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In this study, an innovative woody biomass‐fueled hybrid tetrageneration system composed of a single‐effect lithium bromide‐water absorption refrigeration system, a reverse osmosis desalination system, two organic Rankine cycle for the production of cooling, heating, power, and freshwater in two distinct configurations (configurations A and B), compared and discussed using energy, exergy, economic, and exergoeconomic analyses. The poplar sawdust used as a local woody biomass fuel was a by‐product of the Iran Wood and Paper Industries Company, located in northern Iran. The results revealed that the highest heating production and lowest exergy destruction were related to configuration B. The overall cost of configuration A was higher than that of configuration B. A detailed sensitivity analysis was also developed to study the effect of various factors on the thermodynamic and economic performance of the proposed configurations. By increasing the turbine inlet temperature of ORC1 from 625 to 692 K, the total sum unit costs of product of the system in configurations A and B decreased by 20 and 23 $ GJ−1, respectively (about 21%). [ABSTRACT FROM AUTHOR]

This article reports on a study that explored the relationship between reflective teaching and teachers' self-efficacy beliefs. Two questionnaires, the English Language Teaching Reflection Inventory (Akbari, Behzadpoor, & Dadvand, 2010) and Teachers' Efficacy Beliefs System-Self (TEBS-Self) (Dellinger, Bobbett, Olivier, & Ellett, 2008), were distributed among 225 Iranian EFL (English as a Foreign Language) teachers. Pearson product-moment correlation analysis showed a significant positive relationship between the general factors of teacher reflectiveness and self-efficacy. Standard multiple regression identified Efficacy for Learner Engagement as the only predictor of teacher reflectiveness and Meta-Cognitive Reflection as the only predictor of teacher self-efficacy. Finally, the interconnections between the components of the two constructs were investigated using Structural Equation Modelling. While most of the components of both variables were significantly interrelated, some were not, and Cognitive Reflection and Efficacy for Classroom Management had a negative relationship. The results are discussed in light of the literature, and suggestions for further research are presented.

Septic arthritis of the hip joint (septic hip) is the bacterial infection of the hip. Delayed treatment increases the risk of extensive joint damage, systemic infection, prolonged recovery, higher healthcare costs, and long-term disability. This study explores the repercussions of delayed surgical treatment in pediatric septic hip. In this observational study, pediatric patients diagnosed with septic hip between 2012 and 2021 were retrospectively selected from a major referral center in Shiraz, Iran. We collected clinical and radiological data, including Kocher score and determined Choi classification in follow-up radiographs. Multivariate logistic regression analysis was used to assess the impact of delay to surgery on the development of clinical sequelae and radiological deformities in the presence of potential confounders of age and Kocher criteria. Out of 49 children with delayed presentation, 46 survived and entered the study. Mean delay from symptom presentation to admission was 12.67 ± 10.51 days, and mean delay from admission to surgery was 5.33 ± 6.47 days. Of the 46 patients, 28.26% developed clinical sequelae. The Choi classification revealed that 54.35% of patients developed no residual deformity. A multivariate logistic regression analysis indicated a statistically significant association between delay to surgery and the development of radiological deformities (adjusted odds ratio: 1.36, 95% CI: 1.14–1.64, p = 0.001). Additionally, a separate analysis revealed that each additional day of delay was associated with a 12% increase in the odds of clinical sequelae (adjusted odds ratio: 1.12, 95% CI: 1.03–1.22, p = 0.006). Sensitivity analyses confirmed the relationship of delay from admission to surgery in developing both outcomes. Delay in medical care and surgical management remains the most important factor affecting the outcomes of septic hip. The study underscores the critical role of timely surgical intervention in reducing complications in pediatric septic hip patients. [ABSTRACT FROM AUTHOR]

While root canal anatomy in Middle Eastern populations is well‐studied, research on isthmi in mandibular permanent teeth from this region is limited. This retrospective study used cone‐beam computed tomography (CBCT) to examine isthmi prevalence and location, as well as root canal morphologies (per Vertucci's classification) in mandibular permanent teeth from a subpopulation in Ardabil, Iran. The study is aimed at enhancing our understanding of dental anatomical variations in Middle Eastern populations. A total of 3566 teeth from 384 CBCT scans were evaluated in this retrospective study. Mandibular teeth were evaluated on sagittal, coronal, and axial sections regarding the presence of isthmus and root morphology (Vertucci's classification). CBCT scans of 197 males (51.3%) and 187 females (48.7%) were evaluated, with a mean age of 41.1 ± 11.4 years. Isthmi were most prevalent in molar mesial roots, typically located in the middle third for anterior teeth and first premolars and cervical third for posterior teeth. While gender did not play a significant role, the presence of an isthmus in the mesial root of the left second molars was associated with a younger mean patient age (p < 0.05). Root morphology varied across tooth types. Central and lateral incisors predominantly showed Vertucci's Types I and III. Canines and premolars were mostly Type I, with some variation. Molar mesial roots frequently exhibited Types IV and II, while distal roots were predominantly Type I. Statistically significant differences were found between morphology and gender in the first left premolar (Type I more common in women; Type V in men; p < 0.001) and in the right canine (Type I more prevalent in men; Types III and V more prevalent in women; p < 0.001). The results revealed wide variations in root canal morphology and a relatively high prevalence of isthmi in the study population. Our findings suggest a potential difference in tooth anatomy based on sex and a relationship between age and the presence of isthmi. [ABSTRACT FROM AUTHOR]

Background: This study assessed the prevalence of gastroesophageal reflux disease (GERD) in a general adult population in Iran. The association between GERD and various factors was also evaluated. Methods: We performed a cross-sectional study on 163,018 individuals aged over 35 who were enrolled in the PERSIAN cohort. GERD was defined as the occurrence of heartburn and/or regurgitation symptoms at least several days a month. Survey design analysis for pooled data was performed and multiple regression analysis was conducted to determine the independent risk factors for GERD. Results: The prevalence of GERD in our study was estimated at 21.86% (95% confidence interval:17.4%-36.4%). The mean age of the participants was 49.84 years±9.25 (35–70) and 44.75% of the participants were male. Symptoms of heartburn and regurgitation were reported in 18.65% (n: 29,170) and 6.06% (n: 9,717) of participants, respectively. In the multivariate analysis, several factors were found to be associated with a higher prevalence of GERD: female sex, age >50, current smoking, opium use, weekly consumption of fried foods, frequent consumption of hot tea, less than 6 hours of sleep per night, psychiatric disorders, usage of NSAIDs, and poor oral hygiene, were associated with a higher prevalence of GERD. Conversely, higher education levels and average physical activity were found to be less commonly associated with GERD. Conclusion: We found a relatively high prevalence of GERD (21.86%) in this population-based study in Iran. By identifying modifiable risk factors, this research offers opportunities for targeted interventions and lifestyle modifications to reduce the burden of GERD. [ABSTRACT FROM AUTHOR]

The importance of urban parks for improving the quality of life of residents is becoming increasingly clear as people interact less and less with nature. Urban parks should be designed to have a profound impact on the mental health and well-being of citizens through the provision of high-quality facilities and services. Nevertheless, there are differences in the infl uencing factors in urban parks. Nowadays, urban parks as the lungs of cities are considered important destinations for citizens to get rid of stress and mental fatigue. Therefore, it is important to understand what factors contribute to people feeling mentally better and improving their well-being. Based on people’s experiences and opinions, the present study aims to investigate how urban parks as nature-based solutions in Marivan City, Iran, especially the green infrastructure and its elements in Shano and Zaribar Parks, contribute to respondent’s mental health and overall well-being. The necessary data for this study were collected from 277 respondents using a questionnaire. The questionnaire was randomly distributed both in person and online. The questions were categorized based on 3 indicators directly related to mental health and well-being: perceptual, visual, and functional. Data were analyzed using structural equation modeling in Smart-PLS software. Results indicate that the perceptual, visual, and functional indicators in Marivan’s urban parks have a signifi cant impact on the mental health and well-being of residents. Among these indicators, the visual indicator has shown the highest level of infl uence. [ABSTRACT FROM AUTHOR]

Cutaneous leishmaniasis (CL) is a disease transmitted by mosquitoes and is endemic in many regions of the world and Iran, and annually imposes a large burden on the health system. This study was conducted to identify the effective factors in the preventive behaviors of CL based on the BASNEF model in endemic areas in the northwest of Iran. This cross-sectional study was conducted in Bileh-Savar, 'endemic areas of Ardabil Province, Iran', from June 2022 to October 2022. 200 non-patients were included in the study by a multi-stage sampling method. A standard questionnaire based on the BASNEF model was applied for data collection. The data were analyzed using SPSS version 25. Means and standard deviations were calculated to describe the continuous variables, and multivariate linear regression analysis was used to determine the prediction of intention and behavior by the model structures. The BASNEF constructs predict 27% of behavioral intention changes. Among the constructs, attitude has a greater contribution in predicting changes (R2 = 0.27, p < 0.01). Also, the results showed that the BASNEF constructs predict 23% of behavior changes. Among the constructs, enabling factors have a greater contribution to predicting changes (R2 = 0.23, p < 0.01). This finding shows that behavior is more influenced by environmental factors, and educational interventions based on behavior change models, along with providing environmental conditions, can facilitate behavior change. [ABSTRACT FROM AUTHOR]

Preeclampsia (PE) is a hypertensive disorder that affects pregnancy, mother, and fetus. Early diagnosis of PE remains a challenge. This study aimed to investigate the association between survivin two (rs9904341 and rs17878467) SNPs and PE risk in healthy pregnant women compared to women with preeclampsia. A sample of 166 healthy pregnant women and 160 cases with preeclampsia was included and genotyped for rs9904341 with polymerase chain reaction-restriction fragment length polymorphism (PCR–RFLP) and rs17878467 with amplification-refractory mutation system (ARMS) PCR. The genotypic and allelic assessments were performed using various statistical approaches. The frequency of rs9904341 and rs17878467 polymorphisms was not significantly different between PE and healthy pregnant women. rs9904341: codominant (p = 0.5), dominant (p = 0.24), recessive (p = 0.61), over-dominant model (p = 0.38), and log additive (p = 0.25). rs17878467: codominant (p = 0.41), dominant (p = 0.23), recessive (p = 0.4), over-dominant model (p = 0.42), and log additive (p = 0.24). The frequency of survivin rs9904341 CG and CC genotypes was higher in severe PE women compared to controls and this polymorphism was associated with PE severity only in the dominant model (OR = 1.84, CI 1.04–3.26, P = 0.034). There was a significant association between survivin rs9904341 polymorphism and PE severity. No relationship was found between survivin rs9904341 and rs17878467 polymorphisms and PE onset. The allelic and genotypic frequencies of survivin rs9904341 and rs17878467 polymorphisms are not significantly different between the preeclampsia and control groups in all genetic models. Haplotype analysis showed lower frequency G rs9904341 T rs17878467 haplotype in PE woman and this haplotype was associated with lower risk of PE (OR = 0.54, CI 0.33–0.91, P = 0.02). [ABSTRACT FROM AUTHOR]

Ecological footprint analysis is one of the most useful models for the environmental impact assessment of human activities. This research aimed to estimate the environmental impacts of the tourism industry on Hosainabad village, Kurdistan Province, Iran by using the ecological footprint model. A descriptive-analytical method is used based on documentary library studies as well as field surveys. The statistical population for this study is the number of tourists who visited Hosainabad village in 2018. The findings show that the tourism ecological footprint in Hosainabad village in food, transportation, heating, water, electricity, and waste generation groups was 0.994 hectares) per capita). Comparing this amount with its surrounding spaces indicates that the tourism industry in Hosainabad relies on an area beyond this village to meet its biological needs and environmental sustainability. Findings suggest that decision-makers must pay enough attention to tourists' activities in small areas in order to prevent further environmental disruption. [ABSTRACT FROM AUTHOR]

Writing, as a productive skill, requires an accurate in-depth knowledge of the grammar system, language form and sentence structure. The emphasis on accuracy is justified in the sense that it can lead to the production of structurally correct instances of second language, and to prevent inaccuracy that may result in the production of structurally erroneous sentences. The present research intended to investigate the extent to which different types of error correction and feedback to students' grammar would influence their grammatical accuracy. The study was conducted with 60 upper intermediate English students in an EFL context. In conducting a quasi-experimental design, the present study aimed at investigation of the effectiveness of three error correction strategies. The findings of the study indicated that the participants who received "indirect coded correction" feedback showed better performance compared to those who received "indirect uncoded error correction" or "direct correction" feedback. Additionally, the results made it clear that there was no significant difference between the performance of the participants who were subject to indirect uncoded and direct error correction strategies. (Contains 5 tables and 2 figures.)

Introduction: Type 2 diabetes (T2D) is a common chronic disease that significantly affects an individual's overall health and well-being. The aim of this study is to investigate the factors that influence the health-related quality of life (HRQoL) of patients with T2D. Methods: This study conducted using data from 6th phase (2015–2017) and 7th phase (2018–2022) of the Tehran Lipid and Glucose Study (TLGS). Data were collected through a combination of interviews, physical examinations, and laboratory tests. Quality of life questionnaire (SF-12) that consists of 12 questions was used to assess physical and mental health functioning. The generalized estimating equation model was used to assess the association between socio-behavioral factors and changes in HRQoL. Results: The study included 498 patients with T2D. The changes in HRQoL in patients with T2D followed a sex-specific pattern. Analysis of the physical component score (PCS) and the mental component score (MCS) showed a non-significant change in the total score during the three-year longitudinal study. However, the role physical (RP) of the PCS and the social functioning (SF) of the MCS showed a statistically significant change during this period. In addition, sex, body mass index (BMI), and having cardiovascular disease (CVD) and chronic kidney disease (CKD) showed a significant association with RP changes, and only job status showed a significant association with SF changes. Conclusions: By recognizing the sex-specific patterns in HRQoL changes and understanding the multifaceted nature of factors such as BMI, CVD and CKD, healthcare professionals can develop targeted interventions that go beyond traditional diabetes management. [ABSTRACT FROM AUTHOR]

Reducing emissions from deforestation and forest degradation (REDD) is a specific strategy for combating deforestation and forest degradation to alleviate the effects of climate change. In this study, the potential greenhouse gas (GHG) emission reduction resulting from the implementation of a REDD project is estimated. Changes in forest cover throughout the years 1985, 1990, 1995, 2000, 2010, 2015, and 2020 were analyzed using time-series Landsat imagery (TM, ETM + , and OLI) and a random forest algorithm. Multilayer perceptron neural networks were used to model the transition potential of the forest cover, which were then predicted via Markov chain analysis. The change detection analysis revealed two discernible patterns in forest cover dynamics. Between 1985 and 2000, a notable decrease in forest cover was seen, whereas from 2000 to 2020, it significantly increased. The results suggested that the absence of REDD implementation would result in the deforestation of approximately 199,569 hectares of forest cover between 2020 and 2050, leading to the release of 1,995,695 tCO2e of emissions into the atmosphere. However, with the implementation of REDD, these emissions would be reduced to 405,512 tCO2e, effectively preventing the release of 1,590,183 tCO2e of emissions into the upper atmosphere. This study demonstrates that the implementation of REDD projects can be an effective strategy for reducing GHG emissions and mitigating climate change in the Hyrcanian forests. [ABSTRACT FROM AUTHOR]

Examining Iran's economic developments over the past five decades shows that Iran's economy has always had a high inflation rate. Therefore, it is very important to investigate the factors affecting inflation in the country. The purpose of this research is to investigate the relationship between macroeconomic variables including liquidity, monetary base, oil revenues, budget deficit, economic growth and inflation rate in Iran in the period of 1991-2020. For this purpose, the combination of two approaches of maximum overlap discrete wavelet-Granger causality and wavelet coherence based on the continuous wavelet approach has been used. The advantage of using the wavelet approach is that it allows the analysis of variables in two dimensions of time and frequency. The results of the analysis of both approaches showed that in the short term, oil revenues increase inflation. The results of the long-term research showed that the inflation rate increases the growth of liquidity. Finally, in the long term, oil revenues have been the cause of inflation, and in the short term, the inflation rate has been a factor affecting the growth rate of the budget deficit. Analyzing the phase difference in the time series of economic growth and inflation shows that in the long-term economic growth with oil and inflation are out of phase. In other words, economic growth with oil and inflation does not move in the same direction. [ABSTRACT FROM AUTHOR]

Multi-model Ensembles (MMEs) are widely used to reduce uncertainties associated with simulations and projections of GCM/RCM.MMEs combine the results of multiple climate models to produce a more robust and reliable prediction. By considering the range of outputs from different models, MMEs can improve the overall accuracy of climate projections. Therefore, the study focused on the use of some techniques, namely Multivariate Linear Regression (MLR), Weighted Average (WA), and some ML algorithms including Least Square Support Vector Machine (LS-SVM), Random Forest, (RF) and multivariate adaptive regression splines (MARS) to develop MMEs to simulate precipitation patterns over Iran. The regional climate models (RCMs) used in this research were extracted from the South Asia Coordinated Regional Climate Downscaling Experiments (CORDEX-SA) dataset. By comparing the individual RCMs and MMEs developed using the proposed methods, it was found that MMEs improved their capabilities compared to individual RCMs in their ability to simulate precipitation patterns. Furthermore, the study revealed that the MME developed using RF (MME-RF) exhibited more consistent performance across different spatial regions compared to other methods, especially WA technique, which displayed the lowest performance in comparison to other methods. Regarding the projections of seasonal precipitation under RCP4.5 and RCP8.5 scenarios, a potential decrease (roughly 6.5%) in precipitation in the western regions during autumn season, was observed. Whereas, the southern and southeast regions of Iran in particular showed a pronounced wetting tendency during the autumn season. According to the forecasts, the maximum percentage change (PC) of precipitation in these regions is expected to increase by 13.88%. [ABSTRACT FROM AUTHOR]

The current study aims to assess the prevalence of different genera of Rickettsiales, intracellular bacteria, in dogs across various regions of Iran. Rickettsiales, as zoonotic pathogens, can have various manifestations in different species, including immunosuppression, anaemia and neuropathy. Due to their close interactions with people and livestock, dogs can serve as reservoirs and transmit these pathogens to humans and other animals. The data from this research can be valuable for managing and controlling related diseases and complications in Iran and possibly neighbouring countries. Pertinent data for this study was gathered without time limitations until 1 March 2022, from different databases. Of all the inspected studies, 26 were eligible based on the inclusion criteria. The Egger test result and asymmetry in the funnel plot revealed significant publication bias; therefore, the meta‐analysis model was corrected with the trim‐and‐fill method. After correction, the prevalence of rickettsial infections among dogs varies by genus – 20.1% for Anaplasma spp. and 10% for Ehrlichia spp. – with an overall prevalence estimated at 18.3% by random‐effects analysis. The highest and lowest estimated pooled prevalences were associated with the southwestern (38.5%) and southern (0.3%) provinces of Iran, respectively. The pooled prevalence of rickettsial infection was higher in female dogs (OR = 1.198; p < 0.978; 95% CI, 0.842–1.705) and in dogs ≤2 years (OR = 1.014; p < 0.312; 95% CI, 0.598–1.72), but the difference was not statistically significant. Ultimately, the pooled prevalence of rickettsial infections among dogs is relatively low compared to other countries like Qatar, Iraq, Saudi Arabia and Turkey, which are nearby Iran. Given the significant clinical outcomes of this disease, necessary measures for prevention should be taken. [ABSTRACT FROM AUTHOR]

Background: Patients in the post-resuscitation period experience critical conditions and require high-quality care. Identifying the challenges that critical care nurses encounter when caring for resuscitated patients is essential for improving the quality of their care. Aim: This study aimed to identify the challenges encountered by critical care nurses in providing care during the post-resuscitation period. Methods: A qualitative study was conducted using semi-structured interviews. Sixteen nurses working in the intensive care units of three teaching hospitals were selected through purposive sampling. The Data collected were analyzed using qualitative content analysis. Results: Participants experienced individual, interpersonal, and organizational challenges when providing post-resuscitation care. The most significant challenges include inadequate clinical knowledge and experience, poor management and communication skills, lack of support from nurse managers, role ambiguity, risk of violence, and inappropriate attitudes of physicians towards nurses' roles. Additionally, nurses expressed a negative attitude towards resuscitated patients. Conclusion: Critical care nurses face several challenges in providing care for resuscitated patients. To enhance the quality of post-resuscitation care, address the challenges effectively and improve long-time survival it is crucial to implement interventions such as In-service education, post-resuscitation briefing, promotion of interprofessional collaboration among healthcare teams, providing sufficient human resources, clarifying nurses' roles in the post-resuscitation period and increasing support from nursing managers. [ABSTRACT FROM AUTHOR]

This paper aims to obtain a relation for estimating the median size of bed sediment, d 50 , at the bends of meandering rivers based on real data. To achieve such a purpose, field data, including topographic, sediment sampling, and flow measurements, were collected from various rivers in Iran at different times of the year. Then, the Buckingham Π-theorem was applied to identify the effective dimensionless numbers such as the Shields function, Reynolds particle number, Froude number, submerged specific gravity of sediment, and aspect and curvature ratios. A correlation analysis was conducted between such factors to eliminate those dependent on others. In the following, three regression techniques, containing the power function approach, the general additive model (GAM), and the multivariate adaptive regression spline (MARS), were chosen to achieve the best relation. The obtained results indicated that the developed MARS model produced a better result than the others and was much more satisfactory, with a coefficient of determination (R2) of 0.96 and 0.95 and root-mean-square error (RMSE) of 140.64 and 140.47 for the training and testing phases, respectively. Furthermore, the MARS outputs were validated with an analytical method, which showed that MARS fitted with the field data much better. Consequently, the distinguished merit of this study is the development of a relation for determining d 50 that shows which geometric and hydraulic parameters have the most effect on sediment size in the river bend. [ABSTRACT FROM AUTHOR]

Background: Healthy aging is an important concept developed by the World Health Organization with the aim of enhancing the health of older adults, highlighting the positive aspects of aging, and reinforcing their social roles. Objectives: Since the concept of healthy aging can be interpreted differently by older adults in various societies, this study aimed to explore the perspectives of Iranian older adults regarding healthy aging. Methods: A qualitative descriptive design and content analysis was employed to gather data from 15 purposively selected community-dwelling older adults aged over 60 years in Ilam and Khuzestan provinces, Iran. Semi-structured interviews were conducted and analyzed following Graneheim and Lundman's (2004) content analysis guide. Results: Five main themes and 16 subthemes emerged. These 5 main themes include social participation, mental health, a healthy lifestyle, maintenance of functional ability, and adequacy of economic status. Conclusions: Based on the results, healthy aging is a multidimensional concept. It is recommended that health policy-makers and providers of elderly healthcare services take these factors into account when planning and delivering services aimed at promoting the health of older adults. [ABSTRACT FROM AUTHOR]

The Alborz Mountains are some of the highest in Iran, and they play an important role in controlling the climate of the country's northern regions. The land surface temperature (LST) is an important variable that affects the ecosystem of this area. This study investigated the spatiotemporal changes and trends of the nighttime LST in the western region of the Central Alborz Mountains at elevations of 1500–4000 m above sea level. MODIS data were extracted for the period of 2000–2021, and the Mann–Kendall nonparametric test was applied to evaluating the changes in the LST. The results indicated a significant increasing trend for the monthly average LST in May–August along the southern aspect. Both the northern and southern aspects showed decreasing trends for the monthly average LST in October, November, and March and an increasing trend in other months. At all elevations, the average decadal change in the monthly average LST was more severe along the southern aspect (0.60°C) than along the northern aspect (0.37°C). The LST difference between the northern and southern aspects decreased in the cold months but increased in the hot months. At the same elevation, the difference in the lapse rate between the northern and southern aspects was greater in the hot months than in the cold months. With increasing elevation, the lapse rate between the northern and southern aspects disappeared. Climate change was concluded to greatly decrease the difference in LST at different elevations for April–July. [ABSTRACT FROM AUTHOR]

The extensive oil and gas industrial sectors have caused several environmental problems in Iran. This motivated the governments to consider the potential capacity developing renewable energies such as biomass energy as an excellent strategic plan for sustainable sources. However, biomass energy is at the early stage because of multi-dimensional barriers (e.g., social, technical, and policy). Thus, there is a need to assess and evaluate the existing challenges and provide a strategic plan to assist decision-makers, for the country's sustainable biomass energy development. A novel approach is developed in the current study by extending the Interval-valued Spherical fuzzy best–worst method (IVSFS-BWM) and decision-making trial and evaluation laboratory (IVSFS-DEMATEL). n the seven steps methodology, IVSFS-BWM is utilized to derive the optimum importance weights of contributing factors in sustainable challenges of biomass energy. Then, IVSFS-DEMATEL is employed to find causality and interrelationships between the contributing factors. 39 numbers of challenges as influential parameters are taken into account to study the challenges of biomass energy. A comparison with familiar decision-making competitors' tools has been conducted to show the advantages and robustness of the proposed methodology. The results indicated that the proposed method can adequately deal with subjective uncertainties from decision-making opinions, and the challenge of the contributing factors in biofuel energy as "fear of public health and safety hazards" needs necessary attention to the contributing factors in the system such as "lack of professional training institute," "lack of infrastructural requirements," and "lack of investors," considering the resilience aspects. Moreover, the sensitivity analysis is conducted and by checking all contributing factors, concluded that the system is not fully sensitive to the variation, as it is less partially dependent and reflects the conformity of obtained results as accurately as possible. The outcomes assist decision-makers in providing an effective strategic plan by eliminating the multi-dimensional barriers in sustainable biomass energy development. [ABSTRACT FROM AUTHOR]

Introduction: Selective serotonin reuptake inhibitors (SSRIs) are widely used for the treatment of various mental disorders. Sexual dysfunction is one of the most common side effects of SSRIs, and often leads to poor adherence and treatment discontinuation. While several strategies have been employed to manage SSRI-induced sexual dysfunction, drug holidays has not been extensively studied for this purpose. This clinical trial aims to assess the effect of drug holidays on sexual dysfunction in married men under treatment with SSRIs other than fluoxetine (as its long half-life makes drug holidays ineffective). Methods: This 8-week double-center, randomized, open-label, controlled trial was conducted in the outpatient clinics of Iran Psychiatric Hospital and Tehran Institute of Psychiatry, from January 2022 to March 2023. We included married men aged between18 and 50 years who had experienced sexual dysfunction during treatment with SSRIs, other than fluoxetine. The Male Sexual Health Questionnaire (MSHQ) and the 28-Question General Health Questionnaire (GHQ-28) were used for the assessment of sexual function and mental health status. The drug holidays group was instructed not to take their medications on the weekends. The control group was asked to continue their regular medication regimen without any changes. Both groups were assessed at baseline, and weeks 4 and 8. Results: Sixty-three patients were included and randomly assigned to the drug holidays group (N = 32) or the control group (N = 31). Fifty patients (25 in each group) completed the trial. Drug holidays significantly improved erection, ejaculation, satisfaction, and the overall sexual health of the participants (P < 0.001). No significant change was observed in their mental health status. No major side effects were recorded. Conclusions: Drug holidays significantly improved the MSHQ scores in 'erection', 'ejaculation', 'satisfaction' and 'total' in married men with sexual dysfunction induced by SSRIs, other than fluoxetine, without causing any significant changes in their mental health status. Further research is needed to reach a certain conclusion. Trial registration: The trial was registered at the Iranian Registry of Clinical Trials on 2021.10.25 (www.irct.ir; IRCT ID: IRCT20170123032145N6) before the trial. [ABSTRACT FROM AUTHOR]

Waterborne organisms in marine water generally originate from untreated wastewater discharged into the sea. The presence of numerous leisure beaches in Mahmoudabad city, Iran, annually attracts thousands of tourists from all over the country to participate in recreational swimming activities. This study probabilistically characterized the health risks associated with recreational swimming engendered by waterborne pathogens, such as intestinal enterococci and Escherichia coli (E. coli) at 15 sampling points along the beaches of the study using quantitative microbial risk assessment (QMRA). The mean annual infection risk of E. coli in children and adults was 0.424 and 0.229, respectively. The respective risk in terms of enterococci was 0.999 and 0.997, which were higher than the level recommended by the WHO and EPA. The results show that the risk of infection for children was higher than adults. Related authorities have to consider measures to improve environmental quality to protect tourists' and residents' well-being. [ABSTRACT FROM AUTHOR]

The distribution of calcareous nannofossil species in the upper part of Gurpi Formation and lower part of Pabdeh Formation has been investigated in the Karta section (northwest of Izeh in Zagros Basin, Iran, Eastern Tethys) to provide a biostratigraphic framework from Maastrichtian to Thanetian interval. In this study, 31 genera and 52 species of calcareous nannofossils have been identified and based on the recognized bioevents and the resulting biozones, the studied interval spans from the top of the nannofossil zone UC19TP to the base of the NP7 zone and covers ~10.8 Myr. In this study, the Gurpi Formation spans from the upperUC19TP to NP4 zones, while the lowest part of Pabdeh Formation covers NP5, NP6 and NP7 zones. The studied sequence is continuous and encompasses Cretaceous-Paleogene (K/Pg), Danian/Selandian and Selandian/Thanetian boundaries. The K/Pg boundary is characterized by nannofossil assemblage recognized worldwide, such as the occurrence of Biantholithus, Cruciplacolithus, Braarudosphaera, Praeprinsius, and calcareous blooms of Thoracosphaera spp. A decrease in the abundance of nannofossils is observed in the upper part of the Maastrichtian to the lower part of the Danian; poor to moderate preservation of nannofossils and low diversified nannofossil assemblages cover most of the studied samples. Here, as a result of species poor to moderate preservation, we observe patterns of stepwise extinctions upward in the top of CC25 zone, that culminate with the last occurrence of eight species, just prior to the base of the UC20bTP. We interpret these patterns to be mainly the result of diagenetic alteration. Our dataset provides a record over a long-lasting interval of stepwise extinctions toward the K/Pg boundary that was likely caused by the diagenetically-enhanced Signor-Lipps effect. [ABSTRACT FROM AUTHOR]

Background: Total knee arthroplasty (TKA) is associated with significant blood loss. Antifibrinolytic agents such as tranexamic acid (TXA) are widely used to manage blood loss during TKA. This study aimed to compare the efficacy of three different administration approaches of TXA in TKA. Methods: In a prospective, multicenter study, 285 patients with end-stage osteoarthritis who underwent TKA between 2020 and 2022 in three orthopedic surgery centers were included in the study. To manage bleeding during TKA, one of the three methods of intravenous administration (IV), intra-articular injection (IA), and combination administration of TXA was performed for the patients. Postoperative blood loss was calculated using blood volume and change in hemoglobin level from preoperative measurement to postoperative day 3. Results: The mean baseline Hemoglobin (Hb) was not significantly different between the three study groups (p > 0.05). The mean postoperative Hb of 12 h, 24 h, and 48 h after the surgery was not significantly different between the three stud groups (p > 0.05). The mean intraoperative blood loss in the combined TXA group was significantly lower compared to the IV and IA groups (0.025). The number of blood transfusions in the three study groups was not statistically significant (p > 0.05). No side effect was recorded in any group, as well. Conclusion: Blood loss in the combination TXA group was significantly less than in the other two groups. Combination TXA can help reduce blood loss after TKA surgery. [ABSTRACT FROM AUTHOR]

Background: Given that adolescence is important in community health, and planning, preventing and treating the smoking-caused health problems need to estimate the precise statistics on the prevalence of smoking and consider the effective factors among adolescents, the present study aimed to determine the frequency of and effective factors on smoking among adolescents. Methods: The present descriptive-analytical study was conducted during 2019 among 363 secondary high school boy students in Sanandaj, Iran. Sample was selected by cluster sampling method and data were collected by using a valid and reliable questionnaire. Data were entered in SPSS 23 and analyzed by using descriptive statistics and logistic regression. Results: Based on the results, the prevalence of smoking among the students under study was 19% (n = 69). The results related to logistic regression test indicated age and educational grade, as well as the educational level of father and grade point average (GPA) of previous semester as the factors affecting smoking (P < .05). Conclusion: Due to the greater smoking prevalence among students with more age, higher educational grade, and less GPA in the previous semester, as well as having mother with lower educational level, paying more attention to the above-mentioned students is suggested in designing the smoking prevention educational programs. [ABSTRACT FROM AUTHOR]

Background: Opioid use disorder (OUD) has been associated with adverse health outcomes, and its potential impact on COVID-19 outcomes is of significant concern. This study aimed to assess the susceptibility and clinical outcomes of hospitalized COVID-19 patients with OUD using a propensity score-matched design. Methods: A historical cohort study was conducted in Alborz province, Iran, during the early months of the COVID-19 pandemic. Patients aged 18 years and above with confirmed COVID-19 were included in the study. OUD was defined as a compulsive urge to use opioids or opioid-derivative drugs. Non-opioid abusers with COVID-19 were selected as the control group. Data on demographics, clinical characteristics, laboratory factors, comorbidities, and vital signs were collected. Propensity score matching (PSM) was used to balance the groups and assess the impact of OUD on ICU admission, mortality, the need for intubation, and the severity of pulmonary involvement on CT scans. Results: A total of 442 patients were included in the study, with 351 discharged and 34 deceased. The PSM analysis showed that OUD was not significantly associated with ICU admission (OR: 1.87, 95% CI: 0.22–2.91, p = 0.631). However, opium users had an increased risk of mortality (OR: 2.38, 95% CI: 1.30–4.35, p = 0.005) and a higher likelihood of requiring intubation (OR: 3.57, 95% CI: 1.38–9.39, p = 0.009) compared to non-opioid abusers. The severity of pulmonary involvement on CT scans did not show a significant association with OUD. Conclusion: OUD among hospitalized COVID-19 patients was associated with an increased risk of mortality and the need for intubation. These findings highlight the importance of addressing OUD as a potential risk factor in the management and treatment of COVID-19 patients. Further research is warranted to explore the underlying mechanisms and develop appropriate interventions to mitigate the impact of OUD on COVID-19 outcomes. [ABSTRACT FROM AUTHOR]

Background: Kerman Province is one of the endemic foci of scorpionism in southeastern Iran. Totally 17 species are reported for Kerman Province fauna. The current study seeks to determine the fauna of medically important scorpions in northern parts of this province. Methods: A descriptive cross-sectional study was conducted from January 2019 to March 2021. The specimens were captured from different areas, by rock-rolling during day and using Ultraviolet light at night. The specimens were preserved in ethanol (80%) and then identified using reliable identification keys for scorpions. Results: Totally, 499 specimens were captured from eight cities in northern Kerman. In total, 11 species belonging to three families were identified. Buthacus sp. is reported for the first time from Kerman Province. Buthacus sp., Hottentotta cf. juliae, and Hottentotta cf. schach, were the lowest in frequency of occurrence, against Mesobuthus navidpouri as the highest frequency. Conclusion: The results of this study are useful for the preparation of regional or monovalent antivenom for the Razi Vaccine and Serum Research Institute. Additionally, the obtained data are useful for the effective planning of scorpion control programs in the northern parts of Kerman Province, Iran. [ABSTRACT FROM AUTHOR]

Nowruz, the most important Iranian celebration, is barely mentioned in several pre-Islamic Iranian texts, and there is no information about its origin and rituals in any ancient Iranian texts. The significance of Nowruz during the Achaemenid period is not mentioned in Iranian texts, and there is little evidence to suggest its importance in the Achaemenid era, except for some references to the Coptic Nowruz, which provide some information about its significance during the Achaemenid period. Sassanian texts have more references to Nowruz, but there is no evidence of specific ceremonies or reliable sources for its origin. Furthermore, none of the ancient artifacts directly mention the establishment of Nowruz rituals, and our understanding of this matter can only be inferred from the artifacts, images, and structures. Nowruz celebration is widely held in the geographical region of Iranian culture, especially in modern-day Iran, indicating its ancient significance. It is also one of the celebrations of the Zoroastrians, who prepare for this celebration from early Esfand (the last month of the Iranian calendar) to welcome the spring. Various historical evidence and documents indicate that this celebration has roots in ancient times, but despite its extraordinary importance, no significant information about it is recorded in ancient Iranian texts. Most of our knowledge about this celebration and other ancient Iranian celebrations such as Mehragān, Sade, and other pre-Islamic celebrations is based on Persian and Arabic texts from the Islamic era, including the writings of Ibn al-Muqaffa, Biruni, Masudi, Jahiz, Ibn Nadim, Ferdowsi, and other writers and scholars like Khayyām in his Nowruznāmeh. [ABSTRACT FROM AUTHOR]

The current study seeks to investigate the relationship between the distribution of pedestrians and the integration/connectivity of the street network and land uses in the historical urban fabrics of Iran. In this regard, three historical neighborhoods from the cities of Gorgan (representative of northern Iran), Qazvin (representative of the middle part and west of Iran) and Yazd (representative of the central plateau) were chosen as case studies. In the first step, the integrity and connectivity of the street network of each case were analyzed using the Space Syntax technique. In the second step, the pedestrian intensity was assessed via extensive gate observations at the neighborhood scale. Lastly, the land use patterns in all the above-mentioned cases have been explored. Analyzing the results using statistical methods, it was concluded that the overall spatial configuration of the streets in the historical fabrics of Iran is not a meaningful variable for describing pedestrian movements. On the other side, it seems that the pedestrians' distribution is mainly influenced by land use patterns. Our research suggests that this part of the "Natural Movement" theory which indicates the spatial configuration of the street network influences the flow of human movement is not applicable to the historical fabrics of Iran. Considering that the results in all three cases are quite similar, it can be argued that the findings could be generalized to similar cases of complex street patterns. The results should provide an appropriate reference for urban designers/planners, architects and policymakers dealing with traditional urban fabrics. [ABSTRACT FROM AUTHOR]

Introduction: In acute conditions, severe acute respiratory syndrome coronavirus 2 (SARS‐CoV‐2) causes multi‐organ damage due to the induction of inappropriate immune responses, particularly lung tissue fibrosis. To evaluate the consequence of the deterioration of the immune system, autoimmune markers were assessed. Method s : In a case–control study, 108 patients with coronavirus disease 2019 (COVID‐19) were admitted to the intensive care unit (ICU), and 158 outpatients with mild clinical symptoms, with SARS‐CoV‐2 reverse transcription quantitative polymerase chain reaction (RT‐qPCR) positive tests, were included for comparison. The demographic and hematologic variables and presence of the main autoantibodies in sera of 40 eligible ICU‐hospitalized COVID‐19 patients and 40 COVID‐19 outpatients were assessed. Out of 108 COVID‐19 ICU‐hospitalized patients, 40 were selected as the control group (40/158) who had no underlying diseases before hospitalization, according to their self‐declaration and clinical records at the time of admission. Results: The results demonstrated that the main complete blood count indices, such as red blood cells and platelets, decreased dramatically in ICU‐hospitalized patients. Furthermore, the autoantibody profiles were positive in 45% and 15% of ICU‐admitted patients for antinuclear antibodies and antineutrophilic cytoplasmic autoantibodies, respectively. In ICU patients, anti‐PM/Scl 100 or AMA‐M2 was 33%. Anti SS‐A, anti‐SS‐B, anti‐Ro‐52, and anti‐Jo‐1 in 11.5% for each one were reactive. Other autoantibodies of the ICU group were as follows: CENP (5.6%), Rib‐protein (5.6%), and nucleosome (5.6%). However, only two individuals in the control group had positive results for SS‐A and SS‐B (5%). Conclusion: Induction of such particular autoantibodies by the virus can justify the multi‐organ involvement and severity of the disease in ICU patients, which may also cause other organ involvement in the long term. [ABSTRACT FROM AUTHOR]

Background: Strokes are among the major causes of disabilities worldwide. In recent years, there has been considerable interest in evaluating stroke prognoses. Objectives: In this investigation, we studied the association of lymphocyte-monocyte ratio (LMR), neutrophil-lymphocyte ratio (NLR), platelet-lymphocyte ratio (PLR), C-reactive protein (CRP), erythrocyte sedimentation rate (ESR) and ESR-CRP ratio (ECR) with 3 months outcomes among those with acute ischemic stroke (AIS). Materials & Methods: We carried out the present cross-sectional investigation among AIS patients at an academic hospital in northern Iran (from 2019 to 2021). Within 24 hours after the onset of symptoms, laboratory and clinical data of the patients were obtained. We assessed the results using the modified rankin scale (mRS) 90 days after the initial assessment. Statistical significance for comparing descriptive data was determined as P<0.05. Results: We entered 341 participants (Mean±SD age: 69.10±13.55 years, 53.1% female) into this investigation. Based on univariate analysis, there were poor correlations between NLR (r=0.361, P<0.001), PLR (r=0.215, P<0.05), CRP (r=0.234, P<0.001), LMR (r=-0.184, P<0.05), and ECR (r=-0.191, P<0.05) and a 3-month mRS. Also, after three months, the NLR, PLR, and CRP values were higher in the patients who died, but the LMR (P<0.001) and ECR (P<0.05) were lower. In multivariate comparison, only ECR was independently higher among the participants who died within 3 months (P<0.05). Conclusion: In this study, ECR within 24 hours of symptoms onset was related to functional outcomes and mortality at 3-month follow-up. Thus, ECR might provide valuable prognostic information at a relatively low cost. [ABSTRACT FROM AUTHOR]

Healthcare tends to be one of the most complicated sectors, and hospitals exist at the core of healthcare activities. One of the most significant elements in hospitals is service quality level. Moreover, the dependency between factors, dynamic features, as well as objective and subjective uncertainties involved endure challenges to modern decision-making problems. Thus, in this paper, a decision-making approach is developed for hospital service quality assessment, using a Bayesian copula network based on a fuzzy rough set within neighborhood operators as a basis of that to deal with dynamic features as well as objective uncertainties. In the copula Bayesian network model, the Bayesian Network is utilized to illustrate the interrelationships between different factors graphically, while Copula is engaged in obtaining the joint probability distribution. Fuzzy rough set theory within neighborhood operators is employed for the subjective treatment of evidence from decision makers. The efficiency and practicality of the designed method are validated by an analysis of real hospital service quality in Iran. A novel framework for ranking a group of alternatives with consideration of different criteria is proposed by the combination of the Copula Bayesian Network and the extended fuzzy rough set technique. The subjective uncertainty of decision makers' opinions is dealt with in a novel extension of fuzzy Rough set theory. The results highlighted that the proposed method has merits in reducing uncertainty and assessing the dependency between factors of complicated decision-making problems. [ABSTRACT FROM AUTHOR]

Objectives: Bifid mandibular canal (MC) is an anatomical variation of the MC. This study aimed to assess the prevalence and shape of bifid MC in an Iranian population. Materials and methods: A total of 681 patients who had undergone cone-beam computed tomography (CBCT) for different purposes between 2018 and 2020 were evaluated. After detection, bifid MCs were classified into four types forward, buccolingual, dental, and retromolar. CBCT images were assessed by two oral and maxillofacial radiologists. Data were analyzed by SPSS using an independent t-test and Chi-square test. Results: Bifid MC was found in 23 (3.4%) out of 681 patients, with a mean age of 32.21 years. Ten patients (1.5%) had a bifid MC on the right side, 6 (0.9%) on the left side, and 7 (1%) bilaterally. However, no significant correlation was found between laterality and the prevalence of bifid MC (P > 0.05). Bifid MC was found in 8 males (34.8%) and 15 females (65.2%). Gender had no significant correlation with the prevalence of bifid MC (P > 0.05). Forward type was the most common (n = 8, 1.2%) followed by buccolingual (n = 5, 0.73%), dental (n = 2, 0.3%), and retromolar (n = 1, 0.14%) types. Conclusion: According to the present results, bifid MC was not uncommon in the Iranian population of the present study, and forward type was the most common, followed by buccal and then dental bifid MCs. There was no significant correlation between sex and age with bifid MC but bifid MC was detected more frequently in females than males, and it was seen unilaterally in a higher percentage of the cases. [ABSTRACT FROM AUTHOR]

Purpose: Today, an essential part of sports' duties towards society is the responsibility of the clubs of various sports disciplines. Sports clubs play an indispensable role in developing the health of people in the community and healthily spending their free time. This study investigates the relationship between predictors of experience quality and athlete loyalty. It also evaluates the mediating effect of the quality of athlete experience on the relationship between predictor variables and athlete loyalty. Methodology: The research method was descriptive-correlation. The statistical population of the research was the athletes of Iran's private clubs, using nonprobability sampling and convenience sampling. Data was collected online from 391 athletes in combat sports, bodybuilding, and fitness through Google Forms. 6 hypotheses were proposed and tested using structural equation modeling. Findings: A significant relationship existed between predictor variables and the athlete experience quality (P<0.05). Also, the experience quality mediates the relationship between predictor variables and athletes' loyalty positively and significantly (P<0.05). The results can help to develop and improve marketing strategies to increase the athletes' experience quality in service centers and sports clubs and create customer experience and management processes. It also has implications for managers of service centers and sports clubs or marketing managers who aim to increase customer loyalty and club effectiveness. Originality: This study empirically justifies the relationship between predictor variables for the quality of experience and loyalty of athletes in private clubs. This study also provides insight into the relationships between predictor variables, experience quality, and athlete loyalty in an integrated model. [ABSTRACT FROM AUTHOR]

Assessing areas prone to flash floods is crucial for effective disaster management and mitigation. This study proposes a framework for mapping flood-prone areas by integrating geographic information system (GIS), remote sensing data, and multi-criteria decision-making (MCDM) techniques. The hybrid MCDM model combines the decision-making trial and evaluation laboratory (DEMATEL) with GIS-based analytic network process (ANP) to evaluate flood vulnerability in Golestan province, Iran. Fourteen criteria related to flood potential, including elevation, slope, aspect, vegetation density, soil moisture, flow direction, river distance, rainfall and runoff, flow time, geomorphology, drainage density, soil type, lithology, and land use, were considered. In areas where official data was lacking, a questionnaire was administered to gather information from 15 specialists, experts, and 20 local managers. The relationships between criteria were analyzed using the DEMATEL method, and their weights were determined using the ANP method. Topography was found to have the greatest impact on flood risk, followed by the type of surface and vegetation cover. Hydrographic, soil and geology, climatic also influence flooding in the region. The study identified the northern and central parts of the study area being at higher risk of flooding compared to the southern part. Based on the flood intensity map, 68 villages (50% of all villages in the Qarasu watershed) with a population of approximately 83,595 were identified as at risk of flooding. The proposed GIS-DANP model provides a valuable tool for flood management and decision-making, aiding in risk reduction and minimizing casualties. [ABSTRACT FROM AUTHOR]

The current study examined the associations between perceived actual-ideal discrepancies in facial and bodily attributes and adolescent girls' appearance satisfaction and whether these relationships were moderated by the importance associated with the attributes and/or the country of the participants. A multilingual survey was completed by 900 girls aged 12–18 years old living in Australia, China, India, and Iran. Girls in India and Iran were most satisfied with their appearance followed by girls in China and Australia. Iranian girls had the highest perceived actual-ideal discrepancies in facial and bodily attributes. Chinese and Indian girls perceived their facial attributes to be more important to their overall sense of appearance than their bodily attributes, whereas Australian and Iranian girls valued them equally. Higher perceived actual-ideal facial discrepancies were related to lower appearance satisfaction only for Iranian girls and higher perceived bodily discrepancies were linked to lower appearance satisfaction only for Australian girls. The importance associated with physical attributes and/or the country of participants did not moderate the relationship between perceived discrepancies and appearance satisfaction for facial or bodily attributes. Findings underscore the critical role of cultural nuances in understanding body image among adolescent girls and determinants of appearance satisfaction. [ABSTRACT FROM AUTHOR]

The present study aimed to investigate haemoglobin (Hb) changes before and after packed red blood cell (RBC) transfusion in burn patients. This study was a retrospective cross‐sectional study that was conducted on burn patients in Velayat hospital in Rasht, Iran. The sampling method of this study was consecutive sampling. Data were collected using patient records, including age, gender, body mass index (BMI), total body surface area (TBSA) percentage, length of hospitalisation, Frequency of receiving packed RBCs, and Hb level before each packed RBC transfusion and 4 to 6 hours after transfusion. Paired t tests and analysis of variance (ANOVA) were used to compare the study variables. Pearson's correlation coefficient was used to investigate the relationship between Hb changes after the transfusion of packed RBCs and the study variables. A total of 110 burn patients participated in this study. The average Hb before and after transfusion was 8.07 (SD = 0.97) and 9.16 (SD = 1.01), respectively, which were significantly different (P =.0001). The results showed that there was a significant negative relationship between the variables of age (r = −0.188, P =.0001), BMI (r = −0.110, P =.035), and TBSA percentage (r = −0.122, P =.019) with changes in Hb after transfusion. Also, the duration of hospitalisation had a significant positive relationship with Hb changes after transfusion (r = 0.124, P =.017). In sum, Hb level compensation through packed RBC transfusion in elderly burn patients has more challenges. The number of changes in Hb level after receiving packed RBCs decreased with increasing TBSA, BMI, and age. Also, there was a positive correlation between the duration of hospitalisation and changes in Hb levels. [ABSTRACT FROM AUTHOR]

In business processes, gaining customer satisfaction is vital for online retailing. In this way, it is necessary to identify the important factors for attracting and retaining customers in online retailing. Many factors are involved in efficient customer relationship management (CRM) systems. Their efficient implementation needs a deep focus on key customers, proper organization, knowledge management, technology, market, sales, ordering, support, and many other factors. Therefore, this paper examines the effective factors (including innovation management, market knowledge, competitive intelligence, entrepreneurship management, stakeholder management, project management, and business project management) on the efficiency of the CRM systems for online retailing. The data were collected from Digikala employees in Iran. Based on Morgan's table (Table A2 (Appendix)), 248 samples were randomly selected, and questionnaires were sent to employees, where 234 were fully answered. Research data and assumptions were evaluated using SPSS and PLS software. Research findings showed that innovation management (ß =.390, t = 6.426, p <.001), market knowledge (ß =.296, t = 4.864, p <.001), and competitive intelligence (ß =.115, t = 2.190, p <.005) directly impact the efficient CRM systems for online retailing. Stakeholder management (ß =.283, t = 9.713, p <.001), project management (ß =.229, t = 5.458, p <.001), and business project management (ß =.544, t = 11.351, p <.001) are also effective through the mediator variable of entrepreneurial management (ß =.143, t = 2.314, p <.005) on the efficient CRM systems for online retailing. [ABSTRACT FROM AUTHOR]

This paper is a report on contributions of a critical EFL (English as a Foreign Language) teacher education course to Iranian teachers' professional identity reconstruction. Pre-course and post-course interviews with seven teachers, their reflective journals, class discussions, and the teacher educator's reflective journals were analyzed as guided by grounded theory. Three major shifts were observed in their professional identities: from conformity to and romanticization of dominant ideologies to critical autonomy, from no orientation or an instrumentalist orientation to a critical/transformative orientation of teaching, and from a linguistic and technical view to an educational view of second language education.

In this study, we aimed to examine the relationship between energy-adjusted dietary inflammatory index (E-DII) and a comprehensive profile of malnutrition in Iranian haemodialysis (HD) patients. In this cross-sectional study, 291 participants on HD for at least 6 months before enrollment were included. The current dietary intakes of participants were assessed using a 4-d diet diary-assisted recall, including 2 non-dialysis days and 2 dialysis days to calculate E-DII. To determine the malnutrition status of HD patients, BMI, subjective global assessment (SGA), dialysis malnutrition score (DMS) and malnutrition inflammation score (MIS) were used. Overall, 291 HD patients comprised our study population. After controlling for potential confounders, E-DII was associated with a higher risk of malnutrition, as evidenced by SGA (OR = 2·23; 95 % CI: 1·11, 4·49), DMS (OR = 2·31; 95 % CI: 1·16, 4·60) and MIS (OR = 2·50; 95 % CI: 1·28, 4·88). No significant association was detected between E-DII and BMI either before (OR = 1·78; 95 % CI: 0·83, 3·81) or after adjustment for possible confounders (OR = 1·43; 95 % CI: 0·58, 3·54). This study showed that E-DII was significantly associated with reliable malnutrition markers including SGA, DMS and MIS in HD patients. However, further longitudinal studies are warranted to infer a cause-and-effect relationship between DII and malnutrition. [ABSTRACT FROM AUTHOR]

Background: Primary hypothyroidism is a common endocrine disorder caused by impaired production of thyroid hormones. Recent studies have shown that dietary habits, oxidative stress, and inflammation may play roles in thyroid hypofunction. Thus, the present article aimed to determine the relationship between major dietary patterns and oxidative stress and inflammation in primary hypothyroid patients and healthy people in Iranian adults. Methods: This matched case-control study was conducted on 200 participants (100 cases and 100 controls). The presence of primary hypothyroidism was determined by endocrinologists based on American Thyroid Association (ATA) criteria. Dietary intake was assessed using a validated 168-item, semi-quantitative food frequency questionnaire (FFQ). The principal component analysis (PCA) method was used to derive major dietary patterns. Statistical analysis was performed using logistic regression analysis, and the findings were reported using odds ratios (ORs) with 95% CIs. Results: We identified 2 major dietary patterns (i.e., healthy and Western dietary patterns). After adjusting for confounding variables, participants in the highest tertile of the healthy eating pattern had lower odds of primary hypothyroidism. Also, there was a significant relationship between total antioxidant capacity (TAC) levels and thyroid hypofunction; however, no significant correlation was seen between the Western dietary pattern and malondialdehyde (MDA) and C-reactive protein (CRP) with hypothyroidism. Conclusions: There were statistically direct associations between healthy dietary patterns (loaded with vegetables, nuts and seeds, fruits, dried fruits, olives, garlic, black pepper, starchy vegetables, low-fat dairy, and legumes) and increased TAC levels with a decreased risk of thyroid hypofunction. However, Western dietary patterns and MDA and CRP levels did not associate with an underactive thyroid. [ABSTRACT FROM AUTHOR]

Background: Children with attention-deficit/hyperactivity disorder (ADHD) are more prone to tooth decay. In this regard, parents, especially their mothers, play a major role in the oral health of their children. Materials and Methods: The present study was a cross-sectional descriptive study. The population of this study was 64 children with ADHD referred to pediatric psychiatric clinics in Isfahan. Inclusion criteria include willingness to participate in research. At least 6 months has passed since their child was diagnosed with the disorder and their child is receiving treatment. Lack of obvious physical disorders, psychotic disorders, mental retardation and chronic diseases in children with attention deficit/hyperactivity disorder with the approval of a psychiatrist. Collaboration for dental examination by a dentist. Exclusion criteria include obvious physical and mental disorders in mothers of children with attention-deficit/ hyperactivity disorder. Simultaneous participation in a study similar to the present study due to the possibility of errors in the results. Dissatisfaction with participating in the study and leaving the study during the study. The data collection tool was interview-questionnaire-examination. Clinical interviews were conducted using the Kiddie Schedule for Affective Disorders and Schizophrenia to confirm ADHD and rule out other psychiatric illnesses. Information on decayed, missing, and filled teeth (DMFT) of permanent teeth and dmft of deciduous teeth is recorded separately. The score of each index (D, M, F), (f, m, d) as well as the total index (DMFT), (dmft) is calculated for each person. Data were entered into SPSS software version 26 by descriptive statistical methods, one-way analysis of variance, t-test, and calculation of Spearman correlation coefficient. P < 0.05 was considered statistically significant. Results: The oral health status of children with ADHD did not show a significant relationship with the total score of attitude and knowledge of oral health behaviors of mothers (P > 0.05).The results showed a significant positive relationship between the level of knowledge of the participants and their education level (P < 0.05). Conclusion: The results revealed that mothers' knowledge and attitude about oral health and dental health of children with ADHD were generally at an undesirable level. [ABSTRACT FROM AUTHOR]

Purpose: There is a paucity of evidence regarding the influential factors on Iranian children's diet quality. To assess this issue, we explore the relationship between parental diet quality, socioeconomic status (SES), and nutritional knowledge with their children's diet quality using a cross-sectional sample of the Iranian population. Methods: In this study, paired parents along with one of their children (aged 6–18 years old) who lived with them were included. Dietary intake was assessed using a food frequency questionnaire (FFQ) and diet quality was determined using an Alternative Healthy Eating Index-2010 (AHEI). Nutritional knowledge and SES were also explored using validated questionnaires. Multiple linear regression analysis was used and beta (β) and corresponding 95% confidence interval (CI) were reported. Results: After controlling for potential confounders, the parents' AHEI was significantly associated with their children's diet quality (β = 12.34, 95% CI: 10.75, 13.93; P < 0.001). The nutritional knowledge of parents was significantly associated with children's AHEI after controlling for potential confounders (β = 1.63, 95% CI: 0.14, 3.11; P = 0.032). Moreover, the parents' SES was inversely associated with the AHEI of children (β=-3.76, 95% CI: -5.40, -2.11; P < 0.001); however, further adjustment for confounders attenuated this relationship (Model 3: β = 0.87, 95% CI: -0.76, 2.34; P = 0.269). Conclusions: We found that the children's diet quality could be influenced by their parents' SES, nutritional knowledge, and diet quality. Our findings suggest that improving the nutritional knowledge of parents not only may improve the healthy eating pattern of parents but also could influence their children's diet quality. [ABSTRACT FROM AUTHOR]

Investigating the non-auditory effects of noise on humans has been of interest from different aspects. In this study, the relationship between noise-induced hearing loss (NIHL) and metabolic syndrome. This cross-sectional study was performed on 1380 male workers of one of the oil and gas companies in the south of Iran. The data was obtained via clinical examination and hearing status assessment to evaluate the metabolic syndrome and its components, intravenous blood samples were taken and tested according to NCEPATPIII criteria. For statistical analysis, the data were analyzed using SPSS software version 25 at a significant level of 0.05. The results showed that the body mass index variable increased the chance of developing metabolic syndrome by 11.4%. NIHL increases the chance of developing metabolic syndrome (OR = 1.291). Also, the same results were observed in hypertriglyceridemia OR = 1.255, waist circumference (OR = 1.163), fasting blood sugar (OR = 1.159), blood pressure (OR = 1.068) and HDL (OR = 1.051). Considering the effect of NIHL on metabolic syndrome, it is possible to help reducing the incidence of metabolic syndrome and any of its components by controlling noise exposure and accordingly reducing non-auditory injuries to individuals. [ABSTRACT FROM AUTHOR]

Introduction: Diabetes increases the risk of hospitalization and mortality from COVID-19 due to comorbidities. The purpose of this study was to determine the possible effects of complications related to diabetes and demographic characteristics on mortality and the duration of hospitalization of patients with COVID-19 in the hospital. Methods: The retrospective study was conducted based on a descriptive approach. The statistical population of the study (n=130) consisted of diabetic patients hospitalized with a definite diagnosis of COVID-19 at Amirul Moeminin Ali Hospital in Zabol. The survey period was from 21 March 2021 to 21 March 2022 (one year). Data collection was done by reviewing patients' records by the researcher as well as using questionnaires and checklists. Results: The average hospitalization time due to infection with COVID-19 was 6.5 days (7.3 days for women and 5.3 days for men). The average age of the examined people was estimated at 59.4 years (women 58.4 years and men 60.8 years). The average BMI of patients was obtained at 30.3 kg/m2 (women 30.9 kg/m2 and men 29.3 kg/m2). Out of 130 examined patients, 4 (3.1%) cases died, whose average age was 74 years. Complications of the cardiovascular system were the most common among patients. The most clinical symptoms were cough and the least was vomiting. Conclusion: As the results of this study showed, diabetic patients who were infected with COVID-19 were exposed to a higher risk of hospitalization and more complications from this disease. Therefore, the planners of the Ministry of Health as well as nurses and personnel working in the inpatient wards of COVID-19 patients should pay more attention to these patients. [ABSTRACT FROM AUTHOR]