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Background: Due to the legal necessity of changing the approach of universities from traditional budgeting into the operational budgeting system, it should be noted that this method of budgeting is associated with challenges. The aim of this study was to evaluate the feasibility and prioritization of operational budgeting dimensions in a military medical university. Materials & Methods: This descriptive-analytical and cross-sectional study was conducted in 2020 in two stages. In the first stage, 68 managers, staff and experts of the deputy for Planning and Finance of a Military Medical Sciences university were enrolled by census method. In the second stage, 10 experts were purposefully included in the study. Data collection tool was two valid and reliable questionnaires. Data were analyzed using t-test and SPSS software in the first stage and using AHP approach and Expert Choice software in the second stage. Results: The average overall score and the score for each of the dimensions of ability, authority and acceptance of operational budgeting was 2.3, 2.39, 2.38 and 2.31, respectively which was at an undesirable level (P< 0.05). Also, dimensions of the ability with a weight of 0.547, acceptance with a weight of 0.244 and authority with a weight of 0.209 had the highest weight and importance in the implementation of the operational budgeting system, respectively. Conclusion: Based on the results, it is necessary to pay attention to the three main dimensions of ability, authority and acceptance in implementing operational budgeting in the study population.

The dynamics of open quantum systems is generally described by a master equation, which describes the loss of information into the environment. By using a simple model of uncoupled emitters, we illustrate how the recovery of this information depends on the monitoring scheme applied to register the decay clicks. The dissipative dynamics, in this case, is described by pure-state stochastic trajectories, and we examine different unravelings of the same master equation. More precisely, we demonstrate how registering the sequence of clicks from spontaneously emitted photons through a linear optical interferometer induces entanglement in the trajectory states. Since this model consists of an array of single-photon emitters, we show a direct equivalence with Fock-state boson sampling and link the hardness of sampling the outcomes of the quantum jumps with the scaling of trajectory entanglement.

Abstract Objectives Very few reports have described the Doppler-derived echocardiographic parameters for mechanical pulmonary valve prosthesis (MPVP). This study aims to describe the normal Doppler hemodynamic profile of MPVP using Doppler echocardiography. Methods The current prospective, single center observational study enrolled 108 patients who underwent pulmonary valve replacement (PVR) surgery for the first time and had a normally functioning prosthesis post-operation. The hemodynamic performance of MPVPs, considering flow dependent and flow independent parameters, was evaluated at two follow-up points, at week one and week four post-operation. All assessments were conducted by an experienced echocardiographer. Results The mean age (±SD) of the participants was 26.4 (±8.98). Tetralogy of Fallot (ToF) was the most common underlying disease leading to PVR, with a prevalence of 88%. At first week post-operation, measurement of indices reported the following values (±SD): peak pressure gradient (PPG): 18.51(±7.64) mm Hg; mean pressure gradient (MPG): 10.88(±5.62) mm Hg; peak velocity (PV): 1.97(±0.43)m/s; doppler velocity index (DVI): 0.61(±18); pulmonary velocity acceleration time (PVAT): 87.35(±15.16) ms; effective orifice area (EOA): 2.98(±1.02) cm2;and effective orifice area to body surface area ratio (EOA/ BSA): 1.81(±0.62) cm2/m2. Comparing these measurements with those obtained from the second follow-up (at week four post-op) failed to hold significant difference in all values except for PVAT, which had increased from its primary value (p = 0.038). Also, right ventricular (RV) function showed significant improvement throughout the follow up period. Conclusion The findings of this study help strengthen the previously scarce data pool and better establish the normal values for Doppler hemodynamics in mechanical pulmonary prosthesis.

Actual evapotranspiration is one of the major components of the soil water balance equation. Several methods have been presented for estimating actual evapotranspiration, but the older methods are not practical because of their spatial and temporal dependence. Recently, the Food and Agriculture Organization of the United Nations (FAO) created the WaPOR open-access system on water productivity with the aim of covering countries experiencing water crises in Africa and the Middle East, and the estimation of actual evapotranspiration (ETa) is one of its main products. This portal makes it possible to determine water consumption and water productivity on a large scale with minimal time and cost, so it can be used to manage the agricultural sector. The Google Earth Engine System (GEE), introduced by Google in 2010, is an effective remote sensing instrument for gathering important data from satellite imagery. In this study, the actual evapotranspiration maps of the Maroon-Jarahi basin for 2017 were extracted using the methodology introduced by the FAO and provided in the WaPOR database, and the coding was performed in the GEE system. The results showed that the actual evapotranspiration during this period was highest in July and decreased with the onset of the fall season. Limited water resources are a major obstacle to ensuring food security. Considering that the agricultural sector consumes most of the water in Iran and worldwide, water management in the agricultural sector is of great importance. Water productivity is a key indicator in studying and improving agricultural water management as well as one of the Sustainable Development Goals. In this study, the actual evapotranspiration (AET), net primary production (NPP), and water productivity (WP) for the basin were estimated using the WaPOR portal and Google Earth Engine over a 10-day period with a spatial resolution of 250 m (decadal data). Based on the obtained results, areas with low water productivity were identified. By studying the existing cropping patterns, the type of irrigation system used, and the water and soil conditions in these areas, it was possible to investigate the reason for the low water productivity and propose solutions to improve it.

Multiple sclerosis (MS), a chronic inflammatory demyelinating disease of the central nervous system, is one of the most common neurodegenerative diseases worldwide. MS results in serious neurological dysfunctions and disability. Disturbances in coding and non-coding genes are key components leading to neurodegeneration along with environmental factors. Long non-coding RNAs (lncRNAs) are long molecules in cells that take part in the regulation of gene expression. Several studies have confirmed the role of lncRNAs in neurodegenerative diseases such as MS. In the current study, we performed a systematic analysis of the role of lncRNAs in this disorder. In total, 53 studies were recognized as eligible for this systematic review. Of the listed lncRNAs, 52 lncRNAs were upregulated, 37 lncRNAs were downregulated, and 11 lncRNAs had no significant expression difference in MS patients compared with controls. We also summarized some of the mechanisms of lncRNA functions in MS. The emerging role of lncRNAs in neurodegenerative diseases suggests that their dysregulation could trigger neuronal death via still unexplored RNA-based regulatory mechanisms. Evaluation of their diagnostic significance and therapeutic potential could help in the design of novel treatments for MS.

Autism spectrum disorder (ASD) is a severe neurodevelopmental disorder featuring impairment in verbal and non-verbal interactions, defects in social interactions, stereotypic behaviors as well as restricted interests. In recent times, the incidence of ASD is growing at a rapid pace. In spite of great endeavors devoted to explaining ASD pathophysiology, its precise etiology remains unresolved. ASD pathogenesis is related to different phenomena associated with the immune system; however, the mechanisms behind these immune phenomena as well as the potential contributing genes remain unclear. In the current work, we used a bioinformatics approach to describe the role of long non-coding RNA (lncRNA)-associated competing endogenous RNAs (ceRNAs) in the peripheral blood (PB) samples to figure out the molecular regulatory procedures involved in ASD better. The Gene Expression Omnibus database was used to obtain the PB microarray dataset (GSE89594) from the subjects suffering from ASD and control subjects, containing the data related to both mRNAs and lncRNAs. The list of immune-related genes was obtained from the ImmPort database. In order to determine the immune-related differentially expressed mRNAs (DEmRNAs) and lncRNAs (DElncRNAs), the limma package of R software was used. A protein-protein interaction network was developed for the immune-related DEmRNAs. By employing the Human MicroRNA Disease Database, DIANA-LncBase, and DIANA-TarBase databases, the RNA interaction pairs were determined. We used the Pearson correlation coefficient to discover the positive correlations between DElncRNAs and DEmRNAs within the ceRNA network. Finally, the lncRNA-associated ceRNA network was created based on DElncRNA-miRNA-DEmRNA interactions and co-expression interactions. In addition, the KEGG enrichment analysis was conducted for immune-related DEmRNAs found within the constructed network. This work found four potential DElncRNA-miRNA-DEmRNA axes in ASD pathogenesis, including, LINC00472/hsa-miR-221-3p/PTPN11, ANP32A-IT1/hsa-miR-182-5p/S100A2, LINC00472/hsa-miR-132-3p/S100A2, and RBM26-AS1/hsa-miR-182-5p/S100A2. According to pathway enrichment analysis, the immune-related DEmRNAs were enriched in the “JAK-STAT signaling pathway” and “Adipocytokine signaling pathway.” An understanding of regulatory mechanisms of ASD-related immune genes would provide novel insights into the molecular mechanisms behind ASD pathogenesis.

Background: Heart failure (HF) is a global pandemic and a serious health issue in elderly population. It is among the leading causes of mortality, which imposes immense economic burden and premature deaths. In the present study we evaluate the value of E velocity of mitral inflow/E’ wave of mitral annular velocity/stroke volume (E/e'/SV) index in relation to in-hospital outcomes in patients with acute decompensation of systolic HF. Methods: In this descriptive-cross sectional study, 59 patient admitted with the diagnosis of decompensated HF were selected, and echocardiography was done before initiation of treatment. E/e′/SV ratio calculated for them before initiation of treatment, and then this index compared with duration of admission, treatment type, in-hospital mortality, and other echocardiographic finding including tricuspid regurgitation gradient (TRG), right ventricle (RV) size, RV function, and left atrium (LA) size. Pro-brain natriuretic peptide (Pro-BNP) and cardiac troponin-I (cTN-I) levels were also recorded. Findings: There was a significant statistical relationship between E/e’/SV index with LV and RV function, ejection fraction (EF), and functional class (FC) factor, as well as prior hospital admissions rate. Conclusion: According to the results of present study, E/e’/SV index is not related to the severity of disease, but has a significant relationship with FC and the number of previous admissions.

The common pistachio psyllid (CPP) is thought to respond to nutrient availability in pistachio trees. We determined the effect of a deficiency of leaf iron (Fe) has on the abundance of the pistachio psyllid at a regional scale. First, we monitored the abundance pistachio psyllid in four pistachio orchards (24 trees as 24 repetitions) located in Maybod County, Yazd province in the centre of Iran and then measured leaf nutrient levels. Orchards were located up to 2.6 km apart. Multivariate regressions were used to determine the relationship between leaf nutrients and CPP population growth. The results indicate that the number of psyllid eggs and population growth rate of the nymphs was negatively correlated with Fe levels in the leaves, while peak numbers of psyllid eggs were positively correlated with the levels of Cu in the leaves. In a manipulative field experiment, we conducted two experiments: (1) pistachio trees treated with iron compared with control trees, and (2) pistachio trees previously treated with iron were treated with ammonium sulphate and compared with trees treated with ammonium sulphate. In the first experiment, psyllids in leaf disc-cages had a significantly greater intrinsic rate of population increase and net reproductive rate on Fe-treated trees than the control trees (Stage 1). In the second experiment, psyllids in leaf disc-cages had similar intrinsic rates of population increase and net reproduction both on the ammonium sulphate treated trees (control) and those previously treated with iron. This indicates that iron may have reacted negatively with nitrogen content of the leaves. In general, these findings indicate that when there is a deficiency of iron in the leaves, the application of nitrogen fertilizer had little effect on the performance of CPP and may have played a minor role in the population dynamics of CPP, but the application of a Fe fertilizer without considering the nitrogen content of the leaves may lead to a population outbreak.

Increased production per unit volume of consumed water requires more precise planning in selecting the appropriate irrigation method for the optimal use of available water resources in the agricultural sector. The province of Khuzestan has been ranked third with 13.8 percent of the total date production of the country. Therefore, using pressurized irrigation methods with the goal of optimal utilization of water resources is inevitable. This research was carried out with the aim of investigating the possibility of utilizing subsurface drip irrigation systems in date orchards and determining the most suitable irrigation treatments in terms of yield and water use efficiency for Kabkab cultivar. Mohebbi and Alihoori (2013), in a study conducted with four irrigation treatments including surface irrigation and drip irrigation with 75% and 100% cumulative evaporation of class A evaporation pan in Hormozgan province, showed that despite different amounts of water in treatment irrigations, there was no significant difference in fruit yield, vegetative traits, and shading surface. The highest and lowest water use efficiency was obtained from drip irrigation treatment with 75% water and surface irrigation treatment with water content equal to 100% cumulative evaporation from class A evaporation pan. Therefore, irrigation with drip irrigation method and 75% cumulative evaporation from class A pans were recommended for irrigation of palm groves. The results of Mohebi’s (2005) study on comparing the effects of two equivalent amounts of water, 75% and 100% evaporation of class A pan in two methods of drip irrigation and surface irrigation on the growth and development of the palm cultivar Peeyaram showed that, among different treatments, there were significant differences in vegetative growth indices such as the number of leaflets, the trunk diameter, and the shading surface. However, in terms of leaf number, yield and quality characteristics of fruit including pH, moisture, soluble solids and total sugar content, the differences among treatments were not significant. The irrigation interval was two days in a drip method and seven days in a surface treatment. The results also showed that although different treatments provided different levels of water for trees, there was no significant difference between treatments in terms of yield and quality traits. The effect of treatments on vegetative traits and yield was not significant. Water consumption in 75% evaporation treatment in drip irrigation method was as much as about 40% of water use in surface irrigation. Therefore, treatment of 75% evaporation from the pan was introduced in the drip irrigation treatment method.

Aim of study: This work summarizes the influence of surface drip irrigation (DI) and subsurface drip irrigation (SDI) systems on corn growth indices and actual evapotranspiration (ETc-act) and its components of plant transpiration (Tp) and soil evaporation (E). Area of study: Karaj, Iran Material and methods: The experimental soil was loamy. The corn ETc-act of each mini-lysimeter was measured based on the water balance method. The E was measured using two mini-lysimeters and Tp was estimated from the difference between ETc-act and E. Main results: The resulting data showed that the ETc-act was lower under SDI (384.8 mm) than under DI (423.4 mm). The Kcb-m for the corn increased after sowing and peaked during the mid-season stage, with an average value of 0.47, a minimum value of 0.0 and maximum value of 1.52 under DI and 0.53, 0.0 and 1.74 respectively, under SDI. For Ke-m, the average, minimum and maximum values were 0.33, 0.20 and 0.58 under DI and 0.23, 0.15 and 0.46 respectively, under SDI. The biomass yield was much higher under SDI (81.90 ton/ha) than under DI (63.21 ton/ha). Less E and more Tp occurred under SDI than under DI. SDI achived superior WUE (8.32 kg/m3) compared with DI. Research highlights: SDI was superior to DI based on biomass yield, corn height, stem diameter, and leaf area index which contributed to more favorable soil moisture conditions and low weed incidence; Thus, the SDI system is more productive and would better increase WUE than the DI system.

Regarding the various and several modules involved in the development of High-Tech products and the inability of organizations in providing these projects with hardware, knowledge and financial needs, it is essential to employ the superior resources of the collaborative organizations in the form of strategic outsourcing. On the other hand, the protection of the appropriability and the core information of the organization is mandatory in this collaboration. Therefore, in this paper, using Fuzzy Delphi method the relevant factors of the outsourcing of these projects were identified by selecting the development projects of the complex products in the Organization of Aviation Industries as the case study in the time horizon of February and March in 2018. Following a survey of experts and employing the Structural Equations Modelling in LISREL software, the dimensions were established as Competence (including resources, relations strategy, soft technology, and integration), Needs (including uncertainty, hardware, time and quality), and the project characteris (including technological and appropriability competence). These dimensions were embedded in the conceptual model. The results of the model hypotheses urge that the project characteristics determine the needs of the organization, and the needs are the indicators of the required competence for the development of products. The conclusions can help the managers of the organization related to the development of complex products choose the right projects for outsourcing and competence making in the organization for the long term collaboration. The organization managers can also utilize the model conclusions to select suppliers responsive to the organization needs.

The most important expectaion from defense equipment and weapons acquisition system (DAS) is to fulfill current and future needs of Armed forces in a variable and complex environment effectively and timely. For this purpose, it is necessary that the DAS be able to perform some key activities and this requires some basic capabilities. The capalities enable the DAS to change and rearrange its routine processes and available resources according to environment changes. By interviewing 14 defense acquisition experts, this research tries to identify the capabilities. Through Theme analysis of interviews and Content analysis of 6 available formal defense documents, 12 capabilities were identified. Using the Interpretive Structural Modeling (ISM) showed us 10 capabilities: intelligent management of information and knowledge; looking forward and environment changes perception; creation of common concepts and language; technological perception and management; leading of domestic and foreign capacities; development of robust policies and flexible strategies; innovation and creativeness; management of acquisition program; decision-making; and cooperation between actors located in influence area.

We propose a mechanism for light-induced unconventional superconductivity in a two-valley semiconductor with a massive Dirac-type band structure. The superconducting phase results from the out-of-equilibrium excitation of carriers in the presence of Coulomb repulsion and is stabilized by coupling the driven semiconductor to a bosonic or fermionic thermal bath. We consider a circularly polarized light pump and show that by controlling the detuning of the pump frequency relative to the band gap, different types of chiral superconductivity would be induced. The emergence of novel superconducting states, such as the chiral p-wave pairing, results from the Floquet engineering of the interaction. This is realized by modifying the form of the Coulomb interaction by projecting it into the states that are resonant with the pump frequency. We show that the resulting unconventional pairing in our system can host topologically protected chiral bound states. We discuss a promising experimental platform to realize our proposal and detect the signatures of the emergent superconducting state.

We propose an optical method of shining circularly polarized and spatially periodic laser fields to imprint superlattice structures in two-dimensional electronic systems. By changing the configuration of the optical field, we synthesize various lattice structures with different spatial symmetry, periodicity, and strength. We find that the wide optical tunability allows one to tune different properties of the effective band structure, including Chern number, energy bandwidths, and band gaps. The in situ tunability of the superlattice gives rise to unique physics ranging from the topological transitions to the creation of the flat bands through the kagome superlattice, which can allow a realization of strongly correlated phenomena in Floquet systems. We consider the high-frequency regime where the electronic system can remain in the quasiequilibrium phase for an extended amount of time. The spatiotemporal reconfigurability of the present scheme opens up possibilities to control light-matter interaction to generate novel electronic states and optoelectronic devices.

In the Islamic market, obtaining profits and wealth is not considered as the ultimate goal, but the ultimate goal of each economic activity is divine closeness. The strategy governing in a desirable Islamic market is the victory-victory strategy in which enterprises collaborate with each other and try for satisfying the society demands and enhancing public welfare. This study aims to discuss values affecting Porter competitive strategic decisions considered as a regular pattern in articles on strategic management and marketing. Values considered in competitive strategic decisions including differentiation strategy, cost leadership strategy and focus strategy, were extracted that by defining them we can provide an assistance, even a few, for considering these divine values in policy makings relating to marketing strategic decisions, that these values include quality principle, no fraud principle, ethical services delivering principle, justice and fair in pricing principle, costs optimization principle, individuals social prestige respecting principle. This research is of an applied nature with respect to nature of its objective and descriptive-surveying with respect to its methodology. Its statistical population includes Foods and Beverages Industries’ managers in South Khorasan Province, Iran who are 41 persons. Data gathering method is census. Data analysis indicated that in competitive strategic decisions made in Foods and Beverages Industries, quality principle, costs optimization principle, and individuals’ social prestige respecting principle are complied with and ethical services delivering principle and justice principle are considered in a lower level, that according to the research’s findings, it is due to governance of capitalism principles on Islamic societies.

The aim of this research has been to assess factors affecting the outcomes of university-industry cooperations in 4 advanced technology areas of nanotechnology, biotechnology, aerospace and information technology. By reviewing the literature and global experience, a preliminary model was developed and used to analyse the university-industry cooperative projects. Factors affecting the outcomes of technological cooperations were categorised in four categories, namely individual, organizational, institutional and interactive factors. The model was confirmed using interviews with 20 experts the field of science and technology policy and then used to do a survey with the participation of 279 researchers working on cooperative projects as respondants. Finally, confirmative factor analysis and path analysis were done.

Hydatid disease is a rare parasitic disease, which mainly involves liver then lung tissues. Cardiac involvement is very rare, especially when there is not hepatic involvement. We describe a 47-year-old woman with a history of a lung hydatid cyst who was referred to Rajaei Heart Center, Tehran, Iran in 2012. Her chest computed tomographic scan showed a cardiac mass. Echocardiographic examination illustrated a large, well-defined heterogeneous mass (4.5 × 2.5 cm) in the roof of the right atrium with attachment to the crista terminalis without compressive effect on the inferior and superior venae cavae. The patient was candidate for open-heart surgery via median sternotomy. A cystic mass was observed in the lateral aspect of the right atrial wall. After an injection of hypertonic normal saline into the cystic lesion, the mass was excised totally. The right atrial defect was reconstructed with autologous pericardium. The patient was discharged from the hospital in good condition. Histological examination confirmed the diagnosis of the hydatid cyst.

AbstractThe autonomic nervous system consists of a vast range of nerves and ganglions. Anatomical studies have demonstrated that the sympathetic innervations of the head and neck are affected by the neurons that ramify from the cranial cervical ganglion (CCG). The CCG is the end of the sympathetic cervical trunk, which runs with the vagal nerve during its cervical course. In this study sixteen adult (2 - 5 year) river buffalo of both sexes (eight male, eight female) weighing around 250 - 450 kg were dissected to investigate the weight, situation and arrangement of nerve branches of the cranial cervical ganglion bilaterally. The ganglions showed a fusiform shape and reddish in color. The cranial cervical ganglion covered by the digastricus muscle. It lies in dorsal region of the base of epiglottic cartilage, ventromedial to tympanic bulla and ventrally to atlantic fossa, and medial of the occipital artery. This study showed that the cranial cervical ganglions in river buffalo were well-developed structure. The main branches of cranial cervical ganglion included the internal carotid, external carotid and jugular nerves.

This narrative review aimed to have an algorithmic approach to microphthalmos by a systematic search. The definition can be related to a number of special phenotypes. In the more challenging cases of complex microphthalmos, relative anterior microphthalmos, and nanophthalmos, the surgeon can approach these cases more safely if they have a deep understanding of the anatomical variations and ideal formulae for intraocular lens computation and knows how to avoid intra- and post-operative complications. In this article, we review the criteria by which we recognize and describe pre-, intra-, and post-operative considerations, as well as discuss the ideal intraocular lenses for microphthalmos, given the intricate varieties of small eye phenotypes.

Background and Aim: Proper knowledge, attitude and practice of pregnant women about vaccination during this period will have a significant impact on their and their baby’s health. The aim of this study was to determine the knowledge, attitude and practice of pregnant women toward flu and Td vaccination. Materials and Methods: This study was a descriptive-analytical and cross-sectional study on 312 pregnant women referred to Imam Ali Hospital in Karaj with an age range of 15 to 40 years. Data were collected using a questionnaire. The method of sampling was convenience sampling. The data was analyzed using SPSS software. Results: The mean age of the women was 27.6±6.54 years. 198 (63.5%) of the subjects were housewives and 114 (36.5%) were employed. 248 (79.5%) and 282 (90.4%) of the subjects had appropriate attitudes and knowledge about vaccination with Td vaccines and Influenza, respectively. Also 293 (93.9%) and 137 (43.9%) of the subjects had practice well against both Td and Influenza vaccines. In women with higher education and better economic conditions, and in working women, the practice of both vaccines has become more suitable. As women get older, knowledge and practice about Td vaccination decreased. Also, the most common source of information for pregnant women about the vaccination program were 73.4% of health care workers, 12.5% ​​of the Internet, 10.3% of radio and television, 3.5% of friends and acquaintances, and 0.3% of family members, respectively. In the relationship between knowledge, attitude and practice towards Influenza and Td vaccination, there was a direct and significant relationship between them so that with increasing or decreasing one, the other also increased or decreased. Most of the relationship between awareness and practice items was related to Influenza vaccine (r=0.304) and the lowest relationship between knowledge with practice items was related to Td vaccine (r=0.146). Conclusion: In this study, it was found that with increasing awareness and attitude, vaccination has increased. Regarding Influenza vaccination, due to the significant relationship between the source of information and vaccination, it is recommended that more serious recommendations to be made by the health care staff to pregnant women regarding Influenza vaccination.

Brain is one of the important members of body that life is impossible without it. The brain is affected easily by different factors like physical, chemical factors agents and disrupts brain function in pons, medulla, spinal cord, central and peripheral nervous system. Buprenorphine is an opioid partial agonist that is used as an analgesic and Drug addiction treatment. This drug is metabolized in liver and Excreted through on number of neuroglia cells, neurons and decrease of area on hippocampus. In this research, we have been investigated the impact of Ascending doses of buprenorphine on all rats. in order to perform this research, 35 rats with the same weight range has divided into 7 groups with 5 members that have been injected The drug buprenorphine in 21 days with doses 2,7,10,15,20 and 24 mg/kg and after end of injection, rats were killed by human methods and were sent to laboratory. The results show that intraperitoneal injection of buprenorphine could cause damage on brain tissue. Based on the results have been obtained from statistical tests. The number of neuroglia cells, neurons and hippocampus area does decrease (p

Purpose: To provide the clinical recommendations for the administration of intravitreal anti-vascular endothelial growth factor (VEGF) drugs especially bavacizumab for ocular vascular diseases including diabetic macular edema, neovascular age-related macular degeneration, myopic choroidal neovascularization, retinal vein occlusion and central serous chorioretinopathy. Methods: Twenty clinical questions were developed by the guideline technical committee. Relevant websites and databases were searched to find out the pertinent clinical practice guidelines to answer the questions. The technical committee provided possible answers (scenarios) according to the available evidences for each question. All scenarios along with their levels of evidence and the supported articles were sent to the experts for external review. If the experts did not agree on any of the scenarios for one particular clinical question, the technical committee reviewed all scenarios and their pertinent evidences and made the necessary decision. After that, the experts were asked to score them again. All confirmed scenarios were gathered as the final recommendations. Results: All the experts agreed on at least one of the scenarios. The technical committee extracted the agreed scenario for each clinical question as the final recommendation. Finally, 56 recommendations were developed for the procedure of intravitreal anti-VEGF injection and their applications in the management of ocular vascular diseases. Conclusion: The implementation of this guideline can standardize the management of the common ocular vascular diseases by intravitreal injection of anti-VEGF agents. It can lead to better policy-making and evidence-based clinical decision by ophthalmologists and optimal evidence based eye care for patients.

Background: Curcumin (diferuloylmethane) has been associated with the inhibition of angiogenesis, as well as the prevention of cancers and inflammatory processes. The aim of this study was to assess the efficacy of curcumin in suppressing angiogenesis in the cultured endothelial cells of rat aortic rings. Methods: Eight-week-old male Wistar rats were randomized into five groups each with a different treatment and cell culturing paradigm: controls cultured in the absence of VEGF (vascular endothelial growth factor) (C), controls cultured in the presence of VEGF (C-V), controls treated with curcumin and then cultured in media lacking VEGF (C-TC), diabetics cultured in media supplemented with VEGF (D-V) and diabetics treated with curcumin and then cultured in media supplemented with VEGF (D-V-TC). Each group consisted of 8 animals. Diabetes was induced in by streptozotocin (STZ; 60 mg/kg body weight, IV). After 8 weeks, animals were sacrificed and their aortas were excised. Ring-shaped explants were embedded in a 96-well culture plate. Angiogenesis response was measured by counting the number of primary microtubules in each well. Results: Optic microscopy revealed that the D-V group had the highest number of microvessels, while angiogenesis was not observed in the C or C-TC groups. The number of primary microtubules was significantly lower in the D-V-TC group compared to the D-V group (P

Nowadays, rural tourism is considered as an important part of economic activity. This main economic activity is taken into consideration from different points of view. On the one hand, it is looked as a policy for diversifying the economy of rural communities. On the other hand, it is considered as a mean to reach mobility and national economic growth. Rural tourism can create opportunities and possibilities for rural employment and income. It develops small businesses and provides jobs. Regarding this, the main question of present study: by which means and under which circumstances, tourism, affects rural entrepreneurship development? The aim of this study is to analyze and evaluate the factors affecting the development of entrepreneurship in rural areas in central part of Anar. The research is descriptive in terms of method. Data were gathered from library research and field study, in which, a questionnaire was applied. The population of the study consists of a sample of 30 directors, 90 local authorities and rural residents, who were selected by Simple Random sampling. The SWOT model was applied in order to analyze data. The results showed that the factors related to the strength had the highest rating in the study. Also, “being located on the main roads of the country" among the strengths, "weak entrepreneurial culture among residents" and " negligence of officials" among the weaknesses, "more varied ways to make money" among opportunities and "the destruction of ancient monuments and historic buildings" and "changes in land use and landscape of the village" were among the threats were the most important sub factors in rating. According to the scores of the matrix of internal and external factors, the extracted strategy is to maintaining and protecting.

Purpose: To customize clinical practice guidelines (CPGs) for management of diabetic retinopathy (DR) in the Iranian population. Methods: Three DR CPGs (The Royal College of Ophthalmologists 2013, American Academy of Ophthalmology [Preferred Practice Pattern 2012], and Australian Diabetes Society 2008) were selected from the literature using the AGREE tool. Clinical questions were designed and summarized into four tables by the customization team. The components of the clinical questions along with pertinent recommendations extracted from the above-mentioned CPGs; details of the supporting articles and their levels of evidence; clinical recommendations considering clinical benefits, cost and side effects; and revised recommendations based on customization capability (applicability, acceptability, external validity) were recorded in 4 tables, respectively. Customized recommendations were sent to the faculty members of all universities across the country to score the recommendations from 1 to 9. Results: Agreed recommendations were accepted as the final recommendations while the non-agreed ones were approved after revision. Eventually, 29 customized recommendations under three major categories consisting of screening, diagnosis and treatment of DR were developed along with their sources and levels of evidence. Conclusion: This customized CPGs for management of DR can be used to standardize the referral pathway, diagnosis and treatment of patients with diabetic retinopathy.

Purpose: To report the clinical features of eyes with intraretinal foreign bodies (IRFBs) and to evaluate the results of surgical management in these eyes. Methods: Hospital records of 34 eyes of 33 patients with IRFBs were reviewed. All eyes underwent pars plana vitrectomy to remove the foreign bodies using intraocular forceps or by magnetic extraction. Results: All patients were male with mean age of 28΁12.3 years and were followed for a mean period of 24.5΁2.3 months. The IRFBs were ferromagnetic in 29 (85.3%) cases and were removed using an external magnet in 13 eyes (38.4%) or intraocular forceps in 21 eyes (61.6%). Laser photocoagulation was performed around the IRFB prior to surgery in 7 (20.6%) eyes. Macular pucker and scars developed in 8 (23.5%) eyes and retinal breaks posterior to the sclerotomy were formed in 12 eyes (35.3%) postoperatively. Final visual acuity was 20/40 or better in 12 (35.3%) eyes and 20/200 or better in 23 (67.7%) eyes. Final visual acuity of 20/200 or better had no significant relationship with the site, size, or type of the IRFB or with the interval from trauma to surgery. Conclusion: Despite the complexity of surgical management of IRFBs, anatomic and visual outcomes of vitreoretinal surgery in these cases are generally good. The appropriate route of removal may be determined by the type, size, and site of the IRFB. Removal of magnetic IRFBs using external magnets versus intraocular forceps seems to entail comparable results.

Purpose: To evaluate the demographic and clinical features of childhood pars planitis, and to determine the therapeutic and visual outcomes of the disease. Methods: Medical records of pediatric patients (less than 16 years of age at diagnosis) with pars planitis and at least 6 months of follow-up who were referred to Labbafinejad Medical Center, Tehran, Iran over a 22 year period were reviewed. Results: Overall, 117 eyes of 61 patients including 51 (83.6%) male subjects were included. Mean age at the time of diagnosis was 7.8΁3.2 (range, 3-16) years. Mean best corrected visual acuity (BCVA) was 0.88΁0.76 logMAR at presentation which improved to 0.39΁0.51 logMAR at final visit (P

Purpose: To report the anatomical and functional outcomes of surgery for retinal detachment associated with chorioretinal colobomas. Methods: In this retrospective interventional case series, 28 eyes of 28 patients (including 18 male subjects) who had undergone surgery for retinal detachment associated with chorioretinal colobomas were evaluated regarding the type of intervention, final visual acuity and anatomical outcomes, as well as complications. Cases with less than 3 months of follow-up were excluded. Results: Primary surgery included vitrectomy in 25 (89.3%) and scleral buckling in 3 (10.7%) eyes. The internal tamponade used in eyes undergoing vitrectomy was silicone oil in 23 (92%) eyes and 20% sulfur hexafluoride (SF6) in 2 (8%) eyes. Silicone oil was removed in 11 eyes (45.8%). The mean number of operations per eye was 1.57±0.74, mean follow-up was 40±36 months, and the retina remained attached in 26 eyes (92.9%) at final follow-up. Mean preoperative visual acuity was 2.33±0.55 (range, 1.15-2.9) logMAR which significantly improved to 1.72±0.9 (range, 0.09-3.1) logMAR postoperatively (P < 0.001), however, final median visual acuity was counting fingers at 2 m. The most common complications were cataracts (100%) and ocular hypertension (46.4%). Conclusion: The most prevalent surgical procedure for treatment of retinal detachment associated with chorioretinal coloboma was pars plana vitrectomy and the most frequently used tamponade was silicone oil. Although anatomical success was satisfactory, functional outcomes were not encouraging which reflects the complexity of the condition and associated abnormalities.

Purpose: To evaluate the effect of pars plana vitrectomy (PPV) with internal limiting membrane (ILM) peeling for management of refractory diffuse diabetic macular edema (DME). Methods: In this prospective interventional case series, eyes with refractory diffuse DME unresponsive to macular photocoagulation and/or intravitreal bevacizumab, and best corrected visual acuity (BCVA) ≥20/200 and ≤20/60 underwent triamcinoloneassisted PPV with ILM peeling. Pre- and postoperative evaluations included a complete ophthalmologic examination, fluorescein angiography and optical coherence tomography (OCT). Main outcome measures were BCVA and central macular thickness (CMT). Results: Twelve eyes of 12 patients with mean age of 59.6±3.9 (range, 55-68) years were operated and followed for a mean period of 4.9±1.0 (range, 4-6) months. Mean BCVA at final examination was 0.82 ± 0.18 logMAR which was not significantly better than its preoperative value of 1.00 ± 0.80 logMAR (P=0.959). Visual acuity improved by at least 2 lines in 3 eyes (25%), remained stable in 7 eyes (58%) and decreased by at least 2 lines in 2 eyes (17%). Mean CMT at final examination was 315±95 μm, which was significantly less than its preoperative value of 467±107 μm (P=0.004). Complications included vitreous hemorrhage in 2 and cataract progression in 5 eyes. Conclusion: PPV with ILM peeling for refractory diffuse DME seems to reduce macular thickness, but does not significantly improve visual acuity as observed after an intermediate-term follow up of about 6 months.

PURPOSE: To evaluate the results of pars plana lensectomy in patients with hereditary lens subluxation. METHOD: Hospital records of patients with hereditary lens subluxation who had undergone pars plana lensectomy at Labbafinejad Medical Center, Tehran-Iran from 1996 to 2003 were reviewed. Patients with more than 6 months of follow up were included. Underlying disorders, best corrected visual acuity (BCVA) before and after surgery, intraocular pressure (IOP), postoperative refraction and complications were evaluated. RESULTS: Overall, records of 87 eyes of 49 patients including 27 male and 22 female subjects were reviewed. Mean follow up duration was 20±18 months. Underlying disorders leading to lens subluxation included Marfan syndrome (79.5%), Weill-Marchesani syndrome (8.2%), simple ectopia lentis (8.2%), and homocystinuria (4.1%). The most common indication for surgery was non-correctable refractive error (92.1%). Mean BCVA was 1.13 LogMAR (20/250) preoperatively, which improved to 0.26 LogMAR (20/30-20/40) postoperatively (P < 0.001). BCVA better than 20/40 was achieved in 82.8% of cases after surgery. Angle-supported anterior chamber intraocular lens (ACIOL) was implanted in 85.1% of the eyes. Prophylactic band was applied in 63 eyes (72.4%). Retinal detachment developed in four eyes (4.6%) and was successfully treated. CONCLUSIONS: Lensectomy/anterior vitrectomy with implantation of an angle-supported ACIOL in patients with hereditary lens subluxation improves vision significantly without considerable complications.

PURPOSE: To determine the causes of non-traumatic non-diabetic vitreous hemorrhage (NDVH) and to report the visual and anatomical outcomes and complications of vitrectomy for this condition. METHOD: In a retrospective case series, records of patients who had undergone vitrectomy for non-traumatic NDVH over a ten year period at Labbafinejad Medical Center, Tehran-Iran with at least six months of follow up were reviewed for causes of the condition and outcomes of surgery. RESULTS: From 1993 to 2003, 50 eyes of 49 patients (51% male) with mean age of 62.7±10.3 (range 35-87) years underwent vitrectomy for non-traumatic NDVH. Preoperatively, mean best-corrected visual acuity (BCVA) was 2.36±0.52 LogMAR and relative afferent pupillary defect was positive in 91.1% of the eyes. Mean BCVA increased significantly to 1.38±0.72 LogMAR at six months (P < 0.0001). Causes of non-traumatic NDVH included: branch retinal vein occlusion (56%), central retinal vein occlusion (16%), choroidal neovascularization (12%) and posterior vitreous detachment with retinal break, Eales' disease, familial exudative vitreoretinopathy and Terson's syndrome (each in 4%). The most common causes of poor visual outcomes were: macular pigmentary derangement (26%), optic atrophy (16%), severe lens opacity (12%) and epiretinal membrane (8%). CONCLUSION: Despite the significant increase in VA following vitrectomy, irreversible macular or optic nerve pathology limits significant improvement in central visual acuity in several cases of non-traumatic NDVH. Vascular accidents were the most common cause of this condition.

PURPOSE: To compare the efficacy of classic treatment for ocular toxoplasmosis (pyrimethamine, sulfadiazine and predinsolone) with a regimen consisting of trimethoprim/sulfamethoxazole (TMP/SMX) [co-trimoxazole] plus predinsolone. METHODS: In a prospective randomized single-blind clinical trial, 59 patients with active ocular toxoplasmosis were randomly assigned to two treatment groups: 29 were treated with pyrimethamine/sulfadiazine and 30 patients received TMP/SMX. Treatment consisted of six weeks treatment with antibiotics plus steroids. Anti-toxoplasmosis antibodies (IgM and IgG) were measured using ELISA. Outcome measures included changes in retinochoroidal lesion size after six weeks of treatment, visual acuity before and after intervention, adverse drug reactions during follow up and rate of recurrence. RESULTS: Active toxoplasmosis retinochoroiditis resolved in all patients over six weeks of treatment with no significant difference in mean reduction in retinochoroidal lesion size between the two treatment groups (61% reduction in the classic treatment group and 59% in the TMP/SMX group, P=0.75). Similarly no significant difference was found in visual acuity after treatment between the two groups [mean visual acuity after treatment was 0.12 LogMAR (20/25) in classic treatment group and 0.09 LogMAR (20/25) in TMP/SMX group, P = 0.56]. Adverse events were similar in both groups with one patient in each suffering from any significant drug side effects. The overall recurrence rate after 14 months of follow up was 6.7% with no significant difference between the treatment groups (P = 0.48). CONCLUSION: Drug efficacy in terms of reduction in retinal lesion size and improvement in visual acuity was similar between a regimen of TMP/SMX and the classic treatment of ocular toxoplasmosis with pyrimethamine and sulfadiazine. Therapy with TMP/SMX appears to be an acceptable alternative for the treatment of ocular toxoplasmosis.