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We found that there are disproportionately intractable challenges such as poverty and inequality in an area of Tanzania, Eastern Africa. There was a need to identify and develop the factors critical for their success. Data were collected in rural Iringa, Tanzania on a case study basis, using a semi-structured interview and communication with leaders in this area of Africa, and we analyzed data with a coded transcript. We identified ten factors that are critical for the success of the orphanage literacy. These findings advance understanding of non-governmental organizations (NGOs) and have important practical applications for such enterprises. When the United Nations literacy decade (UNLD, 2003--2012) reached a midpoint, we decided to add to the global awareness of literacy. With initiatives and policy shifts providing a stronger basis for action on literacy, we reached out to Africa. Our concern is that the rise in the global adult literacy rate (15+) from 76 to 83.6 percent over the last two previous decades shows steady progress, with the rates in developing countries showing an even sharper rise from 68 to 79 percent (Richmond, Robinson, & Sachs-Israel, 2008). Thus, we focused on students from grades four to twelve to foster their literary progress as well. This study included 58 students who were also orphans in Kihesa-Iringa, Tanzania. By creating a Coalition of Children's Book Authors, we established a common ground for global literacy in the form of an NGO. However, the complication in literacy levels exists due to the digital-divide challenges coupled with the expense and delay of material delivered to Africa from the United States. Thankfully, our concern has succeeded to have influence even through the digital divide posed several objectives. Our course of action included a comprehensive plan to reach the 58 orphans, train their leaders, and create interactive learning modules. Thus, our contribution to the literature has reacted to the needs of an African community that could use help in not only literacy but also literacy-leadership communication and knowledge-management.

The study examined university-level English instructors' assessment training experiences, classroom-based assessment practices, and assessment training needs in Iran. Sixty-eight instructors who were randomly selected through academic social networks filled out a questionnaire. Eight instructors were also interviewed. The results indicated that the instructors had received insufficient training, especially in practical aspects, because they had solely been exposed to assessment concepts and theories in the limited and impractical assessment courses offered to preservice teachers in their universities. Also, they had recurrently failed to put their limited assessment knowledge into practice. Despite this situation, they preferred to get basic rather than advanced assessment training due to personal and contextual constraints. The study bears implications for university English instructors, teacher educators, and university administrators.

Background: Acute myeloid leukemia (AML) has been identified as a top priority for discovering a reliable biomarker for treatment improvement and patient outcome prediction due to the heterogeneous nature of AML and the obstacle to find an appropriate treatment strategy for this malignancy. Considering the involvement of long noncoding RNA (lncRNA) SNHG7 and BGL3 found in various cancers, the exact expression pattern of these lncRNAs and their clinical implications in acute myeloid leukemia (AML) continue to be elusive. In order to demonstrate a possible mechanism underlying AML pathogenesis, our goal was to examine BGL3 and SNHG7 lncRNA expressions in PI3K pathway. Methods: This case-control cross-sectional study were conducted on RNA extracted from blood samples of 30 patients diagnosed with AML (Ayatollah-Khansari hospital, Arak, Iran) and 30 (age and gender matched) healthy controls. The expression levels of SNHG7 and BGL3 lncRNAs and their target genes Akt and PTEN, were measured using qRT-PCR. Subsequently, by means of statistical analysis, we determined the plausible correlation between the expressions of the aforementioned genes and lncRNA respectively. Results: In AML samples, a considerable increase in the expression levels of SNHG7 lncRNA and Akr gene was accompanied by a marked reduction in the expression levels of BGL3 lncRNA and PTEN gene. Nevertheless, No significant relationship between the expression level of the indicated genes/lncRNAs and age and sex was found. The remarkable correlation between the expression of genes/lncRNAs and the blast percentage in patients was the notable point in the result of this study. Conclusions: As the most straightforward interpretation of our results, we propose that perhaps the association between SNHG7 and BGL3 built through the interaction between Akt and PTEN may play a crucial role in the AML pathogenesis and any element of this axis could be a potential novel target for further profound treatment strategies. Nonetheless, in the context of Hematological Malignancies, particularly AML, more detailed studies are needed in this area to elucidate the precise role played by this interesting testis-specific pathway.

Background: Mucormycosis can be lethal in people with immunocompromising conditions, especially Diabetes Mellitus. Correction of the underlying disorders, instant initiation of antifungal therapy, and surgical resection are the main components of treatment. Herin, we present the successful medical management of Mucormycosis in a patient with Diabetic Ketoacidosis and positive SARS-CoV-2 test who presented with a less seen condition: the simultaneity of mediastinal mass on one side and an endobronchial mass on the other. Case presentation: An 18-year-old male with a history of insulin-dependent DM from 4 years ago presented to our hospital with sudden onset dyspnea, chest pain, sore throat, hoarseness, cough, and sputum. Also, we detected unilateral swelling in the neck and multiple lymph nodes in the neck. Lung auscultation revealed bilateral generalized wheezing. Primary laboratory tests detected high blood sugar, metabolic acidosis, positive urine ketone, high ESR, positive CRP, and leukocytosis; his polymerase chain reaction (PCR) for SARS-CoV-2 was positive. Chest X-ray showed left upper lobe consolidation. Computed tomography scan (CT-scan) of the chest revealed a large collapse consolidation in the left lung, mild left side pleural effusion, mediastinal lymphadenopathy, and distention in the esophagus. With suspicion of malignancy, we performed flexible bronchoscopy and endobronchial Ultrasound (EBUS) which revealed a creamy tumoral lesion in the right main bronchus. The biopsy was consistent with Mucormycosis. We successfully treated Mucormycosis with Amphotericin-B liposomal. Conclusion: Mucormycosis can mimic the clinical characteristics of malignancy, and emphasize the importance of considering appropriate differential diagnoses because timely diagnosis and treatment is potentially life-saving in Mucormycosis.

Non-linearity feature and high fluctuations in financial time series have made the forecasting of stock prices and financial indicators face many challenges. However, recent developments in deep learning (DL) models with structures such as long-short-term memory (LSTM) and convolutional neural network (CNN) have made improvements in the analysis of this type of data. Another approach that can be effective in the analysis of financial time series is the decomposition of capital market signals through algorithms such as complete integrated empirical mode decomposition (CEEMD). Considering the importance of forecasting in the financial markets, in this research, by combining deep learning models and complete integrated empirical mode decomposition (CEEMD), The hybrid CEEMD-DL(LSTM) model has been used to forecast the Tehran Stock Exchange index. In this regard, the daily data of the total index of the Tehran Stock Exchange in the period of 2012/12/01 – 2022/02/20 be used and the results were compared with the results of competing models based on efficiency measurement criteria. Based on the obtained results, the introduced model (CEEMD-DL(LSTM)) has higher efficiency and accuracy in stock exchange index forecasting. Accordingly, the use of this model in financial forecasts is suggested.

Introduction: This systematic review and meta-analysis study aims to investigate the effect of warming up on knee position sense. Methods: The keywords of this systematic review and meta-analysis study were searched on December 1 by two authors in the following electronic databases: PubMed, Web of Science, Scopus, and Google Scholar. The Downs and Black checklist checked the quality of articles. Statistical analysis was performed using CMA software. The I-square statistic was used to examine the data heterogeneity and estimate the percentage of heterogeneity. Besides, the Funnel Plot method was used for assessing the risk of bias in articles, and the trim-and-fill method was used in case of observation of possible bias. Results: Out of 5,133 studies found in selected databases, 31 were selected after reviewing the title and abstract, and seven articles were included in the study after reviewing the full text. The results indicated that warming up has a significant effect on reducing the active absolute angular error (P0.05). Discussion: Warming can reduce absolute and relative angular error. Therefore, it has a significant effect on improving proprioception.

Abstract Introduction An injury can significantly harm both individual and team performance. One of the most important risk factors for sports-related injuries, especially non-collision injuries, is fatigue. It seems that poor proprioception may play an essential role to impose athletes to further injuries. This systematic review and meta-analysis aimed to examine the effectiveness of fatigue on the repositioning sense of the lower extremity joints. Method The electronic databases, including PubMed, Web of Science, Scopus, and Google Scholar were systematically searched from inception to 11January 2024. The obtained records were exported to the EndNote Software version 8. Then, two investigators examined the records independently to find eligible studies based on the inclusion/exclusion criteria. In the case of disagreements, a consequence method was utilized. The quality of the eligible studies was evaluated using the Downs and Black checklist. Comprehensive Meta-Analysis (CMA) software ver. 3 software was used for statistical analysis. Q-test and I2 were employed to examine the data homogeneity. In addition, considering the risk of bias, the Funnel Plot and trim-and-fill method were used. Results After reviewing the titles and abstracts of 3883 studies found in the selected databases, 43 articles were found to be eligible to include in meta-analyses. The results showed that fatigue led to a significant increase in the active absolute error of the knee (SDM = 0.524, 95% CI = 0.406–0.841), ankle in the horizontal plane (SDM = 0.541, 95% CI = 0.367–0.715), ankle in the sagittal plane (SDM = 0.443, 95% CI = 0.088–0.798), and hip (SDM = 0.988, 95% CI = 0.135–1.841). However, fatigue had no significant effects on the passive absolute error of the knee and ankle in horizontal plane and relative angular error of the knee. Conclusion Fatigue can diminish the active joint position sense of the lower extremities and thus may increase the risk of injury by reducing proprioception. Therefore, future research could be conducted to investigate the potential impact of integrated fatigue-mitigating exercises into athletes’ training programs, with the aim of reducing the incidence of sports-related injuries.

Uncertainty, imprecise, incomplete, and inconsistent information can be found in many real-life systems and may cause more complex problems. A neutrosophic set is an effective and useful tool to describe problems with Uncertainty, imprecise, incomplete, and inconsistent information. The neutrosophic set is characterized by three independent degrees namely the truth-membership degree (T), indeterminacy-membership degree (I), and falsity-membership degree (F). In this paper, we present an extension of the VIKOR method for the solution of multi-criteria decision- making problems, namely neutrosophic set-VIKOR (NS-VIKOR) in a refined neutrosophic environment. The weight of each decision-maker is considered a single valued neutrosophic number. The criteria for the weight of every decision-maker are also considered neutrosophic numbers. An aggregation operator is used to combine all decision-makers' opinions into a single opinion for a rating between criteria and alternatives. Euclidean distances from the positive and negative ideal solutions are calculated to construct relative closeness coefficients. Lastly, an illustrative example of tablet selection is provided to show the applicability of the proposed VIKOR approach. (original abstract)

Abstract Background Augmentation of the biologic graft with nonabsorbable suture material during anterior cruciate ligament reconstruction (ACLR) is a relatively new technique to enhance its biomechanical properties and add additional support to the critical process of healing. We aimed to compare the short-term functional patient-reported outcome measures (PROMs) and complication rates of patients treated with either standard single-bundle four-strand hamstring ACLR or added suture augmentation (SA). Methods Patients undergoing arthroscopic ACLR between February 2015-January 2017 and in the standard ACLR group, and between February 2017-September 2019 in the SA-ACLR group operated by adding a no.5 FiberWire® (Arthrex, Naples, FL, USA) braided suture to the hamstring autograft, were retrospectively reviewed and the PROMs were compared. Patients were followed up for a 24-month period and PROMs were assessed by the International Knee Documentation Committee (IKDC) Subjective Knee Form and Tegner-Lysholm knee score. Patients’ demographic and clinical characteristics, and postoperative complications including graft retear requiring revision surgery, deep vein thrombois, and surgical site infection were recorded and analyzed. Results We included 79 patients with mean age of 31.6 ± 8.3 years in the standard ACLR group, and 90 patients with mean oge of 30.5 ± 7.6 in the SA-ACLR group. There was no statistically significant difference between the two groups in terms of age, sex, body mass index, and medical comorbidities. The values of the IKDC scores increased to 75.8 ± 18.9 in the standard ACLR group, and 85.6 ± 12.6 in the SA-ACLR group, 24 months after the operation (P < 0.05). The 24-month postoperative Tegner-Lysholm scores escalated to 79.3 ± 21.0 in the standard ACLR group and 91.0 ± 13.7 in the SA-ACLR group (P < 0.05). Four (5.1%) patients in the standard ACLR group and 4 (4.4%) in the SA-ACLR group experienced graft retear requiring revision surgery (P > 0.05). Incidence of surgical site infection and deep vein thrombosis showed no significant differences between the two groups, 24 months after ACLR. Conclusion SA-ACLR is associated with improved short-term functional PROMs compared to the standard hamstring ACLR. Although SA did not reduce the retear rate, and infection and DVT rates did not differ between study groups, superior improvement of PROMs in SA approach, leverages this method for ACLR.

One of the environmental problems today is the rising land surface temperature and the formation of heat islands in metropolitan areas, which have arisen due to the unplanned expansion of these cities. Satellite imagery is widely used in urban environmental studies to provide an integrated view and reduce costs and time. In this study, Landsat satellite imagery in TM, ETM+, and OLI sensors from 1984 to 2020, remote sensing techniques, and GIS is used to analyze the data, and SPSS software is employed to examine the correlation between the data. The results indicate that the land surface temperature in District 1 of Tehran has increased during the last 38 years. Moreover, land use in District 1 has changed significantly over this period, and urban land use increased from 16 % (1984) to 35 % (2020) while vegetation declined from 32 % to 14 %. The results of linear regression analysis show a significant correlation between satellite images and weather station data. The significance coefficient (Sig) in all stations is less than 0.05 with a 95 % confidence interval. Besides, the coefficient of variation (R) for all stations is above 80 %, and the coefficient R2 has a desirable value. The findings suggest that the trend of rising temperatures in District 1 of Tehran has become an environmental problem and the changes in land use such as declining vegetation and increasing the acceleration of urbanization are among the factors that affect it.

This research investigates the application of machine learning to improve the diagnosis of tinnitus using high-frequency audiometry data. A Logistic Regression (LR) model was developed alongside an Artificial Neural Network (ANN) and various baseline classifiers to identify the most effective approach for classifying tinnitus presence. The methodology encompassed data preprocessing, feature extraction focused on point detection, and rigorous model evaluation through performance metrics including accuracy, Area Under the ROC Curve (AUC), precision, recall, and F1 scores. The main findings reveal that the LR model, supported by the ANN, significantly outperformed other machine learning models, achieving an accuracy of 94.06%, an AUC of 97.06%, and high precision and recall scores. These results demonstrate the efficacy of the LR model and ANN in accurately diagnosing tinnitus, surpassing traditional diagnostic methods that rely on subjective assessments. The implications of this research are substantial for clinical audiology, suggesting that machine learning, particularly advanced models like ANNs, can provide a more objective and quantifiable tool for tinnitus diagnosis, especially when utilizing high-frequency audiometry data not typically assessed in standard hearing tests. The study underscores the potential for machine learning to facilitate earlier and more accurate tinnitus detection, which could lead to improved patient outcomes. Future work should aim to expand the dataset diversity, explore a broader range of algorithms, and conduct clinical trials to validate the models' practical utility. The research highlights the transformative potential of machine learning, including the LR model and ANN, in audiology, paving the way for advancements in the diagnosis and treatment of tinnitus.

Abstract Introduction Generalized joint hypermobility (GJH) can be the result of several hereditary connective tissue disorders, especially Ehlers–Danlos syndrome. Cerebrovascular manifestations are among the most common complications in this disorder, and understanding their extent can help better diagnosis and prevention of hazardous events. We investigated visual evoked potential (VEP) changes in patients with GJH and compared them with healthy individuals. Methods Our case–control study included 90 patients who fulfilled the Beighton score (B score) for joint hypermobility and other 90 healthy participants. All of them went under VEP study, and the amplitude and latency of the evoked potential (P100) were compared to each other. Results The Case group had significantly higher B score (7.18 ± 0.967 vs. 1.18 ± 0.712), P100 latency (110.23 ± 6.64 ms vs. 100.18 ± 4.273 ms), and amplitude (6.54 ± 1.26 mv vs. 6.50 ± 1.29 mv) compared with the Control group, but the difference was only significant regarding B score, and P100 latency (p‐value

Abstract Objective To estimate the possible associations between posture and physical activity (PA). Design A systematic review and meta-analysis. Data sources The search was conducted in seven databases (PubMed, Web of Science, SportDiscus, EMBASE, Scopus, Cochrane Library, and CINAHL) for studies published from inception to January 2023. Eligibility criteria for selecting studies Studies were required to meet following criteria: (1) study design: cross-sectional, case control and cohort studies. (2) Participants: people of all ages without any diagnosed diseases. (3) Exposure and outcome: studies that examined the possible effect or correlations between PA, physical inactivity, physical exertion and human body posture. Results Sixteen cross-sectional studies, two cohort studies and one case control study involving a total of 16772 participants aged from 6 to 79 years were included. Correlational studies showed that there was a significant relationship between PA and posture (C = 0.100, CI 95% = 0.012–0.186). However, regression studies demonstrated that there was not a significant association between PA and posture (C = 1.00, CI 95% = 0.998–1.002). Three studies investigated the association between PA and the lumbar lordosis and showed that there was not a significant association between the lordosis and PA (CI 95%: -0.253–0.048, P = 0.180). In addition, four studies showed that there were not any associations between scoliosis and PA (CI 95%: 0.819, 1.123, P = 0.607). The evidence of heterogeneity and publication bias was found among all analyzed data (P

The rising temperature of the earth's surface and the formation of heat islands in megacities have become two of the biggest environmental threats. This compound problem affects urban climatology, including urban vegetation and air pollution, human health, and the environment, including the group of vulnerable members of the society and public health, leading to the growing death rate. Hence, the purpose of this study is to investigate the leading causes of temperature changes and the development of a thermal island in the city of Tehran following the expansion of this metropolis in recent decades. This research uses thermal remote sensing and GIS techniques to analyze information from Landsat satellite images in (TM-ETM-TIRS) sensors from 1984 to 2020. The results of the research indicated that the surface temperature of the city of Tehran during the years 1984 to 1996, 1998 to 2008, and 2010 to 2020 experienced a relative increase in the summer and winter seasons. In the first decade, the average temperature of the green layer was -7, while the temperature of the magenta and red layers were 20 and 25 degrees, respectively. In the second decade, the average temperatures of the green and dark green classes were -1 and 3 while they were 23 and 27 degrees for the magenta and red classes, respectively. In the third decade, the average temperatures of the green and dark green classes were -1 and 3, and thost of the magenta and red layers increased to 28 and 31 degrees, respectively. Furthermore, the analysis of vegetation cover based on the NDVI index pointed to the continuing reduction of vegetation in the studied years. Regarding the direct correlation between the heat island and vegetation and the concentration of the heat island in the city center, further measures must be taken and the vegetation cover should be increased to reduce the heat island. The city center needs to be decentralized as part of the remedy via proper urban design and planning.

Introduction Kawasaki disease (KD) is a systemic vasculitis, seen mostly in children. Epidemiology of KD is dependent on geographical location and seasonality. Although many years have passed since the first report of KD, multiple related factors are still unknown. Material and methods We investigated the clinical, paraclinical, and therapeutic aspects of KD in Kerman, Iran by performing a retrospective, descriptive, cross-sectional study on all children hospitalized due to KD between 2007 and 2020. Results A total of 340 patients with mean ±SD age of 29.83 ±22.55 months participated in the study. Most of our patients were two to five years old. The male : female ratio was ~ 1.4 : 1. A few of our patients had a family history of KD or vasculitis (0.3%, 1.7%). Typical KD was more common by a large margin (316 patients with typical KD). More than half of our patients had a duration of hospitalization of under ten days. All of our patients were febrile. Hand/foot and lip/mouth changes were the second and third most common clinical findings in more than 60% of our patients. Other manifestations were conjunctivitis in 40%, skin rashes in 34.8%, gastrointestinal manifestations in 33.9%, and lymphadenopathy in 25.3%. Echocardiography revealed abnormalities in 78.6% of the participants; coronary artery aneurysm (CAA) was the most frequent (22.5%) and follow-up echocardiography revealed that all of them regressed within 6 months after treatment. The two laboratory tests with the highest ratio of abnormality were erythrocyte sedimentation rate (95%) and hemoglobin (83.3%). C-reactive protein and liver function tests were also abnormal in most patients. All of our patients received intravenous immunoglobulin and acetylsalicylic acid. Conclusions Kawasaki disease must be considered in every febrile child, especially those with risk factors, because timely diagnosis and treatment are essential to prevent complications. Health policies should focus on appropriate diagnosis and treatment to prevent the occurrence of sequelae.

Abstract Introduction Atherosclerotic cardiovascular diseases (ASCVD) are significant sources of mortality and morbidity with substantial economic implications and preventive measures play key roles in this regard. Metabolic syndrome (MetS) is a common condition, and its association with ASCVD and mortality has made it clinically important. However, controversies persist regarding the best definition for MetS. Here in, we investigated the ability of the International Diabetes Federation (IDF) and the National Cholesterol Education Program Adult Treatment Panel III (NCEP ATP III) in the prediction of ASCVD incidence. Methods We conducted an investigation on individuals diagnosed with MetS as part of the “Kerman Coronary Artery Diseases Risk Factor Study” (KERCADRS). This study was a cohort study conducted on a population aged 15–75 years residing in Kerman, Iran to assess the risk of ASCVD. We employed ACC/AHA ASCVD Risk Estimator for predicting ASCVD occurrence in the future and then compared the results with different definitions of MetS including IDF and NCEP ATP III. Results Patients with MetS consistent with NCEP ATP III had higher ASCVD risk scores than those with IDF (10.63 ± 10.989 vs. 9.50 ± 9.357). NCEP ATP III had better overall performance in terms of specificity, accuracy, sensitivity and positive and negative predictive values especially in higher ASCVD risk score categories. The agreement between IDF and NCEP ATP III was none to slight (Cohen's Kappa 30%, which revealed no agreement (Cohen's Kappa = 0). Conclusion NCEP ATP III has better overall performance compared to IDF. The ability of NCEP ATP III increases as the ASCVD risk score goes higher. IDF may be useful in primary screening and patients with lower ASCVD risk scores.

Background. Since the beginning of COVID-19 pandemic, the importance of clinical criteria for tracheal intubation in critically ill patients with respiratory failure became more noteworthy, especially in resource limitations. The objective was to evaluate the importance of hemoglobin oxygen saturation as a criterion for tracheal intubation in patients with COVID-19. Materials and methods. This is a multi-center, prospective, observational cohort study. We included 117 patients with COVID-19 who needed respiratory support between March to June 2021. Patients were intubated by the protocol of each institution participating in the study and the anesthesiologist’s clinical judgement. Signs of respiratory failure, methods of respiratory support and patient outcome were recorded. Results. Among 117 studied cases, 100 patients had hemoglobin oxygen saturation of 60–90 % in whom 58 were intubated. During hospitalization, 56 intubated patients and 14 non-intubated patients died (96.6 % Vs. 33.3 %). Conclusion. Arterial blood hemoglobin oxygen saturation of 60–90 could not be the correct key to unlock the problem of intubation decision in patients with COVID-19. Therefore, hemoglobin oxygen saturation should not be solely regarded as an indication for intubation in COVID-19.

Introduction: The purpose of this research is to design and explain the model of professional ethics relations and the level of implementation of the policies of the Natural Resources and Watershed Management Organization of the country (a case study of the General Directorate of Natural Resources and Watershed Management in the North of Kerman Province). Material and Methods: In terms of the purpose of this research, it was developmental and applied, which was done in a mixed way. In the qualitative part of the society, there were university professors and experts in the field of human resources management, from among whom 30 people were selected by a judgment method. The tool was exploratory interviews and finally the data was analyzed with Delphi technique. In the quantitative part, the descriptive method was of the correlation type. The statistical population included all the managers and employees of the General Directorate of Natural Resources and Watershed Management of Kerman province and the sub-departments of the cities. The sample consisted of 358 people who were selected based on the available sampling method. A questionnaire was used to collect the required data. Data analysis was done using descriptive statistics and inferential statistics (one-sample t-test and structural equation modeling) using SPSS23 and AMOS23 software. Results: In the qualitative section, 70 sub-dimensions (indices) related to professional ethics were summarized in 5 factors and 79 sub-dimensions (indices) related to the implementation of the organization's policies were summarized in 4 factors. The analysis of the data in the quantitative part showed that there is a positive and significant relationship between the variable of professional ethics and the level of implementation of the organization's policies. Extra-organizational and individual (extra-personal) on the implementation of the organization's policies is significant at the 5% level, and the positive path coefficients show that these structures have had an increasing (direct) effect on the implementation of the organization's policies. Conclusion: Based on the present research, it was found that professional ethics has a significant effect on the level of implementation of the organization's policies.

Aims: This study aimed to determine the effect of E-learning on the understanding of appropriate antibiotic prescribing (AAP) by medical students and to assess their satisfaction with this method. Materials and Methods: This quasi-experimental study was conducted among the physiopathology students of Kashan University of Medical Sciences in the first and second semesters of 2020–2021. Students were divided into E-learning education as an intervention group (IG) and face-to-face education as a control group (CG). After the final examination, the mean scores of students in both groups were compared. In addition, the level of students' satisfaction in the IG with E-learning method was assessed using a standard questionnaire. Data were analyzed using SPSS 22. Results: We included 85 and 47 students in the CG and IG. The mean and standard deviation (SD) of the understanding score about antibiotics in the E-learning group and the face-to-face education group were 18.8 ± 1.26 and 17.16 ± 1.93 out of 19, respectively, which were statistically significantly different (P = 0.004). The mean and SD of the overall score of satisfaction of the students in the IG was 85.48 ± 23.08 out of 130 points (medium level). Furthermore, the level of satisfaction of male students was significantly higher than female students (P = 0.009). Conclusion: E-learning was effective in improving the process of educating students to the AAP. This education method can be used as an alternative or complementary of face-to-face education, especially in critical conditions such as the pandemic of diseases including COVID-19.

There are some business leaders who like to look at academic journals but unfortunately, the crossover literature has not reached them enough. In this article, we attempt to blend scholarly concepts with real-world applications. This article is about how companies need to focus on having all different kinds of people included and treated fairly. Leading scholars have grappled with this idea for decades. Recent empirical studies show companies make more money when they have workers from all backgrounds. But many employees still feel they don’t belong. Leaders must make diversity, fairness, and inclusion the top things to work on by creating new roles and training to help people stop old ways of thinking and learn new ways to include everyone. Much of what we share in this opinion article comes from our consulting work experience in the UK, Japan, UAE, Australia, and Hong Kong. We portray a more detailed picture of the future of leadership coupled with “Diversity, Equity, and Inclusion” and “Artificial Intelligence” that has not been mentioned in the past. This article presents an effective model of leadership in the DEI world that can achieve both business success and employee satisfaction for organizations. This model also blends the notions gathered by scholars and practitioners of leadership and combines them as one of the best ways to be an executive. Indeed, to achieve United Nations SDG 5 and promote diversity and inclusion, there is a need for new leadership roles, and these new and critical roles are not preferable over the other. [ABSTRACT FROM AUTHOR]

Building a dynamic and values-based company is more about the intangible elements of the organization than the financial balance sheet. The capabilities of organizations far exceed profitability potential. People, teams, and structure are the true drivers of success. The aim of this editorial is to present an intergrade HR leadership theory to effectively shed light on the intangible assets of organizations that far succeed the technical and financial components. In this editorial, it is assumed that the emergence of dynamic capabilities depends on the intellectual foundations formed in the company, and these foundations can be included in three levels: individual, social, and organizational. The proposed theory is the result of our qualitative study in 7 multinational companies in the UAE. [ABSTRACT FROM AUTHOR]

Admission in English-medium universities or institutions of higher education depends on the results obtained by candidates in large-scale proficiency tests including Test of English as a Foreign Language (TOEFL) internet-based test (iBT). The structure and administration procedure of the TOEFL iBT speaking test leaves no room for carrying out reciprocal interactions and, consequently, examining applicants' questioning ability. This study highlights the significance of non-native students' skills to ask oral English questions in academic contexts as experienced by non-native graduates from English-medium universities and in the view of Iranian TOEFL iBT instructors. Further, the washback of the absence of the skill in the TOEFL iBT test was investigated in speaking preparation classes. Twelve non-native graduates and nineteen Iranian TOEFL iBT instructors participated in the study. They were all interviewed about the significance of oral questioning. The instructors' views were also sought about the consequences of the disregard of questioning in the test. To triangulate the data, two classes of the instructors were also observed. Classroom observations and interviews were analyzed through content analysis. The results indicated that the participants generally assumed questioning as indispensable in academic interactions. Despite their acknowledgment of its significance, as both the interviews and observations unveiled, the instructors, however, tended not to work on their students' questioning because of the absence of the skill in the test, the students' reluctance, limited preparation time, and dependence of their professional reputation on the test results rather than target situation performance. The study further discusses the implications of the findings for the test construct representation and preparation courses.

Heavyweight concrete is used to prevent harmful radiation for the construction of hospital, military, and nuclear power plants and also to increase the durability for the construction of marine concrete structures. In this research, using a combination of serpentine aggregates and lead slag, the mechanical, durability, impact resistance, and shielding properties of heavyweight concrete were examined. The variables included fine and coarse serpentine aggregates, which were replaced with normal fine and coarse aggregates in amounts of 0, 25, 50, and 100 percent, respectively. The lead slag in all samples was considered constant. Slump, compressive strength, flexural strength, water penetration depth, impact resistance (drop hammer), and gamma ray attenuation coefficient tests were conducted. The chemical composition of serpentine aggregates and lead slag were evaluated by X-ray powder diffraction. The results showed that the density and linear attenuation coefficient (LAC) increased with the increase of fine and coarse serpentine aggregates in heavyweight concrete containing lead slag. The highest density and LAC were obtained in a sample in which 100% fine serpentine aggregates and 100% coarse serpentine aggregates were used. Using 25% of serpentine fine aggregates and 25% of serpentine coarse aggregates in heavyweight concrete samples containing lead slag has achieved the highest compressive strength and flexural strength. But with the increase of fine and coarse serpentine aggregates to more than 25%, the upward trend of increasing compressive strength decreased. Silica constitutes a large part of the chemical structure of serpentine aggregates (about 42%). Increasing the amount of serpentine aggregates in concrete mixes leads to excessive release of calcium hydroxide in concrete. This issue can lead to the formation of a weak zone in concrete and decrease the compressive and impact resistance.

Innovation is an essential tool for the supply chain to gain its competitive advantage and improve its performance. Many researchers have remarked that supply chain innovation is a vital tool for improving the performance of a supply chain and can be very productive. This research attempts to identify and analyze the effective factors on the innovation supply chain in the health sector. The effective factors on the innovative supply chain were extracted by reviewing the literature, similar studies, and experts’ surveys. In this regard, 49 criteria were determined in eight dimensions. Intuitive fuzzy DEMATEL (IFD) and AHP methods were used to determine the weight and the relationships between them. The results indicated organizational innovation as the most important dimension, government support innovation as the most effective dimension, and process innovation as the most affected dimension. Some researchers believe that this period guarantees the survival and success of service organizations in this competition. However, the logistics and communication network of a business is required as a new and innovative landscape to use the competitive advantage opportunities to perceive the global era.

The intensive care unit (ICU) is the most important department for critically ill patients. Different scoring systems are used to assess the severity of the disease and evaluate organ failure during the patient's stay in ICU. Our purpose was to evaluate the C‐reactive protein/Albumin (CRP/Alb) ratio and SOFA score as indicators of 28‐day mortality in ICU patients. A total of 55 patients were enrolled in this study. CRP and CRP/Alb rates, SOFA scores, and demographic data were used to evaluate 28‐day mortality in a referral hospital. Survived and dead patients were significantly different in the CRP, CRP/Alb rates, and SOFA scores. However, in the adjusted model, the SOFA score was the predictor of 28‐day mortality in ICU patients. SOFA score was also confirmed as a predictor of mortality in ICU patients. Besides, the role of CRP and CRP/Alb in the prediction of disease prognosis or mortality requires further studies. [ABSTRACT FROM AUTHOR]

Insulin resistance arising from Non-Alcoholic Fatty Liver Disease (NAFLD) stands as a prevalent global ailment, a manifestation within societies stemming from individuals' suboptimal dietary habits and lifestyles. This form of insulin resistance emerges as a pivotal factor in the development of type 2 diabetes mellitus (T2DM). Emerging evidence underscores the significant role of hepatokines, as hepatic-secreted hormone-like entities, in the genesis of insulin resistance and eventual onset of type 2 diabetes. Hepatokines exert influence over extrahepatic metabolism regulation. Their principal functions encompass impacting adipocytes, pancreatic cells, muscles, and the brain, thereby playing a crucial role in shaping body metabolism through signaling to target tissues. This review explores the most important hepatokines, each with distinct influences. Our review shows that Fetuin-A promotes lipid-induced insulin resistance by acting as an endogenous ligand for Toll-like receptor 4 (TLR-4). FGF21 reduces inflammation in diabetes by blocking the nuclear translocation of nuclear factor-κB (NF-κB) in adipocytes and adipose tissue, while also improving glucose metabolism. ANGPTL6 enhances AMPK and insulin signaling in muscle, and suppresses gluconeogenesis. Follistatin can influence insulin resistance and inflammation by interacting with members of the TGF-β family. Adropin show a positive correlation with phosphoenolpyruvate carboxykinase 1 (PCK1), a key regulator of gluconeogenesis. This article delves into hepatokines' impact on NAFLD, inflammation, and T2DM, with a specific focus on insulin resistance. The aim is to comprehend the influence of these recently identified hormones on disease development and their underlying physiological and pathological mechanisms. [ABSTRACT FROM AUTHOR]