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Objective: Patients with leukemia suffer from significant psychological, spiritual, and social symptoms. Therefore, the current research aimed to study the impact of spiritual end-of-life support on the quality of life for leukemia patients. Method: To this end, the present quasi-experimental research with a pre-test and post-test design was performed. The sample included 60 cancer patients randomly assigned to intervention and control groups through the method of permutation block. The experimental group received spiritual support intervention for eight sessions of 60 minutes, while the control group received no intervention. Patients filled out the questionnaire of World Health Organization Quality of Life. The World Health Organization conducts a three-phase assessment to measure the quality of life. These phases include a pre-test, which is conducted before any intervention takes place. Then comes the post-test, which occurs after the intervention. Finally, there is a follow-up assessment conducted two months after the post-test. The obtained results were analyzed by repeated-measures analysis and independent samples t-test using SPSS software. Results: The findings from the repeated measures analysis revealed that there was a statistically significant interaction between time and group (P = 0.01). In other words, being compared to the control group, the spiritual support significantly increased the life quality of the patients in the experimental group. The experimental group witnessed a sustained enhancement in the quality of life for a period of two months following the intervention (follow-up, P = 0.01). Conclusion: Ultimately, the provision of spiritual support has the potential to enhance the overall well-being of individuals approaching the end of their lives, offering solace and aiding them in comprehending the true essence and purpose of their existence. [ABSTRACT FROM AUTHOR]

Aims Diabetes is a set of complex disorders in the metabolism of proteins, fats, and carbohydrates, which cause physiological and biochemical changes in nerve cells, causing chronic psychomotor and musculoskeletal disorders such as muscle strength and balance disorders. This study aimed to compare the dynamic balance and muscle strength of the lower limbs in type 2 diabetic patients with healthy individuals. Instruments & Methods In this cross-sectional descriptive study, 70 patients with type 2 diabetes and 70 healthy people aged 40 to 70 years without skeletal-muscular and cognitive problems were selected by a multistage sampling (convenience, random block) method. In each group, the demographic questionnaire, Berg Balance Scale, and muscle strength were measured with a manual dynamometer. Chi-square, Fisher's exact test, and independent t-test were used to analyze the data. Findings The mean score of the Berg Balance Scale was higher in the control group than in the type 2 diabetes patients (p<0.05). Also, the strength of the selected muscles of the lower limbs, except the plantar flexor, was higher in the control group than in the diabetic patients (p<0.05). Conclusion Dynamic balance and walking independence are more in healthy people than in diabetic patients. [ABSTRACT FROM AUTHOR]

Background: Nurses working in neonatal intensive care units play a crucial role in providing care to critically ill or premature neonates. However, is not without its challenges, particularly when it comes to making difficult ethical decisions about end-of-life care. In some cases, neonates do not survive despite the best efforts of medical professionals. The present study aimed to investigate the relationship between moral distress, ethical climate, and attitudes towards end-of-life care among nurses working in neonatal intensive care units. Methods: This is a descriptive-analytical cross-sectional study (May 21, 2021).The research population included 126 nurses working in neonatal intensive care units in Kerman province (Kerman, Jiroft, Bam, and Rafsanjan). Data collection tools included four questionnaires: demographic information, the Frommelt Attitudes towards Care of the Dying (FATCOD), the Hospital Ethical Climate Survey, and the Moral Distress Scale. SPSS22 was used to analyze the data. Results: The results revealed that the mean frequency and intensity of moral distress were 44.42 ± 17.67 and 49.45 ± 17.11, respectively. The mean ethical climate was 92.21 ± 17.52 and the FATCOD was 89.75 ± 9.08, indicating NICU nurses' positive perceptions of ethical climate and their favorable attitudes towards EOL care, respectively. The results showed a direct and significant relationship between ethical climate and the FATCOD (P = 0.003, r = 0.26). Discussion: We suggest policymakers and managers design strategies for better ethical climate in hospitals and reduction of moral distress among nurses. [ABSTRACT FROM AUTHOR]

Few studies have examined the molecular alterations in the auditory pathway of infants of diabetic mothers, notwithstanding the fact that maternal diabetes may have an impact on the development of the neonatal peripheral and central nervous systems. Male newborn rats were studied to determine how maternal diabetes affected the expression of gamma-aminobutyric acid (GABAAα1 and GABAB1) and metabotropic glutamate (mGlu2) receptors in the inferior colliculus (IC) in this research. Female rats were given a single intraperitoneal injection of streptozotocin (STZ) at a 65 mg/kg dose to develop a model of diabetic mothers. The study population was split into sham, diabetes without treatment, and diabetes with insulin groups. Their male neonatal rats were anesthetized on P0, P7, and P14 after mating and delivery. The receptors' distribution pattern was studied using immunohistochemistry (IHC). Pairwise comparison in the groups revealed that the GABA receptors (Aα1 and B1) were significantly downregulated in the diabetes without treatment group (p<0.001). Furthermore, pairwise comparison in the groups indicated significant mGlu2 upregulation in the diabetes without treatment group (p<0.001). Regarding the concentration of all receptors, there was no discernible distinction between the diabetes with insulin and sham groups. This investigation showed that the concentration of GABAAα1 and GABAB1 receptors decreased significantly over time, whereas the concentration of mGlu2 receptors increased significantly over time in male neonatal rats born to streptozotocin-induced diabetic mothers. [ABSTRACT FROM AUTHOR]

Context: The Balance Error Scoring System (BESS), originally designed to diagnose and assess athletes with concussion syndrome, is now widely used to evaluate postural stability. To inteipret balance status, a normative database can be a reliable source. However, different anthropometric characteristics and sociocultural backgrounds across populations hinder the application of previously developed databases in different populations. Objective: The present study was designed to develop a normative data set for the general population of healthy Iranian adults according to their age groups and to study the correlation between BESS scores and the participants' sex, height, weight, and body mass index. Design: A cross-sectional study. Participants: A total of 1051 community-dwelling adults aged 20-69 years not suffering from balance disorders, dizziness, or other neurological or musculoskeletal diseases were recruited and stratified into 5 different age groups by decade. Main Outcome Measures: The BESS tests were composed of single-leg, double-leg, and tandem stances, each on a rigid surface and a foam pad. The individuals maintained each position for 20 seconds with eyes closed. The assessor recorded the total number of errors as the individuals' BESS score (range: 0-60). Results: Significant but weak correlations were found between BESS score and height (r = -.13, P<.001) and between BESS score and body mass index (r=.11, P<.001), and the difference between sexes in BESS score was statistically significant in the 50- to 59-year-old (P = .021) and 60- to 69-year-old (P<.001) groups. The BESS scores were significantly different between all age groups (P < .05), except between the 20- to 29-year-old and 30- to 39-year-old groups (P - 1.000) and between the 40- to 49-year-old and 50- to 59-year-old groups (P = .086). Conclusions: This study provided a normative database for different age groups of asymptomatic Iranian adults. The BESS score had weak correlations with height and body mass index and no correlation with weight, and significant differences were found between sexes in 50- to 69-year-old individuals. This study emphasizes the importance of obtaining specific normative data for different populations. [ABSTRACT FROM AUTHOR]

Background and Objectives: Ethical performance is essential for educational leaders, but the ethical decision-making (EDM) process is poorly understood in different contexts. Islamic countries, with a distinctive philosophy, require their theories of ethics. This study aims to explain a model of EDM based on the teachings of Sahifa Sajjadiyya, a collection of supplications and moral guidance by Imam Sajjad, the fourth Shia Imam. Methods: This study was conducted to examine the text of Sahifa Sajjadiyya and extract all the concepts related to the ethics of managers using conventional content analysis. To ensure the accuracy of the interpretation, the researchers consulted various commentaries on the text, such as Riyad-al-Salekin (in Arabic) and several Persian explanations. The consensus of researchers and external audits also verified the validity and reliability of the results. Results: The model derived from this study has three main categories that every manager should consider in every decision: Necessities, facilitating factors, and inhibiting factors of EDM. Each category has interrelated subcategories. Conclusion: According to the findings of this study, the central variable of this model is faith in God's absolute sovereignty as the basis for EDM. The influencing factors that can range from inhibition to facilitation include the manager's individual characteristics, organizational atmosphere, and community culture. These concepts can be used to design decision-making evaluation questionnaires for managers. [ABSTRACT FROM AUTHOR]

Background: Anomia is a language disorder that negatively affects communication abilities in people with aphasia (PWA). We aimed to compare the effect of transcranial direct current stimulation (tDCS) over the left and right inferior frontal gyrus (IFG) and superior temporal gyrus (STG) on the picture-naming accuracy and reaction time in PWA. Methods: A randomized, single-blind, sham-controlled crossover trial was conducted in 2021 at Mobasher Kashani Clinic, Hamadan, Iran. Sixteen patients received both five days of real-tDCS (1 mA for 20 minutes) and five days of sham-tDCS with a seven-day washout period in between. Using the Persian aphasia naming test, picture-naming accuracy and reaction time on 50 images were assessed at baseline, real-tDCS, and sham-tDCS stages. The data were analyzed using STATA software, version 11.0. P<0.05 was considered statistically significant. Results: Sixteen non-fluent PWA participated in the study. Of all patients, 64% benefited from tDCS over the STG and 18% over the IFG. The results showed that real-tDCS had a significant effect on the picture-naming accuracy (P=0.003) and the Persian-Western aphasia battery-one score (P=0.01), whereas sham-tDCS had no noticeable effects. Both the real- and sham-tDCS had no significant effect on the reaction time (P=0.28). Conclusion: Five sessions of individualized tDCS protocol (1 mA for 20 minutes) were adequate to improve picture-naming accuracy in patients with chronic aphasia. [ABSTRACT FROM AUTHOR]

Background and Aim: Tocilizumab is a monoclonal antibody against the Interleukin-6 (IL6) receptor, but its effect on improving the clinical condition of coronavirus disease of 2019 (COVID-19) patients is debated. Accordingly, this study investigated the impact of Tocilizumab as an alternative treatment on the outcomes of COVID-19 patients. Materials and Methods: In this retrospective case-control study, 300 COVID-19 patients in Afzalipour Hospital in Kerman, Iran, from November 2021 to January 2022 diagnosed by Real Time-PCR test with severe pneumonia were classified into two groups: 150 patients in the control group, treated with standard treatment, and 150 patients in the case group, that treated with intravenous Tocilizumab in addition to those treatments. Prognostic factors such as the hospitalization period, need for mechanical ventilation, and the patient's discharge condition were investigated. Results: Effect of Tocilizumab on outcomes of COVID-19 patients, like demanding mechanical ventilation, and length of hospitalization in the case group, despite the presence of poor biological symptoms such as severe lymphopenia in admission, show a significant difference in comparison to the control group. Tocilizumab does not affect the patient's discharge condition and the mortality rate. Conclusion: The results of this study showed that Tocilizumab, despite the lack of an apparent effect on the outcome of the COVID-19 disease (recovery or death), reduced length of hospitalization and the necessity for mechanical ventilation and can be used as an alternative therapy with other treatments. [ABSTRACT FROM AUTHOR]

Background and Aims. In recent years, various studies have been conducted worldwide to investigate the relationship between receiving the flu vaccine with acute cerebrovascular accident or stroke and its hospitalization in the elderly; however, the results of these studies are contradictory. Therefore, this study was aimed at investigating the relationship between receiving the flu vaccine with stroke and its hospitalization in the elderly. Methods. This study is a systematic review and meta-analysis of studies examining the relationship between receiving the flu vaccine with stroke and its hospitalization in the elderly during the years 1980 to 2021 which have been published in ISI Web of Science, Scopus PubMed, Cochrane, Science Direct, Google Scholar, and Embase. All analyses were performed by Stata 15, and the significance level in this study was considered <0.05. Results. In the systematic search, 3088 articles were retrieved, considering the study criteria; finally, 14 studies were included in the meta-analysis. Based on the results of the meta-analysis, the odds ratio (OR) of occurrence and hospitalization of stroke compared to the nonvaccinated group in vaccine recipients is equal to 0.84 (95% confidence interval (CI): 0.78-0.90, P value ≤ 0.001). Publication bias was not observed in this study (P value = 0.101). Conclusion. Getting the flu vaccine can reduce the risk of occurrence and hospitalization of stroke in the elderly by 16% (10%-22%). Therefore, receiving this vaccine as a preventive intervention for stroke in the elderly may be promising. [ABSTRACT FROM AUTHOR]

Background: The highly contagious SARS-COV-2 virus spread rapidly from China and formed a global pandemic. The virus has infected over 509 million people worldwide and killed about 6.32 million up to date. Up on invasion, the Receptor Binding Domain (RBD) of Spike protein plays a crucial role in the entry of the virus into the host cell. The virus N protein is another protein that has a critical role for genome packaging. Methods: As bioinformatics approaches, the cassette design, codon adaptation, and protein stability were investigated in this study. Synthetic genes of RBD and N were cloned separately in pET28a + expression vector. They were transferred into Escherichia coli ( E. coli) BL21 DE3 host cell, and expression of recombinant proteins was induced with IPTG. The recombinant proteins were purified by column chromatography and approved by Western blotting. Animal immunization was performed with each of the recombinant proteins individually and in combination of the two. The antibody titer of the blood serum from control and immunized mice groups was determined by ELISA technique. Finally, the anti-spike neutralization test was performed. Results: The expression and purification of RBD protein were monitored on SDSPAGE, two bands of about 28 and 45 kDa for RBD and N appeared on gel distinctly, which were further validated by Western blotting. According to ELISA results, related antibodies were traced to a dilution of 1/64000 in immunized sera. The neutralization test exhibited produced antibodies' potency to bind the virus proteins. Using SPSS software, statistical analysis was performed by Duncan's test and T-test. Conclusion: According to the present study, recombinant proteins, either RBD alone or in combination with N adequately stimulated the immune response, and the raised antibodies could neutralize the virus in in vitro test. [ABSTRACT FROM AUTHOR]

Background and Aim: The masking level difference (MLD) test is a behavioral test that assesses binaural interactions and central auditory processing. This study aims to design a binaural MLD (BMLD) test application using tonal and Speech Stimuli in Persian. Methods: In the first stage, the BMLD test application was designed in MATLAB software. Then, the spondaic words were recorded and added to the sound processing panel of the application. In the next stage, the MLD of tonal and speech stimuli was measured on 20 subjects aged 18-25 years. To examine the test-retest reliability of the application, all steps were repeated after one week. Results: The MLD values for tonal and speech stimuli under the SoNo-SpNo condition were significantly different from those under the SoNo-SoNp condition (p<0.05). These values for tonal and speech stimuli were 10.50 and 6.12 dB under the SoNo-SpNo condition, and 6.85 and 4.43 under the SoNo-SoNp condition. There was no significant difference in the MLD values between males and females. The intraclass correlation coefficient value for different phase conditions was more than 0.8, indicating the high reliability of the BMLD test application for tonal and speech stimuli in Persian (p<0.05). Conclusion: The designed BMLD test application using tonal and speech stimuli in Persian has similar results compared to the conventional methods of MLD test for other languages, therefore, this application can be used in audiology clinics in Iran to perform the MLD test. [ABSTRACT FROM AUTHOR]

Background: Effective measures to control COVID-19 should be based on an understanding of its epidemiological pattern and the evaluation of its prevalence in the community. This study aimed to examine the reproductive number (R) of COVID-19 and its trend in Fars Province in southern Iran. Methods: In this ecological study, the R trend was examined from July to November 2020. Data were collected from the daily reports of Shiraz University of Medical Sciences. R is the product of three components, namely the number of infection- producing contacts per unit time, the probability of transmission per contact, and the contagiousness period. Incidence and prevalence rates were used to calculate R. The R value was calculated in Microsoft Excel 2016. Results: The first and second peaks of COVID-19 were observed on July 6th and November 22nd, respectively. The median and mean of R were 1.42 and 1.41, respectively. The highest and lowest values of R were observed on October 20th (2.60) and September 1st (0.46), respectively. The values of R had a slightly decreasing trend in the second half of July and November than the first half. In the second half of August and September, an increasing trend was observed than the first half. There was not much change in the second half of October. Conclusion: The highest value of R was related to the dates when there was a higher probability of exposure to the virus, including public holidays and different occasions on which the probability of people's participation in ceremonies, communities, and gatherings was higher. [ABSTRACT FROM AUTHOR]

Background: The aim of this study was to investigate the association between thyroid cancer and 16C/A single nucleotide polymorphism (SNP) in C-C motif chemokine 22 (CCL22) as well as 1014C/T SNP in C-C chemokine receptor type 4 (CCR4). Method: In this case-control study, polymerase chain reaction restriction-fragment length polymorphism (PCR-RFLP) was performed for 113 thyroid cancer patients and 112 age-sex matched healthy controls to investigate the genotype distribution. Results: At position 16C/A in CCL22, 95 patients (84.3%) were found to have CC genotype, while 17 individuals (14.8%) inherited CA genotype and 1 (0.9%) had AA genotype. In the control group, 92 volunteers (82.1%) inherited CC genotype, 18 individuals (16.1%) had CA genotype, and 2 (1.8%) had AA genotype. The frequency of CC, CT, and TT genotypes of 1014C/T SNP in CCR4 gene was 60 (53.1%), 43 (38.1%), and 10 (8.8%) in the patients, and 57 (53.3%), 43 (40.2%), and 7 (6.5%) in the control group, respectively. There were no statistically significant differences between the patients and controls in terms of 16C/A polymorphism in CCL22 (P = 0.816) and 1014C/T SNP in CCR4 1014C/T gene position (P = 0.801). Nevertheless, the study of their association indicated that inheriting the CC genotype of CCR4 was significantly associated with higher stages (stages 3 and 4) in thyroid cancer. Conclusion: 1014C/T genetic variation in CCR4 and 16C/A polymorphism in CCL22 were not found to have a role in genetic susceptibility to thyroid cancer. Inheriting CC genotype at 1014 locus in CCR4 may; however, affect cancer progression in patients with thyroid cancer. [ABSTRACT FROM AUTHOR]

Background. Forward head posture (FHP) is a poor habitual posture of the head and neck. Because of the biomechanical relationship of body segments, posture of cervical spine may influence the posture of the pelvic and lower limb. The objective of this study was to compare the static posture of the trunk, pelvic and lower limb in the sagittal plane in subjects with FHP and without FHP. Methods. In this cross-sectional study, the static posture of 82 university students with the FHP (age: 23 ± 2) and 80 students without the FHP (age: 23 ± 2) has been analyzed with photogrammetry technique. Posture of the neck, trunk, pelvic and lower limb has been measured using craniovertebral angle, horizontal alignment of the pelvis, vertical alignment of the torso, and vertical and sagittal alignments of the body, lower limb angle, hip joint angle, ankle joint angle respectively. The inter- and intra-rater reliability of all postural and correlation of postural angles and the FHP was computed. Results. The ankle joint angle, vertical alignment of the torso, and vertical alignment of the body were different between two groups (p < 0.05). There were significant relationships between FHP severity and the ankle joint angle (r: - 0.17), vertical alignment of the torso (r: - 0.19), and vertical alignment of the body values (r: 0.16). Conclusions. The trunk and lower limb postures were different between groups of the subjects with and without the FHP. The evaluation of the truck and lower limb in subjects with the FHP may help the management of the FHP. [ABSTRACT FROM AUTHOR]

BACKGROUND: Inflammatory cytokines play roles in the pathogenesis of celiac disease. To introduce new diagnostic markers in patients with celiac disease for easy, fast, low cost, and non-invasive diagnosis, we evaluated the peripheral blood expression levels of interleukin-15 (IL-15), interleukin-17A (IL-17A), interleukin23A (IL-23A), granzyme B (GzmB), T-box transcription factor 21 (TBX21), and tumor necrosis factor alpha-induced protein 3 (TNFAIP3) of patients compared with the healthy controls, which were extracted from public databases organized in a protein-protein interaction network, in this group. METHODS: Peripheral blood mononuclear cells were collected from 30 patients with celiac disease and 30 healthy subjects. Total RNA was extracted, and mRNA expression levels of targeted genes were investigated by the quantitative realtime polymerase chain reaction (PCR) method. SPSS software was used for statistical analysis. Receiver operating characteristic (ROC) curve analysis was performed to characterize the diagnostic ability of the studied genes. RESULTS: The expression of IL-15, IL-17A, IL-23A, GzmB, TBX21, and TNFAIP3 genes in peripheral blood mononuclear cells of patients with celiac disease showed a significant increase compared with the control group. Among them, TNFAIP3, IL23A, and GzmB have better resolution and diagnostic value in differentiating patients with celiac disease from healthy controls. CONCLUSION: Our results suggest that TNFAIP3, IL23A, and GzmB could be useful and sensible markers in differentiating patients with celiac disease from healthy controls. However, the diagnostic relevance of other genes recognized by pathway analysis needs to be further investigated. [ABSTRACT FROM AUTHOR]

Although there is no doubt regarding the involvement of oxidative stress in the development of glioblastoma, many questions remained unanswered about signaling cascades that regulate the redox status. Given the importance of the substance P (SP)/neurokinin 1 receptor (NK1R) system in different cancers, it was of particular interest to evaluate whether the stimulation of this cascade in glioblastoma-derived U87 cells is associated with the induction of oxidative stress. Our results showed that SP-mediated activation of NK1R not only increased the intracellular levels of malondialdehyde (MDA) and reactive oxygen species (ROS) but also reduced the concentration of thiol in U87 cells. We also found that upon SP addition, there was a significant reduction in the cells' total antioxidant capacity (TAC), revealing that the SP/NK1R axis may be involved in the regulation of oxidative stress in glioblastoma cells. The significant role of SP/NK1R in triggering oxidative stress in glioblastoma has become more evident when we found that the abrogation of the axis using aprepitant reduced cell survival, probably through exerting antioxidant effects. The results showed that both MDA and ROS concentrations were significantly reduced in the presence of aprepitant, and the number of antioxidant components of the redox system increased. Overall, these findings suggest that aprepitant might exert its anticancer effect on U87 cells through shifting the balance of oxidant and antioxidant components of the redox system. [ABSTRACT FROM AUTHOR]

Gestational diabetes mellitus (GDM) is the most common medical complication of pregnancy. The current study aimed to investigate the possibility of a relationship between affective temperaments and GDM. This ethically approved cross-sectional study was conducted on 120 pregnant women with impaired glucose tolerance and 120 healthy pregnant women, all of whom were admitted to hospitals affiliated with Mashhad University of Medical Sciences for delivery during 2019. Depression Anxiety Stress Scale (DASS)-21 and Temperament Evaluation of Memphis, Pisa, Paris and San Diego-auto-questionnaire (TEMPS-A) were used to gather data. Mann–Whitney test was used to compare data between the two groups. A multivariate binary logistic regression model with maternal age, body mass index, and multiparity as the covariates was used to assess factors associated with GDM. Outcomes of TEMPS-A showed significantly higher scores of anxious and irritable temperaments in the GDM group compared to the control group (p = 0.014 and 0.023, respectively). Multivariate regression showed anxious temperament to be the sole independent predictor of GDM (odds ratio = 1.09, 95%confidence interval = 1.030–1.153; p = 0.003). DASS-21 anxiety score was also significantly higher among patients with GDM (p = 0.002). Severity of anxiety and stress according to DASS-21 was also significantly greater in patients with impaired glucose tolerance (p < 0.001 and p = 0.016, respectively). It is ostensible that affective temperaments, especially anxious temperament, are potentially associated with the development of GDM and impaired glucose metabolism during pregnancy. The association of affective temperaments with pregnancy complications has drawn compelling interest. The findings of this study showed significantly higher scores of anxious and irritable temperaments in GDM patients. GDM patients also showed significantly higher levels of anxiety compared to controls. Predominance of anxious temperament can be a potential risk factor that contributes to the development of GDM. Monitoring for GDM is especially recommended in pregnant women with predominant anxious and irritable temperaments. [ABSTRACT FROM AUTHOR]

Background/Aims: Cervical dysfunction is one of the common symptoms of chronic headaches. This study was conducted to assess the posture of the head, cervical and thoracic spine and the shoulder girdle in people with and without cervicogenic and migraine headaches. Methods: The postural angles of the head, cervical and thoracic spine and the shoulder girdle in frontal and sagittal planes, as well as thoracic spine curvature, were measured on 90 people who were split into three groups: 20 people with cervicogenic headache, 20 people with migraine and 50 people as the control group. Results: There were significant differences among the three groups in the craniovertebral angle, coronal head tilt angle and scapular upward rotation angle (P<0.05). There was no relationship between postural angles. Conclusions: The results of this study revealed that forward head posture was evident in people with cervicogenic and migraine headache. Decreased scapular upward rotation seen in the migraine headache group highlights the importance of shoulder girdle-related dysfunctions in people with chronic headaches. [ABSTRACT FROM AUTHOR]

Background. Celiac disease (CeD) is an autoimmune intestinal disorder caused by gluten protein consumption in genetically predisposed individuals. As biopsy sampling is an invasive procedure, finding novel noninvasive serological markers for screening of at-risk CeD population is a priority. Metabolomics is helpful in monitoring metabolite changes in body fluids and tissues. In the present study, we evaluated serum metabolite levels of CeD patients relative to healthy controls with the aim of introducing new biomarkers for population screening. Method. We compared the serum metabolic profile of CeD patients (n = 42) and healthy controls (n = 22) using NMR spectroscopy and multivariate analysis. Result. 25 metabolites were identified by serum metabolic profiling. Levels of 3-hydroxyisobutyric acid and isobutyrate showed significant differences in CeD patients' samples compared with healthy controls (p < 0.05). According to pathway analysis, our data demonstrated that changes in nine metabolic pathways were significantly disrupted/affected in patients with CeD. These enriched pathways are involved in aminoacyl-tRNA biosynthesis; primary bile acid biosynthesis; nitrogen metabolism; glutamine and glutamate metabolism; valine, leucine, and isoleucine biosynthesis and degradation; taurine and hypotaurine metabolism; glyoxylate and dicarboxylate metabolism; glycine, serine, and threonine metabolism; and arginine biosynthesis. Conclusion. In summary, our results demonstrated that changes in the serum level of 25 metabolites may be useful in distinguishing CeD patients from healthy controls, which have the potential to be considered candidate biomarkers of CeD. [ABSTRACT FROM AUTHOR]

Neonatal colic is a problem in many young infants. The dietary intakes of women during pregnancy may play an important role in maternal health and fetal development and also in the health of the baby's body system after birth. The aim of this study was to compare maternal food intake during pregnancy in infants with colic and in colic-free infants. We compared reports of food intake during pregnancy of 149 women whose infants had colic with 151 women whose infants did not have colic using a retrospective food frequency questionnaire. Few differences were found in maternal dietary intake of cheese, fish, and poultry during pregnancy (P <.001, P =.002, and P =.011, respectively). In addition, mothers of infants with colic reported eating fewer fruit and vegetables than controls during pregnancy (P =.005 and P <.001, respectively). There was no significant difference between the consumption of fast foods and beverages as well as the type of dairy products and the type of oil consumed by mothers in the 2 groups. Mothers should not blame their pregnancy diet for their infants' colic, but a healthy diet has proven effects on fetal health. [ABSTRACT FROM AUTHOR]

Background Occupational stress is one of the undesirable risk factors found in the midwifery profession. It can lead to job burnout, job loss and negatively affect the quality of patient care. This study aimed to estimate the prevalence of occupational stress among Iranian midwives. Methods Through searching national and international databases, a total of 11 observational studies with full texts were extracted. Observational studies in Persian or English that reported the prevalence or frequency of job stress among Iranian midwives were included in the analysis. Irrelevant studies, those conducted on midwifery students and gray literature were excluded. The metaanalysis was conducted using the random-effects model. Results 11 articles reviewed occupational stress in 1196 midwives (an average of 108 midwives per study). Analysis of the articles showed that the pooled prevalence of occupational stress was 70.82% in Iranian midwives. Meta-regression analysis showed that the prevalence of occupational stress was not related to mean age, work experience, articles' publication year or sample size. Conclusions The prevalence of occupational stress is high among Iranian midwives and it can have harmful consequences for them and their patients. Therefore, the training of stress coping strategies seems to be appropriate for this group. [ABSTRACT FROM AUTHOR]

Background: Infective endocarditis (IE), a severe and economically impactful condition, lacks substantial epidemiological data in the North Africa and Middle East (NAME) region. This study focused on analyzing the trends and burden of IE in NAME from 1990 to 2019, taking into account factors like age, gender, and socio-demographic index (SDI). Methods: The Global Burden of Disease data from 1990 to 2019 was retrieved from the Institute for Health Metrics and Evaluation (IHME) website. Results: Between 1990 and 2019, the age-standardized rates (ASR) for IE incidence increased by 59%, and prevalence and years lived with disability (YLDs) rose by 12% and 9%, respectively, while the ASRs for deaths, disability-adjusted life years (DALYs), and years of life lost (YLLs) saw reductions of 22%, 34%, and 34% in the NAME region. Death rates among children under five declined by 72%. Gender and the SDI did not significantly influence these changes. Saudi Arabia witnessed the most significant increase in ASR of IE incidence since 1990, while Turkey had the highest rates in 2019. The year 2019 also saw the highest death rate among those aged 70 and over, with over 91 000 DALYs from IE. DALYs decreased by 71.5% for children under five from 1990 to 2019 but remained stable for individuals in their seventies. Jordan showed the most notable decrease in ASRs for deaths, DALYs, and YLLs among children under five. Conclusion: This study highlights the changing epidemiology of IE in the NAME region, recommending the establishment of multidisciplinary IE registries, antibiotic prophylaxis guidelines for healthcare-associated IE, and strategies to control antimicrobial resistance as key mitigation measures. [ABSTRACT FROM AUTHOR]

Aim: In this study the significant differentially expressed genes (DEGs) related to gastric cancer (GC) and chronic gastritis were screened to introduce common and distinctive genes between the two diseases. Background: Diagnosis of gastric cancer as a mortal disease and chronic gastritis the stomach disorder which can be considered as risk factor of GCs required safe and effective molecular biomarkers. Methods: Microarray profiles were downloaded from Gene Expression Omnibus (GEO) and analyzed via GEO2R. The candidate DEGs plus relevant genes from STRING database were interacted by Cytoscape software version 3.6.0 the central nodes were determined and analyzed. Results: JUN, GAPDH, FOS, TP53, PRDM10, VEGFA, and CREB1 as central nodes and TFF1 and ERG1 as the top changed expressed genes were determined as critical nodes related to gastric cancer. GAPDH, PRDM10, TP53, JUN, AKT1, EGFR, MAPK1, EGF, DECR1, and MYC were identified as common remarkable genes between GC and chronic gastritis. Conclusion: Identification of distinctive and common genes between GC and chronic gastritis can be useful in the early stage detection of disease and reducing risk of GCs. [ABSTRACT FROM AUTHOR]

Objective: Recurrent events data is one of the most important types of survival data whose main feature is correlation between individual's observations. The aim of this study was to analyze the time to bipolar disorder (BD) relapse and determine the related factors using recurrent events models. Method: In this retrospective study, records of 104 BD patients with at least one relapse who were admitted for the first time (2001-2015) in Farabi hospital of Kermanshah were gathered to identify the factors influencing the time intervals between the recurrent survivals data using the Cox model with and without frailty (shared frailty), once with frailty gamma distribution and once with log-normal distribution frailty. All calculations were performed using R and SPSS software, versions 3.0.2 and 16 and the level of significance was considered at 0.05. Results: Among the employed models, Cox model with lognormal shared frailty showed better fit for BD recurrent survival data. According to results of Cox model with lognormal frailty, 2 factors (marital status and history of veteran) were identified to affect the time intervals between relapses. Conclusion: Because of the better fit of the models with the frailty effect on data, the correlation between the recurrent time intervals of each subject's relapse of BD was confirmed. Also, since the risk of subsequent relapses was less in married and veteran patients, marriage and emotional care supports can be considered as effective factors in reducing the risk of subsequent relapses of this disease. [ABSTRACT FROM AUTHOR]

Aim: The present study aimed at investigating the necessity of preoperative liver function tests (LFTs) in patients with uncomplicated gallstone disease before laparoscopic cholecystectomy. Background: Significant relationship between common bile duct (CBD) stones and acute cholecystitis is reported. There are contradictory reports about the effect of CBD stones on liver function tests in patients (LFTs). Methods: In the current study, patients with symptomatic cholelithiasis who referred to hospitals during January 2015 and May 2016 were enrolled. Routine tests and ultrasonography were performed on all patients before surgery. Data were presented as means ± SD and qualitative variables as frequency (percentage) were considered. Statistical analyzes were performed with SPSS software. Results: A consecutive series of 270 patients (58 males and 212 females) who referred for laparoscopic cholecystectomy were enrolled in this retrospective study. Pre- operative LFTs were normal in 249 patients (85%) and abnormal LFT was detected in 41 patients (15 %). Conclusion: This study showed that 15 % of patients with cholelithiasis without dilated CBD had impaired LFTs. Routine LFTs in preoperative evaluation of symptomatic cholelithiasis usually reveals normal findings and is not helpful in uncomplicated cholelithiasis. [ABSTRACT FROM AUTHOR]

Background: Nurses play a key role in providing patient safety. It is known that patient safety requires the improvement of patient safety culture, which can be a difficult process. One of the current challenges of hospitals is to explore the ways to improve patient safety culture. Organizational citizenship behaviors are one of the factors, which can develop organizational culture including safety culture; however, its role is not well established. Methods: In this cross-sectional study, a stratified random sample of 214 nurses was selected from a largest teaching hospital in west of Iran. The institutional research board approved the study protocol. Data were collected using three self-report questionnaires: demographic information; hospital survey on patient safety culture (HSPSC); and organizational citizenship behaviors questionnaire. Data were analyzed using Spearman's correlation coefficient test in SPSS (α < 0.05). Results: Organizational citizenship behaviors were found to be at an intermediate level (56.84 ± 16.22). However, some of its dimensions, including sportsmanship, civic virtue, and courtesy, were at weak levels (< 50%). The mean percentage of positive responses to the patient safety culture was 49.00 ± 14.01. The patient safety culture had significant positive correlations with organizational citizenship behaviors (r = 0.349, P = 0.001) and dimensions of altruism (r = 0.255, P = 0.001), civic virtue (r = 0.434, P = 0.001), and courtesy (r = 0.214, P = 0.001). Conclusion: Our findings proposed the hypothesis that OCB has a statistical significant impact on PSC. Low levels of civic virtue, sportsmanship and courtesy behaviors may be indicative low nurses' interest in participating in organizational affairs and nurses' low attention to measures that prevent harm to their organization. It is recommended that nursing managers focus more on these dimensions, identifying influintioal factors and taking appropriate management measures to promote these behaviors. If our findings are confirmed in future studies, nursing managers can consider the development of organizational citizenship behaviors as one of the managerial approaches for promoting a patient safety culture. [ABSTRACT FROM AUTHOR]

Purpose: To examine the validity and reliability of the Persian versions of the Bad Sobernheim Stress Questionnaire-Deformity/Brace in adolescent idiopathic scoliosis. Materials/methods: Persian forward/backward translation of the Bad Sobernheim Stress Questionnaire-Deformity/Brace was produced, and all stages for a cross-cultural adaptation process were carried out based on the International Quality of Life Assessment guidelines. The measurements of internal consistency and test–retest reliability were assessed by Cronbach's α and intraclass correlation coefficient (ICC), respectively. The Spearman correlation coefficient was used to analyse the concurrent validity by comparison with the Scoliosis Research Society-22r questionnaire. Results: A total of 53 scoliosis patients (age 13.47 ± 1.78 years, Cobb angle 27.66 ± 11.77°) was included. The Bad Sobernheim Stress Questionnaire-Deformity/Brace presented acceptable internal consistency (Cronbach's α for both: 0.72) and ICCs (0.97 and 0.88, respectively). The Bad Sobernheim Stress Questionnaire-Deformity showed no significant correlation with the Scoliosis Research Society-22r, while the Bad Sobernheim Stress Questionnaire-Brace showed a significant correlation with the Scoliosis Research Society-22r total score, function/activity, self-image, and mental health dimensions (p < 0.01). Conclusions: The Persian Bad Sobernheim Stress Questionnaire-Brace validly and reliably measures brace-related stress in AIS patients undergoing brace treatment. The cross-cultural adaptation of the Persian version of the Bad Sobernheim Stress Questionnaire was performed. The Persian-Bad Sobernheim Stress Questionnaire has satisfactory internal consistency, test–retest reliability, and concurrent validity in adolescents with idiopathic scoliosis. The Persian version of the Bad Sobernheim Stress Questionnaire is suitable for clinical investigations. [ABSTRACT FROM AUTHOR]

This study aimed to evaluate the effectiveness of a PLISSIT model sexual counseling to promote sexual function of women with spinal cord injury. In this randomized clinical trial the participants included a total number of 44 women with spinal cord injury randomly assigned to intervention and control groups using random blocking. The intervention group received the PLISSIT sexual counseling in three sessions weekly, and the control group received the routine consultation of the center. Female Sexual Functions of participants were assessed using women's Sexual Function Index questionnaires at three times. Two-way repeated measures ANOVA was used to compare the sexual function at different times. The results of the data analysis showed that the mean score of sexual function of the intervention group was significantly increased from the baseline (15.99 ± 8.48) compared with 4 weeks after intervention (21.57 ± 5.58) and 8 weeks after that (21.75 ± 4.3) (p = 0.000). The mean score of all domains of sexual function including; sexual desire (p = 0.000), arousal (p = 0.000), lubrication (p = 0.003), orgasm (p = 0.001), sexual satisfaction (p = 0.000) and pain (p = 0.048) of the participants of intervention group was increased significantly. Sexual counseling using PLISSIT model is effective in improving sexual function of women with spinal cord injury, and could be used to promote the sexual health of these women. [ABSTRACT FROM AUTHOR]

Aim: Gene assessment of pancreatic adenocarcinoma disease via protein-protein interaction (PPI) Network Analysis. Background: Diagnosis, especially early detection of pancreatic adenocarcinoma as a lethal disease implies more investigation. PPI Network Analysis is a suitable tool to discover new aspects of molecular mechanism of diseases. Methods: In the present study the related genes to pancreatic adenocarcinoma are studied in the interactome unit and the key genes are highlighted. The significant clusters were introduced by Cluster-ONE application of Cytoscape software 3.4.0. The genes are retrieved from STRING date base and analyzed by Cytoscape software. The crucial genes based on analysis of central parameters were determined and enriched by ClueGO v2.3.5 via gene ontology. Results: The number of 24 key genes among 794 initial genes were highlighted as crucial nodes in relationship with pancreatic adenocarcinoma. All of the key genes were organized in a cluster including 216 nodes. The main related pathways and cancer diseases were determined. Conclusion: It was concluded that the introduced 24 genes are possible biomarker panel of pancreatic adenocarcinoma. [ABSTRACT FROM AUTHOR]

The study aimed to predict the happiness of adolescents based on coping styles and religious attitudes. To this end, the correlational research methodology was used. In total, 381 subjects were selected from adolescents of Semnan (Eastern province of Iran), using multistage clustering sampling method. Research tools were Ways of Coping Questionnaire by Lazarus, Golriz and Barahani's Religious Attitude Questionnaire, and Oxford Happiness Questionnaire. Data analysis was performed in SPSS using Pearson's correlation coefficient and multiple regression analysis. Results of Pearson's correlation demonstrated a significant positive relationship between happiness of adolescents and variables of problem-focused coping styles (r = 0.31, P < 0.01) and religious attitudes (r = 0.129, P < 0.05). Meanwhile, a negative significant association was observed between emotion-focused coping styles and happiness (r = −0.184, P < 0.01). Moreover, results of multiple regression analysis indicated that the listed variables explained 17% of the variance of happiness in totality. According to the results, it is recommended that use of problem-focused styles be emphasized in addition to strengthening of religious attitudes to increase the happiness of adolescents. [ABSTRACT FROM AUTHOR]

Background/Aims: Caring for children with cerebral palsy may affect different domains in the caregiver's life. This study aimed to compare the occupational performance of mothers of a child who has cerebral palsy with mothers of a typically developing child. Methods: A total of 41 mothers with a child who has cerebral palsy and 45 mothers with a typically developing child were recruited in this cross-sectional study. The age-matched mothers had only one child. The Canadian Occupational Performance Measure was used to collect data on the occupational performance and satisfaction of mothers. Findings: There was a statistically significant between-group difference in maternal occupational performance and occupational satisfaction (P<0.05), with mothers of children with cerebral palsy reporting lower scores for both. There were no relationships between demographic variables and the occupational performance and satisfaction of mothers with a child with cerebral palsy (P>0.05). The age of children with cerebral palsy had a direct positive relationship with the mothers' level of occupational satisfaction (P<0.05). Conclusion: Mothers who take care of a child with cerebral palsy face significant reductions in occupational performance and satisfaction compared to mothers with a typically developing child, and therefore may need help and education in performing and organising their daily activities and roles. [ABSTRACT FROM AUTHOR]

Aim: To assess the prevalence of health‐promoting behaviours (HPBs) and their associations with some occupational factors among nurses. Background: Health‐promoting behaviours are significant indicators of health status. Nurses’ HPBs may have a direct impact on patients’ care and safety. Methods: A descriptive, questionnaire design was conducted among nursing staff (n = 136) in a district hospital in Iran during 2015. Data was collected using a two‐part questionnaire, which included the Health Promoting Lifestyle Profile II. Data was analysed using the Pearson correlation coefficient, and independent t and ANOVA tests (α = .05). Results: The stress‐management and physical activity dimensions had the lowest mean score and health responsibility had the highest. The HPBs of nurses with rotating/irregular shifts, contract employment, and low income were significantly lower. Conclusions: Nurses’ HPBs should be promoted in the stress management and physical activity dimensions. In this regard, contract nurses, shift nurses, and low‐income nurses are the priorities. Implications for Nursing Management: Nurse managers should give more attention to promote nurses’ HPBs especially in the areas of stress management and physical activity through implementation of healthy lifestyle programs. Nursing policy makers should give attention to permanent recruitment and improving salary as a strategy to improve nurses’ HPBs. [ABSTRACT FROM AUTHOR]

Aim: This study aimed to summarize the available information in the literature to make an accurate estimate of the prevalence of burnout among Iranian nurses. Background and introduction: Burnout is a work‐related stress syndrome that has negative impact on healthcare providers, patients and healthcare delivery systems. Method: A comprehensive search of literature using international [PubMed, Scopus and the Institute for Scientific Information (ISI)] and Iranian scientific data bases [Scientific Information Database (SID), IranMedex and Magiran] was conducted to identify English and Persian language studies, published between 2000 and 2016, that examined the prevalence of burnout among nurses in Iran. The I‐squared test and Chi‐squared‐based Q‐test suggested heterogeneity of reported prevalence among the qualified studies; thus, a random‐effects model was applied to estimate the overall prevalence of burnout among nurses in Iran. Results: Based on 21 selected articles with 4180 participants, the overall prevalence of burnout among Iranian nurses was estimated to be 36% [95% confidence interval (CI), 20–53%] in Iran. Meta‐regression indicated that sample size and year of data collection, mean age of samples, female to male ratio and geographic regions were not statistically significantly associated with the prevalence of burnout. Also, based on Egger's test and funnel plot, there is no publication bias among studies included in the analysis. Conclusion: Professional burnout affects more than one‐third of nursing staff in Iran; thus, effective interventions and strategies are required to reduce and prevent burnout among nurses. Implication for nursing and health policy: Due to the negative consequences of burnout on patients, nurses and organizations, nursing and healthcare managers should intervene to prevent and reduce burnout among nurses in Iran. Policy attention should focus on developing effective interventions to prevent and minimize the burden of burnout among nurses in Iran. Nurses’ involvement in the policy‐making process is crucial in the implementation of effective programs and initiatives tailored to address the higher prevalence of burnout among Iranian nurses. [ABSTRACT FROM AUTHOR]

Background: Poor competence in clinical examination skills among nurses has been reported in practice, and there is a strong consensus that physical examination (PE) education must be improved. However, deficiencies cannot be resolved by theoretical training alone, and new training approaches are required to enable nursing students to perform PE accurately. This study aimed to determine and compare the effect of two new educational methods (mentorship and educational video methods) on the physical examination skills of Iranian nursing students. Methods: This study was a clinical audit with three group pretest posttest design. Eligible nursing students were recruited through the census method and assigned to three groups (mentorship, educational videos, and control group) using permuted block randomization. Students were taught PE skills in three vital systems through three approaches (mentors, educational videos, and routine educational methods). Data were collected using a two-part instrument consisting of a demographic information questionnaire and a 32-item checklist for assessing the students' skills in examining the respiratory system (10 items), cardiovascular system (13 items), and 12 cranial nerves (9 items). Data were analyzed using SPSS software version 16 and descriptive and analytical statistical tests. Results: At baseline, students in all groups scored less than half of the possible scores in all three systems, and the mean scores of the three groups were not statistically different (P > 0.05). After the intervention, the mean scores of students in the mentorship group increased significantly in all three systems (P < 0.001), whereas the mean scores of students in the educational video group and the control group did not change significantly (P > 0.05). Furthermore, after the intervention, the mean scores of the educational video group and the control group did not significantly differ in any of the three systems (P > 0.05). The ANCOVA showed that with posttest score as the covariate, PE skills in all three systems improved one week after the intervention in the mentor group compared to the control group and the educational video group. However, PE skills in all three systems did not improve one week after the intervention in the educational video group compared to the control group. Conclusions: The mentorship method is more effective than the educational video and routine methods for teaching PE skills to nursing students. Nursing schools can use the mentor method in training nursing students, and it is recommended to revise the PE lesson unit in the nursing curriculum and exchange it from a purely theoretical-based unit to a mixture of theoretical and clinical-based training. Educational videos alone cannot improve nursing students' PE skills; thus, if educational videos are used to teach clinical skills, it is necessary to hold hands-on sessions to provide feedback to students and correct their mistakes. [ABSTRACT FROM AUTHOR]

Background: Many studies have assessed the effect of music on driving. However, their results are very scattered and contradictory. Therefore, this systematic review is conducted to determine the effect of music on driving performance and drivers' physiological and psychological indicators. Methods: Scopus, PubMed, and Web of Science databases were searched until July 2023. A manual search in Google Scholar for gray literature was conducted. The Simulation Research Rubric (SRR) tool was used to assess the reporting quality of the studies. Stata software (StataCorp, version 16) was used to perform a meta-analysis. Results: A total of 2650 records were identified. The findings of 19 studies were analyzed. Most of them were carried out in high-income countries (HICs) using simulators. The most frequently used music style was classic rock. The meta-analysis results indicated that music with high and medium volume increases the average driving speed, and music with low volume decreases it. Although music in every mood reduces the average reaction time, it positively reduces response delay and increases coherence. Music with high volume decreases the heart rate, but music with medium and low volume increases it. Listening to music increases the level of arousal and mental load. Conclusion: It was concluded that, in some indicators, listening to music has adverse effects on driving. However, in many indicators, music has a positive impact on improving driving safety. It is better to choose appropriate music for different driving conditions and to train the drivers about it. [ABSTRACT FROM AUTHOR]

Background: Liver cancer is a highly lethal cancer with 5 year survival rate of about 18%. This cancer is a leading cause of death in many countries. As there is not a comprehensive population base study on liver cancer mortality rates by cause in national and provincial level in Iran. We aimed to estimate the liver cancer mortality rate, its patterns, and temporal trends during 26 years by sex, age, geographical distribution, and cause. Methods: We used the Iranian death registration system (DRS), in addition to demographic and statistical methods, to address the incompleteness and misclassification and uncertainty of death registration system to estimate annual liver cancer mortality rate. Direct age standardized approach was applied using Iran national population 2015 as a standard population to facilitate the comparison between the provinces. Results: Liver cancer age standardized mortality rate in Iran increased by more than four times from 1.18 (95% uncertainty interval; 0.86 to 1.61) deaths per 100,000 person in 1990 to 5.66 (95% uncertainty interval; 4.20 to 7.63) deaths per 100,000 person in 2015. Male to female age adjusted mortality ratio changed from 0.87 to 1.82 during the 26 years of the study. With increasing age, liver cancer mortality rate increased in both sex and all provinces. At provincial level, the province with highest mortality rate have 2.96 times greater rate compare to the lowest. Generally, about 71% of mortality at national level is due to hepatitis B and C infection. Conclusions: In order to reduce liver cancer mortality rate, it is recommended to control main risk factors including chronic hepatitis infections. Because of the growing rate of mortality from liver cancer, augmenting life expectancy, and increasing number of the elderly in Iran, policy makers are more expected to adopt measures including hepatitis B vaccination or hepatitis C treatment. [ABSTRACT FROM AUTHOR]

Background: With the increasing number of elderly, especially in recent decades, transfer to nursing homes and the number of centers has also increased but experiences and problems of elders in these centers is less considered. So, the goal of this study is to explore the Elderly peoples’ experiences of nursing homes. Methods: The current research was performed using a phenomenological approach in 2016. Participation in the study is comprised of the elderly residents in a nursing home in Bam city who were selected based on an objective-oriented approach. The sampling was done until data saturation. Data collection methods were observation and an unstructured and in-depth interview. Data were analyzed using seven-stage Colaizzi process. Results: In total, fifteen 68 - 82 years old people participated in our study and 52 primary and conceptual codes that were eventually categorized in five main themes (sense of rejection, sense of daily routine, impaired of communications, sense of hardship and mental obsession) and ten sub-themes emerged. Conclusion: Overall, most of the elders were not satisfied with the conditions. It seems that helpful, community and family education to acculturate respect for the elderly in the community, teach proper coping strategies, use the elderly’s experiences, and consultation with them could be a way to maintain a sense of usefulness, independence and to prevent them from sensing monotonous and routine rhythm of life. [ABSTRACT FROM AUTHOR]

Background andAim. Depression is the most common psychological disorder in hemodialysis patientswhich decreases their quality of life and increases the mortality. This study was conducted to assess the effect of regular exercise on depression in hemodialysis patients. Methods. In a randomized clinical trial, 51 hemodialysis patients were allocated in two groups. Beck Depression Inventory (BDI) scale was used to assessing depression rate in participants. Designed program was educated using poster and face-to-face methods for case group. Intervention was carried out three times a week for ten weeks. At the beginning and the end of the study, depression rate of the subjectswas assessed. Datawas analyzed by SPSS16 software and descriptive and inferential statistics. Findings. According to the results of this study, there were no differences between case and control groups in depression rate at the beginning of the study, but there was significant difference after intervention (P = 0.016). In the beginning of the study, the mean and SD of depression in case group were 23.8 ± 9.29 and reduced to 11.07 ± 12.64 at the end (P < 0.001). Conclusion. The regular exercise program could reduce the depression in hemodialysis patients; therefore it is suggested for training this program for hemodialysis patients. This trial is registered with Iranian Registry of Clinical Trial (IRCT) number IRCT201205159763N1. [ABSTRACT FROM AUTHOR]

Introduction: Species of Candida, Trichomonas vaginalis and different bacteria such as Gardnerella vaginalis are the most important causes of vaginitis. This study aimed to investigate the frequency of bacterial vaginosis and vaginal candidiasis in women presenting to healthcare centers in Hamadan city, west of Iran. Material and Methods: The cross-sectional study recruited 862 women presenting to healthcare centers of Hamadan. During vaginal examination, the posterior vaginal fornix and vaginal wall were sampled by two sterile cotton swabs. One swab sample was placed in a tube containing Ringer serum for wet mount preparation to search for yeasts, mycelium and clue cells. The other swab sample was used for preparing Gram-stained vaginal smear. Candidiasis was diagnosed by observing pseudohyphae and blastospores. Bacterial agents were diagnosed by observing clue cells, and according to Hay-Ison criteria. The data were analyzed by Chi-square test in SPSS (version 16). Results: Vaginitis caused by bacterial agents and Candida species was identified in 104 (12.1%) and 73 (8.5%) of the 862 participants, respectively. Vaginitis was not significantly related with age, marital status, occupation, husband’s occupation. However, a statistically significant difference was reported between education and bacterial vaginitis (P=0.01). Conclusion: A significant relationship was observed between education and bacterial vaginosis; therefore, enhancing knowledge can play a key role in the prevention of women’s sexually transmitted diseases. [ABSTRACT FROM AUTHOR]

Background: Neonate with abnormal weight is at risk of increased mortality and morbidity. Many factors affect pregnancy outcome. Because of the importance and vital role in birth weight, in this study, some of the factors associated with birth weight in a sample of Iranians neonates were investigated. Materials and Methods: In this cross-sectional study, 245 newborns in a sample of Iranians neonates in the year 2013 were selected, and characteristics of neonate and their mothers were derived. Birth weights were registered by the neonatal scale. To identify the direct and indirect factors affecting birth weight, we used path analysis (PA) and IBM AMOS and SPSS software. Results: The mean ± standard deviation of weight in girls (3200 ± 421) g less than boys (3310 ± 444) g significantly (P = 0.04). Gestational age (P < 0.001), birth rank (P = 0.012), distance from a previous pregnancy (P = 0.028), and mother weight (P = 0.04) had a statistical significant relationship with birth weight. In the final PA model, gestational age has a highest total effect, type of delivery with gestational age-mediated had the highest indirect effect and type of delivery, and gestational age had the greatest total impact on the birth weight. Conclusion: Gestational age, sex, distance from a previous pregnancy, maternal weight, type of delivery, number of abortion, and birth rank were related with birth weight. Due to the termination of pregnancy and avoid unnecessary deliveries through cesarean section and other related factors should be further consideration by childbirth experts. In addition, factors affecting these variables are carefully identified and prevented as much as possible. [ABSTRACT FROM AUTHOR]

Background: The transcription factor 7-like 2 gene (TCF7L2) is an element of the Wnt signaling pathway. There is lack of evidence if TCF7L2 has a functional role in lipid metabolism and regulation of the components constitutes the metabolic syndrome (MetSyn). The aims of this study were to evaluate whether the risk allele of TCF7L2 gene polymorphism is associated with dyslipidemia and MetSyn. Materials and Methods: The MetSyn subjects were participated only based on the National Cholesterol Education Program - Third Adult Treatment Panel criteria. In this case-control study, the DNA from MetSyn patients without (n = 90) and with type 2 diabetes (T2D) (n = 94) were genotyped. Results: The results show that the genotype-phenotype for CC, CT/TT of TCF7L2 gene polymorphism correlated with body mass index and waist circumference in MetSyn and MetSyn + T2D subjects (r = -0.949 and r = -0.963, respectively). The subjects that only possess MetSyn but are not diabetics show the 2 h postprandial glucose and fasting blood glucose, glycated hemoglobin significantly lower (P < 0.05) than those subjects have both abnormality. The level of triglyceride in CT/TT carriers in MetSyn was higher than CC carriers (P = 0.025). A comparison with the controls subjects, the frequencies of the T allele in the groups of MetSyn (46.66%) and MetSyn + T2D (47.34%) show significantly different (P < 0.05). The odds ratios for T allele in (MetSyn)/(normal), (MetSyn + T2D)/(normal), and in (MetSyn + T2D)/(MetSyn) were 3.59 (95% confidence interval [CI], 1.33-9.67, P = 0.0093), 3.76 (95% CI, 1.40-10.07, P = 0.0068), and 1.08 (95% CI: 0.55-2.11, P = 0.834), respectively. Conclusion: The results revealed the important insights essential for the role of T CF7L2 that the T allele of T CF7L2 plays a significant role in the susceptibility to dyslipidemia, MetSyn, and T2D. [ABSTRACT FROM AUTHOR]

Background: Many women experience sexual dysfunction following childbirth but this has not been well investigated in Iran. The aim of this study was to evaluate women's sexual function in the postpartum period in Iran. It also sought to determine predicting factors associated with their sexual function. Methods: This was a cross-sectional study among 380 postpartum women attending 10 urban health centers in Ilam province in southwestern Iran. Participants were selected using random cluster sampling. Data was collected using the female sexual function index (FSFI) and a checklist of socio-demographic and maternal status for each of the women. Sexual dysfunction was classified according to an FSFI score of ≤ 28. Data were analysed using SPSS version 22. Results: The majority of participants (76.3%) had sexual dysfunction. Primiparity (adjusted odds ratio (aOR): 1.78 (95% Confidence Interval (CI): 1.11, 2.94); P = 0.006) and exclusive breastfeeding (aOR: 2.47 (95% CI: 1.21, 5.03); P = 0.012) were associated with increased odds of experiencing sexual dysfunction in the postpartum period. Other factors such as age, type of delivery, education, time since delivery and family income did not predict women's postpartum sexual function. Conclusion: This study confirmed findings of previous studies on factors that may have an adverse effect on new mothers' sexual function in the postpartum period. However the effect of type of delivery on postpartum sexual function remains unclear. [ABSTRACT FROM AUTHOR]

Aims: In general, nurses who work in department of psychiatric are in fact interacting with emotional disorders of patients once providing their care services. higher levels of job motivation and satisfaction can markedly foster service improvement. The aim of this study was to evaluate the correlation between anger and job motivation in nurses of a psychiatric hospital. Instrument & Methods: In this cross-sectional descriptive research in 2014, all 50 psychiatry nurses working at Kargarnejad Hospital of Kashan City, Iran, were entirely studied. A demographical questionnaire, the Anger Multiple Scale and the Job Motivation Scale were used for data gathering. Data were analyzed by SPSS 19 software using Pearson correlation coefficient. Findings: The mean score of anger was 3.01±0.36 and of job motivation was 1.70±0.86. There was a significant relationship between job motivation and the number of family members and conditions of employment of nurses (p=0.001). There was a significant inverse relationship between scores of anger and job motivation of psychiatry nurses of the hospital (r=-0.712; p=0.001). Conclusion: There is a relationship between anger and job motivation in nurses of Kashan Psychiatric hospital. [ABSTRACT FROM AUTHOR]

Context: The research on the change in properties of the lower leg muscles by different intensity sinusoidal vertical whole-body vibration ( SV - WBV ) exposures has not yet been investigated. Objective: The purpose of this study was to determine effect of a 20-minute different intensity SV-WBV application to the ankle plantar flexor and dorsiflexor muscles properties and hamstring flexibility. Design: Prospective preintervention -postintervention design. Setting: Physiotherapy department. Participants: A total of 50 recreationally active collegeaged individuals with no history of a lower leg injury volunteered. Interventions: The SV-WBV was applied throughout the session with an amplitude of 2 to 4 mm and a frequency of 25 Hz in moderate-intensity vibration group and 40 Hz in a vigorousintensity vibration group . Main Outcome Measures : The gastrocnemius and tibialis anterior muscle tone was assessed with MyotonPRO, and the strength evaluation was made on the same lower leg muscles using hand-held dynamometer. The sit and reach test was used for the lower leg flexibility evaluation. Results: The gastrocnemius muscle tone decreased on the right side (d = 0.643, P = .01) and increased on the left (d= 0.593, P = .04) when vigorous-intensity vibration was applied. Bilateral gastrocnemius muscle strength did not change in both groups (P >.05). Without differences between groups, bilateral tibialis anterior muscle strength increased in both groups (P < .01). B ilateral gastrocnemius and tibialis anterior muscle tone did not change in the moderate-intensity vibration group (P> .05). Flexibility increased in both groups (P < . 01 ); however, there was no statistically significant difference between the groups ( d = 0 . 169, P = . 55 ). Conclusions: According to study results, if SV-WBV is to be used in hamstring flexibility or ankle dorsiflexor muscle strengthening, both vibration exposures should be preferred. Different vibration programs could be proposed to increase ankle plantar Rexor muscle strength in the acute results. Vigorous-intensity vibration exposure is effective in altering ankle plantar flexor muscle tone, but it is important to be aware of the differences between the lower legs. [ABSTRACT FROM AUTHOR]

Background: Human adenoviruses are 1 of the most common and serious etiologic agents of acute gastroenteritis in children worldwide, especially in developing countries. Methods: In this cross-sectional epidemiology survey, the specimens of 100 stools were collected from children with acute gastroenteritis from June 2008 to July 2009. Polymerase chain reaction (PCR) method was performed with specific primers for detection of F adenoviruses. Results: F adenoviruses (Ad40 and Ad41) were detected in 8% of patients with diarrhea. There was a significant statistical relationship between the age, nutrition variables, and adenovirus infection (P < 0.05). No significant relationship was found between individual variables and the existence of the adenovirus infection. Conclusion: The results of this survey and other studies in different parts of the world show that adenovirus is 1 of the main factors causing acute gastroenteritis in infants and children in developing countries. [ABSTRACT FROM AUTHOR]

Introduction: Hospitals are the most expensive health services provider in the world. Therefore, the evaluation of their performance can be used to reduce costs. The aim of this study was to determine the efficiency of the hospitals at the Kurdistan University of Medical Sciences using stochastic frontier analysis (SFA). Methods: This was a cross-sectional and retrospective study that assessed the performance of Kurdistan teaching hospitals (n = 12) between 2007 and 2013. The Stochastic Frontier Analysis method was used to achieve this aim. The numbers of active beds, nurses, physicians, and other staff members were considered as input variables, while the inpatient admission was considered as the output. The data were analyzed using Frontier 4.1 software. Results: The mean technical efficiency of the hospitals we studied was 0.67. The results of the Cobb-Douglas production function showed that the maximum elasticity was related to the active beds and the elasticity of nurses was negative. Also, the return to scale was increasing. Conclusion: The results of this study indicated that the performances of the hospitals were not appropriate in terms of technical efficiency. In addition, there was a capacity enhancement of the output of the hospitals, compared with the most efficient hospitals studied, of about33%. It is suggested that the effect of various factors, such as the quality of health care and the patients' satisfaction, be considered in the future studies to assess hospitals' performances. [ABSTRACT FROM AUTHOR]

Aim: Determining critical dysregulated proteins in liver cancer was the main aim of this study. Background: Liver cancer is a common health problem characterized by difficulties in early diagnosis and rapid progression. Due to the lack of targeted drugs and the other features of the disease, the survival rate for patients is extremely low. Methods: The related dysregulated proteins for liver cancer were retrieved from the STRING database. The queried proteins were included in a network by Cytoscape software, and the central nodes of the network were enriched via gene ontology. Results: Among 11 introduced central nodes (GAPDH, TP53, EGFR, MYC, INS, ALB, IL6, AKT1, VEGFA, CDH1, and HRAS), HRAS and AKT1 were highlighted as critical dysregulated proteins which can be considered as possible biomarkers. Conclusion: Analysis revealed that AKT1, HRAS and the related biochemical pathways (especially "HIF-1 signaling pathway") are the possible diagnostic and therapeutic agents of liver cancer. [ABSTRACT FROM AUTHOR]

Background: Fractionated carbon dioxide (CO2) can treat hypopigmented scars. Latanoprost is a prostaglandin analog used to treat glaucoma. It can cause adverse effects, such as periocular hyperpigmentation. The aim of this study was to assess the eficacy and safety of latanoprost plus CO2 laser on the repigmentation of hypopigmented scars. Patients and Methods: 28 patients with hypopigmented scars were divided randomly into two groups. The patients in group A were treated in six sessions (1-month intervals) with 10600-nm fractional CO2 laser plus latanoprost 0.005% and those of group B fractionated CO2 laser plus placebo (distilled water). Digital photographs were taken at baseline and 3 months after the last treatment session. The blinded dermatologist compared the photographs and evaluated the eficacy of treatment in the hypopigmented scars using a 4-scale point (grade 1-4). Patient satisfaction was scored from 0 to 10 on a visual analog scale. Results: Follow-up results 12 weeks after the last treatment session demonstrated that 11 of the 14 patients in group A had more than 50% improvement in hypopigmentation The difference in improvement of the two groups was statistically signiicant (P = 0.027). The mean of the VAS scores of patients in group A was 6.50 ± 1.45 and in group B 4.57 ± 1.6. The difference in mean satisfaction of the two groups was statistically signiicant (P = 0.003). Side effects were mild and resolved within 1 to 5 days. Conclusion: The fractional CO2 laser resurfacing plus topical latanoprost can be used as a safe and eficacious method to treat hypopigmented scars. [ABSTRACT FROM AUTHOR]

Background: To date, few results on well-being in individuals with neurological disease have been published, while several studies in other groups have indicated that well-being may not be the only absence of psychological distress, but also positive psychological function. The aim of the present study was to compare the psychological well-being (PWB) between the people with Multiple sclerosis (MS) and normal individuals and identify correlated demographic factors to PWB in people with MS disorder. Materials and Methods: A case-control study was performed in July 2012 on 55 people with MS who were referred to MS clinic (located at the Kashani Hospital), Isfahan Neurosciences Research Centre and 83 normal individuals with matched mean of age, level of education, and gender. The participants filled up the 18-item Ryff's PWB and demographic profile. The data were analyzed by SPSS software based on the independent i-test, and ANOVA. Results: There is significant different in all PWB dimensions between people with MS and normal groups. There were no significant differences in PWB in people with MS in relation to gender and marital status, but individuals with higher level of education scored higher in total PWB, positive relationship with others and purpose in life. Conclusion: People with MS are at risk of lower level of PWB. Interventional programs for improving PWB are strongly recommended. [ABSTRACT FROM AUTHOR]

Background: Glucose uptake by muscles and fat cells is carried out by the GLUT4 system. Isoforms of the SNAP23, syntaxin-4 and VAMP-2 play an important role in regulating GLUT-4 trafficking and fusion in adipocytes. The changes of SNARE proteins levels and thus impaired GLUT-4 displacement can be one of the etiological causes of type 2 diabetes. Due to changes in the expression of these proteins in diabetes, the aim of this study was to investigate the effect of the natural compound resveratrol with anti-diabetic properties on impaired expression of SNARE proteins in type 2 diabetes. Methods: Forty male Wistar rats were used in this study. Type 2 diabetes was induced by administering a single dose of streptozotocin and nicotinamide. The expression of SNAP-23, syntaxin-4 and VAMP-2 proteins were assessed using real-time qRT-PCR. Also, some biochemical parameters were examined, including fasting blood glucose, insulin levels and insulin resistance. Results: The results of this study showed that, resveratrol supplementation increased blood insulin level, reduced the fasting blood glucose, and improved the insulin resistance. In addition, resveratrol supplementation increased the expression of SNAP-23, syntaxin-4 and VAMP-2 proteins that involved in GLUT-4 transport in adipose tissue of diabetic rats. Conclusion: Final results showed that SNARE proteins expression is significantly reduced in diabetic rats and treatment with resveratrol supplementation is associated with the increased expression of these proteins. [ABSTRACT FROM AUTHOR]