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Abstract Background Chronic osteomyelitis is a debilitating bone infection, characterized by a persistent infection over months to years, poses diagnostic and therapeutic challenges due to its insidious nature and potential for severe bone and soft tissue destruction. This systematic review and meta-analysis aims to review the literature on the treatment of chronic osteomyelitis in long bones and assess cure rates in single versus two-stage surgery. Methods Following the PRISMA guidelines and registered with PROSPERO (ID: CRD42021231237), this review included studies that reported on the management of chronic osteomyelitis in long bones using either a planned one-stage or two-stage surgical approach in adult patients. Databases searched included Medline, Embase, Web of Science, CINAHL, HMIC, and AMED, using keywords related to osteomyelitis, long bones, and surgical management. Eligibility criteria focused on adults with chronic osteomyelitis in long bones, with outcomes reported after a minimum follow-up of 12 months. The meta-analysis utilized the random-effects model to pool cure rates. Results The analysis included 42 studies with a total of 1605 patients. The overall pooled cure rate was 91% (CI 95%) with no significant difference observed between single-stage and two-stage surgeries (X2 = 0.76, P > 0.05). Complications were reported in 26.6% of cases in single-stage procedures and 27.6% in two-stage procedures, with prolonged wound drainage noted as a common issue. Dead space management techniques varied across studies, with antibiotic-loaded calcium sulphate beads used in 30.4% of cases. Conclusion This meta-analysis reveals no significant difference in cure rates between single and two-stage surgical treatments for chronic osteomyelitis in long bones, supporting the efficacy of both approaches. The current treatment strategy should include a combination of debridement, dead space management using local and systematic antibiotics and soft tissue reconstruction if necessary.

Abstract Purpose The purpose of this systematic review is to examine the outcomes, complications, and potential advantages of using anatomical interlocking intramedullary nails (IMN) in the treatment of radius and ulnar shaft diaphyseal fractures in adults. Methods Medline, Embase, Web of Science, and Cumulative Index to Nursing and Allied Health Literature (CINAHL) databases were searched between January 2000 and January 2023. Studies meeting criteria were observational or randomized controlled trials evaluating outcomes in IMN for adult diaphyseal forearm fractures. Standardized data extraction was performed and a quality assessment tool was used to evaluate individual study methodology. Descriptive statistics for interventions, functional outcomes, and complications were reported. Meta-analysis was performed for patient-reported outcome measures and operative time. Results A total of 29 studies involving 1268 patients were included with 764 (60%) undergoing IMN, 21% open reduction and internal fixation (ORIF), and 9% hybrid fixation. There was no significant difference between groups in DASH and Grace–Eversmann scores. Operative time was significantly shorter in IMN compared with ORIF. The DASH scores were: 13.1 ± 6.04 for IMN, 10.17 ± 3.98 for ORIF, and 15.5 ± 0.63 in hybrids. Mean operative time was 65.3 ± 28.7 in ORIF and 50.8 ± 17.7 in IMN. Complication rates were 16.7% in the IMN group, 14.9% in ORIF, and 6.3% in hybrid constructs. There were 11 cases of extensor pollicis rupture in the IMN group. Average IMN pronation and supination were 78.3° ± 7.9° and 73° ± 5.0°, respectively. Average ORIF pronation and supination was 82.15° ± 1.9° and 79.7° ± 4.5°, respectively. Conclusions Similar functional outcomes and complication rates along with shorter operative times can be achieved with IMN compared with ORIF. The use of IMN is promising, however, higher quality evidence is required to assess appropriate indications, subtle differences in range of motion, implant-related complications, and cost-effectiveness. Trail Registration PROSPERO (International Prospective Register of Systematic Reviews) (ID: CRD42022362353). Level of evidence III.

Background: Chronic progressive external ophthalmoplegia (CPEO) is a rare disorder that can be at the forefront of several mitochondrial diseases. This review overviews mitochondrial CPEO encephalomyopathies to enhance accurate recognition and diagnosis for proper management. Methods: This study is conducted based on publications and guidelines obtained by selective review in PubMed. Randomized, double-blind, placebo-controlled trials, Cochrane reviews, and literature meta-analyses were particularly sought. Discussion: CPEO is a common presentation of mitochondrial encephalomyopathies, which can result from alterations in mitochondrial or nuclear DNA. Genetic sequencing is the gold standard for diagnosing mitochondrial encephalomyopathies, preceded by non-invasive tests such as fibroblast growth factor-21 and growth differentiation factor-15. More invasive options include a muscle biopsy, which can be carried out after uncertain diagnostic testing. No definitive treatment option is available for mitochondrial diseases, and management is mainly focused on lifestyle risk modification and supplementation to reduce mitochondrial load and symptomatic relief, such as ptosis repair in the case of CPEO. Nevertheless, various clinical trials and endeavors are still at large for achieving beneficial therapeutic outcomes for mitochondrial encephalomyopathies. Key Messages: Understanding the varying presentations and genetic aspects of mitochondrial CPEO is crucial for accurate diagnosis and management.

Optic disc pits are a rare but significant anomaly of the optic nerve head that can lead to visual impairment and associated complications. These pits are characterized by a small, oval-shaped depression in the disc, which can cause fluid accumulation and subsequent damage to the adjacent retina. Although the etiology and pathogenesis of optic disc pits are not fully understood, several theories have been proposed, including abnormal embryonic development and degenerative changes. Diagnosis is typically made through a comprehensive eye examination, including a dilated fundus exam and optical coherence tomography. Management options vary depending on the severity of the condition and associated complications, ranging from observation to surgical intervention.

Leber’s hereditary optic neuropathy (LHON) is a fairly prevalent mitochondrial disorder (1:50,000) arising from the dysfunction of the mitochondrial respiratory chain, which eventually leads to apoptosis of retinal ganglion cells. The usual presentation is that of a young male with a sequential reduction in visual acuity. OCT has been used to study the pattern of optic nerve involvement in LHON, showing early thickening of the inferior and superior retinal nerve fibre layer and ganglion cell layer thinning corresponding with the onset of symptoms. Of the three primary mutations for LHON, the m.14484T>C mutation has the best visual prognosis. Recent emerging therapeutic options for LHON include idebenone and the introduction of genetic vector therapy, which is currently in phase III clinical trials. Screening of family members and adequate advice to avoid environmental triggers, such as smoking and alcohol consumption, are also cornerstones in the management of LHON.

Abstract Background Globally, a surge in electronic cigarette (e-cigarette) use has been observed in recent years, with youth being the most susceptible group. Given their recent emergence, studies assessing the health consequences of using e-cigarettes and exposure to their secondhand aerosols (SHA) are limited. Hence, this study sought to assess associations between e-cigarette use and household exposure to SHA from e-cigarettes with asthma symptoms among adolescents. Methods A school-based cross-sectional study was conducted by enrolling high school students (n = 1565; aged 16–19 years) in Kuwait. Participants self-completed a questionnaire on tobacco products use (e-cigarettes and cigarettes) and asthma symptoms. Current e-cigarette use and cigarette smoking were defined as any use in the past 30 days. Household exposure to SHA from e-cigarettes in the past 7 days was reported as none (0 days), infrequent (1–2 days), and frequent (≥ 3 days). Asthma symptoms included current (past 12 months) wheeze, current asthma (history of clinical diagnosis and current wheeze and/or medication use), and current symptoms of uncontrolled asthma (≥ 4 attacks of wheeze, ≥ 1 night per week sleep disturbance from wheeze, and/or wheeze affecting speech). Associations were assessed using Poisson regression with robust variance estimation, and adjusted prevalence ratios (aPRs) and 95% confidence intervals (CIs) were estimated. Results Among the analytical study sample (n = 1345), current e-cigarette use and cigarette smoking was reported by 369 (27.4%) and 358 (26.6%) participants, respectively. Compared to never e-cigarette users and never cigarette smokers, current e-cigarette users with no history of cigarette smoking had increased prevalence of current wheeze (aPR = 1.54, 95% CI 1.01–2.45) and current asthma (aPR = 1.85, 95% CI 1.03–3.41). Moreover, the frequency of exposure to household SHA from e-cigarettes was associated with asthma symptoms. For example, compared to those with no exposure to household SHA, frequent exposure to household SHA was associated with current wheeze (aPR = 1.30, 95% CI 1.04–1.59), current asthma (aPR = 1.56, 95% CI 1.13–2.16), and current uncontrolled asthma symptoms (aPR = 1.88, 95% CI 1.35–2.62). Conclusions E-cigarette use and their household SHA exposure were independently associated with asthma symptoms among adolescents. Hence, such observations indicate that e-cigarette use and passive exposure to their aerosols negatively impact respiratory health among adolescents.

We sought to investigate the influence of SARS-CoV-2 infection on the cytokine profiles of peripheral blood mononuclear cells (PBMCs) and neutrophils from coronavirus disease 2019 (COVID-19) intensive care unit (ICU) patients. Neutrophils and PBMCs were separated and stimulated with the mitogen phytohemagglutinin. Culture supernatants of mitogen-stimulated PBMCs and neutrophils from 88 COVID-19 ICU patients and 88 healthy controls were evaluated for levels of granulocyte-macrophage colony-stimulating factor (GM-CSF), interferon (IFN)-α, IFN-γ, interleukin (IL)-2, -4, -5, -6, -9, -10, -12, -17A, and tumor necrosis factor (TNF)-α using anti-cytokine antibody MACSPlex capture beads. Cytokine profiles of PBMCs showed significantly lower levels of GM-CSF, IFN-γ, IL-6, IL-9, IL-10, IL-17A, and TNF-α (p < 0.0001) in COVID-19 ICU patients. In contrast, COVID-19 ICU patients showed higher median levels of IL-2 (p < 0.001) and IL-5 (p < 0.01) by PBMCs. As for neutrophils, COVID-19 ICU patients showed significantly lower levels of GM-CSF, IFN-γ, IL-2, IL-4, IL-5, IL-6, IL-9, IL-10, IL-17A, IL-12, TNF-α (p < 0.0001), and IFN-α (p < 0.01). T-helper (Th)1:Th2 cytokine ratios revealed lower inflammatory cytokine for PBMCs and neutrophils in COVID-19 ICU patients. Cytokine production profiles and Th1:Th2 cytokine ratios suggest that severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection has an immunomodulatory effect on PBMCs and neutrophils. This study also suggests that the increased levels of several cytokines in the serum are not sourced from PBMCs and neutrophils.

Introduction Use of tobacco products among adolescents is a major global public health concern. Given the changing landscape of tobacco product use and the lack of epidemiologic data to inform tobacco prevention and control strategies in Kuwait, this study sought to estimate the prevalence and patterns of electronic cigarette (e-cigarette), conventional cigarette, and hookah use among adolescents in Kuwait. Moreover, exposure to secondhand smoke (SHS) and secondhand aerosol (SHA) from e-cigarettes was assessed. Methods This cross-sectional study enrolled high school students (n=1565; 16–19 years) across Kuwait. Current (past 30-day) use of e-cigarettes, conventional cigarettes, and hookah were assessed through self-reported data. Additionally, current (past 7-day) exposure to SHS and SHA in households and public places were ascertained. Associations were evaluated using Poisson regression, and adjusted prevalence ratios (APRs) and 95% confidence intervals (CIs) were estimated. Results Overall, 26.4% (402/1525), 25.1% (383/1525), and 20.9% (318/1525) of the study participants were current e-cigarette users, conventional cigarette smokers, and hookah smokers, respectively. Current use of any tobacco product was reported by 35.1% (535/1525) of the total study participants. The prevalence of concurrent triple use of ‘e-cigarettes, conventional cigarettes, and hookah’ was estimated to be 12.8% (195/1525). Also, among the study participants, 41.9% (619/1479) were exposed to household SHS, 32.0% (469/1465) were exposed to household SHA, and 62.2% (916/1472) were exposed to SHS and/or SHA in public places. Male adolescents were more likely than females to be current e-cigarette users (APR=5.19; 95% CI: 4.09–6.57), conventional cigarette smokers (APR=5.42; 95% CI: 4.26–6.90), and hookah smokers (APR=3.43; 95% CI: 2.72– 4.32). Conclusions A substantial proportion of adolescents in Kuwait are currently using tobacco products and being exposed to SHS/SHA. The findings emphasize the need to continue monitoring all forms of tobacco product use among adolescents and to strengthen tobacco prevention and control programs.

Collapsing glomerulopathy has been delineated as the most common morphological feature in COVID-19 individuals presenting with rapidly progressive renal failure and massive proteinuria. This condition, also known as COVID-19-associated nephropathy, has a poor prognosis. In COVID-19-related collapsing glomerulopathy, an immune dysfunction-mediated "second hit" to podocytes of African origin with APOL1 risk alleles was suggested. However, further research is still required to clarify this aspect of glomerulopathy. [ABSTRACT FROM AUTHOR]

The Oxford classification system has been found to have significant correlations with clinical and laboratory data in patients with IgA nephropathy. Studies have shown that higher grades of mesangial hypercellularity and endocapillary hypercellularity are associated with younger age, higher blood pressure, and higher levels of proteinuria. Segmental glomerulosclerosis has been found to be associated with more severe proteinuria, lower serum albumin levels, and higher levels of creatinine. Tubular atrophy/interstitial fibrosis has been associated with older age, higher serum creatinine levels, and lower estimated glomerular filtration rates. [ABSTRACT FROM AUTHOR]

This investigation into the aerodynamic efficiency and structural integrity of tubercle leading edges, inspired by the agile maneuverability of humpback whales, employs a multifaceted experimental and computational approach. By utilizing static load extensometer testing complemented by computational simulations, this study quantitatively assesses the impacts of unique wing geometries on aerodynamic forces and structural behavior. The experimental setup, involving a Wheatstone full-bridge circuit, measures the strain responses of tubercle-configured leading edges under static loads. These measured strains are converted into stress values through Hooke’s law, revealing a consistent linear relationship between the applied loads and induced strains, thereby validating the structural robustness. The experimental results indicate a linear strain increase with load application, demonstrating strain values ranging from 65 με under a load of 584 g to 249 με under a load of 2122 g. These findings confirm the structural integrity of the designs across varying load conditions. Discrepancies noted between the experimental data and simulation outputs, however, underscore the effects of 3D printing imperfections on the structural analysis. Despite these manufacturing challenges, the results endorse the tubercle leading edges’ capacity to enhance aerodynamic performance and structural resilience. This study enriches the understanding of bio-inspired aerodynamic designs and supports their potential in practical fluid mechanics applications, suggesting directions for future research on manufacturing optimizations.

Introduction: Acceptance of Health, Safety, and Environment (HSE) rules plays a crucial role in determining the performance of employees in HSE-related areas at the workplace. This study aimed to design a questionnaire to investigate influential factors on acceptance of HSE rules among employees. Material and Methods: The face validity of the survey was assessed by ten individuals from the target population, while content validity was evaluated by ten HSE experts using both quantitative and qualitative methods. The impact scores were calculated for the quantitative assessment of face validity, and the Content Validity Ratio (CVR) and Content Validity Index (CVI) values were used to assess content validity. Construct validity was determined through Exploratory Factor Analysis (EFA) and Confirmatory Factor Analysis (CFA) involving 506 participants. The reliability of the survey was evaluated using Cronbach’s alpha and the Intraclass Correlation Coefficient (ICC). Results: All items in the survey showed satisfactory levels of impact score (>1.5), CVR (>0.69), and CVI (>0.79). The mean values for the Impact score, CVI, CVR, and S-CVI-UA were 4.26, 0.963, 0.944, and 0.62, respectively. The survey and its dimensions demonstrated strong reliability, as indicated by Cronbach’s alpha and ICC values exceeding 0.70. Additionally, EFA successfully identified the structure of the questionnaire, and CFA confirmed its goodness of fit. Conclusion: The Persian version of the questionnaire demonstrated satisfactory validity and reliability. This instrument can be effectively used to assess the factors that influence the acceptance of HSE rules among employees in various workplace settings.

Non-linearity feature and high fluctuations in financial time series have made the forecasting of stock prices and financial indicators face many challenges. However, recent developments in deep learning (DL) models with structures such as long-short-term memory (LSTM) and convolutional neural network (CNN) have made improvements in the analysis of this type of data. Another approach that can be effective in the analysis of financial time series is the decomposition of capital market signals through algorithms such as complete integrated empirical mode decomposition (CEEMD). Considering the importance of forecasting in the financial markets, in this research, by combining deep learning models and complete integrated empirical mode decomposition (CEEMD), The hybrid CEEMD-DL(LSTM) model has been used to forecast the Tehran Stock Exchange index. In this regard, the daily data of the total index of the Tehran Stock Exchange in the period of 2012/12/01 – 2022/02/20 be used and the results were compared with the results of competing models based on efficiency measurement criteria. Based on the obtained results, the introduced model (CEEMD-DL(LSTM)) has higher efficiency and accuracy in stock exchange index forecasting. Accordingly, the use of this model in financial forecasts is suggested.

Abstract Background Dietary patterns, encompassing an overall view of individuals’ dietary intake, are suggested as a suitable means of assessing nutrition’s role in chronic disease development. The aim of this study was to evaluate the validity and reproducibility of a food frequency questionnaire (FFQ) designed for use in the Prospective Epidemiological Research Studies in IrAN (PERSIAN), by comparing major dietary patterns assessed by the FFQ with a reference method. Methods Study participants included men and women who enrolled in the PERSIAN Cohort Study at seven of the eighteen centers. These centers were chosen to include dietary variations observed among the different Iranian ethnic populations. Two FFQ were completed for each participant over a one-year study period (FFQ1 upon enrollment and FFQ2 at the end of the study), with 24 interviewer-administered 24-hour dietary recalls (24 h) being completed monthly in between. Spearman correlation coefficients (SCC) were used comparing FFQs 1 and 2 to the 24 h to assess validity, while FFQ1 was compared to FFQ2 to assess reproducibility of the questionnaire. Results Three major dietary patterns—Healthy, Low Protein/High Carb and Unhealthy—were identified, accounting for 70% of variance in the study population. Corrected SCC ranged from 0.31 to 0.61 in the validity and from 0.34 to 0.57 in reproducibility analyses, with the first two patterns, which accounted for over 50% of population variance, correlated at above 0.5 in both parameters, showing acceptable findings. Conclusions The PERSIAN Cohort FFQ is suitable for identification of major dietary patterns in the populations it is used for, in order to assess diet-disease relationships.

This study presents a novel numerical methodology that is designed for the dynamic adjustment of three-dimensional high-rise building configurations in response to aerodynamic forces. The approach combines two core components: a numerical simulation of fluid flow and the adjoint method. Through a comprehensive sensitivity analysis, the influence of individual variables on aerodynamic loads, including lift and drag coefficients, is assessed. The findings underscore that the architectural design, specifically the building’s construction pattern, exerts the most substantial impact on these forces, accounting for a substantial proportion (76%). Consequently, the study extends its evaluation to the sensitivity of fluid flow across various sections of the tower by solving the adjoint equation throughout the entire fluid domain. As a result, the derived sensitivity vector indicates a remarkable reduction of approximately 31% in the applied loads on the tower. This notable improvement has significant implications for the construction of tall buildings, as it effectively mitigates aerodynamic forces, ultimately enhancing the overall comfort and structural stability of these architectural marvels.

Abstract The association between personal habits and metabolic syndrome (MetS) remains controversial. This study aimed to assess the prevalence of MetS among youths and its association with cigarette, tobacco, opium, and alcohol consumption in the Rafsanjan Youth Cohort Study (RYCS). The current cross-sectional study was based on data from RYCS, as part of the Rafsanjan Cohort Study (RCS). RCS is a branch of the prospective epidemiological research studies in Iran (PERSIAN). In the present study, 2843 youths aged 15–35 were included. MetS was diagnosed using the international diabetes federation (International IDF), National Cholesterol Education Panel- Adult Treatment Panel III (NCEP-ATPIII), and Iranian criteria (IDF Iranian). Binary logistic regression models were performed to estimate odds ratios (ORs) and confidence intervals (CIs). The prevalence of MetS was 7.67%, 7.14%, and 10.13% based on NCEP-ATPIII, IDF Iranian, and International IDF criteria respectively. The odds of MetS according to international IDF and Iranian IDF in the alcohol-drinking group in the last 12 months (OR: 1.51, 95%CI 1.02–2.21, OR: 1.66, 95%CI 1.11–2.48 respectively) were greater compared with the non-drinking group. The odds of having high TG in the alcohol-drinking group in the last 12 months was 1.53 times higher than the control group (OR = 1.53, 95% CI: 1.20–1.94). Furthermore, the odds of having high waist circumference (WC) according to IDF International was significantly higher in the tobacco-smoking group in the last 12 months and in the tobacco-smoking group in the last 12 months daily (OR: 1.23, 95%CI 1.01–1.49 and OR: 1.41, 95%CI 1.01–1.98 respectively) compared to the control groups. The prevalence of MetS was 7.67%, 7.14%, and 10.13% based on NCEP-ATPIII, IDF Iranian, and International IDF criteria respectively. The odds of MetS and high TG were greater in the alcohol-drinking group in the last 12 months compared with the non-drinking group. The odds of high WC in the last 12 months, were greater in the tobacco-smoking group compared with the non-smoking group. However, more longitudinal studies are needed to verify the associations observed in the current study.

Abstract In this paper, a new control strategy, along with an innovative switching pattern, is proposed for the transfer of charge from one cell to another, whether they are adjacent or nonadjacent, or even to multiple cells simultaneously. Therefore, this strategy improves the efficiency of state of charge balancing, which is critical for lithium polymer (LiPo) batteries. Unlike in previous studies, all these functions are realized with a simple structure that employs standard DC–DC buck‐boost converters, without any additional complexities. By implementing the proposed control strategy, the effects of inaccuracies in the gain of current sensors, as well as multiplicative measurement noises, are reduced. The proposed method is applied to a set of five series LiPo cells, and a comprehensive investigation is conducted to assess both its balancing algorithm and operation. The simulation results illustrate the effective balancing performance and the achievement of the desired charge transfer through the proposed approach. An experimental setup, which includes five LiPo cells with a capacity of 1530 milliampere‐hours (mAh), is used to verify the proposed method. The outcomes demonstrate that the balancing of all cells is accurately performed under different initial conditions, within an acceptable time frame.

Parathyroid cancer is a rare malignancy originating from the parathyroid glands, which regulate calcium levels in the body. This review article aims to provide a comprehensive overview of parathyroid cancer, including its epidemiology, etiology, clinical presentation, diagnostic methods, treatment options, and prognosis. The article also highlights recent advancements in research and potential future directions for improving the management of this challenging disease. [ABSTRACT FROM AUTHOR]

Objective: This study aims to elucidate the profitability of value premium and size premium anomalies by employing the CHS score by Campbell et al. (2008) as the market-based financial distress indicator and Ohlson's O score (1980) as the accounting-based financial distress indicator.CHS‌ score is a reduced-form econometric model to predict financial distress at short and long horizons. Among the market anomalies, value and size premiums have attracted more attention. Previous research noticed the existence of value premiums in stocks and found that value stocks have higher average returns compared to growth stocks. A value stock refers to shares of a company that appears to trade at a lower price relative to its fundamentals. Common characteristics of value stocks include high dividend yield, high book value to market value ratio, and a low P/E ratio. However, growth stocks often look expensive, trading at a low book value to market value ratio. In addition, researchers highlighted the existence of size premium where small stocks perform better than large stocks. These phenomena led to the formation of investment strategies based on value and size premiums. Value premium strategy involves buying value stocks and selling growth stocks, while size premium strategy entails buying small stocks and selling big stocks. Methods: In this study, the required data was collected from a sample consisting of 168 companies listed on the Tehran Stock Exchange and Iran Farabourse during the period from October 22, 2011, to September 22, 2021. To investigate the relationship between stock excess returns and risk factors, a total of three models were used: 1) Fama and French three-factor model, 2) the augmented three-factor model including the CHS score, and 3) the augmented three-factor model including the O score. Results: According to the findings of this study, the inclusion of the financial distress factor in the Fama and French three-factor model, regardless of the criterion that is used to measure this factor, improves the performance of this model in explaining the fluctuations in the average returns of companies listed on Tehran Stock Exchange and Iran Farabourse. In the meantime, the CHS score, compared to the O score, has a greater contribution to increasing the explanatory power of the mentioned model. Additionally, it is found that both in the original model of Fama and French and the augmented versions of this model, the value premium is mainly seen among value stocks, both small and big ones. The size effect, which is seen in all groups of stocks before the inclusion of the financial distress variable in the mentioned model, after augmenting this model, although loses its importance among big-value stocks, is still an influential factor in explaining the fluctuations of the average returns of small value stocks, small growth stocks, and big growth stocks. Conclusion: The results prove the existence of a negative and highly significant relationship between the financial distress risk and the excess returns of portfolios formed based on size and book value to market value, confirming that in the long run, financially distressed companies compared to healthy companies, realize lower excess returns. This finding can be of interest to the Securities and Exchange Organization (SEO), audit institutions, investors, and creditors.‌ It is suggested that researchers use more dynamic versions of asset pricing models and other indicators of financial distress to analyze and explain fluctuations in stock returns in future research. In this regard, researchers can refer to Fama and French five-factor model (2015) and the newer versions of the capital asset pricing model (CAPM), and by including the factor of financial distress in these models, compare the power of the mentioned models in explaining the fluctuations of stock returns

Abstract Ionic liquids (ILs) have drawn much attention due to their extensive applications and environment-friendly nature. Refractive index prediction is valuable for ILs quality control and property characterization. This paper aims to predict refractive indices of pure ILs and identify factors influencing refractive index changes. Six chemical structure-based machine learning models called eXtreme Gradient Boosting (XGBoost), Light Gradient Boosting Machine (LightGBM), Categorical Boosting (CatBoost), Convolutional Neural Network (CNN), Adaptive Boosting-Decision Tree (Ada-DT), and Adaptive Boosting-Support Vector Machine (Ada-SVM) were developed to achieve this goal. An enormous dataset containing 6098 data points of 483 different ILs was exploited to train the machine learning models. Each data point’s chemical substructures, temperature, and wavelength were considered for the models’ inputs. Including wavelength as input is unprecedented among predictions done by machine learning methods. The results show that the best model was CatBoost, followed by XGBoost, LightGBM, Ada-DT, CNN, and Ada-SVM. The R2 and average absolute percent relative error (AAPRE) of the best model were 0.9973 and 0.0545, respectively. Comparing this study’s models with the literature shows two advantages regarding the dataset’s abundance and prediction accuracy. This study also reveals that the presence of the –F substructure in an ionic liquid has the most influence on its refractive index among all inputs. It was also found that the refractive index of imidazolium-based ILs increases with increasing alkyl chain length. In conclusion, chemical structure-based machine learning methods provide promising insights into predicting the refractive index of ILs in terms of accuracy and comprehensiveness.

The article titled "Oncohypertension; treatment of high blood pressure in cancer patients" explores the connection between high blood pressure and cancer. It highlights that high blood pressure is a common comorbidity in cancer patients and that certain anti-cancer drugs can worsen or cause hypertension. The article emphasizes the need for further investigation into the relationship between hypertension and cardiovascular mortality, morbidity, and renal function. The concept of oncohypertension is introduced as a new entity among oncologists, nephrologists, and cardiologists. [Extracted from the article]

Abstract Background Obesity has become a major health issue in both high and middle-income countries, increasing the risk of cardiovascular diseases and all-cause mortality. Risk of obesity is related to both unchangeable factors such as genetics and gender, and modifiable lifestyle factors. Most importantly, finding the major modifiable lifestyle factors which contribute to obesity may provide valuable benefits to every society. This study aimed to determine the association of demographic and lifestyle parameters with overweight/obesity and abdominal obesity in a population of Iranian adults. Methods In this cross-sectional study, adult participants of Rafsanjan Cohort Study (RCS) (as one of the district areas of the PERSIAN cohort (Prospective Epidemiological Research Studies in IrAN) included the study population. RCS is a population-based prospective cohort of men and women aged 35–70 years, launched in August 2015. Individuals were recruited from four urban and suburban areas of Rafsanjan, south-eastern of Iran. Trained experts interviewed each participant and completed the related questionnaires about his/her socioeconomic status, demography, anthropometric features, personal habits, physical activity and medical history. Multinomial logistic regression models were used to examine the relationships between overweight/obesity/abdominal obesity and associated factors. Results From 9980 participants, 1974 (42.42%) males and 2115 (39.70%) females were overweight, 784 (16.85%) males, 2223 (41.73%) females were obese and 1895 (40.73%) males and 989 (18.57%) females were normal weight. Also, 832 (17.9%) males and 4548 (85.4%) females had abdominal obesity and 3819 (82.1%) males and 778 (14.6%) females didn’t have abdominal obesity. Based on the adjusted multiple logistic regression, overweight/obesity (BMI > 25) was associated with age > 45, female gender, education ≥ 13 years, heavy physical activity, wealth status index (WSI), alcohol consumption, current cigarette smoking and opium consumption compared to reference group. Also, odds of abdominal obesity displayed a significant association with age > 45, female gender, education > 5 years, physical activity, WSI, current cigarette smoking, alcohol and opium consumption compared to reference group. Conclusions Our results recommend local public health strategies that promote training the society on the health benefits of avoiding alcohol, getting more physical exercise and gaining more personal education on the health-threatening lifestyle.

Oral health status can be affected by some factors including drug abuse, systemic conditions and environmental pollutants. The present study was designed to investigate the most important and prevalent dental and oral conditions in adult population of Rafsanjan with the age of 35–70 years. Dental and oral health cohort center as part of the Rafsanjan Cohort Study (RCS) included in the prospective epidemiological research studies in IrAN was established in 2015. Of 9991 subjects enrolled in the RCS, 8682 people participated in the Oral Health Branch of Rafsanjan Cohort Study (OHBRCS).The OHBRCS included 4021 men and 4661 women with the mean age of 49.94 ± 9.51. The most prevalent of oral lesion in total population was candidiasis and the least was aphthous lesion. The prevalence of candidiasis, white and red lesions, periodontal pocket, dental calculus, CAL and the mean of DMFT were higher in the male group than that of female group (p

Soft polymeric materials such as elastomers and hydrogels have played a significant role in recent interdisciplinary research. They are subjected to large stretch and high cyclic loading-unloading conditions where the typical loading mode is biaxial rather than simple uniaxial loading, thus, necessitating further characterization using biaxial loading conditions and subsequently developing robust and versatile numerical models. Although many standards were prepared for common uniaxial tests in situ elastomers including tensile, shear, and fatigue tests, no specific standardized guidelines were prepared to be employed for the biaxial characterization of elastomers and hydrogels. There existed limited works on the biaxial characterization of soft polymers, thus, making it difficult to identify which configurations and results are more reliable. Hence, there were huge discrepancies in the existing literature for biaxial tests in terms of sample configurations (square or cruciform specimens), dimensions, and test setups including strain rate, pre-loading, equi-biaxial and unequi-biaxial tests. Therefore, this paper is aimed at reviewing the published studies on the biaxial characterization of soft polymers in several aspects including (i) sample configurations in terms of geometry and dimension (ii) biaxiality degree of tested specimens where sample should be optimized to reach proper biaxiality, i.e., larger area with homogenous strain distribution in the middle with respect to the edges, (iii) test procedure for the biaxial characterization including strain amplitude, strain rate and loading patterns (iv) a brief review on inflation test of elastomers which was the most common equi-biaxial test studied in the literature. The largest and smallest cruciform samples with the dimensions of 165 × 165 mm2 and 38 × 38 mm2 were used, respectively, while a small sample of 7 × 7 mm2 and large one of 70 × 70 mm2 were also employed for the square specimen. It was concluded that various test parameters and materials were used for the biaxial characterization. This necessitates the importance of preparing a standardized methodology for the biaxial characterization of elastomers based on intended materials and applications. Hence, a few potential geometries based on the optimization performed in the literature were suggested for future investigations in which numerous examinations using different materials and test parameters shall be conducted to reach an ideal sample configuration and methodology for the biaxial characterization of soft polymeric materials.

AbstractInstitutional investors play a crucial role in monitoring and reducing asymmetric information. Institutional investors reduce asymmetric information by demanding high quality in corporate governance practices and information disclosure that leads to informed decisions on investment choices. In the present study, the impact of institutional investors, investment horizons on management efficiency and investment decisions of the companies is investigated. In thes study, the data of 138 companies listed in tehrak stock Exchange during 2018-2011 were investigated. In order to test the hypothesis, Regression models with panel data method and fixed effects approach areused. The results of the testing of research hypotheses indicated that the short-term investment horizon of institutional investors has a negative and significant impact on management efficiency. also, The research findings indicated that the long–term investment horizon of institutional investors has a negative impact on the investment decisions and expenditures of companies with high operating cash flows, by the method based on Bushee(1998)and these investors(with lng-term investment horizon) reduce theinvestment decisions and expenditures of companies with limited funding. This finding could be due to the fact that the majority of institutional investors withlong–term investment horizon in companies with limited fundinghave absolute control and exacerbate the company's problems in order to extract private benefits.

Abstract Our investigation aimed to evaluate the prevalence of early and late menopause and its determinants in adult women of Rafsanjan cohort study. We used data obtained from the Rafsanjan Cohort Study, as a part of the prospective epidemiological research studies in Iran. In this cross-sectional research, 2002 postmenopausal women were included in the present study. Menopause age were divided into three groups (≤ 41 years, 42–54 years, and ≥ 55 years) based on the 10th and 90th percentile. The association between age at menopause with demographic and reproductive characteristics and some clinical risk factors of women was evaluated by logistic regressions. The mean age at menopause among the study participants was 48.63 ± 5.37 years. In this study, 11.49% and 11.39% of the women experienced early and late menopause respectively. After adjusting for all potential confounders, the results showed that taller and smoker women had higher odds of early menopause (OR 1.03, 95% CI 1.00–1.06) and OR 1.85, 95% CI 1.01–3.41) respectively) and women with history of using hormonal contraceptive more than median had lower odds of early menopause (OR 0.61, 95% CI 0.41–0.91). Also older women (OR 8.65, 95% CI 5.31–14.08) and women with a history of diabetes (OR 2.42, 95% CI 1.63–3.60), hypertension (OR 2.06, 95% CI 1.42–2.97), thyroid disease (OR 1.85, 95% CI 1.07–3.20) and depression (OR 2.00, 95% CI 1.35–2.97) had higher odds of late menopause. The results showed that the year of birth, height, smoking, history of diabetes, hypertension, thyroid disease and depression and using hormonal contraceptive were significantly associated with the menopausal age. Since age at menopause can affect subsequent health in women, understanding the determinants of menopausal age is important and should be pursued.

Network slicing has been a significant technological advance in the 5G mobile network allowing delivery of diverse and demanding requirements. The slicing grants the ability to create customized virtual networks from the underlying physical network, while each virtual network can serve a different purpose. One of the main challenges yet is the allocation of resources to different slices, both to best serve different services and to use the resources in the most optimal way. In this paper, we study the radio resource slicing problem for Ultra-Reliable Low Latency Communications (URLLC) and enhanced Mobile Broadband (eMBB) as two prominent use cases. The URLLC and eMBB traffic is multiplexed over multiple numerologies in 5G New Radio, depending on their distinct service requirements. Therein, we present our optimization algorithm, Mixed-numerology Mini-slot based Resource Allocation (MiMRA), to minimize the impact on eMBB data rate due to puncturing by different URLLC traffic classes. Our strategy controls such impact by introducing a puncturing rate threshold. Further, we propose a scheduling mechanism that maximizes the sum rate of all eMBB users while maintaining the minimum data rate requirement of each eMBB user. The results obtained by simulation confirm the applicability of our proposed resource allocation algorithm.

Abstract Cardiovascular disease (CVD) is the leading cause of death and disability in people with diabetes mellitus (DM), since finding the correlation between DM and CVD risk factors can be effective in preventing the incidence of morbidity and mortality in patients. This study aimed to determine the prevalence of cardiovascular risk factors in people with and without metabolic syndrome (MtS) in DM. This cross-sectional study was part of the Rafsanjan Cohort Study as part of the comprehensive Persian (Prospective Epidemiological Research Studies in IRAN) on 35–70-year old adults with and without MtS in DM. Indicators of CVD risk factors, including gender, age, blood pressure, dyslipidemia, smoking, alcohol consumption, fasting blood sugar, creatinine, blood urea, waist circumference, body mass index, family history, physical inactivity, and fruit and vegetable consumption, were collected in the Persian Cohort Questionnaire. The data was analyzed by SPSS software version 22. The prevalence of MtS in 1933 participants was estimated to be 80% (95% confidence interval 78.1–81.8%). In the logistic regression model, smoking, alcohol consumption, and triglycerides were identified as the factors associated with MtS. Our results show that, based on our study, the prevalence of cardiovascular risk factors in DM was high. The suggested solutions in this field are to reduce smoking and alcohol consumption, as well as to control hypertension, hyperlipidemia, and being overweight.

In an era marked by swift technological advancements and an escalating emphasis on collaborative learning, understanding effective methods and technologies for sharing knowledge is imperative to optimize educational outcomes. This study delves into the varied methods and technologies applied to facilitate and support knowledge sharing within learning communities. To achieve this, a systematic literature review was conducted, systematically collecting and scrutinizing pertinent literature. Employing automated searches, title-based selection, and reputation-based filters ensured the inclusion of high-quality studies. The chosen studies underwent a meticulous evaluation, considering factors like relevance, methodological robustness, and currency. The literature review unveiled a diverse array of methods and technologies employed in learning communities to facilitate effective knowledge sharing. The outcomes of this study offer a comprehensive snapshot of the existing literature, underscoring the significance of methods and technologies in supporting knowledge sharing within learning communities. By comprehending the strengths, challenges, and potential future trajectories, educators, researchers, and policymakers can make informed decisions to enhance the efficacy of knowledge sharing within learning communities.

In recent years, the share of renewables in the global energy basket has increased significantly. This will have geopolitical consequences, especially for a country like Iran, whose economy is largely dependent on fossil fuel revenues. By examining the transition process of the global and regional economy towards renewable and clean energy, this article tries to outline Iran's position in the energy transition perspective. The main question is: how will Iran position itself in the global energy transition outlook to 2050? Through scenario planning, the authors identified four possible scenarios, including "meeting sustainable development and transition to green gold", "gradual and independent transition to sustainable development and green gold", "development based on black gold" and "development locked with black gold". They cover a wide range of possible futures. By knowing these scenarios and comparing their desirability, policymakers will be able to properly assess the costs and opportunities of the transition to clean energy in different situations.s

Abstract Opiate use is related to neuropathological disorders, stroke and stroke attributable risk factors. However, secondary exposure to opiate in relation to the above-mentioned complications is studied only in animal models and remains to be evaluated in human populations. We tested whether passive exposure to opiate is associated with stroke and the known stroke predictive factors. We carried out a cross-sectional study of 1541 never smoker women who participated in the Rafsanjan Cohort Study (RCS) with their husbands (2015–2017 recruitment phase). RCS is one of the 19 geographic districts of the Prospective Epidemiological Research Studies in Iran (PERSIAN cohort study). Unadjusted and adjusted multiple logistic regression analyses were performed to evaluate the relationship between second-hand opiate exposure (husband opiate smoking after marriage) and the odds ratio of stroke and the following stroke risk factors and predictive parameters: overweight/obesity (BMI > 25), cholesterol (chol) > 200 mg/dl, fasting blood sugar (FBS) > 125 mg/dl, low density lipoprotein (LDL) > 100 mg/dl, triglyceride (TG) > = 150 mg/dl, hypertension, diabetes, and chronic headache. We observed a significant increased adjusted odds ratio (OR) of stroke (OR = 3.43, 95% CI:1.33–8.82) and its risk factors LDL > 100 mg/dl (OR = 1.37, 95% CI:1.01–1.87) and FBS > 125 mg/dl (OR = 1.58, 95% CI:1.08–2.30) in women associated with husbands’ opiate smoking. This relationship was observed after adjusting for the confounding parameters including age, education years, and first-degree family history of the relevant diseases. The increased odds ratio for stroke and high LDL displayed a dose-sensitive trend with years of husband’s opiate smoking after marriage (respective p-trends: 0.02 & 0.01). We did not observe a significant association between passive opiate smoking and high TG, high Chol or the diseases diabetes, hypertension and chronic headache. However, 89% increased odds ratio of chronic headache was observed to be associated with passive opiate smoking for more than 10 years (OR = 1.89, 95% CI:1.02–3.50). We found an increased risk of stroke and high LDL and FBS in women associated with passive opiate smoking. Furthermore, a dose-sensitive connection was found between the risks of stroke, high LDL and chronic headache with the years of passive opiate exposure. Our results point to the necessity of the future analyses, which further assess whether passive opiate exposure could be considered as an independent risk factor for stroke and metabolic diseases.

Abstract Background Elevated blood pressure is associated with cardiovascular disease, stroke and chronic kidney disease. In this study, we examined the socioeconomic inequality and its related factors in prevalence, Awareness, Treatment and Control (ATC) of hypertension (HTN) in Iran. Method The study used data from the recruitment phase of The Prospective Epidemiological Research Studies in IrAN (PERSIAN). A sample of 162,842 adults aged > = 35 years was analyzed. HTN was defined according to the Joint National Committee)JNC-7(. socioeconomic inequality was measured using concentration index (Cn) and curve. Results The mean age of participants was 49.38(SD = ± 9.14) years and 44.74% of the them were men. The prevalence of HTN in the total population was 22.3%(95% CI: 20.6%; 24.1%), and 18.8%(95% CI: 16.8%; 20.9%) and 25.2%(95% CI: 24.2%; 27.7%) in men and women, respectively. The percentage of awareness treatment and control among individuals with HTN were 77.5%(95% CI: 73.3%; 81.8%), 82.2%(95% CI: 70.2%; 81.6%) and 75.9%(95% CI: 70.2%; 81.6%), respectively. The Cn for prevalence of HTN was -0.084. Two factors, age (58.46%) and wealth (32.40%), contributed most to the socioeconomic inequality in the prevalence of HTN. Conclusion The prevalence of HTN was higher among low-SES individuals, who also showed higher levels of awareness. However, treatment and control of HTN were more concentrated among those who had higher levels of SES, indicating that people at a higher risk of adverse event related to HTN (the low SES individuals) are not benefiting from the advantage of treatment and control of HTN. Such a gap between diagnosis (prevalence) and control (treatment and control) of HTN needs to be addressed by public health policymakers.

Abstract The potential effects of opium consumption on lipid profile remain unquantified. We considered the association between opium use and dyslipidemia. In this cross-sectional study, we used data obtained from the Rafsanjan cohort study, as a part of the prospective epidemiological research studies in IrAN (PERSIAN) with detailed and validated data on opium consumption and selected other exposures. A total of 9932 adults were included in the study. Logistic regression models were used to assess the relationships of opium consumption with the prevalence of dyslipidemia and lipid disorders. In this population, 73.33% had dyslipidemia and the prevalence rates of high TC, high TG, high LDL and low HDL were 54.24%, 47.45%, 34.43% and 11.91% respectively. After adjustment for all confounders, opium users compared with non-users had lower odds ratios (OR) of high TC and high LDL [0.81 (95% confidence interval, CI 0.71–0.92) and 0.80 (95% CI 0.69–0.93) respectively] and greater OR of low HDL [1.30 (95% CI 1.04–1.62)]. Longer duration of opium consumption resulted in lower ORs of high TC, 0.68 (95% CI 0.55–0.84) and high LDL, 0.82 (95% CI 0.67–0.99), and shorter duration of opium consumption resulted in increased odds of low HDL, 1.30 (95% CI 1.02–1.66). High dose of opium consumption was associated with an OR of dyslipidemia of 0.80 (95% CI 0.65–0.97), high TC of 0.80 (95% CI 0.67–0.95), and high LDL of 0.78 (95% CI 0.64–0.96) and low dose of opium consumption, with an OR of low HDL of 1.30 (95% CI 1.02–1.65). In relation to route of consumption, opium smoking was a risk factor for low HDL with an adjusted odds ratio of 1.31 (1.04–1.63). Opium use was associated with selected changes on serum lipid levels, but opium users had higher frequency of cardiovascular disease history.

Background: Acute coronary syndrome is a significant global health concern that can affect patients' health outcomes and quality of life. In addition, adherence to treatment and health literacy can affect health outcomes. Objective: This study aimed to investigate the relationship between treatment adherence, health literacy, and quality of life among patients with acute coronary syndrome. Methods: This cross-sectional study was conducted on 407 patients in Iran from April 2019 to November 2019. Patients were selected by convenience sampling method. Data were collected using demographic questionnaire, World Health Organization Quality of Life Brief Version, Adherence to Treatment Questionnaire, and Health Literacy for Iranian Adults questionnaire. SPSS 25 was used for statistical analysis. Results: Based on descriptive statistics in this study, most of the participants had good treatment adherence level (56.5%); 28.7% of the participants had insufficient health literacy level. The mean score of quality of life was 51.41 ± 12.03, which was greater than the midpoint of the questionnaire. Furthermore, Pearson's correlation coefficient showed a negative association between health literacy, treatment adherence (r = −0.167, p < .01), and quality of life (r = −0.153, p < .01), and a positive association between treatment adherence and quality of life (r = 0.169, p < .01). Conclusion: The results of the current study showed a negative relationship between health literacy, quality of life, and treatment adherence among patients with acute coronary syndrome. [HLRP: Health Literacy Research and Practice. 2023;7(2):e71–e79.]

This study presents a measurement principle for determining the size of the ablation zone in MWA, which could ultimately form an alternative to more expensive monitoring approaches like CT. The measurement method is based on a microwave transmission measurement. A MWA is performed experimentally on ex vivo bovine liver to determine the ablation zone. This setup uses a custom slot applicator performing the MWA at an operating frequency of 2.45 GHz and a custom bowtie antenna measuring the waves transmitted from the applicator. Furthermore, a custom measurement probe is used to determine the dielectric properties. A time-shift analysis is used to determine the radial extent of the ablation zone. Several measurements are carried out with a power of 50 W for 10 min to show the reproducibility. The results show that this method can provide reproducible outcomes to determine the ablation zone with a maximum error of 4.11%.

Objective: An independent audit is one of the tools for evaluating the accuracy of the information and financial relations. If the done audits contain quality components, they will enable stakeholders to be relatively confident of the accuracy of the available information and relationships. Therefore, this study is to discover and identify the components of independent audit quality to meet the needs of stakeholders. Methods: The present study is a qualitative and fundamental piece of research that relies on the interpretive and inductive approach. The "emerging approach with the Glaser method" was implemented through theoretical and purposeful sampling. Its participants included the community of academic experts and independent auditing professionals. In-depth interviews were conducted with the participants and data was collected until reaching the point of theoretical saturation. Results: According to the obtained results, 19 main components affect audit quality. By clustering, these 19 components were classified into three levels comprised of 1) Audit quality components at the users level (Four components including making stakeholders pay part of the costs of achieving audit quality, eliminating irrational goals and requests, increasing the level of understanding audit quality joint and several liability and responsiveness), 2) Audit quality components at the level of auditing firms and auditors (including five components: Designing and implementing infrastructure that promotes and enhances audit quality, management, empowerment and training human resource, having foresight in the field of audit quality and conducting scientific research, increasing the size of audit firms and their share of auditing services market, acquisition of behavioral and professional competence by auditing firms and auditors), and 3) Components of audit quality at the level of auditing supervisory bodies (including seven components: Correcting structural mismanagement and fighting against financial corruption and rent-seeking, encouraging audit firms to increase audit quality, effective qualitative monitoring of auditors' professional and behavioral performance, strengthening and implementing government social responsibilities towards the individuals and the society, reforming the related government laws and regulations, establishing mechanisms for reviewing the behavioral and professional competence of auditing firms and auditors by regulatory bodies, increasing joint and several liability and accountability of regulators, auditors, government officials and stakeholders for their performance towards each other and the community with the aim of reducing the expectation gap between them). The three components of observing the ethics and cultural foundations, the quality of the performance of the managers and audit staff as well as their mindset, and meeting accounting and auditing standards were common among all levels. Conclusion: Meeting the needs of stakeholders and their dissatisfaction with the quality of services provided in the field of independent auditing requires the use of effective components in improving the quality of services of auditing firms and auditors, reducing the level of stakeholder dissatisfaction and increasing the shares of regulatory bodies.

Abstract Background We evaluated the relation between ALT, AST, GGT and ALP with diabetes in the Rafsanjan Cohort Study. Materials and methods The present study is a cross-sectional research including 9991 adults participated via sampling. We used data obtained from the Rafsanjan Cohort Study (RCS), as a part of the prospective epidemiological research studies in IrAN (PERSIAN). Elevated serum levels of ALT, AST, GGT and ALP were defined according to the reference range of the laboratory in the cohort center. Serum liver enzymes levels within the normal range were categorized into quartiles, and their relationship with diabetes was evaluated by logistic regressions. Findings In present study, elevated serum levels of ALT, AST, GGT, and ALP were associated with increased odds of diabetes (adjusted ORs: 1.81, 95%CI 1.51–2.17; 1.75, 95%CI 1.32–2.32; 1.77, 95%CI 1.50–2.08; 1.60, 95%CI 1.35–1.90 respectively). Also, in subjects with normal levels of ALT, GGT and ALP, a dose–response increase was shown for diabetes. Conclusion Elevated levels of ALT, AST, GGT and ALP are related to a higher odds of diabetes. Also, increased levels of ALT, GGT and ALP even within normal range were independently related with the increased odds of diabetes. These results indicated the potential of elevated liver enzymes as biomarkers for the possible presence of diabetes.

One of the most common complications of diabetes is diabetic foot ulcer, which exposes patients to wound infection, osteomyelitis, and lower-limb amputation if left untreated. Therefore, accurate and rapid diagnosis of wound and osteomyelitis infection is an important step in treating this debilitating complication. In this regard, the present study was aimed to determine the incidence of osteomyelitis and assess its risk factors in patients with diabetic foot ulcers during 2013 and 2016 in Birjand, Iran. This epidemiological analytical-retrospective study was conducted using numerical sampling. Demographic and clinical data were obtained by reviewing patients’ medical records and using a checklist developed by the project manager. Data analysis was performed using SPSS software (version 18). Quantitative and qualitative results were reported as mean±standard error and percentage, respectively. The obtained findings indicated a significant association between the location of foot ulcers and the risk of osteomyelitis (P=0.02); accordingly, osteomyelitis is more likely to occur in diabetic ulcers on the toes. However, no significant difference was observed between right and left foot ulcers in terms of osteomyelitis risk. Mean erythrocyte sedimentation rate was also significantly higher in diabetic patients with osteomyelitis than those of non-osteomyelitis ones (P=0.04). However, no significant difference was observed in C-reactive protein and leukocytosis. The age and gender of the patients had no significant effect on the risk of osteomyelitis. Overall, the results of the present study demonstrated a significant relationship between the location of foot ulcers and the probability of osteomyelitis. Accordingly, ulcers located on the toes are more likely to develop osteomyelitis.

Mechanical characterizations of natural rubber filled with carbon-based nanomaterials were extensively studied in tensile and tear modes whereas fewer attempts have been conducted on a dynamic shear condition using a double-bonded shear test piece. This is of importance since natural rubbers are widely used as flexible membranes for wave energy harvesting devices. Therefore, this study was aimed to explore the microstructural, rheological, and dynamic viscoelastic characteristics of natural rubbers filled with different Multi-Walled Carbon Nanotubes (MWCNTs) contents. A combined compounding approach was employed to ensure a homogenous CNT dispersion was achieved. Transmission electron microscopy (TEM) was performed for the materials characterization while the processability and curing parameters of the compounds were investigated using the Mooney viscosity and rheometry test. Dynamic shear properties were compared using a cyclic test performed on a double-bonded shear test piece. TEM images showed that an optimum CNTs dispersion was reached at 3 phr MWCNTs loading whereas increasing CNT content resulted in further inhomogeneity. The addition of CNTs into the natural rubber not only improved the curing properties of the compound, i.e., low scorch and curing times, but it also increased the Mooney viscosity, the rheological properties, and the dynamic shear properties of the nanocomposite compared to the pristine rubber. The Payne and Mullins effects were also observed for all compounds manifesting dependency on the CNTs content and applied strain amplitude. Finally, MWCNT enhanced the dissipated energy of the nanocomposites with respect to the neat rubber in which an increase of 1040 % in energy dissipation for 10 phr MWCNTs compared to the control at a strain amplitude of 200 % was achieved.