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Childhood obesity has become a major non-communicable disease worldwide. It is associated with an increased risk of cardiometabolic factors, including diabetes and hypertension (HTN). The purpose of this study was to evaluate the association between obesity and HTN among Iranian children and adolescents. Cross-sectional data from the SHED LIGHT study performed in Tehran urban area were used in this report. The anthropometric values and blood pressure were analyzed. The obesity status was identified based on body mass index (BMI), waist circumference (WC), and waist-to-height ratio (WHtR). The blood pressure status was defined using percentiles for height, age, and sex. A total of 14,641 children with a mean age of 12.28 ± 3.1 years (6–18) were assessed, and 52.8% of them were boys. The prevalence of HTN was higher among obese compared to healthy weight subjects (p < 0.001). HTN had the strongest association with the central obesity by WC (odds ratio [OR] 4.098, 95% confidence interval [CI] 3.549–4.732), generalized obesity by BMI (OR 3.000, 95% CI 2.749–3.274), and central obesity by WHtR (OR 2.683, 95% CI 2.451–2.936). Moreover, parental university education, having studied in private schools, and the smaller number of household children increased the risk of obesity. The rate of HTN was high among children and adolescents with generalized and central obesities. HTN, elevated blood pressure, boy gender, and socioeconomic status were associated with obesity, emphasizing on the importance of screening and implementing lifestyle changes to decrease future risk of cardiovascular diseases. [ABSTRACT FROM AUTHOR]

Background: Carbapenemase-producing Klebsiella pneumoniae (CRKP) presents a significant challenge to antimicrobial therapy, especially when compounded by resistance to colistin. The objective of this study was to explore molecular epidemiological insights into strains of clinical K. pneumoniae that produce carbapenemases and exhibit resistance to colistin. Eighty clinical isolates of CRKP were obtained from Milad Hospital in Tehran, Iran. Antimicrobial susceptibility and colistin broth disk elution were determined. PCR assays were conducted to examine the prevalence of resistance-associated genes, including blaKPC, blaIMP, blaVIM, blaOXA−48, blaNDM and mcr-1 to -10. Molecular typing (PFGE) was used to assess their spread. Results: Colistin resistance was observed in 27 isolates (33.7%) using the Broth Disk Elution method. Among positive isolates for carbapenemase genes, the most frequent gene was blaOXA−48, identified in 36 strains (45%). The mcr-1 gene was detected in 3.7% of the obtained isolates, with none of the other of the other mcr genes detected in the studied isolates. Conclusion: To stop the spread of resistant K. pneumoniae and prevent the evolution of mcr genes, it is imperative to enhance surveillance, adhere rigorously to infection prevention protocols, and implement antibiotic stewardship practices. [ABSTRACT FROM AUTHOR]

Purpose: Obesity is a chronic low-grade inflammatory condition with increasing global prevalence and is associated with cardiovascular diseases. In this study, we aimed to investigate the prevalence of obesity in the Tehran cohort study (TeCS) population. Methods: We used the data collected by systematic random sampling during the recruitment phase of TeCS. The data comprised 4215 households from all districts of the Tehran metropolis, from which 8296 adults aged ≥ 35 years participated between May 2016 and February 2019. Sociodemographic data, medical history, laboratory tests, and anthropometric measurements were gathered from the participants. Participants with missing data were excluded from the final analysis. Finally, the data was analyzed using SPSS version 23, and distribution maps were created by Stata 14.2. Results: A total of 8211 participants (53.9% women) with an average age of 53.7 ± 12.6 years were studied. The age-weighted prevalence of overweight and obese among women was (37.5% [95% confidence interval (CI): 34.5, 40.6] and 35.5% [95% CI: 32.6 -38.6]) compared to men (47% [95% CI: 43.6, 50.3] and 22.9% [95% CI: 20.1 -25.8]). The prevalence of substantially increased risk of metabolic complications (SIRMC) based on waist circumference (WC) and waist-to-hip ratio (WHR) was 49.2% (95% CI: 46.3 -52.2) and 75.5% (95% CI: 72.7 -78.1) respectively. Conclusions: The prevalence of obesity in Tehran (29.3%) was much higher than in previous reports, particularly among older people, women, and socioeconomically underdeveloped districts. After age 55, more than 80% of women had SIRMC compared to 30% of men. [ABSTRACT FROM AUTHOR]

Background: Henoch-Schönlein purpura (HSP) is the most common type of vasculitis in children. Children with HSP often experience gastrointestinal symptoms, such as abdominal pain, nausea/vomiting, gastrointestinal bleeding, and intussusception. These symptoms are estimated to occur in 50-75% of cases. Objectives: In this study, we evaluated the prevalence of gastrointestinal manifestations in children with HSP and identified associated predictive factors. Methods: For this cross-sectional study, we collected data from 295 children with HSP, aged 1 to 16, who were treated at Mofid Children's Hospital in Tehran, Iran, between 2013 and 2022. We gathered the following information from hospital records: Laboratory results for ALT, AST, bilirubin, stool exam (S/E), WBC, RBC, and occult blood (OB), as well as demographic data. Clinical symptoms evaluated included fever, rash, abdominal pain, distension, tenderness, nausea/vomiting, diarrhea, anorexia, and icterus. Results: Our study included 295 children diagnosed with HSP, consisting of 46.77% females and 53.23% males. The average age was 5.3 ± 2.8 years for female patients and 6.2 ± 2.9 years for male patients. Further analysis indicated that anorexia was the most common symptom, followed by abdominal pain, diarrhea, nausea/vomiting, and bloody stool. We observed no significant differences in symptoms based on sex. Physical examination findings, including abdominal distension and tenderness, were similar across both sexes. Elevated levels of AST and ALT, as well as hyperbilirubinemia, were noted in some patients. Stool analysis revealed positive results for RBC, WBC, and occult blood in certain cases, with 21% testing positive for RBC, 24.85% for WBC, and 23.25% for occult blood. Anorexia showed a correlation with increased AST levels, while bloody stool was associated with higher ALT levels, hyperbilirubinemia, and direct hyperbilirubinemia. Logistic regression analysis confirmed a significant association between bloody stools and elevated ALT levels. Conclusions: In this study, we examined the clinical manifestations and laboratory findings in children with small vessel vasculitis to identify associated predictive factors. Our findings indicated that anorexia and abdominal pain were the most common clinical manifestations, with bloody stool also being a prevalent symptom. Additionally, logistic regression analysis demonstrated that the presence of bloody stool is a significant predictive factor for elevated ALT levels. [ABSTRACT FROM AUTHOR]

This paper presents the results of a study carried out to develop a multi-severity casualty approach for predicting the number of fatalities and two levels of injuries resulting from an earthquake. The two levels of injuries are severity 1, which do not require hospitalization, and severity 2, which do require hospitalization. The method provides a probability distribution of casualty, which can assist policymakers and disaster management authorities in developing emergency response plans. The proposed approach takes into account two main sources of uncertainty: variations in ground motion values (by generating thousands of shaking maps considering the spatial correlation of intra-event uncertainty) and uncertainty in casualty rates (by using the fuzzy set theorem and random sampling). As a case study, the proposed method was applied to the Mosha fault seismic scenario (7.4 Mw) in Tehran, Iran. The results indicated that 200,300 people may lose their lives in that seismic scenario. Additionally, the number of injuries with severity 1 and severity 2 are estimated to be about 420,600 and 232,980, respectively. These numbers exceed the healthcare capacity in Tehran. The estimated number of fatalities was then compared with the results of some existing empirical models in the literature. This comparison revealed that the empirical models underestimate the number of fatalities due to various reasons, such as a lack of strong earthquakes in urban areas to be included in empirical models. Thus, the proposed approach has several advantages for estimating casualties in urban fabrics. [ABSTRACT FROM AUTHOR]

Background: Patients with a stroke often cannot care for themselves after hospital discharge. Assessment of their self-care ability is the first step in planning post-discharge home care. This study aimed to design and validate a measure of perceived self-care ability (PSCA) in stroke patients. Methods: A sequential-exploratory mixed method was conducted in Tehran, Iran, in 2020–2021. The qualitative phase involved in-depth semi-structured interviews with 12 participants. Transcripts were content analyzed. The results guided the development of 81 items. psychometric properties such as face validity (Impact Score > 1.5), content validity ratio (CVR > 0.63), content validity index (Item Content Validity Index: ICVI > 0.78, Scale Content Validity Index/Average: SCVI/Ave > 0.8) and Kappa value (Kappa > 0.7), internal consistency (Cronbach's alpha > 0.7), relative reliability (ICC: inter class correlation coefficient), absolute reliability (Standard Error of Measurement: SEM and Minimal Detectable Changes: MDC), convergent validity (Correlation Coefficient between 0.4–0.7), interpretability, responsiveness, feasibility, and ceiling and floor effects were assessed. Results: Content analysis of the qualitative interviews yielded 5 major categories and 9 subcategories that reflected "Perceptual stability", "Cognitive fluctuations", "Sensory, Motor and Physical health"," The subjective nature" and "The dynamic nature" of PSCA. Results of face and content validity reduced the number of items to 32, capturing three dimensions of PSCA in chronic stroke patients; these dimensions included perceptual ability, threatened health status, and sensory, motor, and cognitive ability. The findings supported the reliability and validity of the measure. Conclusions: The PSCA questionnaire was developed and validated within the Iranian culture. It is useful in assessing the self-care of patients with stroke and in informing practice. [ABSTRACT FROM AUTHOR]

Physical activity is considered one of the most important components of daily activities and a healthy lifestyle for the older adult to achieve well-being. The purpose of this study is to explore older adults' views on physical activity in the neighborhood environment. This study is qualitative and interpretive in nature. In this research, thematic analysis was used to identify, analyze and report patterns in the qualitative data, employing Braun and Clarke's six-step inductive approach. Twenty-four active seniors in the Ekhtiarieh neighborhood of Tehran were interviewed in person. The purpose of the interview was to probe into the deep layers of the interviewees' mindset and obtain valid information. The analysis of the data yielded Hygge as the global theme, and the three main themes of joyful emotions and behavior (Wellness Hygge), perceived social support (Neighborhood Hygge), and safety and security, as well as eight sub-themes. Although Hygge derives Danish culture and its national identity, The creation of a Hygge subculture in the neighborhood through physical activity can be considered as a collective effort to deal with the contradictions in the society with happiness. The findings of this research have been chosen as inspiring concepts for a better and healthier life, to reproduce simple cultural elements that do not exist in the situation of the local culture, by borrowing from the the culture of Denmark, the happiest country in the world. [ABSTRACT FROM AUTHOR]

Background: Eyelid tumors are common in the daily practice of skin tumors and are composed of benign and malignant lesions. Methods: This retrospective case series study collected histopathologic reports of eyelid tumors of patients treated between 2022 and 2023 in Razi and Farabi hospitals (Tehran, Iran). Patient data, including patient age, sex, location of the lesion, and recurrence, were collected. Descriptive and inferential statistics were used to characterize the subgroups. Results: The sample was composed of 154 eyelid tumor specimens, including 72 (47%) malignant cases, 80 (52%) benign cases, and 2 (1%) premalignant cases. Malignant tumors included 81.9% basal cell carcinomas (BCC), 15.3% basosquamous cell carcinomas (BSC), and 1.4% squamous cell carcinoma (SCC). The benign eyelid lesions were comprised of 20% intradermal melanocytic nevus, 11.3% epidermal cyst, 7.6% dermoid cyst, 10% seborrheic keratosis, 6.3% xanthelasma, 2.5% wart, 3.8% compound nevus, 5% fibroconnective tissue, 3.8% squamous papilloma, 3.8% neurofibroma, 2.5% comedone,2.5% apocrine hidrocystoma, 2.5% foreign body type granuloma, and 1.3% of others (arteriovenous hemangioma, cavernous hemangioma, cutaneous horn, etc.) The premalignant lesions were 2 cases of actinic keratosis. Benign lesions had an equal frequency of occurrence in the upper and lower lids. Malignant lesions were seen more in the lower lid. Premalignant lesions were seen in the lower lid. The mean age at diagnosis was 45.8 ± 23.06 years for patients with benign lesions and 63.5 ± 16.7 years for patients with malignant lesions. The mean age for patients with premalignant lesions was 81.5 ± 9.19 years (P < 0.001). Conclusions: In our study, benign lesions were seen predominantly in young persons and malignant lesions were mostly seen in elderly persons. There is an equal occurrence of malignant lesions in males and females, and recurrence after excision was infrequent. [ABSTRACT FROM AUTHOR]

Background: The involvement of the central nervous system is a frequent yet underestimated complication of diabetes mellitus. Visual evoked potentials (VEP) are a simple, sensitive, and noninvasive method for detecting early alterations in central optic pathways. The objective of this paralleled randomized controlled trial was to evaluate the impact of ozone therapy on visual pathways in diabetic patients. Methods: Sixty patients with type 2 diabetes visiting clinics of Baqiyatallah university in Tehran (Iran) hospital were randomly assigned to two experimental groups: Group 1 (N = 30) undergoing a cycle of 20 sessions of systemic oxygen-ozone therapy in addition to standard therapy for metabolic control; Group 2 (N = 30)—serving as control—receiving only standard therapy against diabetes. The primary study endpoints were two VEP parameters; P100 wave latency and P100 amplitude at 3 months. Moreover, HbA1c levels were measured before the start of treatment and three months later as secondary study endpoint. Results: All 60 patients completed the clinical trial. P100 latency significantly reduced at 3 months since baseline. No correlation was found between repeated measures of P100 wave latency and HbA1c (Pearson's r = 0.169, p = 0.291). There was no significant difference between baseline values and repeated measures of P100 wave amplitude over time in either group. No adverse effects were recorded. Conclusions: Ozone therapy improved the conduction of impulses in optic pathways of diabetic patients. The improved glycemic control following ozone therpay may not fully explain the reduction of P100 wave latency though; other mechanistic effects of ozone may be involved. [ABSTRACT FROM AUTHOR]

Physical activity is considered one of the most important components of daily activities and a healthy lifestyle for the older adult to achieve well-being. The purpose of this study is to explore older adults' views on physical activity in the neighborhood environment. This study is qualitative and interpretive in nature. In this research, thematic analysis was used to identify, analyze and report patterns in the qualitative data, employing Braun and Clarke's six-step inductive approach. Twenty-four active seniors in the Ekhtiarieh neighborhood of Tehran were interviewed in person. The purpose of the interview was to probe into the deep layers of the interviewees' mindset and obtain valid information. The analysis of the data yielded Hygge as the global theme, and the three main themes of joyful emotions and behavior (Wellness Hygge), perceived social support (Neighborhood Hygge), and safety and security, as well as eight sub-themes. Although Hygge derives Danish culture and its national identity, The creation of a Hygge subculture in the neighborhood through physical activity can be considered as a collective effort to deal with the contradictions in the society with happiness. The findings of this research have been chosen as inspiring concepts for a better and healthier life, to reproduce simple cultural elements that do not exist in the situation of the local culture, by borrowing from the the culture of Denmark, the happiest country in the world. [ABSTRACT FROM AUTHOR]

Constipation and obstructive bowel disorders are the most common symptoms of prolapse and posterior defects. Prolapse and obstructive defecation disorders are treated using various surgical techniques to repair posterior defects. This study aimed to evaluate the manometry results of patients before and after reconstructive surgery of the posterior compartment. This retrospective cohort study included 40 women with defecation disorders referred to the Imam Khomeini Hospital Complex, an academic center affiliated with Tehran University of Medical Sciences, Tehran, Iran, from 2020 to 2021. Data were collected through medical records and a checklist developed by the researcher before and after surgery. All analyses were performed using SPSS software (version 26), with significance at p<0.05. Forty women with a mean age of 49.47±9.66 years participated in this study. The manometry results showed significant differences in patients before and after surgery in parameters such as maximum resting pressure, push test, constipation, straining during defecation, finger support necessity, sensation of incomplete defecation, dyspareunia, and husband's sexual satisfaction (p<0.001). In addition, all patients had a grade 2 or higher posterior compartment prolapse, which improved in all cases after surgery (p<0.0001). Patients' symptoms significantly improved during the 12-month follow-up after DeLancey level 3 to 1 surgery. This type of surgery proved to be an effective surgical intervention without significant complications in the short-term follow-up. [ABSTRACT FROM AUTHOR]

All companies, regardless of their sector, can take measures to contribute to sustainability, one of these measures consists of their communication strategies to promote responsible consumption among their consumers. That's why, the present study investigates the impact of marketing communications on customers' attitudes towards mobile advertising with the mediate of motivation. The statistical population includes all customers of Chain Stores located in Tehran. A standardized 28-item questionnaire with 5-point Likert Scale was applied for data collection and the sample size was estimated to be 196 people considering the population limitations. In order to analyze data, partial least squares structural equation modeling was applied using smart PLS 3. The results showed consumers need an intrinsic agreement and they hardly accept the in-formation that disagrees with their beliefs. That's why marketers who tend to confirm individuals' attitudes should use highly valuable resources for advertisements. In conclusion, customers' trust in advertising can lead to their loyalty and increase profitability for chain store. It will also lead to greater competition among chain stores in sustainability and dynamic environmental conditions. [ABSTRACT FROM AUTHOR]

Summary: Recovering missing data of defective sensors is an important challenge for reliability of structural health monitoring systems and misjudgment of structural conditions. The present study concerns predicting corrupted data of lost sensors by support vector regression (SVR). The method is tuned via optimizing their parameters by observer–teacher–learner‐based optimization as a powerful meta‐heuristic algorithm. Their performances are compared in predicting the acceleration responses of two real‐world super‐tall buildings: Milad Tower, located in Tehran, and Canton Tower in Guangzhou. Also the minimum required of sensors to predict the acceleration responses are investigated. The results are evaluated by five statistical indices exhibiting that the optimized SVR has sufficient capacity to predict acceleration responses of both towers with limited number of sensors. The proposed method is of practical interest as it does not require finite element modeling of the structure to derive its dynamic responses. [ABSTRACT FROM AUTHOR]

The depositional environment of Asara Shale is discussed in this paper through the detailed analysis of outcrops from the Alborz Basin, NW of Tehran, Iran. The Asara Shale is composed of fine-grained clastic and carbonate (marlstone) strata interbedded with tuff levels. Sedimentary structures include mm- to cm-scale parallel and cross laminations, basal gutter cast, Thalassinoides burrows, bioturbation, clastic/biogenic particle alignment, and normal-size grading. Facies analysis suggests an accumulation dominated by periodic flood energy fluctuations, here related to shallow-marine hyperpycnal discharges. Based on the sedimentary architecture and analysis of the facies associations, five main sedimentary facies have been defined in these outcrops, corresponding to S1, S2, S3, S4, and MM. Suspended‐load‐dominated facies (Facies S) are related to sedimentation from weak turbulent suspensions and consist of massive sandstones (S1), parallel and low-angle-laminated sandstones (S2), ripple-marked sandstones (S3), parallel‐laminated/massive siltstones and mudstones (S4), and microbial mats (MM). Ratios of redox-sensitive elements indicate that the Asara Shale accumulated in an oxygenated depositional environment. This environment is associated with the presence of parallel-crested ripple marks, microbial-induced sedimentary structures (i.e., wrinkle structures), plant fragments, and surface-grazing gastropods. Based on a variety of sedimentary textures and structures, a shallow-water depositional environment is proposed. This study offers new insights into the depositional environment of Asara Shale. Due to the oxic character of this sedimentary basin, and the lack of significant organic matter, it is interpreted that the Asara Shale is not a potential hydrocarbon source for the future explorations. [ABSTRACT FROM AUTHOR]

The photovoltaic modules are mostly installed outdoors, exposing them to different conditions. These conditions significantly affect their performance. One of the most influential factors on photovoltaic modules is the soiling phenomenon from dust deposition. Dust deposition on the surface of the modules causes transmittance loss. Some studies in different parts of the world have tried to find mathematical correlations between particulate deposition and transmittance. These correlations are a function of dust characteristics and environmental factors. This study proposes a new methodology to mathematically combine the photovoltaic model and transmittance loss correlations. The proposed model could examine and predict the effect of soiling on photovoltaic modules' performance. Three photovoltaic modules with different capacities are selected. Using the proposed model, they are modeled by assuming clean and dirty photovoltaic surfaces depending on the installation conditions. This study is based on actual data from the center of Tehran, located at 35° 41′ north latitude and 51° 23′ east longitude for 12 months in the year 2020. The module's performance was investigated in the presence of dust. The presented results are validated by comparing them with other studies. The results show that the soiling effect is not dependent on the modules' capacity. [ABSTRACT FROM AUTHOR]

Background and Objectives: Acinetobacter baumannii, an opportunistic pathogen, is related to hospital-acquired infections and increased mortality. This study aimed to develop the loop-mediated isothermal amplification (LAMP) test for the fast-detecting of A. baumannii isolates as well as determining genetic relatedness for these isolates via the REP-PCR technique. Materials and Methods: LAMP primers and multiplex PCR primers were designed for recognizing A. baumannii isolates harboring the blaSHV-1, blaPER-1, blaTEM-1, AMPC, qnr, and aac (6)-1 genes, were collected (October 2020 to February 2021) from Shahid Motahari Hospital, Tehran, Iran. Combination disc test (CDT) results were used to assess the phenotypic identification of isolates from ESBL producers. The sensitivity of the LAMP method was evaluated using a range of serial dilutions of genomic DNA. Results were compared between the LAMP technique, and multiplex PCR. The genetic diversity of clinical isolates was determined by REP-PCR. Results: Among one hundred A. baumannii samples and based on the combined disc test, 56% of isolates were ESBL producers. The sensitivity of the LAMP technique for the identification of A. baumannii was 4.06 ng/μl whilst the multiplex PCR was (16.2 ng/μl). Regarding multiplex PCR, (68%) of the isolates were blaSHV-1 positive, (40%) blaPER-1, (85%) aac (6)-1, AMPC (67%), blaTEM-1 (63%), and (15%) qnr respectively. While in LAMP, (69%) of isolates were bla positive, (86%) aac (6')-1, and (20%) qnr. The results of AMPC, blaTEM-1, and blaPER-1 genes showed 100% compatibility between multiplex PCR and LAMP assays. The results of REP-PCR indicated there were 17 clones, clone A at 14% was the most prevalent of the isolates. Conclusion: Wherever equipment and financial constraints are crucial, the LAMP test offers a better and more potent detection rate for the identification of A. baumannii isolates than multiplex PCR. Furthermore, the genetic diversity of A. baumannii in these clinical isolates showed frequent commonality of genotypes. [ABSTRACT FROM AUTHOR]

In Islamic cities, the shariʿa determines to what extent women are allowed to attend public spaces. This article addresses women's public attendance in Tehran, in both the classical and modern periods, and compares this with the prescriptions of the shariʿa. Our exploration of the Qurʾan, hadiths, the practices of religious scholars, and the descriptions of women's status in travelogues suggests two distinct views, the first of which prohibits any kind of public appearance and considers home to be the best place for women. The second view holds that women can enter public spaces, but with some preconditions. Amidst the complexity of religion, society, culture, and politics, two shariʿa tenets have not changed significantly over time: veiling and sex segregation. Some female spheres outside the home have vanished as others have emerged. As a result of these shifts, the one notable change has been that women appear more frequently in public. [ABSTRACT FROM AUTHOR]

With the severe outbreak of the novel coronavirus (COVID-19), researchers are motivated to develop efficient methods to face related issues. The present study aims to design a resilient health system to offer medical services to COVID-19 patients and prevent further disease outbreaks by social distancing, resiliency, cost, and commuting distance as decisive factors. It incorporated three novel resiliency measures (i.e., health facility criticality, patient dissatisfaction level, and dispersion of suspicious people) to promote the designed health network against potential infectious disease threats. Also, it introduced a novel hybrid uncertainty programming to resolve a mixed degree of the inherent uncertainty in the multi-objective problem, and it adopted an interactive fuzzy approach to address it. The actual data obtained from a case study in Tehran province in Iran proved the strong performance of the presented model. The findings show that the optimum use of medical centers' potential and the corresponding decisions result in a more resilient health system and cost reduction. A further outbreak of the COVID-19 pandemic is also prevented by shortening the commuting distance for patients and avoiding the increasing congestion in the medical centers. Also, the managerial insights show that establishing and evenly distributing camps and quarantine stations within the community and designing an efficient network for patients with different symptoms result in the optimum use of the potential capacity of medical centers and a decrease in the rate of bed shortage in the hospitals. Another insight drawn is that an efficient allocation of the suspect and definite cases to the nearest screening and care centers makes it possible to prevent the disease carriers from commuting within the community and increase the coronavirus transmission rate. [ABSTRACT FROM AUTHOR]

Increase in antibiotic resistance in Staphylococcus aureus isolated from ear infection is a serious public health problem. The objective of this investigation was to determine the antibacterial resistance profile and genetic variability of the S. aureus isolated from adult patients with otitis externa (OE) and otitis media (OM) infections, Tehran- Iran. The disk diffusion was employed to detect the susceptibility of 45 S. aureus strains. Biofilm production was evaluated by microtiter plate assay. Genetic diversity of the isolates was determined by staphylococcal cassette SCC mec , spa , and MLST techniques. Resistance to mupirocin and vancomycin were identified in 40 and 2.2% of isolates. Out of the 45 S. aureus isolates, 41 (91.2%) strains were considered as positive biofilm strains at different levels. According to our results, S. aureus isolated from OM (44.4%, 20/45) were including CC8/ST239-SCC mec III corresponded to spa types t860, t030, t037, t234, t421 (70%, 14/20) and CC/ST30-SCC mec IV corresponded to spa types t605 and t019 (30%, 6/20) while S. aureus isolated from OE (55.6%, 25/45) were including CC/ST30-SCC mec IV corresponded to spa types t605, t345 and t1130 (52%, 13/25), CC/ST22-SCC mec IV corresponded to spa type t790 (20%, 5/25), CC8/ST8-SCC mec IV corresponded to spa type t008 (16%, 4/25), and CC/ST45-SCC mec IV corresponded to spa types t004 and t038 (12%, 3/25). This study highlighted genetic variability and strong biofilm formation ability among our isolates revealing its crucial role in enhancing the resistance of this bacteria to drugs. Thus, it is necessary to continue the epidemiological analysis to improve the control of ear infections related to S. aureus. [ABSTRACT FROM AUTHOR]

Background: Coronavirus disease 2019 (COVID-19) is a multisystem disease, manifested by several symptoms of various degrees. Severe acute respiratory syndrome coronavirus-2 (SARS-CoV-2) can affect the central nervous system (CNS) through several mechanisms and brain imaging plays an essential role in the diagnosis and evaluation of the neurological involvement of COVID-19. Moreover, brain imaging of patients with COVID-19 would result in a better understanding of SARS-CoV-2 neuropathophysiology. In this study, we evaluated the brain imaging findings of patients with COVID-19 in Shohada-e Tajrish Hospital, Tehran, Iran. Methods: This was a single-center, retrospective, and observational study. The hospital records and chest and brain computed tomography (CT) scans of patients with confirmed COVID-19 were reviewed. Results: 161 patients were included in this study (39.1% women, mean age: 60.84). Thirteen patients (8%) had ischemic strokes identified by brain CT. Subdural hematoma, subdural effusion, and subarachnoid hemorrhage were confirmed in three patients. Furthermore, there were four cases of intracranial hemorrhage (ICH) and intraventricular hemorrhage (IVH). [ABSTRACT FROM AUTHOR]

In today's creative economy, ideas and intellectual capital have replaced natural resources, and human creativity is the ultimate source of economic growth. Creative Capital selects specific cities and regions for work and living, known as creative cities; Cities that have the greatest capacity to attract, retain and nurture creative capital. This research aims to assess where Teheran stands both internationally and nationally among the most creative cities, known for their capacity to attract, retain and nurture creative economy, ideas and intellectual capital. First, a creative city framework is developed based on a review of 11 existing creative city indices. Second, based on their frequency of use, relevance and data availability 40 indicators were identified and computed. Using the VIKOR Method, an effective multi-criteria decision-making approach for diverging indicators, a national and international benchmarking analysis is performed on Teheran and selected cities. Results from the national benchmarking suggest that Teheran generally outperform the other Iran metropolis in 16 indicators. However, results from the international benchmarking show mix findings, where Teheran is well ranked in the human capital factor, and needs improvement in other factors including territorial assets, tolerance and resilience, and R&D and technology. Policy implications are discussed in the conclusion. [ABSTRACT FROM AUTHOR]

The health risk and burden of disease induced by exposure to benzene, toluene, ethylbenzene, and xylene (BTEX) in the outdoor air in Tehran, 2019 were assessed based on the data of five fixed stations with weekly BTEX measurements. The non-carcinogenic risk, carcinogenic risk, and disease burden from exposure to BTEX compounds were determined by hazard index (HI), incremental lifetime cancer risk (ILCR), and disability-adjusted life year (DALY), respectively. The average annual concentrations of benzene, toluene, ethylbenzene, and xylene in the outdoor air in Tehran were 6.59, 21.62, 4.68, and 20.88 μg/m3, respectively. The lowest seasonal BTEX concentrations were observed in spring and the highest ones occurred in summer. The HI values of BTEX in the outdoor air in Tehran by district ranged from 0.34 to 0.58 (less than one). The average ILCR values of benzene and ethylbenzene were 5.37 × 10-5 and 1.23 × 10-5, respectively (in the range of probable increased cancer risk). The DALYs, death, DALY rate (per 100,000 people) and death rate (per 100,000 people) induced by BTEX exposure in the outdoor air in Tehran were determined to be 180.21, 3.51, 2.07, and 0.04, respectively. The five highest attributable DALY rates in Tehran by district were observed in the districts 10 (2.60), 11 (2.43), 17 (2.41), 20 (2.32), and 9 (2.32), respectively. The corrective measures such as controlling road traffic and improving the quality of vehicles and gasoline in Tehran could reduce the burden of disease from BTEX along with the health effects of other outdoor air pollutants. [ABSTRACT FROM AUTHOR]

Purpose: Meeting the patients' requirements as customers of the health care sector is crucially important as a social responsibility. According to the resource constraints, only an efficient utilisation of health services can provide that purpose. This study aims to develop a quantitative assessment framework for radiology centres as a vital section in healthcare to translate the patients' requirements into service quality specifications. This would help to achieve quality improvement by emphasising the voice of customers. Design/methodology/approach: A literature review is conducted to specify the service quality criteria and the patients' requirements related to healthcare and hospitals. Based on the experts' opinions, these criteria and requirements are later customised for the radiology centres. Moreover, the requirements are categorised into five dimensions of SERVQUAL. The interrelations between service elements are also determined through expert group consensus using Pearson correlation. Afterwards, by applying the QFD method, the relations between the requirements and criteria are explored. Additionally, a customer satisfaction survey is executed in Tehran public hospitals to prioritise these requirements and provide an importance-satisfaction analysis. Findings: Based on the result of the case study, service elements are prioritised for improvement, and practical suggestions are provided using the Delphi technique for quality improvement. In addition, a cause-and-effect diagram is presented to highlight the improvement area and provide enhancement suggestions. Originality/value: This study is the first empirical attempt to benefit from the VOC in evaluating and enhancing the quality of service delivered to radiology patients. In doing so, the study applies a hybrid approach of QFD and SERVQUAL as well as other tools to highlight the improvement area and provide enhancement suggestions. The findings can be readily used by the practitioners. [ABSTRACT FROM AUTHOR]

Background: Distal Radial Artery (DRA) is a new arterial access for coronary catheterization. Assessment of the vascular complications of this new procedure is important in the provision of nursing care to cardiac patients. The aim of this study was the nursing assessment of vascular complications of DRA in angiography and angioplasty. Materials and Methods: This qualitative longitudinal study was conducted on 315 consecutive patients who were candidates for coronary catheterization via DRA from 2017 to 2020 in three hospitals in Tehran, Iran. Patients who had palpable DRA and were capable and willing to consent to inclusion in the study were evaluated. Moreover, patients whose DRA access failed, and those who had previously undergone coronary artery bypass graft were excluded from the study. Vascular complications were assessed on the day of the procedure and about 1 month later. Results: After the procedure, 29 cases of ecchymosis, 8 cases of hematoma, and 1 case of arteriovenous fistula in the DRA were observed. We did not observe any major vascular complications. Conclusions: Nursing assessment of the snuffbox area indicated that this approach is a safe and convenient technique for cardiac catheterization with few minor complications. [ABSTRACT FROM AUTHOR]

Tehran, the capital of Iran, is the largest and most populous city in Iran, which is of great importance due to its large population and abundant infrastructure. One of the most critical issues in this city is its need for resilience against all kinds of threats, including natural hazards, because its development was not based on territorial geography. In other words, in developing this 700 square kilometer area, attention has yet to be paid to its different zones. Different zones include the mountains, Shemiranat's alluvial cone area, the Tehran plain, etc. Main and minor faults, surface and underground water resources of the land, differences in formations between various parts of the land, the microclimate of the land in its multiple aspects, local and synoptic air currents, etc., have not been influential in urban development. The most crucial goal of this study is to identify and screen natural hazards in Tehran to improve this city's resilience by introducing a novel integrated MCDM method based on ANP and The Combined Compromise Solution method with Maximum Variance (MV-CoCoSo). Therefore, to increase the strength of Tehran against these disasters, the natural hazards of Tehran must first be identified and ranked. In this regard, practical criteria for evaluating Tehran's resilience were identified using library resources and the formation of expert groups. Then, using the ANP method, the comparative weightings of these effective criteria was investigated. Based on the results obtained, the disaster consequence criterion had the highest importance with a weight of 0.4361, followed by the disaster severity scale criterion with a weight of 0.2371, and the secondary threat possibility criterion (with a weight of 0.1232) was ranked third. Finally, using the MV-CoCoSo method, the natural hazards of Tehran city were classified based on the evaluated criteria. Tehran City's three significant disasters were earthquakes, floods, and landslides. In addition, two experiments were designed to assess the robustness of the research methodology. [ABSTRACT FROM AUTHOR]

Background: The impacts of caring for hospitalized COVID-19 patients on nurses are wide and varied and have not been comprehensively explained in the existing literature. The aim of this study was to explore the nurses' perception of the impacts of caring for hospitalized COVID-19 patients. Materials and Methods: In this qualitative descriptive study, data were collected via semi-structured interviews with 20 nurses and head nurses of emergency/internal wards and Intensive Care Units (ICUs) of 2 hospitals in Tehran, Iran. The purposive sampling method was used, and data analysis was performed using a conventional content analysis approach. Results: After data analysis, 12 subcategories, 3 main categories, and 1 theme (professional resilience) were extracted. The three main categories included "complex care," "professional development," and "caring self-efficacy." Caring for hospitalized COVID-19 patients was complex for nurses; however, the care provided to these patients could also lead to the nurses' professional development and caring self-efficacy. Conclusions: Health organizations and nursing managers can better manage the COVID-19 pandemic and other similar future crises through strategies such as providing nurses with adequate and diverse resources and facilities, encouraging and supporting nurses in various dimensions, providing positive media advertisements for the nursing profession and nurses, and providing nurses with necessary and applicable knowledge and skills. [ABSTRACT FROM AUTHOR]

The spatial models dealing with urban growth dynamics have been widely studied, while rare works have considered under-developed countries. Several problems have been detected in creating, calibrating and applying urban growth models and changing land use. The present work aims the modelling land-use changes through the CA-GA model in which a frame is provided for analysis and producing a map of growth patterns in urban areas in different spatial scales to study and analyse the increasing urban growth in Tehran. To consider the land-use changes in Tehran, ETM+TM images of 1985, 1992, 2000, and 2020 were selected to be analysed by the CA-GA algorithm to model the growth of the urban areas. The total kappa of results in Tehran is about 0.93, indicating the required precision and confidence of applied combinative genetic-Cellular automata modelling methods to model urban development. [ABSTRACT FROM AUTHOR]

The present research was done with the aim of presenting the aspects and indices of research and development management for the scholar performance of Islamic Azad university scientific board members of Tehran. As a mixed survey, this research is a combination of the quantitative and qualitative research methods. The qualitative part population is the commentators’ member of scientific board in Islamic Azad University of Tehran and its sample is 14 people of higher education experts that reached theoretical salivation by 10 people. Data analysis method in qualitative part was done using open, axial and selective coding via interview and Delphi fan methods. The results obtained from the qualitative part showed that the named indices were composed of nine scholar literacy, scientific factors, technical and informational skills, methodological literacy, environmental factors, organizational factors, managerial factors, technological factors and individual properties. This way, totally, 9 aspects, 25 indices and 80 categories were finalized to identify the aspects, indices and categories of research and development management for scientific board member scholar performance of university. In total, management and development indices are among the scholar literacy, scientific factors, technical and informational skills, methodological literacy and environmental factors. [ABSTRACT FROM AUTHOR]

Constipation is a common reason for children seeking medical care worldwide. Abdominal complaints and constipation are also common in lead-poisoned children. This study evaluates the prevalence of abnormal blood lead levels (BLL) among pediatric and adolescent patients and examines the association of constipation with elevated BLL. This was a prospective data collection of patients younger than 18 years old with the chief complaint of constipation seen in the Mofid Children's Hospital gastroenterology clinic and Loghman Hakim pediatric and pediatric gastroenterology clinics were eligible for enrollment in this study. Constipation was defined as infrequent or difficult defecation according to ROME IV criteria lasting 2 months or more. BLL was measured with a fresh capillary whole blood capillary sample. The LeadCare II device assays BLL using an electrochemical technique (anodic stripping voltammetry). A total of 237 patients were enrolled in the study. 122 (51.48%) were female and 115 (48.52%) were male. About one fifth of patients (49; 20.67%) had BLL ≥ 5 µg/dL. The mean BLL in the sample was 3.51 µg/dL. Abdominal pain was the most common symptom accompanying constipation (134; 56%). Multivariate analysis found endoscopic evaluation (P values 0.024, OR 3.646, 95% CI 1.189–11.178), muscle pain (P values 0.020, OR 24.74, 95% CI 1.67–365.83), and maternal education (P values 0.02, OR 4.45, 95% CI 1.27–15.57) with significant differences in groups of patients with normal and elevated BLL. Elevated BLL necessitates an assessment and plans to reduce childhood lead exposure. BLL screening in childhood constipation with refractory chronic abdominal pain may also eradicate the need for invasive procedures like endoscopic evaluation. [ABSTRACT FROM AUTHOR]

The present study was conducted to monitor the genotypes of circulating species A rotavirus (RVA) in Iran and investigate genetic linkages between specific RVA VP7, VP4, VP6, and NSP4 segments. For this purpose, 48 RVA strains were detected during the 2021–2022 seasons. The two combinations of G9P[4] and G9P[8] RVA strains were predominant. However, several other combinations of RVA also were detected. Based on the distribution of I and E genotypes (46 strains) with respect to G and P, the most common strains were G9P[4]‐I2‐E2 (19.5%), G9P[4]‐I2‐E1 (6.5%), G9P[4]‐I1‐E1 (4.3%), G9P[8]‐I1‐E1 (19.5%), and G9P[8]‐I2‐E2 (10.9%), which were followed by several other combinations of G and P RVA strains with different pattern of I‐E genotypes and also emerging, rare and uncommon strains. The present study described the continued circulation of G9 strains with the emergence of uncommon G9P[4] and G9P[8] reassortants with three and two different I‐E genotypes, respectively, which have not been reported previously in Iran. Our findings indicated that these uncommon strains exhibited a unique genotype pattern comprising a mixture of genogroup 1 and 2 genes and suggest the need for further analysis of rare, uncommon, and emerging strains of RVA at all 11 gene segments to determine intergenogroup and intragenotype reassortments. [ABSTRACT FROM AUTHOR]

The hypertonicity of internal anal sphincter resting pressure is one of the main causes of chronic anal fissure. Therefore, the aim of this study was to assess the effect of oral administration of l-arginine on the improvement of the anal fissures by relaxing the internal anal sphincter. Seventy-six chronic anal fissure patients (aged 18–65 years) who were referred to Rasoul-e-Akram Hospital, Tehran, Iran from February 2019 to October 2020 participated in this randomized, double-blind, placebo-controlled trial. Participants were allocated into treatment (l-arginine) and placebo groups. They took a 1000 mg capsule three times a day for 1 month, and then we followed them at the end of the first and third months after the intervention. Clinical symptoms, anal sphincter resting pressure, and quality of life (QoL) were completed at baseline and the end of the study. The analysis of data showed a significant decrease in bleeding, fissure size, and pain for each group; however, in the L-arginine group was more than the control group at the end of the study (P values < 0.001). Following that, a significant increase in QoL was seen just in patients treated with l-arginine (P value = 0.006). In addition, the comparison of anal pressures at baseline and, between groups at the end of the study showed a significant reduction in sphincter pressure in patients treated with l-arginine (P value < 0.001, = 0.049; respectively). The oral administration of 3000 mg l-arginine can heal chronic anal fissures by reducing internal anal sphincter pressure with more negligible side effects. However, we recommend long-term study with more extended follow-up. Clinical trial registry: IRCT20190712044182N1 at Iranian clinical trials, date: 2019-08-27. [ABSTRACT FROM AUTHOR]

Background: Education of the patients with Coronavirus Disease 2019 (COVID-19) and their families is necessary to improve the quality of life. This study investigated the effect of person and family-centered training via telenursing on the quality of life in patients with COVID-19. Methods: This interventional study was performed on 88 patients with COVID-19 18-65 years and 44 family members referred to the Bank Melli Hospital, Tehran, Iran. The samples were randomly assigned into two groups person-centered and family centered. A cyberspace group including patients and their families was created. Four educational sessions planned (15-30-min-every day) and three sessions planned for completing the questionnaires via phone. The data were collected using demographic characteristics form and the 12-item Short-Form Health Survey version 2 before and 6 weeks after the intervention and were analyzed in SPSS 22 using Chi-square test, paired t-test, and independent t-test. Results: The mean scores of quality-of-life increased significantly in the person-centered group from 26.81 ± 5.15 to 34.4 ± 4.39 before and six weeks after intervention, respectively (p < 0.001). The means scores of quality-of-life increased significantly in the family-centered group from 28.11 ± 4.79 to 35.86 ± 3.85 before and 6 weeks after the intervention, respectively. (p < 0.001). Conclusions: The person and family centered methods increase the mean scores of quality-of-life of patients with COVID-19. The family centered method can be more effective to improve the quality of life of these patients. [ABSTRACT FROM AUTHOR]

[Display omitted] • Multi-objective model to evaluate solar systems' air pollution reduction capacity • MIVES-based approach to assess the sustainability impacts of suitable solar systems • Annual CO 2 & PM avoiding by using PV & PVT to 211 & 488 kg/m2 and 1.2 & 1.9 g/m2 • BAPV obtains higher sustainability value as the best socio-economic alternative. • BAPV/T is the eco-friendly alternative having the potential to reduce air pollution. Renewable energy applications are lucrative alternatives to minimize urban environmental impacts. Solar energy, the most abundant, inexhaustible, and cleanest of all renewable sources, provides an opportunity to transform buildings from energy consumers into active energy producers. Nevertheless, photovoltaic (PV) and hybrid photovoltaic/thermal (PV/T) are considered the most viable alternatives for urban settlements. This study, as part of a broader research project, develops a new model to evaluate solar systems' air pollution mitigation capacity and assist decision-makers in adopting the most suitable solution. The approach is based on the integrated value model for sustainability assessment (MIVES), combined with the analytic hierarchy process (AHP) and sensitivity analysis. This multi-objective tool is applied to residential buildings in Tehran, a megacity example with unused rooftops, solar energy harvest potential, and air pollution reduction needs. Results reveal one square meter of PV and PV/T enables avoiding 211 and 488 kg CO 2 emissions annually, as well as 1.2 and 1.9 g PM pollutants, respectively. Although PV achieves higher sustainability indexes as a better socio-economic alternative, PV/T can be a robust solution when stakeholders are more sensitive to environmental requirements and air pollution decrement potential. The critical obstacle to PV/T deployment is the lack of financial incentives. However, allocating 38 % of solar electricity feed-in tariffs to solar thermal energy could solve this issue. Compared to green roofs, solar systems stand out with CO 2 saving and energy production potential. Researchers expect future solar collectors' improvements, such as lower resource consumption, thus, becoming more environmentally friendly and cost-effective solutions. [ABSTRACT FROM AUTHOR]

Introduction: Up to 90% of postmenopausal women and female cancer survivors may be affected by the genitourinary syndrome of menopause (GSM), with a negative impact on sexual function and quality of life. A novel energy-based device among the treatment options for GSM is radiofrequency therapy (RFT). RFT is a treatment option that uses energy from radio waves to heat the tissue. The objective of this study was to assess the impact of RFT on sexual function in female cancer survivors (gynecologic and breast) and non-cancer menopausal women. Methods: In a single-arm prospective trial, the efficacy of RFT in both female cancer survivors (gynecologic and breast) and non-cancer menopausal women with sexual dysfunction at a tertiary and referral center (Imam Hossein Medical Center, Tehran, Iran) was evaluated between April 2022 and December 2022. The study protocol consisted of 3 monthly RFT sessions. Examination was performed at baseline (T0) and 3 months after the last RFT session (T1). The primary outcome was sexual function, which was assessed using the Female Sexual Function Index (FSFI). In addition, adverse events were evaluated during treatment and at T1. Results: A total of 37 female cancer survivors (mean [SD] age: 49.4 [8.9] years) and 37 non-cancer menopausal women (mean [SD] age: 53.8 [5.5] years) were enrolled. Patients exposed to RFT showed a significant improvement in FSFI scores when compared to baseline scores for both female cancer survivors (13.07, 95% CI: 12.27 - 13.86) and non-cancer menopausal women (13.18, 95% CI: 12.34 - 14.03). There was no difference in FSFI total score improvement between the two groups (t(72) = 0.06, P = 0.951). There were no serious adverse events associated with RFT. Conclusion: The efficacy of RFT as a treatment for sexual dysfunction has been demonstrated in both non-cancer menopausal women and female cancer survivors. In both groups, a significant improvement was confirmed. [ABSTRACT FROM AUTHOR]

Summary: In this study, multivariate empirical mode decomposition (MEMD) is used to evaluate the dynamic characteristics of super‐tall buildings. Two super‐tall buildings, including Milad Tower, which is located in Tehran, Iran, and Canton Tower, which is located in Guangzhou, China, are used as examples to estimate the capability of multivariate empirical mode decomposition for recognizing the dynamic characteristics of buildings. A method is suggested to extract the frequency of structures automatically. First, the best segment of required data, including acceleration response and wind speed is found, and then wavelet transform is used to eliminate the noise and find proper and wanted natural frequency. Finally, to investigate all signals, that is, acceleration responses of all channels simultaneously, MEMD is applied to identify the frequency of the filtered signals. The extracted frequencies are selected in the order of amplitude power of each mode for each intrinsic mode function (IMF). The obtained results are appropriate, corresponding to other studies. Hence, the proposed method can automatically select the accurate frequency of super‐tall buildings in less time duration by considering all required data simultaneously. [ABSTRACT FROM AUTHOR]

Background: Protective behaviors play a key role in reducing the incidence of COVID-19 in HealthCare Workers (HCWs), and these behaviors are related to other factors. These related factors have not been comprehensively evaluated and determined in the literature. This study aimed to determine protection behaviors against COVID-19 and their related factors using the Protection Motivation Theory (PMT) among HCWs of hospitals in Tehran, Iran, in 2021. Materials and Methods: For this cross-sectional study, 270 HCWs of different wards in 3 hospitals in Tehran, Iran, were selected through multistage sampling (April to July 2021). The participants completed a self-reporting questionnaire which consisted of a demographic characteristics form and questions about protective behaviors against COVID-19 and other constructs of the PMT (60 items). Data analysis was performed using descriptive and inferential methods. Results: The mean score of the protective behaviors of the HCWs was 4.20 (SD = 0.56) and was significantly higher in the nurses, women, married individuals, and those with a BSc degree compared with others (p < 0.05). Furthermore, the results of multiple regression analysis showed that protection behavior among HCWs could be strongly predicted by the type of profession, protection motivation/intention, and self-efficacy constructs (F14, 255 = 16.34, p < 0.001). Conclusions: The protection behaviors of HCWs against COVID-19 were relatively desirable and these behaviors were related to and predicted by various factors. These results could apply to developing plans for protective behaviors against COVID-19 and possibly other infectious diseases among HCWs. Further research in this regard is recommended. [ABSTRACT FROM AUTHOR]

Background: Lynch syndrome (LS) is one of the commonest genetic cancer syndromes, with an incidence rate of 1 per 250–1000 population. The aim of this study was to evaluate the frequency and characteristics of MMR deficiency in endometrial cancer in Iranian women. Methods: One hundred endometrial carcinoma cases who referred to the gynecological oncology clinic of Imam Hossein Medical Center located in Tehran, Iran, from 2018 to 2020 were included in the study. Immunohistochemistry (IHC) evaluation was performed mainly on the hysterectomy specimens of all endometrial cancer (EC) patients to assess MMR proteins (MLH1, MSH2, MSH6, and PMS2) expression. Results: A total of 23 out of 100 (23%) cases were identified through IHC screening to be MMR-deficient. The most common types were loss of MLH1/PMS2 (17.4%) and solitary MSH2 (17.4%) expressions followed by PMS2/MSH2 loss (13%). MMR deficiency (dMMR) histopathology was significantly overrepresented in patients with family history of cancer or Lynch syndrome (LS) associated cancers (p-values of 0.016 and 0.005, respectively). The rate of myometrial invasion and lower uterine segment involvement were also significantly higher in dMMR EC patients compared to MMR-intact EC (p-value of 0.021 and 0.018, respectively). Conclusion: MMR deficiency, observed in 23% of endometrial cancer cases, was associated with higher rates of poor prognostic factors including myometrial invasion and lower uterine segment involvement. The presence of positive family history of cancer and family history of LS-associated cancer increased the probability of MMR-deficiency in endometrioid endometrial cancer to 47% and 70%, respectively. [ABSTRACT FROM AUTHOR]

In Islamic cities, the shariʿa determines to what extent women are allowed to attend public spaces. This article addresses women's public attendance in Tehran, in both the classical and modern periods, and compares this with the prescriptions of the shariʿa. Our exploration of the Qurʾan, hadiths, the practices of religious scholars, and the descriptions of women's status in travelogues suggests two distinct views, the first of which prohibits any kind of public appearance and considers home to be the best place for women. The second view holds that women can enter public spaces, but with some preconditions. Amidst the complexity of religion, society, culture, and politics, two shariʿa tenets have not changed significantly over time: veiling and sex segregation. Some female spheres outside the home have vanished as others have emerged. As a result of these shifts, the one notable change has been that women appear more frequently in public. [ABSTRACT FROM AUTHOR]

The way workers perceive noise exposure can play an important role in the adoption of safety behaviors. Therefore, the determination of the relationship among risk awareness, behavior, and exposure can be an extremely important issue in controlling noise exposure. The aim of this study was to investigate the association between risk perception and practice of workers. Workers from 16 printing houses in Tehran province participated in present study. A questionnaire was used for determining the level of risk perception and practice about hearing conservation. The results revealed a significant relationship between risk perception and safety behavior adoption (P < 0.001). A positive and significant correlation was found between these two variables (P < 0.001; rs = 0.912). Also, the results showed that workers with hearing impairment had a better practice. In addition, attention should be paid to preventive principles and encouragement of hearing protection devices usage among employees. [ABSTRACT FROM AUTHOR]

Introduction: In this descriptive cross-sectional study, we have made our attempt to recognize the highest microbial contamination in operating rooms (OR), which could have a striking correlation with increasing duration of hospitalization or probability of death. Material & Methods: Totally 3909 samples of surgical equipment have been sampled from the various surgical field from Aug to Oct 2020. The specimens were obtained in the morning shift, and all the bacteria which had more than 50,000 CFU are noticed as pathogenic microorganism. Eventually, we classified the cases into 4 levels in terms of hygiene and sterility, as mentioned in the text. Results: Among all the specimens, the highest contamination rate was related to Sandbags, O2 & CO2 tank, Toilet slippers, ORs desk, and Tourniquets, respectively. Overall, ten species of bacteria have been detected, and also Staphylococcus aureus, E. coli, and Bacillus subtilis were the most commonly transmitted infectious pathogens in the OR ward. Conclusion: According to our findings, it is recommended that adequate cleaning should be done regularly, at least 3 times a week. To improve disinfection methods, we can also increase equipment contact with detergents. [ABSTRACT FROM AUTHOR]

Introduction: In this descriptive cross-sectional study the aim is to assess the plasma concentration of "1,25-dihydroxycholecalciferol" and the serious problems come thereinafter amongst operating room (OR) staffs of Tehran's hospitals. Material and methods: Primarily a questionnaire with some ascertained queries in order to understand the individual's life style have been obtained and secondarily we proceed to gather their blood specimens. The ELISA methods is used for evaluation. Results: Totally about 700 employees in surgical ward of hospitals are assessed Amongst whole the statistical society, just 112 individual's plasma 1,25(OH2)D3 concentration are in the normal range (about 16%) and for 569 bodies (81.28%) the concentration is below the regular rate. Generally some clinical disorders like Alopecia (30.85%), skin lesions (17.57%), gastrointestinal diseases (17.28%) and eye problems (13.57%) were the most complains. Conclusion: According to considerable hypovitaminosis occur in OR's staff and detrimental occasions come afterward for personnel themselves and the patients, we certainly recommend them to utilize fruits and dairy products which enriched with vitamin D besides taking multivitamins and effective supplements. [ABSTRACT FROM AUTHOR]

Background: Despite the large number of pregnant women with the coronavirus disease 2019 (COVID-19), there is not enough analytical study to compare maternal and fetal consequences of COVID-19 infected with non-infected pregnancies. This cohort study aimed to compare maternal and fetal consequences of COVID-19 infected with non-infected pregnancies.Methods: We included pregnant women with and without COVID-19 who were admitted to Arash Hospital in Tehran, Iran, from 1 March to 1 September 2020. Clinical features, treatments, and maternal and fetal outcomes were assessed.Results: A total of 199 women enrolled, including 66 COVID-19 infected and 133 non-infected pregnant women prospectively. Caesarean section was carried out in total 105 women (52.76%). A significant difference was found in term of delivery type between COVID-19 infected and non-infected pregnant women [adjusted risk ratio (aRR): 1.31, 95% confidence interval (CI): 1.04, 1.65, P = 0.024]. No significant association was found between COVID-19 infection and preterm birth (aRR: 1.16, 95% CI: 0.54, 2.48, P = 0.689), low birth weight (aRR: 1.13, 95% CI: 0.55, 2.31, P = 0.723), gestational diabetes (aRR: 1.67, 95% CI: 0.81, 3.42, P = 0.160), pre-eclampsia (aRR: 2.02, 95% CI: 0.42, 6.78, P = 0.315), intrauterine growth restriction (aRR: 0.16, 95% CI: 0.02, 1.86, P = 0.145), preterm rupture of membrane (aRR: 0.19, 95% CI: 0.02, 2.20, P = 0.186), stillbirth (aRR: 1.41, 95% CI: 0.08, 18.37, P = 0.614), postpartum haemorrhage (aRR: 1.84, 95% CI: 0.39, 8.63, P = 0.185), neonatal intensive care unit (ICU) admission (aRR: 1.84, 95% CI: 0.77, 4.39, P = 0.168) and neonatal sepsis (aRR: 0.84, 95% CI: 0.48, 1.48, P = 0.568). The percentage of patients (4/66, 6.06%) being admitted to the ICU was significantly higher than the control group (0%) (P < 0.001).Conclusion: Basically, although pregnancy and neonatal outcomes were not significantly different, the need for ICU care for pregnant women with COVID-19 was significantly higher compared with those without COVID-19. [ABSTRACT FROM AUTHOR]

Acrylamide concentration in food products collected from the Tehran market was investigated by the aid of a dispersive liquid-liquid microextraction (DLLME) system coupled with gas chromatography-mass spectrometry (GC-MS). Also, the dietary exposure distribution and related potential risk for acrylamide ingestion were estimated by the Monte Carlo simulation (MCS). The highest and lowest mean concentration of acrylamide was detected in coffee and roasted nuts samples as 549 and 133 μg/kg, respectively. The mean acrylamide dietary exposure values for children (3–10 years), adolescents (11–17 years), adults (18–60 years), and seniors (61–96 years) were estimated to be 1.81, 1.02, 0.61, and 0.53 μg/kg body weight (BW)/day, respectively. In all age groups, except children, the estimated exposure in men and boys was higher than that in women and girls. Bread, despite containing low acrylamide content groups (157 μg/kg while compared with other, except roasted nuts), showed with the highest contribution rate in all age groups due to its high consumption rate. The estimated incremental lifetime cancer risk (ILCR) for all age groups was noted as greater than 10−4 indicating serious risk to the population. Moreover, the margin of exposure (MOE) values based on carcinogenicity showed health concern to all age groups (< 10,000). Regarding the non-carcinogenic risk, the target hazard quotient (THQ) was lower than 1, and MOE based on neurotoxicity was higher than 125 (safety thresholds), which represented negligible and ignorable risk in all age groups except in a small group of children and adolescents. [ABSTRACT FROM AUTHOR]

Background: Measuring family caregivers' quality of life plays a significant role in improving the quality, efficiency, development, and provision of efficient services for patients with COVID-19. As a result, evaluating the quality of life requires the use of valid and reliable measures that are culturally appropriate. This study was conducted to determine the psychometric properties of the Persian version of the Quality of Life in Life-Threatening Illness–Family Carer Version (QOLLTI – F) in patients with COVID-19. Methods: This methodological study was carried out in 2021 at Baqiyatallah Hospital in Tehran. After gaining approval from the tool creator, the translation was carried out utilizing the forward-backward approach. Cognitive interviews with 10 family caregivers of COVID-19 patients were used to demonstrate face validity. Moreover, construct validity was identified by performing exploratory factor analysis (EFA) (n = 251), confirmatory factor analysis (CFA) (n = 200), and convergent validation using Zarit Burden Interview (ZBI) questionnaire. For scale reliability, internal consistency and stability were performed using Cronbach's Alpha Coefficient and test-retest, respectively. Results: 451 family caregivers of patients with COVID-19 were enrolled in this study. Three factors with a cumulative variance of 51.85% were extracted during EFA: (1) Caregiver's physical-emotional status, (2) Satisfaction with the situation, and (3) Caregiver's concerns. CFA showed that the model enjoyed a moderate to a good fit of information (RMSEA: 0.087; NFI: 0.98; CFI: 0.91; IFI: 0.91; GFI 0.89; standardized RMR: 0.070). A significant correlation was found between the Persian version of the ZBI and participants' total scores of QOLLTI – F v3 (r = –0.196, P = 0.000). Cronbach's Alpha Coefficient = 0.719 and ICC stability reliability = 0.71 of the questionnaire were confirmed. Conclusion: The Persian version of the QOLLTI – F v3 is a valid and reliable scale that can measure family caregivers' quality of life during a Life-Threatening illness in patients with COVID-19. This instrument may be utilized in clinical trials and research to enhance the quality of life for family carers in Iranian society. [ABSTRACT FROM AUTHOR]

The aim of this study is to determine the relationship between knowledge and attitude toward using hearing protection devices as a safe behavior. Also, it is intended to analyze the role of individuals and job characteristics on using earplugs or earmuffs. In this study, workers participated from 16 printing industries located in five areas of Tehran province and completed the questionnaire knowledge, attitude, and practice (KAP) about hearing conservation. Noise measurement was performed based on participants' tasks. With increasing attitude, practice improved (P = 0.001). The results revealed that positive attitude led to improved practice of workers in hearing conservation (r = 0.172; P < 0.001), and with increasing knowledge, negative attitude diminished (P = 0.014). The results indicated that awareness is correlated with attitude, and attitude could directly affect the behavior. Thus, awareness as an intermediate or primary factor might play an important role in developing safe behaviors. [ABSTRACT FROM AUTHOR]

The urban expansion and growth of Tehran have caused many challenges and issues for the city, which has been shown in the form of spatial–social balances with informal expressions, weakness of local governments, biological pollution, etc. The lack of balance in urban service facilities has led to a significant gap in different parts of the city. In this research, main providers of urban facilities concerning spatial inequality were used. The results of this study, using spatial statistics methods and fuzzy logic, showed that the propellants of the city of Tehran are distributed in three ways: cluster, random, and disperse. Hospitals, police stations, subway lines, local governments, and gas stations are clustered. Fire stations, Red Crescent, food and wholesale centers, medical services, housing prices, bus terminals, and hotels are random. Ambulance services and sports clubs are dispersed. These ways of distribution have resulted in a significant difference in the use of services provided by residents of different regions and have contributed to unequal opportunities for citizens in the use of facilities. Deprived districts represent the fact that the urban population is growing faster than the necessary infrastructure which can be built by urban management. The least developed and underdeveloped areas are mostly in the south and southeast of Tehran city, the medium and relatively developed areas are located in the center and west of the city, and the developed areas are located in the north of the city. Findings in this paper are trying to provide main criteria and the results to have a rational assessment of the current situation in the city to solve problems to urban managers and planners, as well as policy and planning strategy for urban development programs to achieve urban sustainability. [ABSTRACT FROM AUTHOR]

Purpose: Obesity is becoming more prevalent worldwide. Magnesium (Mg) intake may play a role in the regulation of energy metabolism and body weight. Therefore, in this cross-sectional study, we aimed to investigate the association between dietary Mg intake and body composition among healthy adults. Methods: A total of 778 adult men and women aged 18–59 years who attended health care centers in Tehran, Iran, entered the final analysis. Dietary intake was assessed with a validated and reliable food frequency questionnaire with 168 items and the dietary Mg intake was estimated using Nutritionist IV software. Anthropometric measurements and blood samples were collected and body composition was evaluated employing the Body Mass Index (BMI), A Body Shape Index (ABSI), Body Adiposity Index (BAI), Body Roundness Index (BRI), Visceral Adiposity Index (VAI), Lipid Accumulation Index (LAP), and Triglyceride-Glucose index (TyG). Multiple linear regression analysis was used to determine the association of the dietary Mg intake with body composition indices. Results: The mean daily dietary Mg intake was 294 ± 140 mg in men and 262 ± 112 mg in women. Unadjusted linear regression showed that dietary magnesium intake is significantly associated with a waist to hip ratio (WHR) and total cholesterol (TC) in men, and hip circumference (HC) in women. After adjusting for potential confounders including age, education, marriage, occupation and smoking, total energy intake, and activity score, there remained no significant association between dietary Mg intake and any of the body composition indices including BMI, ABSI, BAI, BRI, VAI, LAP, and TyG neither in men nor women. Conclusion: Higher Mg intake was not associated with anthropometric indices in Iranian adults, according to our findings. Additional observational studies would be beneficial in clarifying the existing findings. [ABSTRACT FROM AUTHOR]

Renal transplant therapy is essential in patients with End-Stage Renal Disease (ESRD). It is used in patients awaiting a kidney transplant or those who cannot be a transplant candidate. Central venous catheter is one of the most used access routes worldwide but has been recorded as the one with highest mortality and morbidity rate. Thromboembolic events have played a major part for that. This is a descriptive-analytical study, which conducted in a university treatment center in Tehran, Iran. A total of 225 patients were selected for this study that 108 were excluded because of our criteria. Statistical analysis was performed by SPSS v19 and a total of 117 patients were included in this study. The average age of the patients was 51.62±11.26. 79 (67.5%) and 38 (32.5%) patients had medial and lateral tip direction, respectively. The catheter of 85(72.6%) and 32(27.4%) patients was patent and occluded, respectively. The average catheter tip occlusion time in both groups was 22.5 and 7.5 months. Three-month, six-month, twelve-month, and twenty-four-month patency rate were 99%, 94%, 88%, and 30%, respectively. our findings suggest that medial direction of the tip of the catheter reduces complications caused in CVS. Because our study has been conducted in a small scale and there is lack of similar studies, our team suggests extension to a larger scale to confirm or not our results. [ABSTRACT FROM AUTHOR]

Background: Aggressive behavior of patients in psychiatric wards is one of the main challenges faced by healthcare workers. Despite the abundance of research on the frequency of aggressive behavior, not enough attention has been paid to its severity. Furthermore, limited studies have evaluated the restraint methods used to manage aggressive behaviors. Objectives: The current descriptive study aimed to compare the relationship between demographic characteristics, diagnosis of psychiatric illness, medical illness, and hospitalization characteristics with features of aggressive behavior in patients experiencing different types of restraint during hospitalization. Methods: We evaluated subjects admitted to the adult psychiatric wards of Imam Hossein and Taleghani hospitals in Tehran, Iran, in 2018. The patients were controlled by various restraint methods during hospitalization. All the patients were evaluated for the severity of aggression, which was determined utilizing the Persian version of the Modified Overt Aggression Scale (MOAS). All the data along with demographic and clinical characteristics obtained from medical records were analyzed using the Mann-Whitney and Kruskal-Wallis nonparametric test (P-value = 0.05) and Spearman correlation coefficient to describe the factors affecting the aggressive behavior of patients. Results: In this study, the prevalence of aggressive behavior was 11.7%. Among the demographic variables, gender (P-value = 0.003), education level (P-value = 0.05), and the history of aggressive behavior (P-value = 0.001) were significantly associated with the MOAS. Furthermore, as the hospitalization duration increased, the frequency of aggressive behavior decreased, and its severity intensified. Moreover, therewasa significant relationship between aggression severity with admission type (P-value =0.00), concurrent medical illness (P-value = 0.026), and substance abuse (P-value = 0.025). Conclusions: Variables affecting aggressive behavior, such as male gender, involuntary admission, and a history of aggression, might aid in the early detection of patients who may exhibit more severe aggressive behavior. [ABSTRACT FROM AUTHOR]