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Introduction. Rheumatoid arthritis (RA) is a chronic progressive inflammatory disease that causes joint destruction. The condition imposes a significant economic burden on patients and societies. The present study is aimed at evaluating the cost-effectiveness of Infliximab, Adalimumab, and Etanercept in treating rheumatoid arthritis in Iran. Methods. This is a cost-effectiveness study of economic evaluation in which the Markov model was used. The study was carried out on 154 patients with rheumatoid arthritis in Fars province taking Infliximab, Adalimumab, and Etanercept. The patients were selected through sampling. In this study, the cost data were collected from a community perspective, and the outcomes were the mean reductions in DAS-28 and QALY. The cost data collection form and the EQ-5D questionnaire were also used to collect the required data. The results were presented in the form of an incremental cost-effectiveness ratio, and the sensitivity analysis was used to measure the robustness of the study results. The TreeAge Pro and Excel softwares were used to analyze the collected data. Results. The results showed that the mean costs and the QALY rates in the Infliximab, Adalimumab, and Etanercept arms were $ 79,518.33 and 12.34, $ 91,695.59 and 13.25, and $ 87,440.92 and 11.79, respectively. The one-way sensitivity analysis confirmed the robustness of the results. In addition, the results of the probabilistic sensitivity analysis (PSA) indicated that on the cost-effectiveness acceptability curve, Infliximab was in the acceptance area and below the threshold in 77% of simulations. The scatter plot was in the mentioned area in 81% and 91% of simulations compared with Adalimumab and Etanercept, respectively, implying lower costs and higher effectiveness than the other two alternatives. Therefore, the strategy was more cost-effective. Conclusion. According to the results of this study, Infliximab was more cost-effective than the other two medications. Therefore, it is recommended that physicians use this medication as the priority in treating rheumatoid arthritis. It is also suggested that health policymakers consider the present study results in preparing treatment guidelines for RA.

PURPOSE: The effectiveness of diabetes self-management interventions has been more generally demonstrated in adults, but there is little evidence of diabetes self-management specific to older adults situated in Iran. The purpose of this study was to evaluate the effectiveness of Persian Diabetes Self-Management Education on self-efficacy, quality of life, self-care activity, depression and loneliness in older adults with type 2 diabetes. METHODS: In pilot randomized controlled trial, a total of 34 participants ≥60 years with type 2 diabetes were randomly assigned into intervention (n = 17) and control (n = 17) group in an outpatient diabetes clinic in Tehran. To assess the primary outcome of participant experiences, the Diabetes Management Self-efficacy Scale (DMSES) was the method of measurement. The Diabetes Quality of Life-Basic Clinical Inventory (DQoL-BCI), Patient Health Questionnaire-9 (PHQ-9), Diabetes Self-Management Education Scale (DSMES), and adult Social-Emotional Loneliness Scale Short form (SELSA-S) were used as secondary outcomes. Participants’ evaluations were completed at baseline, while measurements were conducted two and four weeks after allocation, using repeated measurements of Univariate and multivariate ANOVA (adjusted for baseline values) to analyze the data. RESULTS: In the multivariate model, there was a significant difference between the control and intervention groups regarding reported quality of life (p = 0.04) and the medical-domain’s reported self-efficacy (p = 0.02). However, there were no significant differences in the reported self-management, depression, loneliness, as well as the other domain of self-efficacy; as compared between the two groups before and after intervention. CONCLUSION: The study depicts a promising impact on older adults, imparted by the pertinent program. The finding showed PDSME has a positive effect on quality of life and medical control domain of self-efficacy. This pilot study showed that the program is feasible and duly beneficial if delivered to older adults. This pilot proves appealing to begin further testing within a larger sample population.

Background/AimsThe participation of children and adolescents with cerebral palsy in leisure activities is associated with their preferences. A better understanding of their leisure preferences and the factors that influence them can help therapists to promote young patients' participation in leisure activities. The aim of this study was to describe the role of individual factors in the prediction of leisure preferences of children and adolescents with cerebral palsy in Iran.MethodsA cross-sectional study design was used. A total of 152 children and adolescents with cerebral palsy were selected to complete the Preferences for Activities of Children questionnaire. Simple and multiple linear regression analyses were performed to assess the role of individual factors in the prediction of preferences for leisure activities.ResultsIndividual factors played a significant role in the prediction of leisure preferences. Their influence on the preferences for recreational, physical and self-improvement domains (r2=0.215; 0.154; 0.127, respectively) were greater than for social and skill-based domains (r2=0.045; 0.052, respectively).ConclusionsPreferences for physical activities need to be augmented while a high preference for social and recreational activities could be used to promote participation in leisure activities. Therapists and other healthcare professionals should consider individual factors relating to leisure preferences when devising therapeutic plans that aim to promote participation in leisure activities.

Objectives: To investigate whether Iranian children and adolescents with Cerebral Palsy (CP) participate in their preferred leisure activities. Methods: A group of children and adolescents (n=152; 59.2% male; aged 7-17 years; Mean±SD of age was 10.93±3.46 years old) diagnosed with CP (39.5% hemiplegic; 28.9% quadriplegic; 31.6% diplegic) were selected to complete the children’s assessment of participation and the enjoyment (CAPE) and Preference for Activities of Children (PAC) questionnaires. Results: Recreational and social activities were the most preferred (PAC mean score=2.13±0.40; 2.08±0.40, respectively), and active-physical activities were the least preferred (PAC mean score=1.60±0.46). Preferences were strongly correlated with leisure participation (P

Introduction: Multiple sclerosis (MS) is an inflammatory disease in which the myelin sheaths of the nerve cells in the brain and spinal cord, which are responsible for communication, are destroyed and cause physical signs and symptoms. According to studies, anti-CD20 monoclonal antibodies have significant results in the treatment of this disease. Thus, the aim of the present study was to determine the effectiveness and cost-effectiveness of Rituximab against Natalizumab in the patients with MS in southern Iran in 2020. Methods: This is an economic evaluation including cost-effectiveness analysis in which the Markov model with a lifetime horizon was used. The study sample consisted of 120 patients randomly selected from among those referred to the MS Association and the Special Diseases Unit of Shiraz University of Medical Sciences. In this study, the costs were collected from a societal perspective, and the outcomes were obtained in the form of Quality Adjusted Life Years (QALY) and the mean recurrence rate. The TreeAge pro 2020 and Excel 2016 software were used for data analysis. Results: The comparative study of Rituximab and Natalizumab showed that the patients receiving Rituximab had lower costs ($ 58307.931 vs. $ 354174.85) and more QALYs (7.77 vs. 7.65). In addition, the incidence of relapse by Rituximab was lower compared to Natalizumab (1.15 vs. 2.57). The probabilistic one-way sensitivity analysis showed the robustness of the results. The scatter plots also showed that Rituximab was more cost-effective for the patients in 100% of the simulations for the threshold of >$ 37,641. Discussion and Conclusion: According to the results of this study, Rituximab had higher cost-utility and cost-effectiveness than Natalizumab. Therefore, it could be a priority for MS patients compared to Natalizumab because it reduced treatment costs and increased effectiveness.

Social isolation stress (SIS) as a type of chronic stress could induce depressive- and anxiety-like behaviors. Our study evaluates the role of opioid system on negative behavioral impacts of SIS in male NMRI mice. We investigated effects of morphine, a nonselective opioid receptor (OR) agonist, naltrexone (NLX), an OR antagonist, naltrindole (NLT), a delta opioid receptor (DOR) antagonist, SNC80, a DOR agonist, U-69593, a kappa opioid receptor (KOR) agonist, nor-Binaltorphimine, a selective KOR antagonist and cyprodime hydrochloride a selective mu opioid receptor (MOR) antagonist on depressive- and anxiety-like behaviors. Using RT-PCR we evaluated ORs gene expression in mice brain. Our findings showed that SIS induced anxiety- and depressive-like behavior in the forced swimming test, open field test, splash test and hole-board test. Moreover, administration of SNC-80 significantly mitigated anxiety- and depressive-like behaviors. NLT decreased grooming-activity in the splash test. Excitingly, administration of agents affecting KOR failed to alter the negative effects of SIS. RT-PCR demonstrated that MOR and KOR gene expression decreased in socially isolated mice; however, SIS did not affect DORs expression. Our findings suggest that SIS at least in part, probably via altering endogenous opioids particularly MORs and KORs but not DORs mediated negative impacts on behavior; also, it could be concluded that DORs might be considered as a novel target for studying depression and anxiety.

Limb-girdle muscular dystrophies (LGMDs) are a highly heterogeneous group of neuromuscular disorders that are associated with weakness and wasting of muscles in legs and arms. Signs and symptoms may begin at any age and usually worsen by time. LGMDs are autosomal disorders with different types and their prevalence is not the same in different areas. New technologies such as next-generation sequencing can accelerate their diagnosis. Several important pathological mechanisms that are involved in the pathology of the LGMD include abnormalities in dystrophin-glycoprotein complex, the sarcomere, glycosylation of dystroglycan, vesicle and molecular trafficking, signal transduction pathways, and nuclear functions. Here, we provide a comprehensive review that integrates LGMD clinical manifestations, prevalence, and some pathological mechanisms involved in LGMDs.

Background and Objectives: Furosemide is one of the elements of drug therapy for cardiogenic pulmonary edema, but its systemic administration is associated with complications, such as hypotension, renal damage, and decreased serum potassium. Inhalation administration is a new route, which does not have the side effects of systemic administration, but its effectiveness is still unclear. The aim of this study was to determine the effectiveness of treatment with the nebulized furosemide in patients with acute cardiogenic pulmonary edema Methodes: This clinical trial study was conducted on 125 patients with acute cardiogenic pulmonary edema reffering to the Department of Emergency Medicine of Rasoul Akram and Firouzgar hospitals in 2017. The samples were randomly assigned to two groups of experimental (62 individuals receiving furosemide with nebulizer) and control (63 individuals receiving normal saline with nebulizer). After the vital Signs intervention, the data relating to the lung were compared using t-test and Chi square test. Results: There was no difference between the two studied groups in terms of the mean changes in systolic (intervention 129, plasebo 128.9) and diastolic blood pressures (intervention 79.2, plasebo 78), pulse rate (intervention 92.2, plasebo 91.8), respiratory rate (intervention 22.8, plasebo 22.3), and blood oxygen saturation (intervention 92, plasebo 91.7). Changes in lung auscultation showed no statistically significant changes between the groups (p = 0.56). Conclusion: The finding of the present study revealed that inhaled furosemide had no positive effect in the patients with acute pulmonary edema. Therefore, considering the novelty of the issue, further studies are recommended.

Atherosclerosis is a dynamic and progressive inflammatory process in the intimal layer of large and medium-sized arteries, and it is the major contributor to the atherosclerotic cardiovascular disease (ACVD), the leading cause of death worldwide. In an atherosclerotic plaque, phagocytosis of apoptotic cells occurs through an intricate process designated efferocytosis. Defective efferocytosis has emerged as a causal factor in the etiopathogenesis of atherosclerosis and its progression into overt ACVD. Both specialized phagocytes (macrophages and dendritic cells) and non-specialized cells with phagocytic capabilities (smooth muscle and endothelial cells) are involved in the efferocytotic process. Moreover, several signaling and regulatory molecules are involved in the different steps of efferocytosis, and they include "Find-Me" signals (lysophosphatidylcholine), "Eat-Me" signals [phosphatidylserine, Mer tyrosine kinase (MerTK), and milk fat globule-EGF factor 8], and "Don't Eat-Me" signals [cluster of differentiation 47 (CD47)]. Regulation of efferocytosis is in a close nexus with inflammation, the key component in atherosclerosis. The predominance of pro-inflammatory and anti-inflammatory molecules plays a crucial role in lesion progression and regression, respectively. Polarization of macrophages towards the M1 phenotype causes them to secrete proinflammatory cytokines, while polarization towards the M2 phenotype causes them to secrete of anti-inflammatory cytokines, including interleukin-10 and transforming growth factor β, so tending to shift the balance towards resolution of the inflammation. Dysfunction of any regulatory signal may cause expansion of the necrotic core of an atherosclerotic plaque with ensuing conversion of the plaque into an unstable plaque with an increased susceptibility to rupture and to atherothrombotic complication. In this review we aim at elucidating the determinant factors and pathways of efferocytosis which can be considered as potential novel targets when striving to develop more personalized and efficient treatment regimens for patients with ACVD.

Background Strabismus surgery, a common ophthalmic procedure, has been associated with a high incidence of emergence delirium and postoperative pain in children. The postoperative complications cause restless behaviors in children, which is requiring more nursing care and prolonged hospitalization. This study aimed to assess the effect of paracetamol on postoperative pain and delirium in children undergoing strabismus surgery under desflurane anesthesia. Methods 80 children ASA I-II aged 5–12 were included in this randomized placebo-controlled trial. Children were randomly allocated into two groups to receive paracetamol (5–10 mg/kg) and normal saline as a placebo. The severity of pain after the surgery was recorded at 1 min after extubation and every 10 min up to 60 min after the operation by using the children's hospital of eastern Ontario (CHEOPS) pain scale and pediatric anesthesia emergence delirium (PAED). Results Our results revealed that pain severity was significantly decreased after paracetamol administration. Also, patients in the paracetamol group required less administration of fentanyl due to less pain compared to the placebo group. Conclusion In conclusion, the present study illustrated that paracetamol reduces postoperative nausea and vomiting. Also, it diminished postoperative pain and the need for opioids.

Ischaemic stroke, which is mostly caused by atherosclerosis, is one of the most widely causes of mortality and morbidity. One of the most important enzymatic activities of paraoxonase-1 (PON1) in association with high-density lipoprotein (HDL) is the prevention of low-density lipoprotein (LDL) oxidation, which gives it an anti-atherogenic activity. PON1 expression and activity is influenced by various factors; the most important of which is genetic polymorphism, mainly single nucleotide polymorphisms (SNPs). The results of various studies in different populations indicate that some SNPs of the PON1 gene are associated with stroke. Therefore, in this review we studied various researches, in which the association of PON1 SNPs with stroke had been investigated in different populations.

Breast cancer is among the most important causes of cancer related death in women. There is a need for novel agents for targeting key signaling pathways to either improve the efficacy of the current therapy, or reduce toxicity. There is some evidence that curcumin may have antitumor activity in breast cancer. Several clinical trials have investigated its activity in patients with breast cancer, including a recent trial in breast cancer patients receiving radiotherapy, in whom it was shown that curcumin reduced the severity of radiation dermatitis, although it is associated with low bioavailability. Several approaches have been developed to increase its absorption rate (e.g., nano crystals, liposomes, polymers, and micelles) and co-delivery of curcumin with adjuvants as well as different conjugation to enhance its bioavailability. In particular, micro-emulsions is an option for transdermal curcumin delivery, which has been reported to increase its absorption. Lipid-based nano-micelles is another approach to enhance curcumin absorption via gastrointestinal tract, while polymer-based nano-formulations (e.g., poly D, L-lactic-co-glycolic [PLGA]) allows the release of curcumin at a sustained level. This review summarizes the current data of the therapeutic potential of novel formulations of curcumin with particular emphasis on recent preclinical and clinical studies in the treatment of breast cancer.

Brain-derived neurotrophic factor (BDNF) is a potent neurotrophic factor that has been shown to stimulate breast cancer cell growth and metastasis via tyrosine kinase receptors TrkA, TrkB, and the p75NTR death receptor. The aberrant activation of BDNF/TrkB pathways can modulate several signaling pathways, including Akt/PI3K, Jak/STAT, NF-kB, UPAR/UPA, Wnt/β-catenin, and VEGF pathways as well as the ER receptor. Several microRNAs have been identified that are involved in the modulation of BDNF/TrkB pathways. These include miR-206, miR-204, MiR-200a/c, MiR-210, MiR-134, and MiR-191; and these may be of value as prognostic and predictive biomarkers for detecting patients at high risk of developing breast cancer. It has been also been demonstrated that a high expression of genes involved in the BDNF pathway in breast cancer is associated with poor clinical outcome and reduced survival of patients. Several approaches have been developed for targeting this pathway, for example TKr inhibitors (AZD6918, CEP-701) and RNA interference. The aim of the current review was to provide an overview of the role of BDNF/TrkB pathways in the pathogenesis of breast cancer and its value as a potential therapeutic target. J. Cell. Biochem. 118: 2502-2515, 2017. © 2017 Wiley Periodicals, Inc.

Background: Studies indicate that balance disorder, motor development problems, and weak postural control are likely to occur in children with severe to profound hearing deficits. Children with hearing deficits also indicate behavioral problems related to impulse control, distraction, and disability to maintain attention in the visual modality. Objectives: The present study, therefore, aimed to investigate the effect of balance exercises on balance performance, motor coordination, and attention in children with hearing deficits. Methods: In this experimental study, 36 children aged 7 to 12 years with severe to profound hearing deficits were randomly divided into two control and experimental groups using permuted block randomization. The experimental group performed a 12-session balance and vestibular sensory, motor exercise program. Assessments were performed as pretest and posttest by four subtests of the Bruininks-Oseretsky test of Motor Proficiency and Continuous Performance test. Then, the mean scores were compared between the pretest and posttest phases and between control and experimental groups by the paired t-test, Wilcoxon signed-rank test, two-sample t-test, and Mann-Whitney U test. Results: The results indicated a significant difference between the control and experimental groups in the pretest and posttest scores of balance (P = 0.000), upper limb coordination (P = 0.000), bilateral coordination (P = 0.004), and visual-motor control (P = 0.023) subtests of Bruininks-Oseretsky test and Continuous Performance test (P = 0.017) in children with hearing deficits. Conclusions: Balance training including vestibular sensory and motor exercise program can simultaneously affect balance performance, motor coordination, and attention in children with hearing deficits.

Within the context of event modeling and understanding, we propose a new method for neural sequence modeling that takes partially-observed sequences of discrete, external knowledge into account. We construct a sequential neural variational autoencoder, which uses Gumbel-Softmax reparametrization within a carefully defined encoder, to allow for successful backpropagation during training. The core idea is to allow semi-supervised external discrete knowledge to guide, but not restrict, the variational latent parameters during training. Our experiments indicate that our approach not only outperforms multiple baselines and the state-of-the-art in narrative script induction, but also converges more quickly., Comment: In Proceedings of the 2021 Annual Conference of the North American Chapter of the Association for Computational Linguistics (NAACL 2021)

Efferocytosis as an apoptotic cell (AC) clearance mechanism facilitates the removal of dangerous and damaged cells, an important process in regulating normal homeostasis. Failure to correctly execute apoptosis and efferocytosis is associated with atherosclerosis, as well as chronic inflammatory and autoimmune disorders such as systemic lupus erythematosus (SLE). Effective and timely efferocytosis involves various molecules that act as "Find-Me" signals or as alarmins to quickly allow identification by phagocytic cells. In recent years, most of these molecules have been investigated, but less attention has been paid to the nuclear molecules associated with efferocytosis of ACs and necrotic cells (NCs). These molecules have several functions including acting as alarmin signals for faster recognition of ACs, facilitating the cleanup of ACs and for maintaining self-tolerance. The same group of molecules is also implicated in several inflammatory and autoimmune diseases. Previous studies have shown that these molecules also serve as targets for pharmacological agents such as necrostatins, recombinant Fcnb, anti-histone, neutralizing antibodies, calbiochem, aminophylline, activated protein C, CD24IgG recombinant fission protein, and recombinant thrombomodulin. Thus, greater understanding of these molecules/pathways will enable developments in the treatment and/or prevention of various disorders, especially autoimmune diseases. Here, we review current knowledge about the mechanisms by which nucleic acids, histones, nucleosomes and monosodium urate microcrystals (MSU) can act as alarmins/"Find-Me" signals, how they might be stimulated in defective efferocytosis and their function and importance as biomarkers for prognosis and treatment of atherosclerosis, inflammatory disorders and autoimmune diseases.

Myocardial infarction (MI) (i.e., heart attack) is the irreversible death (necrosis) of heart muscle secondary to prolonged lack of oxygen supply (ischemia) which accounts for a large number of deaths in the hospital. Diagnosis of myocardial infarction is confirmed based on clinical manifestations and electrocardiographic changes along with increased cardiac enzymes. Electrocardiogram (ECG) is one of the safest and easiest methods in the first place. Therefore, this study aimed to investigate the diagnostic value of standard electrocardiogram in the diagnosis of acute right ventricular infarction following lower cardiac infarction. This research was carried out at a time interval of one and a half years to diagnose acute primary infarction. In this method, the diagnostic value of ST↓ in lead I, ST↓ in lead aVL and I ST↓ + aVL, compared with ST↑ in lead V4R was investigated for diagnosis of right ventricular infarction. ST↑ in the lead V4R is a gold standard for the detection of right ventricular MI. All the patients who had the inclusion criteria were allowed to participate in the study. A total of 66 patients participated in the study. Accordingly, 58 (87%) were male and 8 (13%) were female. The mean age of the population was 54.9 ± 11.41. According to the ST↑ standard in lead V4R, 26 patients (39%) had right ventricular myocardial infarction. There was no significant relationship between angina pectoris and premature infarction (P-Value = 0.869). In this study, the right ventricular was most commonly involved in right coronary artery (78%). There was no significant relationship between the occlusion of right coronary artery and right ventricular infarction in 60 patients (P-Value = 0.94). The results showed that electrocardiogram manifestations help determine the occlusion site and the area at risk (ST↓ in lead aVL and aVL + I, sensitivity = 96%). In myocardial infarction, symptoms such as the ST-Segment elevation in lead aVR and ST-Segment depression in the lower leads are possible. Accordingly, in the lower infarction, ST changes in the leads V1-V6 are helpful in detecting patients at risk. Thus, the use of electrocardiogram in acute myocardial infarction helps detect more invasive patients and prevents extensive myocardial damage and other complications.

Introduction: One of the most common complications of spinal anesthesia in elective cesarean is a headache, known commonly as post-dural-puncture headache (PDPH). Various methods are mainly recommended such as resting and the use of non-opioid analgesics, caffeine, and codeine, but none of them has been fully effective in its treatment. Hence, this study was conducted to evaluate the effect of magnesium sulfate on the prevention of post-dural-puncture headache in the elective cesarean. Method: a total of 68 patients candidate for elective cesarean and admitted to Kamali Hospital were selected using convenient sampling and they were randomly divided into two groups. One group received magnesium and other group received saline. Subjects of case group received magnesium at the dose of 50 mg / kg as bolus and the subjects of control group received normal saline at the same dose as bolus. The incidence of headache and its severity 12, 24, 36, 48 ​​, 60 and 72 hours after surgery were measured in both case and control groups. Results: The mean age of patients in the magnesium sulfate group was 27.94 years with a standard deviation of 5.18 and the mean age of patients in the normal saline group was 29.35 years with a standard deviation of 5.97. The mean body mass index (BMI) in the magnesium sulfate group was 26.34 with a standard deviation of 4.03 and the mean body mass index (BMI) in the normal saline group was 27.15 with a standard deviation of 2.47. Post-dural-puncture headache severity was lower in the case group than that in the control group at all times (P

Multiple sclerosis (MS) is a chronic, autoimmune, and inflammatory disease. If the first-line medicines are not effective enough, specialists will prescribe second-line medicines, such as natalizumab and fingolimod. This study aimed to compare the cost-effectiveness and cost-utility of fingolimod with those of natalizumab in patients with relapsing-remitting multiple sclerosis (RRMS) in Iran, Fars province in 2016.This study was a cost-effectiveness and cost-utility study in which a Markov model was used. The study used the census method to evaluate 81 patients with MS in Iran, Fars province who were being treated with fingolimod and natalizumab. In this study, costs were collected from the societal perspective, and the outcomes were the mean of relapse avoided rate and QALY. The cost data collection form, Kurtzke Expanded Disability Status Scale, and EQ-5D-3L questionnaire were used to collect the required data.The results showed that, compared to natalizumab, patients who used fingolimod had decreased costs (58,087 vs 201,707), increased QALYs (8.09 vs 7.37), and a better relapse avoided rate (6.27 vs 5.83) per patient over the lifetime. The results of the sensitivity analysis showed that the results of the study were robust. Also, the results of the scatter plots showed that fingolimod was more cost-effective based on the QALY and relapse avoided rate in 62% and 56%, respectively, of the simulations for the thresholds below $15,657 for the studied patients.According to the results of this study, the cost-effectiveness and cost-utility of fingolimod were higher than those of natalizumab. Therefore, it is recommended that treatment with fingolimod be the first priority of second-line treatment for MS patients, and policy-makers and health managers are encouraged to make efforts in order to increase insurance coverage and reduce the out-of-pocket payments of these patients.

Background Smoking causes premature and preventable death of millions of educated people. Objectives Given the role model for medical students in the future of the country, the current study aimed at determining the smoking prevalence and its related factors among dormitory students of Shahid Beheshti University of Medical Sciences in Tehran, Iran. Methods The current cross sectional study was conducted with descriptive-analytical approach on 355 dormitory students selected by single-stage random cluster sampling method. Data were collected using a researcher-made questionnaire including demographic and background information and smoking features. Then, data were analyzed with SPSS version. 21, using descriptive statistics and Chi-square test. Results The current study findings indicated that 23.8% (n = 81) of the subjects were current smokers; smoking had a significant relationship with gender variables, history of probation, close friends that smoked, and employment (P < 0.05). Conclusions In comparison to other studies, the smoking prevalence was relatively high. Therefore, the necessity of proper education about the harms and health effects of smoking are felt more than ever.

Background: Multiple Sclerosis (MS) is a chronic and inflammatory disease that can affect the patients’ quality of life and impose many costs on them. Several types of medicine are used to change the course of the disease, treat disease - related attacks, and treat the symptoms of multiple sclerosis. Objectives: The aim of this study was to determine and compare the cost-effectiveness and cost - utility of CinnoVex versus ReciGen as the first line treatment in patients with relapsing-remitting multiple sclerosis in Iran, Fars province, in 2016. Methods: This study was a cost - effectiveness and cost - utility study, in which a Markov model was used. A sample of 178 patients with MS was randomly selected. The costs were summed up from the societal perspective, and the study outcomes were QALY and the mean of relapse was avoided. To collect the required data, the cost data collection form, Kurtzke Expanded Disability Status Scale, and EQ - 5D questionnaire were used. To analyze the data collected, the TreeAge Pro 2011 and Excel 2010 software were used as well. Results: The results showed that the mean cost for ReciGen and CinnoVex patients were 349.84 and 289.92 USD, respectively. In addition, the QALY means were 0.291 and 0.297 and the means of relapse avoided were 0.309 and 0.239 for ReciGen and CinnoVex patients, respectively. The one - way sensitivity analysis showed that the results of the model were sensitive to effectiveness and utility of both medicines, but had little sensitivity to other parameters. Conclusions: According to the results, ReciGen was more cost - effective in terms of relapse avoided and CinnoVex was more cost - effective in terms of QALY. Therefore, ReciGen and CinnoVex can be the preferred options for physicians and for health policymakers and managers, respectively.

Background and Objectives: Depression has an effective role in the performance of patients with spinal cord injury (SCI) and causes several health disorders that affect all life aspects of such patients including their goals and communications and most importantly, health-related quality of life. The current study aimed at investigating depression in patients with SCI referred to the specialized centers of SCI in Tehran, Iran. Materials and Methods: In the current descriptive study, depression status of 51 patients with SCI referred to the specialized centers of the SCI in Tehran from July to November 2017 was investigated using the second version of Beck depression inventory (BDI). The mean depression in and the different levels of the SCI were compared using the statistical tests of Kruskal-Wallis H and independent samples t test; the severity of depression in these groups was determined according to test instructions and the distribution of individuals into different classes of severity of depression was determined and compared using the statistical tests of Pearson correlation, chi-square, and the Fisher exact. Results: The mean score of BDI was above 18 in age and gender groups and there was no significant difference between the groups regarding age (P = 0.301), gender (P = 0.199), and level of SCI (P = 0.374). But, there was a significant difference in the distribution of individuals according to the classification of the severity of depression in the age groups (P = 0.045), however, the difference in the distribution of subjects was not significant in both the gender and the SCI level groups (P = 0.567 and P = 0.477, respectively). Conclusions: The obtained results revealed the need for paying more attention by the authorities and policy makers to the psychological complications, especially depression and providing proper therapeutic services for patients with SCI.

Osteochondroma is the most common benign bone tumor. Typically, it arises from the metaphysis of a long bone near the physis during periods of rapid skeletal growth. Less commonly, osteochondroma may originate from the synovium and para-articular regions1. In very rare instances, histologically similar osteocartilaginous lesions occur in soft tissues away from any bone or joint; these are referred to as extraskeletal osteochondromas (ESOCs)2. ESOC is an uncommon, slow-growing, painless osteocartilaginous lesion, with the highest incidence in the hands and feet3. ESOCs have also been reported in the buttocks, the thigh, the skin, the ankle, the knee, the cerebrum, and the nape of the neck. The peak incidence is in the third and sixth decades of life3-7. To the best of our knowledge, ESOC previously has not been reported in the leg. This case report describes an ESOC in the anteromedial portion of the middle third of the left leg. The patient was informed that data concerning the case would be submitted for publication, and she provided consent. A thirty-six-year-old woman presented with a lump on the anteromedial side of the left leg, which had gradually grown in size over the past ten years. There was no history of leg trauma. Physical findings included a firm and tender 3 × 4-cm mass; there was no neurovascular deficit. Radiographs revealed a lobulated ossified lesion in the anteromedial side of the tibia (Fig. 1). Computed tomography (CT) and magnetic resonance imaging (MRI) confirmed that the lesion was located subcutaneously, with no continuity with the shaft of the tibia (Fig. 2 and Figs. 3-A and 3-B). Slight increased uptake was seen on the nuclear bone scan …

We present a hybrid graphene metasurface and its modulation by electrostatically tuning the conductivity of the graphene. Through modification of unit cell symmetry, multiple Fano-like resonances arise for additional modes over a 300 GHz range.

The effects of gamma radiation treatment (50 and 100 Gy) on potato tubers irradiated at different days (10th, 30th and 50th) after harvest were studied during 5 months of storage at 10°C using Agria and Marfona varieties. A factorial experiment was done, based on a Randomized Complete Block Design with four replications. The 100 Gy radiation treatments on 10th and 30th days after harvest completely prevented sprouting at both varieties studied but on 50th day only Agria tubers not sprouted. This study indicated that early irradiation and absorbed radiation doses significantly decreased sprouting, percent weight loss and specific gravity of tubers. Reducing sugar content significantly increased by delay in irradiation and lower dose of radiation while non-reducing sugars did not decrease significantly by delay in irradiation and higher dose of radiation. The least increase in reducing sugars (10.2%) and most decrease in non-reducing sugar (−12.75%) were observed in tubers that irradiated on 10th day after harvest. The content of ascorbic acid was decreased by irradiation with higher dose. Although delay in irradiation caused less loss of ascorbic acid (8.5%) but showed greater metabolic changes as sprouting, weight loss, firmness, and sugars contents. Also, more increased delay in irradiation needed higher radiation doses for sprout inhibition.