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Introduction: Infectious diarrhea, a significant global health challenge, is exacerbated by flooding, a consequence of climate change and environmental disruption. This comprehensive study aims to quantify the association between flooding events and the incidence of infectious diarrhea, considering diverse demographic, environmental, and pathogen-specific factors. Methods: In this systematic review and meta-analysis, adhering to PROSPERO protocol (CRD42024498899), we evaluated observational studies from January 2000 to December 2023. The analysis incorporated global data from PubMed, Scopus, Embase, Web of Science, and ProQuest, focusing on the relative risk (RR) of diarrhea post-flooding. The study encompassed diverse variables like age, sex, pathogen type, environmental context, and statistical modeling approaches. Results: The meta-analysis, involving 42 high-quality studies, revealed a substantial increase (RR = 1.40, 95% CI [1.29–1.52]) in the incidence of diarrhea following floods. Notably, bacterial and parasitic diarrheas demonstrated higher RRs (1.82 and 1.35, respectively) compared to viral etiologies (RR = 1.15). A significant sex disparity was observed, with women exhibiting a higher susceptibility (RR = 1.55) than men (RR = 1.35). Adults (over 15 years) faced a greater risk than younger individuals, highlighting age-dependent vulnerability. Conclusion: This extensive analysis confirms a significant correlation between flood events and increased infectious diarrhea risk, varying across pathogens and demographic groups. The findings highlight an urgent need for tailored public health interventions in flood-prone areas, focusing on enhanced sanitation, disease surveillance, and targeted education to mitigate this elevated risk. Our study underscores the critical importance of integrating flood-related health risks into global public health planning and climate change adaptation strategies.

Thaddeus Metz has tried to show that the meaning in life, like morality and happiness, is one of the normative categories of life and emphasizes the distinction between the meaning in life and happiness. According to Metz's definition, happiness consists of "positive experiences" and pleasure is basically connected with happiness. Why is happiness different from meaningfulness and what are their differences? These are the main questions that this article addresses. By searching in Metz's works, we can provide some witnesses and reasons why Metz makes a distinction between happiness and meaningfulness. According to Metz's view, happiness is related to the animal realm of the individual, while meaningfulness is related to the human realm, so that although pleasure can increase happiness, but it will not necessarily lead to meaningfulness increase. He makes six distinctions between happiness and meaningfulness: 1. The source of meaning is "relational", but the source of happiness is "intrinsic"; 2. The bearer of meaning is "action", but the bearer of happiness is "sensation"; 3. The greater impact of happiness from “luck” than meaningfulness; 4. The desire to "continue" the state of happiness, wanting "esteem" to be meaningful; 5. The possibility of happiness, only "during the lifetime" in contrast to the possibility of meaningfulness "posthumously"; 6. bias towards the future v lack of bias. Although Metz has mentioned six important distinctions between happiness and meaning, his statement is not comprehensive and other distinctions can be added to Metz's list.

Abstract Background This study aimed to establish normative spirometric equations in a healthy population of Iranian children and adults, and compare these equations with those developed by the Caucasian Global Lung Initiative (GLI) for the first time. Methods Spirometric data from healthy Iranian aged 4–82 years sampled in 2019 were used to derive reference equations using the generalized additive model for location (mu), shape (lambda), and scale (sigma). Results A total of 418 females and 204 males were included in the study. Applying the GLI standards for the Iranian population resulted from the Z scores of FEV1, FVC, FEV1/FVC, and FEF25−75% was not different from zero. Based on the newly calculated LLN, eleven individuals showed significant values below the LLN for FEV1/FVC. In all age groups, this frequency was less than 5%, except for men over 70 years of age, which was 12.5%. There are significant differences between new data and GLI for Caucasian data. Conclusion It is recommended that the values and equations generated from this study should be used by physicians and technicians in their routine practice for the diagnosis and assessment of pulmonary disorders.

Natural gas has recently drawn considerable attention due to its low emissions upon combustion. Pipeline transmission of natural gas is costly and always encounters different obstacles. Therefore, an effective industrial alternative for the storage and transmission of natural gas is needed. Hydrates, also known as solidified natural gas, have been proven to be a more feasible replacement compared to pipeline transmission, CNG, or LNG. Scientists have introduced promoters to shorten the induction time, increase the storage capacity, and improve the stability of hydrates. Nanostructure materials have demonstrated promising promotion results, suggesting a bright future and a critical step in the industrialization of this technology. Researchers have mainly used pure methane, which is the main component of natural gas, to form hydrates. In this article, the fundamentals of the selection of a nanopromoter, the hydrate formation process, and related calculations are demonstrated. Finally, recent results have been brought together to provide an overview of advances towards the use of nanostructure promoters to tune hydrates for future industrial processes.

Antimicrobial coatings can inhibit the transmission of infectious diseases when they provide a quick kill that is achieved long after the coating application. Here, we describe the fabrication and testing of a glass coating containing Ag2O microparticles that was prepared from sodium silicate at room temperature. The half-lives of both methicillin-resistant Staphylococcus aureus (MRSA) and Pseudomonas aeruginosa on this coating are only 2–4 min. The half-life of Clostridioides difficile spores is about 9–12 min, which is extremely short for a spore. Additional tests on MRSA demonstrate that the coating retains its antimicrobial activity after abrasion and that an increased loading of Ag2O leads to a shorter half-life. This coating combines the properties of optical transparency, robustness, fast kill, and room temperature preparation that are highly desirable for an antimicrobial coating.

Abstract Objective & aim The coronavirus disease, so far (COVID-19) has brought about millions of infections and fatalities throughout the world. Our aim was to determine the correlation between rubella IGG titers with the severity COVID-19. Materials & methods This study was conducted among COVID-19 confirmed patients over 18 years of age. The disease severity levels were categorized by WHO interim guidance. The rubella-specific IgG antibody-titer spectrum was measured (within first 48 h of hospitalization) by enzyme-linked immunosorbent assay (ELISA). Result In a study of 46 inpatients with varying COVID-19 disease severity (mild, moderate, severe, and critical), we observed a negative correlation between rubella IgG antibody titers and COVID‐19 severity (P-Value = 0.017), There was an interaction between COVID-19 vaccination history and rubella IGG on severity COVID-19 (P-Value = 0.0015). There was an interaction between age group under 44 years (including national measles- rubella (MR) vaccination in Iran) and rubella IGG titers on severity COVID-19 too (p-value = 0.014). Conclusion In conclusion, MR vaccination seems to have a positive effect in reducing the severity of the disease, emphasizing that, the important and separate effect of the IGG rubella (due to natural or extrinsic immunity) titers is determining.

Abstract Transfer of SARS-CoV-2 from solids to fingers is one step in infection via contaminated solids, and the possibility of infection from this route has driven calls for increased frequency of handwashing during the COVID-19 pandemic. To analyze this route of infection, we measured the percentage of SARS-CoV-2 that was transferred from a solid to an artificial finger. A droplet of SARS-CoV-2 suspension (1 µL) was placed on a solid, and then artificial skin was briefly pressed against the solid with a light force (3 N). Transfer from a variety of solids was detected, and transfer from the non-porous solids, glass, stainless steel, and Teflon, was substantial when the droplet was still wet. The viral titer for the finger was 13–16% or 0.8–0.9 log less than for the input droplet. Transfer still occurred after the droplet evaporated, but was smaller, 3–9%. We found a lower level of transfer from porous solids but did not find a significant effect of solid wettability for non-porous solids.

The irregular and sporadic occurrence of chromite pods in podiform chromite deposits (PCD), especially in mountainous terranes with rough topography, necessitates finding innovative methods for reconnaissance and prospecting. This research combines several remote sensing methods to discriminate the highly serpentinized peridotites hosting chromite pods from the other barren ultramafic and mafic cumulates. The case study is the area of the Sabzevar Ophiolite (NE Iran), which hosts several known chromite and other mineral deposits. The integration of satellite images [e.g., Advanced Spaceborne Thermal Emission and Reflection Radiometer (ASTER) satellite sensor, Landsat series, and Sentinel-2] coupled with change detection, band rationing, and target detection algorithms [including the Spectral Angle Mapper (SAM)] were used to distinguish potential lithological units hosting chromites. Results have been verified by an initial on-field checking and compared with the high-resolution (GSD ~6 cm) orthomosaic images obtained by the processing of photographs taken from an Unmanned Aerial Vehicle (UAV) at a promising area of 35 km2. The combination of visual interpretation and supervised classification by machine learning methods [Support Vector Machine (SVM)] yielded the production of a geological map, in which the lithological units and structures are outlined, including the crust-mantle transition zone units, mafic cumulates, crosscutting dykes, and mantle sequences. The validation of the results was performed through a second phase, made up of field mapping, sampling, chemical analysis, and microscopic studies, leading to the discovery of new chromite occurrences and mineralized zones. All ultramafic units were classified into four groups based on the degree of serpentinization, represented by the intensity of their average spectral reflectance. Based on their presumed protolith, the highly serpentinized ultramafics and serpentinites were classified into two main categories (dunite or harzburgite). The serpentinite with probable dunitic protolith, discriminated for a peculiar Fe-rich Ni-bearing lateritic crust, is more productive for chromite prospecting. This is particularly true at the contact with mafic dykes, akin to some worldwide chromite deposits. The results of our work highlight the potential of multi-scale satellite and UAV-based remote sensing to find footprints of some chromite mineral deposits.

Background: Poor sleep quality is a common issue among patients with end-stage renal disease (ESRD) who undergo dialysis. Nutritional habits are associated with sleep hygiene in patients undergoing dialysis. The objective of this study was to examine the potential correlation between nutritional status and sleep quality in individuals receiving hemodialysis treatment. Materials and Methods: This cross-sectional study included 160 hemodialysis patients. A food frequency questionnaire (FFQ) was used to measure food intake in participants. The Persian-validated version of the Pittsburgh Sleep Quality Index (PSQI) was used to assess sleep quality. Patients were classified as poor or good sleepers with a PSQI score of 5, respectively. Results: Eighty-four percent of hemodialysis patients had bad sleep hygiene. There was a significant association between sleep quality and educational status and age (P < 0.001). Poor sleepers were older (61.65 years versus 51.12) and less educated (31.1% versus 4%). However, there was no significant difference in the intake of micro- and macronutrients between poor and good sleepers (P > 0.05). Conclusion: The results of this study suggest that sleep quality has no significant relationship with nutrient intake in hemodialysis patients. Demographic factors, such as age and educational status, have played a more effective role than nutritional factors in patients' sleep quality.

Background: The aim of this study was to develop a nucleotide geometrical model of the circular mitochondrial DNA (mt-DNA) structure using Geant4-DNA toolkit to predict the radiation-induced damages such as single-strand breaks (SSB), double-strand breaks (DSB), and some other physical parameters. Methods: Our model covers the organization of a circular human mt genetic system. The current model includes all 16,659 base pairs of human mt-DNA. This new mt-DNA model has been preliminarily tested in this work by determining SSB and DSB DNA damage yields and site-hit probabilities due to the impact of proton particles. The accuracy of the geometry was determined by three-dimensional visualization in various ring element numbers. The hit locations were determined with respect to a reference coordinate system, and the corresponding base pairs were stored in the ROOT output file. Results: The coordinate determination according to the algorithm was consistent with the expected results. The output results contain the information about the energy transfers in the backbone region of the DNA double helix. The output file was analyzed by root analyzing tools. Estimation of SSBs and DSBs yielded similar results with the increment of incident particle linear energy transfer. In addition, these values seem to be consistent with the corresponding experimental determinations. Conclusions: This model can be used in numerical simulations of mt-DNA radiation interactions to perform realistic evaluations of DNA-free radical reactions. This work will be extended to supercoiled conformation in the near future.

This investigation was conducted to compare the photosynthetic indices in ironwood trees infected by Viscum album L. and healthy trees located both in stand and out of stand in plain forest of Tamishan, Nour city. In each position, five healthy and five infected trees were selected and photosynthetic parameters, stomatal conductance, transpiration and internal CO2 were examined. Results showed that the amount of photosynthesis and stomatal conductance in healthy and infected branches were varied depending on the position of trees, individual trees and branch type. The amount of transpiration and internal CO2 were significantly different in healthy and infected branches. The highest amount of photosynthesis, stomatal conductance, transpiration and internal CO2 both within and out of stand, were measured in healthy trees (except for stomatal conductance in out of stand). Both within and out of stand, healthy branch of infected tree indicates higher level of photosynthetic activity compared with infected branch. Also, twofold comparison of the four parameters investigated showed that photosynthesis, stomatal conductance, transpiration and internal CO2 in healthy branches within stand were higher than those out of stand. It was also discovered that Viscum album caused disruption in photosynthetic activities of the host plant that, is why conducting supplementary studies in this regard is suggested to future researchers.

BACKGROUND: Non-enzymatic glycosylation of hemoglobin is complications of diabetes. Antioxidant system imbalance can result in the emergence of free radicals’ destructive effects in the long-term. Red clover (Trifolium pratense L.) and alfalfa (Medicago sativa L.) contain isoflavonoids and have antioxidant activity. This experimental study evaluated the inhibitory activity of pure isoflavonoids (daidzein and genistein), red clover and alfalfa extracts on hemoglobin glycosylation. METHODS: This study was performed in Iran. Stock solution of hydroalcoholic extracts of red clover and alfalfa in concentrations of 1 and 10 g/100 ml and stock solution of daidzein and genistein in concentrations of 250 ng, 500 ng, 25 µg and 250 µg/100 ml were prepared as case groups. Control group was without hydroalcoholic extracts of plants and pure isoflavonoids. All experiments were performed in triplicate. Hemoglobin was prepared and antioxidant activities were investigated to estimate degree of nonenzymatic hemoglobin glycosylation. RESULTS: There was no significantly difference between used extracts (extract of red clover and alfalfa) and control of the hemoglobin glycosylation but using daidzein (P = 0.046, 0.029 and 0.021, respectively) and genistein (P = 0.034, 0.036 and 0.028) significantly inhibited (P < 0.050) this reaction in 25 µg/100 ml, 250 and 500 ng/100 ml concentrations when compared to control. in 25 µg/100 ml, 250 ng and 500 ng/100 ml concentrations percentage of inhibition were 32, 80 and 74.5% respectively with used of daidzein and were 21, 83 and 76% respectively with consumption of genistein. CONCLUSION: According to decrease of glycation of hemoglobin with isoflavonoids, two used plant in this study containing isoflavonoid may be useful on diabetes.

[This corrects the article DOI: 10.1371/journal.pone.0097245.].

Objective: Th17 cells are known to be involved in some types of inflammations and autoimmune disorders. RORC2 is the key transcription factor coordinating Th17 cell differentiation. Thus, blocking RORC2 may be useful in suppressing Th17-dependent inflammatory processes. The aim was to silence RORC2 by specific siRNAs in naïve T cells differentiating to Th17. Time-dependent expression of RORC2 as well as IL-17 and IL-23R were considered before and after RORC2 silencing. Materials and Methods: In this experimental study, naïve CD4+ T cells were isolated from human cord blood samples. Cytokines TGFβ plus IL-6 and IL-23 were used to polarize the naïve T cells to Th17 cells in X-VIVO 15 serum free medium. A mixture of three siRNAs specific for RORC2 was applied for blocking its expression. RORC2, IL-17 and IL-23R mRNA and protein levels were measured using qRT-PCR, ELISA and flow cytometry techniques. Pearson correlation and one-way ANOVA were used for statistical analyses. Results: Significant correlations were obtained in time-dependent analysis of IL-17 and IL-23R expression in relation with RORC2 (R=0.87 and 0.89 respectively, p

Objective: To evaluate predictive factors of adolescents′ appraisal of their health. Methods: The nationwide study, entitled "Childhood and Adolescence Surveillance and Prevention of Adult Non-communicable Diseases (CASPIAN) study," was conducted in 2010 among Iranian school students, aged 10-18. In addition to demographic factors and physical examination, variables as family structure, nutrition habits, physical activity, smoking, hygienic habits, violence, school attachment, family smoking, and family history of chronic diseases were assessed. The dependent variable is the self-rated health (SRH) and it was measured by 12 items, which had already been combined through latent class analysis. We had taken a dichotomous variable, i.e. the higher values indicate better SRH. The dependent variable was regressed on all predictors by generalized additive models. Results: 75% of adolescents had a good SRH. The linear and smooth effects of independent variables on SRH were observed. Among all the variables, physical activity had a positive linear effect on SRH (β = 0.08, P value = 0.003). Smoking, violence, and family history of disease associated to SRH non-linearly (P value < 0.05). Family smoking (β = -0.01) and hygienic habits (β = 0.27) related to SRH both linearly and non-linearly. Conclusions: Physical health and high risk behavior, either of linear or non-linear effect, are factors, which seem to shape the adolescents′ perception of health.

Background: Common variable immunodeficiency (CVID) is characterized by a deficiency in the immune system with a heterogeneous collection of disorders resulting in antibody deficiency and recurrent infections. T helper 17 (Th17) cells promote B-cell survival and synergize with the B-cell activating factor to induce their differentiation into the plasma cells. A sub-population of innate lymphoid cells (ILCs) also produces interleukin 17 (IL-17). This study aimed to measure the Th17 specific genes and ILCs counts in the CVID patients in comparison with control subjects. Materials and Methods: Total messenger ribonucleic acid (mRNA) was extracted from the whole blood samples of 10 CVID patients and 10 healthy individuals. IL-17, retinoic acid receptor-related orphan receptor C2 (RORC2), IL-23R, and IL-9 gene expression were measured using the quantitative reverse transcriptase-polymerase chain reaction. Count of lineage negative/CD127 + /CD90 + ILCs in the blood samples was performed by the flow cytometry method. Results: The transcript levels of IL-17 and RORC2 in CVID patients was strongly lower than control subjects (P = 0.049 and P = 0.046, respectively), but slight reduction in the IL-23R expression (P = 0.252) have seen in the CVID patients. Accordingly, the number of ILCs decreased significantly (P = 0.04). Interestingly, IL-9 mRNA level was more significantly in the CVID patients (P = 0.001). Conclusion: The results presented in this study show that the Th17 cell specific genes expression (as the determiner Th17 cells) and ILCs (another lymphoid source of IL-17) are decreased in patients with CVID and this could be an explanation for the defect of their humoral immune response. In addition, elevation of the IL-9 gene expression may shed a new light into the way toward the understanding of the mechanism of autoimmunity in the CVID patients.

Background: Metabolic syndrome (MetSy), an important predisposing factor for the most of noncommunicable diseases, has become a global pandemic. Given different definitions used for the MetSy, recently using a score termed "continuous MetSy risk score (CMetSyS)" is recommended. The aim of this study was to provide a CMetSyS in a population-based sample of Iranian adults and to assess its determinants. Materials and Methods: We used the data of the baseline survey of a community trial entitled "the Isfahan health heart program." The MetSy was defined according to the Revised National Cholesterol Education Program Third Adult Treatment Panel. All probable predictive models and their predictive performance were provided using leave-one-out cross-validated logistic regression and the receiver operation characteristic curve methods. Multiple linear regression was performed to assess factors associated with the CMetSyS. Results: The study population consisted of 8313 persons (49.9% male, mean age 38.54 ± 15.86 years). The MetSy was documented in 1539 persons (21.86%). Triglycerides and waist circumference were the best predictive components, and fasting plasma glucose had the lowest area under curve (AUC). The AUC for our best model was 95.36 (94.83-95.83%). The best predictive cutoff for this risk score was −1.151 with 89% sensitivity and 87.93% specificity. Conclusion: We provided four population-based leave-one-out cross-validated risk score models, with moderate to perfect predictive performance to identify the MetSy in Iranian adults. The CMetSyS had significant associations with high sensitive C-reactive protein, body mass index, leisure time, and workplace physical activity as well as age and gender.

مقدمه: درجه‌ای که افراد اطلاعات بهداشتی درمانی را درک می‌کنند و می‌توانند در سیستم بهداشتی درمانی به‌کار گیرند تحت عنوان سواد سلامت مطرح می‌شود. عواقب ناشی از سواد کم سلامت هم به‌صورت مستقیم و هم به‌صورت غیرمستقیم بروز می کند. از این رو هدف از این مطالعه، تعیین سواد سلامت، وضعیت سلامت و بهره‌مندی از خدمات سلامت و ارتباط بین آنها در بزرگسالان شهر اصفهان بود. روش بررسی: این مطالعه توصیفی تحلیلی از نوع مقطعی بوده که بر روی300 نفر از افراد 18-64 ساله‌ی شهر اصفهان با روش نمونه‌گیری خوشه‌ای که متناسب با حجم نمونه‌ی انتخاب شده بودند در سال1390 انجام شد. ابزار گردآوری داده‌ها پرسش‌نامه‌ی محقق‌ساخته، اقتباس شده از پرسش‌نامه استاندارد سواد سلامت CAHP (Consumer Assessment of Healthcare Providers and Systems ) بود و روایی و پایایی آن سنجیده شد. وضعیت سلامت فرد براساس خودارزیابی فیزیکی و روانی سلامت در طول 6 ماه گذشته اندازه‌گیری شد. میزان بهره‌مندی از خدمات سلامت هم درشش حیطه از افراد سوال شد که شامل تعداد مراجعه به پزشک عمومی، تعداد مراجعه به پزشک متخصص، تعداد مراجعه به درمانگاه یا مطب، تعداد مراجعه به اورژانس، میزان استفاده از خدمات تشخیصی در 3 ماه گذشته و میزان بستری شدن در بیمارستان در یک سال گذشته می‌باشد. برای تحلیل داده ها از نرم افزار SPSS نسخه‌ی 18 آمار توصیفی و آزمون کای اسکوئر استفاده شد. یافته‌ها: میانگین نمره‌ی سواد سلامت 4/2 و در حد متوسط، میانگین نمره‌ی وضعیت سلامت 1/3 و در حد خوب و میانگین نمره‌ی بهره‌مندی از خدمات سلامت 1/2 و در حد ضعیف ارزیابی شد. بین سواد سلامت، وضعیت سلامت و بهره‌مندی از خدمات سلامت ارتباط آماری معناداری مشاهده نشد. بعد خانوار در خودارزیابی وضعیت سلامت افراد مؤثر است. میزان تحصیلات افراد و منطقه‌ی محل سکونت هم در بهره‌مندی افراد از خدمات سلامت مؤثر است. نتیجه‌گیری: با توجه به شیوع سواد سلامت متوسط در بزرگسالان شهر اصفهان و نیز پایین بودن میزان بهره‌مندی از خدمات سلامت لزوم توجه بیش‌تر به امر سواد سلامت و بهبود ارتباط پزشک و بیمار و آگاه‌سازی افراد جامعه از طریق برنامه‌های ارتقای سلامت و یا رسانه‌ها توصیه می‌شود. واژه‌های کلیدی: سواد سلامت؛ وضعیت سلامت؛ خدمات سلامت؛ بهره‌مندی

Background and aims. Incorporation of nano-particles to orthodontic bonding systems has been considered to prevent enamel demineralization around appliances. This study investigated cytotoxicity of Transbond XT adhesive containing 1 wt% titanium dioxide (TiO2) nano-particles. Materials and methods. Ten composite disks were prepared from each of the conventional and TiO2-containg composites and aged for 1, 3, 5, 7 and 14 days in Dulbecco’s Modified Eagle’s Medium (DMEM). The extracts were obtained and exposed to culture media of human gingival fibroblasts (HGF) and mouse L929 fibroblasts. Cell viability was measured using the 3-(4,5-dimethylthiazol-2-yl)-2,5-diphenyltetrazolium bromide (MTT) assay. Results. Both adhesives were moderately toxic for HGF cells on the first day of the experiment, but the TiO2-containing adhesive produced significantly lower toxicity than the pure adhesive (P0.05). There was a significant reduction in cell toxicity with increasing pre-incubation time (P

BACKGROUND: Trans fatty acids (TFAs) are known as the most harmful type of dietary fats. Therefore, this study was done to compare the effects of some different oils including unhydrogenated, blended, ghee, and soft magazine with hydrogenated oil on serum lipid profile of healthy adults. METHODS: This study was a randomized clinical trial conducted on 206 healthy participants of 20 to 60 years of age. Subjects were randomly divided into 5 groups and each of them was treated with a diet containing unhydrogenated oil, ghee, blended oil, soft margarine, or hydrogenated oil for 40 days. Fasting serum lipids were measured before and after the study. RESULTS: Compared to hydrogenated oil, total cholesterol (TC) and triglyceride (TG) had a significant reduction in all groups, LDL-C declined in unhydrogenated oil and soft margarine groups, and apolipoprotein (Apo) B only in unhydrogenated oil group (all P < 0.05). However, there was a significant enhancement in ApoA of ghee oil (P < 0.001). CONCLUSION: Consuming unhydrogenated oil, ghee, soft margarine, and blended oil had some beneficial effects on serum lipids. Keywords: Clinical Trial, Dietary Fat, Commercial Oil, Lipid

مقدمه: سلول TH17 با تولید IL-17 می‌تواند سبب افزایش تولید دو سایتوکین BAFF و APRIL شود که نقش مهمی در بقا و فعال شدن سلول B، و در نتیجه، پاسخ‌های ایمنی هومورال دارند. نارسایی ایمنی رایج متغیر (Common variable immunodeficiency یا CVID)، یکی از بیماری‌های نقص ایمنی اولیه می‌باشد که با کاهش سطح آنتی‌بادی‌ها (نارسایی ایمنی هومورال) همراه است. فراوانی افراد مبتلا به CVID در جمعیت‌های مختلف در محدوده‌ی 1:10000 تا 1:50000 گزارش شده است. هدف از این مطالعه، مقایسه‌ی میانگین بیان ژن IL-17 در بیماران مبتلا به CVID با افراد سالم بود. روش‌ها: ابتدا 2 میلی‌لیتر خون کامل از 10 بیمار مبتلا به CVID و 10 فرد سالم گرفته و سپس تمام mRNA موجود در این نمونه‌ها جدا شد. پس از ساختن cDNA از روی mRNA، میزان بیان ژن IL-17 را با استفاده از روش Real Time-PCR سنجیدیم. یافته‌ها: میزان بیان ژن IL-17 در بیماران مبتلا به CVID نسبت به افراد شاهد کاهش یافت که البته این کاهش از لحاظ آماری معنی‌دار نبود (195/0 = P). نتیجه‌گیری: در این پژوهش نشان دادیم که میزان بیان ژن IL-17 در خون بیماران مبتلا به CVID نسبت به افراد سالم کاهش داشت؛ این موضوع دلیلی بر نقص تولید این سایتوکین است و می‌تواند دلیل نارسایی پاسخ ایمنی هومورال در این افراد باشد.

Introduction: One of the most important indices of effectiveness and delivery quality of sanitary and medical services is patient satisfaction with hospital services. It is necessary that hospitals pay attention to patient's needs and ensure their satisfaction. Therefore the current study was conducted with the aim of identifying the level of patient satisfaction with hospital services delivered from the time of their admission to their release in educational hospitals of Isfahan, Iran. Methods: The present investigation is a descriptive and cross-sectional study conducted in the fall and winter of 2009. The statistical population consisted of 196 patients referring to educational hospitals of Isfahan. Simple random sampling method was used. The data collection tool was a researcher-made questionnaire consisting of 66 questions on 5 areas. Content validity of the study tool was approved by professionals, and its reliability was approved by calculating Cronbach’s alpha (α = 0.87). Data was analyzed by SPSS software using chi-square test, Kruskal-Wallis test, and ANOVA. Results: The average score of patient satisfaction with outpatient admission was 15.5%, clinic physician 27.9%, hospitalization admission 15.9%, nursing services 33%, hospitalization physician 38.6%, public and welfare services 55.2%, hospitalization section 42.1%, and financial-administration section was 14.3%. No significant correlation was observed between demographic characteristics and satisfaction score. Conclusion: The results showed that overall level of patient satisfaction with hospital services was low. Therefore, it is necessary to pay attention to activities and performance of different units of hospitals, identify factors causing dissatisfaction, and direct efforts towards eliminating the shortages and empowering the strengths. It is also necessary to plan for delivering higher quality services, securing financial benefits of the health section, and recognizing and amending some hospital procedures, especially admission and release procedures. Keywords: Satisfaction; Patients; Patient Admission; Patient Discharge; Hospitals

Background: Breast cancer is one of the main causes of mortality and morbidity world-wide. The estimation of the direct medical costs of breast cancer can help payers of the cost to understand the burden of breast cancer on their limited financial resources as well as the society. Methods: We used a cross-sectional study to calculate the direct medical costs of breast cancer among women in Isfahan, Iran. The medical records of all patients which were registered in Seyed Al-Shohada Hospital between March 2005 and March 2010 were reviewed. The relevant data from patients′ profiles extracted. The direct medical costs of received services were calculated with both public and private tariffs. Results: The total numbers of 467 patients in various disease stages were included into the study. The average age of patients was 49 years. The average direct cost per patient per month in stages I to IV were 222.17, 224.61, 316.51 and 828.52 US$, respectively. The surgery cost was the main cost driver for stages I and II with private tariffs. However for stages III and IV, the medication cost was the main cost component for managing breast cancer . Conclusions: The direct economic cost of breast cancer in Iran is very high; nonetheless, as the age of breast cancer in Iran is nearly 10 years lower than Western countries, the burden of the disease in Iran is expected to be significantly high. Medication therapy is the main cost component of the breast cancer.

Introduction: Impaction of third molars can be associated with a number of sequelae, each requiring a different type of treatment. The purpose of this study was to assess the changes in the position of lower third molars following extraction and non-extraction orthodontic treatments. Methods: Pre- and post-treatment panoramic radiographs of 26 class I malocclusion patients (4 male and 22 female) who were treated on a non-extraction basis were compared with those of 30 class I malocclusion patients (5 male and 25 female) who received orthodontic treatment following the extraction of all first premolars. In each group, the lower third molar angulations and their distance from the lower border of the mandible were assessed. Results: Paired t-tests and independent t-tests detected significant changes in the position of the lower third molars in the extraction group. Both the left and right molars became more upright and their distance from the lower border of the mandible increased. Similar changes were only seen in the position of the right mandibular third molars in the non-extraction group. Conclusion: Tooth extractions can bring about favorable changes in the position of mandibular third molars and possibly reduce their incidence of impaction

BACKGROUND: Coronary heart disease is the leading cause of mortality worldwide. A high-fat diet, rich in saturated fatty acids and low in polyunsaturated fatty acids, is said to be an important cause of atherosclerosis and cardiovascular diseases. METHODS: In this experimental study, 40 male rabbits were randomly assigned to eight groups of five to receive normal diet, hypercholesterolemic diet, normal diet plus ghee, normal diet plus olive oil, normal diet plus hydrogenated oil, hypercholesterolemic diet plus ghee, hypercholesterolemic diet plus olive oil, and hypercholesterolemic diet plus hydrogenated oil. They received rabbit chow for a period of 12 weeks. At the start and end of the study, fasting blood samples were taken from all animals to measure biochemical factors including total cholesterol (TC), low-density lipoprotein (LDL), high-density lipoprotein (HDL), triglyceride (TG), fasting blood sugar (FBS), and C-reactive protein (CRP). Moreover, aorta, left and right coronary arteries were dissected at the end of the study to investigate fatty streak formation (FSF). Data was analyzed in SPSS at a significance level of 0.05. RESULTS: In rabbits under normal diet, ghee significantly increased TC, LDL, and HDL compared to the beginning (P < 0.01) and also to the other two types of fat (P < 0.05). Moreover, normal diet plus olive oil significantly enhanced FSF in left coronary arteries and aorta compared to normal diet plus ghee. In groups receiving hypercholesterolemic diets, ghee significantly increased HDL and CRP (P < 0.05) and significantly decreased FBS (P < 0.01). The hypecholesterolemic diet plus olive oil significantly increased HDL (P < 0.01). Supplementation of hypecholesterolemic diet with ghee significantly increased HDL and FBS in comparison with hydrogenated oil. Significant increase of FBS was also detected with the use of ghee compared to olive oil. Ghee also significantly reduced FSF in left and right coronary arteries compared to olive oil. FSF in left coronary arteries was significantly lower in the hypecholesterolemic diet plus ghee group compared to the hypecholesterolemic diet plus hydrogenated oil group. CONCLUSION: According to the achieved results, future clinical trial studies and investigation of other risk factors such as inflammatory factors are required. Keywords: Fatty Streak, Ghee, Hypercholesterolemic, Olive Oil.

Introduction: Impaction of third molars can be associated with a number of sequelae, each requiring a different type of treatment. The purpose of this study was to assess the changes in the position of lower third molars following extraction and non-extraction orthodontic treatments. Methods: Pre- and post-treatment panoramic radiographs of 26 class I malocclusion patients (4 male and 22 female) who were treated on a non-extraction basis were compared with those of 30 class I malocclusion patients (5 male and 25 female) who received orthodontic treatment following the extraction of all first premolars. In each group, the lower third molar angulations and their distance from the lower border of the mandible were assessed. Results: Paired t-tests and independent t-tests detected significant changes in the position of the lower third molars in the extraction group. Both the left and right molars became more upright and their distance from the lower border of the mandible increased. Similar changes were only seen in the position of the right mandibular third molars in the non-extraction group. Conclusion: Tooth extractions can bring about favorable changes in the position of mandibular third molars and possibly reduce their incidence of impaction.

Background: Considering that thyroid nodules and thyroid cancer occur more frequently in people chronically exposed to radiation, the aim of this study was to evaluate the prevalence of thyroid nodules in a population occupationally exposed to radiation in hospitals of Isfahan, Iran. Materials and Methods: In this case-control study, the prevalence of thyroid nodules in staff members occupationally exposed to radiation was determined by ultrasonography. The results were compared with the results of another study among the adult population of Isfahan which selected by cluster random sampling method. The 2 studied groups were matched according to sex and age. Results: The case and control groups included 124 and 471 persons, respectively. The prevalence of thyroid nodules in the case and control groups was 22.6% and 24.6%, respectively (p > 0.05). Although thyroid nodules were significantly more prevalent in females in the control group, no such difference was observed between females and males of the case group (p > 0.05). The number of thyroid nodules (single or multiple) and calcification were not different between the two groups (p > 0.05). In addition, hypoechogenicity of thyroid nodules was not different between the two groups for (p > 0.05). Conclusion: In our study, there was not any correlation between chronic occupational exposure to low dose of radiation and the risk of developing thyroid nodules. Further studies with larger sample sizes, at different doses of radiation, and considering iodine status and thyroid function are thus required.

Objectives: This study was conducted to explore the barriers to physical activity in a representative sample of Iranian children and adolescents.Methods: The studywas conducted in 2007 in urban and rural areas of Isfahan district in Iran. In the qualitative part,we used the grounded theory approach, including semi-structured focus group discussionsand in-depth interviews. The quantitative part comprised 600 randomly selected students.Results: The qualitative study included 34 school students (16 girls), 20 parents (11 mothers) and 11 school staff. All students disclosed that studying was a priority.They pointed to lack of safe and easy-access place for physical activity and unsupportive family as the main barriers. Lack of self-confidence and low self-worth were the two other concepts developed in this context.Parents pointed to lack of safe and easy-access place for activity followed by the priority of studying. The concepts derived from interviews with school staff included unhealthy modeling of parents, priority of studying, and inadequate public know-ledge about how to integrate physical activity in routine daily life.The quantitative survey comprised 600 students including 286 (47.8%) girls. Parents’ education level had inverse association with children’s physical activity level. Significant inverse associations of self-efficacy and physical activity levels were documented.Conclusions: Increasing the public knowledge about adopting physical activity habits in routinedaily life, informing the families and students about the benefits of physical activity to improvelearning, as well as providing safe places such as using the school facilities in non-school hoursshould be considered in planning effective preventive strategies and interventions.

Introduction. To improve the quality of dissertations (as a mandatory course) in general medicine (MD) program, it is useful to know the viewpoints of supervisors about different issues and problems in their supervision process, i.e. the objectives of the course, facilitation methods for learning, problems of the practical phase, and their ideas about the course efficacy. This study explores supervisors' views concerning the thesis process and its related problems in Isfahan University of Medical Sciences. Methods. 106 supervisors from Medical School participated in this cross sectional descriptive study. A self-administered questionnaire, which proved to be valid and reliable was used for data collection. The questionnaires were completed individually in the participants' office or School. SPSS software was used for data analysis. Results were analyzed according to the frequency distribution of variables and compared by t- test and ANOVA. Results. According to the supervisors, the most important problems were allocating appropriate budget, approving the research proposal by the department and school councils, instructing students about literature review and article writing, and not being informed about national research priorities. They considered "learning research methodology" as the main objective of dissertation. Most of them agreed on it as a necessary course for MD program, but believed that students usually faced shortage of time. They claimed that offering thesis as an elective course would improve the quality of the projects. Conclusion. Dissertations in general medicine program are facing some problems. It seems that shortage of time brings about limitations in doing and supervising the projects. It is recommended to revise the approval process of thesis proposals. Moreover, involving students in the preplanned researches, improving the supervisors knowledge in research methodology and statistical analysis, announcing research priorities, and revising the course plan may improve the quality of dissertations.

p38 mitogen-activated protein kinases (MAPKs) respond to a wide range of extracellular stimuli. While the inhibition of p38 signaling is implicated in the impaired capacity to repair ultraviolet (UV)-induced DNA damage-a primary risk factor for human skin cancers-its mechanism of action in skin carcinogenesis remains unclear, as both anti-proliferative and survival functions have been previously described. In this study, we utilized cultured keratinocytes, murine tumorigenesis models, and human cutaneous squamous cell carcinoma (SCC) specimens to assess the effect of p38 in this regard. UV irradiation of normal human keratinocytes increased the expression of all four p38 isoforms (α/β/γ/δ); whereas irradiation of p53-deficient A431 keratinocytes derived from a human SCC selectively decreased p38α, without affecting other isoforms. p38α levels are decreased in the majority of human cutaneous SCCs assessed by tissue microarray, suggesting a tumor-suppressive effect of p38α in SCC pathogenesis. Genetic and pharmacological inhibition of p38α and in A431 cells increased cell proliferation, which was in turn associated with increases in NAPDH oxidase (NOX2) activity as well as intracellular reactive oxygen species (ROS). These changes led to enhanced invasiveness of A431 cells as assessed by the matrigel invasion assay. Chronic treatment of p53-/-/SKH-1 mice with the p38 inhibitor SB203580 accelerated UV-induced SCC carcinogenesis and increased the expression of NOX2. NOX2 knockdown suppressed the augmented growth of A431 xenografts treated with SB203580. These findings indicate that in the absence of p53, p38α deficiency drives SCC growth and progression that is associated with enhanced NOX2 expression and ROS formation.

مقدمه: سرطان پستان از علل اصلی مرگ و میر و ناخوشی در سطح جهان است. این بیماری، 4/21 درصد از کل سرطان‌ها را در بین زنان ایرانی به خود اختصاص می‌دهد. درمان سرطان پستان همچنین یکی از درمان‌های پر هزینه در خدمات درمانی محسوب می‌شود. با توجه به این که منابع مالی برای بخش‌های مراقبت سلامت محدود هستند، هدف از این مطالعه، ارزیابی هزینه‌های درمانی سرطان پستان در یک بیمارستان تخصصی سرطان در اصفهان و برآورد آن برای کل کشور بوده است. روش بررسی: پژوهش حاضر، یک مطالعه‌ی مقطعی برای ارزیابی هزینه‌های مستقیم پزشکی درمان سرطان پستان در ایران بود. داده‌های مطالعه از بیمارستان سیدالشهدا (ع) اصفهان در بین سال‌های 88-1384جمع‌آوری شد. با مراجعه به پرونده‌ی بیماران، مراحل بیماری و درمان آن‌ها شناسایی و هزینه‌های مستقیم مرتبط با درمان بیماران با تعرفه‌ی دولتی و خصوصی به طور جداگانه برای هر بیمار، محاسبه شد. سپس داده‌ها با استفاده از نرم‌افزار SPSS نسخه‌ی 16 مورد تجزیه و تحلیل قرار گرفت. یافته‌ها:میانگین سنی بیماران 49 سال به دست آمد. پراکندگی بیماران در چهار مرحله‌ی بیماری به ترتیب، 1/4 درصد، 2/28 درصد، 6/26 درصد و 1/41 درصد بود. میانگین هزینه‌های مستقیم درمان بیماران در چهار مرحله‌ی بیماری به ترتیب 250/809/103، 180/715/106، 730/462/133 و 070/538/109 ریال محاسبه شد. نتیجه‌گیری: درمان بیماران مبتلا به سرطان پستان در کشور، بیش از 836/304 میلیارد ریال هزینه در بر دارد. سن تشخیص در ایران، حدود 10 سال پایین‌تر از کشورهای غربی است و بار تحمیل شده‌ی ناشی از بیماری، بسیار قابل توجه می‌باشد. پر هزینه‌ترین بخش درمان، دارودرمانی است. انجام مطالعات هزینه- اثربخشی و شناسایی درمان‌های جایگزین، می‌تواند نقش به سزایی در ارتقای کارآمدی درمان بیماران سرطان پستان داشته باشد. واژه‌های کلیدی: سرطان پستان؛ تحلیل هزینه؛ ایران

There are several available indices to assess the group associations between species and sites in order to identify diagnostic species. In this study, we introduced 11 indices of species-site groups and evaluated their quality by means of a TFVI model and four numerical criteria, including average positive fidelity, sharpness, uniqueness and crispness based on of 168 releve of Buxus hyrcana habitats. We used a modified TWINSPAN classification of 168 releve (Nine vegetation community/site groups) to determine the species fidelity value. The results showed that new classification obtained from assigning releve using TFVI model based on IndVal, UbinB and Ochiai indices returned the highest values of the fourfold criteria in evaluating classification quality. Moreover, they achieved higher qualities compared to other indices. Also results of cluster analysis and PCA diagram showed that 11 species-site groups’ association indices can be divided into four groups. The scatter plot of association indices along two first axes in PCA (eigenvalues 0.556 and 0.365, respectively) explained 92% of total variation, and species fidelity values based on IndVal and Ochiai indices were similar and noticeably different with other indices. Finally, the results of this study revealed that IndVal and Ochiai indices have the most priority in determining diagnostic species of vegetation communities compared to the other examined association indices.

Background: Diabetes mellitus is a chronic disease which many factors are involved and is developing considerably worldwide. Increasing aging population and obesity in the societies has improved the scale of the type 2 diabetes significantly. The aim of this study was to determine the direct medical costs of outpatient cares of diabetes in Iran. Methods: Active patients of Isfahan Endocrinology and Metabolism Research Center (IEMRC) by the end of March 2011 were employed for data extraction. Type 2 diabetics were classified into 4 groups based on their therapeutic regimens. Type and frequency of health care services were extracted from the patients′ profiles manually. The incidence of major diabetes complications were also examined from the subjects′ profiles. The numbers of services used by the patients in different treatment groups were multiplied by the desired medical tariffs to calculate the direct medical costs. Results: 2898 number of cases was reviewed in this study; 63.8 % women and 36.2% men. 4.3% of the patients were placed group I; 50.1% in group II, and 34.6% and 11% in groups III and IV respectively. The age distribution of the patients varied widely from 30 to 90 years; 5.8% between 30 and 39 years, 62.3% between 40 and 59, and 31.9% at 60 and over. Nephropathy (72.4%), and neuropathy (39%) were the most frequent adverse effect between the type 2 diabetics in Isfahan. The group III with spending $192.3 in total was absorbed the highest amount of the resources between the patients′ groups. The average direct medical cost of outpatient cares of diabetics per year was 155.8 US $. Conclusions: The direct medical cost of diabetes management is progressed sharply in past years in Iran. Pharmaceutical expenditures was the main cost component of outpatient cares for diabetes. It is estimated that the Iranians directly spend approximately $4.05 milliard annually to manage 5.2 million diabetics in the country.

Abstract BACKGROUND: Abdominal obesity is a predictor for many cardio-metabolic disorders in different age groups. The use of available information on factors associated with abdominal obesity has been proposed as an effective way of identifying at-risk individuals. To assess the effectiveness of a risk scoring system for abdominal obesity in a large and representative population of youths. METHODS: Waist-to-height ratio (WHtR) is an effective surrogate measure of abdominal obesity in children. This analysis was performed to find out the normal cut off value for WHtR by calculating the risk score. To develop a risk score to identify high-risk individuals for abdominal obesity, we analyzed data from a national survey, entitled CASPIAN Study, that was conducted on a nationally - representative sample of Iranian students aged 6-18 years. The risk equation was determined by a multiple logistic regression analysis, and Receiver Operator Characteristics (ROC) analysis was used to determine the cut-off value for the risk equation. RESULTS: The independent risk factors associated with abdominal obesity were living in rural area, attending public school, positive family history of diabetes and obesity in first and second degree relatives, lower mother’s education level, number of household members; whereas physical activity decreased this risk. The area under curve (AUC) for the ROC was 63% (95% CI: 0.612, 0.643).A CASPIAN study population value>=39 had optimum sensitivity (64%) and specificity (54%) for determining abdominal obesity score. CONCLUSION: This method can be helpful in screening and prevention of abdominal obesity by identifying those at-risk individuals in a timely manner. Keywords: Risk Score; abdominal obesity; prediction; children.

Background: This study aimed to determine how age groups effect on the phenotype of metabolic syndrome (MetS) among Iranian population. Materials and Methods: This cross-sectional study was conducted as part of Isfahan Healthy Heart Program. Height, weight, waist circumference, and blood pressure were measured by trained health-care professionals. MetS was defined as having three or more of the National Cholesterol Education Program III criteria. The relation between different age groups and different phenotypes of MetS was examined using the multinomial logistic regression. Results: We found low high-density lipoprotein-cholesterol (HDL-c) was the most common feature, followed by hypertriglyceridemia (HTG), abdominal obesity (ABO), hypertension (HTN), and high fasting blood glucose in decreasing order of prevalence. The most prevalent combination of MetS components was hypertrigeceridemia, low HDL-c and ABO (50.7%) in all subjects and especially in younger age group (63.2%). In elder age group, the most prevalent three components combination was HTG, Low HDL-c and HTN (43.9%). Logistic regression analysis demonstrated that elder subjects were at approximately 12 times higher risk of having the combination HTG, ABO, low HDL-c, and HTN (P < 0.001) compared to the middle age subjects who had a lower risk for the same combination; (2 [1.49-3.49]) (P < 0.001). Conclusion: This study provides a nationally representative estimate of the prevalence of different phenotypes of MetS across different age groups. Regarding different phenotypes of MetS in various age groups need to have important implications in the clinical management of these patients and the implementation of public health.

Background: The risk of cardiovascular disease in dialysis patients is higher than the general population. Vitamin D receptors exist in myocardium inhibit cardiac hypertrophy. N-terminal pro-B-type natriuretic peptide (NT-pro-BNP) is a neurohormone secreted by the heart in response to ventricular mass increase. This study aimed to evaluate the effect of oral vitamin D on serum level of pro-B-type natriuretic peptide (pro-BNP) in peritoneal dialysis patients. Materials and Methods: In a randomized clinical trial, 84 peritoneal dialysis patients (49 males and 35 females) were randomly divided into two groups. The intervention group received 50000 units oral vitamin D per week, for 12 weeks if 25-hydroxy-vitamin D level was

In order to investigate the effect of environmental factors, including slope gradient, aspect and elevation on regeneration of Juniperus excelsa subsp. polycarpus, some Juniper stands were selected at Hezar Masjed Mountains, north of Khorasan Razavi province, north-east of Iran. Maps of slope gradient, aspect, elevation and landform were used and combined together to develop homogenious polygons of land units. The sampling was made, using stratification method and three sample plots, each 1000 m2. The plots were then laid out on the land units. To study the physico-chemical properties, one soil sample was made from subsoil, at each plot. The soil data were analyzed, using the Principle Component Analysis (PCA). Some parameters, including number of Juniper seedlings and their total height, collar diameter, health and vitality status were measured. The results showed that the elevation has significant effect on number of the seedlings, collar diameter and total height of the seedlings and proportion of health classes. Slope gradient showed significant effect on number of the seedlings per plot. The geographic aspect showed significant relation only with the proportion of moderate healthy seedlings. The impact of land form on Juniper seedlings was not significant. The Principle Component Analysis (PCA) output showed that phosphorus, clay, silt, EC and CaCo3 are the most important factors influencing regeneration of Juniperus excelsa subsp. polycarpus.

This research was performed in Chamestan Forest and Rangeland Experimental Station since 1994. In this research chestnut leaved oak (Quercus castaneifolia) was planted at pure and mixed plantation, including Siberian elm (Zelkova carpinifolia), maple (Acer velutinum), hackberry (Celtis australis) and hornbeam (Carpinus betulus). The aims of this research were as follows: 1. investigation on nutritional elements of the leaves and their return by senescent leaves at both pure and mixed plantations, 2. litter production of the species and nutrient fluxes in the two plantation types. For these reasons, sampling was made from the fresh leaves in August and for the senescent leaves in November, and the elements were measured in laboratory. Litter traps were located within the treatment's plots for litter collection and litter dry weight was measured and recorded. The results showed that the mixed plantations produced more amounts of nutritional elements than the pure plantations. Dry litter production was 5.02 to 6.14 ton per hectare per year, which was more than the European temperate broadleaved forests production. The concentration of elements in the mixed oak- maple plantation was more than the pure oak and the other mixed plantations. It can be concluded that investigation on nutritional behavior of forest trees is very important for sustainable forest management.

Plant litter decomposition plays an important role in forest soil fertility due to nutrient cycling and soil organic matter formation. Litter decomposition, results in return of leaves nutrient to soil and supply of necessary elements for plant growth. In fact, nutrient availability is highly related to litter nutrient dynamic in soil. In this study the nutrient dynamic of Norway spruce litter was investigated in both pure and mixed condition to determine whether its nutrient dynamic is affected by its composition with broad-leaved litters or not. For this reason, Norway spruce litters were treated for 400 days at pure and mixed conditions with Beech (Fagus orientalis lipsky), Alder (Alnus subcordata C.A.Meyer) and Maple (Acer velutinum Boiss.) litters in pure Norway spruce plantation at Lajim site, using litter bag method. The results showed that the non-additive effect of litter composition on dynamic of lignin and manganese was neutral, but on dynamic of nitrogen, potassium and magnesium was positive, whereas on dynamic of calcium was negative. The finding of this study showed that litter mineralization rate of nitrogen in the three treatments of litter composition was higher than the its rate in the pure Norway spruce litter, whereas the mineralization rate of manganese was negative at the end of the study time in all the combinations, except for Norway spruce mixed with beech.

BACKGROUND: Due to geographical, racial, nutritional and socio-economical effective factors in pubertal age, assessment of pubertal stages should always be based on native, up-to-date and reliable references data from the same background population. This study is conducted to determine the age of different pubertal stages in school-age girls of Isfahan. METHODS: This was a cross-sectional study of 5.5 to 17 years-old girls of Isfahan among 3204 population in 2006. The data was collected through the multistage cluster probability sampling basis. Pediatric endocrinologist evaluated pubertal stages by inspection and palpation according to Tanner staging. Weight, height and skin fold thickness were measured and recorded. The subjects were asked about menarche occurrence and the age of its onset if there is any. The difference between mentioned factors and different pubertal stages were calculated and analyzed by Covariance statistical estimation. FINDINGS: The mean age and standard deviation of thelarche, pubarche and menarche was 10.46±1/37, 11.15±1/30 and 12.56±1/15 year, respectively. Different pubertal stages have a significant relation to BMI and skin fold thickness (p