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Background and purpose: As an endogenous antioxidant, bilirubin has surprisingly been inversely correlated with the risk of non-alcoholic fatty liver disease (NAFLD). Thereupon, the current evaluation was designed to assess the positive effects of bilirubin on the autophagy flux, as well as the other pathogenic processes and parameters involved in the expansion of NAFLD. Experimental approach: Thirty adult male rats weighing 150-200 g with free access to sucrose solution (18%) were randomly subdivided into 5 groups (n = 6). Subsequently, the animals were euthanized, and their blood specimens and liver tissue samples were collected to measure serum biochemical indices, liver histopathological changes, intrahepatic triglycerides content, and tissue stereological alterations. Furthermore, the expression levels of autophagy-related genes (Atgs) were measured to assess the state of the autophagy flux. Findings/Results: Fasting blood glucose, body weight, as well as liver weight, liver-specific enzyme activity, and serum lipid profile indices markedly decreased in rats that underwent a six-week bilirubin treatment compared to the control group. In addition, histopathological studies showed that hepatic steatosis, fibrosis, inflammation, and necrosis significantly decreased in the groups that received bilirubin compared to the control animals. Bilirubin also caused significant alterations in the expression levels of the Atgs, as well as the Beclin- 1 protein. Conclusion and implication: Bilirubin may have potential ameliorative effects on NAFLD-associated liver damage. Moreover, the beneficial effects of bilirubin on intrahepatic lipid accumulation and steatosis were comparable with the group that did not ever receive bilirubin.

Abstract Background Atherosclerosis is a chronic inflammatory condition affecting the large arteries and is a major cause of cardiovascular diseases (CVDs) globally. Increased levels of adhesion molecules in cardiac tissue serve as prognostic markers for coronary artery occlusion risk. Given the antioxidant properties of bilirubin and its inverse correlation with atherosclerosis, this study aimed to assess the beneficial effects of bilirubin on atherosclerotic indices and heart structure in high-fat diet-fed diabetic rats with atherosclerosis. Methods Atherosclerosis was induced in three out of five groups of adult male Sprague Dawley rats through a 14-week period of high-fat diet (HFD) consumption and a single low dose of streptozotocin (STZ) (35 mg/kg). The atherosclerotic rats were then treated with intraperitoneal administration of 10 mg/kg/day bilirubin for either 6 or 14 weeks (treated and protected groups, respectively), or the vehicle. Two additional groups served as the control and bilirubin-treated rats. Subsequently, the mRNA expression levels of vascular cell adhesion molecule 1 (VCAM-1), intercellular adhesion molecule 1 (ICAM-1), lectin-like LDL receptor 1 (LOX-1), and the inducible nitric oxide synthase (iNOS) were analyzed using quantitative reverse transcriptase-polymerase chain reaction (qRT-PCR). Histopathological and stereological analyses were performed to assess changes in the heart structure. Results Bilirubin significantly decreased the expression of VCAM-1, ICAM-1, LOX-1, and iNOS genes in the treated group. Moreover, bilirubin mitigated pathological damage in the left ventricle of the heart. Stereological analysis revealed a decrease in the left ventricle and myocardium volume, accompanied by an increase in vessel volume in rats treated with bilirubin. Conclusion These findings demonstrate that mild hyperbilirubinemia can protect against the progression of atherosclerosis and heart failure by improving lipid profile, modulating adhesion molecules, LOX-1, and iNOS gene expression levels.

Fintech and its entrepreneurial opportunities have the ability to play an effective role in the development of the financial industry. Therefore, it is necessary to make a correct and effective policy in this area to identify its probable future. This study is exploratory in terms of purpose and practical in terms of orientation. Interviews and questionnaires were used to collect data. 28 drivers were extracted by reviewing the background and interviewing experts. In order to screen the propellants, expert questionnaire and fuzzy Delphi method were used. Then the propellants screened were ranked through the priority assessment questionnaire and the developed COPRAS technique. The two drivers of the development of smart contracts in the financial industry and the tendency of financial institutions towards open innovation had the highest priority and were used to write research scenarios. Based on these two drivers, 4 scenarios of the era of pristine opportunities, the era of conservative managers, the era of dilapidated infrastructure and the ice age were developed. Then, using the MABAC technique, the scenario of the age of dilapidated infrastructures was selected as the possible scenario of the research. Research proposals were proposed based on priority drivers and possible scenarios. Government support, providing sufficient funds in order to create the necessary infrastructure for the development of smart contracts by banks or establishing a cooperative relationship between banks and financial institutions, fair legislation, development of regtechs, creating compatibility between current systems with new technologies were the most important practical proposals of the study.

Background. Designing a payment system for healthcare workers- doctors and nurses, in particular- in the hospitals is more intricate than that for other organizations. Beyond the legal compliance, the unique features of the medical professions and nursing work environment should be considered. Due to the lack of adequate researches on payment methods for doctors and nurses in Iran, especially regarding the recent changes in "fee for services" (FFS) payment, the present study aimed to investigate the payment challenges faced by the doctors and nurses in Iranian public hospitals. Methods. Challenges were identified by interviews, and prioritized by adopting the MARCOS method. The study population included the hospital managers, healthcare payment method experts, and doctors and nurses in the public hospitals. Targeted sampling and semi-structured interviews were conducted to collect the data. In the MARCOS method, criteria determination, weighting, and scoring of the challenges were performed by five experts in the field of healthcare payment. Criteria included decreased motivation (25%), reduced productivity (15%), correction cost (40%), and implementation difficulty of the correction (20%). Calculations were performed using Excel software and determining the relevant priorities. Results. A total of 16 interviews were conducted in this study, with 10 interviews about the academic faculty and hospital managers in Isfahan University of Medical Sciences, three about the nursing experts in Tehran, and three about the Ministry of Health experts. According to MARCOS method calculations, the top 4 challenges in compensating doctors were identified as: low FFS ceiling, lack of job difficulty incentives, the inadequate impact of full-time work, and the progressive taxing. Additionally, the 2 primary challenges in compensating nurses were: irregular payment of FFS, and collective payment of FFS instead of individual payment. Conclusion. At the time of this study, Iranian public hospitals provided the doctors with individual rights, benefits, and allowances, while it provided the nurses with collective rights, benefits, and overtime pay. Although these compensation methods often posed different challenges, most of the issues were associated with the allowance payments. By prioritizing key challenges, authorities may have developed the necessary solutions for addressing the challenges as well as enhancing the satisfaction of doctors and nurses in Iranian public hospitals.

Before the coronavirus pandemic, higher education centers and companies paid little attention to e-learning. The outbreak of the pandemic and the development of digital technologies have caused companies to pay much attention to e-learning. Therefore, companies are looking for the effective use of e-learning tools. The current research seeks to provide a framework to improve the effectiveness of the e-learning system in Hyper Famili chain stores. The current research is applied in terms of orientation and has a quantitative nature in terms of methodology. This study used two Fuzzy Delphi and Marcos methods for data analysis. The theoretical population of the research was managers, experts, and consultants in the field of education in Hyper Famili. Sampling was done as a judgment based on the expertise of experts in eLearning. The sample size was equal to 10 people. Interviews and questionnaires were used to collect data. The questionnaires used in this research were expert and priority questionnaires. In the first stage, 32 factors were obtained through literature review and interviews with eLearning experts. As a next step, these factors were screened by the distribution of expert questionnaires and the fuzzy Delphi method. Ten factors were selected for final prioritization with Marcos. The screened factors were prioritized by distributing priority questionnaires and Marcos. According to the scores, the most important factors have been found. Practical research proposals were developed based on the most prioritized factors. Some practical suggestions of the research were holding a training workshop on the benefits and applications of e-learning for senior managers, considering the appropriate budget for purchasing and preparing the necessary infrastructure in the field of e-learning, preparing strategic and operational documents based on future developments of new technologies in Iran and the world and the use of instructors with electronic teaching skills.

Abstract Background Lipotoxicity, caused by adipocyte triglyceride over‐accumulation, contributes to obesity‐related comorbidities such as hypertension, type 2 diabetes, coronary heart disease, respiratory dysfunction, and osteoarthritis. This study focuses on determining how sirtuin‐1 (SIRT‐1) mediates quercetin's (QCT) effect on 3T3‐L1 adipocytes. Key aspects of this study include preventing adipogenesis, inducing lipolysis, and stimulating adipocyte apoptosis. Methods 3T3‐L1 adipocytes underwent treatment with varying QCT doses, lipopolysaccharide (LPS), and the SIRT‐1 inhibitor EX‐527, followed by 3‐(4,5‐dimethylthiazol‐2‐yl)‐2,5‐diphenyl‐2H‐tetrazolium bromide [MTT] assay for cell viability assessment. Furthermore, quantitative real‐time polymerase chain reaction measured mRNA expression levels of adipogenesis markers (fatty acid synthase [FASN] and peroxisome proliferator‐activated receptor gamma [PPARγ]), lipolysis markers (adipose triglyceride lipase [ATGL] and hormone‐sensitive lipase [HSL]), and apoptosis markers (B‐cell lymphoma2 [Bcl‐2], Bcl‐2 Associated ‐X‐protein [BAX] and Caspase‐3). Results The data showed that LPS + QCT significantly reduced cell viability in a dose‐ and time‐dependent manner, unaffected by LPS + QCT + EX‐527. Treatment with LPS + QCT did not affect FASN and PPARγ expression but significantly increased ATGL and HSL mRNA expression compared with LPS alone. Interestingly, EX‐527 reversed the effects of LPS + QCT on lipogenesis and lipolysis markers completely. QCT enhanced apoptosis in a SIRT‐1 independent pattern. Conclusion The data suggest that QCT suppresses adipogenesis while increasing lipolysis via SIRT‐1. However, QCT's effects on apoptosis appear to be independent of SIRT‐1. These findings provide further evidence for QCT's effects on adipocytes, particularly its interaction with SIRT‐1.

Abstract Introduction Adipose triglyceride lipase (ATGL) is a crucial enzyme responsible for the release of fatty acids from various tissues. The expression of ATGL is regulated by insulin and this enzyme is linked to Insulin resistance (IR). On the other hand, ATGL‐mediated lipolysis is connected to macrophage function and thus, ATGL is involved in inflammation and the pathogenesis of lipid‐related disorders. This study aimed to investigate the correlation between ATGL, obesity, Metabolic Syndrome (MetS), and inflammation. Methods A total of 100 participants, including 50 individuals with obesity and 50 healthy participants, were recruited for this study and underwent comprehensive clinical evaluations. Blood samples were collected to measure plasma lipid profiles, glycemic indices, and liver function tests. Additionally, peripheral blood mononuclear cells (PBMCs) were isolated and used for the assessment of the gene expression of ATGL, using real‐time PCR. Furthermore, PBMCs were cultured and exposed to lipopolysaccharides (LPS) with simultaneous ATGL inhibition, and the gene expression of inflammatory cytokines, along with the secretion of prostaglandin E2 (PGE2), were measured. Results The gene expression of ATGL was significantly elevated in PBMCs obtained from participants with obesity and was particularly higher in those diagnosed with MetS. It exhibited a correlation with insulin levels and Homeostatic Model Assessment for IR (HOMA‐IR), and it was associated with lipid accumulation in the liver. Stimulation with LPS increased ATGL expression in PBMCs, while inhibition of ATGL attenuated the inflammatory responses induced by LPS. Conclusions Obesity and MetS were associated with dysregulation of ATGL. ATGL might play a role in the upregulation of inflammatory cytokines and act as a significant contributor to the development of metabolic abnormalities related to obesity.