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Objective: The emerging concept of value co-creation marketing as a new paradigm; is a shift from an organization-based perspective to a more moderate perspective upon interactions among the organization, customers, and value co-creation experience leading to frequent mutual interaction. Co-creation amongst companies and customers is one of the most prospective areas in both consumers' cyber-space and the real world, and also quite an emerging research territory which has not been the target of particular research studies in Iran yet; however, the same handful of studies are conducted to highlight the necessity for more rigorous investigations to understand this phenomenon. This research intends to explore the value co-creation fields and mechanisms of Foreign Language Institutions located in Iran. Methods: The present study utilizes Mixed-Methods Research; initially, the main themes were extracted from the studies relevant to co-creation through Thematic Analysis Method which were verified by twenty experts and specialists selected via judgmental sampling. Then, the Pairwise Comparison Matrix questionnaires were provided and distributed amid twelve career experts by theoretical and targeted sampling for the Fuzzy DEMATEL Method in pursuance of the ranking of Fields and Mechanisms. Results: The findings expressed that value co-creation has five main Fields and 27 Mechanisms (The five main fields' subsets) in Foreign Language Institutions that can substantially contribute to the management board pursuing mutual satisfaction and sense of engagement leading to effective performance in this market of intense and cut-throat rivalry. Conclusions: The findings can be used as a basis for strengthening mechanisms of value cocreation in foreign language institutions. [ABSTRACT FROM AUTHOR]

Osteoarthritis (OA) is the most common type of arthritis and although there is no definitive cure for it, there are treatments for symptom management. The present study was conducted to evaluate the effects of silicon dioxide (SiO2) on clinical symptoms of knee OA and compare it with avocado soybean unsaponifiable (ASU) and placebo. This study is a double-blind randomized clinical trial on 104 patients with knee OA referred to Rheumatology Clinic, Rasoul Akram Hospital, Tehran. Patients were randomly divided into three groups, including patients treated with ASU, SiO2, and placebo for 3 months. Subsequent referral was performed at weeks 4, 8, and 12, and the stiffness, physical function, and pain scores were recorded based on the WOMAC questionnaire. In this study, the effect of treatment of placebo and SiO2 and ASU in patients with knee OA based on WOMAC questionnaire showed a significant reduction in terms of pain, joint stiffness, physical function, and total scores of WOMAC in the cases of the SiO2 group compared with the other two groups. The findings of this study showed that the therapeutic effects of SiO2 in patients with knee OA in terms of pain and stiffness and physical function scores were more than the ASU and placebo groups. [ABSTRACT FROM AUTHOR]

Nature conservation efforts cannot succeed without stakeholder participation. The inherent complexity of nature-based ecotourism has made the development of sustainable ecotourism operations a challenge, so it is essential to increase community stakeholder participation. Hence, this study investigates local community participation in Lar National Park (LNP) and the Jajrud Protected Area with the Sustainable Use of Natural Resource Areas (JPA) in Iran and evaluates how this influences the sustainability of ecotourism. This study found that in LNP, sustainable ecotourism development involving local communities is increasing because of the high level of attachment and interest to this part of pristine nature. In the JPA, the relationship between local community participation and ecotourism sustainability is significant too. As a result, natural habitats have been degraded and sustainability has decreased. To conserve these critically endangered natural areas, managers and decision-makers must increase community participation and education to encourage local communities to engage more in developing sustainable ecotourism. [ABSTRACT FROM AUTHOR]

Benchmarking is the major reason for the widespread use of DEA models for efficiency analysis. Determining the closest targets for DMUs, DEA models play a key role in benchmarking their best performance. In fact, these models help develop certain performance enhancement plans that need fewer attempts made by DMUs. Therefore, this study proposes a novel method based on the network DEA to determine the most appropriate target for every stage in addition to benchmarking the DMUs. The proposed model differs from those proposed by other studies in the fact that all DEA models of benchmarking consider input and output values to be linear. However, in real-world problems, many DMU inputs and outputs have nonlinear values (values are the coefficients of inputs or outputs in modeling and can be the price of desirable outputs or the cost of inputs and undesirable outputs), something which was taken into account in the modeling process in this study. The proposed model was employed to benchmark cement factories listed on the Tehran Stock Exchange. [ABSTRACT FROM AUTHOR]

Ecotourism in protected areas facilitates responsible travel to natural places that conserve the environment, deliver economic benefits to local communities, and offer interpretation and education to visitors. Proper planning and sufficient monitoring of ecotourism sustainability indicators is needed to manage visitor activities in protected areas. Therefore, identifying the major impacts and mitigating them in the early stages of ecotourism development could contribute significantly to the achievement of sustainable development. There is a current gap between the situation in the field and academic contributions to this problem in protected areas of Iran. In the present study, we evaluated ecotourism sustainability levels in four different types of protected areas in Iran, including Lar National Park, Jajrud Protected Area with Sustainable Use of Natural Resource Areas, Tangeh Vashi National Natural Monument, and Kavdeh Wildlife Refuge. We developed a comprehensive list of ecotourism sustainability indicators, including 38 indicators in the environmental–physical dimension, 42 indicators in the demographic–social dimension, and 30 indicators in the economic–institutional dimension. Harnessing local community expertise, we adopted a Delphi approach to determine sustainability levels and factors impacting sustainability. Ecotourism in Lar National Park was most sustainable because of the high levels of restrictions protecting the area and the difficulty in access. Conversely, ecotourism sustainability was lowest at Tangeh Vashi National Natural Monument, which allowed for an uncontrolled influx of visitors. We discuss further factors that impact sustainability, such as population growth, expanding urbanization, an increase in physical and economic activities, and extended annual periods of ecotourism activities. Although the presented ecotourism sustainability indicators are specific to Iran, this study can also be seen to provide a template to plan for sustainable ecotourism in other countries. Altogether, our results suggest conducting a type-by-type analysis of the particular circumstances of various protected areas. [ABSTRACT FROM AUTHOR]

Background: Nutrition-related factors have been of great interest as one of risk factors of biliary stones. This study evaluated the association of dietary patterns with biliary stone among Iranians. Methods: This is a hospital-based case-control study, which was conducted in a general hospital in Tehran, Iran. A total of 110 patients with gallstone or common bile duct (CBD) stone confirmed by Ultrasonography within the last 6 months before collecting data were recruited. Controls were age-matched patients admitted to the other wards of the same hospital for a broad spectrum of disorders including traumas and orthopedic conditions, or elective surgeries, or throat/ear/nose disease and had no gallbladder disorders, participated in this study. We used a valid and reliable food frequency questionnaire to assess dietary intakes of participants. Dietary patterns were determined by factor analysis. Results: By design, age was similar in both groups (57.66 ± 16.39 years vs. 56.00 ± 10.64 years in cases and controls, respectively). Two dietary patterns were extracted; "Unhealthy" (high consumption of artificial juice, processed meats, refined grains, sweets and desserts, pickles, snacks, and red meats), and "Healthy" (high consumption of vegetable oils, vegetables, fruits, fish, legumes, and nuts, as well as low consumption of hydrogenated fats and salt). Participants in the highest tertile of "Healthy" dietary pattern were significantly less likely to have the gallstones disease (OR: 0.33, 95% CI = 0.120.89) compared to the reference group (low tertile of "Healthy" dietary pattern) (P = 0.02). Conclusions: High consumption of vegetable oils, vegetables, fruits, fish, legumes, and nuts, as well as low consumption of hydrogenated fats and salt in context of healthy dietary pattern are inversely associated with risk of gallstones. [ABSTRACT FROM AUTHOR]

Z-numbers can generate a more flexible structure to model the real information because of capturing expert's reliability. Moreover, various semantics can flexibly be reflected by linguistic terms under various circumstances. Thus, this study aims to model the portfolio selection problems based on aggregation operators under linguistic Z-number environment. Therefore, a multi-stage methodology is proposed and linguistic Z-numbers are applied to describe the assessment information. Moreover, the weighted averaging (WA) aggregation operator, the ordered weighted averaging (OWA) aggregation operator and the hybrid weighted averaging (HWA) aggregation operator are developed to fuse the input arguments under the linguistic Z-number environment. Then, using the max-score rule and the score-accuracy trade-off rule, three qualitative portfolio models are presented to allocate the optimal assets. These models are suitable for general investors and risky investors. Finally, to illustrate the validity of the proposed qualitative approach, a real case including 20 corporations of Tehran stock exchange market in Iran is provided and the obtained results are analyzed. The results show that combining linguistic Z-numbers with portfolio selection processes can increase the tendencies and capabilities of investors in the capital market and it helps them manage their portfolios efficiently. [ABSTRACT FROM AUTHOR]

• This study creates a new evaluation DPSIR of ecotourism ecological security (EES) • EES assessments are lacking for protected area. • Critical impact factors are identified and the driving mechanism is constructed. Evaluating the ecological security of ecotourism (EES) in protected areas is critical because these areas play a vital role in protecting biodiversity and natural resources. This study evaluated the EES status of Central Alborz Protected Area (Northern Iran), based on a Driver, Pressure, State, Impact, and Response (DPSIR) model. We developed a comprehensive list of 59 indicators for the DPSIR model and employed an Analytical Network Process (ANP) model to determine indicator weights harnessing the opinion of experts on which indicators are most influential. This approach facilitated the identification of regions with the highest EES vulnerability, notably in the northern and western sectors of our study area along the boundary between Tehran and Mazandaran provinces. Here, the mechanisms that drive EES change the most include ecotourism activities, livestock overgrazing, and uncontrolled physical and economic activities, along with extensive road and highway development, and land use and land cover changes. Indicators that are most effective for determining the EES status, include physical and economic activities. We conclude by discussing indicators to respond to the increasing threat to EES in Protected Areas such as the involvement of government in strategic integrated management. Our study serves as a methodological blueprint on how to evaluate the EES of Protected Areas. [ABSTRACT FROM AUTHOR]

Important aspect of sperm function such as motility and capacitation appear to be mediated at least partially though hyaloronic acid (HA). Present study investigated effects of different doses of HA on sperm motility and vitality in human. Sperm was obtained from 20 male from IVF clinic in Imam Khomeini Hospital. Sperm motility and vitality in human semen was analyzed according to WHO criteria before and 4 hours after treatment with different doses of HA (0.750, 1000 and 1250 μg/ml). The results showed that in 1000 μg/ml the percent of stage 3 and 4 increased compare to control group. Percent of stage 1 and 2 decreased in group with 1000 μg/ml HA, there was an increase in the percentage of stage 3 and 4 and decrease in percentage of stage 1 and 2 compare to control. In the group treated with 1250 μg/ml stage 1 and 2 increased while stage 3 and 4 decreased. Vitality in all groups decreased except of the group treated with 1000 μg/ml HA. The group with 1250 μg/ml showed significantly decrease in vitality compare to fresh group (P < 0.05). The present study showed that the effects of HA on sperm motility and vitality is dose dependant and 1000 μg/ml HA had the effective role on sperm parameters. [ABSTRACT FROM AUTHOR]

Background: Syndactyly is the most common congenital malformation of the hand, with an incidence of 1 in 2000-2500 live births. In this study we evaluated the surgical outcomes and complications of patients with syndactyly. Methods: The surgical outcomes and complications of 42 patients, 27 male and 15, female, undergoing surgery for syndactyly were evaluated. The study took place in Imam Khomeini Hospital, in Tehran, Iran during 1996 to 2011. Having had the inclusion criteria, the patients were assessed for function, cosmetic outcome, sensation and occurrence of complications. The patients were followed-up for at least 3 years. Results: The mean age of patients was 4.4 years. There was a positive familial history for the disease in 8 patients. 71.4%, 90.4% and 73.8% of the participants had good results regarding cosmetic outcome, sensation and function, respectively. Conclusion: The overall results of surgery for syndactyly in this study were interpreted as good in 78.5%, moderate in 12.5% and fair in 8.4% of the patients. This study confirmed better surgical outcomes in patients older than 18 months. [ABSTRACT FROM AUTHOR]

• This study identified and monitored LULC changes in the Jajrud and Tangeh Vashi. • We used Landsat imagery for LULC monitoring and CA-MC for simulation. • Trend of LULC changes in the Jajrud and Tangeh Vashi has led to the destruction of valuable biological habitats. Exploring land use and land cover (LULC) changes in protected areas (PAs) is critical for effective environmental management and sustainability. PAs are ecological regions which play a critical role in preserving natural, ecological, economic, and even cultural values of specific areas. This study monitored LULC changes in two PAs within Tehran province in Iran, namely Jajrud and Tangeh Vashi, using Landsat imagery for the years 1989-2019 and simulated a future LULC map for 2050 using the Markov chain-cellular automata model. The simulated map indicated that built-up areas will have the top increasing trend in Jajrud by 2050; however, high-density pasture will decrease because of the heavy dependency and immediate vicinity of Jajrud to Tehran, the largest city and the capital of Iran. In Tangeh Vashi, bare land expansion will have the top increasing trend, whereas the volume of high-density pasture will have the top decreasing trend. According to the results, the LULC changes in Jajrud and Tangeh Vashi are already greater than management plan standards and have led to the destruction of valuable biological habitats. Without proper planning and managerial strategies, the continuation of such changes will further destroy ecosystems and cause species extinction and unsustainability in the studied PAs. [ABSTRACT FROM AUTHOR]