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Abstract Background This study aimed to adapt mental health first aid guidelines to support individuals with or at risk of developing eating disorders in Iran. This adaptation seeks to enhance the support available for the Iranian population dealing with these disorders. Methods We employed the Delphi expert consensus method, utilizing two panels: health professionals (n = 37 in the first round; n = 29 in the second) and individuals with lived experience (n = 20 in the first round; n = 18 in the second). The health professionals panel was selected from the graduates of various eating disorders associated scientific fields who had a history of providing services to or conducting research on people with eating disorders, and the lived experience panel had a history of eating disorders themselves or in their family. The panel of individuals with lived experience included those who had personal or familial histories of eating disorders. Efforts were made to ensure cultural, gender, and age diversity in the selection of panel members. Panellists rated the importance of each item for inclusion in the guidelines for Iran based on the English-language Mental Health First Aid guidelines for eating disorders. Items deemed essential by at least 80% of both panels were included in the final guideline. Additionally, panel members were invited to suggest any missing items. Results A total of 57 participants took part in the first round of the survey, and 47 participated in the second round. In the first round, 204 items across 11 categories were assessed, with 174 items endorsed by the panels. Thirteen items were re-scored in the second round, and 17 items were rejected. Participants suggested 11 new items in the first round. In the second round, 18 out of 24 items were endorsed, while six were rejected. Ultimately, 192 items were incorporated into the Iranian guidelines. Conclusions The adaptation process considered Iran's social and cultural characteristics, including the stigma associated with mental health disorders, religious beliefs and rituals such as fasting, linguistic differences between English and Farsi, distrust of strangers, the influence of friends and family, differences in food access, and low mental health literacy. We recommend piloting the adapted guidelines in high schools, universities, and non-governmental organizations to evaluate their feasibility and effectiveness in real-world settings. Furthermore, it is essential to establish mechanisms for feedback, update content based on the latest evidence, and collaborate with the media to promote educational programs and public participation.

This case report describes the treatment of a 9-year-old boy with impacted maxillary central incisors due to 2 supernumerary teeth. A sequential approach comprising of surgical removal of the supernumerary teeth and 2 stages of surgical exposure and orthodontic traction of the impacted teeth resulted in correct repositioning of incisors. Close monitoring and multidisciplinary cooperation during various stages of treatment led to a successful esthetic outcome, with optimal periodontal health and functional occlusion.

IntroductionThere is some evidence comparing the efficacy of telehealth to in-person mental health care, but there is limited research specifically comparing these modalities in nurses. The study aimed to compare the effects of Mindfulness-based Stress Reduction (MBSR) and Internet-delivered Mindfulness-based Stress Reduction (iMBSR) on burden of psychosomatic symptoms of nurses working at Al-Alhamzeh general hospital, Aldiwaniyeh, Iraq.MethodsThe study was a semi-experiment study with a pre-posttest design on 72 registered nurses. Subjects were randomly allocated in group A, in-person MBSR and group B, internet-delivered MBSR. Intervention in two groups was held at 8 weekly sessions. The data collection instrument included sociodemographic, Patient Questionnaire Health-15 (PHQ-15), and General Health Questionnaire-12 (GHQ-12). Data were analyzed with SPSS version 24 by descriptive and non-parametric inferential tests.ResultsThe study found that 50% of the nurses in both groups reported mild somatic symptoms, and 40% reported moderate symptoms, with the majority showing no signs of mental distress. A more significant reduction in GHQ scores compared to PHQ scores was observed from pre-to post-intervention. Notably, the online MBSR group showed a significant decrease in GHQ scores, both between groups (p = 0.04) and within the online MBSR group itself (p = 0.02), highlighting the greater impact of the intervention in this group.ConclusionThe study highlights the positive effects of both in-person and online MBSR interventions on reducing depressive symptoms and improving mental health outcomes among nurses. Online MBSR, in particular, shows promise in addressing medically unexplained symptoms and enhancing mental well-being.

In the present study, Ba-doped Ag3PO4/SnO2 type-II heterojunction nanocomposites were fabricated and systemically investigated for the degradation of basic yellow 28 (BY28) dye and Cr(VI) reduction in the photocatalytic process under visible-light irradiation. XRD, XPS, FESEM, DRS, and PL analyses were performed to determine the characterization of synthesized photocatalysts. The optimal 1.5 wt% Ba-doped Ag3PO4/SnO2 nanocomposite exhibited an efficient photocatalytic activity with rate constant of 0.0491 min−1 for BY28 degradation and 0.0261 min−1 for Cr(VI) reduction, which is 13.3 and 7.5 times higher than that of the SnO2 nanorods. Such enhanced performance can arise from the one-dimensional structure, extended light absorption toward the visible region, formation of the type II heterojunction, the new defect-related energy states, and efficient charge separation. Furthermore, the photostability of the photocatalysts was studied and a plausible photocatalytic mechanism was proposed.

Abstract Background Fuzzy cognitive mapping (FCM) is a graphic technique to describe causal understanding in a wide range of applications. This practice review summarises the experience of a group of participatory research specialists and trainees who used FCM to include stakeholder views in addressing health challenges. From a meeting of the research group, this practice review reports 25 experiences with FCM in nine countries between 2016 and 2023. Results The methods, challenges and adjustments focus on participatory research practice. FCM portrayed multiple sources of knowledge: stakeholder knowledge, systematic reviews of literature, and survey data. Methodological advances included techniques to contrast and combine maps from different sources using Bayesian procedures, protocols to enhance the quality of data collection, and tools to facilitate analysis. Summary graphs communicating FCM findings sacrificed detail but facilitated stakeholder discussion of the most important relationships. We used maps not as predictive models but to surface and share perspectives of how change could happen and to inform dialogue. Analysis included simple manual techniques and sophisticated computer-based solutions. A wide range of experience in initiating, drawing, analysing, and communicating the maps illustrates FCM flexibility for different contexts and skill bases. Conclusions A strong core procedure can contribute to more robust applications of the technique while adapting FCM for different research settings. Decision-making often involves choices between plausible interventions in a context of uncertainty and multiple possible answers to the same question. FCM offers systematic and traceable ways to document, contrast and sometimes to combine perspectives, incorporating stakeholder experience and causal models to inform decision-making. Different depths of FCM analysis open opportunities for applying the technique in skill-limited settings.

Key Clinical Message This case highlights the rare and atypical presentation of giant, multiple pilomatricomas (PMs) with a pseudo‐bullous appearance and lymphangiomatous pathology. It underscores the importance of considering PM in the differential diagnosis of atypical lesions, especially those mimicking cystic or hemorrhagic malignant conditions, to prevent misdiagnosis and ensure appropriate management.

Methods used to upright lingually tilted mandibular molars frequently result in extrusion and unwanted rotations.

Abstract Aim The present study is an attempt to investigate the relationship between Corley’s model variables in mental health nurses. Background Based on Corley’s model, burnout and moral distress in nurses are, in retrospect, the consequences of the interplay of organizational and individual factors such as perceived organizational justice, moral sensitivity, and moral courage. The relationship between two variables or three variables of Corley’s moral distress model has been investigated, but the test of Corley’s moral distress model with more variables has not been done. Therefore, this research was proposed with the aim of investigating the relationship between the variables of moral courage and moral sensitivity (as characteristics of nurses), perceived organizational justice (as an antecedent), moral distress, and job burnout (as consequences of moral distress). Methods The study was conducted as a descriptive correlational study involving 500 nurses working in the mental health wards of hospitals. Data collection was conducted using perceived organizational justice scale, moral sensitivity scale, moral courage scale, moral distress scale, and burnout inventory. Results The results showed a significant relationship between perceived organizational justice, moral sensitivity, moral courage, and moral distress (

Abstract Background The evidence on the psychological consequences of coronavirus 2019 mainly relates to general psychiatric problems, and a few studies have reported the incidence and predictors of obsessive-compulsive disorder. Objective To determine the prevalence of obsessive-compulsive disorder (OCD) and its predictors in Iranian COVID − 19 recovered individuals at 3–6 months, 6–12 months, and 12–18 months after recovery. Method In this cross-sectional analytical study, 300 participants were randomly selected based on the inclusion criteria from three hospitals in three different regions of Tehran, Iran, and were assessed by the Clinical Demographic Information Questionnaire, the Obsessive Compulsive Inventory-Revised (OCI-R), the Depression, Anxiety and Stress Scale 21 (DASS21), The Pittsburgh Sleep Quality Index (PSQI) and Posttraumatic Stress Disorder Checklist for DSM-5 (PCL-5). The obtained data were analyzed with SPSS version 26. Results The results showed that the mean score of OCD is 30.58 ± 15.22, with a prevalence of 71% (n = 213). Female gender (BF = 0.50, p = 0.01), sleep disturbance (BF = 0.02, p = 0.001), PTSD (BF = 0.009, p = 0.0001), depression (BF = 0.0001, p = 0.0001), and stress (BF = 0.0001, p = 0.001) are the strongest predictors of the presence of OCD in recovered COVID − 19 individuals. Conclusion OCD-like symptoms was observed in the majority of COVID − 19 recovered individuals with mild to moderate severity. In addition, the stated prevalence, severity, and significance varied according to sociodemographic and health inequalities.

Abstract Background Oral mucositis (OM) is one of the main problems in almost all patients undergoing head and neck radiotherapy (RT). Owning to the antioxidant and anti-inflammatory properties of curcumin, the effect of both oral and topical formulations of curcumin was assessed on radiation-induced OM (ROM) in this study. Methods The safety and efficacy of curcumin mouthwash 0.1% (w/v) and curcumin-nanocapsule were evaluated in ameliorating severity and pain/burning associated with OM during RT. The current randomized, placebo-controlled trial was conducted on 37 patients with head and neck cancers. Patients with grades 1 to 3 of ROM were randomized to receive one of the three interventions: curcumin mouthwash (0.1% w/v); Sinacurcumin soft gel containing 40 mg curcuminoids as nano-micelles (SinaCurcumin®40); or placebo mouthwash with a similar transparent appearance to curcumin mouthwash for 1 min three times daily during RT. Study evaluations were conducted at baseline and weekly thereafter for up to 3 weeks using the Numeric rating scale (NRS) and world health organization (WHO) scale. Results Among the 45 patients randomized, 37 (mean (SD) age of 53.36 (15.99) years; 14 [37.8%] women) completed the treatment according to the protocol. Patients treated with either oral or topical curcumin showed a significantly reduced severity and burning related to OM during the first 3 weeks after administration (P-Value

For the effective conservation of plant species, it is imperative to manage habitat loss and fragmentation by establishing a protected area network that comprehensively encompasses their habitat. In this study, we identified the suitable habitats for some endemic plant species in the Swat District, Pakistan, to conduct a thorough analysis of proposed protected areas (hotspot areas). Utilizing data from a recent botanical survey, environmental parameters from World-Clim, and various other sources, we determined the habitat of each species using the MaxEnt species distribution model. The modeled habitat suitability for each species were combined to generate maps illustrating endemic richness (hotspots), as well as to prioritize areas based on conservation value and habitat suitability. Future climate projections spanning from 2000 to 2050 were acquired from the WorldClim database Nineteen bioclimatic variables were assessed, incorporating data from three global climate models: CCSM4, HadGEM2-AO, and MPI-ESM-LR. We modeled seven endemic species from the Swat District and, by combining their maps, found three hotspot areas which show more environmental suitability under future climatic conditions. The future model forecasts a significant decrease in population density by the year 2050. Currently, these species exhibit their highest density along the eastern and southern borders of the valley, particularly in the Karakar, Elum border, Mankial Kalam, and Gabral Kalam areas. The anticipated alterations in density and distribution could have a considerable impact not only on the tree species but also on the associated sub flora.

Peer moderation has been used as a beneficial strategy in asynchronous online discussions to assist student learning performance. However, most studies in peer-moderated asynchronous online discussions (PMAOD) have focused only on learning effectiveness and perceptions of students rather than on students' knowledge dimensions and cognitive processing patterns. This study combined quantitative content analysis (QCA) and lag sequential analysis (LSA) to explore student knowledge dimensions and cognitive processing patterns in PMAOD. The participants were 84 students in an undergraduate blended course from University Putra Malaysia (UPM), Malaysia. The Revised Bloom Taxonomy (RBT) was used as the codification scheme to code the discussion transcripts of participants assigned the role of peer moderators in a reciprocal manner over seven weeks. Behavioural distributions and patterns of high- and low-quality discussion groups were compared. Results showed that students were primarily sharing knowledge dimensions and cognitive processes of metacognition and understanding, respectively. Additionally, it was found that there was a modest proportion of off-topic discussions. Nonetheless, by means of LSA, it was found that PMAOD exhibited a certain degree of self-sustainability in knowledge and cognitive process behaviours, with the exceptions of "procedural knowledge" and the cognitive process of "applying" and, in terms of diversity in knowledge dimension and cognitive processing, high-quality discussion groups outperformed low-quality groups.

BackgroundAdolescents are a large proportion of the population in sub-Saharan Africa and face multiple risks to their health and well-being. Prior systematic reviews have focused on specific adolescent sexual and reproductive health outcomes such as teen pregnancies, HIV/AIDS, and sexually transmitted diseases. A comprehensive synthesis of the influential factors that shape different aspects of adolescent sexual and reproductive health can inform health policy and program development for this important segment of the population. ObjectiveThis paper presents the protocol for an umbrella review that aims to synthesize the existing knowledge in the literature on the associations among individual, family, and societal factors and sexual and reproductive health outcomes among adolescents in sub-Saharan Africa. MethodsWe will include systematic reviews that identify factors associated with sexual and reproductive health outcomes among adolescents, 10-19 years of age, in sub-Saharan Africa. Reviews can include quantitative and qualitative primary studies with or without meta-analysis. Academic and gray literature searches will identify reviews from PubMed, Scopus, CINAHL, Cochrane Database of Systematic Reviews, ProQuest, Google, and Google Scholar. Two reviewers (MZG and KO) will independently carry out title, abstract, and full text screening, assess methodological quality, and extract data. We will assess the methodological quality of the included studies using the Joanna Briggs Institute standard forms. The review will present findings in narrative form and in tables and will follow PRISMA (the Preferred Reporting Items for Systematic Reviews and Meta-Analyses) reporting guidelines. ResultsA preliminary search in April 2023 found 1351 articles to be screened. ConclusionsThis umbrella review will permit a comprehensive and high-level understanding of the various factors that influence adolescent sexual and reproductive health in sub-Saharan Africa. Trial RegistrationPROSPERO International Prospective Register of Systematic Reviews CRD42023394512; https://www.crd.york.ac.uk/prospero/display_record.php?RecordID=394512 International Registered Report Identifier (IRRID)DERR1-10.2196/51278

SARS-COV-2 has roused the scientific community with a call to action to combat the growing pandemic. At the time of this writing, there are as yet no novel antiviral agents or approved vaccines available for deployment as a frontline defense. Understanding the pathobiology of COVID-19 could aid scientists in their discovery of potent antivirals by elucidating unexplored viral pathways. One method for accomplishing this is the leveraging of computational methods to discover new candidate drugs and vaccines in silico. In the last decade, machine learning-based models, trained on specific biomolecules, have offered inexpensive and rapid implementation methods for the discovery of effective viral therapies. Given a target biomolecule, these models are capable of predicting inhibitor candidates in a structural-based manner. If enough data are presented to a model, it can aid the search for a drug or vaccine candidate by identifying patterns within the data. In this review, we focus on the recent advances of COVID-19 drug and vaccine development using artificial intelligence and the potential of intelligent training for the discovery of COVID-19 therapeutics. To facilitate applications of deep learning for SARS-COV-2, we highlight multiple molecular targets of COVID-19, inhibition of which may increase patient survival. Moreover, we present CoronaDB-AI, a dataset of compounds, peptides, and epitopes discovered either in silico or in vitro that can be potentially used for training models in order to extract COVID-19 treatment. The information and datasets provided in this review can be used to train deep learning-based models and accelerate the discovery of effective viral therapies.

SARS-COV-2 has roused the scientific community with a call to action to combat the growing pandemic. At the time of this writing, there are as yet no novel antiviral agents or approved vaccines available for deployment as a frontline defense. Understanding the pathobiology of COVID-19 could aid scientists in their discovery of potent antivirals by elucidating unexplored viral pathways. One method for accomplishing this is the leveraging of computational methods to discover new candidate drugs and vaccines in silico. In the last decade, machine learning-based models, trained on specific biomolecules, have offered inexpensive and rapid implementation methods for the discovery of effective viral therapies. Given a target biomolecule, these models are capable of predicting inhibitor candidates in a structural-based manner. If enough data are presented to a model, it can aid the search for a drug or vaccine candidate by identifying patterns within the data. In this review, we focus on the recent advances of COVID-19 drug and vaccine development using artificial intelligence and the potential of intelligent training for the discovery of COVID-19 therapeutics. To facilitate applications of deep learning for SARS-COV-2, we highlight multiple molecular targets of COVID-19, inhibition of which may increase patient survival. Moreover, we present CoronaDB-AI, a dataset of compounds, peptides, and epitopes discovered either in silico or in vitro that can be potentially used for training models in order to extract COVID-19 treatment. The information and datasets provided in this review can be used to train deep learning-based models and accelerate the discovery of effective viral therapies.

Introduction: SARS CoV-2 pandemic has caused illness and death in millions of people worldwide. Extensive studies are being conducted on the effect of meteorological parameters on the number of patients and clinical symptoms of COVID-19. Materials and Methods: This cross-sectional descriptive study was conducted in Abarkouh city with a population of 51199 people during 215 days (from April 20, 2020 to November 20, 2020). The present study aimed to investigate the effect of meteorological parameters, such as temperature, humidity, sunshine hours, evaporation, and maximum wind speed on the number of cases with definite diagnosis of COVID-19. Moreover, symptoms in the infected patients were assessed using Pearson correlation coefficient and regression coefficient. Results: During the 215 days of the study, a total of 2526 symptoms were diagnosed in 1298 outpatients. Among which, fever and body aches were the most common symptoms in the subjects. The results of examining the relationship between meteorological parameters and the prevalence of symptoms showed that there was a negative correlation between the minimum and maximum temperature, sunshine hours, evaporation, and wind speed with the number of cases and the prevalence of symptoms. The results of regression coefficient also showed that among the meteorological parameters, the minimum temperature variable had the most negative effect on the prevalence of symptoms as well as the number of cases. Conclusion: The results showed that changing the meteorological parameters in cold weather can increase both the number of patients and clinical symptoms of outpatients with COVID-19.

Abstract Knowledge on diet composition allows defining well-targeted conservation measures of large carnivores. Little is known about ecology of critically endangered Asiatic cheetah, especially the overall diet and its possible regional differences. We used cheetah scats, metabarcoding technique and microsatellite markers to assess the individual and overall diet composition of the species across its entire range in Asia. Cheetahs were primarily predating on mouflon; following by ibex, cape hare and goitered gazelle. Despite their high availability, small-sized livestock was never detected. Goitered gazelles were only detected in an area where the habitat is mainly flatlands. In hilly areas, mouflon was the most frequent prey item taken. Ibex was typically taken in rugged terrain, but mouflon was still the most frequently consumed item in these habitats. High consumption of mouflon in comparison to goitered gazelle suggests that human pressure on lowland habitats has possibly forced Asiatic cheetahs to occupy suboptimal habitats where gazelles are less abundant. The protection of flatlands and the removal of livestock from them are needed to ensure the long-term survival of Asiatic cheetah. The laboratory and bioinformatics pipelines used in this study are replicable and can be used to address similar questions in other threatened carnivores.

IntroductionMetabolic risk factors (MRFs) predispose populations to a variety of chronic diseases with a huge burden globally. With the increasing burden of these risk factors in Iran, in this study, we aimed to report the estimated burden attributed to MRFs at national and subnational scales in Iran, from 1990 to 2019.MethodsBased on the comparative risk assessment method of the Global Burden of Disease (GBD) Study 2019, data of deaths and disability-adjusted life years (DALYs) attributable to four top MRFs in Iran including high systolic blood pressure (SBP), high fasting plasma glucose (FPG), high body mass index (BMI), and high low-density lipoprotein (LDL) for the 1990–2019 period, were extracted. The socio-demographic index (SDI) was used to report the data based on the corresponding socio-economic stratifications. The results were reported in national and subnational 31 provinces of Iran to discover disparities regarding the attributable burden to MRFs. Furthermore, we reported the causes of diseases to which the attributable burden to MRFs was related.ResultsOverall, the age-standardized high LDL, high SBP, high BMI, and high FPG-attributed death rate changed by −45.1, −35.6, +2.8, and +19.9% from 1990 to 2019, respectively. High SBP was the leading risk factor regarding attributed age-standardized death rates reaching 157.8 (95% uncertainty interval: 135.3–179.1) and DALY rates reaching 2973.4 (2652.2–3280.2) per 100,000 person-years, in 2019. All rates increased with aging, and men had higher rates except for the +70 years age group. At the subnational level, provinces in the middle SDI quintile had the highest death and DALY rates regarding all four MRFs. Total deaths, DALYs, YLLs and YLDs number by the causes of diseases linked to MRFs increased over the study period. Cardiovascular diseases, diabetes mellitus, and kidney diseases were the main causes of burden of disease attributable to MRFs.ConclusionHerein, we found divergent patterns regarding the burden of MRFs as well as disparities in different regions, sex, and age groups for each risk factor and related causes. This could provide policymakers with a clearer vision toward more appropriate decision-making and resource allocation to prevent the burden of MRFs in Iran.

Quaternary ammonium compounds (QACs) are among the most commonly used antibacterial agents. The aim of this study was to synthesize a dimethacrylate monomer functionalized with a QAC and to study its effect on the properties of an orthodontic adhesive primer. Urethane dimethacrylate monomer functionalized with a QAC (UDMAQAC) was synthesized and then characterized by nuclear magnetic resonance spectroscopy (NMR) and Fourier transform infrared spectroscopy (FTIR). 5, 10, 15 and 20 wt% of UDMAQAC was added to an orthodontic adhesive primer (control group). FTIR analysis was used to measure the degree of conversion (DC). The bond strength of dental brackets was measured by shear bond strength (SBS) test and adhesive remaining index (ARI) was evaluated by stereomicroscope. Agar diffusion test and MTT assay were used to evaluate the antibacterial property and cell viability, respectively. Statistical analysis included one-way ANOVA with Tukey’s post hoc test and Kruskal-Wallis nonparametric test (P˂0.05). Although the obtained data did not show significant differences between the SBS and DC of different groups, but the highest values were obtained by adding 10 wt% monomer. Adding more than 10 wt% UDMAQAC resulted in significant increase in antibacterial property. The 15 and 20 wt% groups showed significantly lower cell viability

Objective: The accounting and financial units play a crucial role in promoting financial reporting systems of the public sector. Reliable and accurate financial accounting and reporting increase accountability, budget control, transparency of financing, and improve the effective management of assets and liabilities. The efficiency and effectiveness of financial management is essential for making any change in the quality of public sector performance. An effective financial unit in the public sector is needed to achieve the goals of an Iranian resilient economy and financial discipline. The main purpose of this study is to provide a financial management and accounting maturity model for public sector reporting units in Iran. A maturity model with a good leveling will enable managers to evaluate public sector units. It also provides sufficient motivation for managers to attain higher levels of the maturity model and to attract the support of CEOs for improving actions. Maturity models are customized to the conditions of each country in the developed countries. Methods: Maturity-related studies were reviewed to identify the components of financial management and accounting maturity. Then, the initial maturity model was designed based on the authors' experiences and the situation in the Iranian public sector. In the next stage, semi-structured interviews were conducted with Iranian public sector specialists selected through purposive sampling. The focus group technique was used to collect data through group interaction. Findings from the group interviews were analyzed using semantic analysis. Results: The primary extracted components were modified using the opinions of experts. Dimensions of the maturity model include 1) information technology, 2) financial reporting, 3) budgeting and financial planning, 4) rules and regulations, 5) financial supervision and governance, 6) leadership, 7) efficiency and effectiveness, and 8) human capital. Based on the several discussions held in the focus group meetings, checklists can be used to measure the dimensions of the maturity model. It is also necessary to use experts to assess the maturity of reporting units. Conclusion: Our results provide a clear framework for evaluating reporting units in the public sector. Managers can use the proposed maturity model in their policies for public sector units. Public sector organizations can use it to assess the status of their accounting and financial management units in Iran. They can also evaluate the strengths and weaknesses of the public sector accounting and financial management unit and use the model as a roadmap to develop the position of financial management. The results of this paper improve the quality of financial reporting of public sector organizations. In addition, the extracted components of the maturity model may lead to the presentation of the Excellence Award to the financial management and accounting units in the public sector of Iran.

Background and purpose: Enamel demineralization around orthodontic brackets is a significant problem. This study aimed to compare the efficacy of Casein phosphopeptide amorphous calcium phosphate (CPP-ACP) varnish and fluoride varnish in preventing enamel demineralization around and beneath orthodontic brackets. Materials and methods: Twenty extracted premolars were randomly divided into two groups and orthodontic brackets were bonded to their buccal surface by composite. The amount of fluorescent light reflected back from the enamel at the mesial and distal of the bracket was measured using a DIAGNOdent™ pen. MI varnish (CPP-ACP) was applied on the exposed enamel of the distal half of the teeth in group I while FluoroDose varnish was applied on the same area in group II. The mesial half of the teeth served as the control group. All teeth underwent two demineralization cycles and after each cycle, enamel demineralization was quantified at mesial and distal areas (T1, T2). The brackets were then debonded, and area under the brackets was also measured by DIAGNOdent™ pen (T3). Data were analyzed using repeated measures ANOVA and paired t-test. Results: In both groups, significant difference was noted between the mesial and distal areas in degree of demineralization at T2 (P

Background and Objectives: The distribution of causes of death indicates the distribution of risk factors for death, and is a basis of planning and intervention to reduce risk factors. The quality of the registered information has problems due to the weakness of the processes of completing and issuing the death certificate or the coding method. The purpose of this study was to explain the challenges of death registration and to provide a solution in this regard. Methods: This qualitative study was conducted in the second half of 2019 in Guilan University of Medical Sciences. The target population was the directors and experts of the death registration program. Sampling was done purposefully by counting. Data was collected through in-depth interviews using a questionnaire and simultaneous contractual content analysis to identify key themes. To ensure the validity and acceptability of the data, the participants and two research colleagues reviewed the data frequently. Results: According to the content analysis of 24 interviews, the main challenges of death registration included manpower, organizing the death registration system in the country, and death registration software system and its implementation. These themes were abstracted from 45 subcategories and 13 main categories. Conclusion: Considering the challenges described by death registration managers and experts, the main proposed interventions to improve the death registration system include recruiting appropriate staff, empowering and motivating various human resources departments, developing internal and external cooperation, increasing public participation, monitoring and continuous assessment to identify the strengths and weaknesses of the death registration system and adressing them, attention to the development of death registration software and its required infrastructure such as Internet access and equipment, attention to the multiplicity of systems, and efforts to integrate them.

Abstract Background The spread and severity of the COVID-19 pandemic have been to such an extent that to shape an effective, collective response, governments need the participation of society and the cooperation of a wide range of civil society organizations and institutions. The objective of this study was to identify the activities of non-governmental organizations (NGOs) in response to the covid-19 pandemic in Iran and the challenges they confronted. Methods We conducted a qualitative analysis based on twenty-two individual, virtual, and semi-structured interviews. Interviewees were selected through purposeful and snowball sampling. All interviews were performed with active health-related NGO representatives willing to participate in the study and continued until data saturation. Data analysis was performed using qualitative content analysis. Results The activities and challenges raised by NGO representatives were identified in 6 main categories, including the need for the participation of NGOs in the fight against pandemics, response to the COVID-19 crisis in the society, challenges in providing services to the target group in the COVID-19 crisis, NGOs challenges in interacting with governmental and non-governmental institutions, information sources used by NGOs in the COVID-19 crisis and strategies to support NGOs in their efforts. Conclusion Considering the crucial challenges for their participation, such as the NGO access to the target groups, lack of communication network, and constructive interaction between government institutions and the NGOs, it is recommended to increase the capacity of these institutions and intervene to establish a constructive and long-term relationship with the government.

Abstract Background The beliefs and attitudes of caregivers of working children about mental health issues and first aid and their attitudes about the stigma of mental health problems can affect their motivation to seek professional help for affected children. This study aimed to assess the mental health literacy among caregivers of child labor about first aid for mental health and their attitudes about the stigma of mental disorders. Methods The Depression Health Literacy Questionnaire has been used in this cross-sectional study. All caregivers of working children who were willing to participate were included in the study. This group is covered by a Non-Governmental Organization (NGO) located in the 17th district of Tehran. Results Questionnaires completed by 131 caregivers were analyzed. The average age of the participants was 32.6 (± 7.9) years. Of which 130 (99.2%) were mothers. Amongst, only 37 individuals (28.2%) were confident in their ability to help their children in case of depression symptoms. A majority of participants, 109 (83.2%), believed that asking a depressed child about suicidal ideation was harmful. Conclusion According to the findings of this study, the literacy among caregivers of child labor about mental health first aid in our study needs to be improved. There is also a need for educational and community-based programs to reduce the stigma about mental health disorders, including depression.

Although many studies have been conducted on the efficacy of behavioral activation in depression, few studies have evaluated the efficacy of this treatment in patients with mixed depression and anxiety through telecare. To determine the effects of a telenursing scheduled intervention of brief behavioral activation therapy on depression and anxiety symptoms of patients with mixed anxiety and depression disorder (MADD). A randomized controlled trial. Thirty subjects with MADD were randomly assigned to an intervention group and a control group. The eight-session person-centered behavioral activation intervention was delivered twice weekly via tele-nursing. Depression and anxiety symptom severity were assessed using the Hamilton Anxiety Rating Scale and the Hamilton Depression Rating Scale at baseline, at the end, and one month after the intervention. Data were analyzed by independent t -tests, chi-square tests, and repeated-measures tests using SPSS version 24. The results showed that after the implementation of the intervention, the depression score in the intervention group decreased from 19.86 (±8.56) to 17.21 (±6.71). In contrast, depression scores increased from 18.67 (±9.72) to 19.47 (±7.33) in the control group. For anxiety symptoms, there was a clinically significant decrease after the intervention only in the intervention group. The results showed the effects of brief behavioral activation tele-nursing on a non-significant reduction in depression symptoms and a significant clinical reduction in anxiety symptoms after the intervention in MADD. • Tele-behavioral activation therapy is an effective, accessible, and flexible treatment for psychiatric outpatients, especially when traditional in-person therapy is challenging. • Brief Behavioral Activation Teletherapy (BBAT) effectively reduces depression symptoms and significantly lowers anxiety levels. • BBAT combines behavioral activation principles with teletherapy's convenience • Health providers using BBAT should consider technical issues, accessibility challenges, and patient comfort with telehealth technology. [ABSTRACT FROM AUTHOR]

This study presents a case study of asynchronous online discussions' (AOD) growth patterns in an undergraduate blended course to address the gap in our current understanding of how threads are developed in peer-moderated AODs. Building on a taxonomy of thread pattern proposed by Chan, Hew and Cheung (2009), growth patterns of thirty-six forums were explored on three patterns: Short Thread Pattern (SHTP), Extended Thread Pattern (ETP), and Split Thread Pattern (STP). The impact of peer moderating supports on thread growth was also investigated. Types of peer moderators' supports were explored utilizing a coding scheme from Smet, Keer, Wever, and Valcke's (2010) study. STP pattern was found to be more common than the other patterns with 74 (37.94%) out of 195 threaded discussions growing on it. The results also showed that, compared to SHTP, in both STP and ETP the occurrences of "Information exchange" and "Knowledge construction" supports appeared to be more, while the presences of supports stimulating "Development", "Access and motivation" and "Socialization" were less. Furthermore, the use of "Access and motivation" and "Socialization" supports appeared to enhance early thread termination when used individually. Thread continuity was reinforced by the use of "Knowledge construction" support with other moderating supports.

It is commonly discussed that a key challenge for online collaboration is to promote group awareness. Although this challenge has gained intensified consideration by scholars, scarce attempt has been devoted into development of a reasonable hypothetical comprehension of what group awareness really is and how it can be studied empirically. This paper discusses the conceptions and the research approaches that underlie research on group awareness in computer-supported collaborative learning circumstances. While reviewing literatures they were classified in three categories (behavioral, knowledge and social awareness) and variations in underlying techniques for visualization of awareness were also provided. It was found that research is dominated by the knowledge awareness, which focus on awareness of self and group members' level of expertise, skills, prior knowledge of task as well as areas of interest. However, some researchers studied all dimensions of awareness. Findings suggest that the notion of displaying of awareness information has been shifted from implicit to the explicit technique through which users intentionally express their current understanding and feelings or assess self and others and provide necessary information to be visualized. The paper suggests some areas for future empirical investigations and concludes with some theoretical considerations on the nature of group awareness.

BackgroundKidney dysfunction is a risk factor for cardiovascular disease and chronic kidney disease. Herein, we aimed to describe the attributable burden of kidney dysfunction at the national and sub-national levels in Iran.MethodsThe Global Burden of Disease (GBD) 2019 data were extracted on the deaths, disability-adjusted life years (DALYs), years of life lost, and years lived with disability attributed to the risk factor of kidney dysfunction by age and sex at the national and provincial levels from 1990-2019. Also, risk exposure was reported by summary exposure value (SEV) with a range of 0 to 100. The estimated values were based on a comparative risk assessment framework.ResultsIn 2019, the age-standardized death rate and age-standardized DALYs rate attributable to kidney dysfunction were 58.2 (95% uncertainty interval of 48.8-68.1) and 1127.2 (981.1-1282.7) per 100,000 population in Iran, respectively. Also, the Sistan and Baluchistan province (1729.3 [1478.3-2006.4]) and the province of Tehran (681.9 [571.4-809.8]) had the greatest and lowest age-standardized DALYs rates, respectively. Nationally, SEVs increased from 22.8 to 26.2. The age-standardized burden attributable to kidney dysfunction had a positive association with age advancement. The attributable age-standardized deaths and DALYs rates in all socio-demographic index regions decreased from 1990-2019. Also, the highest and lowest attributable age-standardized DALYs rates of kidney dysfunction came from ischemic heart disease and peripheral artery disease in 2019, respectively.ConclusionAlthough the attributed age-standardized DALYs and death rates decreased from 1990-2019, risk exposure increased and remains a crucial risk factor in Iran. Therefore, policymakers should consider preparing a preventive program that takes into account different levels of prevention of kidney dysfunction.

Background. Given the high prevalence of depressive disorders in the present world and the lack of adequate awareness about prevention and appropriate interventions, increasing mental health literacy is vital for promoting mental health to reduce depression and its consequences. Methods. In this descriptive cross-sectional study, participants were recruited among the second high school students in the 2018-2019 academic year. The sample size was 2038, and samples were selected by multistage cluster sampling from different areas of Tehran. Demographic variables like age, gender, level of education, and parents’ characteristics and mental health literacy questions in treatment and prevention areas were evaluated. Results. Analyses showed that of high school students, 83% considered getting help from psychiatrists and 80% considered learning stress management as the best preventive measures, while as the best treatment measures, 79.5% considered counseling the best place to refer for visiting a professional and 45% selected general counseling centers. Conclusion. The study results showed that high school students have a positive attitude toward preventing and treating depressive disorders, getting help from specialists, and useful measures for depressed people. But they did not know enough about preventive measures, including learning effective coping skills, reading self-help books, and continuing to take psychiatric medications. Planning and providing the necessary training are important, especially for high school students.

Background: Divorce has become a global issue that is increasing in many industrial and developing countries, including Iran. One of the significant reasons for divorce is sexual dysfunction. This study aimed to explore the perceptions and experiences of Forensic Medicine Department service recipients and providers in evaluating male sexual dysfunction following filing for divorce.Methods: This study was a qualitative study that was analyzed through a content analysis approach. Purposive sampling was done with maximum variation until data saturation was reached. Individual interviews were used to collect data. The data were collected through in-depth quasi-structured interviews with 20 service recipients and 9 service providers of the Forensic Medicine Department in Tehran from January 2022 to March 2022. Results: The data analysis led to the extraction of two main categories, including existing challenges of the forensic medical system in the process of sexual assessment with 3 sub-categories (absence of the plaintiff in the assessment process, sharing a common room with other clients, the psychosocial pressure associated with a Rigi scan test) and features of desirable evaluation services with 5 sub-categories (service delivery to couples, service delivery by observing ethical principles, confidentiality and human dignity, comprehensive physical-psychological-communicative assessment, service delivery that emphasizes informing couples of the path ahead, provision of services if the authenticity of the sexual problem is proven).Conclusion: Our research results indicate that the national Forensic Medical Department faces certain challenges regarding the assessment and diagnosis of sexual dysfunctions among divorce applicants. Based on these results, certain modifications should be made to the evaluation procedures of these applicants. Forensic medicine policymakers and decision-makers can utilize the results of this study to address the existent shortcomings and even prevent the increase in divorce rates due to sexual dysfunctions by developing appropriate guidelines

Background: Previous studies have shown that spiritual experience may reduce cardiovascular disease (CVDs). However, little is known about the relationship between spiritual health and the gender-specific risk of CVDs in communities with different cultures. Methods: A total of 3249 individuals (53.7% female, 75.0% middle-aged) participated in the Tehran Lipid and Glucose Study (TLGS) from 2015 to 2017 were included. Based on the ACC/AHA pooled cohort equation, CVD risk over ten years was examined. Spiritual health was measured using a developed tool for measuring spiritual health in Muslim populations (SHIMA-48). Linear regression models were used to assess the association between spiritual health and ACC/AHA risk scores. The natural logarithm scale was calculated to consider the normal distribution hypothesis of the regression model. Results: The current results suggest a slight but significant increase in the mean of spiritual health in women compared to men in both cognitive/emotional and behavioral dimensions (P < 0.001). In both sexes, a higher prevalence of smoking was observed in participants with lower levels of spiritual health (P < 0.004). In men, compared to those with a low level of spiritual health (the first tertile), the logarithm of the ACC-AHA risk score was reduced by 0.11 (P = 0.004) and 0.18 (P < 0.001) for those in the second and third tertiles of spiritual health, respectively. This result may be attributed to higher cigarette smoking among the latter group. Similar results were not observed in women. Conclusions: Current results indicate a gender-specific association between spiritual health and cardiovascular disease risk. Our findings imply that promoting spiritual health can be considered an effective strategy in future preventive interventions, primarily by controlling the desire to smoke in men.

Objective: This study was designed to compare object relations and anger control between MS patients and normal individuals. Method: The present study was a cross-sectional case-control study with two groups: the case group (patients with MS) and the control group (normal controls without MS). 80 patients and 80 healthy individuals were selected according to the inclusion and exclusion criteria using a simple random sampling method. The research’s data collection tool was a three-part questionnaire consisting of demographic information, the Bell Object Relations and the Reality Testing Inventory (BORRTI) and the State-Trait Anger Expression Inventory 2 (STAXI-2). The data were analyzed by the SPSS software version 26 using descriptive and analytical statistics (stepwise regression). Results: The results showed that in terms of object relations, there was no significant difference between the two groups except in alienation of relations (P = 0.035). The results also showed that in general, there was no statistically significant difference between the anger index of the group of MS patients and the normal controls. However, 12.8% of MS patients were significantly different in state of anger, trait anger and anger control compared to normal individuals. This difference was especially higher in angry temperament (P = 0.025) and the anger expression-in (P = 0.04). Conclusion: Although patients with MS were not significantly different from healthy individuals in terms of intrapsychic and interpersonal functions in the context of object relations and anger management, it seems that more complex and multifaceted explanations lie in the results that need further research.

The main purpose of this study is to investigation the relationship between financial distress and restatement of financial statement for listed companies on the Tehran Stock Exchange (TSE). Consequently, in this study a sample of 107 nonfinancial listed companies on the TSE from 2010 to 2016 were investigated. Emerging Market Scoring (EMS) model was used for determining the financial distress and bankruptcy risk. In conducting this study, two main hypotheses were proposed. Comparison of means tests (t-test) and multiple linear regression analysis on panel data were used to test these hypotheses. The research results showed that there is no significant difference between the magnitude of financial restatement in financially distressed and non-distressed companies. However, bankruptcy risk is positively related to magnitude of financial restatement. That is, the more the bankruptcy risk, the more magnitude of financial restatement.

Due to the benefits of political connections and the lower necessity of responding to market pressures to increase information quality by politically connected firms, it is expected that these firms will provide low-quality accounting information. With respect to the extended role of government in the economy of Iran, this study aims to investigate the impact of political connections on the accounting information quality of the firms listed in the Tehran Stock Exchange (TSE). The statistical sample includes 101 listed firms over the 2010-2018 period. Financial restatement and the intensity of financial restatement are used as indicators of the low quality of accounting information. To achieve the research objectives, two hypotheses have been proposed, and to test the hypotheses, the logistic regression and the multiple linear regression analysis in a panel data model were conducted. The results show that political connections have a positive effect on the occurrence and the intensity of financial restatement. Therefore, it seems that the firms' accounting information quality is affected by their political connections.

Abstract Background and Aims Nongovernmental organizations (NGOs) have enormous potential to effectively prevent and manage diseases; however, little research is available on interventions used to improve NGOs' participation in this area. A scoping review was conducted to identify options proposed or implemented to improve the participation of the NGOs in preventive care. Methods Pubmed, Web of Science, and ProQuest were extensively searched. Google Scholar was also searched to find potential studies related to the subject. Relevant keywords were used in the English language. The reference list of relevant studies was also scanned. Studies were screened with defined inclusion and exclusion criteria. Relevant data were then extracted. Two individuals independently screened and extracted studies. The interventions implemented or proposed to promote the participation of the NGOs in the implementation of preventive interventions were deductively identified and classified. Results Eighteen articles were included in our review. We identified 31 interventions and categorized them into 11 strategies, including (1) building strong collaboration among NGOs and with governments; (2) expanding networks and sustained relations among NGOs; (3) evaluating the NGOs' performance; (4) increasing intersectoral collaboration; (5) advocating for the role of NGOs; (6) supporting NGOs from the side of government; (7) empowering the abilities and capabilities of NGOs; (8) defining the precise roles and responsibilities of the parties; (9) strengthening the health system governance; (10) increasing the health literacy of the community; and (11) developing required regulations, rules, and policies. None of the interventions identified had evidence of its effectiveness. Conclusion The current evidence on effective interventions to strengthen NGOs' participation in implementing health care is scanty. It means there is an information gap in the effect of interventions to improve NGOs' participation in health.

ObjectiveThe purpose of the present study was to investigate the association of COVID-19 vaccination with the quality and quantity of sleep, the level of stress, and temporomandibular joint (TMJ) disorders (TMDs) in Iranian dental students.Materials and methodsIn this cross-sectional research, we applied a questionnaire including 30 questions on the Perceived Stress Scale (PSS), sleep quality and quantity, Diagnostic Criteria for Temporomandibular Disorders (DC/TMD), and vaccination status. All vaccinated students of the dental schools located in the city of Tehran were invited to participate in the study. Participants were divided into three groups: those vaccinated for less than a month, those vaccinated for 1–3 months, and those vaccinated for more than 3 months. A paired t-test served for statistical analysis.ResultsOverall, 171 out of 235 students (72.77%) completed the questionnaire, among which 90 individuals were fully vaccinated, and were included in the data analysis. Stress levels decreased (mean difference = −1.23, p-value = 0.002) and sleep quality and quantity improved mostly 1–3 months after the vaccination (mean difference = −0.5, p-value = 0.016). However, TMD symptoms were mostly alleviated in people vaccinated for more than 3 months (mean difference = −2.86, p-value

The main goals of treatment of dentofacial deformities are to achieve optimal esthetics and ideal functional occlusion. The conventional orthognathic surgical approach includes a long presurgical orthodontic phase, which takes about 18 months. During this phase, the patients’ appearance is deteriorated and their motivation to continue treatment significantly decreases. In the surgery first approach (SFA), orthognathic surgery is performed prior to orthodontic treatment, and orthodontic treatment is performed postoperatively to improve dental occlusion and for final settling. The SFA has two main advantages namely shortening of treatment period, and early improvement of the appearance of patient. The SFA has significant advantages especially for class III patients. This study aimed to review the available articles on this topic published from 2012 to 2019 to achieve a comprehensive understanding of different aspects of the SFA. The databases were searched by two researchers and a total of 11 eligible articles were selected for study inclusion. The results were categorized into two categories of stability of the results of the SFA, and duration of treatment, in comparison with the conventional approach. Although different aspects of the SFA have been previously evaluated by dental clinicians, a considerable gap of information still exists regarding the details of this approach, which calls for further research in this respect.