Search

Abstract Background Conflict is an inevitable aspect of healthcare team collaboration. Effective conflict management training can improve the performance of healthcare teams. This study aimed to investigate the effect of conflict management education based on the Fogg model on the attitude of medical students toward conflict management. Method This randomized controlled trial was conducted at Tehran University of Medical Sciences in 2022–2023. Freshman medical students volunteered to participate in this study. Then, they were randomly divided into intervention (12 groups of 4 people, n = 48) and control (12 groups of 4 people, n = 48) groups. The intervention groups received Fogg model-based education, and the control groups were taught using a conventional method. Student attitudes toward conflict management were evaluated using the Conflict Management Attitude questionnaire. Results The intervention group showed significantly higher mean total attitude scores and scores for subscales 2 and 3 in the post-test compared to the control group (P = 0.003, P = 0.001, and P = 0.001, respectively). When the pre-test was included as a covariate, ANCOVA results showed a significant increase in the total attitude score of students (P = 0.010) as well as in the scores for subscales 2 and 3 following the educational intervention (P = 0.004, and P = 0.003, respectively). Conclusion This study showed that intervention in conflict management using the Fogg model can improve the attitude of medical students toward conflict management. This approach can help medical educators use creative, model-based methods in teaching conflict management to prepare students to work in healthcare teams.

Introduction: Understanding the relationship between medical students' attitudes towards conflict management and their dominant conflict management styles is crucial for improving their ability to effectively handle challenging situations. This study aimed to determine the relationship between medical students' attitudes towards conflict management and their conflict management styles. Method: This was a descriptive, analytical study involving 244 first-year general medicine students from Tehran University of Medical Sciences. The Conflict Management Attitude Questionnaire (CMAQ) and the Conflict Management Styles Questionnaire (DUTCH) were used to collect data. Pearson's correlation coefficient and independent t-tests were employed for data analysis. Results: The results showed that students predominantly used problem-solving (15.80 ± 2.18) and compromising (15.00 ± 2.23) styles. Pearson's correlation analysis revealed a significant positive correlation between the average score of attitudes towards conflict management and the average scores of the compromising and problem-solving styles (P = 0.014, r = 0.162; P = 0.000, r = 0.287, respectively). Additionally, a significant negative correlation was found between the average score of attitudes towards conflict management and the average score of the avoiding style (P = 0.010, r = -0.170). The t-test results indicated a significant difference in the competing style between male and female students (P = 0.038). Conclusion: Identifying the strengths and weaknesses of clinical education is the first step towards improving the quality of medical education. Then the faculty development programs planners should design, implement and evaluate educational development programs for clinical faculty to improve their educational skills in the clinical education environment.

Today, with increasing access to the internet and portable computing tools, the possibility of utilizing these tools in education has significantly expanded. Consequently, various tools have been introduced for creating and developing content and designing mobile-based educational courses. One of the essential and widely used tools for content creation and mobile-based course development is the MIT App Inventor tool, developed by a group of researchers at the Massachusetts Institute of Technology (MIT). It requires guidance on using this technology tool for content production in designing and implementing practical educational courses in health-related domains. This article aims to introduce the App Inventor software and its utilization in Technological Pedagogical Content Knowledge (TPACK). The tool is particularly beneficial for individuals outside the tech industry who seek to incorporate educational applications into teaching and learning processes.

Abstract

Hydrogels have unique properties such as water retainer, softness, flexibility, and biocompatibility that cause their application in biology. Among the various hydrogel structures can be referred to intelligent hydrogels. These structures can respond to environmental stimuli. Environmental stimuli can be physical, including temperature or chemicals, such as pH. In this study, the application of smart hydrogels in the fields of medicine, protein, and gene delivery, as well as tissue engineering has been divided and the results of this study show that different types of smart hydrogels with different capabilities have been identified. The mechanical strength of hydrogels is suitable for physiological function and various purposes such as biomedical applications, tendon and ligament repair, cartilage replacement, and tissue engineering. Currently, hydrogels are used to make contact lenses, health products, tissue engineering scaffolds, drug delivery systems, and wound dressing. Most studies in the field of smart drug delivery have been reported, especially in anticancer drugs, and also tissue engineering that can achieve more desirable results in the near future.

Introduction: Serum vitamin D levels are related to a wide spectrum of factors including low sunlight exposure, high oxidative stress, low physical activity and sleep disorders. In this paper we are going to investigate the most crucial parameters associated with serum vitamin D levels in survey of ultraviolet intake by nutritional approach (SUVINA) study with a data mining approach.Material and Methods: Data including demographic, anthropometric, clinical and laboratory information were extracted from the SUVINA dataset comprising 289 subjects who were enrolled into our study. The XGBoost algorithm was used to define the most important features related to vitamin D level in our population.Results: Applying XGBoost modeling for vitamin D level showed that the presented scheme can determine the most important determinants of serum vitamin D level with an accuracy of 91%. Pro-oxidant anti-oxidant balance (PAB), body fat percentage, physical activity level (PAL), age, restless leg syndrome (RLS), and dietary inflammatory index (DII) density were the most important variables correlated with vitamin D deficiency.Conclusion: Using XGBoost and with an accuracy of more than 90%, we showed that the six most important risk factors for vitamin D deficiency are PAB, PAL, age, body fat percentage, RLS and DII density, respectively.

Although "Information and Communications Technology" provides numerous and intact opportunities for development, it has some challenges and threats. The law seeks to support opportunities for prevention from and fighting with challenges and threats. Since realising the essence of any concept leads to analysing its legal effects, analysing cyberspace in light of conceptual framework first results in understanding this space and then understanding its legal effects. Considering vast and new loads of information and Communications Technology as the main question, finding the concept of cyberspace as an objective and untouchable space and its legal effects is the subject of this article. This study has been done in a descriptive-analytical way using library and internet sources. The findings of this research indicate that cyberspace law is both different and similar to physical world law. However, the principles and basis of legislation and the tools, conditions, and effects of conducting conduct in cyberspace differ from the physical world.

Urban crime prevention remains a critical challenge intertwined with socioeconomic disparities. This study investigates the spatial nexus between urban deprivation and crime decline in Chicago from 2015 to 2022, addressing the question: How do changes in neighborhood deprivation relate to crime reduction patterns? Using comprehensive crime incident and census tract Area Deprivation Index (ADI) data, this study conducted exploratory spatial analysis, regression modeling, and local bivariate relationship analysis. The findings reveal persistent hotspots of concentrated deprivation on Chicago’s south and west sides, alongside a general citywide crime decline. However, the current research uncovered significant spatial heterogeneity in both deprivation patterns and crime reduction, challenging the achievement of equitable public safety outcomes. Surprisingly, while crime incidents in 2015 and 2022 significantly predicted crime change, ADI scores were not statistically significant predictors in our regression model. Local bivariate analysis exposed diverse relationships between ADI changes and crime rate changes across neighborhoods, with 72.2% of census tracts showing no statistically significant relationship. This underscores the complexity of urban crime dynamics and the importance of local context in understanding these patterns. Our research contributes a nuanced understanding of the intricate relationship between urban deprivation and crime patterns, providing valuable insights for policymakers, law enforcement agencies, and urban planners. These findings highlight the need for integrated, long-term strategies that address both crime prevention and socioeconomic disparities, ultimately fostering safer, more equitable urban environments and informing evidence-based interventions tailored to specific neighborhood contexts.

Introduction: Thalassemia is a genetic disease with an autosomal recessive pattern. Prenatal diagnosis (PND) and termination of pregnancy in the case of fetus infection is the best way to prevent this disease. This study was performed with aim to evaluate the incidence rate and causes of new cases of major β-thalassemia (MBT) after implementing the national prevention program in Kerman University of Medical Sciences. Methods: This was descriptive and analytical study on health system research. Information of patients (Date of birth, status of other siblings) and carrier couples (year of marriage, kinship relationship, performing screening at the time of marriage, history of surveillance, and causes of the birth of beta-thalassemia patient) was obtained from the data available in the Health Department of Kerman Universities of Medical Sciences from 2011 to 2019. Data were analyzed by SPSS (Version 24) using Fisher's exact test. Results: The 9-year incidence rate in the whole region was 0.55 per 10,000 live births. The success rate of the program in the whole region was 84.37%. Fifteen patients were born between 2011 and 2019. The most important cause of MBT incidence was the lack of identification of thalassemia couples and their lack of awareness about their condition (46.6%). Nine (60%) of the patients' parents had consanguineous marriages. There was no statistically significant relationship between causes of new cases of MBT and the level of education and occupation of the patients' parents (P>0.05). Conclusion: Although the implementation of the prevention program has significantly reduced the number of new cases of MBT, appropriate planning to improve the quality of counseling services and carrier couples care and increase the level of awareness and change the attitude of target groups to eliminate the incidence of the disease is necessary.

Abstract Background Medical students should effectively manage conflicts in teamwork and communication with other team members. This study aimed to develop and validate a tool to evaluate attitude of medical students and physicians toward conflict management. Method A multi-step process was employed to develop and validate a Conflict Management Attitude Questionnaire (CMAQ) based on the steps recommended in AMEE Guide No. 87. First, the initial items were obtained from the literature review and focus group. After cognitive interviews with the medical students and revision of the questionnaire, content validity was performed by experts. The construct validity and reliability of the questionnaire were assessed using exploratory Factor Analysis (EFA) and Cronbach’s alpha coefficient, respectively. Results This multi-step process resulted in a 12-item, five-point Likert-type questionnaire with satisfactory construct validity. Exploratory factor analysis revealed three factors, comprising the four items from the "perceived interactions in conflict management" subscale loading on the first factor, and five items from the "perceived value of learning conflict management" subscale loading on the second factor, along with three items from the "perceived application of conflict management" subscale loading on the third factor. All subscales described 56.48% of the variance. Validation results showed that Content Validity Index (CVI) and Content Validity Ratio (CVR) were greater than 0.75. Cronbach's alpha coefficient was 0.791. Conclusion This study showed that CMAQ has valid evidence for assessing the attitude of medical students toward conflict management with favorable psychometric properties and strong evidence of construct validity. However, due to the lack of evidence on any specific questionnaire to evaluate the attitude towards conflict management, future studies should conduct a confirmatory investigation regarding other aspects of medical students' attitudes toward conflict management.

Background: Healthcare workers (HCWs) have a high risk of catching SARS-CoV-2 infection. Seroprevalence studies can provide related data on HCWs with a history of infections. Despite numerous seroepidemiological reports of COVID-19 in different groups, there are no such reports for HCWs working in Rafsanjan City, Iran. This study aimed to determine the SARS-CoV-2 seroprevalence among HCWs. Methods: Blood samples were obtained from 295 participants, including healthcare personnel and administrative staff. The SARS-CoV-2 IgG antibody was measured by the ELISA method, and the obtained data were analyzed with the Chi-square test and logistic regression. A P

Introduction: Phenylketonuria (PKU) is the most common inherited metabolic disease in Iran that can be prevented by prenatal diagnostic tests (PND). This study was performed aimed to determine the incidence of PKU and the effect of implementing a prevention program on reducing its incidence in the population covered by Kerman University of Medical Sciences. Methods: This was a descriptive study on health system research. All PKU carrier couples and patients covered by Kerman University of Medical Sciences in 2019 were studied. Data were obtained from the national form of epidemiological study of genetic diseases and genetic surveillance form from the Deputy Minister of Health. Frequency tables and graphs were used to describe the information. Results: In this study, 68 patients and 63 carrier couples were covered and 37 (60.6%) carrier couples were at risk of having a sick child and all of them were under the care of health care centers. For 91.9% of them and 61.9% high-risk relatives, the type of gene mutation was determined. PND tests were performed on 28 (87.5%) pregnant women. Seven affected fetuses were diagnosed, all of which were aborted with parental consent. 32 high-risk couples (86.5%) used safe method of contraception. The 13-year incidence of PKU in the whole region was 1.13 and the expected incidence was 1.36 per 10,000 live births. Conclusion: Implementation of prevention program had an effect on reducing the incidence of PKU. The high frequency of consanguineous marriages can affect the high incidence of PKU. It is necessary to identify the patient's relatives who are at risk of having a sick child (consanguineous marriage), refer them to a genetic counseling center and determining their status can be effective in reducing the incidence of the disease.

Background: There are still conflicting results on thepostoperative consequences of patients with hip and femoralfractures based on the type of anesthesia. The aim of this studywas to compare mortality and morbidity of general and spinalanesthesia in patients undergoing hip and femoral fractures.Methods: In this analytical cross-sectional study, the informationof 93 patients who had undergone hip and femoral surgery withgeneral and spinal anesthesia was studied during 2011-2019 inthe medical records by census method. Data were analyzed usingSPSS 23 software and descriptive and analytical statistics.Results: The general anesthesia group consisted of 29 patientsand the spinal anesthesia group included 64 patients. The twogroups were the same in terms of demographic information,preoperative hemodynamic variables, and previous medicalhistory. The results of the independent t-test with a significancelevel of 5% did not show a significant difference between thetwo groups in the following variables: mean duration of surgeryand duration of anesthesia, mean arterial pressure and heartrate after surgery, changes in blood pressure, and heart rateduring surgery, bleeding, intravenous fluids and blood productsintake, postoperative hemoglobin, number of days hospitalizedin the Intensive Care Unit and surgical ward. The mean postoperative mean arterial pressure score in the general anesthesiagroup was significantly higher than the spinal group (P=0.004).Complications and mortality after surgery did not differ betweenthe two types of anesthesia.Conclusion: In general, these two methods of anesthesia do notdiffer from each other in terms of postoperative complications andmortality, and physicians can choose the appropriate anesthesiamethod according to the specific conditions of the patients

Introduction: Peripheral nerve block leads to effective pain control. Peripheral nerve blocks are used both in general anaesthesia and as regional anaesthesia alone. The aim of this study was to compare the characteristics of the supraclavicular block with bupivacaine (0.5%) in combination with dexmedetomidine, granisetron and magnesium sulphate in upper-limb orthopaedic surgery. Materials and Methods: This double-blind clinical trial was carried out on 105 patients who were candidates for upper-limb orthopaedic surgery in Valiasr Hospital in Arak. The patients were divided into three equal groups (dexmedetomidine, granisetron and magnesium sulphate) using the block method for randomisation. Mean arterial pressure, heart rate and arterial oxygen saturation every 5 min until the end of the surgery, onset and duration of sensory and motor block, mean opioid consumption in 24 h and post-operative pain during recovery and 2 h after surgery at 4, 8, 12 and 24 h were recorded. Data were analysed by SPSS.22 software. Results: The lowest heart rate at all times and the lowest blood pressure from 40 min to the end of surgery were observed in the dexmedetomidine group (P < 0.05). The time to the onset of sensory block and the time to the onset of motor block were shorter in the magnesium sulphate and dexmedetomidine groups, respectively. Moreover, the duration of the sensory and motor block was longer in the dexmedetomidine group (P = 0.0001). In addition, pain and amount of opioid consumption were lower in the dexmedetomidine group (P = 0.0001). Conclusion: Magnesium sulphate caused earlier onset of sensory block, while dexmedetomidine increased the duration of sensory and motor block. In the dexmedetomidine group, haemodynamic changes were made in the form of a decrease in heart rate and blood pressure, which, of course, did not require special treatment. As such, magnesium sulphate as an adjuvant is recommended to be used in cases where there is a requirement for the rapid onset of sensory block. Meanwhile, dexmedetomidine should be used as an adjuvant for the rapid onset of motor block and increase of the duration of sensory and motor block when taking into account the patients' physical conditions and the anaesthesiologist's discretion.

Background & aim: Novel coronavirusease 2019 (Covid-19) started in China and caused unexplained pneumonia. The risk of adverse pregnancy outcomes increase in respiratory viral infection during pregnancy. This systematic review was performed to investigate the maternal and neonatal outcomes in pregnant women infected with Covid-19.Methods: In this systematic review, the international databases (PubMed, Cochrane Library, Web of Science, Scopus, Embase, PsycINFO, Google scholar) as well as national databases (SID and Magiran) were searched to find out the articles published from 1 September 2020 to 30 April 2021 regarding maternal and neonatal outcomes in pregnant women infected with Covid-19. Keywords were selected based on Mesh (“Pregnancy”, “Gravidity”, “Delivery”, “Infant”, “Newborn”, “Neonate”, “Outcome”, “Complication”, “Abortion”, “Obstetric Labor, Premature”, “Cesarean Section”, “Fetal Death”, “Infant, Premature”, “Coronavirus Infection”, “COVIDK19”). The full texts of articles were reviewed by two independent reviewers and the relevant data was extracted.Results: 20 studies including 78 pregnant women entered in this review. All women were at third trimester of pregnancy except 2 cases who were less than 28 weeks. The most prevalent clinical symptoms were fever, cough and sore throat. The most common maternal outcomes were intrauterine distress, rupture of membranes and preterm delivery. Most infants delivered by cesarean section. The most common neonatal complications were prematurity, small for gestational age, fetal distress, low birth weight and bacterial pneumonia.Conclusion: In this systematic review, we found some evidence to suggest that COVID-19 pneumonia causes negative maternal and neonatal outcomes in pregnant women infected with Covid-19.

AbstractMany codes advocating public morals have been challenged during recent years. The decriminalization of immoral acts, as one of the most important aspects of modern criminal law, has been rooted in the arguments of scholars such as John Stuart Mill and Joel Feinberg on the state intervention in individual liberties. These scholars by developing freedom restricting principles have advocated a kind of minimalist criminalization in the sphere of public morality. Moreover, the international human rights law system, in an effort to balance cultural diversity and universal values, has endorsed public morality as one of the permissible restrictions on unrestricted civil-political liberties. In fact, following developments in the performance of governments in the field of public morality, the international human rights system, by providing a progressive interpretation of the principles governing criminalization, reject the legal moralism has attempted to defend a kind of rights-oriented criminalization that protects the rights and freedoms of vulnerable people.

Abstract Objective Uncoupling protein 2 (UCP2) plays a crucial role in energy homeostasis via insulin secretion regulation, free fatty acid concentrations, and lipid metabolism. This study aimed to investigate the association of 45-bp ins/del polymorphism of UCP2 with susceptibility to NAFLD (Non-Alcoholic Fatty Liver Disease) and T2DM (Type 2 Diabetes Mellitus). DNA was extracted from the white blood cells of the subjects, and the gene polymorphism was determined using polymerase chain reaction (PCR). In this study, 72 patients with NAFLD, 71 healthy individuals as control, 80 patients with T2DM, and 77 healthy controls were enrolled in the study. Results A higher prevalence of insertion/insertion genotype was observed in T2DM patients compared to the controls (p- value˂ 0.05). There was no difference in genotype distribution between NAFLD patients and controls (p-value > 0.05). NAFLD patients with D/D, D/I genotype had higher triglyceride, ALT, and AST levels; however, their HDL levels were lower than healthy controls. Patients with T2DM with D/D or D/I genotype also had significantly higher fasting serum glucose (FSG). While we found an association between the 45 bp I/D polymorphism in 3ʹUTR of UCP2 and T2DM, no correlation between this polymorphism and NAFLD was identified.

Introduction and purpose: One of the important missions of nursing education is the mental health of nursing students who play an important role in promoting the health of the community. It is necessary to maintain nursing studentschr('39') mental health due to their prominent role in providing health services during the coronavirus disease 2019 (COVID-19) pandemic. Therefore, this study was conducted to determine the mental health status of nursing students in the School of Nursing, Islamic Azad University, Sari Branch, Sari Iran, during the COVID-19 pandemic. Methods: This analytical study was conducted based on a descriptive cross-sectional method using the census method on all nursing students of Islamic Azad University, Sari Branch. Data collection tools were a demographic form and the 12-item General Health Questionnaire. Results: Totally, 278 participants completed the study, among which 70 (25.2%) participants worked in the COVID-19 hospitals and 208 (74.8%) participants did not work. The highest and lowest mean scores of mental health were related to the first-year and sixth-semester students (5±3.10 and 3.7±2.51), respectively. Moreover, the mean of mental health was significantly higher in participants who had contact with COVID-19 patients than others, indicating poor mental health among them (P

Background: Phenylketonuria (PKU) is a genetic autosomal recessive disorder, which, if not treated on time, can lead to mental retardation and severe developmental delay. The aim of this study was to assess the PKU neonatal screening program in Kerman County, Iran. Methods: This was a health system research study carried out on all newborns screened for PKU from 2012 to 2018 in Kerman. Data were extracted from the Comprehensive Social Genetics Program forms, genetic records, and the national form for investigation of genetic disease incidence. Results: Totally, 121,533 newborns were screened. 108,972 (89.7%) were Iranian, and 12,561 (10.3%) were non-Iranian. Screening coverage in the Iranian population was 92.1%. 80.9% of Iranian and 62.8% of non-Iranian newborns were screened from 3 to 5 days of age. Timely screening of newborns in the Iranian and non-Iranian populations in 2012 was 70.0% and 46.9%, and in 2018, it was 90.2% and 75.1%, respectively. The first visit at the PKU treatment center in 30.7% of Iranian and 33.3% of non-Iranian neonates was before 14 days of age. In the Iranian population residing in Kerman, the incidence rate of PKU was estimated to be 1.35 per 10,000 live births. 62.5% of parents of Iranian and 100% of parents of non-Iranian PKU patients were relatives. Conclusion: PKU screening coverage in Kerman is relatively acceptable, and most newborns were screened on time. Timely screening of newborns in both populations has increased since the beginning of the program until the time of this study. Interventions are required to improve early diagnosis and start treatment during the first 2 weeks of life. The incidence of PKU in Kerman County is approximately equal to the national average. Due to the fact that most parents of PKU patients are relatives, increasing awareness to prevent consanguineous marriages can be effective in decreasing the incidence of this disease.

Background and Aims: Although irritable bowel syndrome is one of the most common gastrointestinal disorders presented to gastroenterologists, therapeutic strategies are not yet well-established. Accordingly, we conducted a randomized, double-blind, placebo-controlled, clinical trial to evaluate the possible superiority of adding glutamine supplement to low fermentable oligo- di- monosaccharides and polyols (FODMAP) diet in patients with irritable bowel syndrome (IBS).Methods: Eligible adults were randomized to receive a low FODMAP diet either with glutamine (15 g/day) or a placebo for 6 weeks. The primary endpoint was a significant reduction in IBS-symptom severity score (IBS-SSS). Secondary endpoints were changes in IBS symptoms, stool frequency, consistency, and quality of life.Results: The study group enrolled 50 patients, among which 22 participants from each group completed the study protocol. The glutamine group had significant changes in total IBS-severity score, dissatisfaction of bowel habit and interference with community function (58% reduction; P < 0.001, 57% reduction; P < 0.001, 51% reduction; P = 0.043, respectively). Improvement in IBS-severity score of more than 45% was observed in 22 of 25 participants (88%) in the glutamine group, while it was only 15 of 25 participants (60%) in the control group (p = 0.015). No serious adverse events were observed.Conclusions: Our findings indicated the superiority of adding glutamine supplementation to a low FODMAP diet in amelioration of IBS symptoms while confirming the beneficial effects of a low FODMAP diet in IBS management.

Abstract Background Preeclampsia (PE) is a serious complication of pregnancy and one of the main causes of maternal and neonatal mortality and morbidity in the world. Finding a biomarker with high sensitivity and specificity could lead to prediction and early diagnosis of the disease and reduces its complications. In this study, we evaluated diagnostic accuracy of Soluble fms-like tyrosine kinase-1 (sFlt-1) to Placental growth factor (PlGF) ratio for diagnosis of PE. Methods The cases included 23 mild, 15 severe preeclamptic patients, and 20 normal term pregnant women as control referred to GYN ward of the Persian Gulf Hospital in Bandar Abbas from 2014 to 2016. Levels of sFlt-1 and PlGF were measured. Receiver Operating Characteristic (ROC) curve analysis was applied to calculate diagnostic accuracy of sFlt-1/PlGF ratio. Results The mean Level of sFlt-1/PlGF in PE patients (91.33 ng/ml) was significantly higher than control women (17.62) (P

Abstract Objective GCK rs780094 polymorphism is a single nucleotide polymorphism that has been associated with obesity, type II diabetes and dyslipidemia in some populations, conditions that highly related to NAFL etiology. The present study aimed to evaluate the relationship between NAFLD and rs780094 polymorphism in patients with NAFLD in Tabriz city, northwest of Iran. The rs780094 polymorphism was determined in 74 patients with NAFLD by PCR–RFLP technique. Demographic information was collected using a questionnaire and biochemical analysis was performed using standard laboratory methods. Results There was a significant difference between case and control subjects for alanine aminotransferase, aspartate aminotransferase, HDL-C and triglycerides (P

Purpose Improving physicians’ critical thinking abilities could have meaningful impacts on various aspects of routine medical practice, such as choosing treatment plans, making an accurate diagnosis, and reducing medical errors. The present study aimed to measure the effects of a curriculum integrating critical thinking on medical students’ skills at Tehran University of Medical Sciences, Iran. Methods A 1-group pre-test, post-test quasi-experimental design was used to assess medical students’ critical thinking abilities as they progressed from the first week of medical school to middle of the third year of the undergraduate medical curriculum. Fifty-six participants completed the California Critical Thinking Skills Test twice from 2016 to 2019. Results Medical students were asked to complete the California Critical Thinking Skills Test the week before their first educational session. The post-test was conducted 6 weeks after the 2 and half-year program. Out of 91 medical students with a mean age of 20±2.8 years who initially participated in the study, 56 completed both the pre- and post-tests. The response rate of this study was 61.5%. The analysis subscale showed the largest change. Significant changes were found in the analysis (P=0.03), evaluation (P=0.04), and inductive reasoning (P

This study aimed to report a one-pot, eco-friendly and room temperature procedure to prepare highly stable (at least 15 months) silver nanoparticles (AgNPs) using the aqueous leaf extract of Cordia myxa. The effects of different parameters, such as applied pH in the reaction mixture, amount of the leaf extract, silver ion concentrations, time of reaction and synthesis temperature, on the formation of NPs and their Surface Plasmon Resonance (SPR) spectra were studied. The characterisation of the prepared AgNPs was done using UV-Vis spectroscopy, Fourier Transform Infrared (FTIR), X-Ray Differentiation (XRD) and Transmission Electron Microscope (TEM) techniques. The shape of the synthesised AgNPs was spherical and it sized 3–10 nm with a face-centred cubic structure with SPR spectra at 410 nm. A possible reaction mechanism of AgNP formation by biomolecules of C. myxa was also introduced. The efficiency of the synthesised AgNPs as an excellent catalyst for the reduction of organic azo dyes using NaBH4 was proved. Dose-dependent cytotoxic activity of the prepared AgNPs against SW480 and HCT116 human colon cancer cell lines was also shown using MTT assay. Furthermore, the Ferric-Reducing Antioxidant Power (FRAP) assay was utilised to confirm the antioxidant activity of NPs. Non-toxic reagents and low-cost synthesis were the main features that made these AgNPs more attractive for chemical/biomedical applications.

Background: Along with an increase in the rate of cesarean sections, the complications and problems associated with this procedure have also increased in Iran. Factors such as complications associated with caesarean scars, the high cost of chemical treatments, and failure of medications in treatments have led to an increased use of traditional and biological therapies in the healing and preventing of cesarean wound infections. Objective: To determine the effect of an amniotic membrane dressing on cesarean wound healing. Methods: This study is a prospective, randomized double-blind clinical trial. Patients participating in the study were women who underwent cesarean sections at Amir-al-Momenin Hospital in Gerash, Iran. Patients were randomly divided into two groups (N = 45 for each group). In one group, the cesarean wound was dressed using an amniotic membrane; in the control group, the dressing was performed using a simple dressing. The wound healing was assessed by the Redness, Edema, Ecchymosis, Discharge, Approximation (REEDA) scale 24 hours and 8 days after the cesarean procedure. Results: The average REEDA score, reflecting wound healing was significantly different between the groups 24 hours after the cesarean section, which proved to be less in the amniotic membrane group (.00 ± .00 vs. 0.60 ± 1.30; P = .003). However, on the 8th day after the cesarean section, there was no significant difference between the groups (P = 0.078). Conclusions: The findings of this study showed that the application of an amniotic membrane dressing can be helpful in early stage wound healing of cesarean.

Background: Preeclampsia (PE) is a serious complication of pregnancy with hallmarks of incomplete placentation, placental ischemia and endothelial dysfunction. Imbalance between vascular endothelial growth factor (VEGF), placenta growth factor (PlGF) and their receptors play important role in pathophysiology of PE. Objective: This study was aimed to asses PlGF mRNA expression in placenta of women affected with PE. Material and Methods: In this cross-sectional study, expression of PlGF mRNA was evaluated in 26 mild PE cases, 15 severe preeclamptic women and 20 normotensive controls. Patients were sub-classified as early onset PE (9) and late onset (32). After RNA extraction, PlGF expression was quantified with qRT-PCR. Results: The results of PlGF mRNA expression between mild-severe, and early-late onset PE patients showed no statistically significant difference compared with the control group (p=0.661, p=0.205 respectively). Conclusion: Despite we found no distinct differential expression of PlGF mRNA in placental tissue of PE patients compared with control women, but according to decreased level of this angiogenic factor in PE even before clinical onset of the disease, determining molecular mechanisms related to reduced secretion of PlGF into the maternal circulation may be useful for future therapeutics

The present quasi-experimental research aimed to examine the differential effect of metacognitive strategy training and critical thinking awareness-raising on EFL learners’ reading comprehension of general reading (GR), cause and effect (CE), and argumentative (ARG) texts. The study set to investigate the extent to which raising Iranian EFL learners’ awareness of critical thinking skills and three sets of metacognitive reading strategies including global, problem-solving, and support may influence the three groups of participants’ reading comprehension. To this end, a purposeful sample of 54 intermediate male Iranian EFL learners attending three classes was recruited from a pool of 85 English learners and was randomly assigned as two experimental groups receiving metacognitive training (MCG) and critical thinking awareness-raising (CTG) and a control group (CG). The research data were gleaned using a researcher-made piloted 54-itme reading comprehension test. The results of the paired sample t-test analyses demonstrated that both MCG and CTG made significant improvements in comprehending GR and ARG texts from the pre-test to the post-test and that both outperformed the CG in comprehending GR and ARG post-tests. With regard to CE comprehension, the only significant difference was observed between the MCG and the CG. The findings offer a number of pedagogical implications.

Objective Nonunion is defined as a minimum of a 9-month period of time since an injury with no visibly progressive signs of healing for 3 months. Recent studies show that application of mesenchymal stromal cells (MSCs) in the laboratory setting is effective for bone regeneration. Animal studies have shown that MSCs can be used to treat nonunions. For the first time in an Iranian population, the present study investigated the safety of MSC implantation to treat human lower limb long bone nonunion. Materials and Methods It is a prospective clinical trial for evaluating the safety of using autologus bone marrow derived mesenchymal stromal cells for treating nonunion. Orthopedic surgeons evaluated 12 patients with lower limb long bone nonunion for participation in this study. From these, 5 complied with the eligibility criteria and received MSCs. Under fluoroscopic guidance, patients received a one-time implantation of 20-50×106 MSCs into the nonunion site. All patients were followed by anterior-posterior and lateral X-rays from the affected limb, in addition to hematological, biochemical, and serological laboratory tests obtained before and 1, 3, 6, and 12 months after the implantation. Possible adverse effects that included local or systemic, serious or non-serious, and related or unrelated effects were recorded during this time period. Results From a safety perspective, all patients tolerated the MSCs implantation during the 12 months of the trial. Three patients had evidence of bony union based on the after implantation Xrays. Conclusion The results have suggested that implantation of bone marrow-derived MSCs is a safe treatment for nonunion. A double-blind, controlled clinical trial is required to assess the efficacy of this treatment (Registration Number: NCT01206179).

The present study was an attempt to investigate the effect of meta-cognitive strategy (planning, self-monitoring) awareness raising instruction on reading comprehension of Iranian ESP learners. Participants of three groups each comprising of 21 Iranian male students studying “Civil Engineering” in “Islamic Azad University of Buin Zahra” were selected and assigned to three groups: two experimental groups (group A, and B) and one control group (group C). To meet the aim of the study, two reading comprehension tests were administered to the participants in three groups. In the first phase, a reading comprehension was administered as a pre-test. In the second phase, two experimental groups received five sessions of instruction on planning and self-monitoring awareness raising strategies on the Cognitive Academic Language Learning Approach (CALLA) and control group received no training. In the third phase, after completion of the instruction, a reading comprehension test as a post-test was administered to the groups. The findings indicated that the participants in two experimental groups outperformed the control group in the post-test of reading comprehension. It is concluded that the instruction of planning and self-monitoring metacognitive strategies as learning aids can lead to the improvement of students’ reading comprehension performance.

Objective: Nonunion is defined as a minimum of 9 months since injury without any visible progressive signs of healing for 3 months. Recent literature has shown that the application of mesenchymal stromal cells is safe, in vitro and in vivo, for treating long bone nonunion. The present study was performed to investigate the safety of mesenchymal stromal cell (MSC) implantation in combination with platelet lysate (PL) product for treating human long bone nonunion. Materials and Methods: In this case series clinical trial, orthopedic surgeons visited eighteen patients with long bone nonunion, of whom 7 complied with the eligibility criteria. These patients received mesenchymal stromal cells (20 million cells implanted once into the nonunion site using a fluoroscopic guide) in combination with PL product. For evaluation of the effects of this intervention all the patients were followed up by taking anterior-posterior and lateral X-rays of the affected limb before and 1, 3, 6, and 12 months after the implantation. All side effects (local or systemic, serious or non-serious, related or unrelated) were observed during this time period. Results: From a safety perspective the MSC implantation in combination with PL was very well tolerated during the 12 months of the trial. Four patients were healed; based on the control X- ray evidence, bony union had occurred. Conclusion: Results from the present study suggest that the implantation of bone marrow- derived MSCs in combination with PL is safe for the treatment of nonunion. A double blind, controlled clinical trial is required to assess the efficacy of this treatment (Registration Number: NCT01206179).

Background: Evaluation on the toxicity of two mainly contaminant heavy metals, cadmium (Cd) and lead (Pb) through the food chain was the aim of this study. Methods: A total number of 270 healthy common carp (4±1.14 g) in April, 2015 transported to the Khatam Alanbia University of Technology, Behbahan, Iran. Fishes were divided into three groups and transferred to the 20 L aquaria each containing 30 juveniles. The first group (control) fed by metal-free Artemia fransiscan anauplii throughout the experiment. The second and third groups were feeding by Cd and Pb (1.5 mg/L free ion) contaminated nauplia, respectively. The experimental study was carried out for three weeks and sampling was done in 4th, 7th, 14th and 21st days. Finally, the alterations in plasma biochemical responses were determined. Results: Alanine aminotransferase and aspartate aminotransferase activities increased in response to feeding Pb-contaminated nauplia. Creatine phosphokinase activity showed significant increase in fourth day about both Cd and Pb and at the end of experiment only in Cd treatment (P

Background: The aim of this study was to detect low parasite and asymptomatic malaria infections by means of three malaria diagnostic tests, in a low transmission region of Minab district, Hormozgan Province, southern Iran. Methods:Blood samples of 200 healthy volunteers from Bagh-e-Malek area were evaluated using microscopic, rapid diagnostic tests (RDT) and nested-PCR to in-spect malaria parasite. Results:The results showed no Plasmodium parasite in subjects by means of mi-croscopy and RDT. However, 3 P. vivax positive samples (1.5%) were discovered by Nested-PCR while microscopy and RDT missed the cases. Conclusion:Microscopy as the gold standard method and RDT correctly identi-fied 98.5% of cases, and molecular analysis is sensitive and reliable, especially in the detection of "asymptomatic" infections for active case surveillance. Regarding the existence of asymptomatic malaria in endemic area of Hormozgan, Iran, nest-ed-PCR could be considered as a sensitive tool to interrupt malaria transmission in the country, beside the microscopic and RDT methods.

BACKGROUND: Regular determination of blood pressure is very important in children, since early diagnosis of hypertension may reduce cardiovascular morbidity and mortality. This study was conducted to determine the frequency of hypertension among 7-12 year-old children in Rafsanjan during 2007. METHODS: In this cross-sectional descriptive study, 2370 male and female school-age children (7-12 years old) were included using multistage sampling method. Their height and blood pressure were measured by a standard meter tape and a sphygmomanometer. The criteria of the American Society of Heart, Lung, and Blood were used for definition of hypertension. The collected data was analyzed by chi-square test and analysis of variance in SPSS17. RESULTS: The prevalence of hypertension among the studied children was 3.5%. There was a relationship between age and the rates of high systolic and diastolic pressure in both genders. The prevalence of hypertension among male and female subjects was 1.8% and 5.2%, respectively. The highest level of hypertension was among 12 year-old children. Moreover, 2.5% of boys and 5.1% of girls had interstitial blood pressure. CONCLUSION: The frequency of interstitial blood pressure and hypertension in our participants was apparently lower than the rates reported by similar studies. This difference is might have been caused by utilizing the new and more accurate criteria determined by the American Society of Heart, Lung, and Hypertension in the present research.

Introduction: Serum vitamin D levels are related to a wide spectrum of factors including low sunlight exposure, high oxidative stress, low physical activity and sleep disorders. In this paper we are going to investigate the most crucial parameters associated with serum vitamin D levels in survey of ultraviolet intake by nutritional approach (SUVINA) study with a data mining approach. Material and Methods: Data including demographic, anthropometric, clinical and laboratory information were extracted from the SUVINA dataset comprising 289 subjects who were enrolled into our study. The XGBoost algorithm was used to define the most important features related to vitamin D level in our population. Results: Applying XGBoost modeling for vitamin D level showed that the presented scheme can determine the most important determinants of serum vitamin D level with an accuracy of 91%. Pro-oxidant anti-oxidant balance (PAB), body fat percentage, physical activity level (PAL), age, restless leg syndrome (RLS), and dietary inflammatory index (DII) density were the most important variables correlated with vitamin D deficiency. Conclusion: Using XGBoost and with an accuracy of more than 90%, we showed that the six most important risk factors for vitamin D deficiency are PAB, PAL, age, body fat percentage, RLS and DII density, respectively. [ABSTRACT FROM AUTHOR]