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Few studies have scrutinized the use of popular media as a practical tool for reducing homophobia and providing services for LGBTQ+ people. This survey study sought to gauge the association of LGBTQ+ individuals’ subjective judgment that social support is available through media (Perceived Media Support; PMS) with their identity and psychological status. We turn to Cultivation Theory and the Parasocial Contact Hypothesis as guiding frameworks to develop the Perceived Media Support Inventory (PMSI), capturing the emotional, instrumental, informational and esteem support that LGBTQ+ individuals perceive from popular media. We collected data from 200 self-identified participants in Iran. Factor and item analyses verified the robustness of the PSMI. PMS was revealed as associated with identity certainty in gays, lesbians and transgender people, identity affirmation in bisexuals, decreased acceptance concerns in transgender people, reduced anxiety in gays, and elevated resilience to stressful circumstances in LGBTQ+s. Besides, surprisingly, PMS was linked to several ramifications, such as identity uncertainty in bisexuals, identity superiority and concealment motivation in gays, internalized homonegativity in transgender people, difficult orientation/identity development process in gays, anxiety in LGBTQ+s in general, a feeling of psychological distance from the community in lesbians and feeling of hatred toward the community in gays. Findings suggest that perceived media support has positive and negative psychological consequences on Iranian LGBTQ+ people, leading us to theorize the dialectics of cultivated media support.

Background & Aim This study aimed to determine health status of Iranian transgender people who referred to Forensic Medicine Center in order to provide equal and accessible health services to transgender people. Materials and methods As part of this cross-sectional study, 200 transsexuals (106 transgender men/TM, 94 transgender women/TW) from Fars Province, Iran, completed a questionnaire including 24 items on socio-demography and health status in 2021. The data were analyzed using SPSS version 16, and also Chi-square test and Fisher's exact test were used for the data analysis. A p-value Results The gender identity age distribution was significantly different between TW and TM (P = 0.004). Women were significantly more likely to engage in unprotected intercourse than men (p = 0.001), but perceived financial, medical, and social barriers were not significantly different between the two groups (P > 0.05). However, women reported more family obstacles than men (P = 0.006). Conclusion Both women and men have experienced equal financial, medical, and social challenges in the health system, but women face more constraints in their family lives.

BACKGROUND: ErbB/PI3K signaling is widely recognized as a critical modulator of malignancy and miRNAs have been found to play a crucial role in the regulation of this pathway. OBJECTIVE: This study aimed to identify novel miRNAs related to the ErbBs loci and investigate the functional effects of these miRNAs on ErbB/PI3K signaling in cancer progression. MATERIALS and METHODS: Bioinformatics tools and RNA-seq data were used to discover novel miRNAs in breast and colon cancer cells. Gene expression levels were determined using RT-qPCR. Western blotting and dual-luciferase assays were used to identify the regulatory mechanism between ErbB4-miR1/2 and related genes. The effects of ErbB4-miR1/2 on cell proliferation, viability, ROS production, and migration were assessed by PI-flow cytometry, colony formation, MTT, ROS, scratch, and transwell assays in SKBR3 and SW480 cells. RESULTS: MicroRNA prediction tools, RNA-seq data, RT-qPCR, and sequencing results identified ErbB4-miR1 and ErbB4-miR2 (ErbB4-miR1/2) as novel miRNAs encoded by ErbB4 gene. ErbB4-miR1/2 were downregulated in breast and colon tumor tissues and also in different cancerous cells. RT-qPCR and dual-luciferase assays revealed that ErbB2 and ErbB3 genes are regulated by ErbB4-miR1/2. Consistently, a decrease in the p-AKT/AKT protein ratio verified the suppressive effect of ErbB4-miR1/2 on ErbB/PI3K activity. Furthermore, ErbB4-miR1/2 overexpression suppressed cell proliferation, viability, and migration, and increased ROS production. CONCLUSIONS: ErbB4-miR1/2 are novel tumor suppressor miRNAs which attenuate ErbB/PI3K signaling in breast and colon cancer cells.

In this study, a framework is developed to perform two-stage stochastic programming in a district energy system. This framework optimizes the sizing of energy components to minimize the total cost and operating CO2 emissions. Uncertainties in electricity demand, solar irradiance, wind speed, and electricity emissions are considered. A group of buildings at University of Utah is used as the case study to test the optimization framework. This study is novel by forming an open-source framework, considering electricity emissions with more details compared to previous studies in the literature, and performing the optimization for a campus in the U.S. This study’s results show the trade-off between cost and emissions when different energy configurations are used for three electricity purchasing cases. This framework can help facility managers to evaluate the optimum sizing of their district energy system to minimize the cost and emissions.

Electricity generation emission factors (EGEF) quantify the relationship between an emitted pollutant and the amount of electricity generated. Quantifying the variability among calculated EGEF is important when EGEFs are used to inform decision-making for environmental sustainability.First, variabilities in EGEF due to variability in the amount of coal, natural gas, and petroleum emissions within the fuel mix are quantified for California, Texas, and New York in 2017. The results show a higher coefficient of variation for SO2 and NOx compared to CO2 EGEF.Next, changes in the EGEF over time are studied using decomposition analysis for California, Texas, and New York from 1990 to 2017. The results show that the main factor in reducing EGEF in California is the improvement in the generation efficiency of power plants; in Texas, it is the increase in the ratio of renewable to non-renewable electricity generation; and in New York, it is the change in the mix of fossil fuels that are consumed for electricity generation.Finally, the effect of variability of EGEF on environmental impact categories is analyzed. Eutrophication of air, eutrophication of water, and smog formation are subject to high uncertainty because SO2 and NOx EGEFs are used to quantify these impacts, whereas global warming potential has less uncertainty because it only uses CO2 EGEF.

The building sector accounts for nearly 40% of total primary energy consumption in the U.S. and E.U. and 20% of worldwide delivered energy consumption. Climate projections predict an increase of average annual temperatures between 1.1&ndash, 5.4 &deg, C by 2100. As urbanization is expected to continue increasing at a rapid pace, the energy consumption of buildings is likely to play a pivotal role in the overall energy budget. In this study, we used EnergyPlus building energy models to estimate the future energy demands of commercial buildings in Salt Lake County, Utah, USA, using locally-derived climate projections. We found significant variability in the energy demand profiles when simulating the study buildings under different climate scenarios, based on the energy standard the building was designed to meet, with reductions ranging from 10% to 60% in natural gas consumption for heating and increases ranging from 10% to 30% in electricity consumption for cooling. A case study, using projected 2040 building stock, showed a weighted average decrease in heating energy of 25% and an increase of 15% in cooling energy. We also found that building standards between ASHRAE 90.1-2004 and 90.1-2016 play a comparatively smaller role than variation in climate scenarios on the energy demand variability within building types. Our findings underscore the large range of potential future building energy consumption which depends on climatic conditions, as well as building types and standards.

Introduction and Aim: Researchers and specialists believe that health maintenance and improvement through university students, as a part of society, play a crucial role in community configuration which should not be ignored. Since there was a few studies in these fields, researchers have sought to explore how mentioned workshops is related to cognitive emotion regulation, anxiety, depression, and sleep quality for the student volunteers of Shiraz University of Medical Sciences. Materials and Methods: In a randomized controlled trial, 152 students were allocated into the 3 equal groups (study1: “perseverance workshop” study2:”sleep and wakefulness workshop” and control group). Data collection instruments were the Granovsky cognitive emotion regulation scale, the Beck depression and anxiety inventories and Pittsburgh sleep Quality Index (PSQI-P) Questionnaire. Results: The results of comparing the anxiety and depression between groups showed that there was a decreasing and significant trend in the two intervention groups, before and after the two workshops (P < 0.001). For PSQ analysis, within-group comparisons in those who have participated sleep and wakefulness workshop showed that the change trend was significant and in linear form. In addition, to compare those who have participated in perseverance workshop with the control group, there was a significant difference between the pretest and posttest results in the Cognitive Emotion Regulation subgroups. Conclusion: It can be said that the implementation of the workshops could improve the emotional state of the participants in comparison to the control group.

Background: One unprecedented year after the coronavirus disease 2019 (COVID-19), the pandemic is no longer a short-term stressor; the unremitting/chronic effects of COVID-19 disease is likely to cause impaired physical and mental health upon population and the implemented public health and social measures to limit transmission and reduce mortality and morbidity from COVID-19 expose many people to social isolation, job loss, and economic recession. This study aims to compare mental status and four mental symptoms (somatization, anxiety, depression, and social functions) between two periods during the first year of the COVID-19 pandemic. Materials and Methods: Current study consists of two cross-sectional mental health surveys on the Iranian adult population carried out in two periods of March to April 2020 and December 2020 to February 2021 in two important Provinces of Iran (Fars and Khorasan Razavi). In the first survey, 1337 individuals participated in the study and completed the General Health Questionnaire-28, while in the second survey, 1205 participants completed the same questionnaire. Results: Among 1337 participants of the first survey, there were 876 (65.5%) females and 461 (34.5%) males with an average age of 37.41±10.58 years. In the second survey, there were 1205 participants with mean age of 33.79±19.57 years. The rates of females and males were 57.7% and 42.3%, respectively. Compared to the first survey, the second one showed that poor mental health condition that was 1.40 (95% confidence interval: 1.17-1.67) times higher based on the age, sex, education, marital status, economic, alcohol, cigarette, water-pipe, and sedative (P

The building sector accounts for nearly 40% of total primary energy consumption in the U.S. and E.U. and 20% of worldwide delivered energy consumption. Climate projections predict an increase of average annual temperatures between 1.1-5.4°C by 2100. As urbanization is expected to continue increasing at a rapid pace, the energy consumption of buildings is likely to play a pivotal role in the overall energy budget. In this study we used EnergyPlus building energy models to estimate the future energy demands of commercial buildings in Salt Lake County, Utah, USA, using locally-derived climate projections. We found significant variability in the energy demand profiles when simulating the study buildings under different climate scenarios, based on the energy standard the building was designed to meet, with reductions ranging from 10% to 60% in natural gas consumption for heating and increases ranging from 10% to 30% in electricity consumption for cooling. A case study, using projected 2040 building stock, showed a weighted average decrease in heating energy of 25% and an increase of 15% in cooling energy. We also found that building standards between ASHRAE 90.1-2004 and 90.1-2016 play a comparatively smaller role than variation in climate scenarios on the energy demand variability within building types. Our findings underscore the large range of potential future building energy consumption which depend on climatic conditions, as well as building types and standards.

Background: The function of healthcare workers, particularly nursing staff, in taking care of coronavirus disease 2019 (COVID-19) patients, cannot be overemphasized. As the pandemic lasts, burnout among the nursing staff needs to be considered as an important challenge. This was aimed to assess the nurses’ burnout and factors affecting this variable. Materials and Methods: In this cross-sectional study, Maslach Burnout Inventory was completed by 261 nurses in Shiraz hospitals (Iran) in April 2020. This questionnaire addresses different aspects, including emotional exhaustion, personal achievement, and depersonalization, to determine the intensity of perceived burnout among nurses during the outbreak. Results: Our data demonstrated that the nurses’ burnout in Shiraz hospitals during the COVID-19 pandemic was high (64.6%). Emotional exhaustion and depersonalization were observed in 63.6 and 53.3 percent of the participants, respectively. Moreover, the rate of successful personal achievement among these nurses was >97%. Work experience

Cities are responsible for 75%–80% of emissions worldwide, and policies that target emissions reductions are often implemented at an urban scale. This paper reviews studies using life cycle assessment (LCA) methods, specifically input-output and hybrid analysis, which used a consumption based accounting system to quantify direct (Scope 1) emissions and indirect (Scope 2 and Scope 3) emissions at the urban scale. Life cycle greenhouse gas emissions for case studies are scaled toward three metrics: nominal Gross Domestic Product, population, and population density; as these factors are known to be influential in life cycle assessment results at these scales. However, this work illustrates that, for the cities and countries considered in these case studies, the similarity between cities within the same country is more pronounced than any effects of Gross Domestic Product (economy) or population/population density (city size) across cities in different countries. Accounting for greenhouse gas emissions at city scale using LCA methods presents difficulties in three LCA phases: In Phase 1, there is no agreement available on a concisely defined city boundary and the extent to which indirect emissions are included; In Phase 2, there is a lack of publicly available data from governments for a wide range of locations; In Phase 3, there are few studies among those reviewed that provided a thorough analysis of greenhouse gas emissions using life cycle impact assessment at urban scale. Because of these issues with LCA Phases 1–3, Phase 4 (interpretation of results) cannot be performed effectively to assist with emissions reduction policymaking and planning.

Objective Cancer is a stressful event in life, and the dreadful impact and problems created for patients and families by cancer negatively affect their quality of life. Therefore, regarding the increasing number of cancer patients and the nature of this disease, the need to recognize and understand the priorities and problems of patients after the diagnosis of cancer is of high importance. This study was designed and implemented with the aim of identifying the perceived priorities of women with breast cancer. Methods This study is a qualitative research of content analysis type. To collect data, purposeful sampling and deep semi-structured individual interviews were used. The subjects were women with breast cancer who visited the Breast Disease Research Center of Shahid Motahari Clinic in Shiraz, and the data were saturated after 15 interviews. The four criteria presented by Lincken and Guba were used to evaluate the validity and reliability. To analyze the qualitative data, conventional qualitative data analysis and MAXQDA10 software were used. Two themes were obtained in the assessment of interviews and analysis of data: 1) Supportive relief; 2) Therapeutic support. Results Some of the participants highlighted the role of social and family support in coping with the disease, and considered social communication and continued support in the form of empathic relationship as a turning point in their lives. The absence of a fertility specialist in the cancer treatment system was the main complaint of most participants. The results showed that receiving support from family and the healthcare system is the most important perceived priorities in breast cancer patients. Conclusion The results of this study show the importance of social support as a perceived priority in breast cancer patients to improve their quality of life. Development and reinforcement of the supportive network seem to be essential to provide the best possible help to these patients.

Mental health disorders are prevalent in children in all societies. The onset of most mental disorders is in youth (12–24 years of age), but most of the time they are first detected later in life. Poor mental health is strongly related to other health and development concerns so it is common to show high grade of stress, substance use, violence, and depression. The effectiveness of some interventions has been strongly established, although more researches are needed to improve the range of affordable and feasible interventions. The shortage of educational and fiscal policies and the fairly low attention to this subject is the main challenge addressing mental-health needs. Therefore, universal or early intervention programs are needed to develop protective factors by increasing competence or skills, to reduce existing negative behaviors. Moreover child discipline problems can be reduced by school multicomponent intervention strategies and as a result promotion in student’s achievement becomes evident.

Background: Autism is a neurodevelopmental disorder that onset in the first 3 years of life and led to lifelong disability.Despite the early onset of symptoms, diagnosis of thissyndromedoes not happenuntil severalyears later, somany childrenlosethe opportunityfor earlyintervention.There arevarious toolsforscreening anddiagnosis, buttheirdesign, strengths and weaknesses aredifferent. The aim of this study was assess these tools from various aspects to provide a comprehensive view. Materials and methods: This study is a narrative literature review on screeningtoolsof autism. Comprehensive searches of the scientific literature were conducted in textbooks and 8 electronic databases(proquest,wiley,google scholar,SID,Scopus, Web of Science ،Science Direct ، and Medline) and Pediatric book. language restriction (Persian and English) was applied. The search strategy consisted of keywords and medical subject headings for autism and various screening tests. Result: In this study, 28 screening tests were identified from 1992 to 2014. CHAT is oldest test and the most recent test is CAST The minimum age that can perform the screening is six months that related to ITC. Minimum time of testing was 5 minutes for CHAT and the maximum time was 90-120 minutes for ASIEP-3.RAADS-R test was the highest specificity and specificity (100%) and the lowest specificity was 14% in ESAT test Conclusion: The results of this study indicate that any of the autism screening tools consider specific skill and various aspects of the disease, careful evaluation is need to choose proper test.

Background and Aim: The prevalence of cancer in women under 50 years of age has been increased in recent years. Cancer treatment methods can lead to infertility in women with cancer. Fertility and childbearing, as the most important conflicts in the life of women with breast cancer, significantly affect their quality of life. Materials and Methods: This research is a qualitative study of content analysis type. Purposeful sampling and semi-structured individual interviews were performed for data collection. The participants were women with breast cancer referred to the Breast Disease Research Center of Shahid Motahari Clinic in Shiraz. The data were saturated after 15 interviews. To assess the validity and reliability, we used the four criteria provided by Lincoln and Guba. The conventional qualitative data analysis and MAXQDA10 software were used to analyze the qualitative data. Results: Explaining the conflicts which women with breast cancer are faced has led to the extraction of four main categories: (1) paradox of decision-making to childbearing, (2) fear, (3) sinister emotions, and (4) challenges. The results showed that the paradox of decision-making on childbearing is the most important challenge with which the patients with breast cancer are faced, causing a state of fear, anxiety, and the emergence of sinister emotions in them. Conclusion: It seems that paying more attention to preserving reproductive capacity before starting the treatment plays an important role in solving the biggest conflict in the life of breast cancer patients.

Background: Maternal thyroid function alters during pregnancy. Inadequate adaptation to these changes results in thyroid dysfunction and pregnancy complications. Objectives: This prospective study aimed to evaluate the prevalence of thyroid diseases in pregnancy and its outcomes in south of Iran. Materials and Methods: This prospective study was conducted on 600 healthy singleton pregnant women who aged 18 to 35 years old at 15 to 28 weeks of gestation. We investigated the prevalence of thyroid dysfunctions in women. Multivariate analysis was performed to determine the effect thyroid dysfunction on obstetric and neonatal outcome. Results: Thyroid stimulating hormone (TSH) levels of 0.51, 1.18, 1.68, 2.4, and 4.9 mIU/L were at 2.5th, 25th, 50th, 75th, and 97.5th percentile in our population. The prevalence of clinical hypothyroidism, subclinical hypothyroidism, overt hyperthyroidism, and subclinical hyperthyroidism in all pregnant women was 2.4%, 11.3%, 1.2%, and 0.3%, respectively. In addition, 1.4% of patients had isolated hypothyroxinemia. Clinical hypothyroidism was associated with increased risk of preterm delivery (P = 0.045). Subclinical hypothyroidism had a significant association with intrauterine growth restriction (IUGR) (P = 0.028) as well as low Apgar score at first minute (P = 0.022). Maternal hyperthyroidism was associated with IUGR (P = 0.048). Conclusions: We revealed that thyroid dysfunction during pregnancy was associated with IUGR and low Apgar score even in subclinical forms. Further studies are required to determine whether early diagnosis and treatment of thyroid diseases, even in subclinical form, can prevent their adverse effect on fetus.