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Purpose: The aim of this study is to investigate drug use disorders which are a major cause of Disability Adjusted Life Years (DALYs) in the Eastern Mediterranean Region (EMR). Methods: This article is a part of the global burden of diseases (GBD), injuries, and risk factors 2019 study. The GBD modeling approach was used to estimate population-level prevalence of drug use disorders. We combined these estimates with disability weights to calculate years of life lived with disability (YLDs), years of life lost (YLLs), and disability-adjusted life-years (DALYs) for 1990–2019. Results: It is estimated that in 2019 in EMR around 3.4 million people have drug use disorder which has increased by 137% compared to 1990. Also, in 2019, DALY number for drug use disorders was 1217.9 (95% UI: 940.4, 1528.9) thousand years and 7645 (95% UI: 6793.7, 8567.9) deaths occurred. The DALY rate increased 39.6% in the region since1990, whereas the global rate increased by 24.4%. United Arab Emirates, Libya, and Iran were most affected by drug use disorders with the highest rates of age-standardized DALY in EMR in 2019. The most prevalent drug use disorder in the region is opioid use which is accountable for 80% of all drug use disorders DALYs. Conclusion: Despite many interventions, drug use disorders are still responsible for high rates of DALY in the region which has increased since 1990 in both males and females; more comprehensive policies, better control measures and proper education could reduce the adverse effects. [ABSTRACT FROM AUTHOR]

Anthropogenic climate change is exerting immense pressure on water resources in Iran. This study investigates future precipitation and meteorological droughts across the country considering performances of 41 general circulation models (GCMs). The findings indicate a significant increase in long-term average annual precipitation (LAAP) across Iran with an overall north-to-south increasing gradient, particularly in areas prone to extreme events. However, focusing solely on LAAP is misleading. Projected precipitation reveals substantial inter-annual variability, impacting both the severity and duration of meteorological droughts. For instance, 100-year return period droughts are expected to intensify in severity (The Shared Socio-economic Pathway SSP1-2.6: 4–91%, SSP8-5.5: 46–204%) and duration (SSP1-2.6: 19–76%, SSP8-5.5: 40–127%) across most regions, except the Persian Gulf coastal zone, where droughts may become less severe (SSP1-2.6: 23%, SSP8-5.5: 23%) and shorter in duration (SSP1-2.6: 27%, SSP8-5.5: 10%). Additionally, bivariate frequency analysis suggests that major droughts could become significantly more frequent in the future. [ABSTRACT FROM AUTHOR]

Introduction: In 1969, Li-Fraumeni syndrome (LFS), which is a rare cancer predisposition syndrome, was reported for the first time. The main problem in LFS is the mutation in the TP53 gene, which is a crucial tumor suppressor gene in the cell cycle. A hereditary syndrome is inherited in an autosomal dominant pattern. There is a significant correlation between this syndrome and various cancers such as sarcoma, breast cancer, brain tumors, and different other types of malignancies. This study aimed to identify the possibility of LFS in cancer patients in the East Azarbaijan, Iran. Methods: In this experimental study, 45 children with cancer in the Northwest of Iran were investigated for LFS. DNA was extracted from the whole blood cells using the salting-out method. The region within the exons 5-8 of the TP53 gene has been replicated via Polymerase Chain Reaction (PCR) method. The PCR products were sent for Sanger sequencing, and finally, the data were analyzed by Chromas software. Results: In the studied probands, in 12 (26.67%) cases, polymorphisms in Exon 6 and Introns 6 and Intron 7 were identified, and no mutation was observed in exons 5-8 of the TP53 gene. Conclusion: Our results show that there were no mutations in exons 5-8 of the TP53 gene as an indication of LFS possibility in these families. Further studies are needed to be done in a bigger population, and Next-Generation Sequencing (NGS) needs to be done to evaluate the whole genome of these patients to complete our data. [ABSTRACT FROM AUTHOR]

Background: Blastocystis sp. is a zoonotic protozoan parasite, and there is limited information about its molecular prevalence and subtypes (STs) distribution in camels globally, especially in Iran. Objectives: This study aimed to examine the prevalence, STs distribution, and zoonotic potential of Blastocystis sp. in one‐humped and two‐humped camels in Ardabil province, northwestern Iran. Methods: A PCR‐sequencing tool using the SSU rRNA gene was employed to examine the occurrence and genetic variation of Blastocystis sp. in 150 faecal samples from Bactrian (Camelus bactrianus, 50 samples) and Dromedary (Camelus dromedarius, 100 samples) camels in Ardabil province. Results: The overall prevalence of Blastocystis sp. in camels was determined to be 12% (18/150) through microscopy and PCR analyses. Phylogenetically, this study identified three distinct zoonotic STs: ST7, ST10, and ST14. ST10 was the most prevalent, comprising 50% (9/18) of the isolated STs from camels. ST14 closely followed with 38.9% (7/18), while ST7 made up 11.1% (2/18) of the total STs. In brief, ST10, ST14, and ST7 represented 50% (7/14), 35.7% (5/14), and 14.3% (2/14) of the Blastocystis‐positive cases in one‐humped camels, respectively. Further, each of the ST10 and ST14 accounted for 50% (2/4) of the Blastocystis‐positive samples in two‐humped camels. An analysis of the available data reveals that out of the 37–44 identified Blastocystis STs, 15 (ST1–ST7, ST10, ST14, ST15, ST21, ST24, ST25, ST26, and ST30) have been reported in camels. The predominant STs observed are ST10 and ST14. Furthermore, among the 15 zoonotic STs (ST1–ST10, ST12–ST14, ST16, and ST23) of Blastocystis reported thus far, nine zoonotic STs (ST1–ST7, ST10, and ST14) have been found in camels. Conclusions: These findings indicate that camels serve as a proper reservoir for a diverse array of Blastocystis STs and thereby can play a significant role in the transmission of this protozoan infection to humans, animals, and water reservoirs. [ABSTRACT FROM AUTHOR]

A total of 360 fecal samples were randomly collected from 150 cattle, 150 sheep, and 60 humans (30 people with close animal contact and 30 individuals without close animal contact) at 10 farms in Ilam, western Iran from June 2022 to August 2023. All samples were directly examined for Blastocystis by zinc sulfate flotation, followed by microscopic observation. Positive samples were further subtyped using conventional PCR and sequencing methods. A mean prevalence of 5.3% (16/300) was estimated for Blastocystis infection among examined animals, with 6% and 4.7% for cattle and sheep, respectively. Among the people who had close and non‐close animal contact, 16.7% (5/30) and 3.3% (1/30) were infected with Blastocystis, respectively (p < 0.05). All 22 positive samples were successfully sequenced at the SSU rRNA locus. Accordingly, Blastocystis isolates infecting domestic animals in Ilam belonged to the four STs (ST1‐ST3, and ST10). Of the 16 animal isolates, nine sequences (four ST10, three ST3, and two ST1) were related to cattle, and seven sequences (three ST10, two ST3, and two ST2) were isolated from sheep. Among the six human isolates, ST3 was the most predominant ST, followed by STs 1, 2, 6, and 7 (one case each). Of note, ST1‐ST3 were isolated in various farms both from animals and their breeders, which indicates the possible circulation of these STs between animal and human populations. [ABSTRACT FROM AUTHOR]

Due to the rising concern about heavy metals in settled dust, a risk assessment of Arsenic (As), Cadmium (Cd), Copper (Cu), Lead (Pb), Nickel (Ni) and Zinc (Zn) has been conducted using multiple exposure paths, including oral ingestion, direct skin contact, and inhalation of dust around lake Urmia in Iran for the time period of 2020. Metal concentrations were assessed and sources were identified based on the enrichment factor and Pearson correlation coefficient. The metal concentrations were in the following order: Zn > Cu > Ni > Pb > Cd > As with arithmetic means of 3.5, 4.8, 57, 33, 25 and 83 mg/kg, respectively, which are within the range of Iran-EPA soil guideline values. A very weak correlation (r < 0.7) was found between the studied elements. The average enrichment factor (EF) for As, Cd, Cu, Ni, Pb, and Zn was 0.7, 4, 1.8, 0.5, 3.2 and 0.8, respectively, suggests minor enrichment for metals and influence from anthropogenic activity. The lifetime cancer risks (LTCR) due to exposure (three routes of inhalation) to metals were in the negligible risk category. The oral route had the highest hazard index (HI) between all of exposure paths. The HI was less than 1 for all three exposure paths. Moreover, the sensitivity analysis showed that exposure duration (ED) for As and Ni and exposure frequency (EF) for Cd and Pb had the highest impacts on LTCR values. Therefore, this study suggests the continuous monitoring of heavy metals in settled dust around the Lake Urmia as it is associated with the high health risk for the neighbourhood in the Lake Urmia's basin. [ABSTRACT FROM AUTHOR]

Background: Consecutive droughts and quantitative and qualitative reduction of surface and underground water resources have caused an increase in greenhouse and hydroponic cultivation for most garden crops, including strawberries, in Iran. On the other hand, most of the inputs of greenhouse crops in Iran are imported. To possibility of replacing vermicompost with peat moss under hydroponic cultivation, an experiment was done in a split plot based on randomized complete blocks design in three replications in Isfahan (Iran) Agricultural and Natural Resources Research Center in 2019. The main treatment was substrate at four levels included different levels of vermicompost (30 and 50%) and peat moss (30 and 50%) in combination with perlite and sub-treatment were Selva and Camarosa cultivars. Results: The results showed that Camarosa cultivar and Selva cultivar in (perlite/ peat moss 50:50) and Selva cultivar in (perlite / vermicompost 70:30) had maximum yield. Leaf number and chlorophyll index were maximum in Camarosa cultivar in peat moss substrates. Strawberry cultivars had the highest root fresh weight, the content of vitamin C and total soluble solids (TSS) in substrates containing vermicompost. Camarosa cultivar in (perlite / peat moss50:50) and Selva cultivar in (perlite /vermicompost 50:50) had maximum root dry weight. Also, the highest number of inflorescences was related to substrates containing peat moss and (perlite /vermicompost 70:30). Maximum amount of fresh and dry weight of shoots were observed in (perlite/ peat moss70:30). Selva cultivar had more inflorescences (16.5%) than Camarosa cultivar and Camarosa cultivar produced more fresh and dry weight of shoots (16.5%, 23.01%) than Selva cultivar. Conclusion: Expriment results highlighted the importance of considering both main and sub-treatments in agricultural research, as they interacted to influence various growth and yield parameters. 50% vermicompost treatment combined with perlite had a positive impact on plant growth and in quality index such as vitamin C content and TSS was highest. while the choice of cultivar affected different aspects of plant development. Selva cultivar was known to be more tolerant to salinity caused by vermicompost. Vermicompost is local and more economical, also salt resistant cultivars are recommended in a controlled (30%) amount of vermicompost. [ABSTRACT FROM AUTHOR]

Landsliding and slope instability pose significant risks to human settlements and infrastructure. This study aims to develop a landslide susceptibility map for the mountainous regions of Tehran province, Iran. The rock engineering approach was employed at a regional scale, utilizing a database of regional landslides. The semi‐quantitative Rock Engineering System method was applied, considering 10 conditioning factors. The model was validated using historical landslide data, showing strong correlation. The majority of landslides occurred within medium and high susceptibility zones. Geological units, particularly the Karaj Formation's claystone layers, displayed a clear association with landslide susceptibility. The rock engineering approach yielded a highly accurate susceptibility map. Findings can inform future territorial planning in the area. [ABSTRACT FROM AUTHOR]

This study examines the influence of human activities and climate variability on 86 dams and hydropower across Iran. The term 'mirage water' is introduced to estimate the impact of these factors on inflow. Data analysis shows that out of 1729 m3s−1 of mirage water, 705 m3s−1 are contributed by anthropogenic activities and 1024 m3s−1 by precipitation deficits. This indicates that some parts of Iran's strategic investments in water resources management over the past 60 years have failed. The study underscores the necessity for enhanced management practices and infrastructure investments to ensure sustainable water resources in arid and semi-arid regions. [ABSTRACT FROM AUTHOR]

Background: Consecutive droughts and quantitative and qualitative reduction of surface and underground water resources have caused an increase in greenhouse and hydroponic cultivation for most garden crops, including strawberries, in Iran. On the other hand, most of the inputs of greenhouse crops in Iran are imported. To possibility of replacing vermicompost with peat moss under hydroponic cultivation, an experiment was done in a split plot based on randomized complete blocks design in three replications in Isfahan (Iran) Agricultural and Natural Resources Research Center in 2019. The main treatment was substrate at four levels included different levels of vermicompost (30 and 50%) and peat moss (30 and 50%) in combination with perlite and sub-treatment were Selva and Camarosa cultivars. Results: The results showed that Camarosa cultivar and Selva cultivar in (perlite/ peat moss 50:50) and Selva cultivar in (perlite / vermicompost 70:30) had maximum yield. Leaf number and chlorophyll index were maximum in Camarosa cultivar in peat moss substrates. Strawberry cultivars had the highest root fresh weight, the content of vitamin C and total soluble solids (TSS) in substrates containing vermicompost. Camarosa cultivar in (perlite / peat moss50:50) and Selva cultivar in (perlite /vermicompost 50:50) had maximum root dry weight. Also, the highest number of inflorescences was related to substrates containing peat moss and (perlite /vermicompost 70:30). Maximum amount of fresh and dry weight of shoots were observed in (perlite/ peat moss70:30). Selva cultivar had more inflorescences (16.5%) than Camarosa cultivar and Camarosa cultivar produced more fresh and dry weight of shoots (16.5%, 23.01%) than Selva cultivar. Conclusion: Expriment results highlighted the importance of considering both main and sub-treatments in agricultural research, as they interacted to influence various growth and yield parameters. 50% vermicompost treatment combined with perlite had a positive impact on plant growth and in quality index such as vitamin C content and TSS was highest. while the choice of cultivar affected different aspects of plant development. Selva cultivar was known to be more tolerant to salinity caused by vermicompost. Vermicompost is local and more economical, also salt resistant cultivars are recommended in a controlled (30%) amount of vermicompost. [ABSTRACT FROM AUTHOR]

Background: Different populations and areas of the world experienced diverse COVID-19 hospitalization and mortality rates. Claims data is a systematically recorded source of hospitalized patients' information that could be used to evaluate the disease management course and outcomes. We aimed to investigate the hospitalization and mortality patterns and associated factors in a huge sample of hospitalized patients. Methods: In this retrospective registry-based study, we utilized claim data from the Iran Health Insurance Organization (IHIO) consisting of approximately one million hospitalized patients across various hospitals in Iran over a 26-month period. All records in the hospitalization dataset with ICD-10 codes U07.1/U07.2 for clinically/laboratory confirmed COVID-19 were included. In this study, a case referred to one instance of a patient being hospitalized. If a patient experienced multiple hospitalizations within 30 days, those were aggregated into a single case. However, if hospitalizations had longer intervals, they were considered independent cases. The primary outcomes of study were general and intensive care unit (ICU) hospitalization periods and case fatality rate (CFR) at the hospital. Besides, various demographic and hospitalization-associated factors were analyzed to derive the associations with study outcomes using accelerated failure time (AFT) and logistic regression models. Results: A total number of 1 113 678 admissions with COVID-19 diagnosis were recorded by IHIO during the study period, defined as 917 198 cases, including 51.9% females and 48.1% males. The 61–70 age group had the highest number of cases for both sexes. Among defined cases, CFR was 10.36% (95% CI: 10.29–10.42). The >80 age group had the highest CFR (26.01% [95% CI: 25.75–26.27]). The median of overall hospitalization and ICU days were 4 (IQR: 3–7) and 5 (IQR: 2–8), respectively. Male patients had a significantly higher risk for mortality both generally (odds ratio (OR) = 1.36 [1.34–1.37]) and among ICU admitted patients (1.12 [1.09–1.12]). Among various insurance funds, Foreign Citizens had the highest risk of death both generally (adjusted OR = 2.06 [1.91–2.22]) and in ICU (aOR = 1.71 [1.51–1.92]). Increasing age groups was a risk of longer hospitalization, and the >80 age group had the highest risk for overall hospitalization period (median ratio = 1.52 [1.51–1.54]) and at ICU (median ratio = 1.17 [1.16–1.18]). Considering Tehran as the reference province, Sistan and Balcuchestan (aOR = 1.4 [1.32–1.48]), Alborz (aOR = 1.28 [1.22–1.35]), and Khorasan Razavi (aOR = 1.24 [1.20–1.28]) were the provinces with the highest risk of mortality in hospitalized patients. Conclusion: Hospitalization data unveiled mortality and duration associations with variables, highlighting provincial outcome disparities in Iran. Using enhanced registry systems in conjunction with other studies, empowers policymakers with evidence for optimizing resource allocation and fortifying healthcare system resilience against future health challenges. [ABSTRACT FROM AUTHOR]

Purpose: Cataract, or lens opacification, is a major public health burden accounting for more than half of all blindness worldwide. Plant-based dietary indices provide a unique approach to investigating a modifiable risk for age-related cataracts (ARC). The purpose of this study was to investigate the association between plant-based diet indices and risk of ARC. Design/methodology/approach: This case-control study was conducted on 97 patients with newly diagnosed ARC and 198 healthy people (as a control group) in Iran. Convenience sampling and a food frequency questionnaire were used. Three plant-based dietary indices were used based on the health promoting qualities of food items, the overall plant-based diet index (PDI), healthful plant-based diet index (H-PDI) and unhealthful plant-based diet index (U-PDI) which comprised refined carbohydrates and highly processed foods. The plant-based dietary indices were used to investigate relationships with risk of ARC. Findings: After adjusting for potential covariates, no significant association between a higher adherence to O-PDI and risk of ARC. As well, a higher adherence to H-PDI was inversely associated with the risk of ARC (OR = 0.35,95%CI:0.16–0.78). In contrast, there was a significant positive association between a higher adherence to U-PDI and the risk of ARC (OR = 3.67,95%CI:1.66 – 8.15). Originality/value: The findings of this study have underscored the potential impact of the quality of plant-based food selections on the likelihood of developing ARC. Therefore, adopting a plant-based diet that is rich in nutrient-dense plant-based foods while being low in unhealthy options may have the potential to reduce the risk of ARC. [ABSTRACT FROM AUTHOR]

Transportation systems are a basis of disability-related activity involvement in society. In Tehran, the capital of Iran, a paratransit system for disabled people has been operating since 2013, but the market share is gradually losing for reasons unknown to practitioners. Although paratransit systems for people with disabilities exist in many cities, no comprehensive study has been completed to identify attitudinal and contextual barriers to the continuance intention to use the system, particularly in a low-income developing country. Thus, due to limitations faced by qualified experts in this field, the adoption of efficient transportation policy and engineering interventions is still limited. The Technology Continuance Theory (TCT) is employed in this study as a structural equation modeling framework to analyze and quantify relationships based on the data gathered by face-to-face interviews. The mediation/moderation analyses in this paper reveal that (i) stress, (ii) self-efficacy, (ii) social isolation, (iv) mode captivity, (v) experience of usage, and (vi) type of disability are of prime importance in disabled people's intention to reuse the paratransit system. Stress is examined through serial mediation analysis. The analysis reveals that stress due to the system's uncertain attributes significantly influences satisfaction. Self-efficacy and social isolation are presented for the moderation and moderated-mediation analyses. It is found that the urban mobility performance of the system is of more importance to disabled people with lower self-efficacy (high social isolation); however, their stress is not significantly reduced even by increasing the usefulness of the system. The mode captivity is also redefined in this context and entered as a moderator. It is found that, for captive riders, satisfaction does not have a dominating role in the intention to use the paratransit system, as the users are constrained by taking what is available or nothing. The usage experience is another moderator, and our analysis shows that attitude is a determinant of behavior for long-term users, while satisfaction with a transient effect is a dominating factor for short-term ones. Finally, the users are categorized by type of disability , and the moderation analysis shows that for people with physical disabilities, the system's performance is the most influential factor in their satisfaction, while for people with sensory disabilities, other factors related to amenity, safety, and support are also prominent. This paper ultimately presents explicit and thorough policy considerations and practical implications. The article's concluding remark will comprise a disclosure of previously undisclosed insights that underlie the study's findings. • Transportation systems are a basis of activity participation of disabled people. • We try to investigate factors the operator of a paratransit system must consider to attract and retain users. • Technology Continuance Theory is employed in this study as a structural equation modeling framework. • This analysis finally suggests detailed, clear, and specific engineering measures. [ABSTRACT FROM AUTHOR]

Water reforms fail mainly because stubborn contextual constraints are not effectively considered. This study proposes a context-sensitive water governance assessment by designing a comparative approach within a case study and making inductive analytic generalizations. The framework is applied empirically to the Zayandeh Rud basin in the rentier state of Iran. The results indicate that the rentier-weak state context has led to centralized rent-seeking governance and limited implementation capacity – characteristics of the entire country, not just the water sector. Water issues will, therefore, require context-sensitive, problem-driven analysis beyond addressing water governance challenges. [ABSTRACT FROM AUTHOR]

This study was designed to study dual risk of MWFs and vibration according to exposure simulation of selected industry. Air samples of two types MWFs were evaluated according to NIOSH 5026. Vibration acceleration exposure was assessed based on the ISO 8041:2005 standard. Cell treatment of both MWF air samples and vibration as the same as dual exposure to MWF airborne and vibration was assessed. There is a potency of nitrosamine formation in airborne samples of ethylamine containing MWF, while heterocyclic including bore is found in airborne bore containing MWF. DNA breaks caused by boron-containing MWF were higher than nitrosamine air samples. Oxidative stress production and chronic inflammation were highlighted in the response to cell treatments. The risk of cell toxicity in machining workers was evaluated at a level lower than the occupational exposure limit for MWFs and vibration. [ABSTRACT FROM AUTHOR]

The global water resource crisis caused by population growth, and increasing water demand has led to using treated wastewater in many regions. Effective distribution of wastewater treatment across various consumer sectors is crucial for sustainable environmental practices and resource management. Wastewater Allocation (WA) is a multi-criteria decision-making problem, and this study used modified VIKOR (VIekriterijumsko KOmpromisno Rangiranje) method in the combination with GP (Goal Programming) technique to optimize WA in Iran. The environmental effects were evaluated using Leopold Matrix results. The proposed approach resulted in an allocation of 6912 m3/day for urban green space irrigation 10,368 m3/day for the agricultural irrigation, and 2592 m3/day for industrial water demand at the Shahreza wastewater treatment plant. The research shows that better recommendations for resource allocation may be developed by combining quantitative assessment, optimization, and mathematical models. This approach has proven successful in maximizing the reuse of wastewater for a variety of uses. [ABSTRACT FROM AUTHOR]

Background: Emergency medical service providers are frequently exposed to a variety of stressors as a result of their work environment. These stressors can have detrimental effects on both the physical and mental well-being of individuals. This study was conducted with the aim of exploring stress management strategies in emergency medical service providers. Methods: This study was conducted in 2023 using a qualitative approach and content analysis method. A purposive sampling method was used to include 16 emergency medical system providers from Hamadan city. Semi-structured interviews, with a duration of 45–60 min, were conducted for data collection. The Data were analyzed using Graneheim and Lundman's conventional content analysis approach. Results: The analysis of the interview data revealed three themes: readiness for the worst conditions, assistance based on supportive partnerships, and striving for balance. The six categories within these three themes were mental preparation, risk management, collaborations in emergency response, supportive communication, adaptive behaviors, and maladaptive responses. Conclusions: The results of this study shed light on the various stress management strategies employed by emergency medical service providers. Understanding and implementing effective stress management strategies can not only enhance the well-being of emergency medical service providers but also improve the quality of patient care. Further research and action are essential to promote the resilience and mental health of these professionals, ensuring their overall well-being and job satisfaction. [ABSTRACT FROM AUTHOR]

Background: Hemotropic Mycoplasma species (hemoplasmas) cause hemolytic anemia in cats worldwide and are recognized as emerging zoonotic pathogens. There is no comprehensive study on the prevalence and species diversity of hemoplasmas in domestic cat populations in different regions in Iran. Thus, the aims of the present study were to provide data on the prevalence and molecular characterization of hemotropic Mycoplasma species in apparently healthy cats from six Iranian provinces with different climates. In addition, potential risk factors associated with hemoplasmosis in cats were assessed. Results: Mycoplasma spp. DNA was detected in the blood of 56 / 361 cats (15.5%) using genus-specific PCR. Further examinations with species-specific PCR and Sanger sequencing showed that 38 cats (10.5%) tested positive for Candidatus Mycoplasma haemominutum (CMhm), 8 cats (2.2%) tested positive for Mycoplasma haemofelis (Mhf), and 2 cats (0.6%) tested positive for Candidatus Mycoplasma turicensis (CMt). Co-infection with CMhm, and Mhf was observed in 7 cats (1.9%). One cat (0.3%) showed mixed infection with CMhm, Mhf, and CMt. There were statistically significant relationships between Mycoplasma positivity and being female, living in shelter (cattery), and being over 3 years old (P < 0.05). No significant association was observed for the cat breed and sampling localities. Conclusions: Current study findings revealed that hemoplasma infections are common among Iran cat populations. Considering the impact of such emerging zoonotic pathogens on the One Health, routine screenings, increasing public awareness, effective control, and prophylactic strategies for minimizing infection in cats and subsequently in human are strongly recommended. [ABSTRACT FROM AUTHOR]

Attaining sustainable agriculture requires water consumption management. A water allocation optimization model was developed for the Moghan irrigation network (northwest of Iran) based on the AquaCrop plug-in model. The genetic algorithm was applied to optimize water allocation for five main crops, including wheat, first-cultivation maize, second-cultivation maize, soybeans, and alfalfa. The heuristic economic utility (EU) function was used as the objective function to optimize water allocation. In this function, drained water salinity was applied as a penalty factor to the total benefit, and soil salinity deterioration due to irrigation was also considered as a factor in each crop's benefit. The results showed that the optimal allocated water depth was 17% less than the normal water consumption. Moreover, the application of soil water salinity coefficients did not affect the ratio of EU to EB (economic benefits) for wheat and alfalfa. However, first-cultivation maize, second-cultivation maize, and soybeans cultivation led to a reduction in EU within the study area. A combination of the crops cultivation led to a change in river water quality and an 8.2% reduction in the ratio of EU to EB function. [ABSTRACT FROM AUTHOR]

Purpose: The presence of toxic heavy metals (HMs) in agricultural crops ‎can be considered as a noteworthy threat for consumers. The aim of this study was to assess the content of HMs ‎(Pb, As, Cr, Cd, Co, Hg, and Ag) and their potential health risk in summer crops and vegetables (watermelon, cantaloupe, cucumber, melon, tomato, onion, ‎potato, raw and stewed vegetables) in Ilam province, Iran. Methods: Totally, 31 crop samples were collected from local farms during the 2019 harvest ‎season and the elements ‎ content were evaluated using inductively coupled plasma-mass spectrometry (ICP-MS). The non-carcinogenic health risk of HMs to the adults and children was estimated by Monte Carlo simulation method and target hazard quotients (THQs). Results: In general, the results showed that the concentration of Cr in the studied ‎agricultural crops was higher than other HMs. As well as, the carcinogenic risk (CR) obtained for adults and children were more than the acceptable range for As. Also, CR for As in raw vegetable was the most (‎8.19E-1) and violated the threshold risk limit. The total carcinogenic risk of HMs in children was higher than that in adults. Conclusion: These results suggest that the agricultural crops were not safe for human consumption with potential risks associated. Due to the possible health effects of such products consumption, proper action should be taken to avoid chronic exposure, prevention of further pollution and consequent adverse health implications. [ABSTRACT FROM AUTHOR]

Down syndrome (DS) is a chromosomal condition that is characterized by multiple pathological phenotypes. Oxidative stress caused by DS in individuals leads to DS phenotypes, which include various morphological abnormalities and externalizing disorders. Oxidative stress is an imbalance between the production of free radicals and reactive metabolites and the antioxidant defenses. Considering the physical and behavioral problems of adolescents with DS, the family is the first source of support for these adolescents. So one of the methods that can help adolescents with DS is family-based intervention. This study aimed to investigate the effects of family-based interventions on oxidative stress and social skills of adolescents with DS. The design of the research was quasi-experimental and pre-test/post-test with a control group. The study sample was 24 adolescents with DS in Rasht City, Guilan Province, Iran, in 2023, who were selected by the convenience sampling method. To collect data, blood laboratory evaluation and strengths and difficulties questionnaire (teacher form) were used before and after the training. The experimental group received behavioral management group training for 10 sessions, and the control group did not receive any training. Data were analyzed using univariate and multivariate analysis of covariance. The results showed that family-based interventions improved oxidative stress and increased social skills of adolescents with DS (p < 0.001). According to these results, family-based interventions can have important implications for social adaptation and the prevention of physical problems in individuals with DS. [ABSTRACT FROM AUTHOR]

This research investigates factors influencing students' commuting choices to university campuses, focusing on the post-COVID-19 era, attitudes, and socio-economic variables. The study includes original data collected from a total of 785 participants who were surveyed at Shiraz University, located in Iran. The study results indicate that while public transportation and university shuttle buses continue to be widely used for transportation, a considerable proportion of students prefer personal cars, mostly driven by favourable impressions. The closeness to the campus is a crucial factor in this regard, as the students residing within a distance of 3 km exhibit a preference for walking. Moreover, the significance of bio-security factors such as cleanliness and the effective control of crowds for modal choice in the post-COVID-19 era. The study's findings give valuable insights for service providers and university administrators in the development of sustainable commuting programmes that align with the university's environmental goals. [ABSTRACT FROM AUTHOR]

Background: Snails of the Lymnaeidae family are the intermediate hosts of Fasciola species, the causative agents of fascioliasis. The purpose of this study was to determine the prevalence of Fasciola species in lymnaeid snails and to investigate the association of geoclimatic factors and Fasciola species distribution in northwestern provinces of Iran using geographical information system (GIS) data. Methods: A total of 2000 lymnaeid snails were collected from 33 permanent and seasonal habitats in northwestern Iran during the period from June to November 2021. After identification by standard morphological keys, they were subjected to shedding and crushing methods. Different stages of Fasciola obtained from these snails were subjected to the ITS1 polymerase chain reaction–restriction fragment length polymorphism (PCR–RFLP) method for species identification. The associations of weather temperature, rainfall, humidity, evaporation, air pressure, wind speed, elevation, and land cover with the distribution of Fasciola species were investigated. Geographical and statistical analysis was performed using ArcMap and SPSS software, respectively, to determine factors related to Fasciola species distribution. Results: Of the 2000 snails collected, 19 were infected with Fasciola hepatica (0.09%), six with F. gigantica (0.03%), and 13 with other trematodes. Among geoclimatic and environmental factors, mean humidity, maximum humidity, and wind speed were significantly higher in areas where F. hepatica was more common than F. gigantica. The altitude of F. hepatica-prevalent areas was generally lower than F. gigantica areas. No significant relationship was observed between other investigated geoclimatic factors and the distribution of infected snails. Conclusions: The present study showed the relationship of humidity and wind speed with the distribution of snails infected with F. hepatica or F. gigantica in the northwestern regions of Iran. In contrast to F. gigantica, F. hepatica was more prevalent in low-altitude areas. Further research is recommended to elucidate the relationship between geoclimatic factors and the presence of intermediate hosts of the two Fasciola species. [ABSTRACT FROM AUTHOR]

Tropospheric ozone time series consist of the effects of various scales of motion, from meso-scales to large timescales, which are often challenging for global models to capture. This study uses two global datasets, namely the reanalysis and the daily forecast of the Copernicus Atmosphere Monitoring Service (CAMS), to assess the capability of these products in presenting ozone's features on regional scales. We obtained 16 relevant meteorological and several pollutant species, such as O 3 , CO, NO x , etc., from CAMS. Furthermore, we employed a comprehensive set of in situ measurements of ozone at 27 urban stations in Iran for the year 2020. We decomposed the time series into three spectral components, i.e., short (S), medium (M), and long (L) terms. To cope with the scaling issue between the measured data and the CAMS' products, we developed a downscaling approach based on a long short-term memory (LSTM) neural network method which, apart from modeled ozone, also assimilated meteorological quantities as well as lagged O 3 observations. Results show the benefit of applying the LSTM method instead of using the original CAMS products for providing O 3 over Iran. It is found that lagged O 3 observation has a larger contribution than other predictors in improving the LSTM. Compared with the S , the M component shows more associations with observations, e.g., correlation coefficients larger than 0.7 for the S and about 0.95 for the M in both models. The performance of the models varies across cities; for example, the highest error is for areas with high emissions of O 3 precursors. The robustness of the results is confirmed by performing an additional downscaling method. This study demonstrates that coarse-scale global model data, such as CAMS, need to be downscaled for regulatory purposes or policy applications at local scales. Our method can be useful not only for the evaluation but also for the prediction of other chemical species, such as aerosols. [ABSTRACT FROM AUTHOR]

Objective: Beta-thalassemia major (B-TM) is an inherited hematological disease that affects nearly 300 million people worldwide. This study aimed to evaluate the effects of group-based mobile learning on stress, anxiety, depression, and pain among beta-thalassemia major patients. Materials and Methods: This randomized clinical study was conducted on 48 patients with beta-thalassemia major in Jahrom, Iran. Participants were randomly assigned to the control and intervention groups. Their partners in the intervention group were trained in self-care through mobile learning. The 21-item Depression, Anxiety, and Stress Scale and a visual analog scale for pain assessment were used to collect the data. Data were analyzed using the Statistical package for the Social Sciences version 23.0. Results: Although there was no significant difference between the control and intervention groups in the mean pre-test scores of depression (P = .21), anxiety (P = .05), stress (P = .48), and pain (P = .46), the mean post-test scores of depression, anxiety, and stress in the intervention group were significantly lower than the control group (P = .0001). The mean scores of depression (P = .33), anxiety (P = .74), stress (P = .83), and pain (P = .6) did not change significantly in the control group, while all these mean scores decreased significantly in the intervention group for DASS (P = .001) and pain (P = .002). Conclusion: Group-based mobile learning is effective in reducing depression, anxiety, stress, and pain in B-TM. [ABSTRACT FROM AUTHOR]

While there are some recommendations about early insulin therapy in newly diagnosed Type 2 Diabetes Mellitus (T2DM) patients, there is not sufficient evidence on this strategy's cost-effectiveness. This study compared early insulin therapy versus oral anti-diabetic drugs (OADs) for managing T2DMusing a cost-effectiveness analysis approach in Iran. In this economic evaluation, a decision analytic model was designed. The target population was newly diagnosed type 2 diabetic patients, and the study was carried out from the perspective of Iran's healthcare system with a one-year time horizon. Basal insulin, Dipeptidyl peptidase-4 (DPP-4) inhibitors, and Thiazolidinediones (TZDs) were compared in this evaluation. The main outcome for assessing the effectiveness of each intervention was the reduction in the occurrence of diabetes complications. Strategies were compared using the incremental cost-effectiveness ratio (ICER), and deterministic and probabilistic sensitivity analyses were carried out. The DPP-4 inhibitors strategy was the dominant strategy with the highest effectiveness and the lowest cost. Early insulin therapy was dominated (ICER: $-53,703.18), meaning that it was not cost-effective. The sensitivity analyses consistently affirmed the robustness of the base case findings. The probabilistic sensitivity analysis indicated probabilities of 77%, 22%, and 1% for DPP-4 inhibitors, TZDs strategies, and early insulin therapy, respectively, in terms of being cost-effective. In terms of cost-effectiveness, early insulin therapy was not cost-effective compared to OADs for managing newly diagnosed T2DM patients. Future studies in this regard, utilizing more comprehensive evidence, can yield more accurate results. [ABSTRACT FROM AUTHOR]

Context The incidence of anxiety, which stems from both intrinsic and extrinsic factors, has been increasing worldwide. Various methods by which it can be treated or prevented have been reported thus far. One of the most popular and effective treatments is supplementation therapy. Zinc, which is an essential nutrient found in various plants, animal foods, and supplements, has been shown to be a potential nutrient in anxiety reduction by acting on γ-aminobutyric acid (GABA), glutamatergic, serotonergic, neurogenesis, and immune systems. It can also influence important receptors, such as GPR39. Thus, zinc has received considerable attention with respect to its potential role as a therapeutic or detrimental factor for anxiety; yet, the available evidence needs to be analyzed systematically to reach a convergent conclusion. Objective The objective was to systematically review any potential connection between adult human anxiety and zinc intake. Data Sources and Extraction Nine original human studies, of which 2 assessed the relationship between zinc consumption and anxiety (based on a questionnaire) and 7 assessed the relationship between serum zinc levels and anxiety, were included based on specific selection criteria. Studies that had been written in English and published in peer-reviewed publications with no restrictions on the date of publication were searched in the Google Scholar and PubMed databases. This project was also reported according to the PRISMA guidelines. Data Analysis As per the studies analyzed in this review, there was a noticeable relationship between serum zinc levels and anxiety, which means that patients with anxiety have lower levels of zinc in their serum, as compared with healthy individuals. Furthermore, zinc consumption was inversely associated with anxiety. Conclusion The results provide plausible evidence for the positive role of zinc in the treatment of patients afflicted with anxiety, albeit with some limitations. [ABSTRACT FROM AUTHOR]

This study aimed to assess the global status and genetic diversity of Microsporidia infection in different birds. An online search was conducted in international databases from 1 January 1990 to 30 June 2022. A total of 34 articles (including 37 datasets) were included for the final meta-analysis. The pooled global prevalence of Microsporidia infection in birds was 14.6% (95% CI: 11.6–18.1). The highest prevalence of Microsporidia was found in wild waterfowl which was 54.5% (28.1–78.6). In terms of detection methods, the pooled prevalence was estimated to be 21.2% (95% CI: 12.1–34.4) and 13.4% (95% CI: 10.3–17.3) for using microscopic and molecular detection methods, respectively. Enterocytozoon bieneusi was the most common pathogen (24/31; 77.42% of the studies) according to PCR-based methods, and genotype D was the highest reported genotype (nine studies). In conclusion, designing strategies for the control and prevention of Microsporidia infection in birds should be recommended. [ABSTRACT FROM AUTHOR]

The poetry of the Iran-Iraq War (1980–1988) is commonly grafted to classical Persian topoi, imagery, metaphors. Several war poets use classical poetry to communicate with their audiences as this poetry is familiar and they can effortlessly convey their political and ideological message. This article investigates how modern amateur poets use classical poetry to create their own poems for political and religious use. I shall specifically analyse a few instances in which the poetry of the classical Persian poet Hafez of Shiraz (1315–1390) is integrated in various ideologically Shiite contexts. Some scholars have argued that Hafez's ghazals have little cohesion, characterizing the poem's couplets as 'pearls at random strung', but as we shall see these ghazals enjoy thematic coherence, even their ambiguity creates spaces for a modern appropriation and interpolation of couplets in his poetry, allowing the use of a poem as a commentary on religious and political events. While I shall give attention to Hafez's art of poetry, my main focus will be upon the modern application of his poetry by professional Shiite singers (maddāḥs) who perform such poems to whet the emotions of their audiences, placing the poem in a purely Shiite or ideologically Islamist propaganda. [ABSTRACT FROM AUTHOR]

BACKGROUND: The reform of hospital payment systems is a top priority for policymakers in many countries, including Iran. As knowledge of the current situation and experience with previous reforms are gained, the next phase will focus on improvement. Therefore, this study aims to identify the challenges to hospital payments in the Iranian health system. METHODS: This qualitative study used semi-structured interviews and focus group discussion meetings to collect data from 29 informants, including physicians, hospital administrators, faculty members, supervisors, and executive managers with expertise in hospital payment systems. Purposive sampling was used to recruit participants. Data were analyzed using content analysis. RESULTS: The content analysis resulted in five themes and twenty-two sub-themes. Policy and regulation issues, payment methods, fair payment to providers, infrastructure and systems, and behavior of providers were cited as major challenges and drawbacks of Iran's hospital payment systems. CONCLUSIONS: Understanding the barriers to hospital payments is essential for reforming or alleviating the problem. This research has shed light on the current state of the hospital payment system in the Iranian health system. Knowledge of the issues with the current system and the needs of healthcare providers is essential for effective reform. [ABSTRACT FROM AUTHOR]

Background: Rabies remains a public health problem in middle-income countries like Iran, despite being preventable. This study aimed to evaluate the six-year incidence of animal bites in the southern Caspian Sea region from 2016 to 2022, and focus on estimating the direct costs of animal bite cases using the incidence-based method. Methods: A multicenter, registry-based study was conducted using surveillance data of animal bites. Results: Of the 40 922 cases reported during the study period, 65.9% were male and 34.1% were female. Animal bites were most frequent among individuals over 50 years of age (23.5%), while children under 10 years of age had the lowest frequency of animal bites (2.3%). Animal bites were most common in June. Dogs were responsible for 33 277 (81%) cases, cats for 5,624 (13.7%) cases, cows for 1054 (2.5%) cases, and other animals for the remaining cases. During the six-year study period, four deaths due to rabies were reported in the study area. The annual bite incidence rate was 386.3 per 100 000 people in northern Iran. The males-to-female ratio was highest in 2019 (M/F ratio = 2.4, 95% CI = 1.2-3.4). Conclusion: The elderly are at higher risk of animal bites, especially in rural areas. It is important to emphasize the use of protective clothing, washing wounds with soap water and rabies vaccination as initial treatment. Targeted vaccination efforts for eligible animals should be prioritized to minimize unnecessary financial burden. Educating farmers about rabies prevention programs, especially in cases of cow bites, is also important. [ABSTRACT FROM AUTHOR]

Since the (Covid-19) pandemic outbreak, questioning regarding climate and incident of Covid-19 infection rates has been debated, while there is no clear research evidence until now in Iran. This study has focused on investigating the association between Covid-19 cases and demographic –meteorological factors in arid and semi-arid zones of Iran (from March 1, 2020, to January 31, 2022) by analyzing with Via Poisson and negative binomial regression. As a result, the incidence rate of both Covid-19 hospitalization and mortality cases reached peaks in the summer followed by the autumn. Interestingly, Covid-19 hospitalization cases are associated with humidity, temperature, and wind factors seasonally and monthly, but mortality cases are just associated with wind. In conclusion, the result demonstrated that demographicand meteorological factorsare positively and negatively associated with Covid-19 cases. Therefore, identifying the environmental factors contributing to the excess Covid-19 can help to prevent future pandemic waves in Iranian arid and semi-arid zone. [ABSTRACT FROM AUTHOR]

Presence of fluoride in drinking water resources is one of the most important challenges related to water management and health issues. This study aimed to monitor the fluoride concentration in rural areas of North Khorasan province, Iran. During a seven-year sampling period, the water quality of over 500 points was assessed annually, based on SPADNS colorimetric method. The geostatistical analyses and spatial distribution of fluoride were performed through global Moran's I index (spatial autocorrelation), and inverse distance weighting (IDW). In addition, the health impact probabilities of fluoride were evaluated via comparing concentrations with Iran national standard and the health risk assessment method recommended by EPA. According to the results, the measured concentrations of fluoride were in the range of 0–8.73 mg/L (average ± SD = 0.855 ± 0.458 mg/L). The lowest fluoride concentrations were determined in Esfarayen and Farouj counties (0.63 mg/L) and highest ones in Maneh Samalghan (0.9 mg/L). Moreover, Global Moran's I was calculated to be close to zero, indicating a random distribution of fluoride throughout the province. The average THQs for adult and children age groups were 4.94 and 3.61, respectively, which showed a high non-carcinogenic risk for both adult and children age groups. However, the concentration of fluoride in all studied water resources has not exceeded the standard and was in a good condition. Therefore, it is necessary to control the excessive concentrations, especially in areas with higher amounts. [ABSTRACT FROM AUTHOR]

Introduction: The breast cancer burden is still increasing, both in developing and developed countries. The present study was conducted to determine the survival rate of breast cancer based on tumor biological subtypes in patients referring to three referral oncology centers at Mashhad University of Medical Sciences, Mashhad, Iran. Methods: The present population-based study was conducted at Imam Reza Hospital, Omid Hospital, and Reza Oncology Center, Mashhad University of Medical Sciences, Mashhad, Iran Demographic information, the status of biomarkers in immune-histochemical evaluation, clinical and pathological features of the tumor, type of therapy, recurrence, or death was recorded for each eligible patient. Results: In total, 247 patients were included in the study. The mean age of patients was 48.8 ± 1.3 years. The mean time of survival was 2.64±0.13 years. In detail, the survival rate from the first year to the fifth year was reported as 100%, 96%, 91%, 90%, and 89%, respectively. The survival rate of the luminal B subtype was higher than other subtypes but the difference was not significant (P=0.7). Only in terms of metastasis, there was a significant difference between the alive and dead patients (P=0.0001). Conclusion: Despite no significant relationship between biological markers, the breast cancer subtype, and its survival rate, the overall survival rate of the patients decreased lightly through five years. However, further studies are required to indicate more accurate data about the breast cancer survival rate in our region. [ABSTRACT FROM AUTHOR]

Background: Drug injection is a major health-related problem worldwide. Injection cessation and relapse to injection could significantly alter the risk of HIV and hepatitis C virus (HCV) among people who inject drugs (PWID). This study aimed to estimate the rate of injection cessation and relapse to injection among PWID in Iran. Methods: This cohort study was conducted from 2018 to 2021 in the cities of Kerman and Tehran. Using a respondent-driven sampling (RDS) approach, 118 PWID with a history of injection in the last six months and negative HIV and HCV tests were recruited. Follow-up visits occurred every three months over a period of one year. Participants were interviewed and tested for HIV and HCV using rapid tests. Injection cessation was defined as the no injection of any type of drugs in the last three months. Relapse to injection was defined as re-initiating drug injection among those who had ceased injection. Two separate Cox regression models were applied, and an adjusted hazard ratio (aHR) with a 95% confidence interval (CI) were measured to assess the factors associated with each outcome. Results: The rate of injection cessation was 26.1 (95% CI: 21.3, 32.0) per 100 person-years, and the rate of relapse to injection was 32.7 (95% CI: 24.7, 43.2) per 100 person-years. At the baseline interview, 39.8% (n = 47) of participants reported injection cessation in the past three months before the interview. In the multivariable Cox regression analysis, the rate of relapse to injection was greater among women (aHR = 1.58; 95% CI: 1.01, 2.52), and those with higher monthly income (aHR = 1.63; 95% CI: 1.03, 2.59). However, there was no significant variable that predicted injection cessation. Conclusion: Injection cessation was common among PWID in Iran, however, one-third relapsed to injection shortly after cessation. Harm reduction programs should include comprehensive strategies to reduce the probability of relapse among PWID who achieve injection cessation. [ABSTRACT FROM AUTHOR]

Background: The COVID-19 pandemic has significantly impacted healthcare services worldwide, including bariatric surgery. There is a concern that the pandemic-induced stay-at-home orders and social restrictions may negatively affect weight reduction outcomes post-bariatric surgery. This study aimed to examine the impact of the COVID-19 on weight loss up to six months after three types of bariatric surgeries including One-Anastomosis Gastric Bypass (OAGB), RY Gastric Bypass (RYGB), and Sleeve Gastrectomy (SG) before and two time periods during the COVID-19 pandemic. Methods: We conducted a retrospective study using data from a comprehensive database of bariatric surgery patients in Iran. We recruited 882 patients who underwent bariatric surgery from the initiation of COVID-19 to 6 months before public vaccination (Time period 3); among them, 311 patients underwent surgery in the first six months of the pandemic (Time period 2). These patients were compared with 1368 ones in the control group who completed their 6 months follow-up before the pandemic. The study compared the BMI reduction, excess weight loss (EWL), and total weight loss (TWL) outcomes between these groups using Generalized Estimating Equations (GEE) with gamma distribution to adjust for factors that were unevenly distributed across the groups. Results: The age of participants in time periods 2 and 3 had a mean (standard deviation) of 38.97 (10.99) and 38.84 (10.71), respectively. In all groups, the majority of patients were females, accounting for 76.02%, 71.06%, and 75.74% for the control group and time periods 2 and 3, respectively. There was no significant difference between the groups in terms of weight reduction, as measured by BMI reduction, EWL, and TWL (related P values: 0.283, 0.465 and 0.169). Regression analysis indicated that higher baseline BMI values were associated with greater BMI reduction (0.04, 95% CI: 0.03–0.05), but this did not translate to higher EWL or TWL. Males showed greater BMI reduction (0.33, 95% CI: 0.18–0.49) and EWL (1.58, 95% CI: 0.79–2.37) than females, while females achieved higher TWL compared to males. Among different types of surgery, the OAGB resulted in more weight reduction among patients in the study. Conclusion: In conclusion, our study reveals that bariatric surgery remains effective for weight reduction during the first 6 months of the pandemic in Iran. Implementation of pandemic protocols ensures comparable efficacy to non-pandemic times. However, caution is needed in generalizing results beyond our specific context due to study limitations. Further research is essential to comprehensively assess the pandemic's broader impact on bariatric surgery outcomes under varying conditions. [ABSTRACT FROM AUTHOR]

Background: The incidence of gastric cancer is known to be high in the elderly population. Identification of the best perioperative chemotherapy regimen is challenging in patients with resectable gastric cancer. In this study, we aimed to evaluate and compare the outcomes and safety of epirubicin, cisplatin, and 5-fluorouracil (ECF), docetaxel, cisplatin, and 5-fluorouracil (DCF), oxaliplatin plus 5-Fluorouracil and leucovorin (FOLFOX), and docetaxel, oxaliplatin, leucovorin, and 5-Fluorouracil (FLOT) chemotherapy regimens to identify the most appropriate treatment option for elderly patients with resectable gastric cancer. Materials and Methods: In this retrospective observational cohort study, data were extracted from the medical archives (2017-2021) of Omid Hospital, which is a tertiary oncology referral hospital in Isfahan, Iran. Patients with resectable gastric cancer, above 60 years of age, who were perioperatively treated with one of the mentioned chemotherapy regimens and met the inclusion criteria, were enrolled in this study. The survival parameters and safety profile of the regimens were evaluated and compared in this population. Results: A total of 63 patients were included in this study. The median follow-up period of the patients was 24 months (range, 7-51 months). The results of survival analysis revealed that the FLOT and DCF regimens were significantly associated with longer overall survival (OS) as compared to the other regimens (median OS: 38 and 33 months, respectively). Based on the results, the progression-free survival was longer in the DCF regimen (median: 24 months) compared to the other regimens; however, only the difference with the ECF regimen (median: 14 months) was significant. The results of Cox regression analysis showed no significant difference in the overall adjusted hazard ratio of mortality between the FLOT and DCF regimens (P = 0.802). The DCF and FOLFOX regimens accounted for the highest and lowest rates of adverse events (e.g., neutropenia and mucositis), respectively. Conclusion: Considering the higher rate of adverse events in the DCF group, besides the significant improvement of OS and the acceptable adverse event profile of patients treated with the FLOT regimen, it can be proposed that this chemotherapy regimen is the most appropriate treatment option for elderly patients with resectable gastric cancer. [ABSTRACT FROM AUTHOR]

Introduction: In acute conditions, severe acute respiratory syndrome coronavirus 2 (SARS‐CoV‐2) causes multi‐organ damage due to the induction of inappropriate immune responses, particularly lung tissue fibrosis. To evaluate the consequence of the deterioration of the immune system, autoimmune markers were assessed. Method s : In a case–control study, 108 patients with coronavirus disease 2019 (COVID‐19) were admitted to the intensive care unit (ICU), and 158 outpatients with mild clinical symptoms, with SARS‐CoV‐2 reverse transcription quantitative polymerase chain reaction (RT‐qPCR) positive tests, were included for comparison. The demographic and hematologic variables and presence of the main autoantibodies in sera of 40 eligible ICU‐hospitalized COVID‐19 patients and 40 COVID‐19 outpatients were assessed. Out of 108 COVID‐19 ICU‐hospitalized patients, 40 were selected as the control group (40/158) who had no underlying diseases before hospitalization, according to their self‐declaration and clinical records at the time of admission. Results: The results demonstrated that the main complete blood count indices, such as red blood cells and platelets, decreased dramatically in ICU‐hospitalized patients. Furthermore, the autoantibody profiles were positive in 45% and 15% of ICU‐admitted patients for antinuclear antibodies and antineutrophilic cytoplasmic autoantibodies, respectively. In ICU patients, anti‐PM/Scl 100 or AMA‐M2 was 33%. Anti SS‐A, anti‐SS‐B, anti‐Ro‐52, and anti‐Jo‐1 in 11.5% for each one were reactive. Other autoantibodies of the ICU group were as follows: CENP (5.6%), Rib‐protein (5.6%), and nucleosome (5.6%). However, only two individuals in the control group had positive results for SS‐A and SS‐B (5%). Conclusion: Induction of such particular autoantibodies by the virus can justify the multi‐organ involvement and severity of the disease in ICU patients, which may also cause other organ involvement in the long term. [ABSTRACT FROM AUTHOR]

This study aimed to investigate Aflatoxin‐M1 (AFM1) contamination in pasteurized and raw milk samples consumed in Kerman and Rafsanjan in southeastern Iran. In this cross‐sectional study, a total of 100 samples of raw (n = 67) and pasteurized (n = 33) milk were randomly collected from retail stores, supermarkets, and milk transport tankers in the winter of 2020 and the summer of 2021. The level of AFM1 contamination in the collected samples was evaluated by high‐performance liquid chromatography with fluorescence detection (HPLC‐FD). AFM1 was detected in 95% of samples and its median concentration was 17.38 ng/L. The median concentration of AFM1 in the pasteurized milk samples (24.89 ng/L) was significantly higher than in the raw milk samples (13.54 ng/L). The AFM1 contamination level in 20% (raw = 13% and pasteurized = 7%) of the samples was higher than the maximum permitted level (MPL) recommended by the European Union (i.e., 50 ng/L), whilst 4% (raw = 3% and pasteurized = 1%) of the samples was higher than the Iranian maximum standard limit (i.e., 100 ng/L). The hazard index (HI) was higher than 1 in 16%, 18%, and 35% of total milk samples for men, women, and children, respectively. The AFM1 contamination level in the milk samples collected in southeastern Iran was worrying. The margin of exposure (MoE) values were lower than 10,000 for children. Because aflatoxins are among the most potent carcinogens known, prevention of milk contamination in all stages from the farm to the table can considerably reduce the community's exposure to AFM1 and its consequent health risks. [ABSTRACT FROM AUTHOR]

Ritual practices as behavior, and the cognitive acknowledgment of life and death, foster a depth in social identity, collective social memory, and a societal worldview. This paper outlines the evidence of Early Bronze Age burial practices in northwestern Iran to discuss the newly discovered chamber tombs at Kohne Tepesi within the broader context of mortuary practices during the middle and last part of the 3rd millennium b.c. The findings from Kohne Tepesi support the idea that, at least for parts of Kura-Araxes society, burial rites and commemoration of the dead played a crucial role in their worldview. Furthermore, this site demonstrates that the changes in symbolic practices and social behavior during the Early Kurgan period were not spontaneous but rooted in the last phases of the Kura-Araxes period and that the perceptions of earlier traditions had been conserved in long-term social memory. [ABSTRACT FROM AUTHOR]

Agricultural drainage water production in southwestern Iran is a serious problem, but this low-quality water can be considered a potential alternative source of freshwater. In this regard, the cultivation of salinity-resistant plants using drainage water can be considered a suitable measure. Quinoa (Chenopodium quinoa Willd.) is a valuable halophyte, and the World Health Organization has recognized it as a plant that can guarantee the world's future food security. For this purpose, this study was conducted to investigate the sustainable use of drainage water for quinoa cultivation (2019–2020). First, quinoa seed germination experiments were conducted in the laboratory using four different salinity solutions [0 (control), 9, 18, and 27 dS/m ]. Then, field research was conducted in the form of a split-plot factorial design so that irrigation management and planting date were implemented as the main treatments and genotype factor as subtreatment in small plots. Four genotypes of quinoa were planted on the research farm on three dates, January 20 (D1), February 5 (D2), and February 20 (D3). Irrigation managements include irrigation with water from the Karun River (as freshwater, I1), drainage water from sugarcane fields (I2), and alternating irrigation with freshwater and drainage water (I3). An average reduction of 4% in the total germination at 27 dS/m salinity compared to the control treatment indicated that quinoa was well adapted to salinity during germination. The highest biomass was produced by the Rosada genotype cultivated on the D3 under I1 management at a rate of 540 g/m2 , followed by the Q26 genotype cultivated on the D1 under I3 management (499 g/m2). Finally, it can be concluded that, to maintain the salt balance in the soil, leaching at the end of the growing season is necessary to remove salts and maintain sustainable haloculture. [ABSTRACT FROM AUTHOR]

The significant rainfall in October 2018 in northern Iran caused devastating flooding that caused considerable economic losses and claimed at least nine lives. Following the flooding, several bridges have suffered different levels of damage. Immediately after the event, the authors conducted a field investigation to study the performance of RC bridges during the flood. This paper presents the failure modes of flood-affected bridges and provides reasons for every failure case. The results revealed that scour around foundations, pier tilting, flexural failure of piers, and superstructure unseating were the most significant failure modes observed. Pile-supported bridges performed notably better than those with shallow foundations. In addition, observations have revealed that structural integrity plays a crucial role in the general stability of bridges during flooding. Pier ductility is another significant parameter that affects the performance of bridges during flood events. Finally, fragility curves were developed based on the empirical data set provided from the post-flood status of the bridges in the affected region. The river flow velocity (Vs), maximum flow discharge (Qp), and Qp normalized to the 10-year average river discharge (Qm) were considered intensity measures of the fragility analysis. The correlation analyses revealed that despite Vs and Qp/Qm , the flow discharge was not an appropriate intensity measure for generating fragility curves. [ABSTRACT FROM AUTHOR]

Background: Interaction between researchers and policymakers is an essential factor to facilitate the evidence-informed policymaking. One of the effective ways to establish this relationship and promote evidence-informed policymaking is to employ people or organizations that can play the role of knowledge brokers. This study aims to analyze the communication network and interactions between researchers and policymakers in Iran's health sector and identify key people serving as academic knowledge brokers. Methods: This study was a survey research. Using a census approach, we administered a sociometric survey to faculty members in the health field in top ten Iranian medical universities to construct academic-policymaker network using social network analysis method. Network maps were generated using UCINET and NetDraw software. We used Indegree Centrality, Outdegree Centrality, and Betweenness Centrality indicators to determine knowledge brokers in the network. Results: The drawn network had a total of 188 nodes consisting of 94 university faculty members and 94 policymakers at three national, provincial, and university levels. The network comprised a total of 177 links, with 125 connecting to policymakers and 52 to peers. Of 56 faculty members, we identified four knowledge brokers. Six policymakers were identified as key policymakers in the network, too. Conclusions: It seems that the flow of knowledge produced by research in the health field in Iran is not accomplished well from the producers of research evidence to the users of knowledge. Therefore, it seems necessary to consider incentive and support mechanisms to strengthen the interaction between researchers and policymakers in Iran's health sector. [ABSTRACT FROM AUTHOR]

Background: The labor supply of nurses, as one of the main healthcare workers, is an important issue in health human resources planning in all health systems. Finding the factors affecting it, could help policymakers to solve the shortage of nursing work supply. The present study aimed to investigating the quantity and factors affecting the nurses' labor supply in Iran. Method: In this cross-sectional study, a sample of 598 nurses working in public hospitals of Shiraz (Iran) were selected via proportionate stratified random sampling method. The required data was collected using a structured questionnaire which asked working hours and other related factors. To analyze the data, descriptive statistics, univariate analysis and multivariate linear regression were performed using STATA 15. The multivariate labor supply model was estimated separately for married and single nurses. Results: The average weekly working hours of nurses was 54.65 h in all medical centers and 50.28 h in the main hospital. The regression results showed that the labor supply of nurses with work experience (β = − 0.368, P = 0.014), satisfaction with work shift arrangement (β = − 2.473, P = 0.001), income between 60-89 million rial (β = − 14.046, P = 0.002), income between 90-119 million rial(β = − 12.073, P = 0.012), and working in the emergency department (β = − 5.043, P = 0.017) had negative and significant relationship; But there was a positive and significant relationship with satisfaction of the work environment (β = 1.86, P = 0.011), workload at work (β = 1.951, P = 0.023) and employment status (contractual employees) (β = 4.704, P = 0.004). Conclusion: The labor supply function of nurses is affected by demographic, economic and non-economic factors. The most contributing factors were related to non-economic variables. It seems that the non-financial cost and benefits related to the job as well as internal factors have more important role on the nurses' labor supply. [ABSTRACT FROM AUTHOR]

Background: One of the common concerns of healthcare systems is the potential for re-admission of COVID-19 patients. In addition to adding costs to the healthcare system, re-admissions also endanger patient safety. Recognizing the factors that influence re-admission, can help provide appropriate and optimal health care. The aim of this study was to assess comorbidities that affect re-admission and survival in COVID-19 patients using a joint frailty model. Methods: This historical cohort study was done using data of patients with COVID-19 who were re-hospitalized more than twice in a referral hospital in North of Iran. We used the joint frailty model to investigate prognostic factors of survival and recurrence, simultaneously using R version 3.5.1 (library "frailtypack"). P-values less than 0.05 were considered as statistically significant. Results: A total of 112 patients with mean (SD) age of 63.76 (14.58) years old were recruited into the study. Forty-eight (42.9%) patients died in which 53.83% of them were re-admitted for a second time. Using adjusted joint model, the hazard of re-admission increased with cancer (Hazard ratio (HR) = 1.92) and hyperlipidemia (HR = 1.22). Furthermore, the hazard of death increased with hyperlipidemia (HR = 4.05) followed by age (HR = 1.76) and cancer (HR = 1.64). It Also decreased with lung disease (HR = 0.11), hypothyroidism (HR = 0.32), and hypertension (HR = 0.97). Conclusion: Considering the correlation between re-admission and mortality in the joint frailty model, malignancy and hyperlipidemia increased the risk of both re-admission and mortality. Moreover, lung disease probably due to the use of corticosteroids, was a protective factor against both mortality and re-admission. [ABSTRACT FROM AUTHOR]

Background: In many parts of the world, including Iran, walnut (Juglans regia L.) production is limited by late-spring frosts. Therefore, the use of late-leafing walnuts in areas with late-spring frost is the most important method to improve yield. In the present study, the phenotypic diversity of 141 seedling genotypes of walnut available in the Senejan area, Arak region, Markazi province, Iran was studied based on morphological traits to obtain superior late-leafing genotypes in the cropping seasons of 2022 and 2023. Results: Based on the results of the analysis of variance, the studied genotypes showed a significant variation in terms of most of the studied morphological and pomological traits. Therefore, it is possible to choose genotypes for different values ​​of a trait. Kernel weight showed positive and significant correlations with leaf length (r = 0.32), leaf width (r = 0.33), petiole length (r = 0.26), terminal leaflet length (r = 0.34), terminal leaflet width (r = 0.21), nut length (r = 0.48), nut width (r = 0.73), nut weight (r = 0.83), kernel length (r = 0.64), and kernel width (r = 0.89). The 46 out of 141 studied genotypes were late-leafing and were analyzed separately. Among late-leafing genotypes, the length of the nut was in the range of 29.33–48.50 mm, the width of the nut was in the range of 27.51–39.89 mm, and nut weight was in the range of 8.18–16.06 g. The thickness of shell was in the range of 1.11–2.60 mm. Also, kernel length ranged from 21.97–34.84 mm, kernel width ranged from 21.10–31.09 mm, and kernel weight ranged from 3.10–7.97 g. Conclusions: Based on important and commercial traits in walnut breeding programs, such as nut weight, kernel weight, kernel percentage, kernel color, and ease of kernel removal from nuts, 15 genotypes, including no. 92, 91, 31, 38, 33, 18, 93, 3, 58, 108, 16, 70, 15, 82, and 32 were superior and could be used in walnut breeding programs in line with the introduction of new cultivars and the revival of traditional walnut orchards to commercialize them. [ABSTRACT FROM AUTHOR]

The majority of Iranian fig production is exported, making it one of the world's most well-known healthy crops. Therefore, the main objective of the current experiment was to investigate the effects of various types of organic fertilizers, such as animal manure (cow and sheep), bird manure (partridge, turkey, quail, and chicken), and vermicompost, on the nutritional status of trees, vegetative and reproductive tree characteristics, fruit yield, and fruit quality traits in dried fig cultivar ("Sabz"). According to the findings, applying organic fertilizers, particularly turkey and quail, significantly improves vegetative and reproductive characteristics. However, other manures such as sheep, chicken, and vermicompost had a similar effect on the growth parameters of fig trees. Additionally, the findings indicated that except for potassium, use of all organic fertilizers had an impact on macro and microelements such as phosphorus, nitrogen, and sodium amount in fig tree leaves. Also, based on fruit color analysis in dried figs, the use of all organic fertilizers improved fruit color. Moreover, the analyses fruit biochemical showed that the use of some organic fertilizers improved that TSS and polyphenol compounds such as coumarin, vanillin, hesperidin gallic acid and trans frolic acid. In general, the results indicated that the addition of organic fertilizers, especially turkey manure, led to increased vegetative productivity and improvement in the fruit quality of the rain-fed fig orchard. [ABSTRACT FROM AUTHOR]

The accumulation of heavy metals in crops irrigated with wastewater is a serious environmental problem. Wastewater irrigation is widespread, particularly for rice due to its high water demands. This can lead to heavy metal accumulation in rice and subsequent entry into the human body, posing detrimental health effects. This study investigated heavy metal accumulation in 12 rice brands (6 imported and 6 domestic) from the Bushehr city market in Iran. The mean values of lead, arsenic, and cadmium in domestic rice brands were 0.246±0.194, 0.074±0.025, and 0.150±0.124 mg kg-1 respectively, while in imported rice brands they were 0.086±0.031, 0.085±0.021, and 0.031±0.007 mg kg-1 respectively. The mean lead and cadmium levels in domestic rice brands slightly exceeded the FAO/WHO limit, while the mean arsenic concentration was below the limit. To protect human health and reduce food contamination with heavy metals, preventive measures such as regular monitoring of heavy metals in food must be taken. [ABSTRACT FROM AUTHOR]

The Covid-19 outbreak changed travel behaviour in many ways. This paper evaluates these changes in Tehran, Iran, from a transportation sustainability perspective. It uses data from travel surveys before and during the pandemic to evaluate changes in travel activity and their impacts on public transportation (PT) system costs and revenues, air quality and traffic crashes. A structural equation model (SEM) is used to assess the potential impact of passengers' characteristics, details of each transportation mode and the severity of Covid-19 on travel behaviour. Hypothesis testing is used to compare the changes that occurred in air quality and traffic crashes. SEM outputs indicate that the frequency of trips previously made by sustainable modes and changes in regular trips have the highest impact on the sustainability of trips made during the Covid-19 pandemic. Air quality declined in many city districts. The pandemic caused reductions in PT ridership and an increase in private car use, which threaten the long-term sustainability of public transit services. Crash fatalities declined slightly, particularly during periods of movement restrictions. However, motorcycle fatal crashes increased in comparison with the reduction in motorcycle trips, apparently due to increased traffic speeds. The government did not use the pandemic as an opportunity to promote sustainable and low-contagion modes. This analysis infers that the Covid-19 outbreak reduced the overall transportation sustainability in Tehran. [ABSTRACT FROM AUTHOR]

In this study, the optimization of the location of oil production and injection wells, the number of production and injection wells, and the economic evaluation in the water injection process has been carried out using three algorithms: PSO, GA, and HGAPSO. Optimizing the oil extraction process by optimizing well locations, the optimal number of production and injection wells, and economic evaluation can improve the performance and efficiency of the process. In this study, the optimization of the water injection process into oil reservoirs using the PSO, GA, and HGAPSO algorithms has been addressed. Additionally, economic evaluation, considering costs and profits from oil production using the best-optimized parameters, has been conducted, and the best Net Present Value (NPV) has been calculated. Initially, the optimal well location problem is modeled, taking into account reservoir characteristics and geological conditions. Using the PSO and GA algorithms, the best well location and number of water injection wells have been obtained, leading to improved efficiency and cost reduction. Then, the GA algorithm is used to combine and modify viewpoints and optimize the number and location of wells. This algorithm explores optimal solutions in the well location space. Economic evaluation is performed using the best-optimized parameters by the algorithms. Costs of water injection, oil production costs, and profits from increased oil production are considered. By calculating the best Net Present Value (NPV), optimal decisions regarding the water injection process and enhancing the performance of oil reservoirs are made. Simulation results indicate that the GA algorithm outperforms other algorithms and can be used as a robust and effective method for optimizing well locations and the number of production and injection wells in the oil injection process. Ultimately, this study assists the oil industry in making better decisions about optimizing water injection and improving the efficiency and profitability of the process using the introduced optimization algorithms. [ABSTRACT FROM AUTHOR]