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The purpose of this study is to explain the role of financing sources mergers and acquisitions on corporate performance based on Pecking Order Theory. What distinguishes this research from other mergers and acquisitions is the variable financing methods that are measured using a Pecking Order Theory of debt ratios, accumulated profits, and financial leverage. And to measure the firm's performance, variables such as equity returns, asset returns and the Kyotubin ratio are used.This study, using regression data on a sample of companies listed in the Tehran Stock Exchange that were acquired by other companies during the years 1391 to 1395, It shows that the source of financing of mergers and acquisitions has a different impact on the performance of the company. Whatever the company uses its debt ratio to fund, the company's performance has changed, increasing equity returns and decreasing returns on corporate assets. Also, increasing Retained earnings and Leverage as a source of financing , has increased the rate of return on assets and corporate performance, but the return on equity and value of the company has not changed.

Abstract Background Erectile dysfunction (ED) is a common condition with various contributing factors, including lifestyle and dietary habits. Caffeine, a widely consumed stimulant, has been linked to multiple physiological effects on vascular function and hormonal balance that might influence sexual function. This meta-analysis aims to evaluate the association between caffeine intake and the risk of ED by analyzing data from cohort studies. Methods A systematic search was conducted across PubMed, Web of Science, Scopus, and Embase databases, and a manual search was conducted on Google Scholar for studies on the relationship between caffeine intake and ED in adult men. The search included observational studies published up to April 1, 2024. Four cohort studies were included, and their data were extracted and analyzed by STATA version 18. Results Four included cohort studies comprised 51,665 cohort members. The study population included adult males, on average, aged 18 to 80. The results indicate that there was no significant relationship between coffee consumption and the risk of ED (relative risk [RR] = 0.94, 95% CI: 0.86–1.03; p = 0.999). Conclusions The current evidence suggests no significant relationship between caffeine intake and ED, but limited studies limit conclusions. Future research should focus on larger sample sizes, standardized outcome assessments, and different dosages and forms of caffeine consumption.

Background and purpose: Type 2 diabetes is a health problem and is an emergency that has the fastest growth worldwide. Diabetes is one of the priorities of all public health systems this study aimed to determine the quality of diabetes control in urban family physician centers of Sari city in 1382-1398. Materials and methods: This study was a cross-sectional and cross-sectional study. The required sample size was 275 patients who were selected randomly (a total of 300 patients) and 20 clusters (center), each consisting of 15 diabetic patients, were controlled. The population of the study included all patients with type 2 diabetes referred to health care centers of sari. The cases included age, sex, level of FBS, 2 hpp, HbA1c, blood pressure, triglyceride, cholesterol, HDL, LDL, and body mass index as well as eye examination and amputation were also recorded all the information contained the seal of the family physician. In this study, after data collection, the degree of conformity was compared with ADA guidelines. According to the American diabetes association (ADA), the goal of the treatment of this disease is reaching FBS: 90-130, HbA1c below 7%, BS2hpp

Introduction: The extract of Thymus kotschyanus Boiss, in addition to its antioxidant properties, also has a marvellous anti-amyloidogenic effectthat can be used for the treatment of amyloidosis. The aim of this study was to prepare silver nanoparticles from the aqueous extract of mountain thyme (Thymus kotschyanus Boiss), to investigate its antioxidant and inhibitory effect on the production of amyloid nanofibrils (bovine serum album (BSA) as a model protein). Material & Methods: This study was conducted experimentally in the laboratory of Payam Noor University in Qom Province in 2022. First, nanoparticles were prepared from aqueous thyme extract and added to AgNo3 silver nitrate solution (one millimolar). ThenFTIR, EDX, DLSand SEM methods were used to study the properties and size of the nanoparticles. The removing of free radicals 2,2-diphenyl-1-picrylhydrazyl (DPPH) method was used to study the antioxidant effects of the extract and the Concorde absorption method was used to study the production of amyloid nanofibrils. The chemical composition of the extract was analysed using the gas chromatography method. For statistical analysis, descriptive statistics and ANOVA tests were used with SPSS software version 23. Findings: The phytochemical analysis of the extract revealed seven compounds. Most compounds were associated with 5,4-alpha-epoxy-3-methoxy (43.53%), 2-ethyl-piperidine-1-methyl (31.02%) and thymol (23.65%). The UV-Vis spectrum showed the highest absorbance at 460 nm. The SEM results confirmed the production of spherical nanoparticles with a size of 70-93 nm. The concentrations of 0.8 and 1 mg/ml of the extract were able to inhibit DPPH by more than 50%. The highest antioxidant activity in the sample containing 2 ml of the nanoparticle solution (sample 5) was 56.82%. The highest inhibition of amyloid nanofibril production was observed at a concentration of 2 mg/ml with 95%. Discussion & Conclusion: Thus, the synthesized nanoparticles have potent antioxidant and anti-amyloidogenic properties and can be used as antioxidants.

Purpose: Obesity is associated with a chronic inflammatory condition, which plays an important role in the development of insulin resistance and disorder in appetite regulation. Resistance training (RT) can improve low-grade systemic inflammation caused by obesity by improving body composition. Hence, this study aimed to investigate whether RT with improvement in inflammatory status leads to improvement of metabolic markers and appetite-regulating peptides in obese women. Methods: Sixteen obese and healthy women were randomly divided into RT and control groups. The RT group participated in 8 weeks of RT. Blood samples and anthropometric characteristics were taken before the start of the exercise protocol and 3 days after the last training session. Serum levels of leptin, ghrelin, adiponectin, tumour necrosis factor (TNF-α), fasting glucose, insulin, and homeostatic model assessment of insulin resistance (HOMA-IR) were also measured. Results: After 8 weeks of training, body weight (BW) and body mass index (BMI) in the control group increased significantly (P < 0.01), but in the training group, anthropometric characteristics remained unchanged. Serum levels of ghrelin and leptin, adiponectin and tumour necrosis factor remained unchanged after 8 weeks of RT. A significant increase in insulin and homeostatic model assessment of insulin resistance levels was observed in the control group (P < 0.05). Conclusion: It seems that 8 weeks of RT is not enough to induce an anti-inflammatory response and improve body composition and subsequently improve appetite and metabolic markers.

Introduction: With the emergence of the corona virus, the educational system as well as other areas of the society has faced many challenges. This research was conducted with the aim of the challenges of virtual education in the country's medical sciences universities during the Corona era as a review of the qualitative studies conducted in Iran. Methodology: In this review study (a review of qualitative studies) in order to comprehensively search the available evidence and studies, SID, Iranmedex, Magiran and Google Scholar search engine were analyzed. The search criteria did not limit the start date, but the end date was set at the end of September 2022. The search was conducted to find articles with the keywords of virtual education, corona, students, professors as a combination of words. Results: From a total of 6 studies, the themes of "inefficient education, lack of educational infrastructure, confusion in organization, communication challenges and weak interactive platform" were identified as the main factors of virtual education challenges in the Corona era. Conclusion: The results of the present study showed that the students and professors of Iranian medical sciences universities were facing serious challenges in the field of virtual education, which is necessary in each university specifically and in accordance with the structure of that environment, effective solutions to adjust and solve them. Present problems.

Background and aim: For any progress, countries need scientific outputs, and that is only possible through research. Therefore, the aim of this study was to analyze the status of scientific outputs of Qom University in the Web of Science (WoS), emphasizing scientific collaboration and mapping co-authorship networks. Materials and methods: This applied documentary study was conducted using scientometric techniques and social network analysis. The research population was 1222 documents of scientific outputs of Qom University indexed in the WoS from 2002 to 2019. Data were analyzed using Excel, Bib Excel, Isi.exe, SPSS 25, UCINET as well as descriptive and analytical statistics. Netdraw software was used to map the network, and the Spearman test was applied to identify the relationship between research variables. Findings: Findings showed that the trend of scientific outputs of Qom University in the studied years was upward, and the growth rate of total scientific outputs of this university was 39%. Most scientific outputs were in the fields of chemistry, engineering and mathematics, and 90% of the indexed documents were research articles. In terms of co-authorship pattern, three co-authors were the most one so that the most collaboration was with universities of Islamic Azad, Soran in Iraq and Payam-e-Noor as well as with countries of the United States, Iraq and Australia. Nasrullahzadeh, Ehsani and Bayat had the highest centrality in terms of index, closeness and intermediate, respectively. Moreover, the density of the network was 0.004, and there was a significant and direct relationship between scientific outputs and centrality indicators. Conclusion: In terms of growth rate, the scientific outputs of Qom University have no desirable condition, and in terms of co-authorship pattern, three co-authors are the most one.

Abstract Nowadays, radiation grafting polymer adsorbents have been widely developed due to their advantages, such as low operating cost, high efficiency. In this research, glycidyl methacrylate monomers were grafted on polypropylene polymer fibers by simultaneous irradiation of gamma-ray with a dose of 20 kGy. The grafted polymer was then modified using different amino groups and tested for adsorption of cobalt ions in an aqueous solution. Finally, the modified polymer adsorbent with a high efficiency for cobalt ions adsorption was synthesized and tested. Different modes of cobalt ions adsorption were tested in other adsorption conditions, including adsorption contact time, pH, different amounts of adsorbent mass, and different concentrations of cobalt ions solution. The adsorbent structure was characterized with FT-IR, XRD, TG and SEM techniques and illustrated having an efficient grafting percentage and adsorption capability for cobalt removing by batch experiments. The optimum conditions were obtained by a central composite design: adsorbent mass = 0.07 g, initial concentration = 40 mg/L, time = 182 min, and pH = 4.5 with ethylenediamine as a modified monomer and high amination percentage. Kinetics and equilibrium isotherms observation described that the experimental data followed pseudo-second-order and Langmuir models, respectively. The maximum adsorption capacity from Langmuir isotherm capacity is obtained equal to 68.02 mg/g.

Introduction: Today, the use of new technologies has expanded in various fields. One of these cases is the use of smartphones and barcode reader software and two-dimensional barcodes. In this study, we tried to evaluate the influence of barcode utilization in the training of residents. Methods: This was a descriptive cross-sectional study conducted in the emergency department of Ghaem Hospital, in which the effect of using educational barcodes on 30 medical residents of the emergency, internal medicine, and neurology was investigated. A questionnaire recording the performance of residents in medical emergency procedures was used. Also, demographic variables of residents were recorded. Data analysis was performed using descriptive and inferential statistics in SPSS software.Results: A total of 30 residents completed the study questionnaire before installing the poster, and 29 of them completed the post-test questionnaire. Of these, 10 (33.3%) were emergency medicine residents, 13 (43.3%) Internal medicine and 7 subjects (23.3%) were neurology residents. All of them (100%) found the use of QR codes practical and easy. Analysis of data related to pre-test and post-test scores of residents shows that their average scores in the pre-test, 7 ±2.39, and their average scores in the test post 10.86 ±2.431, which indicates a significant increase after using the QR code poster (P-value = 0.000) Conclusion: The use of QR codes has been practical, easy, and user-friendly. Also, comparing the average scores of participants before and after the installation of these codes, shows that it has had a significant effect on training residents.

Introduction: Teaching the necessary knowledge and skills in the emergency department has always faced challenges due to its importance, unique features and multidisciplinary expertise. Today, advances in information and communication technology have also revolutionized education. The purpose of this article is to investigate the feasibility and experiences of using virtual reality and augmented reality technologies in the education of the emergency department by reviewing the studies conducted in the world. Methods: This research is based on a systematic review in which the quality of the articles was evaluated using the STROBE standard checklist. The primary studies carried out, through articles on the educational capacities of augmented and virtual reality technology in the emergency department; in Persian language databases; SID, Magiran and English language databases; Science Direct, PubMed, Scopus and Google Scholar search engine were done until the end of September 2022. Farsi keywords; Emergency, medical emergencies, education, virtual reality, augmented reality and mixed reality were used as a combination of words; Also, Boolean search methods and OR operators and Mesh keywords including: Emergency, Education, Virtual Augmented, Virtual Reality, Mixed Reality, EMS, MR, VR, AR were used. Findings: Among the 9 reviewed studies, the largest number of extracted studies, i.e. three articles, were conducted in China. Other articles were from America, Germany, Iran and Netherlands. The research method used in 8 articles was intervention, and only one article was tool design and content analysis using the Delphi method. The types of tools used in these studies were: a wearable module on the head with two categories of movement and operation, playing virtual reality simulation videos with the help of television and virtual reality glasses, a wearable headset and two hand controllers with triggers that make hand movements. Such as grasping, pushing and turning, virtual simulated scenes, an immersive room-scale multi-user virtual reality 3D simulation environment with a virtual emergency scenario, wearable modules and mouse and keyboard prototypes, and an interactive training module. The results of the studies also showed the improvement of educational performance, enthusiasm for learning, educational satisfaction, increased skills, improved response capacity, effectiveness of education and control of emotions in emergency situations. Conclusion: The results of this study clarified several issues: 1- The volume of studies in the field of emergency department training with the help of virtual world tools is very small. 2- Augmented reality and mixed reality tools have not yet entered the field of medical education in the emergency department. 3- These tools can cause complications and challenges in using them. 4- Most of the studies have been conducted in the last 3 years, which show that this field of educational tools to promote and improve performance due to continuous evaluations is at the beginning.

Introduction: Advances in the field of technology in the field of virtualization today have led to the creation of tools that can easily evoke the presence of the patient in a more attractive situation than the current situation or by adding information to the real world to deepen the understanding of reality. Make Virtual reality and augmented reality technology has seriously entered the field of medicine for two decades. The emergency department has also been able to use this tool with its special features; therefore, the current research tries to have a systematic review of the therapeutic use of augmented and virtual reality technology in the emergency department. Methodology: This research is based on a systematic review in which the quality of the articles was evaluated using the STROBE standard checklist. The primary studies carried out, through articles on the use of virtual reality and augmented reality therapy in the emergency department; in Persian language databases; SID, Iranmedex, Magiran and English language databases; Science Direct, PubMed, Scopus and Google Scholar search engines were conducted until the end of September 2022. Keywords of Emergency, Augmented Reality, Virtual Reality, Mixed Reality, Treatment, Cure, Therapy, Medical, EMS, MR, VR, and AR were considered as a combination of words. Findings: Among the 14 reviewed studies, the largest number of extracted studies with 4 articles were conducted in Canada; and mostly it was a randomized and controlled prospective intervention method. Most of the studies with 10 articles were in the field of providing emergency services to children and adolescents under 18 years of age, and the effective components of virtualization technology were: reducing pain, managing anxiety and distress, improving hemodynamic parameters, and controlling fear and anger. Among the reviewed articles, none of the studies used augmented reality or mixed reality tools. Conclusion: The results of the collected studies on the use of virtualization therapy show that so far this tool has had significant effects on controlling emotions and improving hemodynamic parameters. Analyzing the mechanism of the effect of virtual reality in different groups can help to establish a cause and effect relationship and the targeted use of these tools. It is also necessary to design these tools in such a way that their use does not prevent the normal procedures in the emergency department.

Introduction: Point-of-Care Testing (POCT) could be helpful in clinical decisions, treatment selection, monitoring, prognostication, operational decision-making, and resource utilization. This study aimed to review the role of POCT in time metrics of performing urgent interventions in the emergency department (ED) or disposition time to proper care. Methods: This was a systematic review of the literature based on the PRISMA statement. PubMed, Scopus, Web of Science, and EMBASE databases were searched for studies reporting the application of the POCT in the ED with outcomes of the time to intervention or disposition. Results: After reviewing 3708 articles, 16 studies with 100,224 participants were included in this systematic review. There were 5 randomized clinical trials (RCTs), 5 retrospective cohorts, 2 prospective cohorts, and 4 before-after studies. All studies were performed in an ED setting except for one study of prehospital EMS air medical transport. Different panels, ultrasound, cardiac parameters, echocardiography, and polymerase chain reaction (PCR) POCTs were used in the studies. Regarding the outcome measures, studies with many types of patients referring to ED used different indices of time to intervention or time to disposition. Studies on different shock circumstances used the time to the first bolus of hydration or vasopressor or intravenous antibiotics for septic shock patients and central venous catheterization (CVC) placement time in one study. Time to imaging was considered as the outcome in some studies. Overall, there was a high risk of bias, especially in case of the randomization methods, and non-blinded designs in RCTs. There was lower possibility of bias in non-randomized studies but the studies did not have enough follow-ups and in case of studies using advanced panels of POCT, results do not seem to be easily applicable to public health care in many countries. Conclusion: In synthesis of the evidence, all included studies were reporting the benefits of the POCT in decreasing the time to proper interventions and increasing the time to negative interventions in the last lines of critical care as well as the intubation and CVC placement.

Background: According to statistics, tramadol use is extremely prevalent in Iran. Besides, tramadol overdose is mostly observed in young individuals. Given the significance of this issue and the increasing prevalence of tramadol use in Iran, this study aimed to systematically review tramadol poisoning in Iran. Methods: In this review, a search was conducted in Persian databases of IranMedex, SID, Medlib, Magiran, as well as Google Scholar using the keywords of “poisoning and tramadol” without a time limitation. Results: Some of the main issues related to tramadol poisoning were as follows: the majority of cases consumed tramadol to commit suicide; most tramadol consumers were aged below 30 years; the majority of patients with tramadol poisoning were single and male; tramadol was mostly used orally; in most studies, patients were hospitalized for >24 hours; the majority of patients concomitantly took other medications with tramadol; in most studies, patients had a history of tramadol use; most studies reported a relationship between tramadol dose and seizures, and the most common cause of hospital referral was decreased consciousness level. Conclusion: Tramadol misuse and poisoning could lead to seizures and often death. Besides, most cases with tramadol poisoning were aged below 30 and consumed tramadol to commit suicide. Thus, it is crucial to improve the youth’s awareness about tramadol use, develop methods to prevent suicides, and limit access to this drug, especially in young adults.

The aim of this study was to investigate the effect of various types of entrepreneurial activities of rural women on the sustainable food security of their households in Khorramabad township. The statistical population of the present study was rural women entrepreneurs in Khorramabad township (N = 395) who were selected as a sample using Jrejcie and Morgan table (n=190) and three-stage cluster sampling method. The main data collection tool was a researcher-made questionnaire. The results showed that the food security situation of households is not in a favorable condition (2.59). The results of the Kruskal-Wallis test showed that in terms of sustainable food security, there is a significant difference in the types of entrepreneurial activities of rural women in terms of consumption and access dimensions (P

Abstract Bioethanol produced by fermentative microorganisms is regarded as an alternative to fossil fuel. Bioethanol to be used as a viable energy source must be produced cost-effectively by removing expense-intensive steps such as the enzymatic hydrolysis of substrate. Consolidated bioprocessing (CBP) is believed to be a practical solution combining saccharification and fermentation in a single step catalyzed by a microorganism. Bacillus subtills with innate ability to grow on a diversity of carbohydrates seems promising for affordable CBP bioethanol production using renewable plant biomass and wastes. In this study, the genes encoding alcohol dehydrogenase from Z. mobilis (adh Z ) and S. cerevisiae (adh S ) were each used with Z. mobilis pyruvate decarboxylase gene (pdc Z ) to create ethanologenic operons in a lactate-deficient (Δldh) B. subtilis resulting in NZ and NZS strains, respectively. The S. cerevisiae adh S caused significantly more ethanol production by NZS and therefore was used to make two other operons including one with double copies of both pdc Z and adh S and the other with a single pdc Z but double adh S genes expressed in N(ZS)2 and NZS2 strains, respectively. In addition, two fusion genes were constructed with pdc Z and adh S in alternate orientations and used for ethanol production by the harboring strains namely NZ:S and NS:Z, respectively. While the increase of gene dosage was not associated with elevated carbon flow for ethanol production, the fusion gene adh S:pdc Z resulted in a more than two times increase of productivity by strain NS:Z as compared with NZS during 48 h fermentation. The CBP ethanol production by NZS and NS:Z using potatoes resulted in 16.3 g/L and 21.5 g/L ethanol during 96 h fermentation, respectively. For the first time in this study, B. subtilis was successfully used for CBP ethanol production with S. cerevisiae alcohol dehydrogenase. The results of the study provide insights on the potentials of B. subtilis for affordable bioethanol production from inexpensive plant biomass and wastes. However, the potentials need to be improved by metabolic and process engineering for higher yields of ethanol production and plant biomass utilization.

The aim of this study was to compare the relationship between shock index (SI) and respiratory adjusted shock index (RASI) scores with the final outcome of sepsis patients referred to the emergency department. This was prospective research that examined individuals who had been diagnosed with sepsis, determined by the presence of at least two of the three quick sepsis-related organ failure assessment (qSOFA) criteria and the presence of an infectious disease based on a diagnosis made by a hospital physician of Imam Reza and Ghaemshahr of Mashhad in 2019. Demographic information of patients, SI score, RASI score, and information related to the patient's clinical symptoms were recorded in the checklist. The final outcome of this study was considered mortality. Data analysis was performed using descriptive and inferential tests. In the present study, a total of 178 patients, 46 patients (25.8%) were transferred to the intensive care unit, and 98 patients (55.1%) were admitted to the normal wards. Eighty-five patients (47.75%) died and the mean length of hospital stay of all patients was 11.07 ± 9.23 days. Forty-four patients (24.7%) had referred with a decreased level of consciousness and 44 patients (24.7%) presented with confusion. The rest of the patients reported normal levels of consciousness. Kaplan Mir analysis with log-rank was performed to determine the difference in survival distribution in different SI groups: Survival distribution was not statistically different for the four defined groups (based on statistical quartiles (P = 0.320). Receiver operator curves were considered as the date of death in the case of the deceased and the date of discharge from the hospital in the case of the living as censored. The AUC of the RASI scoring system for predicting mortality was 0.614 (P = 0.009) while this value was not significant for SI (P = 0.152). In logistic regression analysis, it was found that by adjusting for the variables of age, sex, sepsis etiology, blood pressure and heart rate, level of consciousness, and gender, patients with the lower respiratory rate (OR 1.6, z = −0.159 p = 0.007), younger age (OR 1.6, z = −0.029 p = 0.006) and higher RASI score are more in risk of mortality (OR 1.29, z = 1.209, p = 0.031). The results of our study showed that RASI scoring can be a good criterion for predicting the chance of mortality in patients with sepsis and could be used complementary to previous criteria such as SI. Patients with high RASI scores should be given more attention to reducing the chance of death.

مقدمه: نیازسنجی آموزشی نخستین گام در تدوین و توسعه برنامه های آموزشی ارتقا دهنده مهارت ها و دانش نیروی انسانی قلمداد می شود و می تواند عامل ایجاد و تضمین اثربخشی کارکرد آموزش و بهسازی سازمانی و نیز توانمندسازی نیروهای انسانی ماهر و متخصص محسوب شود که در نظام سلامت از اهمیت بسزایی برخوردار است. یکی از بخش های مهم ارائه دهنده خدمات سلامت بخش اورژانس است که به دلیل فشردگی اطلاعات، پیچیدگی مسائل و نیاز به سرعت عمل بالا در این واحدها، ارتقای آموزش ها و مهارت ها در این بخش بسیار مهم و ضروری است. لذا در مقاله حاضر نیازهای آموزشی پزشکان و پرستاران بخش اورژانس؛ بر اساس مطالعات انجام شده؛ مورد کنکاش قرار گرفته است. روش کار: این پژوهش مبتنی بر یک مرور نظام‌مند می باشد که ارزیابی کیفیت مقاله ها با استفاده از چک لیست استاندارد STROBE، صورت گرفته است. مطالعات اولیۀ انجام شده، از طریق مقاله هایی که در زمینه ارتقای آموزشی طب اورژانس و تربیت حرفه مندان بخش اورژانس و فوریت های پزشکی؛ در پایگاه‌های اطلاعاتی فارسی زبان؛ SID ،Iranmedex ،Magiran و پایگاه‌های انگلیسی زبان؛ Science Direct، PubMed، ProQuest،Cochrane Library،Embase ،Scopus و موتور جستجوگر Google Scholar در بازه زمانی سالهای 2010 تا 2022 منتشر شده است، انجام گرفت. کلید واژه‌های فارسی؛ اورژانس، فوریت های پزشکی، آموزش، آموزش مداوم، نیازهای آموزشی، مهارت های مورد نیاز و عبارات مرتبط با اورژانس به صورت ترکیب واژگان و لغات انگلیسی Emergency, Education, Continuing Education, Educational Needs, Needs Assessment با کمک روش های جستجوی بولین و عملگرهای And و OR مورد توجه بوده است. یافته ها: در این مطالعه مرور سیستماتیک نیازهای آموزشی حرفه مندان بخش اورژانس بررسی گردید که پس از جستجو در پایگاه های اطلاعاتی با کلیدواژه های متناسب، 21 مقاله که شرایط لازم را بر اساس معیارهای ورود داشتند، آنالیز شد. از میان مطالعه های مورد بررسی، بیشترین تعداد مطالعات استخراج شده در آمریکا(9مقاله) و ایران(8مقاله) انجام شده است. روش تحقیق بکار رفته در 18 مقاله، توصیفی-مقطعی بود و روشهای دلفی، مطالعه کیفی با انجام مصاحبه و تحلیل محتوا نیز بین مطالعات وجود داشت. 9 پژوهش در حوزه های اختصاصی و مابقی به طور کلی به نیاز سنجی پرداخته بودند. به لحاظ جمعیت هدف نیز پرستاران، پزشکان، دانشجویان و کارورزان، دستیاران، اعضای هیات علمی، کارکنان و مدیران؛ در این مطالعات، مشارکت داشته اند. نتیجه گیری: آنالیز نتایج مطالعات از نیاز آموزشی به مهارتهای لازم در زمینه تشخیص صحیح و سریع، آموزش های لازم برای انجام اقدامات درمانی فوری، ارائه صحیح و استاندارد خدمات مراقبتی، مدیریت شرایط و موقعیت های بحرانی و مهارت های ارتباطی؛ حکایت دارد. اگرچه در طول یک دهه گذشته محققان پژوهش در آموزش تلاش زیادی برای شناسایی نیازهای آموزشی بخش اورژانس داشته اند با این حال به نظر می رسد علیرغم مطالعات بسیار بر روی بخش اورژانس، مطالعات نیازسنجی از انسجام لازم برای ارائه راهبردهای آموزشی کارآمد برخوردار نیست.

Establishing enzyme-free sensing assays with great selectivity and sensitivity for glucose and H2O2 detection has been highly required in biological science. In particular, the exploitation of nanomaterials by using noble metals of high conductivity and surface area has been widely investigated to act as selective catalytic agents for molecular recognition in sensing platforms. Several approaches for a straightforward, speedy, selective, and sensitive recognition of glucose and H2O2 were requested. This paper reviews the current progress in electrochemical detection using metal–organic frameworks (MOFs) for H2O2 and glucose recognition. We have reviewed the latest electrochemical sensing assays for in-place detection with priorities including straightforward procedure and manipulation, high sensitivity, varied linear range, and economic prospects. The mentioned sensing assays apply electrochemical systems through a rapid detection time that enables real-time recognition. In profitable fields, the obstacles that have been associated with sample preparation and tool expense can be solved by applying these sensing means. Some parameters, including the impedance, intensity, and potential difference measurement methods have permitted low limit of detections (LODs) and noticeable durations in agricultural, water, and foodstuff samples with high levels of glucose and H2O2.

With the onset of the coronavirus crisis, disruption of the domestic food supply chain, loss of revenue, and payments that affect food production have led to severe tensions and food security risks in many developing countries. The rural communities are more at risk of food insecurity due to less access to healthcare and social inequality. Therefore, this study aimed to assess the impact of the COVID-19 pandemic on food security and food diversity of rural households. The sample included 375 household heads living in the rural areas of Khorramabad county, which was determined using a three-stage cluster sampling method. Data were collected using standard Household Food Insecurity Access Scale (HFIAS) and Household Dietary Diversity Score (HDDS) questionnaires. The results showed that the food security situation of rural households has deteriorated, and consumption of some food groups changed during the COVID-19 pandemic. The results of the multinomial regression model showed that gender, level of education, monthly income, number of employed members, nutrition knowledge, employment status, livestock ownership, and access to credit were significantly associated with the food security of households during the COVID-19 pandemic. The household head's gender, level of education, monthly income, nutrition knowledge, employment status, livestock ownership, and access to credit were significantly associated with dietary diversity during the COVID-19 pandemic. Based on the findings, providing emergency food assistance and cash payments to food-insecure households can reduce the risk of food insecurity in rural households. It is suggested that government policies focus on identifying vulnerable households in rural areas, especially female-headed households, low-income households, and households without a wage income.

Coronaviruses are a large family of viruses that have endangered the lives of many people with several outbreaks throughout history. The Coronavirus Disease 2019 (COVID-19) recently caused a pandemic [1]. It began in China from December 2019, and by now it has affected 201 countries, more than 37,423,660 people worldwide, and claimed the lives of more than 1,074,817 people [2].

Introduction: COVID-19 has affected the pattern of referral to medical centers and quarantine against COVID-19 might delay referral and management of surgical emergencies. This study aimed to compare the pooled event rate of pediatric perforated appendicitis before and during the COVID-19 pandemic. Methods: This was a systematic review and meta-analysis study based on the PRISMA guidelines. Scopus, Web of Sciences, and PubMed databases were searched for studies reporting the rate of perforated appendicitis based on the post-appendectomy observations or imaging methods. The Egger bias test and funnel plot were used to detect and depict publication bias. Statistical analysis was performed in Comprehensive Meta-analysis package version 3. Results: Twelve studies were eligible for inclusion in our study. The pooled prevalence of pediatric perforated appendicitis in the pre-COVID era was 28.5% (CI95%: 28.3 to 28.7%) with a heterogeneity of 99%. In the COVID era, the event rate proportion was 39.4% (CI95%: 36.6 to 42.3%) with a heterogeneity of 99%. There was a significant difference in the subgroup analysis within the pre-COVID and COVID era (P

BACKGROUND: Advanced stages of dementia interfere with elderly self-care. Consequently, they need caregivers who take responsibility for their care in the long-term. Restrictions to the caregiver's access to information, resources, and organizational support have created problems in their caregiver role, which is why the World Health Organization (WHO) emphasizes caring for caregivers by providing evidence-based information and training programs. As there is no clinical practice guideline for home care in the Islamic Republic of Iran, this study aims to develop a home health care guideline for the elderly with dementia. MATERIALS AND METHODS: The ADAPTE process provided by the Guidelines International Network was considered as the basis. In order to identify the care needs of Iranian patients with dementia, semi-structured interviews were added to this guideline. DISCUSSION: The identification and implementation of the perspectives of patients and caregivers during the process of guidelines adaptation increase the applicability of the guidelines. Improved quality of life for the patients in their place of residence is one of the expected consequences of this guideline's implementation. The developed guidelines will be used at home health care centers, and dementia and Alzheimer's associations in Iran.

Introduction: Skin and soft tissue infections are important causes of outpatient visits to medical clinics or hospitals. This study aimed to review the literature for the accuracy of Clinical Resource Efficiency Support Team (CREST) guideline in management of cellulitis in emergency department. Method: Studies that had evaluated cellulitis patients using the CREST guideline were quarried in Scopus, Web of Science, and PubMed database, from 2005 to the end of 2020. The quality of the studies was evaluated using Scottish Intercollegiate Guideline Network (SIGN) checklist for cohort studies. Pooled area under the receiver operating characteristic curve (AUROC) of CREST guideline regarding the rate of hospital stay more than 24 hours, rate of revisit, and appropriateness of antimicrobial treatment in management of cellulitis in emergency department was evaluated. Results: Seven studies evaluating a total of 1640 adult cellulitis patients were finally entered to the study. In evaluation of the rate of the appropriate treatment versus over-treatment, the pooled AUROC was estimated to be 0.38 (95% confidence interval (CI): 0.06 – 0.82), indicating low accuracy (AUROC lower than 0.5) of guideline for antimicrobial choice. CREST II patients had a significantly lower odds ratio (OR) of revisiting the Emergency Department, OR=0.21 (95% CI: 0.009‎ – ‎ 0.47). Pooled AUROC value of 0.86 (CI95%: 0.84 – 0.89) showed accuracy of the CREST classification in prediction of being hospitalized more or less than 24 hours. Conclusion: CREST classification shows good accuracy in determining the duration of hospitalization or observation in ED but it could lead to inevitable over/under treatment with empirical antimicrobial agents.

مقدمه: همه‌گیری کوید 19 در دنیا منجر به ایجاد استرس و اضطراب زیادی در بین مردم شده است. با توجه به اینکه کارکنان درمانی در خط اول مبارزه با بیماری کووید 19 هستند، بیشترین میزان خطر و اضطراب را دارا می باشند. بنابراین هدف از انجام این مطالعه بررسی اضطراب کادر درمانی و عوامل روانشناختی موثر بر آن در زمان پاندمی کوید 19 در ایران به صورت یک مطالعه سیستماتیک می باشد. روش کار: در این مطالعه مرور سیستماتیک جهت جستجوی مقالات پایگاه های اطلاعاتی فارسی زبان؛ پایگاه مرکز اطلاعات علمی جهاد دانشگاهی(SID)، مگیران و موتور جستجوی گوگل اسکالر از سال 2018 تا 2021 با استفاده از کلید واژه های فارسی؛ اضطراب، کرونا ویروس، کوید 19، کادر درمانی، پرستاران انجام شد. برای انتخاب مطالعات و استخراج داده ها، ابتدا عناوین تمام مقالات بدست آمده توسط دو نفر مورد بررسی قرار گرفت و سپس موارد تکراری حذف شد. اطلاعات مربوط به مقالات منتخب شامل: نویسنده اول، سال انجام انتشار مقاله، عنوان مطالعه، جامعه مورد مطالعه، روش مورد مطالعه، حجم نمونه، ابزار مورد بررسی و در نهایت نتایج بدست آمده در فرم استخراج داده ها ثبت گردید. نتایج: در مرحله اولیه جستجوی مطالعات، 624 مطالعه بررسی گردید. 610 مطالعه بدلیل مرتبط نبودن با موضوع مورد مطالعه و تکراری بودن و عدم دسترسی به مقاله کامل حذف گردید. در نهایت 14 مطالعه جهت نگارش این مطالعه مورد استفاده قرار گرفت. عوامل روانشناختی مختلفی نظیر(استرس، افسردگی، فرسودگی شغلی، تاب آوری، حمایت اجتماعی خانواده، افکار خودکشی، تنظیم هیجان، حساسیت اضطرابی، سرسختی روانشناختی، رفتارهای مراقبتی، نشخوار فکری، باورهای بهداشتی و فعالیت بدنی)، در میزان بروز اضطراب و پیش بینی آن نقش داشتند. از میان مطالعات مورد بررسی 5 مطالعه مربوط به سال 1400 و 9 مطالعه مربوط به سال 1399 می باشد. جامعه مورد مطالعه در سه مطالعه اردبیل، دو مطالعه ملایر، دو مطالعه جهرم و یک مطالعه زاهدان، زرندیه، البرز، کرمان، تربت حیدریه، میانه و رشت می باشد. ابزار مورد بررسی در 10 مطالعه CDAS، 2 مطالعه اضطراب بک و 2 مطالعه هم DASS بود. نتیجه گیری: نتایج این مطالعه نشان داد که عوامل روانشناختی مختلفی در بروز میزان اضطراب در کادر بهداشت و درمان تاثیرگذار هستند که هر کدام به نوعی می توانند در میزان بروز اضطراب نقش داشته باشند. بنابراین شناسایی علت این اختلالات روانشناختی در این افراد امری ضروری است تا با استفاده از شیوه های مناسب بتوان سلامت روان این افراد را حفظ نمود.

مقدمه: بیمارستان ها به عنوان مهم ترین مراکز ارجاع آسیب دیدگان در زمان حوادث غیر مترقبه به شمار می روند. ایران یکی از کشورهای بلاخیز دنیا می باشد و عدم آمادگی بیمارستان ها در زمان حوادث غیر مترقبه موجب خسارت های فروانی به سیستم بهداشت و درمان کشور می شود. لذا هدف از انجام این مطالعه میزان آمادگی بیمارستان های ایران در برابر حوادث و بلایا به صورت یک مطالعه مرور سیستماتیک انجام شد. روش کار: مطالعه حاضر یک مرور نظام مند می باشد. مطالعاتی که به زبان فارسی در مورد میزان آمادگی بیمارستان های ایران در مورد حوادث و بلایاها منتشر شده است با کلمات کلیدی "حوادث غیر مترقبه"، "بلایاها"، "آمادگی بیمارستان ها" جستجو و با استفاده از چک لیست پریسما مورد بررسی قرار گرفت. جستجوی مقالات بدون هیچ گونه محدودیت زمانی در پایگاه داده های Google scholar، Sid، Magiran، انجام گردید. یافته ها: از 365 مقاله مورد بررسی 32 مطالعه مورد بررسی نهایی قرار گرفت. 10 مطالعه در استان تهران، 5 مطالعه در کرمانشاه و یک مطالعه در اهواز، ایلام، مازندران، یزد، مرکزی، اصفهان، قزوین، بیرجند، تبریز، شمال ایران، جهرم، زابل، سمنان، ارومیه، شیراز، زنجان و کل ایران بود. اکثر بیمارستان های مورد بررسی آموزشی بودند. سه مطالعه در بیمارستان های نظامی و یک مطالعه بیمارستان های خصوصی را مورد بررسی قرار داده بودند. از میان مطالعات مورد بررسی؛ 20 مطالعه به صورت توصیفی مقطعی، 12 مطالعه به صورت توصیفی تحلیلی و یک مطالعه به صورت میدانی انجام شد. همچنین میزان آمادگی بیمارستان های مورد بررسی شده نشان داد که بیش از نیمی از بیمارستان های مورد بررسی آمادگی متوسط، 7 مطالعه آمادگی خوب(مطلوب) و 8 مطالعه آمادگی ضعیف(پایین) داشتند. نتیجه گیری: نتایج مطالعه حاضر بیانگر آن بود که در مجموع آمادگی بیمارستان های ایران در حد متوسط می باشد. بنظر می رسد تیم های بحران در بیمارستان های ایران می بایست قبل از وقوع حوادث و بلایا در حدی که اوضاع و احوال و منابع موجود اجازه می دهد از آمادگی لازم برخوردار باشند و اطلاعات لازم را در زمینه ی مدیریت بحران فراگرفته و برنامه ریزی های لازم را انجام داده تا به هنگام وقوع بلایا تصمیم‌گیری های درست و منطقی انجام داده و نقش خود را به عنوان تیم بحران ایفا نمایند.

Background: The internet has unique properties that include ease of access, ease of use, low cost, anonymity, and its attractiveness which resulted in problems such as internet addiction. Different statistics has been reported about internet addiction rate, but there is not a suitable estimation about the growth of Internet addiction in Iran. The aim of this study is to analyze the growth of Internet addiction in Iran using meta-analysis method.Methods: At the first stage, by searching in scientific databases such as Magiran, SID, Scopus, ISI, Embase and use of keywords like Internet addiction, 30 articles were chosen. The outcomes of the study combined together with using meta-analysis method (random effects model). The analysis of the data was performed using R and Stata software.Findings: Based on 30 studies and sample size of 30439, the growth rate of Internet addiction based on the random effects model was 8% [with confidence interval (CI) of 95%]. The meta regression model showed that the trend of Internet addiction growth rate in Iran increased from 1385 to 1394.Conclusion: This study showed that the prevalence of Internet addiction in Iran seems moderate. Therefore, the necessity of identification, treatment, and prevention of the age groups which are at the risk is being sensed by the responsible and related authorities.

Objective: To evaluate the efficacy of some medicinal plants and systemic glucantime in a comparative manner against the causative agent of cutaneous leishmaniasis both in vitro and in BALB/c mice. Methods: For in vivo testing, inbred mice were challenged with Leishmania major parasites and the resultant ulcers were treated with extract based-ointments applied topically two times per day for a period of 20 days. A group of 56 mice were randomly divided into 7 subgroups. The control group received the ointment void of extracts, whereas the reference group received glucantime only. The efficacy of treatments was evaluated by measuring ulcer diameter, parasite burden and NO production. Results: Our results indicated that plant extract based-ointments were effective in reducing ulcer size and parasite burden in spleens, but their effects did not differ significantly from that of glucantime. The plant extracts tested in this study were able to increase NO production that helped parasite suppression. Conclusions: Our findings indicate that the tested plant extracts are effective against Leishmania major both during in vitro and in vivo experiments, but further researches are required to recommend a potential plant extract as an alternative drug.

Using online social networks and information collection from sites can affect purchasing behavior. Consumer cognize their friends' buying decisions more valuable to the anonymous' decisions and trust them more. This Study examine the impact of intention to use online social networks on brand's performance with emphasize on customer-based brand equity. Data were collected through a questionnaire that was distributed among 384 college students. Research findings suggest that there is a positive relationship between the intention to use online social networks and customer-based brand equity, but there is no significant relationship between the intention to use online social networks and Brand market performance. Also there is a positive relationship between customer-based brand equity and Brand market performance.

Social networks form a basis for maintaining social contacts, finding users with common interests, creating local content and sharing information. Recently networks have created a fundamental framework for analyzing and modeling the complex systems. Users' behavior studies and evaluates the system performance and leads to better planning and implementation of advertising policies on the web sites. Therefore, this study offers a framework for online social networks' characteristics. In terms of objective, this survey is practical descriptive. Sampling has been done among 384 of graduate students who have good experiences of membership in online social network. Confirmatory factor analysis is used to evaluate the validity of variables in research model. Characteristics of online social networks are defined based on six components and framework's indexes are analyzed through factor analysis. The reliability is calculated separately for each dimension and since they are all above 0.7, the reliability of the study can be confirmed. According to our research results, in terms of size, the number of people who apply for membership in various online social networking is an important index. In terms of individual preference to connect with, people who are relative play essential role in social network development. In terms of homogeneity variable, the number of people who visit their friends’ pages is important for measuring frequency variable. In terms of frequency, the use of entertainment and recreation services is more important index. In terms of proximity, being in the same city is a more important index and index of creating a sense of belonging and confidence is more important for measuring reciprocity variable.