Search

Population aging has become a significant phenomenon in the 21st century due to rising life expectancy and declining fertility rates. The global elderly population, estimated at 727 million in 2020, is projected to double by 2050, with developing countries facing a greater proportion of elderly residents. This demographic shift will impact various sectors of society, including healthcare, leading to increased demand for medical services and higher costs. Public-Private Partnerships (PPP) are an effective mechanism to improve access to health services for the elderly, enhance service quality, and manage costs. It is crucial for policymakers to explore global experiences with PPP to develop strategies that address the unique economic and social conditions in Iran, ensuring an effective response to the rapid changes in healthcare needs for the aging population.

Background: The use of different educational methods and programs, such as simulation and virtual training, plays an important role in effective Cardiopulmonary Resuscitation (CPR) learning for nursing students. This study was conducted with the aim of comparing mannequin-based simulation training with virtual training on CPR learning among nursing students. Materials and Methods: This parallel randomized controlled trial was conducted in 2022. We selected 73 nursing undergraduate students and randomly assigned them to two groups: mannequin-based simulation and virtual training groups. The knowledge, attitude, and performance of CPR in both groups were evaluated and compared before, immediately after, and 1 month after the intervention. Data analysis was performed using independent t-test and the repeated-measure analysis of variance (ANOVA) using the Statistical Package for Social Sciences (SPSS) software. Results: Within-group differences were significant in both mannequin-based simulation and virtual training groups in terms of knowledge, attitude, and CPR performance before and after training, as well as between before and 1 month after training (p < 0.001). In addition, the mean performance of simulation group students was significantly higher than the virtual group (p < 0.001), but no significant difference was observed between the two groups in terms of knowledge and attitude dimensions before training, after training, and 1 month after training. Conclusions: Both mannequin-based simulation and virtual training methods increase CPR learning. Considering that students’ knowledge and attitude increase significantly using both training methods and the performance of students in the simulation group is better than in the virtual group, the use of a multimodal approach is recommended for CPR training of nursing students.

Introduction: Complexity metrics have been suggested to characterize treatment plans based on machine parameters such as multileaf collimator (MLC) position. Several complexity metrics have been proposed and related to the Intensity-modulated radiation therapy (IMRT) quality assurance results. This study aims to evaluate aperture-based complexity metrics on MLC openings used in clinicaland establish a correlation between plan complexity and the gamma passing rate (GPR) for the IMRT plans.Material and Methods: We implemented the aperture-based complexity metric on MLC openings of the IMRT treatment plan for breast and central nervous system (CNS) cases . The modulation complexity score (MCS), the edge area metric (EAM), the converted area metric (CAM), the circumference/area (CPA), and the ratio monitor unit MU/Gy are evaluated in this study. The complexity score was calculated using Matlab. The MatriXX Evolution was used for dose verification. The dose distribution was analyzed using the OmniPro-I'mRT program and the gamma index was assessed using two criteria: 3%/3 mm and 3%/2 mm. The correlation between the calculated complexity score and the GPR is analyzed using SPSS.Results: The complexity score calculated by MCS, EAM, CAM, CPA, and MU/Gy shows breast plan is more complex than the CNS plan. The results of the correlation test of the complexity metric and GPR show that only the EAM metric shows a good correlation with GPR for both cases.Conclusion: EAM strongly correlates with the gamma pass rate. The MCS, CAM, CPA, and MU/Gy have a weak correlation with the GPR.

Abstract Background Prostate-specific membrane antigen (PSMA) PET/CT imaging is widely used for quantitative image analysis, especially in radioligand therapy (RLT) for metastatic castration-resistant prostate cancer (mCRPC). Unknown features influencing PSMA biodistribution can be explored by analyzing segmented organs at risk (OAR) and lesions. Manual segmentation is time-consuming and labor-intensive, so automated segmentation methods are desirable. Training deep-learning segmentation models is challenging due to the scarcity of high-quality annotated images. Addressing this, we developed shifted windows UNEt TRansformers (Swin UNETR) for fully automated segmentation. Within a self-supervised framework, the model’s encoder was pre-trained on unlabeled data. The entire model was fine-tuned, including its decoder, using labeled data. Methods In this work, 752 whole-body [68Ga]Ga-PSMA-11 PET/CT images were collected from two centers. For self-supervised model pre-training, 652 unlabeled images were employed. The remaining 100 images were manually labeled for supervised training. In the supervised training phase, 5-fold cross-validation was used with 64 images for model training and 16 for validation, from one center. For testing, 20 hold-out images, evenly distributed between two centers, were used. Image segmentation and quantification metrics were evaluated on the test set compared to the ground-truth segmentation conducted by a nuclear medicine physician. Results The model generates high-quality OARs and lesion segmentation in lesion-positive cases, including mCRPC. The results show that self-supervised pre-training significantly improved the average dice similarity coefficient (DSC) for all classes by about 3%. Compared to nnU-Net, a well-established model in medical image segmentation, our approach outperformed with a 5% higher DSC. This improvement was attributed to our model’s combined use of self-supervised pre-training and supervised fine-tuning, specifically when applied to PET/CT input. Our best model had the lowest DSC for lesions at 0.68 and the highest for liver at 0.95. Conclusions We developed a state-of-the-art neural network using self-supervised pre-training on whole-body [68Ga]Ga-PSMA-11 PET/CT images, followed by fine-tuning on a limited set of annotated images. The model generates high-quality OARs and lesion segmentation for PSMA image analysis. The generalizable model holds potential for various clinical applications, including enhanced RLT and patient-specific internal dosimetry.

The issue of the nature of the state is one of the most important issues in political philosophy, and any interpretation of it will follow an interpretation of government ends, ideal government, and the necessity to obey the government, political legitimacy and freedom in its own way. The present study, which is theoretical in terms of its fundamental content, applies the theoretical framework of Mouffe's radical democracy, and focuses on one of the prominent figures of the political philosophy of public law in the 20th century, and finally attempted to answer the main question of what is the ideal government the type and the nature of it in the political theology of Karl Schmitt? The results illustrate that the understanding and interpretation of the nature of the state as well as the desired government in Schmitt's political philosophy and political theology in the light of understanding the fundamental concepts in his thought such as political theology is political matter, rule friend/enemy/independent dictatorship, sovereignty, the concept of exception in criticism of European liberal parliamentary system, negative anthropology, adaptation of citizenship to political nationality, criticism of the concept of majority in liberal democracy. The results also state that Schmidt's ideal government is compatible with the identity-oriented type of radical democracy. The significance of the study dates back to the growing criticism of liberal democracy and the emergence of radical democratic governments, especially in Latin America.

Background: Radiomic feature reproducibility assessment is critical in radiomics-based image biomarker discovery. This study aims to evaluate the impact of preprocessing parameters on the reproducibility of magnetic resonance image (MRI) radiomic features extracted from gross tumor volume (GTV) and high-risk clinical tumor volume (HR-CTV) in cervical cancer (CC) patients. Methods: This study included 99 patients with pathologically confirmed cervical cancer who underwent an MRI prior to receiving brachytherapy. The GTV and HR-CTV were delineated on T2-weighted MRI and inputted into 3D Slicer for radiomic analysis. Before feature extraction, all images were preprocessed to a combination of several parameters of Laplacian of Gaussian (1 and 2), resampling (0.5 and 1), and bin width (5, 10, 25, and 50). The reproducibility of radiomic features was analyzed using the intra-class correlation coefficient (ICC). Results: Almost all shapes and first-order features had ICC values > 0.95. Most second-order texture features were not reproducible (ICC < 0.95) in GTV and HR-CTV. Furthermore, 20% of all neighboring gray-tone difference matrix texture features had ICC > 0.90 in both GTV and HR-CTV. Conclusion: The results presented here showed that MRI radiomic features are vulnerable to changes in preprocessing, and this issue must be understood and applied before any clinical decision-making. Features with ICC > 0.90 were considered the most reproducible features. Shape and first-order radiomic features were the most reproducible features in both GTV and HR-CTV. Our results also showed that GTV and HR-CTV radiomic features had similar changes against preprocessing sets.

Introduction: During the past two decades, computer aid models for simulation of heavy metals have been remarkably developed. Prediction of soil pollution plays an important role in pollution control and land management. But in large areas, collecting data in a direct way is challenging in terms of cost and time. In recent years, the use of indirect methods such as artificial neural network (ANN) and other similar models to estimate heavy metals has been considered. There are 27 salt mines in Garmsar city. Of these, 16 mines are active. Salt extracted from these mines are used as one of the food spices. On the other hand, due to mining activities, the soils of this region may be contaminated with heavy metals. Therefore,in this study, the effectiveness of terrain and spectral indices for predicting total soil Cadmium (Cd) around the soils of Garmsar salt mines was evaluated by ANN – multilayer perceptron (MLP) model.Material and methods: For this research, 49 soil samples were collected from the 0-20 cm Physicochemical properties of soil samples such as percentage of clay, sand, silt, soil acidity (pH), electrical conductivity (EC) and lime percentage were determined. Total Cd concentration was measured by atomic absorption spectroscopy (AAS) (Varian, Spectra 220). All terrain attributes used in this study were derived from a digital elevation map (DEM) and to calculate the spectral indices, Landsat-8 OLI/TIRS bands image with a resolution of 30 meters were used. Twenty-five auxiliary data variables derived from a DEM and Landsat-8 were used to predict total soil Cd in the study area. Based on the auxiliary data obtained and the correlation coefficients between these data and the predicted total Cd value, 2 models were evaluated. The collected data were randomly divided into categories training and validation and were used to evaluate the MLP model.Results and discussion: The results of this study show that the auxiliary data extracted from landsat-8 bands (with the highest accuracy and lowest error rate) were the effective parameters in predicting soil contamination with Cd. Based on the results obtained from the evaluation of ANN performance in estimating total Cd, the value of root mean square error (RMSE) and coefficient of explanation (R2) were 0.05 and 0.95 for the first model and 0.10 and 0.80 for the second model. In model 1, saturation index (Sat I), grain size index (GSI), carbonate index (CrI), soil color index (color I) and gypsum index (GI) were important and main parameters in total Cd modeling. The results of the present study showed the high efficiency of the ANN model in predicting total soil Cd.Conclusion: Due to the development of machine learning models in the field of environmental engineering especially in simulation of heavy metals, having a turning point for their advancement is very important. The results of this research show that the MLP model is suitable for total soil Cd prediction and this method can save the cost of soil sampling and analysis. Therefore, it is recommended to validate the method applied in this study to prepare total soil Cd map in similar areas.

One important issue in using radiopharmaceuticals as therapeutic and imaging agents is predicting different organ absorbed dose following their injection. The present study aims at extrapolating dosimetry estimates to a female phantom from the animal data of 89Zr radionuclide accumulation using the Sparks-Idogan relationship. The absorbed dose of 89Zr radionuclide in different organs of the human body was calculated based on its distribution data in mice using both MIRD method and the MCNP simulation code. In this study, breasts, liver, heart wall, stomach, kidneys, lungs and spleen were considered as source and target organs. The highest and the lowest absorbed doses were respectively delivered to the liver (4.00E-02 and 3.43E-02 mGy/MBq) and the stomach (1.83E-03 and 1.66E-03 mGy/MBq). Moreover, there was a good agreement between the results obtained from both MIRD and MCNP methods. Therefore, according to the dosimetry results, [89Zr] DFO-CR011-PET/CT seems to be a suitable for diagnostic imaging of the breast anomalies for CDX-011 targeting gpNMB in patients with TNBC in the future.

Background: Type 2 diabetes (T2D) is a chronic disease with a high prevalence globally, which is in the second place of importance for the investigation of chronic diseases. According to previous studies, Quality of Life (QOL) is low in diabetic patients. Hence, this study was conducted with the aim to evaluate the effect of the empowerment model on the QOL of patients with T2D. Materials and Methods: A randomized controlled trial was performed on 103 T2D patients over 18 years of age, with a definitive diagnosis of diabetes and medical records in a diabetic center. Patients were randomly assigned to either the intervention or the control groups. Routine education was presented to the control group, and the empowerment model was used for education in the experimental group for 8 weeks. The data collection tools used consisted of a demographic characteristics form and the diabetic clients QOL questionnaire. The one-way analysis of variance, Chi-square test, paired t-test, and independent t-test were used for data analysis. Results: After the intervention, there were significant differences between the two groups in terms of the physical (p = 0.003), mental (p = 0.002), social (p = 0.013), economic (p = 0.042), and illness and treatment dimensions of QOL (p = 0.033), as well as the total QOL score (p = 0.011). Conclusions: According to the results of this study, the training program based on empowerment significantly increased the QOL of patients with T2D. Therefore, using this method can be recommended in patients with T2D.

Background: Simulation of tomographic imaging systems with fan-beam geometry, estimation of scattered beam profile using Monte Carlo techniques, and scatter correction using estimated data have always been new challenges in the field of medical imaging. The most important aspect is to ensure the results of the simulation and the accuracy of the scatter correction. This study aims to simulate 128-slice computed tomography (CT) scan using the Geant4 Application for Tomographic Emission (GATE) program, to assess the validity of this simulation and estimate the scatter profile. Finally, a quantitative comparison of the results is made from scatter correction. Methods: In this study, 128-slice CT scan devices with fan-beam geometry along with two phantoms were simulated by GATE program. Two validation methods were performed to validate the simulation results. The data obtained from scatter estimation of the simulation was used in a projection-based scatter correction technique, and the post-correction results were analyzed using four quantities, such as: pixel intensity, CT number inaccuracy, contrast-to-noise ratio (CNR), and signal-to-noise ratio (SNR). Results: Both validation methods have confirmed the appropriate accuracy of the simulation. In the quantitative analysis of the results before and after the scatter correction, it should be said that the pixel intensity patterns were close to each other, and the accuracy of the CT scan number reached

Industrial and agricultural processes have resulted in the release of cadmium metal into the ecosystem. One way to remove this heavy metal is adsorption. This research aimed to determine the efficiency of magnetic nanographene for removing cadmium ions from aqueous solution., This research was done in a discontinuous system at a laboratory scale. For this purpose, the effect of effective parameters such as pH, concentration, contact time, ambient temperature, adsorbent dose, and other factors was investigated. The results showed that the maximum amount of cadmium absorption occurred in the conditions of pH=6, concentration 100 mg/l, contact time 120 min, ambient temperature 45 ° C and adsorbent dose 0.01 g. Thermodynamic parameters showed that the absorption process of cadmium metal was spontaneous and endothermic in the temperature range of 288 to 318 K The pseudo-second-order model with adsorption rate constant (K2 = 0.0092) and coefficient of determination (R2 = 0.99) showed that it describes the laboratory data better. Also, the examination of adsorption isotherms showed that the Freundlich isotherm (R2 = 0.96) was more suitable for describing the adsorption process and was more consistent with the laboratory data. According to the results of this research, magnetic oxide nanographene adsorbent with 92.8% efficiency can be used to remove cadmium from aqueous solutions.

Background and Objectives: Emergency medical technicians (EMTs), as the front line of dealing with patients with COVID-19, are exposed to the intensification of stress caused by these conditions, and it is essential to identify related factors, such as resilience and spiritual intelligence in this context. This study was conducted to determine the relationship between perceived stress, spiritual intelligence, and resilience of EMTs during the COVID-19 pandemic. Methods: This cross-sectional study was conducted on 108 EMTs in Shahroud in 2021. Data collection tools included the demographic checklist, Cohen’s perceived stress questionnaire, King’s spiritual intelligence questionnaire, and Conrad Davidson’s questionnaire (CD-RISC). To analyze the data, descriptive and inferential (independent t-test, Pearson correlation, and multiple regression) statistics were used. Results: The mean scores of perceived stress and resilience of employees were at medium and high levels, respectively. There was no significant relationship between perceived stress and spiritual intelligence (r=-0.49, P=0.24), but there was a meaningful negative correlation between perceived stress and resilience (r=-0.31, P=0.002). A positive and significant relationship was observed between perceived stress score and age and work experience. Conclusion: Considering the significant relationship between perceived stress and resilience in the present study, it is suggested that the administrators provide solutions such as creating training courses to manage stress and increase resilience in EMTs.

Background. Studies have shown a significant relationship between the width and thickness of keratinized gingiva around the implant and changes in marginal bone level, with a significant effect on the health and esthetic of tissues around the implant, especially in the anterior region of the maxilla, which is an esthetic area. Methods. Ten patients referring to the Faculty of Dentistry seeking implant placement in the anterior maxilla were included in the study. The connective tissue of the palatal gingiva of the surgical site was folded to the buccal aspect with the buccal base, and the thickness and width of keratinized gingiva around the buccal surface of each implant were measured in three time intervals, including before surgery and 6 and 12 weeks after surgery. Based on the results of the Kolmogorov-Smirnov test, Friedman test and repeated-measures ANOVA were used to analyze the data. Results. The intervention significantly affected changes in the gingival thickness. After the intervention, gingival thickness significantly increased compared to the baseline (P0.05). Conclusion. Buccal-based modified palatal flap in anterior maxillary implants increased the thickness of keratinized gingiva, with no significant effect on the keratinized gingiva width.

Background: This study evaluated the performances of neural networks in terms of denoizing metal artifacts in computed tomography (CT) images to improve diagnosis based on the CT images of patients. Methods: First, head-and-neck phantoms were simulated (with and without dental implants), and CT images of the phantoms were captured. Six types of neural networks were evaluated for their abilities to reduce the number of metal artifacts. In addition, 40 CT patients' images with head-and-neck cancer (with and without teeth artifacts) were captured, and mouth slides were segmented. Finally, simulated noisy and noise-free patient images were generated to provide more input numbers (for training and validating the generative adversarial neural network [GAN]). Results: Results showed that the proposed GAN network was successful in denoizing artifacts caused by dental implants, whereas more than 84% improvement was achieved for images with two dental implants after metal artifact reduction (MAR) in patient images. Conclusion: The quality of images was affected by the positions and numbers of dental implants. The image quality metrics of all GANs were improved following MAR comparison with other networks.

Background & Aim: Vaccination is the most efficient strategy to tackle the COVID-19 epidemic, and it is important in many ways. Additionally, healthcare workers represent an important vaccine information source for the general population. This systematic review and meta-analysis aimed to evaluate the COVID-19 vaccine acceptance rate among healthcare workers. Methods & Materials: This study was conducted based on the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guideline, and the protocol of this study was registered in PROSPERO with the registration number CRD42023402082. Searches were conducted up to 20 October 2023 in data resources, including PubMed, Scopus, Web of Science, and Google Scholar. The random-effects model was used for meta-analysis, and the I2 index was used to evaluate heterogeneity among studies. The STATA software (version 14) was used for data analysis. Results: During the initial search, 6132 articles were selected. After the screening, study selection, and quality assessment, 93 studies entered the meta-analysis process, and a total of 196235 healthcare workers were examined. The overall vaccine acceptance rate among healthcare workers was reported as 68.56% (95% confidence interval (CI) =18.7-99.7; I2 = 99.750%; p< 0.001). Conclusion: The overall acceptance rate of the COVID-19 vaccine in healthcare workers was lower than expected. Also, some determining factors were identified. The analysis of the vaccine acceptance rate and the factors affecting it can help healthcare officials and policymakers with proper healthcare planning.

In the present study, with the aim of investigating the personality of Ashurai poems, the character traits in this type of poetry have been investigated using a descriptive-analytical method. The ritual poet describes the character of this incident with the help of components such as praise of great men, the revival of Ashura culture, and identification. The behavior and morals of the characters are based on Ashurai poems and they perform appropriate actions in different situations, as they have a convincing reason for any change in their behavior and show a logical reaction when dealing with incidents. In this type of poem, the characters of the story are not created by the poet, but what is depicted is considered in the fictional world of the poem and the outside world of the poem and in the context of the events. The expression of Ashurai characters, sometimes with interpretation and sometimes without interpretation, makes the reader familiar with the nature of the character. This is where the reflection of the inner characteristics of the Ashurai character draws the fluid flow of the mind to Ashura culture. IntroductionThe character is the central factor around which the whole story revolves. Other factors get their objectivity, perfection, meaning, and concept and even the reason for their existence from the personality factor. Religious figures have red lines approaching them is not for everyone. In fact, the character is the industry that gives soul and life to the story and the reader demands it. The main character of the ritual poem opens the knots and becomes the main character of the narrative and the center of the power of the audience. Secondary characters in Ashurai poems are attracted to the main characters and accept their ideals. Materials and MethodsIn the present descriptive-analytical study, the personality analysis of Ashura poems has been carried out with a case study of the poems of Yazd religious poets in the post-revolutionary period using the survey and library approach. Research FindingsThe Ashurai poet does not seek the idealism and mythologizing of the Ashurai character in ritual poetry, but the idealistic character himself. With this initiative, he revives the broken relationship between the individual and the community, and finally implements the social construction with a symbolic order. The revival of Ashura culture, identification, formation of collective identity, anthropology, etc. are the most important basis for the creation of Ashurai characters; therefore, the main characters of Ashurai poetry find a social face. In other words, the characters of Ashurai poetry are dynamic and all-around characters that cause the dynamism and mobility of the society, and there is no trace of any "standard" or "static" character in these poems. The Ashurai poet recreates the characters of Karbala by looking at the culture of Ashura, the people of the society, and the real characters, together with the tools of his imagination and artistic talent. He puts all the elements of the speech in direct relation to the action and reaction of the character in order to objectify his thoughts and emotions with this method and to train "individual" and "type" characters with his Ashurai speech. Discussion of Results and ConclusionsThe expression of Ashura characters, sometimes with interpretation and sometimes without interpretation, makes the reader familiar with the nature of the character. This is where the reflection of the inner characteristics of the Ashura personality draws the fluid flow of the mind to the Ashura culture. The Ashurai poet recreates Ashurai’s personality by looking at Ashura and conscious or unconscious discourses. The characterization of religious and Ashura poems has differences from the characterization of other poems. The difference between Ashurai characters and myths is that the characters of Ashurai poetry are reasonable and acceptable, which is considered one of the strengths of this type of poetry.The main criterion of being a character is his determining role in the plot of words and stories. It may be that during the events, depending on the circumstances of the event, the words, actions, and behavior of the dynamic characters in Ashurai poems cannot be predicted, but these changes work together with a pattern of behavior and this factor itself is proof of human dynamism. The character in these poems is alive, and the Ashurai poet, unlike Ferdowsi, does not try to create a superhuman or holy character. This is not a sign of the poet's lack of artistic or visual talent in creating a character, but rather, he narrates the real self of the character. The formation of events and moving forward are other characteristics that can be seen in the characters of this type of poetry. The poet establishes a coherent relationship between the characters. In other words, the poet, with his special intelligence and elegance, recounts the prevailing thoughts and opinions of the society through the use of various elements such as action, dialogue, environment, space, etc. It should be noted that in Ashurai poetry, all the verses are written for a character from Ahl al-Bayt.

Radiotheranostics refers to the pairing of radioactive imaging biomarkers with radioactive therapeutic compounds that deliver ionizing radiation. Given the introduction of very promising radiopharmaceuticals, the radiotheranostics approach is creating a novel paradigm in personalized, targeted radionuclide therapies (TRTs), also known as radiopharmaceuticals (RPTs). Radiotherapeutic pairs targeting somatostatin receptors (SSTR) and prostate-specific membrane antigens (PSMA) are increasingly being used to diagnose and treat patients with metastatic neuroendocrine tumors (NETs) and prostate cancer. In parallel, radiomics and artificial intelligence (AI), as important areas in quantitative image analysis, are paving the way for significantly enhanced workflows in diagnostic and theranostic fields, from data and image processing to clinical decision support, improving patient selection, personalized treatment strategies, response prediction, and prognostication. Furthermore, AI has the potential for tremendous effectiveness in patient dosimetry which copes with complex and time-consuming tasks in the RPT workflow. The present work provides a comprehensive overview of radiomics and AI application in radiotheranostics, focusing on pairs of SSTR- or PSMA-targeting radioligands, describing the fundamental concepts and specific imaging/treatment features. Our review includes ligands radiolabeled by 68Ga, 18F, 177Lu, 64Cu, 90Y, and 225Ac. Specifically, contributions via radiomics and AI towards improved image acquisition, reconstruction, treatment response, segmentation, restaging, lesion classification, dose prediction, and estimation as well as ongoing developments and future directions are discussed.

Abstract Evaluation of extracellular domain of human epidermal growth factor receptor-2 (HER2-ECD) oncomarker status is an impressive factor in screening, diagnosing and monitoring early-stage breast cancer (BC). Electrochemical aptamer-based nanobiosensor with high sensitivity and selectivity for quantitative and qualitative measurement of HER2-ECD oncomarker was developed. In this study, the nanocomposite made by distinct materials included reduced graphene oxide nano-sheets (rGONs) and rhodium nanoparticles (Rh-NPs) on the graphite electrode (GE) surface. This structure resulted in amplified electrochemical activity, high surface area, stability, and bio-compatibility. Each of the steps of preparing nanomaterials and setting up biosensor were carefully examined by analytical and electrochemical techniques. Various modified electrodes were constructed and analyzed in terms of electrochemical performance, morphology, size, and shape of nanomaterials. The GE-based aptasensor had a noteworthy and conducive results against HER2-ECD with a wide dynamic range of 10.0–500.0 ng/mL, a low limit of detection (LOD) of 0.667 ng/mL (significantly less than the clinical cut-off), and a low limit of quantification (LOQ) of 2.01 ng/mL. The benefits provided by this aptasensor such as broad dynamic range, high sensitivity, selectivity, stability, reproducibility, and low cost suggest tremendous potential for non-invasive detection and monitoring of the HER2-ECD levels of BC care and clinical diagnosis.

Background and Objective: Palliative care for newborns and their families is urgent. Nurses' experiences need to be considered in order to implement palliative care. Therefore, the present study was conducted to explain the Nurses' Experiences of Palliative Care in the NICU. Material and Methods: This study was conducted by qualitative content analysis in the neonatal intensive care units of Isfahan, Iran, in 2020. Inclusion criteria for nurses were the consent to participate in the study and experience of caring for the newborn and their family at the end of life. For data collection by the purposeful sampling method, in-depth semi-structured interviews were conducted with 12 nurses. Interviews were recorded, typed, and analyzed. Goba and Lincoln criteria were used to ensure the rigor of the data. Results: The first theme was palliative care for the newborn. This theme consists of two categories: "compassionate end-of-life care" and " spiritual end-of-life care". The second theme was palliative care of the family. This theme consists of two categories: "Palliative care of the family before the death of the newborn" and "Palliative care of the family after the death of the newborn ". Conclusion: The results of this research are in line with the WHO definition of palliative care in pediatric, which refers to the active total care of the child's body, mind and spirit, and family support. The results of this research are used to improve the care of infants and families at the end of life and death for officials and nurses of NICU.

Abstract Background Materials with high atomic numbers are part of the composition of dental implant systems. In radiotherapy of oral cavity cancers, an implant can cause dose perturbations that affect target definition, dose calculation, and dose distribution. In consequence, this may result in poor tumor control and higher complications. In this study, we evaluated dose homogeneity when a dental implant replaced a normal tooth. We also aimed to evaluate the concordance of dose calculations with dose measurements. Materials and methods In this study, 2 sets of planning CT scans of a phantom with a normal tooth and the same phantom with the tooth replaced by a Z1 TBR dental implant system were used. The implant system was composed of a porcelain-fused-to-metal crown and titanium with a zirconium collar. Three radiotherapy plans were designed when the density of the implant material was corrected to match their elements, or when all were set to the density of water, or when using the default density conversion. Gafchromic EBT-3 films at the level of isocenter and crowns were used for measurements. Results At the level of crowns, upstream and downstream dose calculations were reduced when metal kernels were applied (M-plan). Moreover, relatively measured dose distribution patterns were most similar to M-plan. At this level, relative to the non-implanted phantom, mean doses values were higher with the implant (215.93 vs. 192.25), also, new high-dose areas appeared around a low-dose streak forward to the implant (119% vs. 95%). Conclusions Implants can cause a high dose to the oral cavity in radiotherapy because of extra scattered radiation. Knowledge of the implant dimensions and defining their material enhances the accuracy of calculations.

The financing of technological projects in the can be used to accelerate the growth, attract capital or supply liquidity to knowledge-based companies. The cooperative financing model in the framework of usury-free banking with the support of the real sector of the economy and the correct implementation of bank contracts play a key role in achieving Islamic banking system. The aim of the research is to identify the factors influencing investment in the technological projects of the incubation phase and to design the model of cooperative financing of the projects in order to create a risk distribution mechanism, attract people's participation, and support the knowledge-based economy. This is a development-applied research and the way of data collection is survey type. To collect data, a researcher-made questionnaire distributed among the experts of the risky investment system and the managers of the banking system was used. Factors affecting investment were identified in two sectors, including internal to the organization such as entrepreneurial team, product characteristics and technological company, and external to the organization such as technological business ecosystem and macroeconomic factors. The method of The Partial Least Squares regression (PLS) with the help of Smart Pialas software showed that the investment stages of technological projects have a medium and high impact on investment. Then, the proposed financing model was presented by using cooperative contracts according to the operational model and playing the role of bank intermediary in the usury-free banking system.

Introduction: Contamination of water with heavy metals has turned into a health concern, particularly in the developing countries. In this study, concentration of heavy metals and associated carcinogenic and non- carcinogenic risk was investigated in water samples collected from Gonbad-e Kavus, a high-risk area for cancer. Materials and Methods: Samples were collected from Gorgan River, Golestan reservoir and wells around villages with high prevalence in 2018.Samples were analysed through inductively coupled plasma mass spectrometry. After determining the concentration of heavy metals in water samples from different sources, health risk assessment was carried out according to the Environmental Protection Agency. Results: Arsenic in samples 6-9 was higher than 10 µg/L, calcium and magnesium in sample 5 was higher than 200 mg/L and 150 mg/L respectively, and sodium in all samples was higher than 50 mg/L. According to the findings, these concentrations were higher than the maximum allowed limit in most water samples. Hazard quotient (HQ) in samples 8 and 9 were associated with arsenic and health risk in sample 1 was related to antimony. Furthermore, since all samples contained high amounts of lithium, water from this area better should not be consumed by children older than one year. Conclusion: Given the high rate of arsenic contamination, consumption of water in the study area could be health threatening for all individuals and is not recommended for children. This highlights the need for taking immediate actions to review the water treatment process and ensure safety of the drinking water in this area.

Abstract The Ashura event influenced the composition of some of the melodies and types of music. In this article, the beauty of Yazd's lamentation, vocal music of Ashura poems, and their effects on the musical system are the subject of study. The composer establishes the theme and then makes similar themes to expand the poem. While reciting the poems on Hosseini Ashura, the singer progresses with the change of tone and modulation. As a result, in Yazd's Ashura poetry and lamentation, the combination of poetry with the style of song melodies, the presentation of a specific type of music called "Bayat Yazd", the use of musical jumps, and also new melodic styles are some of the characteristics of this kind of poetry. Poetry is the music of words and phrases; this is even more important in the lamentation poem because, in addition to the proportion of meter and content, it also requires the function of a music type. The music of Ashura's poems affects the word and the meter in the same way. Yazd's Ashura poems have developed in terms of the appropriate meter, theme, style, language, and music. Sometimes, according to the music and melody, the meter, form, and rhymes could be modified. All of these modifications depend on the poet's sense and experience. When he opens his mouth, he reveals his hidden meaning with his melody. If the beats create a melodic style, it is called the rhythm of the music, and if the beats represent how the words flow, it is called poetry. Singing is a sub-device. The vocal lines add a specific beauty in performing the lament. In expressing and reciting Yazd's lamentations, knowing the beat and method of breaststroke from one, three, five, or seven, and sometimes a mixture of beats is necessary. Combining different types of external music with semantic and internal music creates a new atmosphere in lamentation. The main variation of lamenting is the addition of frequent or non-repetitive sections. Poets who want to take the path of Ashura should first comprehend the song's spirit and the secrets behind it because not every poem is suitable for every kind of singing. The secret of Yazd's Ashura lamentation and poetry is the novelty of the theme, the combination, and connection of the poem with the melodies, which includes the events of Karbala and recounting the emotional, moral, and cultural needs of the people of their time. But before composing a poem, the composer should consider the extent of the singer's voice, performance, and the way he expresses himself because each singer's voice has characteristics that if the composer does not consider such features, his song could not be so heartwarming and impressive. The Ashura poet can connect the geometric composition of the word with the music. He familiarizes the strings of each song with the texture of each word in creating an Ashura-Hosseini poem. In Ashura poems, melodies or selected musical sentences and meters, in addition to beauty, reveal the content of speech and express the tragic event of Ashura and the desert of Karbala. The role of music and sound in the poems of lamentation is theological. The music of the lyrics complete and promote the art of lamentation rituals and keep alive the Ashura culture.

Background and purpose: Water quality is an important factor that affects all aspects of eco-system and health food-to-business activities to the sustainability and health of the echo systemThis study was carried out with the aim of investigating the qualitative changes in the Ziarat River water. Materials and Methods: Samples from the Ziarat River Station (5 stations) were sampled each year in 2018. Samples were transferred to the Golestan University of Medical Sciences in accordance with the standard conditions, along with ice. The parameters of nitrate, phosphorus, biochemical oxygen demand (BOD), chemical oxygen demand (COD), ammonium, total hardness and total Fecal coliform was measured according to standard method and the Water Quality Index (WQI) was calculated. Results: The results of the study, based on the WQI index, showed that the index for all stations was between 29.68 and 64.78, and in some of them the average was (50-70) and some stations had poor quality ( 50-25). The most effective parameter on the water quality of the river is the BOD parameter, and then it is the total solids, turbidity, phosphate, nitrate and total Fecal coliform. Conclusion: The highest level of pollution in the terminal stations (4 and 5) due to more industrial activity is the entry of sewage and effluents into the river in Gorgan. Among the measured parameters of nitrogen and phosphorus as nutrients, if left unchecked, it poses a risk of eutrophication. Agricultural, livestock and recreational activities around the river affect the water quality of the river. So that a more appropriate quality was observed in the upstream stations. Considering that the Ziarat River is one of the most important sources of water supply needed in the agricultural and industrial sectors in Golestan province. Therefore, monitoring and control of pollutants entering this river is essential.

Introduction: Exposure of grain products in polluted soil lead to adverse effects on human health. In this study, concentrations of HM (As-Cr-Hg) were analyzed in wheat grain cultured in Gonbad-e-Kavus City, Golestan province, Iran. Furthermore, its potential health risk was evaluated among residents. Materials and Methods: The sampling sites were located in arable lands. After separating the wheat grains and cleaning them, the seeds were collected in plastic bags for analysis by ICP/MS method. Digestion of samples was performed with Multi wave PRO microwave apparatus. Results: The mean concentrations of Arsenic (As), Chromium (Cr), Mercury (Hg), and Nickel in wheat seeds were 0.186 ± 0.08, 0.9 ± 0.07, 0.021 ± 0.019, and 0.5 ± 0.17, respectively. The results showed that concentrations of HM in wheat were as follow: Cr > Ni > As > Hg. The Hazard Quotient (HQ) was significantly different among various HMs. The largest HQ was related to As ranging from 0.33 to 13.3. The lowest HQ was attributed to Cr, which may be related to its high RfD = 1.5 mg kg−1. Conclusion: Different HMs varied largely in terms of their HQ. Regarding the exposed people, As and Hg had the highest contributions to the aggregate risks of HMs, while Cr had the lowest contribution. Although the findings showed low environmental concentrations of the studied elements and implied no danger to human health, it should be considered that many non-cancerous conditions weaken the immune system and prone the human beings to cancerous diseases.

Breast cancer (BC), one of the most common and life-threatening cancers, has the highest incidence rate among women. Early diagnosis of BC oncomarkers is considered the most effective strategy for detecting and treating BC. Finding the type and stage of BC in women as soon as possible is one of the greatest ways to stop its incidence and negative effects on medical treatment. The development of biosensors for early, sensitive, and selective detection of oncomarkers has recently attracted much attention. An electrochemical nano biosensor (EN) is a very suitable option for a powerful tool for cancer diagnosis. This comprehensive review provides information about the prevalence and pathobiology of BC, recent advances in clinically available BC oncomarkers, and the most common electrochemical nano biosensors for point-of-care (POC) detection of various BC oncomarkers using nanomaterial-based signal amplification techniques.

Background and Aim: Salinity is one of the most important factors affecting growth, photosynthesis and valuable metabolites regarding large scale cultivations. The aim of this research was studying the effect of salinity on growth and pigment composition of Chlorella sp. Collected from paddy-fields of the Golestan Province for evaluating of the potentiality for large scale cultivation. Materials and Methods: Purification was done using N8 culture media at 2 uE.m-2.S-1 irradiance, 280C and continuous illumination at pH 7.2. Salinity treatments were Sodium Chloride at 0, 0.25.0.5 and 1% ( 17 to 170 mM) concentration. Survival and growth were assayed by turbidity, pigment composition as in vivo and in vitro were measured after normalization at the dry weight unit. Results: Results showed that the sharp increase in growth rate viewed at 5th day after inoculation at both control and treatments. Survivality would be keep at this salinity range. The optimum of growth and the highest degree of special growth rate were seen in 0.5% salinity. Difference between the growth at 0.5 and 1 % salinity were significant. The ability of carotenoide production at the 9th day after inoculation were significantly more than the other treatments and insignificant for chlorophyll production. Conclusion: The results show that Chlorella sp., have acclimatized potentiality against this degree of tension and regarding that would be considered as a suitable candidates for future bio fertilizer and soil conditioner inoculation in Golestan province. Document Type: Research ar

64Cu is a favorable radionuclide in nuclear medicine applications because of its unique characteristics such as three types of decay (electron capture, β− and β+) and 12.7 h half-life. Production of 64Cu by irradiation natCu and natCuNPs in Tehran Research Reactor was investigated. The characteristics of copper nanoparticles were investigated with SEM, TEM and XRD analysis. The cross section of 63Cu(n,γ)64Cu reaction was done with TALYS-1.8 code. The activity value of 64Cu was calculated with theoretical approach and MCNPX-2.6 code. The results were compared with related experimental results which showed good adaptations between them. Keywords: 64Cu radioisotope, Copper nanoparticles, Production yield, MCNPX, TALYS-1.8

Objectives: Metal artifacts are one of the major issues encountered in computed tomography (CT) images since they may make distinguishing healthy and tumor organs and computing dose distribution through radiotherapy very difficult. Accordingly, designing generative adversarial neural networks (GANs) will help reduce metal artifacts. Methods: Training and validating images with and without metal artifacts were simulated in MATLAB. Then, these images were used as the input data for the GAN, while CT images of 30 patients with head and neck cancer were used as testing data for the GAN. Finally, the quality metrics of denoised images were compared with those of the noisy images. Results: The images of patients with one dental implant have shown more improvement in the oral cavity area (16.81%), which is very important in treatment planning. Simulated images were used for the validation of the GAN's ability for metal artifact reduction. Moreover, the GAN was affected by the density and position of the metal artifacts in the CT images. Conclusions: Corrected images allow us to improve the quality of the CT images of patients with metal artifacts.

In this article the rate of return (ROR) and risk factors faced by international oil company (IOC), in IPC contract of Darkhowein oil field is modeled. For this purpose, we analyze the IPC contract specific risk factors that can contribute to a reduction in the rate of return for the international oil company including oil price, production level, capital cast, operating cost, and remuneration. The results of the cash flow risk analysis show the impact of these factors on the contractor's rate of return on IPC contracts is not significant in comparison to Buy-back contracts. The most important risk factor in Buy-back contracts is capital cast, which affects a large part of the contractor's returns, but in these contracts, this risk has been significantly reduced due to the government's additional compensation. In general, according to the results, it can be said that in IPC contracts, the contractor's return rate has not been heavily influenced by risk factors, and therefore the risk of the international oil company has fallen in these contracts.

The nuclear disasters in Chernobyl and Fukushima have shown that such nuclear incidents are causing serious and undesirable long-term damage to the environment and the health of living beings, including humans. So that they should be taken very seriously. Considering the importance of the subject, in this paper, the simulation of the transmission and emission of cesium 137 nuclear abandoned from the contingency incident of Bushehr Power Plant in the Persian Gulf using the CROM (Código de cRiba para evaluaciÓn de iMpacto) code has been discussed. We assumed that the incident took place on July 1, 2018, and the most dangerous and an important nucleus of the abandoned is cesium 137. The simulation results show that the Cs-137 released from the incident is moved to the west and northwest of Persian Gulf and approach the head of the Persian Gulf after fifteen days. Then driven by the discharge of the Arvandrood River to the south coast and center of the Gulf moves forward and leads to the bottom. About two months later (late August) it will leave the Strait of Hormuz and will advance the Oman Sea and the Indian Ocean. Now, if this happens on January 1, after about 30 days, cesium 137 reaches the head of the Persian Gulf, and four months later (late March) will leave the Strait of Hormuz. The results of this study can be used under the same conditions in the nuclear emergency of Bushehr Power Plant.

Oil futures contracts make it possible for all market participants to remain safe against the crude oil price fluctuations. Islamic Republic of Iran needs to import oil futures contracts to energy exchange for two reasons: First, its national income is highly dependent on crude oil price and instability in oil price leads to unstable economic situation. Second, Oil futures markets provide necessary instruments to reduce risk of oil deals, reduce volatility, increase flexibility and provide broader commercial dimensions to refiners and other buyers of petroleum and related industries. But now, exchange energy, due to jurisprudential constraints, is not able to use this powerful instrument of hedging risk, and this is incompatible with the implementation of economic resistance and resilience policies. This study analyzes financial nature of oil futures contracts and investigates the intend of the parties to the contract and shows that oil futures contracts are not, in any way, type of selling or obligation to selling because the acquisition and consequently delivery of asset are not intended by parties. Therefore, all of those jurisprudential obstacles are wrong about these contracts and are caused by the poor in recognizing the issue.

Introduction: The groundwater is the main resource of water. This study aimed to investigate water quality variations in the villages of AqQala in a eleven-year period as well as designing and implementing the Water Quality Index (WQI). Materials and Methods: In order to investigate water quality variations, the data in the villages of AqQala city was collected in an eleven-year period (2005-2015). Also, according to the research objectives, a sample period in year 2015 was carried out. Samples were measured according to the standard method for examination of water and wastewater. In order to calculate the Groundwater Water Quality Index (GWQI), the Iranian Water Quality Index Software (IWQIS) was used. Results: Some parameters of water quality, including pH, calcium, magnesium and potassium in all sources, were in standard limit. Some of the parameters were higher than the standard limit, which included turbidity, ammonium, phosphate in all sources and sulfate, chloride, sodium, iron and manganese, silicate and alkalinity in some resource. The results measured by the GWQI index in groundwater resources showed that the groundwater source was not with excellent water quality. About 19.3% of sources had poor qualities and the other sources had good qualities. Conclusion: The results of water quality over this period showed that some parameters were increased; which leads to water quality reduction. Therefore, comprehensive management of drinking water resources is essential for people's health.

Introduction:Sulfur oxidizing bacteria are important in agriculture. The aim of this study was to identify the sulfur oxidizing bacteria in Sarcheshmeh (Kerman, Iran) agricultural soil. Materials and methods: Sampling was conducted from agricultural soil in Kerman province, Iran. After enrichment, samples were purified in the basic mineral culture containing sulfur as the only source of energy. Sulfur oxidation capability was evaluated based on the variation of pH and sulfate content and then strains of sulfur oxidizing were isolated and identified using morphological characteristics and phylogenic techniques. The best strains were selected and were evaluated for variation of pH and sulfate content by isolates in different pH and temperature. Results: Six sulfur-oxidizing strains were isolated and identified which had similarity to Thiobacillus and Starkeya genous. Isolates of 103, 129, 190 and 158 were mesophyll and neutrophil, but isolates of 192 and 156 were thermophile and alkalophill. Of these isolates, isolate 103 was 99.86% similar to Starkeya novella, identified as superior isolate, due to the most sulfur oxidation capability in the synthetic mineral medium containing sulfur. Discussion and conclusion: Isolate 103 was able to grow in neutral to slightly alkaline conditions with pH 7.5. Most of the growth of this isolate was at 30 ° C as aerobic. This isolate was facultative chemolithotroph and the results of this research showed capacity of the isolate for oxidizing sulfur, so that it could be used as a practical isolate in bio-fertilizers for neutral to alkaline and saline conditions in agriculture.

ABSTRACT Introduction: Heavy metals have an important role in human health because of their nutritive value and possible adverse effects. The objective of this study was to assess level of heavy metals and selenium in rice harvested in the Golestan Province, Iran. Materials and Methods: This study was conducted in the Golestan Province, northern Iran. The area under rice cultivation is 45714 acres. Overall, 69 rice samples were collected from rice farms in different areas of the province including high-risk (42 samples) and low-risk areas (27 samples) for esophagus cancer (EC). Concentrations of heavy metals were measured by polarograph. Voltammetric analysis was carried out using 797 VA computrace (Metrohm). Results: Maximum concentrations of zinc, cadmium, lead, copper, nickel, cobalt and selenium in high-risk areas for EC were 70.6, 0.41, 5.05, 14.4, 8.8, 0.88 and 0.48 mg/kg as dry weight, respectively. Maximum concentrations of these elements in the low-risk area for EC were 88.4, 0.37, 3.9, 17.2, 8.1, 0.27 and 0.25 mg/kg as dry weight, respectively. The concentration of Se in high-risk areas were significantly higher than that in low-risk areas (P

Adopting appropriate and efficient tools for risk management is a core element in managing a variety of risks. Insurance-Linked Securities are modern financial-insurance tools which have been utilized widely by the insurers to cover risks especially catastrophe related risks and massive risks. Moreover, these securities are financial tools that occur in life insurance securitizations. Heretofore, the risk securitizations have been inside the insurance industry and the operational models for issuing such securities on oil and gas projects' risks have not been presented to the literature yet. Considering the importance of oil and gas sector and also the high diversity and variety of oil and gas projects' risks and in order to diversify the risk management tools in the hands of oil and insurance industries, this paper has tried to develop a model for issuing oil risk securities based on Simon's theory of bounded rationality (1996). This model is consistent with conditions in Iranian oil and insurance industries and the Islamic juridical (Shari'ah) considerations for the corresponding investments.

Background: The aim of this study was to evaluate respiratory problems via pulmonary function testing in cement transport workers at Incheh Borun border in northeast of Iran in 2016. Methods: The study was conducted on 358 male workers. All subjects were evaluated for respiratory symptoms via pulmonary function testing and completion of the American Thoracic Society questionnaire. Results: Mean age of workers was 34.8±12.87 yr (age range 16-79 yr). Mean duration of employment was 6.1±4.36 yr. Most workers (75.4%) were illiterate or had elementary education. In addition, 56 (15.6%) subjects were smokers. Only three individuals (0.3%) had obstructive pattern. There was a significant relationship between age of workers and frequency of respiratory problems (P

Introduction One of the best methods in the diagnosis and control of breast cancer is mammography. The importance of mammography is directly related to its value in the detection of breast cancer in the early stages, which leads to a more effective treatment. The purpose of this article was to calculate the X-ray spectrum in a mammography system with Monte Carlo codes, including MCNPX and MCNP5. Materials and Methods The device, simulated using the MCNP code, was Planmed Nuance digital mammography device (Planmed Oy, Finland), equipped with an amorphous selenium detector. Different anode/filter materials, such as molybdenum-rhodium (Mo-Rh), molybdenum-molybdenum (Mo-Mo), tungsten-tin (W-Sn), tungsten-silver (W-Ag), tungsten-palladium (W-Pd), tungsten-aluminum (W-Al), tungsten-molybdenum (W-Mo), molybdenum-aluminum (Mo-Al), tungsten-rhodium (W-Rh), rhodium-aluminum (Rh-Al), and rhodium-rhodium (Rh-Rh), were simulated in this study. The voltage range of the X-ray tube was between 24 and 34 kV with a 2 kV interval. Results The charts of changing photon flux versus energy were plotted for different types of anode-filter combinations. The comparison with the findings reported by others indicated acceptable consistency. Also, the X-ray spectra, obtained from MCNP5 and MCNPX codes for W-Ag and W-Rh combinations, were compared. We compared the present results with the reported data of MCNP4C and IPEM report No. 78 for Mo-Mo, Mo-Rh, and W-Al combinations. Conclusion The MCNPX calculation outcomes showed acceptable results in a low-energy X-ray beam range (10-35 keV). The obtained simulated spectra for different anode/filter combinations were in good conformity with the finding of previous research.

Background and aims: Considering the important role of the family in patients with diabetes in management and good control of the disease, the present study was conducted to compare the efficacy of patient-centered and family-centered teaching methods (based on empowerment model) on the laboratory variables of patients with type II diabetes. Methods: This was a quasi-experimental study and applied. 147 patients with type 2 diabetes refrred to diabetic center of shahroud were divided into three groups: control (A), patient-centered intervention (B), and family-centered intervention (C) through simple random allocation. Before the intervention and three months after that, nonfasting and fasting blood glucose, cholesterol, triglycerides, and low and high-density lipoprotein was carried out from patients as laboratory indexes. The intervention was carried out in the form of patient-centered in group B and family-centered in group C and routine education was conducted in the control group. Data was analysed using SPSS software and Chi-square and ANOVA tests. Results: There was no significant difference in the demographic variables and laboratory variables among the three groups before the intervention (P>0.050). A significant difference was found between all of these variables after the intervention FBS: (P=0.012), BS: (P=0.002), triglicerid: (P=0.015), cholesterol: (P=0.013), LDL: (P=0.010), HDL: (P=0.022). A significant difference was reported between all of the laboratory variables in the intervetion groups in comparision with the control group (P

Background: Traffic accidents are among the important health issues that threaten human life. Children are among the main victims of these accidents. This research aimed to study the epidemiology of fatal and nonfatal road traffic accidents and their outcomes in children and adolescents in Shahroud, Iran. Materials and Methods: This descriptive and analytical study was conducted from July to December 2011. Data were collected through a researcher-made questionnaire. After verifying its content validity and reliability, the questionnaire was completed by emergency medical technicians. The data were analyzed using descriptive and inferential statistics (the Chi-square test). Results: Of 363 studied cases, the majority of accidents happened in July with 108 (29.8%) cases and on Thursdays (18.7%). About 89.3% of drivers were male and aged 39 to 40 years (44.6%). Most accidents happened during 8 to 12 AM (23.7%). Moreover, 21.28% (1161 persons) of all injured people and 18.75% (48 persons) of all deceased victims were children under 14 years old. None of the victims under 14 years of age used protective tools. Head and spine trauma, respectively, were reported as the most common injury in this age group. There was no significant differences between victims aged less and more than 14 years old in terms of spinal cord injury (P=0.03). Conclusion: Based on the results of this study, it is recommended to take some basic actions such as improving roads, identification of black spots, installation of warning signs at those points, and extending controls and supervisions by police. It is also very important to use standard protective tools for children and adolescents, force rules for using appropriate safety equipment for this age group, and provide public trainings for the people to raise their level of awareness.

Wastewater of hospitals can cause many risks to public health due to having a variety of pathogenic microorganisms, pharmaceutical substances, and other hazardous toxic substances. The aim of this study was to evaluate the chemical quality of effluents from wastewater treatment plant of Falsafi Hospital and Hakim Jorjani Hospital in Gorgan, Iran, and to compare them technically and economically. This descriptive-analytical study was performed on 64 samples of raw wastewater entrance and output effluent obtained from treatment plants using extended aeration process and sequencing batch reactors (SBR) in two hospitals in Gorgan. All experiments for determination of pH, free residual chlorine, biochemical oxygen demand (BOD), chemical oxygen demand (COD), and total suspended solids (TSS) were performed using standard methods. Finally, the obtained data were analyzed using t-test and Mann-Whitney test in SPSS software. Based on the results, the removal efficiency of BOD, COD, and TSS of the extended aeration system was 91, 90.8, and 95.7 percent, respectively, while these values for the SBR system were found to be 91.7, 91.9, and 95.3 Percent, respectively. Moreover, in the output of the two hospitals, pH values were recorded as 6.69 ± 0.26 and 7.33 ± 0.2 and the average amount of free residual chlorine was 0.12 and 0.13 mg/l, respectively. This study demonstrates good performances of the extended aeration activated sludge system and the SBR system in terms of reduction of pollution load to its standard limits for agriculture and irrigation purposes. However, due to slightly better efficiency, lower cost of investment, and operation compared to other methods, the SBR system is recommended.

Clinical studies have shown that hyper-homocysteinemia is a potent independent risk factor for cardiovascular diseases, and many different methods have been investigated for lowering it in hemodialysis (HD) patients. Our study investigated the effect of Vitamin B 12 supplementation on serum homocysteine levels in these patients. This randomized trial was conducted on 140 HD patients. They were randomly distributed by lottery method into two groups: intervention and control. In the intervention group, 100 μg/mL of Vitamin B 12 was intravenously injected two times a week, for eight weeks. No intervention was performed in the control group. Serum levels of homocysteine, hemoglobin (Hb), and hematocrit (Hct) were measured at the beginning and again after eight weeks (2 months) of treatment. About 91% of the patients had hyperhomocysteinemia (serum homocysteine >15 μmol/L). The median baseline levels of serum homocysteine in the intervention and control groups were 31.9 and 26.9 μmol/L, respectively (P = 0.1). After eight weeks, the median homocysteine level reduced significantly in the Vitamin B 12 group to 22.2 versus 28.4 μmol/L in control group (P = 0.006). The mean Hb and Hct also changed significantly during our study (12.3 vs. 11.4 g/dL; P = 0.003 and 37.9 vs. 35.3%; P = 0.02, respectively). Our results demonstrated the existence of a statistical negative relationship between Vitamin B 12 and serum levels of homocysteine. Detailed investigations with larger sample sizes and longer-term use of Vitamin B 12 are recommended.

To determine the effects of educational instructions on hemodialysis patients′ knowledge and quality of life (QOL), we studied 99 patients randomly assigned to control and experimental groups after participation in a pretest exam. The two groups were not significantly different in terms of demographic composition. The instrument used in this study was a questionnaire regarding patients′ knowledge and the standard questionnaire to assess QOL for end-stage renal disease (ESRD) patients. Then, intervention (nutritional education) was conducted in the experimental group lasting for 12 weeks. After 16 weeks, a post test regarding subjects′ knowledge on dietary instructions and their QOL were as conducted. There was no significant difference in QOL score and knowledge score before and after intervention in the control group, but there was a significant difference in the experimental group. In addition, after the intervention, the difference in knowledge and QOL score persisted between the two groups. The results of this study supported the positive effects of educational program on patients′ knowledge and QOL among ESRD patients. It is recommended that dietary instruction be included in all educational programs to improve ESRD patients′ QOL.

Background and aim: Change the traditional approach to empowerment in education and care in diabetic patients is by creating a proper ground for improvement self-care and health status in patients with diabetes. The present study was conducted to determine the relationship between empowerment with dimensions of quality of life and some related factors in patients with type 2 diabetes. Methods: This descriptive-analytic study was performed on 156 patients with type2 diabetes in Shahroud town in 2013.The relationship between empowerment with dimensions of quality of life and some related factors was evaluated using demographic information form, empowerment Questionnaire(DES-28), diabetes patients-specific quality of life questionnaire. Results: The overall mean of empowering score in patients was 82/56±16/84. There was a significant and positive correlation between empowerment and all dimensions of quality of life (P=

Aims: This study designed to investigate the concentration of some heavy metals (HM) in the soil of agricultural land of Gonbad-e Kavus in Golestan province and relationship of these metals with esophageal cancer disease. Materials and Methods: For the investigation of pollution, especially HM in the soil, 5 points were randomly selected from each village (3 villages). The samples dried and screened by 200 mesh sieve.Then, the samples were analyzed for HM using ICP/MS. Results: The mean of Cadmium (Cd), Zinc, Cobalt, Chromium, Manganese, Nickel, Arsenic, Copper (Cu), Lead (Pb), and Iron (Fe) in soil was 0.5938 ± 1.7, 74.06 ± 18.9, 12.06 ± 1.28, 68.68 ± 5.85, 627.37 ± 53.3, 38.43 ± 4.4, 6.51 ± 1.21, 29.37 ± 4.3, 17.25 ± 3.5, and 27766.06 ± 2200 mg/kg, respectively. Conclusion: The concentration of metals except Cd and iron was less than the global standards. The concentration of some metals in the soil is almost high due to the high consumption of urea, phosphate, and nitrogen fertilizers. Therefore, it is recommended to educate farmers and use less chemical fertilizers.

زمینه و هدف: با توجه به آلودگی بالای شیرابه محل دفن و جهت جلوگیری از آلودگی محیط زیست، این مطالعه با هدف بررسی تعیین تاثیر فرایند انعقاد الکتریکی در حذف مواد آلی، نیتروژن، فسفر و کدورت، طراحی و اجرا شد. مواد و روش ها: مطالعه حاضر یک مطالعه توصیفی تحلیلی با رویکرد تجربی و آزمایشگاهی بود. از شیرابه تولیدی در مرکز دفن و کمپوست شهر گرگان نمونه گرفته شد و وارد راکتور الکتروکواگولاسیون شد. در شراط مختلف عملکردي، زمان ماند20، 40 و 60 دقیقه، pH برابر 3 ، 6 و 9 و اختلاف پتانسیل الکتریکي20، 40 و 60 ولت، از شیرابه داخل راکتور نمونه برداری شد و طبق روش استاندارد پارامترهای مورد مطالعه اندازه گیری شد. این طرح پژوهشی با توجه به ماهیت آن منافاتی با مسائل اخلاقی نداشت. یافته ها: بیشترین میزان حذف در میزان ولتاژ 60 ولت، زمان 60 دقیقه و pH برابر حدود خنثی (6.9-6.5) بود. میزان حذف کدورت، ،COD نیترات و فسفر در شیرابه خام به ترتیب برابر 59/14، 44/33، 40/81و 48/86درصد بود. این مقادیر برای پساب خروجی تصفیه خانه که تحت راکتور انعقاد الکتریکی قرار گرفته بود به ترتیب برابر 88/9، 80/5، 59/16و 62/35درصد بود. نتیجه گیری: فرایند انعقاد الکتریکی به عنوان فرایند پیش تصفیه، باعث حذف مواد آلی، کدورت، مواد مغذی، کاهش بار آلی و افزایش تجزیه پذیری شیرابه می گردد و میتواند به عنوان گزینهای موثر جهت پیش تصفیه موثر فاضلاب، جلوگیری از آلودگی محیط زیست، منابع آب و حفاظت از آنها مدنظر قرار گیرد

زمينه و هدف: اين مطالعه با هدف ارزيابي کيفيت آب رودخانه زرين گل با استفاده از شاخص‌هاي کيفي آب با توجه به وجود فعاليت‌هاي کشاورزي ، تفريحي و پرورش ماهي در اطراف اين رودخانه، طراحي و اجرا گرديد. مواد و روش‌ها: با توجه به فعاليت‌هاي کشاورزي و دامداري اطراف رودخانه، 9 ايستگاه نمونه برداري مشخص شده و نمونه برداري با تناوب دو هفته يکبار در تابستان و پاييز انجام شد و پارامترهاي مورد نياز جهت محاسبه شاخص‌هاي کيفي آب طبق روش استاندارد اندازه گيري شد. با توجه به پارامترهاي اندازه گيري شده شاخص کيفي آب (NSF WQI) و شاخص کيفيت آب هاي سطحي ايران (IRWQISC) محاسبه شد. پارامترهاي اندازه گيري شده شامل پارامتر کليفرم گرماپاي، اکسيژن مورد نياز بيوشيميايي، نيترات، اکسيژن محلول، هدايت الکتريکي، اکسيژن مورد نياز شيميايي، فسفات، کدورت، سختي کل، pH و کل جامدات بود. به دليل کاربردي بودن اين طرح پژوهشي و ارزيابي وضعيت منابع آب استان گلستان و برنامه ريزي و مديريت منافاتي با مسائل اخلاقي نداشت. يافته‌ها: نتايج حاصل از مطالعه بر اساس هر دو شاخص نشان داد که اين شاخص براي تمام ايستگاه‌ها بين 54 تا 61 بوده و براساس شاخص NSF WQI متوسط (70-50) و بر اساس شاخص IRWQISCدر دو طبقه متوسط(55-45) و نسبتا خوب(70 – 55/1) قرار مي‌گيرد. نتيجه‌گيري: پارامترهاي تاثيرگذار شامل کل جامدات، کدورت، نيترات، درجه حرارت و کلي فرم مدفوعي بوده است. با توجه به شاخص به دست آمده مشخص شد که کيفيت آب رودخانه براي کشاورزي مناسب بوده، ولي براي مصارف شرب بايد تصفيه شود.