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Summary Objectives The aim of this study was to examine the laryngeal palpatory scale (LPS) to ascertain possible correlation with neck surface electromyography (sEMG). Methods Two otolaryngologists and one certified speech-language pathologist assessed 21 participants (seven women and 14 men; with a mean age of 42.8 years; ranged: 21 to 70 years) with muscle tension dysphonia (MTD) diagnosed with the current version of the LPS rating system. Consequently, relationships between LPS and objective measures of sEMG were evaluated using Spearman's rank correlation coefficient (r). Results The results show that there was a low to moderate between correlations, (statistically positive and significant in 10 correlations among the examined items/states). Conclusions In conclusion, low-moderate positive correlations between sEMG and LPS ratings were found with particular strength for LPS ratings of tightness and ratings made during dynamic tasks. Further investigations can provide useful evidence for researchers and clinicians to document treatment outcomes by using LPS and sEMG in patients with MTD and leading to the more standardized care and improved information about patient progress.

Background Studies have reported contradictory findings regarding the efficacy of chemical mouthwashes for chemotherapy-induced oral mucositis. Objectives This study sought to compare the effect of the combined solution of grape vinegar and rose water versus chlorhexidine mouthwash on chemotherapy-induced oral mucositis. Methods 60 patients were randomly assigned to either chlorhexidine or the vinegar and rose water solution. Fifty-three patients completed the study. Patients rinsed their mouths with mouthwash three times a day for 14 days. Findings Chlorhexidine mouthwash and the grape vinegar and rose water solution decreased chemotherapy-induced oral mucositis. The therapeutic property of the grape vinegar and rose water solution was similar to that of chlorhexidine mouthwash in treating oral mucositis.

Coronavirus disease 2019 (COVID-19) is a worldwide public health problem that has attracted much attention due to its clinical findings. Measurement of IgG and IgM antibodies is of great importance for researchers and it will help to develop a new diagnostic and therapeutic method in clinical care. In this cross-sectional study, we aim to measure the IgG and IgM antibody levels in 401 suspected COVID-19 volunteers. We also measure the time duration for the appearance of IgG and IgM antibodies from the onset of symptoms to sampling time. Of 401 participants enrolled in the study, 255 (63.59%) were healthy, 79 (19.70%) were a carrier, 59 (14.71%) were cured and 8 (1.99%) were borderline. Of 142 subjects diagnosed with COVID-19, 41 (28.87%) presented with gastrointestinal (GI) symptoms, 83 (58.45%) had no GI symptoms, and 18 (12.68%) were asymptomatic. According to our findings, the measurement of IgG and IgM antibodies will provide the tool for the diagnosis of COVID-19 and significantly boost research into novel diagnostic and therapeutic approaches.

Micromixers have important applications in various pharmaceutical and medical fields. In the present study, the enhancement of mixing index in electroosmotic micromixer with different geometries is investigated. The commercial software COMSOL Multiphysics 5.4 is employed to solve the mathematical models. The SIMPLEC algorithm is employed for coupling the velocity and pressure fields. A second-order upwind scheme is used to reduce the artificial diffusivity. The results show a remarkable effect of the electric field on the mixing efficiency. The optimum geometry is the one with no obstacle in the mixing chamber. For the optimum geometry, it is demonstrated that the mixing efficiency increases with the voltage, however there are optimum values for frequency and inlet velocity in which the micromixer exhibits its best performance. The optimum values of frequency and inlet velocity are 8 Hz and 0.1 mm/s, respectively. It is revealed that the micromixer with no obstacle can reach the mixing efficiency of about 97%.

Objectives: This paper describes the validation process of the final form of the Persian version of the Overall Assessment of the Speaker Experience of Stuttering for Adults (OASES-A-P). The impact of stuttering on the Persian-speaking people who stutter was compared to other languages. Methods: This study with a cross-sectional design involved 92 Persian-speaking adults who stutter (24 females and 68 males; mean age=20.05±4.85 years). Face and content validity, internal consistency, test-retest reliability, and item analysis for discriminant validity were examined. The impact scores and impact ratings were calculated in total and for the sections separately. Results: Cronbach alpha and ICC proved to be high (0.98; 0.95, P

The purpose of this paper is to test the structural relationship of perceived value and tourist satisfaction with environmentally responsible behavior through the mediating role of tourist activity involvement in Alandan Lake located at Chahardangeh rural district in Sari, Iran. Regarding the goal, the current research is practical, and regarding the method of data collection, it is considered descriptive - correlation. The statistical population for the study consists of tourists who visited Alandan Lake. Participants were 200 Alandan tourists (113 male and 87 female) selected using convenience sampling method. All of the participants completed scales of perceived value, tourist satisfaction, environmentally responsible behavior and tourist activity involvement. Data were analyzed by the path analysis using LISREL software. The results showed that perceived value had a structural effect on environmentally responsible behavior. Perceived value by mediating tourist activity involvement had an indirect effect on environmentally responsible behavior. Moreover, tourist satisfaction had a direct effect on environmentally responsible behavior and also tourist satisfaction by mediating tourist activity involvement had an indirect effect on environmentally responsible behavior. Perceived value and tourist satisfaction can directly and by mediating tourist activity involvement influence environmentally responsible behavior.

BACKGROUND Considering the fact that both spreader flap and spreader graft techniques cause respiratory complications and yield different aesthetics results in patients undergoing open rhinoplasty, this study was aimed at comparing these 2 techniques in terms of aesthetics and respiratory side effects. METHODS The study was conducted on patients undergoing open rhinoplasty in Ardabil, Iran, during 2016 to 2017. During the Study, a questionnaire containing 7 items related to respiratory complications and 7 items related to aesthetics side effects was completed for each of the patients. After that, the patients were photographed from 6 standard views by the researchers and then the aesthetics side effects were assessed. Finally, the obtained data were all fed into SPSS Software Version 16 and the needed statistical analyses were conducted. RESULTS One hundred thirty patients were investigated in this study the majority of whom were female. Rhinoplasty in 69 of them was done with spreader graft technique and in 61 of them with spreader flap technique. The analysis of the side effects in these 2 groups of patients indicated that the use of spreader graft technique increases the incidence of nasal hump while the use of spreader flap technique results in an increase in the incidence of obstructive sleep apnea. As regards the other respiratory and aesthetics side effects, the 2 techniques did not yield significantly different results. CONCLUSION The findings of the present research indicated that there is no significant difference between the use of spreader graft and spreader flap techniques. Therefore, considering the clinical conditions of patients, either of the 2 techniques can be used effectively in rhinoplasties.

Objectives Laryngeal palpation is a routine clinical method for evaluation of patients with muscle tension dysphonia (MTD). The aim of this study was to develop a new comprehensive valid and reliable “laryngeal palpatory scale” (LPS), based on psychometric criteria. Methods The scale items were selected based on an in-depth analysis of the literature and an expert focus group. Scale item generation and item reduction were followed by a psychometric assessment. Qualitative and quantitative content validity (the content validity ratio (CVR), content validity index (CVI)), the qualitative face validity, and the inter-rater reliability were determined. For this purpose, 531 patients were assessed and finally 55 patients with primary MTD (26 women, mean age: 40.8 years, SD: 12.5; 29 male, mean age: 41.6 years, SD: 11.8) participated in the study. A weighted kappa (k*) statistic was used to examine the inter-rater reliability for each single item. Results Based on the CVR, three items were omitted because they had a score of less than 0.62. The CVI for all remaining items was greater than 0.79 and the scale CVI was equal to 0.96. The final 45 items were a result of the study. The inter-rater reliability for each single item ranged from 0.41 to 1, indicating moderate to almost perfect agreement. Conclusions The LPS is a reliable and valid instrument for assessing patients with MTD. However, future studies are needed to provide adequate data on sensitivity, specificity, concurrent validity, and cutoff scores.

Pluripotent cells appear to be in a transient state during early development. These cells have the capability to transition into embryonic stem cells (ESCs). It has been reported that mouse pluripotent cells cultivated in chemically defined media sustain the ground state of pluripotency. Because the epigenetic pattern of pluripotent cells reflects their environment, culture under different conditions causes epigenetic changes, which could lead to genomic instability. This study focused on the DNA methylation pattern of repetitive elements (REs) and their activation levels under two ground-state conditions and assessed the genomic integrity of ESCs. We measured the methylation and expression level of REs in different media. The results indicated that although the ground-state conditions show higher REs activity, they did not lead to DNA damage; therefore, the level of genomic instability is lower under the ground-state compared with the conventional condition. Our results indicated that when choosing an optimum condition, different features of the condition must be considered to have epigenetically and genomically stable stem cells.

A new bi-supported Ziegler–Natta catalyst was prepared successfully by supporting TiCl4 on the carbon black (CB) and magnesium dichloride. Then, this catalyst was used to prepare ultrahigh molecular weight polyethylene (UHMWPE) nanocomposites via in situ polymerization. The effects of difference molar ratios of triisobutylaluminum as activator to TiCl4, polymerization temperature, pressure of monomer and polymerization time on productivity of the catalyst were studied. The maximum activity was obtained at [Al]/[Ti] = 121:1. Increasing monomer pressure raised catalyst activity. Increasing temperature to 60 °C increased the polymerization yield; however, the higher temperature decreased the productivity of the catalyst. Scanning electron microscopic images showed that homogeneous dispersion of CB nanoparticles in the polymeric matrix was achieved without any agglomeration of CB. The crystallization behavior was evaluated using differential scanning calorimeter. The results showed that the crystallinity degree of UHMWPE slightly increased with increasing of CB, indicating that the CB acted as hindrance and nucleating agent. Furthermore, with introducing CB to polymeric matrix up to 1.6 wt%, the melting temperature and crystallization temperatures were slightly increased. The thermogravimetric analysis showed that incorporation of CB has improved thermal stability of polymeric matrix compared to pure UHMWPE. Viscoelastic properties were also investigated using dynamic mechanical thermal analysis. Obtained results showed that with introducing CB, the storage and loss modulus were improved especially at low temperatures and the glass transition temperature was slightly altered. Significant incensement in mechanical properties of the polyethylene was observed by adding nanofiller, in the other words, the presence of CB considerably improved tensile strength, Young’s modulus, and yield stress.

Background: In patients with the Congenital Sucrase-Isomaltase Deficiency (CSID), who lack intestinal sucrase-isomaltase enzyme, a suspension of yeast sucrase is applied as a drug to compensate the enzyme deficiency. While antipsychotic drugs are used for the treatment of schizophrenia, administering multiple drugs at the same time may counteract each other. Methods: In this study, the interaction between trifluoperazine and haloperidol as antipsychotic drugs on oral drug yeast sucrase was investigated. In this regard, the kinetic parameters of enzyme were determined in the presence or absence of the drugs. The kinetic parameters of the drugs such as Ki and IC50 were also calculated. Lineweaver - Burk plot was used to reveal the type of inhibition. Results: The results showed that both drugs could reduce sucrase activity and decrease the Vmax of the enzyme by non-competitive inhibition. The IC50 and Ki values of the drugs were determined to be 0.7 and 0.068 mM and 0.45 and 0.063 mM for haloperidol and trifluoperazine, respectively. The results suggested that trifluoperazine binds to the enzyme with higher affinity than haloperidol. Fluorescence measurement was used for conformational investigations of the drugs and sucrase interaction. It was shown that the drugs bind to free enzyme and enzyme-substrate complex which are accompanied with hyperchromicity. This suggests that tryptophan residues of the enzyme transferred to hydrophobic medium after binding of the drugs to the enzyme. Conclusion: The finding of this research revealed that both trifluoperazine and haloperidol could inhibit sucrase in non-competitive manner. The kinetic parameters and conformational changes due to binding of trifluoperazine to the enzyme were different from that of haloperidol.

Objective: To assess various antioxidative activities of Satureja khozestanica essential oil (SKE) and its effect on oxidation of low density lipoprotein (LDL) induced by CuSO4 in vitro by monitoring the formation of conjugated dienes and malondialdehyde (MDA). Methods: The formation of conjugated dienes, lag time and MDA were measured. Inhibition of this Cu-induced oxidation was studied in the presence of several concentrations of SKE. Also total antioxidant activity and free radical scavenging of SKE were determinated. Results: It was demonstrated that SKE was able to inhibit LDL oxidation and decrease the resistance of LDL against oxidation. The inhibitory effects of SKE on LDL oxidation were dose-dependent at concentrations ranging from 50 to 200 μg/mL. Total antioxidant capacity of SKE was (3.20依0.40) nmol of ascorbic acid equivalents/g SKE. The SKE showed remarkable scavenging activity on 2, 2-diphenyl- picrylhydrazyl, IC50 (5.30依0.11) ng/mL. Conclusions: This study shows that SKE is a source of potent antioxidants and prevents the oxidation of LDL in vitro and it may be suitable for use in food and pharmaceutical applications.

Introduction. Cardioprotective effect of high density lipoprotein (HDL) is, in part, dependent on its related enzyme, paraoxonase 1 (PON1). Fatty acid composition of HDL could affect its size and structure. On the other hand, PON1 activity is directly related to the structure of HDL. This study was designed to investigate the association between serum PON1 activity and fatty acid composition of HDL in healthy men.Methods. One hundred and forty healthy men participated in this research. HDL was separated by sequential ultracentrifugation, and its fatty acid composition was analyzed by gas chromatography. PON1 activity was measured spectrophotometrically using paraxon as substrate.Results. Serum PON1 activity was directly correlated with the amount of stearic acid and dihomo-gamma-linolenic acid (DGLA). PON1/HDL-C was directly correlated with the amount of miristic acid, stearic acid, and DGLA and was inversely correlated with total amount ofω6 fatty acids of HDL.Conclusion. The fatty acid composition of HDL could affect the activity of its associated enzyme, PON1. As dietary fats are the major determinants of serum lipids and lipoprotein composition, consuming some special dietary fatty acids may improve the activity of PON1 and thereby have beneficial effects on health.

Muscle tension dysphonia (MTD) is a functional dysphonia, which appears with an excessive tension in the intrinsic and extrinsic laryngeal musculatures. MTD can affect voice quality and quality of life. The purpose of the present study was to assess the effectiveness of vocal function exercises (VFEs) on perceptual and self-assessment ratings in a group of 15 subjects with MTD.The study comprised 15 subjects with MTD (8 men and 7 women, mean age 39.8 years, standard deviation 10.6, age range 24-62 years). All participants were native Persian speakers who underwent a 6-week course of VFEs. The Voice Handicap Index (VHI) (the self-assessment scale) and Grade, Roughness, Breathiness, Asthenia, Strain (GRBAS) scale (perceptual rating of voice quality) were used to compare pre- and post-VFEs.GRBAS data of patients before and after VFEs were compared using Wilcoxon signed-rank test, and VHI data of patients pre- and post-VFEs were compared using Student paired t test. These perceptual parameters showed a statistically significant improvement in subjects with MTD after voice therapy (significant at P 0.05 (*) and P 0.004 (**)). Also results indicated statistically noticeable reduction in the mean VHI scores across subjects with MTD (significant at P 0.05 (*) and P 0.004 (**)).Significant improvement after therapy for participants has been observed by the aid of auditory-perceptual ratings of voice quality (with the GRBAS scale) and the patient's self-assessment ratings measurements (with the VHI). As a result, the data provide evidence regarding the efficacy of VFEs in the treatment of patients with MTD.

Simmary Objective Vowel production in essence is auditorily controlled; hence, the role of the auditory feedback in vowel production is very important. The purpose of this study was to compare formant frequencies and vowel space in Persian-speaking deaf children with cochlear implantation (CI), hearing-impaired children with hearing aid (HA), and their normal-hearing (NH) peers. Methods A total of 40 prelingually children with hearing impairment and 20 NH groups participated in this study. Participants were native Persian speakers. The average of first formant frequency (F 1 ) and second formant frequency (F 2 ) of the six vowels were measured using Praat software (version 5.1.44). One-way analysis of variance (ANOVA) was used to analyze the differences between the three3 groups. Results The mean value of F 1 for vowel /i/ was significantly different (between CI and NH children and also between HA and NH groups) (F 2, 57 = 9.229, P 1 was significantly different (between HA and NH groups) (F 2, 57 = 3.707, P post hoc Tukey test revealed that the differences were between HA and NH children ( P 2 for vowel /o/ was significantly different (F 2, 57 = 4.572, P 2 for vowel /a/ was significantly different (F 2, 57 = 3.184, P Conclusion About 1 year after implantation, the formants shift closer to those of the NH listeners who tend to have more expanded vowel spaces than hearing-impaired listeners with hearing aids. Probably, this condition is because CI has a subtly positive impact on the place of articulation of vowels.

Summary Objectives Phonation is influenced by hearing as a feedback mechanism. The purpose of the present study was to compare selected acoustic parameters in children using cochlear implants (CIs), those using hearing aids (HA), and their normal-hearing (NH) peers. Methods The participants were 15 children using CI (mean age: 72 months), 15 children using HA (mean age: 74 months), and 15 NH children (mean age: 77 months). The vowel /a/ was produced to measure perturbation and mean fundamental frequency. The six Persian vowels in /C b VC d / were obtained to extract vowel duration. Data were analyzed by one-way analysis of variance. Results Results revealed a statistically significant difference between the NH group and the HA group regarding fundamental frequency ( F 2,51 = 3.443, P F 2,51 = 1.629, P F 2,51 = 6.519, P F 2,51 = 7.151, P F 2,51 = 5.894, P F 2,51 = 8.070, P F 2,51 = 3.884, P F 2,51 = 4.926, P F 2,51 = 8.442, P F 2,51 = 4.117, P P Conclusion It seems that after 8 months of using CI, auditory control of voice production would be enabled. Furthermore, children with hearing impairment potentially regard vowel sound duration as a distinguishing feature, whereas in NH speakers, the duration has the least effect in vowel identification.

Teachers are at high risk of developing voice problems because of the excessive vocal demands necessitated by their profession. Teachers' self-assessment of vocal complaints, combined with subjective and objective measures of voice, may enable better therapeutic decision-making. This investigation compared audio-perceptual assessment and acoustic variables in teachers with and without voice complaints.Ninety-nine teachers completed this cross-sectional study and were assigned to one of two groups: those "with voice complaint (VC)" and those "without voice complaint (W-VC)." Voice samples were collected during reading, counting, and vowel prolongation tasks. Teachers were also asked to document any voice symptoms they experienced. Voice samples were analyzed using Dr. Speech program (4th version; Tiger Ltd., USA), and labeled "normal" or "abnormal" according to the "grade" dimension "G" from GRBAS scale.Twenty-one teachers were assigned to the VC group based on self-assessment data. There were statistically significant differences between the two groups with regard to self-reported voice symptoms of hoarseness, breathiness, pitch breaks, and vocal fatigue (P 0.05). Fourteen participants in the VC group and 40 from the W-VC group were determined to demonstrate "abnormal" vocal quality on perceptual assessment. Only harmonic-to-noise ratio was significantly higher for the W-VC group (ES = 0.55).Teachers with and without voice complaints differed in the incidence, but not type of voice symptoms. Teachers' voice complaints did not correspond to perceptual and acoustic measures. This suggests a potential unmet need for teachers to receive further education on voice disorders.

Summary Objective Normal-hearing (NH) acuity and auditory feedback control are crucial for human voice production and articulation. The lack of auditory feedback in individuals with profound hearing impairment changes their vowel production. The purpose of this study was to compare Persian vowel production in deaf children with cochlear implants (CIs) and that in NH children. Methods The participants were 20 children (12 girls and 8 boys) with age range of 5 years; 1 month to 9 years. All patients had congenital hearing loss and received a multichannel CI at an average age of 3 years. They had at least 6 months experience of their current device (CI). The control group consisted of 20 NH children (12 girls and 8 boys) with age range of 5 to 9 years old. The two groups were matched by age. Participants were native Persian speakers who were asked to produce the vowels /i/, /e/, /ӕ/, /u/, /o/, and /a/. The averages for first formant frequency ( F 1 ) and second formant frequency ( F 2 ) of six vowels were measured using Praat software (Version 5.1.44, Boersma & Weenink, 2012). The independent samples t test was conducted to assess the differences in F 1 and F 2 values and the area of the vowel space between the two groups. Results Mean values of F 1 were increased in CI children; the mean values of F 1 for vowel /i/ and /a/, F 2 for vowel /a/ and /o/ were significantly different ( P F 1 and F 2 showed a centralized vowel space for CI children. Conclusions F 1 is increased in CI children, probably because CI children tend to overarticulate. We hypothesis this is due to a lack of auditory feedback; there is an attempt by hearing-impaired children to compensate via proprioceptive feedback during articulatory process.

Objective Muscle biopsy is a very important diagnostic test in the investigation of a child with suspected neuromuscular disorder. The goal of this study was to review and evaluate pediatric muscle biopsies during a 2-year period with focus on histopathology diagnosis and correlations with other paraclinic studies. Materials & Methods We investigated 100 muscle biopsies belonging to patients with clinical impression of neuromuscular disorder. These patients have been visited consecutively by pediatric neurologists during 2010 to 2012. Samples were investigated by standard enzyme histochemical and immunohistochemical techniques. Result Sixty-nine (69%) males and 39 (39%) females with a mean age of 5.7 years were evaluated. Major pathologic diagnoses were Muscular dystrophy (48 cases), Neurogenic atrophy (18 cases), nonspecific myopathic atrophy (12cases), congenital myopathy (6 cases), storage myopathies (4 cases) and in 6 cases there was no specific histochemical pathologic finding. EMG was abnormal in 79 cases. Degree of correlation between EMG and biopsy result was significant in children ≥ 2 years of age. Conclusion This study confirms the high diagnostic yields of muscle biopsy especially only if standard and new techniques such as enzyme study and immunohistochemistry are implemented. Also, we report 11 cases of Merosin negative congenital muscular dystrophy. This is the largest documented case series of Merosin deficient congenital muscular dystrophy reported from Iran.

This study aims at finding the effect of group work on Iranian EFL learners' writing accuracy. Moreover, the effect of gender on text production has also been investigated. Over a month, sixty Iranian EFL learners were chosen as the participants of this study. They were divided into two groups. The experimental group wrote collaboratively while the control group underwent individual writing tasks. Both groups participated in four essay writing sessions. The participants wrote on the same topics and genre. The results revealed that the students in the collaborative writing group outperformed the students in the control group, hence emphasizing the significant role of collaboration in L2 writing. Regarding gender effect, the data analysis showed the females in the collaborative group outperformed males in the same group proving that gender plays a significant role in Iranian EFL collaborative writing setting. The results have some implications for English writing instructors and learners.