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Nauman Hashmani, Maria Hashmani, Noureen Asghar, Mahnoor Islam, Sharif Hashmani Department of Ophthalmology and Visual Sciences, Hashmanis Hospital, Karachi, PakistanCorrespondence: Nauman Hashmani 68/B Khayaban-e-Shahbaz, DHA Phase 7, Karachi, PakistanTel +92 321-2828062Email naumanhashmani@hashmanis.edu.pkPurpose: To quantify and assess the reproducibility of the corneal stromal thickness profiles captured by the SD-OCT. Secondly, we correlated the zonal thicknesses to the age, gender and axial length.Methods: We included 227 normal eyes of 227 patients with a maximum hypermetropia of +5 and myopia of – 6 diopters (D). Subjects with an intraocular pressure exceeding 22 mm Hg, evidence of cataract formation, history of ophthalmic surgery or disease were excluded. Lastly, reproducibility was evaluated in a subset of 50 participants by means of an identical scan protocol repeated by 2 different OCT operators.Results: Stromal values were consistently thicker in the peripheral cornea (p< 0.001). Age was negatively correlated with approximately every sector of the stroma with notable exceptions of the center (r=0.117, p=0.088) and the superior inner (r=0.057, 0.409), middle (r=0.086, p=0.209) and outer locations (r=0.120, p=0.079). There was no statistical significance in most sectors when looking at the axial length, gender and K1/K2. This method was highly reproducible in terms of both the ICC and COV.Conclusion: Corneal stromal mapping is highly reproducible and shows a negative correlation to age. Additionally, the periphery of the stroma is consistently thicker to the center. Other variables like gender and axial length show no relationship to the corneal stroma.Keywords: cornea, corneal stroma, OCT, AS-OCT, tomography, topography

Cancer has a high rate of incidence and mortality throughout the world. Although several conventional approaches have been developed for the treatment of cancer, such as surgery, chemotherapy, radiotherapy and thermal therapy, they have remarkable disadvantages which result in inefficient treatment of cancer. For example, immunogenicity, prolonged treatment, non-specificity, metastasis and high cost of treatment, are considered as the major drawbacks of chemotherapy. Therefore, there is a fundamental requirement for the development of breakthrough technologies for cancer suppression. Polysaccharide-based drug delivery systems (DDSs) are the most reliable drug carriers for cancer therapy. Polysaccharides, as a kind of practical biomaterials, are divided into several types, including chitosan, alginates, dextran, hyaluronic acid, cyclodextrin, pectin, etc. Polysaccharides are extracted from different natural resources (like herbal, marine, microorganisms, etc.). The potential features of polysaccharides have made them reliable candidates for therapeutics delivery to cancer sites; the simple purification, ease of modification and functionalization, hydrophilicity, serum stability, appropriate drug loading capacity, biocompatibility, bioavailability, biodegradability and stimuli-responsive and sustained drug release manner are considerable aspects of these biopolymers. This review highlights the practical applications of polysaccharides-based DDSs in pharmaceutical science and cancer therapy.

Abstract SARS-CoV-2 variants of concern (VOC) have been associated with increased viral transmission and disease severity. We investigated the mechanisms of pathogenesis caused by variants using a host blood transcriptome profiling approach. We analysed transcriptional signatures of COVID-19 patients comparing those infected with wildtype (wt), alpha, delta or omicron strains seeking insights into infection in Asymptomatic cases. Comparison of transcriptional profiles of Symptomatic and Asymptomatic COVID-19 cases showed increased differentially regulated gene (DEGs) of inflammatory, apoptosis and blood coagulation pathways, with decreased T cell and Interferon stimulated genes (ISG) activation. Between SARS-CoV-2 strains, an increasing number of DEGs occurred in comparisons between wt and alpha (196), delta (1425) or, omicron (2313) infections. COVID-19 cases with alpha or, delta variants demonstrated suppression transcripts of innate immune pathways. EGR1 and CXCL8 were highly upregulated in those infected with VOC; heme biosynthetic pathway genes (ALAS2, HBB, HBG1, HBD9) and ISGs were downregulated. Delta and omicron infections upregulated ribosomal pathways, reflecting increased viral RNA translation. Asymptomatic COVID-19 cases infected with delta infections showed increased cytokines and ISGs expression. Overall, increased inflammation, with reduced host heme synthesis was associated with infections caused by VOC infections, with raised type I interferon in cases with less severe disease.

Abstract Background Pakistan reported 1.57 million COVID-19 cases between 2020 and 2022, based on approximately 30.6 million SARS-CoV-2 RT-PCR (reverse-transcription polymerase chain reaction) tests conducted. This study utilized data from one of the largest in-country testing facilities, Aga Khan University Hospital (AKUH) in Karachi, Pakistan, to explore gender and age-related in RT-PCR testing patterns. Methods We conducted a retrospective review of SARS-CoV-2 RT-PCR test data extracted from AKUH clinical laboratory records between February 2020 and February 2022. Gender and age distributions were examined in the context of testing patterns across the period. Multivariate regression models assessed independent associations between COVID-19 positivity and key variables. Results We reviewed 470,249 RT-PCR tests, finding that most tests were in those aged 21–40 years (48.1%). Overall, COVID-19 test positivity was 20.6%. In all, 57.7% were performed for males, predominant amongst those tested across all age groups and waves. Females had significantly lower odds of testing positive for COVID-19 (OR: 0.9; 95% CI: 0.9-1.0). However, when adjusted for gender, age and pandemic phases, the positivity rates between males and females were the same. The odds of a positive result increased significantly with age; individuals aged > 80 years had 2.5 times higher odds of testing positive than those aged 0–10 years (aOR 2.5, 95% CI 2.3–2.7). Conclusions The analysis indicates a consistent male dominance in COVID-19 testing, with higher positivity rates in older age groups. Our study highlight the importance of examining demographic characteristics in disease associated data especially, representation of females amongst cohorts.

Background and purpose: In December 2019, a series of pneumonia cases of unknown origin were reported in Wuhan, China, named by the World Health Organization as COVID-19. The risk factors for developing the disease of COVID-19 are still not well known, but evidence shows that some factors, including respiratory diseases such as tuberculosis, are important risk factors in the disease of COVID-19. It should be noted that tuberculosis, like SARS-COV-2, is mainly transmitted through breathing and affects the lungs. Also, some studies show that infection with Mycobacterium tuberculosis causes more rapid and severe pneumonia symptoms in COVID-19 and is the main cause of death due to severe disease. Considering that the disease of COVID-19 is a newly emerging pandemic and the risk factors related to its incidence and severity are still being investigated and considering that tuberculosis is a curable infectious disease that can affect other respiratory diseases. This study was conducted to investigate the probable and definite frequency of COVID-19 (COVID-19) in the first and second peaks of the coronavirus pandemic among patients with a history of tuberculosis. Materials and methods: This study was descriptive-cross-sectional and the study population included patients with a history of tuberculosis whose diagnosis date was between 2015 and 2020. The number of these samples was equal to 1532. The sampling method was census. The time of investigation in terms of contracting COVID-19 was after the first peak and during and after the second peak of Corona (from the second half of May 2019 to November 2019). The data collection tool included a checklist containing demographic variables and clinical symptoms related to COVID-19. The method of collecting information was in the form of telephone interviews and document review. Data collection was done by trained interviewers. For this purpose, the questioners were first given the necessary training on how to complete the checklist. Data entry was done in Excel software and transferred to SPSS V.16 software for analysis. The description of the variables is presented in terms of number, percentage, mean, standard deviation, and median. A chi-square test was conducted to compare the grouped variables. Results: In this study, the prevalence of probable and definite cases of COVID-19 among patients with a history of tuberculosis was reported as 5.5% (85 people), and suspected, probable and definite cases were reported as 15.6% (239 people). Also, there was no correlation between age groups, gender, place of residence, type of tuberculosis, marriage, diabetes, kidney disease dialysis, immunodeficiency,, and liver disease with the prevalence of COVID-19 among patients with a history of tuberculosis. It should be noted that in this group of patients, heart disease, lung disease, cancer, chemotherapy, high blood pressure, and brain and nerve diseases were related to the spread of COVID-19. Also, the highest frequency of suspected, probable, and definite COVID among patients with a history of tuberculosis was diagnosed respectively in 2019 with 38.5% (25 out of 65 cases with a history of tuberculosis), in 2014 with 26.7% (63 out of 236 cases with a history of tuberculosis) and 20.8% (58 people out of 279 cases with a history of tuberculosis) in 2018. Conclusion: Due to the significant difference in the prevalence of Covid 19 in patients who have not received the flu vaccine, it is necessary to inject the flu vaccine in these patients. Advice to quit smoking in these patients should be a priority. Because no independent study on Covid disease was observed in patients with tuberculosis, further studies in this field are necessary.

Abstract Background The equitable distribution of healthcare resources represents a paramount objective in the realm of global health systems. Thus, the present study sought to assess the fairness in the allocation of health resources at Qazvin University of Medical Sciences (QUMS), both prior to and subsequent to the implementation of the Health Transformation Plan (HTP) using the Gini coefficient and the Hirschman–Herfindahl index (HHI). Methods This descriptive-analytical study aimed to investigate the distribution of healthcare resources among general practitioners (GPs), specialists, and subspecialists employed at QUMS between 2011 and 2017. Demographic data pertaining to the cities were obtained from the statistical yearbooks of the Statistical Center of Iran, while information regarding the healthcare workforce was extracted from QUMS records. The analysis utilized two key measures, namely the Gini coefficient and the HHI, to assess the fairness of resource distribution. Data analysis was performed using Microsoft Excel 2016 and the Stata statistical software. Results The highest number of GPs, specialists, and subspecialists was observed in 2014, 2017, and 2017, respectively, while the lowest number was recorded in 2016, 2011, and 2015, respectively. From 2011 to 2017, the Gini coefficient for GPs ranged between 0.61 and 0.63. Among specialists, the lowest Gini coefficient value was observed in 2015 (0.57), while the highest was recorded in 2017 (0.60). The Gini coefficient for subspecialists remained constant at 0.52 from 2011 to 2017. The HHI revealed a high concentration of GPs in the cities of Qazvin province. Although the disparity gradually decreased in the specialties of eye, ear, nose, and throat, and pediatrics, the concentration still persists in Qazvin. In general surgery, the index value is low, indicating some level of inequality. In anesthesia and neurology, the index value decreased after the HTP and reached 5700; however, achieving equality (below 1000) still requires further efforts. No significant change in the index was observed after the HTP in specialties such as neurosurgery, rehabilitation, and nuclear medicine. Subspecialists also exhibited a concentration in the city of Qazvin. Conclusion Based on the analysis of the Gini and HHI, it is evident that the distribution of GPs has not undergone significant changes following the implementation of the HTP. The Gini coefficient, which ranges from 0.4 to 0.6, indicates a high to complete level of inequality in the distribution of specialists and subspecialists. Moreover, the HHI exceeds 1000, reflecting a concentration of resources in specific areas. As a result, the HTP has not yet achieved its goal of ensuring a fair distribution of human resources. To address this issue, it is recommended to redesign distribution policies, including the allocation of physical health resources, such as specialized hospitals, beds, and medical equipment. Additionally, increasing student admissions in specialized and subspecialized fields and implementing tariff incentives can contribute to a more equitable distribution of resources. By aligning distribution policies with the principle of fairness, the healthcare system can better address the issue of resource distribution.

Background and aim: Librarians, as practitioners of Library and Information Science (LIS), by playing various roles, can contribute to the promotion of research and expansion of human knowledge. The aim of the present study was to investigate librarians' scientific publications indexed in the Scopus database between 2016 and 2020 using the scientometric approach. Materials and methods: The present study, which was conducted using a scientometric approach, is descriptive in terms of data collection and applied in terms of the objective. The research population was all articles indexed in the Scopus database in 2016-2020 in which the word "librarian" is included in at least one of the authors’ organizational affiliations. The number of these articles amounted to 2207 after review and screening by the researchers. Findings: In general, librarians accounted for 1.5% of the worldwide scientific production in the field of LIS. Librarians were the first, second or third author in more than 60% of the articles analyzed. Totally, 61% of the articles by librarians were published in non-LIS disciplines such as biological sciences, medicine, and computer science, and the chi-square test showed that the participation of librarians was significantly higher in non-LIS disciplines than in LIS disciplines (p

Abstract Mosquitoes are the most important vectors of serious infectious diseases in the world. Dengue, Zika, chikungunya and yellow fever are emerging and re-emerging infectious diseases, associated with the distribution of two key vectors i.e. Aedes aegypti and Aedes albopictus throughout the world including countries neighbouring Iran. Entomological surveillance was planned and performed monthly from May to December during 2014–2020 in selected counties of Mazandaran Province, North of Iran, by ovitrap, larval collection, hand catch and human baited trap. Overall, 4410 Aedes specimens including 2376 larvae (53.9%) and 2034 (46.1%) adults belonging to six species, namely Aedes vexans, Aedes geniculatus, Aedes caspius, Aedes echinus, Aedes pulcritarsis and Aedes flavescence were collected and morphologically identified. Over the seven years of surveillance, Ae. aegypti and Ae. albopictus were not found by any sampling method. Aedes vexans and Ae. geniculatus were the most abundant species, their populations peaked in October and November and was positively correlated with precipitation and relative humidity. Aedes flavescence was a new species record for the province. A flowchart for planning and implementation of invasive mosquito surveillance for provincial health authorities in the country is proposed. These surveillance efforts provide basic and timely information for the health system to act promptly on integrated and intensified surveillance and control programs should Ae. aegypti and Ae. albopictus detected in the province.

Implantable and wearable bioelectronic systems can enable tailored therapies for the effective management of long-term diseases, thus minimising the risk of associated complications. In this context, glucose fuel cells hold great promise as in- or on-body energy harvesters for ultra-low-power bioelectronics and as self-powered glucose sensors. We report here the generation of gold nanostructures through a gold electrodeposition method in a soft template for the abiotic electrocatalysis of glucose in glucose fuel cells. Two different types of soft template were used: a lipid cubic phase-based soft template composed of Phytantriol and Brij®-56, and an emulsion-based soft template composed of hexane and sodium dodecyl sulphate (SDS). The resulting gold structures were first characterised by SAXS, SEM and TEM to elucidate their structure, and then their electrocatalytic activity towards glucose was compared in both a three-electrode set-up and in a fuel cell set-up. The Phytantriol/Brij®-56 template led to a nanofeather-like Au structure, while the hexane/SDS template led to a nanocoral-like Au structure. These templated electrodes exhibited similar electrochemical active surface areas (0.446 cm2 with a roughness factor (RF) of 14.2 for Phytantriol/Brij®-56 templated nanostructures and 0.421 cm2 with an RF of 13.4 for hexane/SDS templated nanostructures), and a sensitivity towards glucose of over 7 μA mM−1 cm−2. When tested as the anode of an abiotic glucose fuel cell (in a phosphate-buffered solution with a glucose concentration of 6 mM), a maximum power density of 7 μW cm−2 was reached; however the current density in the case of the fuel cell with the Phytantriol/Brij®-56 templated anode was approximately two times higher, reaching the value of 70 μA cm−2. Overall, this study demonstrates two simple, cost-effective and efficient strategies to manipulate the morphology of gold nanostructures, and thus their catalytic property, paving the way for the successful manufacturing of functional abiotic glucose fuel cells.

Introduction: Epidermal growth factor receptor (EGFR)-tyrosine kinase inhibitor therapy is effective as a first-line treatment of advanced non-small-cell lung cancer (NSCLC). This research study investigated the distribution of EGFR mutations in patients diagnosed with NSCLC to assist in selecting patients who could benefit from tyrosine kinase inhibitor therapy. Materials and Methods: This cross-sectional study was conducted between July 2017 and November 2022. A real-time multiplex ​Polymerase Chain Reaction (PCR) assay supplied by Roche Diagnostics was used to examine DNA obtained from 682 tumor biopsies collected from NSCLC patients. DNA amplification was performed in a Cobas z 480 instrument for mutation analysis. The PCR assay was designed using specific primers and probes to detect 43 different mutations targeting exons 18-21. Results: Among the 682 samples, 466 (68.3%) were males, and 216 were females. The male-to-female ratio was 2.1. Twenty per cent of the male and 37% of the female samples were positive for EGFR mutations. The most common mutations were the in-frame deletion of exon 19, followed by L858R in exon 21, exon 20 insertion and S769I, exon 18 G719X. In addition, three mutations, namely del exon 19, T790M and exon 20 insertions were also detected in a patient, suggesting an actively progressive disease. Conclusions: This study showed that EGFR mutations are more common in Pakistani female patients than males. Secondly, in-frame deletion of exon 19 and exon 21 mutation L858R are prevalent in most of the NSCLC patients. The prevalence of common and rare EGFR mutations in Pakistani patients provides an opportunity for a subset of patients' chance of therapy.

Abstract Background and Aims COVID‐19 morbidity and mortality varied globally through the pandemic. We studied the relationship of SARS‐CoV‐2 variants of concern (VOC) with COVID‐19 severity and mortality among hospitalized patients in Pakistan. Methods A retrospective review of clinical, laboratory, and vaccination data of 197 COVID‐19 adult patients at the Aga Khan University Hospital, Karachi between April 2021, and February 2022 was performed. SARS‐CoV‐2 VOC identified in respiratory samples were analyzed. Univariate and multivariate analysis was conducted to identify factors associated with COVID‐19 outcomes. Results The median age of cases was 55 years and 51.8% were males. Twenty‐four percent of females were pregnant. Of COVID‐19 cases, 48.2% had nonsevere disease, while 52.8% had severe/critical disease. Hypertension (48%) and diabetes mellitus (41%) were common comorbids. SARS‐CoV‐2 VOC identified comprised; Omicron (55.3%), Beta (14.7%), Alpha (13.7%), Delta (12.7%), and Gamma (3.6%) variants. Most (59.7%) study subjects were unvaccinated. Of vaccines, 88% had received inactivated virus COVID‐19 vaccines. Increased risk of severe disease was associated with age ≥50 years (odds ratio [OR]: 5.73; 95% confidence interval [CI]: [2.45–13.7]), as well as with diabetes mellitus (OR: 4.24; 95% CI: [1.82–9.85]). Full vaccination (OR: 0.25; 95% CI: [0.11–0.58]) or infection with Omicron (OR: 0.42; 95% CI: [0.23–0.74]) was associated with reduced disease severity. The risk of mortality increased with age ≥50 years (OR: 5.07; 95% CI: [1.92–13.42]) and a history of myocardial infarction (OR: 5.11; 95% CI: [1.45–17.93]) whilst, infection with Omicron was found to reduce the risk (OR: 0.22; 95% CI: [0.10–0.53]). Conclusion Our study describes the relationship between the severity of COVID‐19, in‐hospital mortality in relation to SARS‐CoV‐2 variants, and the impact of COVID‐19 vaccination in Pakistan. Outcomes were more favorable in younger individuals, after vaccinations and with Omicron variant infections. Most cases received inactivated virus vaccines therefore these data highlight the protection provided against severe COVID‐19.

Abstract Mediastinal lymph node fine needle aspiration (MLN-FNA) is a common procedure; however, the physician factor in pathological category, and anatomical site are not routinely assessed. Cytology reports for endobronchial ultrasound (EBUS)/endoscopic ultrasound (EUS) MLN-FNA specimens (8846) were retrieved for July 2012–Dec 2019, classified by hierarchical free text string match algorithm into 51 diagnostic categories, four mutually exclusive diagnostic groups (benign |suspicious |malignant |insufficient), and 24 anatomical sites. Pathologist and submitting physician/surgeon bias were assessed using logistic regression and funnel plots|control charts centered on the group median (diagnostic/capture) rate. Eleven pathologists and seven submitting physician/surgeon were involved in more than 250 specimens each. Overall, the MLN-FNAs were benign|suspicious|malignant|insufficient in 46%|4%|25%|24% of specimens. Percent malignant (number of samples) varied by station; 7| 4R| 4L| 2R| 10R| 11R| 11L were respectively 21%(3,101), 27%(2,453), 19%(1,289), 41%(435), 27%(497), 24%(357), 26%(229). The number of outlier (P

Pakistan is considered as endemic to hepatitis viruses, particularly hepatitis B virus (HBV). Though vaccine against HBV is available but is still spreading in developing countries because of the various socioeconomic conditions. Therefore developing of edible vaccine is a good approach to target the spread and control of such deadliest viruses particularly in developing countries. Various fruits or vegetables can be used for production of edible vaccine. Here we are using carrot as it is much economical as compared to many fruits with greater shelf life and can be consumed without any processing. The current study was done after realizing the high transformation rates centered on strain and cultivar selection reporting a highly efficient protocol to transform carrot seedling exploiting direct somatic embryogenesis of carrot to give high transient expression of protein. In vitro grown disease-free healthy carrot plants were employed and transferred to MS medium with 1 mg/l BAP and 0.5 mg/l 2, 4- D. The surface antigen S gene of Hepatitis B Virus, a potential antigen for production of antibodies by the immune system was acquired from native genotype of HBV and cloned in vector pCAMBIA 1301. This construct was introduced into Agrobacterium tumefaciens and transformed to local carrot cultivars. The transformation efficiency of HBsAg gene was upto 52 % in one carrot cultivar that proved to be highest values reported till date. Hence, carrot cultivar offers promising prospects for production of economically viable and efficient anti-HBV vaccine. This study laid the basis for the development of a novel edible vaccine for hepatitis B in Pakistan that could be administered orally and especially in carrot which is essential vegetable crop grown widely. [ABSTRACT FROM AUTHOR]

AbstractMigration is a phenomenon common to all countries and reverse migration is reflective of migration from urban to rural areas. It is a phenomenon that gradually increases and could have consequences in the society. The purpose of this study is to investigate environmental, physical, economic, and social causes and consequences of reverse migration to rural areas of Buin and Miandasht. This research is descriptive-analytical in which the data were collected using the library-field method. From the 5 rural districts of this county, 5 villages that had the most reverse migrant households were selected. Then, a sample of 290 reverse migrants was determined and questioned using the Cochran method. According to descriptive data, environmental-physical aspects with a mean of 40.14 have been the most important factors of migration. The results of the confirmatory factor analysis and the path coefficient of the main causes show a 40% influence of social causes, 41.7% of economic causes, and 48.2% of physical-environmental causes on reverse migration. The results of the independent t-test for all variables (i.e. positive and negative consequences of reverse migration) also showed that the average negative effects are physical (29.86%), economic (14.09%), and social (20.90%). The average positive effects are physical (14.38%), economic (24.68%), and social (30.13%). In examining the results, the change in natural landscapes with an average of 3.96 had the greatest environmental-physical impact. The improvement of educational indicators with an average of 3.44 had the greatest social impact and increasing land and housing price with an average of 3.45 had the greatest economic impact.Keywords: migration, Reverse Migration, Migration Causes and Consequences, Rural Areas, Buin and Miandasht. Introduction Migration and population movements show the subtleties of human life. Migration is a common phenomenon in all countries and reverse migration represents migration from city to village. In fact, today, two-way migration is usually more evident; albeit at a slower step, movement from villages to cities and migration from cities to villages still exists. In fact, the sharing of migrants to the villages has taken on a reverse trend in some regions and the villages are moving towards ‘accepting migrants’ and especially the migration of city dwellers to the villages or "reverse migration". Therefore, this study investigates the causes and consequences of this type of migration in rural areas of Buin and Miandasht County and also analyzes the probable differences between different villages. Materials and MethodsThe present study is survey in nature using the descriptive-analytical method. The library and field methods are used to collect the data. The statistical population includes reverse and return migrants to the rural areas of Bouin and Miandasht. According to the topic, firstly, 5 villages named Qara Boltaq, Qaim Abad, Boltaq, Betlijeh, and Dashkasan were selected among five rural districts by the cluster sampling method. Then, 290 people from migrant households were selected based on Cochran's formula by simple random sampling, and a questionnaire was completed by the participants. The normality of the data was confirmed by the Kolmogorov-Smirnov test. Factor analysis, t-test, Friedman, and analysis of variance tests have also been used to check the indicators. Research FindingsThe obtained results showed that environmental-physical factors are the most important causes of migration. In this context, the highest mean of environmental-physical aspects belongs to the components of pollution in the urban environment (lack of healthy weather and natural landscapes and the absence of pollution in the village). The highest mean of the economic dimension belongs to the appropriate price of land and housing and the low cost of living in the village. In the social dimension, the components of kinship relations, sense of place belonging, social security, and retirement have had the highest mean. The results of the structural equations model of factor analysis showed that 40% of social causes, 41.7% of economic causes, and 48.2% of physical-environmental causes are the main causes of reverse migration. Descriptive findings also confirm physical-environmental causes with an average of 40.14 as the most important factor. Examining the mean of positive and negative consequences also shows that the averages of negative physical, economic, and social effects are 29.86, 14.09, and 20.90, respectively. The average positive effects of physical, economic, and social factors are 14.38, 24.68, and 13.30, respectively. Therefore, the highest averages are linked to negative physical and positive social effects, respectively. The results of variance analysis to compare different factors affecting reverse migration showed that there is a significant difference between the villages of Qara Botlaq and Qaim Abad in terms of physical factors, and there is no difference between different villages and also between different factors. There is no significant difference in positive environmental-physical and economic effects among villages, but there is a difference in social effects among villages. There is a significant difference between the negative physical-environmental effects in the villages of Qara Boltaq and Dashkasan. There is a significant difference between the social effects of the two villages of Boltaq and Dashksan, Boltaq and Qaimabad, but the negative economic effects do not have a significant difference. Discussion of Results and ConclusionsRegarding the age group (both young and old), the results clearly show the need for providing jobs and housing, on the one hand, and special services on the other hand. Regarding the activity status, since the highest percentage is assigned to retired people, it shows the effect of the age of the population in the region in the future. The return time of more than 66% of people has been in the last 5 years and shows an increasing trend in the coming years. The satisfaction of about 80% of people on the average level of moving to the village can be seen from the numbers. Generally, suitable planning and considering the new conditions are necessary for the villages. Based on the descriptive findings, the government's support has the lowest average for the rural economy, and local management needs more attention to this issue. According to the path coefficient results, the main causes of reverse migration are physical-environmental causes. Due to regional differences and natural characteristics, and the problems of cities and metropolises that are the origin of reverse migration, this result has been different from other studies. Regarding the positive and negative consequences, the highest averages are related to negative physical and positive social effects, respectively, and these results are consistent with other studies. Another important point is that the causes of migration are almost the same at the city level and there is no noticeable difference in location. Also, there is no significant difference in positive environmental and economic effects among villages, but there are differences in social effects between villages. In other words, the social differences are more visible resulting from the arrival of immigrants in the mentioned rural areas. ReferencesPersian References- Afarakhteh, H., Manafi Azar, R., & Valaei, M. (2016). Spatial effects of return migration in Miandoab County. 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Investigating the impact of international migration, migration acceptability and human development index on economic growth (case study: Afghanistan). Katab Quarterly, 13(6), 103-122.- Momeni, A., Jahanshiri, M., & Turkashund, Z. (2021). Analysis of effective factors in the growth of reverse migration to suburban settlements of Najafabad. Journal of Urban Peripheral Development, 3(1), 183-198.- Nobakht, R., Ghasemi Ardahai, A., & Rostam Alizadeh, V. (2017). Determinants of return migration in Iran during the period 2015-2016. Journal of Demographic Studies, 3(1), 209-183.- Rabbani, R., Taheri, Z., & Rusta, Z. (2011). Investigating the causes of reverse migration motivations and its impact on social and economic development, a case study: Rural immigrants in Tankabon and Ramsar cities. Journal of Research and Urban Planning, 2(5), 83-108.- Shayan, H., Erfani, Z., & Sojasi Ghidari, H. (2021). Comparative analysis of reverse migration (urban-rural)Iran on a provincial scale. Quarterly Journal of Village and Space Sustainable Development, 2(3), 1-18.- Taheri, M., Armaghan, S., & Vali Shariat Panahi, M. (2021). Explaining the role of reverse migrations in the economic-social development of rural settlements (case study: villages in Region 19). Journal of Human Geography, 12(4), 75-92.- Taghavi, F., Moulai Hashjin, N., & Qureishi, M. B. (2017). A comparative study of physical-spatial approach and related policies in rural development planning during two recent decades (case study: Ghaemshahr, Mazandaran). Journal of Geography and Development, 15(47), 213-230.- Yaqoubi, J., & Zabidi, T. (2018). Assessing reverse migration's motivations and consequences in Ijroud County, Zanjan Province. Journal of Rural Research, 9(2), 196-209. English References- Babi, M., Guogping, X., & Ladu, J. (2017). Causes and consequences of rural-urban migration: The case of Juba Metropolitan, Republic of South Sudan. Journal of Earth and Environmental Science, 81(1), 1-8.- Behera, M., Mishra, S., & Behera, A. R. (2021). The COVID-19 led reverse migration on labour supply in rural economy: challenges, opportunities and road ahead in Odisha. The Indian Economic Journal, 69(3), 392-409.- Delango, M. W. (2019). The causes and consequences of rural-urban migration: the case of Wolaita Sodo Town Merhal Sub-City. Budapest International Research and Critics Institute Journal (BIRCI-Journal), 2(4), 99-114.- Gnana, S. R. (2022). Why should people leave their villages and migrate to cities? Research Gate, 1-14.- Kahsai, M., & Schaeffer, P. (2009). Deconcentration, counter-urbanization or trend reversal?. Regional Research Institute, West Virginia University.- Khan, A., & Arokkiaraj, H. (2021). Challenges of reverse migration in India: a comparative study of internal and international migrant workers in the post-COVID economy. Journal of Comparative Migration Studies, 9, 1-19.- Liu, J. (2022). Childhood and rural to urban migration in China: A tale of three villages. Journal of Children & Society, 1-16.- Martin, R., & Radu, D. (2012). Return migration: The experience of Eastern Europe. International Journal of Migration, 50(6), 109-128.- Mlambo, V. (2018). An overview of rural-urban migration in South Africa: its causes and implications. Archives of Business Research, 6(4), 63-70.- Stockdale, A., & Catney, G. (2014). A life course perspective on urban-rural migration: the importance of the local context. Journal of Population, Space and Place, 20(1), 83-98.- Tong, W., & Lo, K. (2021). Back to the countryside: rural development and the spatial patterns of population migration in Zhejiang, China. Agriculture, 11, 788.- Trask, B. S. (2022). Migration, urbanization, and the family dimension. United Nations Department of Economic and Social.- Wang, H. (2013). China’s return migration and its impact on home development. UN Chronicle, 50(3), 34-36.- Wang, W. W., & Fan, C. C. (2006). Success or failure: selectivity and reasons of return migration in Sichuan and Anhui, China. Journal of Environment and Planning, 38(5), 939-958.- World Economic Forum (2017). Migration and its impact on cities, report. Switzerland, 1-172.

Abstract Background Achieving equity in the distribution of health services is one major goal in the health system. This study aimed to determine equality in distributing health human resources (physicians) in the Qazvin University of Medical Sciences before and after the Health Transformation Plan (HTP) based on the Hirschman-Herfindahl index (HHI). Methods In this descriptive-analytical study, the statistical population was general practitioners (GPs), specialists and subspecialists in the Qazvin University of Medical Sciences from 2011-to 2017. We extracted demographic statistics of the cities from the Statistical Center of Iran. Physicians’ statistics were obtained from the Curative Affairs Deputy at the Qazvin University of Medical Sciences. We assessed inequality using the HHI. Results The highest number of GPs was in 2014, and specialists and subspecialists were in 2017. The lowest number of GPs, specialists, and subspecialists were in 2016, 2011 and 2015. The HHI for GPs in 2011–2017 was between 4300 and 5200. The lowest concentration for specialists before the HTP plan was the cardiologist with 3300, and after the HTP, the internal specialist with 3900. Also, the numerical value of this index for all subspecialty physicians after the HTP was 10,000, the highest level of concentration. Conclusion The values obtained from the HHI index indicate the high concentration and disproportionate and inequitable distribution of human resources in the health sector in this province. The number of specialists in some cities is still much less than acceptable, and some cities even have shortcomings in the critical specialists.

Background and Purpose: Several evidences have shown some synergistic effect of diabetes co-morbidity on the tuberculosis (TB) treatment results, while some other studies have not found such associations. This study aimed to investigate the relationship between TB-diabetes co-morbidity and outcomes of TB treatment. Materials and Methods: The research population in this case control study were patients with smear positive tuberculosis. The cases were 158 patients with TB and diabetes selected by consensus method, while controls were 316 patients randomly selected from TB patients without diabetes. Results: Frequency of unfavorable outcome among cases was higher than among controls (7.6% vs 7.3% respectively, p-value =0.901). Multivariate logistic regression models showed that the odds ratios for adverse treatment outcome, death, treatment failure, positive smear after the intensive phase of treatment and high grade positivity (2+ & 3+) were 0.97(0.45- 2.06), 0.97(0.42-2.24), 0.91(0.17-4.85), 1.39(0.79- 2.44) and 2.57(0.83- 7.92) respectively. Moreover, treatment adverse outcomes among patients with drug complications (22.2% vs. 6.5%, p-value =0.010) and rural residents (10% vs 4.9% respectively, p-value =0.037) were significantly higher than those among patients without complication and urban residents respectively. Conclusion: Although we did not observe any significant association between TB-diabetes co-morbidity and treatment results, there was a significant effect measure regarding the effect of smear positivity at the end of the intensive phase of treatment, especially high grade of smear positivity. Because of probable bias in the classification of the exposure, screening of TB patients regarding diabetes mellitus at the beginning of the treatment is recommended.

In the vein of other areas of human knowledge, the theories and models developed for management and leadership are being settled by some scientific paradigms. In this respect, two major paradigms, namely, the Newtonian and quantum, have extensively influenced all organizational theories and models. Implementing such models accordingly calls for new management styles, here termed quantum management (QM). For this purpose, 16 experts of educational management, selected by purposive sampling, were interviewed until theoretical saturation was reached. The study findings demonstrated that the causal conditions with a weak coefficient of determination (R², 28%) were the moderate predictors of QM in educational organizations. As well, the underlying and intervening conditions along with QM with a medium R2 (51%) could strongly predict the strategies/enablers, and then the strategies/enablers with a medium R2 (55%) were the strong predictors of the QM consequences.

Lignocellulosic agricultural biomass generated by agriculture sector remains underutilized which can be a key source for bio-development. Biomass from dilute acid hydrolysate comprise a considerable quantity of fermentable sugars while carbonyl degradation of compounds (Furans, acetic acid, and phenolic compounds) exhibit severe toxicity to fermentation microbes. The study was carried out to hydrolyse the sugarcane bagasse and to optimize different detoxification strategies. Sugarcane bagasse was hydrolysed with acid at 121°C for 20, 40 and 60 minutes. Afterwards analysis of detoxification methodologies like over-liming (pH 6; pH 9.0), vacuum evaporation (3-fold; 5-fold) and charcoal treatment (1%, 30 min; 5%, 60 minutes) were carried out. The results indicate that concentrations of sugars and degradation products was observed to enhance with an increase of hydrolysis time. Overliming utilizing calcium hydroxide resulted in 50% decline of furfurals while substantial decrease of phenolic compounds was observed. Fivefold vacuum evaporated concentration of hydrolysate exhibit considerable decrease in the concentration of acetic acid and furans. Furfural and hydroxymethyle furfural were removed completely removal with 5% treatment of charcoal at 60°C while acetic acid and phenolics also reduced. The detoxified hydrolysate can be applied in industry for production of several important products. [ABSTRACT FROM AUTHOR]

AbstractProblem Definition: In recent decades, the catastrophic increase in environmental degradation in its various dimensions has been considered by the international community. In the context of these environmental disorders, many inappropriate behaviors that are the result of ignorance and lack of environmental knowledge should not be ignored and rural areas can have a double impact in this regard due to their closer relationship with the environment.Purpose: The purpose of the present study is to evaluate the level of environmental knowledge and awareness of the villagers in the rural area of Choghakhor.Methodology: This research is applied and descriptive-analytical (based on survey) in terms of type and method, respectively. The statistical population includes villagers in the Choghakhor area of Boroujen County. Accordingly, 251 samples from 2065 households were selected by random sampling and questioned.Results: The results of the study show that the average score of environmental knowledge in the sample group is 140.27 which is higher than the cut-off score; therefore, the level of villagers’ environmental awareness and knowledge is above average. The results of the chi-square test and ETA correlation coefficient show that there is a positive and moderate relationship between gender and marital status with the level of awareness and environmental knowledge. For the variables of age and education, according to the value of Kendall's tau-b correlation coefficient -0.179 and 0.401, this relationship is negative-weak and positive-average, respectively. But, there is no relationship between the level of environmental awareness and knowledge and the villagers’ employment status or occupation. Conversely, this relationship exists weakly for the income variable. The results of one-way analysis of variance with the F value (1.248) are not significant and this shows that the spatial difference is not significant with respect to environmental awareness and knowledge.Innovation: The innovation of research lies in the application of indicators appropriate to local conditions, type of tests, and research location. Keywords: Village, Sustainable Rural Development, Environmental Awareness and Knowledge, Choghakhor Area. References- Abdul-Halim, N. S., Ruslan, N. S., Idris, N. S. U., & Nawawi, S. A. (2021). Knowledge, attitude and practice of environmental sustainability among Sustainable Science students in Universiti Malaysia Kelantan. In IOP Conference Series: Earth and Environmental Science (Vol. 842, No. 1, p. 012048). IOP Publishing.- Ahmadian, D., & Haghighatian, M. (2016). Sociological analysis of the role of cultural factors on urban environmental behaviors studied (citizens of Kermanshah). Journal of Urban Sociological Studies, 6(18), 51-76 (in Persian).- Akpafun, S., Ndinwa, G., & Chukumah, C. (2020). Evaluation of Environmental Awreness Level Aong Sakeholders in in Rural and Urban Communites, Southern Nigeria. International Journal of Climate Research, 4(1), 1-15.- Al-Rabaani, A., & Al-Shuili, A. (2020). Environmental Knowledge, Attitudes, and Behavior among Omani Post-Basic Education Students. European Journal of Social Sciences, 60(1), 29-38.- Arcury, T. A., & Johnson, T. P. (1987). Public environmental knowledge: A statewide survey. The Journal of Environmental Education, 18(4), 31-37.- Bahram Soltani, K. (2008). Environment. Tehran: Urban Planning and Architecture Research Center of Iran (in Persian).- Banan, Gh. A. (1973). Human environment and prevention of its pollution. Tehran: National Association for the Protection of Natural Resources and Human Environment (in Persian).- Bashirun, S. N., & Noranee, S. (2020). Influence of Environmental Knowledge and Attitude on Employee Green Behaviour. International Journal of Academic Research in Business and Social Sciences, 10(6), 937–946.- Dehkhoda, A. A. (1994). Dictionary of Dehkhoda. Tehran: University of Tehran (in Persian).- Fazeli, M., & Salehi, J. (2014). The gap between tourists' attitudes, knowledge and environmental behavior. Journal of Tourism Management Studies, 22, 161-137 (in Persian).- Frick, J., Kaiser, F. G., & Wilson, M. (2004). Environmental knowledge and conservation behavior: Exploring prevalence and structure in a representative sample. Personality and Individual Differences, 37(8), 1597-1613.- Geiger, S. M., Geiger, M., & Wilhelm, O. (2019). Environment-specific vs. general knowledge and their role in pro-environmental behavior. Journal of Frontiers in Psychology, 10, 718.- Sareban, V. H., & Toutakhane, A. M. (2019). Modeling the environmental knowledge of local communities in tourist villages case study: touristic road of Qaleh Chaei, Ajabshir County. Journal of Rural Development Strategies, 6(1).- Khoshfar, G., Salehi, S., Vesal, Z., & Abaszade, M. R. (2015). Evaluate the Social factors affecting environmental awareness of villagers (Case study: The Village-city of Jagharq in Binalud county). Journal of Rural Research, 6(1), 137-158 (in Persian).- Lin, S. T., & Niu, H. J. (2018). Green consumption: Environmental knowledge, environmental consciousness, social norms, and purchasing behavior. Journal of Business Strategy and the Environment, 27(8), 1679-1688.- Liu, P., Teng, M., & Han, C. (2020). How does environmental knowledge translate into pro-environmental behaviors?: The mediating role of environmental attitudes and behavioral intentions. Journal of Science of the Total Environment, 126-138.- Makhdoom, M. (1996). Sustainable Development. Journal of Jihad, 194, 3-10 (in Persian).- McBride, B. B., Brewer, C. A., Berkowitz, A. R., & Borrie, W. T. (2013). Environmental literacy, ecological literacy, ecoliteracy: What do we mean and how did we get here? Ecosphere, 4(5), 1-20- Mikuła, A., Raczkowska, M., & Utzig, M. (2021). Pro-Environmental Behaviour in the European Union Countries. Energies, 14(18), 5689.- Mostafa, M. M. (2007). Gender differences in Egyptian consumers’ green purchase behaviour: the effects of environmental knowledge, concern and attitude. International Journal of Consumer Studies, 31(3), 220-229.- Noori, H., & Norouzi, A. (2017). Fundamentals of Environmental Planning for Sustainable Rural Development. Isfahan: University of Isfahan Press (in Persian).- Pourtarery, M., Roknedin Eftekhari, A., & Rahmati, M. (2013). The Impacts of Legal Knowledge in Rural Social Welfare (A Case: Study of Western Mian Kohe, Country area Poldokhtar-Lorestan Province-Iran). Journal of Geography and Planning, 16(42), 45-63.- Riahi, V., Javan, F., & Dehghani, N. (2017). Analysis of the viewpoint of training the villagers to protect the environment of rural areas (Case Study: Rezvanshahr city). Journal of Human and Environment, 14(39), 67-78 (in Persian).- Salehi, S. (2012). Environmental Behvaior and Education. Journal of Educational Sciences, 18(2), 201-226 (in Persian).- Salehi, S., & Imam Gholi, L. (2012). Experimental study of the relationship between environmental awareness and behaviors (study of urban and rural areas of Sanandaj city). Journal of Social Problems of Iran, 1, 121-147 (in Persian).- Shakouei, H. (2011). New Thoughts in the Philosophy of Geography. Seventh Edition. Tehran: Gitashenasi Publication (in Persian).- Sojasi Qeidari, H., & Faal Jalali, A. (2018). Assessing the Villagers’ Environmental Behavior and Awareness (Case Study: Zanglanloo Rural District). Journal of Spatial Planning, 8(1), 29-50 (in Persian).- Sojasi Qeidary, H., & Azizi, S. (2016). Assessing Rural Farmers Environmental Literacy Level (Case Study: Villages of Zoeram Dehestan in Shirvan District). Journal of Geography and Environmental Planning, 27(3), 107-130 (in Persian).- Statistics Center of Iran (2016). General Census of Population and Housing in 2016, Chaharmahal and Bakhtiari Province. (n.p) (in Persian).- Webster (2022). Merriam-webster Dictionary. Retrieved from:https://www.merriam-webster.com/dictionary/environment.

Abstract Background Mutations in the Rv0678, pepQ and atpE genes of Mycobacterium tuberculosis (MTB) have been reported to be associated with reduced antimycobacterial susceptibility to bedaquiline (BDQ). Resistance conferring mutations in treatment naïve MTB strains is likely to have implications for BDQ based new drug regimen that aim to shorten treatment duration. We therefore investigated the genetic basis of resistance to BDQ in MTB clinical isolates from BDQ naïve TB patients from Pakistan. In addition, mutations in genes associated with efflux pumps were investigated as an alternate mechanism of resistance. Methods Based on convenience sampling, we studied 48 MTB clinical isolates from BDQ naïve TB patients. These isolates (from our strain bank) included 38 MDR/pre-XDR/XDR (10 BDQ resistant, 8 BDQ intermediate and 20 BDQ susceptible) and 10 pan drug susceptible MTB isolates. All strains were subjected to whole genome sequencing and genomes were analysed to identify variants in Rv0678, pepQ , atpE, Rv1979c, mmpLS and mmpL5 and drug resistance associated efflux pump genes. Results Of the BDQ resistant and intermediate strains 44% (8/18) had variants in Rv0678 including; two reported mutations S63R/G, six previously unreported variants; L40F, R50Q and R107C and three frameshift mutations; G25fs, D64fs and D109fs. Variants in efflux pumps; Rv1273c (G462K), Rv0507c (R426H) and Rv1634c (E198R) were found to be present in drug resistant isolates including BDQ resistant and intermediate isolates. E198R in efflux pump gene Rv1634c was the most frequently occurring variant in BDQ resistant and intermediate isolates (n = 10). Conclusion We found RAVs in Rv0678 to be commonly associated with BDQ resistance. Further confirmation of the role of variants in efflux pump genes in resistance is required so that they may be incorporated in genome-based diagnostics for drug resistant MTB.

The purpose of this research was to the effectiveness of self-instruction training on executive functions and cognitive inhibition of students with Special learning disorder. This was a quasi-experimental study with a pretest-posttest design with an experimental group and a control group. The statistical population of the study was all students with special learning disorders in Tabriz in the academic year 1399-1400, of which 30 samples in two homogeneous groups of second grade male students with learning disabilities, by alternative sampling method. The instruments used in this study were the Colorado Willcutt et al (2011) Learning Disabilities Questionnaire, the Coolidge Neurological Questionnaire (2002), the Computers sample Stroop Test (1953). The experimental group received self-instruction training in 12 sessions of 90 minutes and during this period the control group did not receive any training. Data analysis using covariance analysis test of self-instruction training on improving executive functions and cognitive inhibition in all stages of sample Stroop test (P

COVID-19 resulted in extensive morbidity and mortality worldwide. SARS-CoV-2 evolved rapidly, with increasing transmission due to Variants of Concern (VOC). Identifying VOC became important but genome submissions from low-middle income countries (LMIC) remained low leading to gaps in genomic epidemiology. We demonstrate the use of a specific mutation RT-PCR based approach to identify VOC in SARS-CoV-2 positive samples through the pandemic in Pakistan. We selected 2150 SARS-CoV-2 PCR positive respiratory specimens tested between April 2021 and February 2022, at the Aga Khan University Hospital Clinical Laboratories, Karachi, Pakistan. Commercially available RT-PCR assays were used as required for mutations in Spike protein (N501Y, A570D, E484K, K417N, L452R, P681R and deletion69_70) to identify Alpha, Beta, Gamma, Delta, and Omicron variants respectively. Three pandemic waves associated with Alpha, Delta and Omicron occurred during the study period. Of the samples screened, VOC were identified in 81.7% of cases comprising mainly; Delta (37.2%), Alpha (29.8%) and Omicron (17.1%) variants. During 2021, Alpha variants were predominant in April and May; Beta and Gamma variants emerged in May and peaked in June; the Delta variant peaked in July and remained predominant until November. Omicron (BA.1) emerged in December 2021 and remained predominant until February 2022. The CT values of Alpha, Beta, Gamma and Delta were all significantly higher than that of Omicron variants (p

Abstract Understanding key host protective mechanisms against SARS-CoV-2 infection can help improve treatment modalities for COVID-19. We used a blood transcriptome approach to study biomarkers associated with differing severity of COVID-19, comparing severe and mild Symptomatic disease with Asymptomatic COVID-19 and uninfected Controls. There was suppression of antigen presentation but upregulation of inflammatory and viral mRNA translation associated pathways in Symptomatic as compared with Asymptomatic cases. In severe COVID-19, CD177 a neutrophil marker, was upregulated while interferon stimulated genes (ISGs) were downregulated. Asymptomatic COVID-19 cases displayed upregulation of ISGs and humoral response genes with downregulation of ICAM3 and TLR8. Compared across the COVID-19 disease spectrum, we found type I interferon (IFN) responses to be significantly upregulated (IFNAR2, IRF2BP1, IRF4, MAVS, SAMHD1, TRIM1), or downregulated (SOCS3, IRF2BP2, IRF2BPL) in Asymptomatic as compared with mild and severe COVID-19, with the dysregulation of an increasing number of ISGs associated with progressive disease. These data suggest that initial early responses against SARS-CoV-2 may be effectively controlled by ISGs. Therefore, we hypothesize that treatment with type I interferons in the early stage of COVID-19 may limit disease progression by limiting SARS-CoV-2 in the host.

Abstract Objective We investigated the discrepancy between clinical and PCR-based diagnosis of COVID-19. We compared results of ten patients with mild to severe COVID-19. Respiratory samples from all cases were tested on the Roche SARS-CoV-2 (Cobas) assay, Filmarray RP2.1 (bioMereiux) and TaqPath™ COVID19 (Thermofisher) PCR assays. Results Laboratory records of ten patients with mild to severe COVID-19 were examined. Initially, respiratory samples from the patients were tested as negative on the SARS-CoV-2 Roche ® assay. Further investigation using the BIOFIRE ® Filmarray RP2.1 assay identified SARS-CoV-2 as the pathogen in all ten cases. To investigate possible discrepancies between PCR assays, additional testing was conducted using the TaqPath™ COVID19 PCR. Eight of ten samples were positive for SARS-CoV-2 on the TaqPath assay. Further, Spike gene target failures (SGTF) were identified in three of these eight cases. Discrepancy between the three PCR assays could be due to variation in PCR efficiencies of the amplification reactions or, variation at primer binding sites. Strains with SGTF indicate the presence of new SARS-CoV-2 variant strains. Regular modification of gene targets in diagnostic assays may be necessary to maintain robustness and accuracy of SARS-CoV-2 diagnostic assays to avoid reduced case detection, under-surveillance, and missed opportunities for control.

Abstract This work sought to quantify pathologists’ diagnostic bias over time in their evaluation of colorectal polyps to assess how this may impact the utility of statistical process control (SPC). All colorectal polyp specimens(CRPS) for 2011–2017 in a region were categorized using a validated free text string matching algorithm. Pathologist diagnostic rates (PDRs) for high grade dysplasia (HGD), tubular adenoma (TA_ad), villous morphology (TVA + VA), sessile serrated adenoma (SSA) and hyperplastic polyp (HP), were assessed (1) for each pathologist in yearly intervals with control charts (CCs), and (2) with a generalized linear model (GLM). The study included 64,115 CRPS. Fifteen pathologists each interpreted > 150 CRPS/year in all years and together diagnosed 38,813. The number of pathologists (of 15) with zero or one (p 600 CRPS each(total 52,760 CRPS), that pathologist, endoscopist, anatomical location and year were all strongly correlated (all p

Tomato waste products (peels and seeds) are rich source of nutrients and bioactive substances, which play a significant role in enhancing the nutritional profile and prolonging shelf life. For this purpose, the effect of tomato waste powder (TWP) at different replacing levels (2, 4 and 8 %) on the physico-chemical, rancidity and organoleptic properties of cookies at storage intervals of 0, 15, 30 and 45 days were evaluated. Results demonstrated that TWP had high contents of protein (18.96 %), crude fiber (21.03 %), total phenols (48.35 mg GAE/100g) and lycopene (466 μg/100g). All properties of cookies were affected significantly by the addition of TWP from T1 to T3. During storage TWP had a nonsignificant effect on physicochemical properties with the exception of moisture. Rancidity parameters decreased significantly from T0 (control sample without TWP) to T3 (Sample with 8% TWP) and increased with storage, but the change was less than control (without TWP). Cookies supplemented with 4% TWP were most liked by judges. Conclusively, TWP could be used to improve storage stability of food products. [ABSTRACT FROM AUTHOR]

Background and Objective: Aging period is associated with potential threats such as loneliness and isolation. One of the most common mental disorders in the elderly is cognitive disorders and depression. Therefore, the purpose of this study was to investigate the role of smartphones use in depression in the retired elderly people of Yazd city. Materials and Methods: This cross-sectional study was conducted on 408 elderly people who were covered by the retirement center of Yazd province in 2018. The samples were selected through random sampling method. The questionnaires included demographic characteristics, internet usage, and GDS (Depression Scale). After data collection, analysis was performed using SPSS software version 18 and Mann-Whitney, Kruskal-Wallis and Chi-square. Results: 74.1% (74 people) of the elderly who used the Internet had no depression and 38.4% (60 people) of the elderly reported the reason for using the mobile phone is obtaining information and severe depression in this group was less than the other group (8.3% including 5 people). Mean depression score by gender (p = 0.046), marital status, education, income, lifestyle (p≤0.001), and reason for internet use (p = 0.043) were significantly different in the two groups of Smartphone and non-Smartphone users. Conclusion: Given the results and the positive role of smart phones in reducing depression in the elderly, programs for the elderly need to be designed through social networks. Using the Internet and social networks can help increase the respect and confidence of older people at community level, and isolate and loneliness caused by child marriage, death of a partner, and physical and mental disabilities can be Reduced by using a Smartphone and improved the mental health of the elderly, also through proper policymaking and activation of support systems to improve their well-being, efforts can be made to achieve a favorable period for them.

Background and purpose: AIDS, can cause psychological and social problems in patients and affects their quality of life. Therefore, infected people need more care. This study was conducted to investigate the effect of different care methods in quality of life of HIV+ patients. Materials and methods: HIV-positive patients in Mazandaran were divided into two groups of intervention (n=34) and control (n=17). Patients in intervention group received medical and social care for one year. Quality of life was assessed in both groups before and after the intervention using WHOQOL-Brief and a researcher-made questionnaire. Results: The study population included 49 patients including 56.67% males and 43.33% females. Before the intervention there was no significant difference in quality of life between the two groups. But after the intervention, satisfaction from personal relationships decreased significantly while social-occupational worries and concerns about the disease showed significant increase in intervention group. Compared to the control group, after one year, satisfaction from current treatment (P=0.02), concerns about the disease (P=0.0009), and quality of social life (P=0.02), showed significant increases in the intervention group. Conclusion: The participants in this study had low levels of quality of life and physical and mental health care could be of great benefit in improving quality of life of HIV+ patients. In designing care protocols for these patients, all aspects of life should be considered.

Staphylococcus aureus is an important infectious factor in the food industry and hospital infections. Many methods are used for detecting bacteria but they are mostly time-consuming, poorly sensitive. In this study, a nano-biosensor based on iron nanoparticles (MNPs) was designed to detect S. aureus. MNPs were synthesized and conjugated to Biosensors. Then S. aureus was lysed and nano-biosensor (MNP-TiO2-AP-SMCC-Biosensors) was added to the lysed bacteria. After bonding the bacterial genome to the nano-biosensor, MNPs were separated by a magnet. Bacterial DNA was released from the surface of nano-biosensor and researched by Nano-drop spectrophotometry. The results of SEM and DLS revealed that the size of MNPs was 20–25 nm which increased to 38–43 nm after modification and addition of biosensors. The designed nano-biosensor was highly sensitive and specific for the detection of S. aureus. The limit of detection (LOD) was determined as 230 CFU mL−1. There was an acceptable linear correlation between bacterial concentration and absorption at 3.7 × 102–3.7× 107 whose linear diagram and regression was Y = 0.242X + 2.08 and R2 = .996. Further, in the presence of other bacteria as a negative control, it was absolutely specific. The sensitivity of the designed nano-biosensor was investigated and compared through PCR.

Problematic internet use (PIU) can cause mental and physical harm to individuals and may be an emerging factor contributing to unsafe work behavior. In this study, the relationship between PIU and safety behavior was investigated. Moreover, it was hypothesized that safety climate can moderate the relationship between PIU and safety behavior. Participants were employees from a mining industry in Iran. Three validated questionnaires were distributed to gather the required data regarding PIU, safety climate, and safety behavior. Hierarchical regression analysis was used to assess the moderating effect of safety climate on the relationship between PIU and safety behavior. The size of moderation effect was assessed using f2 index. Four hundred eighty-five employees participated in this study. The results demonstrated a negative relationship between PIU and safety behavior. The moderating effect of safety climate on the relationship between PIU and safety behavior was supported. The f2 index was 0.027 which demonstrates a small moderation effect. In conclusion, PIU has a significant negative effect on the safety behavior of employees. Providing a strong safety climate can be a long-term solution for reducing the negative effect of PIU on safety behavior.

ObjectiveAssess the work environment of salaried pathologists via (1) the national workload system (L4E), (2) work distribution among/in three hospital groups, and (3) the frequency of significant absences or departures (SADs).MethodsAutomated analysis of pathology reports from a regional laboratory (accessioned 2011-2019) using validated computer code.ResultsThe study set contained 574,099 pathology reports, reported by 63 pathologists. The average yearly L4E workload units/full-time equivalent for three hospital groups were 8,101.6, 6,906.5 and 4,215.8. The average Gini coefficient for full-time pathologists in the three hospital groups were respectively 0.05, 0.16 and 0.23. The average yearly SADs rates were respectively 13%, 16% and 9%. The group with the highest SADs rate had the intermediate Gini coefficient and intermediate workload.ConclusionsHigh individual workload and work maldistribution appear to be associated with SADs. Individual workload maximums and greater transparency may be essential for limiting staff turnover, maintaining high morale, and efficient laboratory function with a high quality of care.

Purpose- In addition to preservation of and getting religious and legal rights of the government and people, one of the most important goals of ownership and consolidation of national and government domains is to keep and develop renewable natural resources and to allocate them for development of agricultural and productive activities. The ultimate goal of the legislator, has been movement towards comprehensive agricultural self-sufficiency, deprivation reduction, and development in villages. The present study aims at investigating the effect of national land resource allocation on rural sustainable development. As a result, the rural districts of Northern and Southern Bar’an, as a part of the central province of Isfahan, were selected. Design/methodology/approach- The present study is applied in terms of aims, descriptive-analytical in terms of research method, and survey study in terms of data collection. Data collection was performed through library and field studies. The population of the research consisted of farmers of five villages of the Northern Bar’an rural district and five villages of the Southern Bar’an rural district and 30 experts. A sample 260 farmers were selected using Cochran formula. Findings- The results indicated that the effectiveness of the allocation of national and government lands on the dimensions of rural sustainable development is at a moderate level. It shows poor efficiency of allocation of national and public land resources. Research limitations / implications- Problems like farmers' reluctance to cooperate and questionnaire distribution were among the challenges faced in this research. Originality/value: Given the importance of the studied region in production and agricultural, the findings of the present study can be regarded a big step in exploiting the potentiality of this region to determine strategies for sustainable rural development.

We have investigated the drivers of agricultural land use change to villa gardens in South Baraan and Kararaj rural districts in Isfahan County. Questionnaires were distributed among 184 farmers randomly selected from 426 in five selected villages. As the results showed, among spatial (i.e. environmental, economic, and social) drivers, environmental drivers (including dehydration) had the greatest impact. Social drivers, including the prevalence of constructing second homes and increasing demand in the land market, and economic drivers, including high agricultural inputs, were in the next ranks. The study of managerial drivers suggested that the interference of government in the agricultural market was a major driver in land use change. The same questionnaire was taken by 30 different land use experts selected by the snowball method. The results showed that, among locational-spatial drivers, social drivers had the greatest and economic drivers had the least impact on land use change. Also, among social drivers, the most effective factor was the purchase of land and construction of second homes. Among environmental drivers, the most effective factor was the cut-off of the Zayandehrud River. Of economic drivers, the most effective one was the higher income of tourism land use. Finally, the most effective management drivers were the poor monitoring, administrative corruption, and the ploy of some employees in government institutions. In the examined conditions, the farmers had little tendency to continue farming activities. This was strengthened by the shift of land use to more productive and less cumbersome activities.

Purpose- Today, tourism has become the largest industry in the world with both direct and indirect socio-economic effects. Given the diverse climatic conditions and limited water resources for agriculture in Iran, among various forms of tourism, tourism in desert areas with a multifaceted approach can narrow the gap caused by environmental constraints and play an important role in the development of different areas such as eastern regions of Isfahan province, which have many tourist attractions. In this research, we try to identify and evaluate land suitability for tourism development in counties located in desert areas of Isfahan province. Design/methodology/approach- In this research, the multi-criteria evaluation (MCE) method was used in the GIS environment. Considering the variety of criteria used, before preparing the final map of land suitability, selected criteria were categorized in different groups with regard to topography, climate, land covers and animal species diversity, environment, hazards, socio-economic aspects. Then, land suitability classes in each of the mentioned groups were identified. In the following step, the maps produced in each of these groups were given to the relevant experts to generate the final map of the land suitability according to the current situation, weigh the selected criteria based on the AHP paired comparison, and implement the results of this comparison in the GIS environment through applying weighted linear combination (WLC) method. Findings- The results of multi-criteria evaluation showed that the study area has highly suitable lands in almost all assessment groups, and there were no specific human and natural constraints in this area. The result of the final land suitability map also showed that 21044 square kilometers of the total area (nearly 30 percent) were ranked in the “very suitable” and “suitable” classes, indicating high capacity and capabilities or minimum natural and human constraints for tourism development in the region. Practical implications- Making use of the capabilities of desert areas in eastern regions of Isfahan province and providing the necessary conditions for tourism development with regard to the particular natural and human conditions of this region can offer the best available, affordable, and effective alternatives in the short term to tackle the current problems based on the principles of sustainable development in these areas. The problems include socioeconomic inequalities between developed and underdeveloped regions of Isfahan province, limited water resources for development of agricultural activities, and low ecological capacity of the region for some activities especially in vulnerable communities.

BackgroundWe investigated the genome diversity of SARS-CoV-2 associated with the early COVID-19 period to investigate evolution of the virus in Pakistan.Materials and methodsWe studied ninety SARS-CoV-2 strains isolated between March and October 2020. Whole genome sequences from our laboratory and available genomes were used to investigate phylogeny, genetic variantion and mutation rates of SARS-CoV-2 strains in Pakistan. Site specific entropy analysis compared mutation rates between strains isolated before and after June 2020.ResultsIn March, strains belonging to L, S, V and GH clades were observed but by October, only L and GH strains were present. The highest diversity of clades was present in Sindh and Islamabad Capital Territory and the least in Punjab province. Initial introductions of SARS-CoV-2 GH (B.1.255, B.1) and S (A) clades were associated with overseas travelers. Additionally, GH (B.1.255, B.1, B.1.160, B.1.36), L (B, B.6, B.4), V (B.4) and S (A) clades were transmitted locally. SARS-CoV-2 genomes clustered with global strains except for ten which matched Pakistani isolates. RNA substitution rates were estimated at 5.86 x10-4. The most frequent mutations were 5' UTR 241C > T, Spike glycoprotein D614G, RNA dependent RNA polymerase (RdRp) P4715L and Orf3a Q57H. Strains up until June 2020 exhibited an overall higher mean and site-specific entropy as compared with sequences after June. Relative entropy was higher across GH as compared with GR and L clades. More sites were under selection pressure in GH strains but this was not significant for any particular site.ConclusionsThe higher entropy and diversity observed in early pandemic as compared with later strains suggests increasing stability of the genomes in subsequent COVID-19 waves. This would likely lead to the selection of site-specific changes that are advantageous to the virus, as has been currently observed through the pandemic.

ObjectiveQuantify changes in workload in relation to the anatomic pathologist workforce.MethodsIn house pathology reports for cytology and surgical specimens from a regional hospital laboratory over a nine- year period (2011-2019) were analyzed, using custom computer code. Report length for the diagnosis+microscopic+synoptic report, number of blocks, billing classification (L86x codes), billings, national workload model (L4E 2018), regional workload model (W2Q), case count, and pathologist workforce in full-time equivalents (FTEs) were quantified. Randomly selected cases (n = 1,100) were audited to assess accuracy.ResultsThe study period had 574,093 pathology reports that could be analyzed. The coding accuracy was estimated at 95%. From 2011 to 2019: cases/year decreased 6% (66,056 to 61,962), blocks/year increased 20% (236,197 to 283,751), L4E workload units increased 23% (165,276 to 203,894), W2Q workload units increased 21% (149,841 to 181,321), report lines increased 19% (606,862 to 723,175), workforce increased 1% (30.42 to 30.77 FTEs), billings increased 13% ($6,766,927 to $7,677,109). W2Q in relation to L4E underweights work in practices with large specimens by up to a factor of 2x.ConclusionsWork by L4E for large specimens is underrated by W2Q. Reporting requirements and pathology work-up have increased workload per pathology case. Work overall has increased significantly without a commensurate workforce increase. The significant practice changes in the pathology work environment should prompt local investment in the anatomic pathology workforce.

Abstract Background Succinate dehydrogenase (SDH)- deficient renal cell carcinoma (RCC) is a newly identified rare subtype of RCC, having only gained acceptance from the World Health Organization in 2016. To the best of our knowledge, there are only 55 reported cases worldwide. Here, we report a new case of SDH-deficient RCC. Case presentation A 49-year-old male patient was incidentally found to have a large right renal mass. He had no personal or family history of paragangliomas (PGL), pheochromocytomas (PC), or gastrointestinal stromal tumors (GIST). The neoplasm was unilateral and unifocal. He underwent an open partial nephrectomy. Detailed pathological analysis was conducted to confirm the diagnosis. Genetic testing revealed a pathogenic mutation in the SDHB gene. He has been followed for 24 months now and has remained well without any evidence of local or distant recurrence. In this report we describe our experience with this diagnosis and review the relevant clinical, pathological, and genetic features. Conclusions Without the identification of SDHB deficiency, this patient’s personal and familial predisposition to PC, PGL, GIST and metachronous RCCs may have gone undetected despite his RCC diagnosis. When faced with an eosinophilic RCC, pathologists should routinely search for vacuoles or flocculent cytoplasmic inclusions. When these are present, or in cases of difficult eosinophilic renal tumors, staining for SDHB is recommended. For tumours without adverse pathologic features (i.e. high nuclear grade, coagulative necrosis, or sarcomatoid differentiation) excision alone may be a reasonable option, with the addition of regular surveillance for PC and PGLs in those found to harbor germline SDH mutations.

Objective: This research has been conducted so as to use the Porter Five Competitive Model and to obtain the votes of experts in the press industry. A pathological assessment of the industry in the country has been achieved and a desirable model has been developed for transforming the industry to face environmental change. Methods: In this research, the qualitative method has been applied to respond to research propositions. In the Pathology section for the press industry, Delphi's methodology was used to collect the views of the experts. And Grounded Theory was used to develop different aspects of the governmental press environment. The statistical population of this research includes all experts in media and press industry. Results: The findings, based on reviewing the experts' opinions in order to achieve a model of industry transformation propose two types of factors: 1) environmental factors including economic, political and legal-legislative factors; and 2) factors within the press industry including the audience, the human resources system and alternative competitors. Conclusion: In order to achieve a model of industry transformation are one of the factors: 1) environmental factors including economic, political and legal-legal factors; 2) factors of the press industry including the audience, the human resources system and alternative competitors.

Abstract Deterministic modeling lonely provides a unique boundary layout, depending on the geological interpretation or interpolation from the hard available data. Changing the interpreter’s attitude or interpolation parameters leads to displacing the location of these borders. In contrary, probabilistic modeling of geological domains such as lithofacies is a critical aspect to providing information to take proper decision in the case of evaluation of oil reservoirs parameters, that is, applicable for quantification of uncertainty along the boundaries. These stochastic modeling manifests itself dramatically beyond this occasion. Conventional approaches of probabilistic modeling (object and pixel-based) mostly suffers from consideration of contact knowledge on the simulated domains. Plurigaussian simulation algorithm, in contrast, allows reproducing the complex transitions among the lithofacies domains and has found wide acceptance for modeling petroleum reservoirs. Stationary assumption for this framework has implications on the homogeneous characterization of the lithofacies. In this case, the proportion is assumed constant and the covariance function as a typical feature of spatial continuity depends only on the Euclidean distances between two points. But, whenever there exists a heterogeneity phenomenon in the region, this assumption does not urge model to generate the desired variability of the underlying proportion of facies over the domain. Geophysical attributes as a secondary variable in this place, plays an important role for generation of the realistic contact relationship between the simulated categories. In this paper, a hierarchical plurigaussian simulation approach is used to construct multiple realizations of lithofacies by incorporating the acoustic impedance as soft data through an oil reservoir in Iran.