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Abstract This study investigates the influence of LDHs (Layered Double Hydroxides) microparticles and steel fibers on the mechanical properties of lightweight concrete. Through a combination of experimental analysis and finite element modeling, the effects of LDHs and steel fibers on flexural strength and crack resistance were evaluated. The experimental results demonstrate a significant increase in flexural strength and toughness with the incorporation of LDHs microparticles and steel fibers. The finite element model corroborates these findings, highlighting the synergistic enhancement of mechanical properties due to LDHs and steel fibers. Additionally, the study discusses the frontier applications of LDHs in improving fracture characteristics and highlights the potential of hybrid reinforcement strategies in lightweight concrete. The findings reveal that both the quantity of microparticles and steel fibers significantly impact the concrete's residual strength. In scenarios without steel fibers, an optimal weight fraction of approximately 1 wt.% LDHs demonstrate a 39% increase in bearing capacity. Notably, under comparable conditions, the influence of LDHs microparticles on enhancing concrete mechanical characteristics appears to surpass the effects induced by steel fibers. However, at 2 wt.% LDHs usage, a decrease in load capacity by 3.3% is observed compared to the 1 wt.% LDHs configuration. This research provides valuable insights into optimizing concrete properties through novel material combinations and paves the way for future advancements in structural engineering.

The compound 4-phenylbutyrate (4-PBA) has been identified as a potential anticancer agent due to its favorable safety profile, exhibiting minimal side effects. This makes 4-PBA a promising candidate for further development as an anticancer drug. To develop new and potentially more effective anticancer agents, a series of novel derivatives of 4-PBA were synthesized. The chemical structures of the newly synthesized compounds were confirmed through spectroscopic analyses, including 1H NMR, 13C NMR, and FTIR spectra. Furthermore, the cytotoxic activity of all the synthesized compounds was evaluated against three different human cancer cell lines - MCF-7 (breast carcinoma), A549 (lung carcinoma), and SKOV-3 (ovarian carcinoma) – as well as MRC5 (normal lung) using the MTT assay. The results revealed that most of the synthesized compounds exhibited significant cytotoxic effects on the A549 and MCF-7 cell lines, while demonstrating a lesser degree of cytotoxicity against SKOV-3. Compound A4 demonstrated particularly potent anticancer activity across all the studied cancer cell lines. Molecular docking studies revealed that the synthesized compounds could inhibit enzymes, including pyruvate dehydrogenase kinase 2 (PDB ID: 2BU8) and histone deacetylase complex (PDB ID: 1C3R), by forming hydrogen bonds and hydrophobic interactions. In addition, the pharmacokinetic properties, ADME characteristics, of the synthesized compounds were computationally predicted. These predicted ADME profiles further enhanced the potential of these compounds as effective anticancer agents.

In this paper, we introduce the concepts of transformed functions and q-difference inverse transforms. Then, we apply them to solve some partial q-difference equations. Finally, we provide four examples to show how we can benefit from the obtained results. [ABSTRACT FROM AUTHOR]

ABSTRACT Objective The main objective of this study was to compare the knowledge and attitude of general dentists, senior dental students, and orthodontic residents toward obstructive sleep apnea (OSA). Materials and Methods A questionnaire was designed and administered among 73 senior dental students, 84 general dentists, and 50 orthodontic residents. The questionnaire asked for demographic information of the participants and assessed their knowledge and attitude toward OSA. The validity and reliability of the questionnaire were confirmed by experts. Data were analyzed by the Kruskal−Wallis and Bonferroni tests using SPSS (α = 0.05). Results The mean knowledge scores of general dentists and senior dental students were significantly lower than those of orthodontic residents (p

In this work, we study new asymptotic properties of positive solutions of the even-order neutral differential equation with the noncanonical operator. The new properties are iterative, which means they can be used several times. We also use these properties to obtain new criteria for oscillation of the studied equation.

Abstract Preventing energy waste in residential and office buildings has emerged as a critical issue in both developed and developing countries over recent decades. The growing demand for oil and energy reserves has amplified the urgency of this concern. The deployment of building energy management systems (BEMSs) can lead to timely responses to changes in environmental conditions, the prevention of energy wastage, a reduction in CO2 emissions, and an increase in the longevity of building equipment. Despite the undeniable benefits of BEMSs, their market size remains small, creating challenges for providers in reaching potential customers. This research seeks to identify and prioritize the marketing strategies for BEMSs. A case study was conducted, employing the “Strengths, Weaknesses, Opportunities, and Threats” analysis as a tool for identifying marketing strategies related to BEMSs. This method resulted in the identification of 18 distinct marketing strategies. These strategies were subsequently prioritized using a novel fuzzy multicriteria decision‐making technique, VIkor‐topSIS, considering six specific criteria. The findings of the study suggested a hierarchical influence of six criteria on the BEMS market, arranged in the following order of significance: effectiveness, cost, attainability, complexity, timing, and popularity. Furthermore, the top three marketing strategies for BEMSs were found to be internet advertising strategies, discounts to consumers, and online sales. The analysis of the results has also offered valuable insights into the strengths and weaknesses of the studied BEMS provider, as well as the opportunities and threats present within the BEMS market.

Abstract Healthcare waste disposal center location (HCWDCL) impacts the environment and the health of living beings. Different and sometimes contradictory criteria in determining the appropriate site location for disposing of healthcare waste (HCW) complicate the decision-making process. This research presents a hybrid multi-criteria decision-making (MCDM) method, named PROMSIS, to determine the appropriate HCWDCL in a real case. The PROMSIS is the combination of two well-known MCDM methods, namely TOPSIS and PROMETHEE. Moreover, fuzzy theory is used to describe the uncertainties of the problem parameters. To provide a reliable decision on selecting the best HCWDCL, a comprehensive list of criteria is identified through a literature review and experts’ opinions obtained from the case study. In total, 40 criteria are identified and classified into five major criteria, namely economic, environmental, social, technical, and geological. The weight of the considered criteria is determined by the Analytical Hierarchy Process (AHP) method. Then, the score of the alternative HCWDCLs in each considered criterion is obtained. Finally, the candidate locations for disposing of HCWs are ranked by the proposed fuzzy PROMSIS method. The results show that the most important criteria in ranking the alternatives in the studied case are economic, environmental, and social, respectively. Moreover, the sub-criteria of operating cost, transportation cost, and pollution are identified as the most important sub-criteria, respectively.

Considering the role of inflammatory mediators in both orthodontic movements and the development of periodontal diseases and taking into accountthe role of Interleukin 17 as an important inflammatory mediator in orthodontic treatments and the impact of low-level laser therapy (LLLT) as a new and appropriate adjuvant therapy, the aim of the present study was to investigate the effect of LLLT on IL-17 levels in gingival cervicular fluid (GCF) during orthodontic treatment.Materials & Methods:In this clinical trial study, 12 patients in need of orthodontic treatment were selected. In these patients, one side of the mouth was randomly selected for laser irradiation and the other side as a control. Diode LLL irradiation with a wavelength of 810 nm was performed throughout the gingival Cervicular on days 0, 2, 18, and 30 after orthodontic treatment. Sampling was performed on days 0, 2, 18, and 30 by placing paper points in distal, mesial, palatal, and buccal sulcus of the maxillary fifth molar on the both sidesfor 30 seconds. All samples were then transferred to the laboratory and IL-17 level was determined by ELISA reader. Data were analyzed using Paired t-test and One-way ANOVA.Results:Mean IL-17 levels at day zero (p value = 0.62) and day 2 after orthodontic treatment (p value = 0.19) were not significantly different betweenthe control and laser treated sides, howeverthey were significantly lower in the laser-treated group than the control group on days 18 and 30 after orthodontic treatment (p value < 0.001). The mean IL-17 levels decreased in both groups during the treatment period, but this decreasewas significant on day 18.Conclusion:The results of the present study indicate thetherapeutic role of diode LLL in reducing inflammation, and Il-17 levels in both sides of the mouth gradually decreased over time, and thisdecrease was more pronounced in the laser-treated side than in the control side

Purpose: The aim of the study is to evaluate the effect of metformin in complication improvement of hospitalized patients with COVID-19. Methods: This was a randomized clinical trial that involved 189 patients with confirmed COVID-19 infection. Patients in the intervention group received metformin-500 mg twice daily. Patients who received metformin before admission were excluded from the control group. Patients who were discharged before taking at least 2000 mg of metformin were excluded from the study. Primary outcomes were vital signs, need for ICU admission, need for intubation, and mortality. Results: Data showed that patients with diabetes with previous metformin in their regimen had lower percentages of ICU admission and death in comparison with patients without diabetes (11.3% vs. 26.1% (P=0.014) and 4.9% vs. 23.9% (P≤0.001), respectively). Admission time characteristics were the same for both groups except for diabetes and hyperlipidemia, which were significantly different between the two groups. Observations of naproxen consumption on endpoints, duration of hospitalization, and the levels of spO2 did not show any significant differences between the intervention and the control group. The adjusted OR for intubation in the intervention group versus the control group was 0.21 [95% CI, 0.04-0.99 (P=0.047)]. Conclusion: In this trial, metformin consumption had no effect on mortality and ICU admission rates in non-diabetic patients. However, metformin improved COVID-19 complications in diabetic patients who had been receiving metformin prior to COVID-19 infection, and it significantly lowered the intubation rates.

This study aims to develop appropriate models for income distribution in Iran using the econophysics approach for the 2006–2018 period. For this purpose, the three improved distributions of the Pareto, Lognormal, and Gibbs-Boltzmann distributions are analyzed with the data extracted from the target household income expansion plan of the statistical centers in Iran. The research results indicate that the income distribution in Iran does not follow the Pareto and Lognormal distributions in most of the study years but follows the generalized Gibbs-Boltzmann distribution function in all study years. According to the results, the generalized Gibbs-Boltzmann distribution also properly fits the actual data distribution and could clearly explain the income distribution in Iran. The generalized Gibbs-Boltzmann distribution also fits the actual income data better than both Pareto and Lognormal distributions.

The effective distribution of relief goods is critical in mitigating the impact of natural disasters and preserving human life. This study addresses a relief goods distribution problem, assuming the existence of multiple relief orders that must be delivered to various disaster-stricken regions from a network of warehouses using a fleet of diverse vehicles. The objective is to identify the most suitable warehouse for each relief order, allocate relief orders to vehicles, batch the orders in the designated vehicles, and devise routing plans to minimize the total delivery time. A mixed-integer linear programming model is formulated to tackle this problem. Owing to the problem’s NP-hard nature, a metaheuristic algorithm, known as the Multiple League Championship Algorithm, is developed. Furthermore, two innovative variants of the MLCA , namely the League Base Multiple League Championship Algorithm (L- MLCA) and the Playoff Multiple League Championship Algorithm (P-MLCA), are introduced.Experimental results indicate that the P-MLCA outperforms the other two algorithms. The solutions derived from the P-MLCA are compared with the optimal solutions obtained by a commercial solver for small-scale problems. This comparative analysis demonstrates the promising performance of the P-MLCA in finding the optimal distribution of relief goods.

Abstract Background Irritable bowel syndrome (IBS) is one of the world's most common gastrointestinal (GI) disorders, and current treatments do not meet patients' demands. This study aimed to investigate melatonin's therapeutic effects on IBS score, GI symptoms, quality of life, and sleep parameters in both groups of IBS patients with and without sleep disorders. Methods In this randomized double-blinded placebo-controlled trial study, 136 patients with a diagnosis of IBS based on ROME IV criteria were enrolled and then divided into two groups respecting having sleep disorders or not. Patients of each group were randomized in a 1:1 ratio to receive melatonin 6 mg daily (3 mg fasting and 3 mg at bedtime) for 2 months (8 weeks). Blocked randomization was used in this process. All patients were evaluated both at the beginning and the end of the trial regarding IBS score, GI symptoms, quality of life, and sleep parameters through valid questionnaires. Results In both groups of patients with and without sleep disorders, a significant improvement was observed in IBS score and GI symptoms, including the severity and the frequency of abdominal pain, the severity of abdominal bloating, satisfaction with bowel habits, disease's impact on patient's life, and stool consistency; however, there was no significant improvement in the frequency of defecations per week. In patients with sleep disorders, significant improvement in sleep parameters, including subjective sleep quality, sleep latency, sleep duration, sleep efficiency, and daytime dysfunction, was observed, while in patients without sleep disorders, there was no significant improvement in sleep parameters. In addition, quality-of-life improvement was observed in a significant number of melatonin recipients compared to placebo in both groups of patients. Conclusion Melatonin can be considered an effective treatment for improving IBS score, GI symptoms, and quality of life in IBS patients with and without sleep disorders. It is also effective to improve sleep parameters in IBS patients with sleep disorders. Trial registration This study has been registered to the Iranian Registry of Clinical Trials (IRCT) with the approval number IRCT20220104053626N2 on the date of 13/02/2022.

Abstract This paper proposes a metamaterial‐based multilayer antenna for WiFi and WiMAX applications. The multilayer structure is beneficial for achieving a gain of more than 15 dB. The substrate is made of FR‐4, and the superstrate is Rogers RT/duroid 5880 with a dielectric constant of 2.2 and a loss tangent of 0.009. The desired metamaterial structure is realized using metallic square rings printed on the superstrate. The thickness of the substrate is 1.58 mm, and the overall area of the antenna is 105×72.5 mm2. Using an area‐efficient multilayer configuration for this microstrip antenna, its gain is cost‐effectively enhanced to more than 18 dB, and the shape of the radiation patterns is also appropriate. This antenna is fabricated and fully measured; the measurement and simulation results are in excellent agreement.

Abstract This study aims at reducing energy consumption in supply chain networks by providing optimal integrated production and transportation scheduling. The considered supply chain consists of one main manufacturing center, multiple production units (i.e., suppliers), and multiple heterogeneous vehicles as the transportation fleet. To schedule this complex supply chain network in an energy‐efficient way, several decisions should be made concerning the assignment of orders to suppliers and determining their production sequence, splitting orders, assigning orders to vehicles, and assigning delivery priority to orders. To cope with the problem, a mixed‐integer linear programming model is presented. Due to the complexity of the problem, a novel development of the genetic algorithm named the Multiple Reference Group Genetic Algorithm (MRGGA) is also proposed. Four objectives are considered to be optimized to meet both suitability and energy‐efficiency aspects in the supply chain network. These optimization objectives are to minimize the total orders' delivery times to the manufacturing center, fuel consumption by the vehicles, energy consumption at supplies, and maximize orders' quality. To analyze the performance of the proposed algorithm, a real case and a set of generated instances are solved. The results obtained by the proposed algorithm are compared with an existing genetic algorithm in the literature. Moreover, the results are also compared with the optimal solutions obtained from the mathematical model for small‐size problems. The results of the comparisons show the efficiency of the proposed MRGGA in finding energy‐efficient solutions for the considered supply chain network.

This study aims to introduce a method to integrate and coordinate departments’ activities to enhance the service quality of organizations using Quality Function Deployment (QFD). To this purpose, the classical two-dimensional House Of Quality (HOQ) matrix is changed to a three-dimensional form (3D-HOQ). The 3D-HOQ is applied to the marketing and Human Resources (HR) departments of a bank to determine customers’ and employees’ demands, respectively. The 3D-HOQ is also employed to provide a unique list of technical requirements to satisfy the identified demands. Obtaining a unique list of technical requirements with the cooperation of both departments reduces the inconsistency between departments, saves cost and time by preventing reworks and parallel works, and increases the organization’s efficiency. Moreover, 3D-HOQ is combined with the SERVQUAL technique and fuzzy theory to determine the weight of obtained technical requirements. The study is conducted in four main steps: 1) identifying the customers’ and employees’ demands; 2) identifying the technical requirements for simultaneous satisfaction of both customers’ and employees’ demands; 3) determining the relationships between the technical requirements and the identified demands; and 4) prioritizing technical requirements. Applying the 3D-HOQ resulted in identifying 30 customers’ demands, 30 employees’ demands, and 50 technical requirements. The study results show that “using new banking technologies” has the highest weight among the customers’ demands, and “job security” has been found to have the highest weight among employees’ demands. Moreover, “Intra-organizational processes automation” has been identified as the technical requirement with the highest weight.

Abstract Herein, we reported the synthesis of nineteen novel 1,2,4-triazole derivatives including 1,3-diphenyl-2-(1H-1,2,4-triazol-1-yl) propan-1-ones (7a-e), 1-(1,3-diphenylpropan-2-yl)-1H-1,2,4-triazole (8a-c) and 1,4-diphenyl-2-(1H-1,2,4-triazol-1-yl) butane-1,4-diones (10a-k). The structures of these derivatives were confirmed by spectroscopic techniques like IR, 1H-NMR, Mass spectroscopy and Elemental analysis. The cytotoxic activities of the synthesized compounds were evaluated against three human cancer cell lines including MCF-7, Hela and A549 using MTT assay. Compounds 7d, 7e, 10a and 10d showed a promising cytotoxic activity lower than 12 μM against Hela cell line. The safety of these compounds was also, evaluated on MRC-5 as a normal cell line and relieved that most of the synthesized compounds have proper selectivity against normal and cytotoxic cancerous cell lines. Finally, molecular docking studies were also, done to understand the mechanism and binding modes of these derivatives in the binding pocket of aromatase enzyme as a possible target.

Key Clinical Message In patients with acute symptoms such as pain, swelling, and erythema of the upper extremities shortly after receiving COVID‐19 vaccines, even inactivated virus vaccines, these symptoms may indicate thrombosis, which may be due to the vaccination. Abstract BBIBP‐CorV COVID‐19 vaccine (Sinopharm vaccine) is an inactivated whole virus vaccine to control the COVID‐19 pandemic. Studies concluded that inactivated COVID‐19 vaccines do not increase the risk of thrombosis. This report presents a 23‐year‐old man with the chief complaint of severe pain, swelling, and erythema of the right upper extremity following his second dose of the Sinopharm vaccine. Duplex ultrasound of the right upper extremity revealed upper extremity deep vein thrombosis, and treatment started with oral anticoagulation. It is probably the first upper extremity deep vein thrombosis case following inactivated COVID‐19 vaccines.

Filamentous fungi is the basic source of hydrolytic enzymes and widely used for industrial applications. Aspergillus fumigatus have been widely used for the production of hydrolytic enzymes. The present study was undertaken to demonstrate the production of glucoamylase from Aspergillus fumigatus using wheat bran as substrate. A. fumigatus was isolated from organic waste samples from river Ravi, Lahore, Punjab, Pakistan and the conditions were optimized for its growth. Various carbon and nitrogen sources were utilized for the supplementation of growth medium in order to produce higher level of glucoamylase. The produced enzyme was partially purified by fractional ammonium sulphate precipitation followed by dialysis for the removal of salt. The dialyzed sample was further purified by ion exchange and gel filtration chromatography. The purified protein was utilized for the kinetic studies. Purification studies resulted in 12 fold purification with 45% yield of the glucoamylase. SDS-PAGE analysis of the purified enzyme revealed an approximate size of 60 kDa. Under optimal conditions, we were able to produce 28 U/mL of glucoamylase. Highest enzyme activity was observed when A. fumigatus was grown on 3% wheat bran in the presence of 0.7% Tween-80 at 40°C for 72 hours at pH 5.0. Kinetic studies demonstrated the Km and Vmax values 9.1 mg/mL and 40 µM min-1 mg-1 respectively when starch was utilized as substrate. Present study revealed a new source of glucoamylase, which have ability to utilize a variety of agriculture products as carbon sources that can be useful for enzyme industry. This study discovered a new strain, which is a unique machine that can act as an attractive alternative source for the production of industrial enzymes for starch hydrolysis. To our knowledge this is the highest glucoamylase activity from Aspergillus fumigatus sp. so far. [ABSTRACT FROM AUTHOR]

Background: Attention to the issue of intelligence and its promotion in children with cleft lip and cleft palate (CL and CP) is necessary to reduce their injuries in life. This study aimed to determine the intelligence quotient (IQ) and emotional intelligence (EQ) in children with CL and CP in comparison to healthy children. Materials and Methods: In this descriptive study, 140 children, including 70 children with CL and CP, were selected from the Children treated in Craniofacial and Cleft Research Center, Spearman correlation, ANOVA and 70 healthy children were selected from the Pediatric Dentistry Department of Isfahan University, in the age range of 5–9 years. After obtaining the consent of the children's parents, the Raven IQ questionnaire and the Mayer and Salovey EQ questionnaire were given to the children. Data were analyzed by the Pearson correlation coefficient tests (α =0.05). Results: EQ score in healthy children was significantly higher than in children with CL and CP (P < 0.001). The percentage of IQ cognitive intelligence in healthy children and children with CL and CP was not significantly different (P = 0.641). In healthy children, no significant relationship was observed between cognitive intelligence IQ and EQ (r = 0.018, P = 0.882). However, among children with CL and CP, there was a significant inverse relationship between cognitive intelligence IQ and EQ (P < 0.001, r = −0.526). Conclusion: CL and CP have no effect on IQ in children, but it does affect EQ.

Key Clinical Message Patients complaining of rectal bleeding, constipation, and a suspicious mass in colonoscopy should undergo biopsy. Histological features such as fibromuscular obliteration in the lamina propria favor SRUS, a benign disorder.

Background: Since the outbreak of COVID-19, various treatments have been frequently reported for patients infected with this virus, especially in transplant patient recipients. Investigating o the literature and organ transplant patients with COVID-19, it could pave the way to understanding, handling, and treatment of COVID-19. Methods: We had a brief review of the literature on immunosuppressive therapy in kidney transplants infected with COVID-19 based on the PubMed Database by keywords “kidney, transplant, COVID-19, and immunosuppress” after hospitalization of a kidney transplant reception infected with COVID-19. He had already been recorded in the Organ Transplant Registry (ID≠ 64510) of Tabriz University of Medical Sciences /Iran. Results: We reported the clinical course of a 45-year-old man with a history of kidney transplant and immunotherapy who was infected with COVID-19 with respiratory infections and positive RT-PCR (Real-time polymerase chain reaction). He was treated with hydroxychloroquine, Kaletra, Cellcept, and Prednisolone for 5 days, and finally discharged from the hospital. In addition, the reviewing of 48 papers with 745 samples showed that immunosuppressant medications alone could be a therapeutic choice in kidney transplants infected with COVID-19 with careful management. Conclusion: The patients with organ transplantation infected with COVID-19 may show different clinical signs, clinical course, and prognosis due to underlying diseases and the use of immunosuppressant medications. It might be best to continue taking the immunosuppressant medications but to modify them based on patients conditions such as clinical symptoms, laboratory results, paraclinical examinations.

Automotive and aircraft industries are advancing swiftly, creating a constant need for innovative and trustworthy materials. Aluminum composites (aluminum matrix composites [AMCs]) exhibit enhanced mechanical and tribological behaviors when contrasted to their conventional equivalents and as a result have superior potential to be widely accepted for automotive and aircraft engineering and other component applications. This study aims to provide a thorough and critical analysis of the most recent research initiatives concerning the processing, characteristics, and applications of AMCs. It covers the recent advancements in the aluminum-based composites reinforced with SiC, TiC, and graphene, fabrication methods, and mechanical properties of AMCs. Graphene nanoplatelets are many times stronger and yet lighter than steel and other metals, and thus a good contender for reinforcing them. However, the homogeneous distribution of graphene into the metal or aluminum is a challenging aspect for material researchers. The fabrication techniques for AMCs for achieving homogeneous distribution of graphene are critically reviewed. The mechanical properties, specifically microhardness, wear behavior, and tensile strength of aluminum-based composites, are reviewed and analyzed. Finally, a way forward for fostering further development in this area has been discussed.

BackgroundProstate cancer (PCa) is the second most prevalent cancer among men worldwide. This study presents estimates of PCa prevalence, incidence, death, years-of-life-lost (YLLs), years-lived-with-disability (YLDs), disability-adjusted-life-years (DALYs), and the burden attributable to smoking during 1990-2019 in North Africa and Middle East using data of Global Burden of Diseases (GBD) Study 2019.MethodsThis study is a part of GBD 2019. Using vital registration and cancer registry data, the estimates on PCa burden were modeled. Risk factor analysis was performed through the six-step conceptual framework of Comparative Risk Assessment.ResultsThe age-standardized rates (95% UI) of PCa incidence, prevalence, and death in 2019 were 23.7 (18.5-27.9), 161.1 (126.6-187.6), and 11.7 (9.4-13.9) per 100,000 population. While PCa incidence and prevalence increased by 77% and 144% during 1990-2019, respectively, the death rate stagnated. Of the 397% increase in PCa new cases, 234% was due to a rise in the age-specific incidence rate, 79% due to population growth, and 84% due to population aging. The YLLs, YLDs, and DALYs of PCa increased by 2% (-11.8-23.1), 108% (75.5-155.1), and 6% (-8.9-28.1). The death rate and DALYs rate attributable to smoking have decreased 12% and 10%, respectively. The DALYs rate attributable to smoking was 37.4 (15.9-67.8) in Lebanon and 5.9 (2.5-10.6) in Saudi Arabia, which were the highest and lowest in the region, respectively.ConclusionsThe PCa incidence and prevalence rates increased during 1990-2019; however, the death rate stagnated. The increase in the incidence was mostly due to the rise in the age-specific incidence rate, rather than population growth or aging. The burden of PCa attributable to smoking has decreased in the past 30 years.

Objective: The pure opportunities available in the free zones, benefiting from new technologies and risk-free investments, have attracted entrepreneurs and private sector investors in various fields, especially tourism, in the hope of a bright future and it has made economic opportunities to a safe and profitable investment. In fact, free zones, using their unique features and advantages, provide services to investors and tourists at home and abroad. Anzali Free Zone is also one of the seven free-trade zones in Iran, which has special importance in this regard. To the extent that, fluctuations in industrial investments and foreign exchange incomes have caused the tendency to invest in service sectors and attract tourists to this region. Therefore, this research identified sustainable tourism development strategies and investment opportunities in Anzali Free-Trade Industrial Zone. Methods: The present study was applied research in terms of purpose and it was a descriptive survey in terms of methodology. This article was conducted using the SWOT analytical model and the statistical sample of the research was 10 professors, managers, and senior experts in tourism. Results: Anzali Free Zone has relative strength in terms of internal factors (average above 2.5) and has 9 critical success factors (rank 4) and 5 critical failure factors (rank 1). In general, the results suggest that the strengths of the region will overcome its weaknesses. It is also relatively strong in terms of external factors (average above 2.5) and has 10 environmental opportunities for success (rank 4) and 5 environmental threats (rank 1) that may lead to failure. So, findings showed that this region is located in the strategic point of SO and according to the proposed strategies, the investment opportunities of the region are as follows: investing in water, nature, and trade tourism projects, creation of ecotourism resorts, investment in tourism projects such as the Marina project, designing daily nature tours in the region, investing in tourist transportation projects (renting bicycles, carriages, etc.), establishing service companies what organizing scientific camps in the region, sponsoring beach sports programs, investing in reconstruction projects of region, and Investing in mass advertising projects of regional services. Conclusion: Based on the results, it is clear that by exploiting the strengths of tourism in the region, it is possible to make maximum use of environmental opportunities for the development of sustainable tourism, and currently, tourism projects of the region have a better position for investment. In this regard, it is better to use the nature of the region (wetland, forest, sea, beach, and etc.) in order to develop tourism. Types of tourism (sports, water, and, etc.) should be considered as much as possible. The residents have a critical role in this regard. The tourism department of the region, in cooperation with the university, should design and develop tourism development programs. It is necessary to form a working group and a think tank and, use collective intelligence to plan according to all aspects. Regional laws should be reviewed to remove problematic laws and facilitation laws should be considered.