, Hamedan, Semnan, and Ardabil provinces were the hot spots of CE. The results of geographical weighted regression analysis showed that in Khorasan Razavi, North Khorasan, Chaharmahal Bakhtiari, Hamedan, Semnan, Ardabil, Zanjan, Qazvin, and Ilam provinces, the highest correlation between temperature, humidity, vegetation density and the incidence of hydatidosis was observed ( P <0.001)., Conclusion: The use of maps could provide reliable estimates of at-risk populations. Climatic factors of temperature, humidity, NDVI had a greater impact on the probability of hydatidosis. These factors can be an indicator used to predict the presence of disease. Environmental and climatic factors were associated with echinococcosis., Competing Interests: Conflict of interest The authors declare that there is no conflict of interest., (Copyright © 2022 Parandin et al. Published by Tehran University of Medical Sciences.)

Background: The COVID-19 pandemic and social distancing measures have limited outdoor activities for many people, including university students who live inside the campus and far from their families. We investigated if and how the fear of COVID-19 had impacted visiting green areas and consequently the quality of life., Methods: The assessments were taken through a questionnaire-based survey of the university students living inside the campus in two universities (Konkuk and Sejong universities) in Seoul, South Korea in 2021 (n=255). Measuring three variables, the participants were asked to self-estimate their fear of COVID-19 and quality of life during the pandemic, and the time and frequency of the park visit. Structural equation modeling (SEM) and confirmatory factor analysis (CFA) were conducted to explore the potential relationship between the three main observed variables., Results: In the case of the campus students, visiting the green area cannot play a mediating impact on the effect of the COVID-19 fear and quality of life. Likewise, the data did not support the effect of COVID-19 fear on the quality of life for this group of students, however, significant correlations were found between the COVID-19fear and visiting green spaces ( P <0.05) (positive effect on visiting, and negative effect on the time of visit)., Conclusion: Students perceived not a considerable improvement in their quality of life after visiting green areas. It might be due to the fear of staying outdoor for a long time (frequency) during the pandemic, and students' lifestyles. However, the quality of life for the students is likely to be influenced by other factors, rather than the fear of COVID-19., Competing Interests: Conflicts of interest The authors declare that there is no conflict of interest., (Copyright © 2022 Choi et al. Published by Tehran University of Medical Sciences.)

Breast cancer is the most common invasive cancer in women and the second leading cause of cancer death in women after lung cancer. The purpose of this study is a targeted delivery toward in vitro (on MCF7 and 4T1 breast cancer cell lines) through niosomes-based nanocarriers. To this end, different bioactive molecules, including hyaluronic acid (HA), folic acid (FA), and polyethylene glycol (PEG), were used and compared for surface modification of niosomes to enhance endocytosis. FA-functionalized niosomes (Nio/5-FU/FA) were able to increase cell cytotoxicity and reduce cell migration and invasion compared to PEG-functionalized niosomes (Nio/5-FU/PEG), and HA-functionalized niosomes (Nio/5-FU/HA) groups in MCF-7 and 4T1 cell lines. Although the Nio/5-FU/PEG and Nio/5-FU/HA demonstrated MCF7 cell uptake, the Nio/5-FU/FA exhibited the most preponderant endocytosis in pH 5.4. Remarkably, in this study 5-FU loaded niosomes (nonionic surfactant-based vesicles) were decorated with various bioactive molecules (FA, PEG, or HA) to compare their ability for breast cancer therapy. The fabricated nanoformulations were readily taken up by breast cancer cells ( in vitro ) and demonstrated sustained drug release characteristics, inducing cell apoptosis. Overall, the comprehensive comparison between different bioactive molecules-decorated nanoniosomes exhibited promising results in finding the best nano formulated candidates for targeted delivery of drugs for breast cancer therapy., Competing Interests: The authors declare that the research was conducted in the absence of any commercial or financial relationships that could be construed as a potential conflict of interest., (Copyright © 2022 Rezaei, Rezaei, Karimifard, Mahmoudi Beram, Dakkali, Heydari, Afshari-Behbahanizadeh, Mostafavi, Bokov, Ansari, Farasati Far, Akbarzadeh and Chaiyasut.)

Background: Cerebral palsy (CP) is a non-progressive encephalopathy before, during, or after childbirth with almost the most common type, i.e. spastic diplegic, leading to a frequent walking problem, In-toeing. Orthoses can reduce the consequences of CP., Objective: This study aimed to evaluate the effect of combining twister wrap orthoses (TWO) with high-top shoes on the balance parameters of children with spastic diplegic CP., Material and Methods: In this quasi-experimental study, twenty children (aged 6.8 ± 0.5 years) with spastic diplegic CP with in-toeing gait participated. The tests were conducted in three conditions: 1) in bare-foot, 2) with high-top shoes, and 3) with high-top shoes plus TWO and the orthoses effects on balance parameters were compared., Results: High-top shoes positively decreased center of pressure (COP) sway in the anterior-posterior (AP) direction. Both high-top shoes and high-top shoes with TWO conditions compared to bare-foot conditions significantly improved standing balance by decreasing the ellipse area. Pairwise, wearing TWO and high-top shoes significantly reduced the COP sway in the medial-lateral (ML) and AP directions with a significant difference between using the combined orthoses and the shoe without TWO in ML of COP displacement., Conclusion: High-top shoes alone and the combination of high-top shoes with TWO conditions may enhance the stability of children with spastic diplegia more than barefoot. Although the use of combined orthoses induced significant improvement in the ML direction of COP displacement., (Copyright: © Journal of Biomedical Physics and Engineering.)

Background: Provided that COVID-19 pandemic has led to mental wellbeing disorders for city dwellers, and given that there is a significant association between outdoor activities and mental health, this paper investigated how the frequency of walking during the pandemic contributes to the immediate and subsequent 'mood'., Methods: A longitudinal data collection method was adopted to verify the 'mood' of the participants before and after walking. The survey was conducted with 100 participants in a walking path in Shiraz, Iran, on Jan 2021. The quantitative analysis methods were performed in SPSS to examine the mental wellbeing outcomes of walking in the outdoor walking path when considering the psychological impacts of the pandemic and the quantity., Results: The result affirms the positive contribution of walking in the improvement of mental-wellbeing-mood during the pandemic; though, such a mood boost is in a direct relationship with the quantity of the activity within a week. Moreover, other factors can play a significant role, including the 'mood before walking', and the age of the participants., Conclusion: It is likely that encouraging people to consider walking as their routine activity can lead to several positive consequences on mental wellbeing since walking as a basic outdoor activity during the pandemic can contribute on the mood. ., Competing Interests: Conflicts of interest The authors declare that there is no conflict of interest., (Copyright © 2021 Heidarzadeh et al. Published by Tehran University of Medical Sciences.)

Background: Assessment is a necessary part of training postgraduate medical residents. The implementation of methods located at the "shows how" level of Miller's pyramid is believed to be more effective than previous conventional tools. In this study, we quantitatively compared electronic and conventional methods in assessing ophthalmology residents., Methods: In this retrospective study, eight different conventional methods of assessment including residents' attendance, logbook, scholarship and research skills, journal club, outpatient department participation, Multiple Choice Question (MCQ), Objective Structured Clinical Examination (OSCE), and professionalism/360-degree (as one complex) were used to assess 24 ophthalmology residents of all grades. Electronic media consisting of an online Patient Management Problem (e-PMP), and modified electronic OSCE (me-OSCE) tests performed 3 weeks later were also evaluated for each of the 24 residents. Quantitative analysis was then performed comparing the conventional and electronic assessment tools, statistically assessing the correlation between the two approaches., Results: Twenty-four ophthalmology residents of different grades were included in this study. In the electronic assessment, average e-PMP scores (48.01 ± 12.40) were much lower than me-OSCE (65.34 ± 17.11). The total average electronic score was 56.67 ± 11.28, while the total average conventional score was 80.74 ± 5.99. Female and male residents' average scores in the electronic and conventional method were (59.15 ± 12.32 versus 83.01 ± 4.95) and (55.19 ± 10.77 versus 79.38 ± 6.29), respectively. The correlation between modified electronic OSCE and all conventional methods was not statistically significant (P-value >0.05). Correlation between e-PMP and six conventional methods, consisting of professionalism/360-degree assessment tool, logbook, research skills, Multiple Choice Questions, Outpatient department participation, and Journal club active participation was statistically significant (P-value < 0.05). The overall correlation between conventional and electronic methods was significant (P-value = 0.017)., Conclusion: In this study, we conclude that electronic PMP can be used alongside all conventional tools, and overall, e-assessment methods could replace currently used conventional methods. Combined electronic PMP and me-OSCE can be used as a replacement for currently used gold-standard assessment methods, including 360-degree assessment.

Transcranial direct current stimulation (tDCS) of the prefrontal cortex is known as a promising intervention in major depression disorder (MDD). However, limited information on predictors of therapeutic response to tDCS are available. This study aimed to investigate clinical and demographic predictors of therapeutic response in patients taking no medications. For this purpose, the required data were collected from 2 independent tDCS trials on 116 MDD patients. Accordingly, 84 patients underwent 10 sessions of 2 mA tDCS daily each one lasted for 20 min and 32 patients received 10 twice sessions of 2 mA tDCS daily each one lasted for 20 min. Anodal electrode was located over the left dorsolateral prefrontal cortex (DLPFC), and cathode was over the right supraorbital region. Depression symptoms and the underlying clinical dimensions were assessed using the Beck Depression Inventory (BDI-II) at baseline and after the tDCS treatment. Of the included 116 patients, 47.4% showed an antidepressant response. Results of logistic regression analysis showed that the reduction in BDI-II scores after tDCS was associated with the baseline values of cognitive-affective symptoms factor, loss of pleasure, loss of interest, and sleep problems. Pronounced sleep disturbances and cognitive-affective symptoms were identified as the potential clinical predictors of response to tDCS. However, more prospective tDCS studies are necessary to validate the predictive value of the derived model., (Copyright © 2021. Published by Elsevier Ltd.)

Competing Interests: Conflict of interest The authors declare that there is no conflict of interest.

Background: The fast-growing trend of urbanizations and the dwellers' stressful lifestyle in megacities has led to several drawbacks from the mental health perspective. Provided that there is a significant association between the green environment and mental health, we investigated different functions of a green roof from two perspectives of well-being and environment., Methods: After investigating on different functions of the green roof and classifying them into two sections, a self questionnaire survey was conducted in May 2020 on 100 citizens of the Seoul metropolitan area after, South Korea visiting the green roof. They were asked to clarify their perception of the different functions of green roof gardens. The statistical analysis was performed to show the differences in perception and how each variable can contribute to such differences., Results: The results illustrated a high satisfaction rate among the visitors of green roofs. The perception of the well-being functions was higher than those of environmental functions. However, age group can alter the perception significantly, as the senior citizens significantly perceived the well-being functions. In contrast, the awareness of the environmental functions was higher among the younger participants., Conclusion: Providing practical information about the ideal functions of green roofs, this study offered helpful insight for the planners who focus on society's general health and work in two different sections: developing the city landscape and mental health improvement., Competing Interests: Conflicts of interest The authors declare that there is no conflict of interest., (Copyright © 2021 Rezaei et al. Published by Tehran University of Medical Sciences.)

Lymphatic filariasis (LF) is an important neglected parasitic disease according to the World Health Organization. In this study, we aimed to determine the prevalence of human LF in Asia using a systematic review and meta-analysis approach. Records from 1990 to 2018 in reputable databases including PubMed, Science Direct, Embase, and Cochrane Library were searched using a panel of related keywords. All 48 countries of Asia were searched one by one in combination with the keywords. In all, 41,742 cases identified in this study were included in the analysis. According to our findings, the pooled prevalence of LF in Asia was estimated at 3% (95% CI: [1.7, 5.2]). There was no major trend in the cumulative prevalence of LF over time. Some countries in Asia including China, Japan, Vietnam, and South Korea succeeded in eliminating LF as a public health problem, but others still need to monitor the disease. Based on the initiative of the WHO starting in 2000, some countries in Asia succeeded in eliminating LF as a public health problem. Other countries have taken steps to eliminate the disease with variable degrees of success. These efforts might be affected by issues such as climate change.

The main purpose of this pilot study was to assess the regional diagnostic reference level (RDRL) of computed tomography (CT) examinations to optimise medical exposure in five pediatric medical imaging centers in Tehran, Iran where the most frequent CT examinations were investigated. For each patient, CT volume dose indexes (CTDIvol) and dose length product (DLP) in each group were recorded and their third quartile was calculated and set as RDRL. Pediatrics were divided into four age groups (<1; 1-5; 5-10 and 10-15 years). Then, the third quartile values for head, chest and abdomen-pelvic CTs were, respectively, calculated for each group in terms of CTDIvol: 21.3, 24.4, 24.2 and 36.3 mGy; 2.9, 3.2, 3.7 and 5.7 mGy; 3.7, 5.7, 6.3 and 6.8 mGy; and in terms of DLP: 322.2, 390.1, 424.9 and 694.1 mGy.cm; 53.1, 115.2, 145.3 and 167.6 mGy.cm and 128.7, 317.7, 460.2 and 813.8 mGy.cm. Finally, RDRLs were compared with other countries and preceding data in Iran. As a result, CTDIVOL values were lower than other national and international studies except for chest and abdomen-pelvic values obtained in Europe. Moreover, this matter applied to DLP so that other formerly reported values were higher than the present study but European values for chest and abdomen-pelvic scans and also Tehran studies conducted in 2012. Variation of scan parameters (tube voltage (kVp), tube current (mAs) and scan length), CTDIvol and DLP of different procedures among different age groups were statistically significant (P-value < 0.05). The variations in dose between CT departments as well as between identical scanners suggest a large potential for optimization of examinations relative to which this study provides helpful data., (© The Author(s) 2020. Published by Oxford University Press. All rights reserved. For Permissions, please email: journals.permissions@oup.com.)

Competing Interests: Conflict of interest The authors declare that there is no conflict of interest.

Background: Cysticercosis in among the neglected tropical disease caused by eating the egg of parasite Taenia solium . In this review, we aimed to verify the prevalence of human cysticercosis in different countries of Asia using systematic review and meta-analysis approach., Methods: Based of the protocol, reliable databases including PubMed, SCOPUS, Science Direct, Embase, and Cochrane Library from 1990-2018 were searched using a panel of keywords. Overall, 48 countries of Asia were searched in turn and data were analyzed using a category of statistical tests., Results: Out of 28 included studies, 586175 samples were collected and included in the data analysis. Based on the meta-analysis results, the overall pooled percent of cysticercosis was estimated 3.8% (95% CI: [2.0, 7.0]). According to the result of heterogeneity statistics including I-squared, chi-square, and tau-squared, it was statistically significant (Tau2 = 2.94, chi2 = 12733.31, P <0.001, I2 = 100%) therefore a random effect model was used to handle the heterogeneity of studies. To evaluate the trend of cysticercosis over the time, Cumulative meta-analysis was performed and the result showed that there was a minor upward tendency in the prevalence of cysticercosis over the time., Conclusion: Although, considering the religious culture and food habits in Asia, we might have expected to witness a low prevalence of human cysticercosis, but we noticed more or less significant infection in some countries of the region. Regarding the new feature of immigration and travel between countries, all authorities are advised to take measures on controlling and monitoring the disease., Competing Interests: Conflict of interest The authors declare that there is no conflict of interests., (Copyright© Iranian Public Health Association & Tehran University of Medical Sciences.)

Background: The Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) epidemic broke out in December 2019 and is now characterized as a pandemic. Effective control of this infectious disease requires access to diagnostic techniques, for both case finding and epidemic size estimation. The molecular technique is routinely used worldwide. Although it is the "standard" case detection and management method, it has its own shortcomings. Thus, some easy-to-use rapid serological tests have been developed., Methods: One hundred and fourteen positive RT-PCR-diagnosed patients were tested by VivaDiag Kit, a brand of rapid serological kits available in hospitals affiliated to Tehran University of Medical Sciences (TUMS), Tehran, Iran. Frozen serum specimens taken from healthy people in summer and fall 2019 were also tested as negative controls., Results: Test sensitivity was 47.9% (95% confidence interval [CI]: 38.8-56.9) for IgM and 47.0% (95% CI: 38.0-56.0) for IgG. There was no difference between IgG and IgM seropositivity except in one case. Specificity was calculated as 99.0% (95% CI: 96.4-99.9) for IgM and of 100.0% (95% CI: 0.98.2-100.0) for IgG. Sensitivity was higher in men and older participants., Conclusion: This test can be used for epidemiological investigations, especially for the estimation of the level of infection in the community, after it is properly corrected for sensitivity and specificity. The low sensitivity could be attributed to the technical limitations of the kit or low levels of antibodies after infection. The different sensitivity in age and sex groups supports the hypothesis that different people show different immune responses to this virus., (© 2020 The Author(s). This is an open-access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/4.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.)

Objectives: The study systematically reviewed the effectiveness of pharmacological treatments alone or combined with brief cognitive-behavioural therapy (BCBT) for treating Iranian amphetamine abusers. The secondary aim was to review the efficacy of BCBT alone or combined with pharmacological treatments for treating amphetamine abusers in the world., Evidence Acquisition: Published trials were considered for inclusion. The review was conducted based on the Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines. Web of Science, MEDLINE (via PubMed), Cochrane Central Register of Controlled Trials, Cochrane Drugs and Alcohol Group's Specialised Register of Trials, Embase, CINAHL, Scopus, PsychINFO, Iran Medex, Magiran and the Scientific Information Database were searched (January 2001 to March 2019). The reference lists of included studies were hand searched for more information. A systematic literature search in eight databases produced 10 trials., Results: Risperidone reduced positive psychotic symptoms while aripiprazole reduced negative psychotic symptoms. Methylphenidate reduced craving and depression compared with placebo. Topiramate reduced addiction severity and craving for methamphetamine abuse compared with placebo. Buprenorphine reduced methamphetamine craving more than methadone. Haloperidol and risperidone reduced psychosis. Riluzole reduced craving, withdrawal, and depression compared with placebo. Abstinence from amphetamine or reduction in amphetamine abuse was confirmed in four BCBT studies and one study which applied BCBT with a pharmacological treatment which were stable between two and 12-months. Other changes in BCBT studies were as follows: reduced polydrug use; drug injection, criminality and severity of amphetamine dependence at six-month follow-up; improved general functioning; mental health; stage of change as well as improved motivation to change in a pharmacological + BCBT study., Conclusion: A review of trials indicates that pharmacological treatments and BCBT in a research setting outperform control conditions in treating amphetamines abuse and associated harms. Large-scale studies should determine if both treatments can be effective in clinical settings.

Currently, there is not definitive information regarding the efficacy of transcranial direct current stimulation (tDCS) for Post-traumatic stress disorder (PTSD). This study aimed to examine the efficacy of tDCS for PTSD and its sub-symptoms. In a double-blind, controlled randomized clinical trial, 40 participants with PTSD were randomly assigned to receive either 10 tDCS sessions delivered at 2 mA to the right (cathode) and left (anode) dorsolateral prefrontal cortex (DLPFC) or 10 sham tDCS sessions to the same area. A blinded rater assessed PTSD, depressive, and anxiety symptoms before treatment, following it, and after a 1-month follow-up period. According to the results: i) PTSD patients demonstrated a significant reduction in PTSD symptoms, hyper-arousal and negative alterations in cognition and mood sub-symptoms as well as depressive and anxiety symptoms in the active stimulation compared to the sham stimulation at post-treatment and follow-up; ii) active stimulation when compared to sham stimulation revealed greater reductions in re-experiencing sub-symptoms from baseline to post-test. However, follow-up differences did not reach significance; iii) With respect to avoidance sub-symptoms, there were no significant differences between the active and sham stimulation at post-test and follow-up. This study supported the efficacy of 10 sessions of bilateral DLPFC tCDS delivered at 2 mA for the treatment of PTSD symptoms. Taken together, these findings suggest that although tDCS can reduce PTSD symptoms, researchers should consider the different types of PTSD and use strategies to ensure sufficient power to detect a potential effect of tDCS on various types of PTSD., (Copyright © 2019 Elsevier Inc. All rights reserved.)

Aims: This review study aimed to investigate the strategies for implementing the nursing process in the clinical practice and the assessment of the implementation rate of this process in clinical settings of lower-income countries., Design: An integrative review., Method: The search was conducted of EMBASE, MEDLINE, CINAHL, Scopus and ISI databases from 1975-July 2018. Following the formation of the research team, two researchers independently selected the eligible studies; finally, 39 articles were approved by the research team for this study., Results: The researchers identified three themes: Effects of implementing the NP in clinical settings, Development and application of electronic software in the NP and Factors affecting the implementation of the NP. This review revealed that nurses and nursing managers in hospitals are interested in implementing the nursing process in the form of widely and continuously. But the necessary infrastructure, such as manpower, electronically or manually tools, has not yet been provided, and the implementation of the nursing process is done either imperfectly or not done., Competing Interests: No conflicts of interest declared., (© 2019 The Authors. Nursing Open published by John Wiley & Sons Ltd.)

A total of 70 broiler chickens were used to evaluate the apparent ileal digestibility coefficient (AIDC) of protein and amino acids, and apparent digestibility coefficient (ADC) of energy in the protein rich Fungal Biomass of Neurospora intermedia (FBN) obtained from bioethanol production. The chickens were housed in 10 pens with seven chickens per pen and fed one of two experimental diets between day 28 and 35 of age. The experimental diets were wheat-soybean meal-based control diet and a diet composed of 70% control diet and 30% of FBN. There were no difference (P > 0.05) between the control and FBN diet on chick feed intake and body weight at day 35. However, the AIDCs of crude protein and amino acids were significantly (P < 0.01) higher in control diet than in the FBN diet except for proline and phenylalanine. The AIDC of CP (0.74), cysteine (0.68), methionine (0.70), AME (15.6), and threonine (0.69) in FBN were comparable to the corresponding values in other protein-rich feedstuffs such as soybean meal and fish meal. The results from this study show that FBN may be an alternative protein source for poultry., (© 2019 Poultry Science Association Inc.)

We aimed to explore the meaning of elder abuse and its sociocultural factors from the perspectives of Kurdish older people. We purposively selected the participants, 38 female and 17 male, from a rural area in Boukan country, Iran. Data were collected using semi-structured interviews and focus group discussions and were analyzed applying conventional content analysis. Researchers finally characterized viewpoints of the participants into two themes including structural changes in family interactions and changes in sociocultural values. Public education about moral norms and enactment of supportive laws for elderly people may help minimize elder abuse.

Determining depression symptoms in schizophrenic patients is a challenging process because of a degree of similarity between depression symptoms and negative symptoms and the extrapyramidal side effects of neuroleptic drugs, but it is crucial to evaluate and measure depression among patients with schizophrenia for a better clinical outcome. The Calgary Depression Scale for Schizophrenia (CDSS) is a valid and reliable instrument used for the evaluation of depression in schizophrenia. This study aimed to determine the psychometric properties of the Persian version of CDSS in a sample of people with schizophrenia. Clinical interviews were conducted with 95 schizophrenic patients (40 inpatients and 55 outpatients), who were assessed with the Positive and Negative Syndrome Scale (PANSS), Hamilton Depression Rating Scale (HDRS-17 and HDRS-24 items), and the Calgary Depression Rating Scale (CDSS). Then an exploratory factor analysis was conducted to determine correlations between scales, Cronbach's alpha, and cutoff scores. The factor analysis led to the extraction of a unifactorial solution. The CDSS had significant relationships with PANSS Negative and PANSS General. However, it had no significant relationship with PANSS Positive and the PANSS Total. The CDSS also had significant relationships with HDRS-17 and HDRS-24. In addition, Cronbach's alpha of total score, test-retest reliability, and cutoff score were estimated at 0.86, 0.82, and 8 (sensitivity = 0.79 and specificity = 0.84), respectively. The findings support the CDSS unifactorial approach. Results also showed that the CDSS Persian version had acceptable psychometric properties; thus, it could be employed to evaluate depression among schizophrenic patients., (Copyright © 2019. Published by Elsevier B.V.)

Background: Patients with type-2 diabetes have poor adherence to the therapeutic regime. It can result in various complications in body systems associated with undesirable metabolic control. Purpose: The present study aimed to explore the inhibitors of medication adherence in patients with type-2 diabetes. Patients and methods: This was a qualitative study using a conventional content analysis method. Participants were 12 patients with type-2 diabetes referred to the diabetes unit in Saghez, Kurdistan Province in 2015. The purposive sampling method was used with a maximum variation in sampling, and data collection was continued until data saturation was achieved. Semi-structured interviews were used for data collection. Interviews were recorded and immediately transcribed verbatim. Results: Data analysis led to the development of four main categories including disbelief in medical explanatory/prescriptive knowledge, lived experiences of the disease, challenges of everyday life, and interactive/economic challenges. The main inhibitors were the patient's understanding of his/her own physical status and strategies used for maintaining the internal balance. Healthcare providers need to take patients' perceptions into account when they are prescribing medicinal diets. Another inhibitor was the incidents of everyday life, including economic and social challenges, and interactions to receive education and skills for living with the disease. Conclusion: Beliefs of the medical team and patients should be brought closer to each other, and patients' trust in the medical team should be increased. Nurses should consider the unique experience of every patient when giving healthcare recommendations, and try to limit the existing challenges as much as possible., Competing Interests: The authors declare no conflicts of interest in this work.

Introduction: Bipolar patients have abnormalities in cognitive functions and emotional processing. Two resting state networks (RSNs), the default mode network (DMN) and the sensorimotor network (SMN), play a decisive role in these two functions. Dorsolateral prefrontal cortex (DLPFC) is one of the main areas in the central executive network (CEN), which is linked to the activities of each of the two networks. Studies have found DLPFC abnormalities in both hemispheres of patients with bipolar depression. We hypothesized that the bilateral repetitive transcranial magnetic stimulation (rTMS) of DLPFC would produce changes in the activity of both the SMN and DMN as well as relevant cognitive function in patients with bipolar depression that responded to treatment. Methods: 20 patients with bipolar depression underwent 10 sessions of 1 Hz rTMS on right DLPFC with subsequent 10 Hz rTMS on left DLPFC. Changes in electroencephalography resting networks between pre and post rTMS were evaluated utilizing low-resolution electromagnetic tomography (eLORETA). Depression symptom was assessed using the Beck Depression Inventory (BDI-II) and cognitive function was assessed by Verbal Fluency Test (VFT), Rey Auditory Verbal Learning Test (RAVLT), Stroop Test, and Wisconsin Card Sorting Test (WCST). Results: Responders to rTMS showed significantly lower DMN activity at baseline and a significant decrease in SMN connectivity after treatment. Non-responders did not significantly differ from the control group at the baseline and they showed higher activity in the SMN, visual network, and visual perception network compared to control group following treatment. Bilateral rTMS resulted in significant changes in the executive functions, verbal memory, and depression symptoms. No significant changes were observed in selective attention and verbal fluency. Conclusion: Bilateral stimulation of DLPFC, as the main node of CEN, results in changes in the activity of the SMN and consequently improves verbal memory and executive functions in patients with bipolar depression.

Background: We aimed to investigate the trends of interested and extra time spending activities in order to find potential correlation between computer-based activities (CBA) and healthy lifestyle (HLA)., Methods: Information was adapted from the South Korea governmental open source database which gathered from official measurement statistical results. Various types of the interested and extra time spending activities were categorized into eight main activities based on the library research and expert comments. Moreover, two main categories of sports and outdoor activity (S&OA) were found to be attributed to HLA. Descriptive and analytical statistics analyses, besides correlation analysis were conducted; through Kolmogorov-Smirnov test for normalizing data and Fisher's exact test for making the comparison., Results: Among demographic variables, watching and listening as well as social activities, were the most interesting activities for almost all citizens, furthermore computer games and social network system (CG&SNS) were found to have a negative association with HLA., Conclusion: Newly emerged computer-based activities, such as game behavior, would be among the main determinates of the HLA. The associated implications are provided to assist the authorities and governments in making the policy and planning., Competing Interests: Conflicts of Interest The authors declare no conflict of interest.

Persian walnut ( Juglans regia L.) is known to have originated in central and eastern Asia. Remnants of these wild populations can still be found in the Hyrcanian forest in north-eastern Iran. In this study, 102 individual walnut trees from four geographic populations in the Azadshahr province (Vamenan, Kashidar, Rudbar and Saidabad) were sampled. We characterized individual trees using 28 standard morphological traits. The range of traits varied widely for some economically important characteristics including nut weight (6.1-19.79 g), kernel weight (2.9-9.4 g), and kernel fill percentage (26.51-60.34%). After morphological evaluation, 39 superior individuals based on nut quality and kernel fill percentage were selected for further genetic analysis. Individual superior trees were genotyped using 10 simple sequence repeat markers (SSR) and genetic diversity. Number of alleles per locus ranged from 3 (WGA005) to 12 (WGA054). Clustering analysis of 10 SSR loci divided the genotypes into three main groups. PCoA analysis clearly sorted genotypes into one of four distinctive groups which aligned with the cluster analysis. All analyses showed that individuals from Saidabad were genetically distinct. Likewise, results indicated that the high level of genetic diversity in Azadshahr region walnuts may provide a diverse source for superior walnuts in walnut breeding programs., Competing Interests: Compliance with ethical standardsThe authors declare that they have no conflict of interest.

Background: Repetitive transcranial magnetic stimulation (rTMS) is a potential non-invasive treatment for post-traumatic stress disorder (PTSD). However, the treatment parameters of rTMS required to optimize therapeutic efficacy remains unclear., Objective: The aim of the present study was to investigate the efficacy of bilateral rTMS and unilateral right rTMS and compare the efficacy of bilateral rTMS and unilateral rTMS on PTSD symptoms., Methods: Sixty-five veterans with current combat-related PTSD symptoms were randomly selected to receive bilateral rTMS (1200 pulses at 20 Hz followed by 1200 pulses per session), unilateral right rTMS (2400 pulses at 20 Hz) or sham rTMS over the dorsolateral prefrontal cortex (DLPFC)., Results: Results showed significant differences among the 3 groups. Patients demonstrated significant PTSD symptom reductions in the bilateral group compared to the sham group in session five and endpoint. There were no significant differences between the bilateral and unilateral right groups at endpoint. Unilateral right group when compared to sham group showed greater symptom reductions from baseline to endpoint. There were no significant differences between the unilateral right and sham groups in session five., Conclusion: Our findings suggest that bilateral and unilateral right rTMS are superior to sham rTMS but does not support the hypothesis that bilateral rTMS is more effective than unilateral high-frequency right-sided rTMS., (Copyright © 2018 Elsevier Inc. All rights reserved.)

Background: The aim of this study was to investigate the correlation and interaction between the air pollution's components with cardiopulmonary endurance of elderly people in eight regions by using a multi-modal and correlation analysis., Methods: The data of air pollution was collected in eight selected regions in 2013 to 2015. At the same time, total number of 880 male and female, older than 65 year-olds, were investigated based on the cardiopulmonary endurance measurement in the same regions. The correlation, interaction and multiple linear regressions was tested between the air pollution components in each region and cardiopulmonary endurance of elderly people, also between the air pollution components in each region and gender, respectively. In this case, the regression analysis for both hypotheses was conducted., Results: There was a correlation between the level of air pollution and cardiopulmonary endurance, especially for the carbon monoxide which has a strong effect, it was followed by the effect of sulfur dioxide and fine dust, meanwhile nitrogen dioxide seems not to be effective for this measurement test. Furthermore, it was highly unlikely that gender was a significant factor for the correlation between air pollution and cardiopulmonary endurance., Conclusion: The importance and correlation between air pollution and cardiopulmonary capacity is a critical determinant for the public health of a society, while at the same time having a serious impact on certain age groups. Provided that the factor of gender is highly unlikely to modify this impact, it is necessary to study the potential of other factors., Competing Interests: Conflicts of Interest The authors declare no conflict of interest.

The present investigation was designed to examine disconnection and rejection (DR) schemas, negative emotional schemas (NESs) and experimental avoidance (EA) as mediating variables of the relationship between the childhood trauma (CT) and depression. Specifically we examined the mediating role of NESs and EA between DR schemas and depression. The study sample consist of 439 female college students (M age =22.47; SD=6.0), of whom 88 met the criteria for current major depressive disorder (MDD) and 351 who had history of MDD in the last 12 months. Subjects were assessed by Structured Clinical Interview for DSM-IV (SCID) and completed the Childhood Trauma Questionnaire (CTQ), the Early Maladaptive Schemas Questionnaire (SQ-SF), the Leahy Emotional Schemas Scale (LESS), the Acceptance and Action Questionnaire (AAQ-II), and the Beck Depression Inventory-II (BDI-II). The findings showed that DR schemas were mediator of the relationship CT and depression but CT through the NESs and EA did not predict depression. NESs were mediator of the relationship between DR schemas and depression and EA was mediator of the relationship between DR schemas and depression. In general, results suggest that intervention of depressed women may need to target the changing of DR schemas, NESs and reduction of EA., (Copyright © 2016 Elsevier Ireland Ltd. All rights reserved.)

The purpose of this study is to assess the effects of propacetamol on attenuating hemodynamic responses subsequent laryngoscopy and tracheal intubation compared to lidocaine. In this randomized clinical trial, 62 patients with the American Anesthesiologists Society (ASA) class I/II who required laryngoscopy and tracheal intubation for elective surgery were assigned to receive propacetamol 2 g/I.V./infusion (group P) or lidocaine 1.5 mg/kg (group L) prior to laryngoscopy. Systolic and diastolic blood pressures (SBP, DBP), mean arterial pressure (MAP), and heart rate (HR) were recorded at baseline, before laryngoscopy and within nine minutes after intubation. In both groups P and L, MAP increased after laryngoscopy and the changes were statistically significant (P < 0.001). There were significant changes of HR in both groups after intubation (P < 0.02), but the trend of changes was different between two groups (P < 0.001). In group L, HR increased after intubation and its change was statistically significant within 9 minutes after intubation (P < 0.001), while in group P, HR remained stable after intubation (P = 0.8). Propacetamol 2 gr one hour prior intubation attenuates heart rate responses after laryngoscopy but is not effective to prevent acute alterations in blood pressure after intubation.

Background: Anxiety is the one of the most common problems before the surgery. Its prevalence rate ranged from 11 to 80 percent in all the adult patients. Delay in wound healing and increasing use of narcotics and anesthetics are some of the other accompanying problems. Aromatherapy is one of the complementary medicine components. It is applied by special type of oil extracted from aromatic plants for medical objectives. This study aimed to investigate the effects of inhalation aromatherapy on anxiety level in preoperative patients., Methods: This was a clinical study done on 72 patients candidate for heart and abdominal surgery admitted in Golestan and Imam Khomeini hospitals. The patients were selected according to our study objectives and inclusion criteria. Then, they were divided in two case and control groups. The Spielberger scale was used for evaluating the anxiety level. Twenty minute of inhalation with handkerchief containing lavandula was used in the case group and placebo also (water) in the control group., Results: The average of anxiety level in inhalation aromatherapy group decreased from 51.00 to 38.61 from before to after the intervention. This average in the inhalation group with placebo was 50.67 before the intervention and decreased to 49.53 after the intervention. The results of independent t-test statistically showed a significant difference between the two groups after the intervention., Conclusions: The findings showed that inhalation aromatherapy was effective on reduction of anxiety level and this method can be applied as a complementary medicine on the clinic.

The aim of this qualitative study is to explore the way people using modern health care perceive its consequences in Ouraman-e-Takht region of Iranian Kurdistan. Ouraman-e-Takht is a rural, highly mountainous and dry region located in the southwest Kurdistan province of Iran. Recently, modern health practices have been introduced to the region. The purpose of this study was to investigate, from the Ouramains' point of view, the impact that modern health services and practices have had on the Ouraman traditional way of life. Interview data from respondents were analyzed by using grounded theory. Promoting survival was the core category that explained the impact that modern health practices have had on the Ouraman region. The people of Ouraman interpreted modern health practices as increasing their quality of life and promoting their survival. Results are organized around this core category in a paradigm model consisting of conditions, interactions, and consequences. This model can be used to understand the impact of change from the introduction of modern health on a traditional society.

Background: Sleep patterns and habits in high school students in Iran have not been well studied to date. This paper aims to re-address this balance and analyse sleep patterns and habits in Iranian children of high school age., Methods: The subjects were 1,420 high school students randomly selected by stratified cluster sampling. This was a self-report study using a questionnaire which included items about usual sleep/wake behaviours over the previous month, such as sleep schedule, falling asleep in class, difficulty falling asleep, tiredness or sleepiness during the day, difficulty getting up in the morning, nightmares, and taking sleeping pills., Results: The mean duration of night sleep was 7.7 h, with no difference between girls, boys, and school year (grade). The mean time of waking in the morning was not different between genders. About 9.9% of the girls and 4.6% of the boys perceived their quality of sleep as being bad, and 58% of them reported sleepiness during the day. About 4.2% of the subjects had used medication to enhance sleep. The time of going to bed was associated with grade level and gender. Sleep latency was not associated with gender and grade level, l and 1.4% experienced bruxism more than four times a week., Conclusion: Our results are in contrast with that of previous studies that concluded sleep duration is shorter in Asia than in Europe, that boys woke-up significantly later than girls, and that the frequency of sleep latency category was associated with gender and grade level. The magnitude of the daytime sleepiness, daytime sleepiness during classes, sleep latency, and incidences of waking up at night represent major public health concerns for Iran.