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Background. Adequate physical activity is essential to healthy aging. This study aimed to examine the construct validity of the Persian version of the Physical Activity Scale for the Elderly (PASE) among community-dwelling adults, which would be used as a screening tool at the Neyshabur longitudinal study on the aging (NELSA) Center. Methods. This cross-sectional study was conducted in Neyshabur, Iran, as a pilot phase at the NELSA center between May and January 2019. The sampling method was a stratified random method. For explanatory factor analysis (EFA) and confirmatory factor analysis (CFA), 300 and 650 community-dwelling adults aged 50 and older were selected, respectively. EFA was used with the principal component extraction method, and Varimax rotation and CFA were performed with the maximum likelihood estimation method. Results. Of the 950 participants, 445 (46.8%) were male, and 505 (53.2%) were female. The mean age of participants was 63 ± 8.6 years. The mean physical activity score was 89.7 ± 70.7. According to the percentage of variance explained in EFA, all five extracted factors explained 62.7% of the total variance. The results of CFA showed that all item-scale relationships were significant (P < 0.05), except for household activity (Q8) and leisure time activity (Q2) (P > 0.05). The values of the fit indices showed that the model fits well with the data. Conclusion. The EFA and CFA confirmed the construct validity of the Persian version of PASE. This questionnaire is suitable for measuring the physical activity level of older Persian adults. Practical Implications. The Persian version of PASE is suitable for measuring the physical activity level of older Persian adults.

Background. Understanding the complex interplay of faculty members’ personality traits is essential for optimizing teaching and learning environments. To this end, this study investigated and prioritized the impact of personality dimensions (personal, scientific, and professional) related to the teaching of faculty members on the learning of students. Methods. The current study was conducted with a practical purpose using a meta-synthesis coding method, specifically theme analysis. This method discovers new and fundamental topics and metaphors by providing a systematic approach for researchers through the combination of different studies, expands the current knowledge, and provides a comprehensive view of the issues. Results. Out of a total 114 articles , number of 85 codes, 10 concepts and 3 components were identified concerning the personality dimensions of university professors. Based on the findings, the codes of "teaching skills", "research skills", "interactive ability", and "individual ability" were the most frequent components of the personality dimensions of faculty members. Conclusion. According to the findings, universities should pay special attention to academic mastery, eloquence, and interest in teaching when recruiting faculty members. Additionally, it is important to plan and organize teaching empowerment workshops for them. This leads to more satisfaction among students and improves the quality of teaching and learning. Therefore, the findings of this study can be used in the policymaking of ministries and universities when recruiting faculty members.

Abstract Background Considering the values and preferences of individuals who attempt to quit smoking is a crucial step in the development of smoking cessation technologies. This study aimed to explore preferences regarding smart smoking cessation technologies. Methods This parallel convergent mixed-methods study was conducted in two phases: quantitative and qualitative. In the quantitative phase, a cross-sectional study was conducted with 360 participants selected through stratified random sampling from technology-based smoking cessation clinics in Tabriz, Tehran, and Karaj cities in Iran. Data on demographic characteristics and preferences for smart smoking cessation technologies were collected using questionnaires and analyzed using descriptive statistics. In the qualitative phase, 25 users of these technologies were selected through purposeful and snowball sampling. The data were gathered through in-depth semistructured interviews and analyzed using qualitative content analysis with a conventional approach. Quantitative and qualitative data were integrated using the merging strategy and convergence model. Results The quantitative phase results indicated that the highest preference was related to wearing and using a smartwatch for smoking cessation and using mobile apps. In the qualitative phase, 17 subcategories were extracted and classified into 8 main categories: high effectiveness, better management of the smoking cessation process, personalized technology, safe and uncomplicated technologies, attractiveness and innovative design, scientific basis, mobile applications, and smart monitoring devices. Conclusion By combining and integrating quantitative and qualitative results, it can be concluded that users are more interested in wearable technologies and interactive mobile applications. The findings of this study can assist smoking cessation technology developers in designing and improving their tools based on user needs and preferences to enhance their effectiveness and acceptability.

Background: Pentoxifylline has anti-inflammatory effects in end stage renal disease (ESRD) patients and may play an important role in reducing inflammatory factors and improving quality of life (QoL) in hemodialysis (HD) patients. Methods: In this randomized placebo-controlled trial 88 chronic hemodialysis patients were divided into two groups with equal numbers. Intervention group received tablet pentoxifylline 400 milligrams and control group received the matching placebo, daily for 3 months. At baseline and after 3 months, inflammatory factors including serum levels of tumor necrosis factor-alpha (TNF-a) and C-reactive protein (CRP) were measured. Also, the Medical Outcome Study 36-Item Short-Form Health Survey (SF-36) quality of life (QoL) questionnaire was completed by each patient at the beginning and end of the study. Results: Significant reduction in serum levels of TNF-a, CRP as well as substantial improvement of all dimensions of QoL were observed in intervention group after 3 months of pentoxifylline treatment (P = 0.04; P

Abstract Objective The aim of the present study was the association between the relationship between Dietary Quality Index-International (DQI-I) and Healthy Eating Index (HEI) and the urinary levels of F2alpha-isoprostane (F2a-IP) and 8-hydroxy-2’-deoxyguanosine (8-OHdG) was investigated as indicators of oxidative stress. Results Based on HEI (low, moderate, and good), the diet quality of both groups was classified as moderate. In all participants, HEI (β=-0.29; P = 0.04) and DQI-I (β=-0.46; P = 0.005) were inversely associated with 8-OHdG. Furthermore, a negative correlation was found between HEI (mean β=-3.53; P = 0.04) and DQI-I (mean β=-5.53; P = 0.004) with F2a-IP. The quality of the footballers’ diet was higher than that of the control group. Following a high-quality diet, which is rich in antioxidants, is likely to effectively reduce oxidative stress.

Abstract Background Appreciating the various dimensions of the coronavirus disease 2019 (COVID-19) pandemic can improve health systems and prepare them to deal better with future pandemics and public health events. This study was conducted to investigate the association between the survival of hospitalized patients with COVID-19 and the epidemic risk stratification of the disease in Golestan province, Iran. Methods In this study, all patients with COVID-19 who were hospitalized in the hospitals of Golestan province of Iran from February 20, 2020, to December 19, 2022, and were registered in the Medical Care Monitoring Center (MCMC) system (85,885 individuals) were examined.The community's epidemic risk status (ERS) was determined based on the daily incidence statistics of COVID-19. The survival distribution and compare Survival in different subgroups was investigated using Kaplan–Meier and log-rank test and association between the survival and ERS by multiple Cox regression modeling. Results Out of 68,983 individuals whose data were correctly recorded, the mean age was 49 (SD = 23.98) years, and 52.8% were women. In total, 11.1% eventually died. The length of hospital stay was varying significantly with age, gender, ERS, underlying diseases, and COVID-19 severity (P

Introduction: Percutaneous Coronary Intervention (PCI) is a fundamental procedure for coronary artery disease management, yet the risk of adverse events such periprocedural myocardial injury (PMI) persists. This double-blind, randomized clinical trial aims to assess the efficacy of empagliflozin in preventing myocardial injury during PCI procedure. Methods: A total of 90 patients were randomly assigned to two groups A and B; Group A as the intervention group received empagliflozin 25 mg 24 hours before and empagliflozin 10 mg 1-2 hours before coronary intervention and group Bas the control group received placebo at similar intervals. The primary outcome involved comparing baseline, 8-hour, and 24-hour cTnI and baseline and 24-hour hs-CRP levels after PCI in both groups to measure the incidence of periprocedural myocardial injury (PMI) and anti-inflammatory effects of empagliflozin. Results: Baseline cTnI levels with P=0.955, 8 hours after PCI with P=0.469, and 24 hours after the intervention with P=0.980 were not statistically different in the two groups. Baseline levels of hs-CRP in both intervention and control groups were not statistically significantly different (P=0.982). Also, there was no statistically significant difference in hs-CRP levels 24 hours after PCI in two groups (P=0.198). Finally, the results showed that MACEs did not occur in any of the groups. Conclusion: The results of this trial could not express the advantages of acute pretreatment with empagliflozin in preventing PCI-related myocardial injury.

Background: Diagnostic thinking and clinical competence are the two main domains of efficient nursing care. This study assessed the association between diagnostic thinking and clinical competence among emergency nurses. Methods: The present correlation study was conducted in 2020 on 113 nurses working in emergency departments in a northwestern province of Iran over two consecutive years. A stratified random sampling method was used for recruiting nurses. Data was gathered via a demographic questionnaire, the Diagnostic Thinking Inventory, and the Nurse Competence Scale and analyzed using the SPSS 18 software. Pearson's correlation assessed the association between the nurses' diagnostic thinking and clinical competence at a significance level of 0.05. Results: According to the findings, the nurses’ diagnostic thinking abilities were poor (154.15 ±15.73, range of 150-155), while their clinical competence was good (61.62±18.97, range of 51-75). Significant correlations emerged between thinking flexibility, work role (r=0.22, p=0.017), and memory structure. In addition, thinking flexibility was significantly associated with work role (r=0.22, P=0.017), and memory structure was correlated with teaching-coaching function (r=0.22, P=0.015), diagnostic functions (r=0.25, P=0.006), management of situations (r=0.45, P=0.0001), therapeutic interventions (r=0.42, P=0.0001), regimens (r=0.18, P=0.056), and work role (r=0.4, P=0.0001). Conclusion: Amplifying thinking procedures and using diagnostic thinking patterns enhance emergency nurses' practice, performance, and clinical competence and promote nursing care. Lecturers and planners must employ modern educational methods to increase nurses' thinking skills and clinical competence.

Abstract Background Emergency ward nurses face a variety of occupational hazards due to the nature of their occupational and professional duties, which can negatively affect their health. Therefore, this study aimed to evaluate the effects of an educational intervention based on the protection motivation theory on the protective behaviors of emergency ward nurses against occupational hazards in Tehran, Iran, in 2023. Methods The present quasi-experimental study was conducted with two intervention and control groups, using a pretest-posttest design. A total of 124 nurses working in the emergency wards of four hospitals (two hospitals for the intervention group and two hospitals for the control group by random assignment) were selected by multistage sampling method. The educational intervention based on the protection motivation theory was implemented for the intervention group for three weeks. The nurses of both groups completed a demographic questionnaire and the scale of emergency ward nurses’ protective behaviors against occupational hazards before, immediately, and one month after the intervention. Data analysis was performed using descriptive and inferential methods. Results The two groups were similar in terms of demographic characteristics at the baseline (p > 0.05). Protective behaviors of emergency nurses against occupational hazards and their sub-scales (physical, chemical, biological, ergonomics, and psychosocial hazards) were higher in the intervention group than in the control group immediately and one month after the educational intervention. In addition, the measurement over time also showed the positive effect of time and educational intervention on the protective behaviors of emergency nurses against occupational hazards and their sub-scales in the intervention group. Conclusion These findings showed that the educational intervention based on the protection motivation theory can be effective and helpful in improving the protective behaviors of emergency ward nurses against occupational hazards and their sub-scales. Future studies can focus on a more specific design of this kind of intervention based on the type of occupational hazards and needs of nurses in different wards.

Objective To examine the relationship between burnout and occupational fatigue exhaustion and recovery among orthopaedic nurses in Tabriz, Iran.Design Descriptive, cross-sectional survey and correlational analysis.Setting Two hospitals associated with Tabriz University of Medical Sciences, Iran, from August to September 2022.Participants 92 bedside nurses in orthopaedic wards, each with >1 year of clinical experience.Outcome measures Burnout was assessed using the Copenhagen Burnout Inventory, and occupational fatigue exhaustion/recovery was measured with the Occupational Fatigue Exhaustion/Recovery Scale. Pearson’s correlation, independent t-test, one-way analysis of variance and multivariable linear regression analyses determined statistical significance.Results The mean burnout score was 63.65 (±15.88) out of 100 and the recovery rate was 35.43 (±15.60) out of 100. There were significant correlations between total burnout and each of the exhaustion recovery dimensions: chronic fatigue (r=0.70), acute fatigue (r=0.65) and intershift recovery (r=0.56). Nurses exceeding 44 weekly work hours reported higher burnout (66.52±14.77, p=0.005) than those working fewer hours (56.25±16.12, p=0.005). Rotational shift status was associated with increased burnout (64.97±15.32) compared with fixed shifts (55.54±17.42, p=0.04). Chronic fatigue (B=0.39, 95% CI 0.21, 0.57; t=4.29, p

Background: Uncertainty is a common challenge for nurses in clinical decision-making, which can compromise patient care quality and safety. To address this issue, it is essential to understand how nurses perceive and cope with uncertainty in their practice. Aim: This study aimed to explore nurses’ perceptions of uncertainty in clinical decision-making using a qualitative approach. Methods: This study was conducted with a qualitative approach and conventional content analysis in 2020. Participants consisted of 17 nurses from different wards of teaching hospitals in Northwestern Iran, recruited using the purposive sampling method. Data were collected through semi-structured interviews and analyzed simultaneously with data collection (June to December 2020). The data were analyzed using the content analysis approach suggested by Wildemuth. Data were managed with MAXQDA10 software. The analysis revealed four main themes and ten subthemes that described the nurses' experiences of uncertainty in clinical decision-making. Results: The main themes were: difficult choice, difficult situation, insufficient judgment, and emotional burden. Conclusions: The study participants defined uncertainty in clinical decision-making as a difficult choice that occurs in difficult situations, which influenced their clinical judgment and emotional well-being. These findings provide valuable insights for developing interventions to help nurses manage uncertainty and improve their decision-making skills and safety.

Background: The COVID-19 pandemic has had a profound impact globally, presenting significant social and economic challenges. This study aims to explore the factors affecting mortality among hospitalized COVID-19 patients and construct a machine learning-based model to predict the risk of mortality. Methods: The study examined COVID-19 patients admitted to Imam Reza Hospital in Tabriz, Iran, between March 2020 and November 2021. The Elastic Net method was employed to identify and rank features associated with mortality risk. Subsequently, an artificial neural network (ANN) model was developed based on these features to predict mortality risk. The performance of the model was evaluated by receiver operating characteristic (ROC) curve analysis. Results: The study included 706 patients with 96 features, out of them 26 features were identified as crucial predictors of mortality. The ANN model, utilizing 20 of these features, achieved an area under the ROC curve (AUC) of 98.8 %, effectively stratifying patients by mortality risk. Conclusion: The developed model offers accurate and precipitous mortality risk predictions for COVID-19 patients, enhancing the responsiveness of healthcare systems to high-risk individuals.

Background & Aim: Stroke, as the primary and most critical cerebrovascular condition, is known as a leading cause of disability and mortality. Timely and appropriate care plays an important role in reducing death and associated complications. The purpose of this research is to assess the knowledge and adherence of emergency nurses to tissue plasminogen activator guidelines for patients with stroke. Methods & Materials: In this descriptive study, a random quota sampling method was employed to select participants. A total of 170 emergency department nurses in Tabriz hospitals in 2023 self-administered knowledge and adherence scales. Data were analyzed using SPSS version 26, employing t-test, one-way ANOVA and Pearson’s correlation coefficient. Results: The mean (SD) age of the nurses was 34.24±6.57 years, with a majority (101 nurses, 59.4%) having completed courses on the process and activation of Code-724. The mean scores for nurses' knowledge and adherence to tissue plasminogen activator guidelines were 52.67±10.37 (range score: 0-100) and 68.14±5.18 (range score: 15-75), respectively. A positive yet weak relationship was observed between nurses' knowledge and adherence to the guidelines (r=0.263, P=0.332). No significant association was found between nurses' socio-demographic characteristics and their knowledge and adherence scores (P>0.05). Conclusion: The findings revealed suboptimal scores in nurses' knowledge and adherence to tissue plasminogen activator guidelines for stroke patients. Given the importance of adequate knowledge for adherence to guidelines, it is suggested to implement essential training and supervision measures for nurses.

Abstract Background Preeclampsia is a significant complication that occurs during the second half of pregnancy. Recent studies have indicated that dietary factors play a crucial role in the development of preeclampsia. The Diet Quality Index-International (DQI-I) and Dietary Diversity Score (DDS) are appropriate indices for assessing the quality of foods, meals, and diets. This study aimed to investigate the relationship between DQI-I, DDS, and preeclampsia. Methods This study utilized a case-control design. A total of 90 newly diagnosed preeclampsia cases and 90 healthy controls were included from a referral hospital in Tabriz, Iran. DQI-I and DDS were calculated based on information obtained from a reliable Food Frequency Questionnaire consisting of 168 food items, which assessed participants’ usual diet. Logistic regression analysis adjusted for age, body mass index, education, family history of preeclampsia, and total energy intake was used to estimate odds ratios (ORs). Results The mean age and pre-pregnancy body mass index of the participants were: 27.14 ± 4.40 years and 26.09 ± 3.33 kg/m2, respectively. After adjusting for various confounders, we found significant inverse association between the risk of developing preeclampsia and both DQI-I and DDS. The highest quartile of DQI-I had a significantly lower risk of developing preeclampsia compared to the first quartile (OR = 0.02, 95% CI [0.005, 0.08]) (P

Background & Aims Emergency department nurses should be trained people with high knowledge, skills, innovativeness, and ablity to judge and make decisions in critical clinical situations. This study aims to determine clinical reasoning level and its relationship with innovation in nurses working in the emergency departments of hospitals in Tabriz, Iran. Materials & Methods In this descriptive-correlational study conducted in autumn 2021, 170 nurses working in all emergency departments of hospitals in Tabriz city were included by stratified random sampling method. Data were collected using Liou et al.’s clinical reasoning scale and the Hurt-Joseph-Cook innovativeness Scale. The data analysis was done using Pearson correlation test, t-test, ANOVA, and linear regression analysis in SPSS software, version 26. Results The mean age of participants was 34.54±6.97; most of them were female (56.5%) and married (69.4%) with permament employment (56.5%). The mean scores of clinical reasoning and innovation were 60.91±7.079 (Ranged 15-75), and 102.11±10.26 (Ranged 20-140), respectively. The results showed a significant relationship between clinical reasoning and innovation (P

Abstract Proper nutrition plays a vital role in modulating oxidative status. There is an increasing popularity of plant-based dietary patterns among athletes. Therefore, the present study aimed to determine the plant-based diet index (PDI) score among male footballers and their non-athlete controls, as well as its relationship with oxidative biomarkers by evaluating the urinary excretion of F2alpha-isoprostane (F2a-IP) and 8-hydroxy-2′-deoxyguanosine (8-OHdG). A group of footballers (n = 45) and a healthy non-athlete group (n = 45) were selected. The two groups were matched based on body mass index (BMI) and age. The mean (standard deviation (SD)) age of the subjects was 22.88 (2.41) years, and their BMI was 22.08 (1.35) kg/m2. Anthropometric indices were evaluated, and fasting morning urine samples were analyzed to measure oxidative biomarkers. The PDI, unhealthy plant-based diet index (uPDI), and healthy plant-based diet index (hPDI) were calculated using valid food frequency questionnaire data. Generalized estimating equation models were used for all analyses. Compared to the non-athlete group, the PDI score was significantly greater in the footballer group (β = 9.8; P

Aim: Traffic accidents are caused by several interacting risk factors. This study aimed to investigate the interactions among risk factors associated with death at the accident scene (DATAS) as an indicator of the crash severity, for pedestrians, passengers, and drivers by adopting “Logic Regression” as a novel approach in the traffic field. Method: A case-control study was designed based on the police data from the Road Traffic Injury Registry in northwest of Iran during 2014–2016. For each of the pedestrians, passengers, and drivers’ datasets, logic regression with “logit” link function was fitted and interactions were identified using Annealing algorithm. Model selection was performed using the cross-validation and the null model randomization procedure. Results: regarding pedestrians, “The occurrence of the accident outside a city in a situation where there was insufficient light” (OR = 6.87, P-value

Objectives During the last two decades, cigarette smoking witnessed a global increase in use, especially among youth. Loneliness is one of the possible psychosocial determinants of smoking. This study examined the association between loneliness and attitudes towards cigarette smoking among university students of Iran.Design Cross-sectional study.Setting and participants This study was conducted among 538 university students, who were recruited using the cluster random sampling method. Loneliness and smoking attitudes of the samples were assessed using the revised version of the University of California Los Angeles Loneliness Scale and the Scale of Cigarette Smoking Attitude (CSA). Descriptive statistics, Pearson’s correlation coefficient and multivariable regression analysis were used to analyse the data.Results From a total of 538 participants, 301 (59.9%) students were young women. The mean age of the students was 22.2±2.9 years. Only 56 (10.4%) of the students were married and 370 (87.9%) of them were lived with their families. 131 (24.3%) students experienced cigarette smoking. In terms of university-related characteristics, 205 (38.1%) of the students studied in the faculty of medicine. Also, 30% of the students had a positive or indifferent attitude towards smoking, while 26.4% of the students reported feeling lonely. The mean scores for loneliness and CSA were 41.42±11.29 and 48.64±11.2, respectively. Statistically, a significant positive correlation was found between loneliness and CSA (r=0.289; p

Background & Aims: Although most countries have long used female staff for prehospital emergency medical services (EMS), this is quite a recent development for the Iranian health system. It is hence necessary to analyze the perspectives of its recipients about the feasibility of assigning female staff to prehospital EMS to improve this service and compare it with other countries. This study aimed to design and evaluate the psychometric properties of a scale for assessing the feasibility of using female staff in prehospital EMS. Materials & Methods: This was a methodological study. The literature was reviewed to develop items for the scale. The scale's content validity index (CVI) was then evaluated based on expert opinions, and its face validity was examined by eliciting comments from the target group and experts. Following that, 456 EMS recipients from East Azerbaijan Province, Iran, completed the electronic version of the scale. Finally, the construct validity and reliability of this scale were determined using exploratory factor analysis (EFA) and internal consistency (Cronbach's alpha), respectively. Results: The findings confirmed the scale's high content validity and internal consistency, as well as its acceptable face validity. The EFA findings also revealed three factors, all of which were based on primary domains: the need for engagement (17 items), groundwork (14 items), and staffing (9 items). Conclusion: The study's findings suggested that the intended scale's design and psychometric properties were appropriate for Iranian culture. Therefore, it can be used to examine public opinion before, during, and after the inclusion of female personnel in prehospital EMS.

Introduction: Acknowledging the considerable influence of undernutrition on health outcomes and HRQOL, this study sought to appraise the nutritional risk status of elderly patients with cardiovascular diseases (CVD) through the utilization of the Nutritional Risk Screening (NRS). Additionally, the investigation aimed to evaluate the correlation between NRS status and HRQOL within the context of patients referred to a cardiac hospital in Tabriz, Iran. Methods: This cross-sectional study was conducted in Tabriz, Iran. The participants were selected randomly from patients referring to Shahid Madani Heart Hospital, a comprehensive university hospital during July to December 2018. A linear regression was used for control of confounding variables (age, gender, education level, marital status, and income levels) and predict the relationship between nutrition risk status and HQRL. Results: Of the 200 patients with CVD participated in this study, 68 (34%) of participants had normal nutrition status, 108 (54%) were at risk for undernutrition, and 24 (12%) had undernutrition. A total of 24 aging patients with undernutrition, 13 (54%) were divorced or widowed. 86% of patients with diabetes were at risk for undernutrition and 13.9% had undernutrition. There were statistically significant relationship between undernutrition and HRQOL dimensions, age, gender, and marital status. Conclusion: The study revealed a correlation between elevated undernutrition scores in patients and factors such as older age, female gender, and marital status of being divorced or widowed. Furthermore, the results imply that a notable elevation in the risk score for undernutrition in patients is significantly linked to impaired HRQOL among elderly individuals with CVD.

Background. Using personal protective equipment, including masks, is one of the most important ways to prevent coronavirus disease 2019 (COVID-19). The aim of this study was to estimate the prevalence and pattern of mask use and its association with COVID-19-related morbidity and mortality in different areas of Tabriz, Iran. Methods. In this population-based study, 6,600 pedestrians were selected by multi-stage proportional sampling method in nine areas of Tabriz in 2021. The data was collected using the observation method. For each participant, we recorded gender, approximate age, mask usage, type of mask, and correct or incorrect use. The data of COVID-19-related morbidity and mortality for six months (from 21 March 2021 to 22 September 2021) were obtained from the Integrated Syndromic Surveillance System (ISSS). Results. The overall prevalence of facial mask use was 56.8% (95% CI: 55.56 – 57.95). Out of 3,421 men, 1,599 (46.7%; 95% CI: 45.1-48.4) and out of 3,179 women, 2,147 (67.5%; 95% CI: 65.9-69.2) were used face mask (P

Abstract Background Breast cancer may negatively affect people’s quality of life. We investigated the predictors of quality of life in women with breast cancer with the mediating role of resilience. Method In a cross-sectional design, 218 patients completed a survey referring to the Valiasr International Hospital Oncology Center in Tabriz, Iran. Four validated self-report measures assessed HRQoL as measured by the SF-12, Resilience, Hope, and Perceived Social Support (MSPs). The mediating roles of resilience between HRQoL and the fitness of the proposed model were investigated using path analysis. SPSS version 24 software and Lisrel 8.8 software were used for data analysis. Results The results of path analysis showed that the final model had a good fit to the data (Chi-Square/ degrees of freedom (Normed Chi2) = 2.08, RMSEA = 0.014, goodness fit index = 0.99, both comparative fit index = 0.99 both CFI = 0.99 and IFI = 1). In this model, age and psychosocial factors predicted health-related quality of life. Conclusions Age and psychosocial factors especially social support are important components in predicting health-related quality of life among those suffering from breast cancer.

Abstract Background Dietary patterns that include high-quality and varied food groups have the potential to modulate oxidative status. This research was conducted to determine dietary diversity score (DDS) and food quality score (FQS) in football players and their matched non-athletes, also their associations with oxidative indicators assessed by the urinary levels of F2alpha-isoprostane (F2a-IP) and 8-hydroxy-2'-deoxyguanosine (8-OHdG). Methods Participants consisted of 45 male football players and 45 male non-athletes in two age-and body mass index (BMI)-matched groups from Shiraz City, Iran. Anthropometric measurements were performed, and urine samples were analyzed to determine oxidative biomarkers. Dietary data derived from a reliable food frequency questionnaire with 168 items was completed to determine DDS and FQS. For data analysis, an appropriate generalized estimating equation model was set up. Results Our results demonstrated that FQS (β = 5.46; P

Abstract Background Patients with acute myocardial infarction are at greater risk for chronic heart failure and mortality. Currently, there is limited evidence supporting the beneficial effects of sodium-glucose cotransporter-2 inhibitors on cardiovascular outcomes in non-diabetic patients with reduced left ventricular ejection fraction following acute myocardial infarction. Furthermore, the clinical effects of the combination of standard-dose sodium-glucose cotransporter-2 inhibitors with colchicine and high-dose sodium-glucose cotransporter-2 inhibitors in this setting have not been evaluated yet. Methods A prospective, double-blinded, parallel-group, placebo control randomized trial will be carried out at Shahid Madani Heart Center, the largest teaching referral hospital for cardiovascular diseases, affiliated with Tabriz University of Medical Sciences. A total of 105 patients with reduced left ventricular ejection fraction (≤ 40%) following the first episode of ST-elevation myocardial infarction undergoing primary percutaneous coronary intervention with stent insertion will be randomized 1:1:1 to receive empagliflozin 10 mg daily, a combination of empagliflozin 10 mg daily and colchicine 0.5 mg twice daily, or empagliflozin 25 mg daily for 12 weeks. The primary outcomes are changes in the New York Heart Association functional classification and high-sensitivity C-reactive protein from the randomization through week 4 and week 12. Discussion The present study will be the first trial to evaluate the efficacy and safety of early treatment with the combination of standard-dose empagliflozin and colchicine as well as high-dose empagliflozin in non-diabetic patients with reduced left ventricular ejection fraction following ST-elevation myocardial infarction. The results of this research will represent a significant step forward in the treatment of patients with acute myocardial infarction. Trial registration Clinical trial ID: IRCT20111206008307N39. Registration date: 27 October 2022. Graphical Abstract

Background: The topical application of boron has been significantly associated with intensifying wound healing. Using 3% boric acid in deep wounds significantly contributes to wound healing and reduces the duration of hospitalization in the intensive care. The objective of this study was to assess the therapeutic impact of a topical gel containing sodium pentaborate pentahydrate on the management of wounds resulting from grade 1 to 3 hemorrhoids. Methods: In this randomized double-blind placebo-controlled trial, we applied a topical gel consisting of sodium pentaborate pentahydrate 3% on 206 eligible patients with the diagnosis of grade 1, 2, and 3 hemorrhoid diseases. Then patients were randomly allocated to two groups of sodium pentaborate pentahydrate or placebo gel with a ratio of 1:1 and received the allocated gel for four weeks. Patient hemorrhoid symptoms severity, hemorrhoid degree, and anoscopy findings were compared before and after the trial. Results: Before the intervention, symptom severity (p > 0.05) and anoscopy findings (p = 0.815) were similar between the two groups. Subsequent to the intervention, a majority of patients in the intervention group experienced a reduction in anal itching compared to the placebo group [adjusted mean difference (aMD) 95% CI: -1.98 (−2.2 to −1.8), p = 0.007]. Moreover, resting pain [aMD (95% CI): -1.37 (−1.6 to −1.1), p = 0.015], pain during defecation [aMD (95% CI): -2.19 (−2.4 to −2.0), p = 0.005], feeling a lump in the anus (aMD (95% CI): -0.71 (−1.2 to −0.2), p = 0.011), bleeding during defecation (41.7% vs. 66.9%, p = 0.027), and hemorrhoid degree (p

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.

Background: Substance abuse has significant health impacts on families and society as a whole. We aimed to provide detailed prevalence estimates of substance abuse among the Azar Cohort Study respondents in Tabriz, Iran. Methods: Data on 15006 participants of Azar Cohort Study were analyzed. The variables included tobacco smoking, alcohol use, drug abuse, and socio-demographic characteristics. The prevalence of substance abuse (with a 95% confidence interval) was calculated using the direct standardization method. Results: Overall, 9.3% and 6.2% of the participants were regular and heavy cigarette smokers, respectively. Also, 1.9% and 2.1% of participants reported a history of using illicit drugs and alcohol, respectively. Substance abuse was more prevalent among males than females. Substance abuse varied significantly with age and socioeconomic variables. Conclusion: We identified specific demographic and socioeconomic groups with a higher prevalence of all studied behaviors. Such high-risk groups should be targeted when designing substance abuse prevention programs.

Abstract Introduction COVID-19 vaccination of children can help reduce the severity of the infection and the death rate caused by it and also helps achieve herd immunity. The level of acceptance and high vaccination coverage is the main elements in the success of immunization programs. Children’s vaccination is dependent on their parent’s decision. This study aims to identify predictors of the children’s COVID-19 vaccination accomplishment by their parents. Method In this case-control study, 577 vaccinated children as cases and 366 un-vaccinated children as controls were randomly selected from the general population of Tabriz, Iran 2022, and their data were collected by telephone calls and interviews with the children’s parents. Cases and controls were compared in terms of clinical and demographic factors of the child as well as the socioeconomic status (SES) of their parents by using a multivariable mixed-effect logistic regression model. Results According to the results of the multivariable logistic regression, the age of the child (OR = 1.26 95% CI (1.14, 1.40), p-value

Abstract Background In Iran, tracking of patients and its associated data recording in private healthcare centers are poor, and thus a majority of patients suffering from Covid-19 are treated without any control on the isolation and quarantine processes. The present study aims to investigate the factors contributed to referral to private or public healthcare centers that provide Covid-19 care services. Methods This cross-sectional study was conducted from November 2021 to January 2022 in Tabriz, Iran. We invited a total of 258 and 202Covid-19 patients from governmental and private healthcare centers, respectively, to participate in the study by convenient sampling method. Applying a self-administered questionnaire, we collected data on the reason of referring to the healthcare centers, patient’s waiting time, quality of healthcare services received by the patients, patients’ level of satisfaction, accessibility, insurance coverage, perceived severity of the disease, and the level of staff compliance from health protocols. Logistic regression model was used for data analysis by using SPSS-26 software. Results Adjusted for other variables, higher socio-economic status (AOR (Adjusted Odds Ratio) = 6.64), older age (AOR = 1.02), referral of friends and family members (AOR = 1.52), shorter waiting time (AOR = 1.02) and higher satisfaction (AOR = 1.02) were contributed to referral to private centers. Better accessibility (AOR = 0.98) and wider insurance coverage (AOR = 0.99) were also contributed to referral to governmental centers. Conclusion Providing more appropriate insurance coverage by private healthcare centers, and promoting their level of accessibility seems to promote patients’ referral to such centers. Moreover, establishing an accurate system for recording patients’ information and follow up in private centers might promote the role of private healthcare centers in managing the overload of patients on healthcare system during such epidemics.

Background: Neonatal respiratory distress syndrome (NRDS) affects approximately up to 7% of all term newborns. This study aimed to assess the efficacy and safety of investigational beractant (BeraksurfTM, Tekzima Company) in comparison with poractant alfa (Curosurf®, Chiesi Pharmaceuticals) as surfactant replacement therapy in NRDS. Methods: This trial was a randomized, controlled, single-blind, phase III study of two natural surfactants which was conducted in NICU of Alzahra hospital in Tabriz for 8 months. 220 infants were enrolled in 2 groups to receive either 100 mg/kg BeraksurfTM or 200 mg/kg Curosurf® as an initial dose endotracheally. Additional doses were given if needed. Infants’ gestational age, birth weight, discharge weight and other demographic information were recorded. Efficacy outcomes were changes in fraction of inspired oxygen (FiO2) and the number of infants who reached FiO2 less than 0.3 (treatment success rate) which were compared between both groups with analysis of covariance (ANCOVA). Results: The results showed that the treatment success rate was 92% and 72% in BeraksurfTM and Curosurf® groups, respectively (P-value< 0.001). In addition, no difference was observed in the efficacy of these two treatments in terms of binary outcomes and incidence of complications such as mortality. Conclusion: The result analysis of current study implies BeraksurfTM has same beneficial impact on clinical management of RDS as Curosurf® among infants below 32 weeks. However, larger studies are needed to evaluate further efficacy and safety outcomes of this surfactant in comparison with the reference products in other subgroups.

IntroductionIn gynecologic oncology, ovarian cancer is a great clinical challenge. Because of the lack of typical symptoms and effective biomarkers for noninvasive screening, most patients develop advanced-stage ovarian cancer by the time of diagnosis. MicroRNAs (miRNAs) are a type of non-coding RNA molecule that has been linked to human cancers. Specifying diagnostic biomarkers to determine non-cancer and cancer samples is difficult.MethodsBy using Boruta, a novel random forest-based feature selection in the machine-learning techniques, we aimed to identify biomarkers associated with ovarian cancer using cancerous and non-cancer samples from the Gene Expression Omnibus (GEO) database: GSE106817. In this study, we used two independent GEO data sets as external validation, including GSE113486 and GSE113740. We utilized five state-of-the-art machine-learning algorithms for classification: logistic regression, random forest, decision trees, artificial neural networks, and XGBoost.ResultsFour models discovered in GSE113486 had an AUC of 100%, three in GSE113740 with AUC of over 94%, and four in GSE113486 with AUC of over 94%. We identified 10 miRNAs to distinguish ovarian cancer cases from normal controls: hsa-miR-1290, hsa-miR-1233-5p, hsa-miR-1914-5p, hsa-miR-1469, hsa-miR-4675, hsa-miR-1228-5p, hsa-miR-3184-5p, hsa-miR-6784-5p, hsa-miR-6800-5p, and hsa-miR-5100. Our findings suggest that miRNAs could be used as possible biomarkers for ovarian cancer screening, for possible intervention.

Introduction: Nurses of the emergency department experience stressful events that affect their mental health and reduce the quality of their work life. Career adaptability is considered a personal capability that enables employees to adapt to changes and avoid the negative consequences of job mismatch. This study was conducted to study career adaptability and its correlation with the quality of work life in the emergency department. Material and Methods: This descriptive-correlational study was conducted on 104 nurses in the emergency department of teaching–therapeutic hospitals in Tabriz who were selected using random stratified sampling. Data was collected using a demographic checklist, the Career Adapt-Abilities Scale (CAAS) by Savickas, and the Quality of Nursing Work Life (QNWL) scale by Brooks & Anderson. Data were analyzed in SPSS using descriptive statistics (frequency, mean and standard deviation) and inferential statistics (independent t-test, one-way analysis of variance, Pearson’s correlation coefficient, and linear regression analysis). Results: The total scores of career adaptability and the quality of nursing work life were 88.55±25.01 from the achievable range of 24-120 and 141.15±22.56 from the achievable range of 42-252, respectively, which were moderate. In this study, 85.6% of nurses enjoyed a moderate quality of work life. Furthermore, the results of Pearson’s correlation indicated a significant positive correlation between career adaptability and scopes with the quality of work life score (p=0.05). Regression analysis results indicated that career adaptability significantly predicts the quality of nursing work life (p=0.000). Conclusion: In this study, nurses experienced moderate career adaptability and quality of work life. Given the above factors, and considering adaptability as a variable predicting quality of work life, it is suggested to take measures to increase career adaptability in nurses through training or consulting interventions to improve the quality of nursing work life.

Abstract Background Parents’ cognition about the type and nature of consequences a disaster may pose on the children’s psychosocial health, could be a major protective factor against the long-term overwhelming complications. Given the lack of a reliable instrument to measure parents’ cognition about disasters’ effects on children’s well-being, this study was conducted to develop and validate the parents’ cognitive perception inventory of disaster effects on children’s well-being (PCP-DCWB). Methods In this cross-sectional study 300 parents of the survived primary school aged children from the Iran’s northwest earthquake on August 2012 were recruited in the city of Varzegan. Exploratory factor analysis (EFA) was applied to identify the subcomponents and Cronbach’s alpha and Guttmann Split-half coefficients were calculated to assess the internal consistency reliability of the scale. Results Structural indicators of the Kaiser–Meyer–Olkin measure (0.69) and Bartlett’s test of Sphericity (P

Abstract Background High intensity and endurance exercises lead to exercise-induced oxidative stress (EIOS), exercise-induced muscle damage (EIMD), and inflammation, which are the influencing factors on muscle soreness, localized swelling, and sports performance decrease. Therefore, the purpose of this study is to determine the effectiveness of Tribulus terrestris (TT) as an herbal supplement with antioxidant and anti-inflammatory properties on the nutritional, oxidative, inflammatory, and anti-inflammatory status, as well as the sports performance of recreational runners. Methods/design This study is a double-blind, randomized, placebo-controlled trial, which will be conducted among recreational runners of Tabriz stadiums, Iran. Thirty-four recreational runners will be selected, and participants will be assigned randomly to two groups: to receive 500 mg TT supplement or placebo capsules twice daily for 2 weeks. Both groups will do high-intensity interval training (HIIT) workouts during the study. Baseline and post-intervention body composition, muscle pain, and aerobic and anaerobic performance will be assessed. In addition, assessment of malondialdehyde (MDA), total antioxidant capacity (TAC), total oxidant status (TOS), superoxide dismutase (SOD), glutathione peroxidase (GPx), uric acid (UA), 8-iso-prostaglandin F2α (8-iso-PGF2α), protein carbonyl (PC), catalase (CAT), glutathione (GSH), nitric oxide (NO), high-sensitivity C-reactive protein (hs-CRP), interleukin-6 (IL-6), interleukin-10 (IL-10), tumor necrosis factor-alpha (TNF-α), creatine kinase (CK), myoglobin (MYO), lactate dehydrogenase (LDH), insulin-like growth factor-1 (IGF-1) irisin, cortisol, and brain-derived neurotrophic factor (BDNF) will be done during three blood samplings. Changes in oxidative stress, anti/inflammatory biomarkers, and sports performance will be assessed as primary outcomes. Discussion This study will be the first to assess the potential effects of TT on recreational runners. Our results will contribute to the growing body of knowledge regarding TT supplementation on the nutritional, oxidative, inflammatory, and anti-inflammatory status and sports performance in recreational runners. Trial registration Iranian Registry of Clinical Trials ( www.irct.ir ) (ID: IRCT20150205020965N8 ). Registration date: 13 February 2021.

Introduction Illness perception and self-efficacy in patients with coronary artery disease (CAD) may affect medication adherence, which is one of the most important challenges in disease management in this group of patients. Objective The present study aimed to investigate the factors influencing medication adherence in CAD patients, especially the effect of illness perception and self-efficacy. Methods This study was cross-sectional and conducted from April to September 2021. A total of 259 patients with confirmed CAD were selected by convenience sampling method based on inclusion criteria. Illness perception, self-efficacy, and medication adherence were investigated using Brief IPQ, SCSES, and MARS_10 questionnaires, respectively. The data were analyzed using the STATA software (version 14) and the regression path analysis method. Results Patients had moderate illness perception and high self-efficacy, and 61.8 of them adhered to their medication regimen. Greater illness perception, better self-efficacy, and higher education had a positive effect on medication adherence, and increasing age had a negative effect on it. The final path model shows a good fit of the data in the model (χ2: 0.37, df: 274, χ2/df: 0.36, CFI: 1, IFI: 0.95, TLI: 1.07, and RMSEA: 0.00). Conclusion The results of the present study suggest that patients’ illness perception can play an important role in predicting self-efficacy in disease management and the level of medication adherence in patients with CAD. To improve self-efficacy and medication adherence, future intervention studies should focus on the patient's illness perceptions and their improvement.

Offshore operations are generally challenging and hazardous, and the workers are exposed to conditions that may lead to fatigue. A cross-sectional study evaluated physical and psychological job demands and their associations with fatigue among offshore workers. The offshore workers (n = 251) completed a questionnaire including demographic/job details, Multidimensional Fatigue Inventory (MFI‒20), and Job Content Questionnaire (JCQ). Data were analysed using linear regression modelling. Results indicated that the physical (particularly performing repetitive motions and applying pressure with hands and wrists) and psychological (e.g., intense task concentration and fast working) job demands were relatively high. The total mean (SD) fatigue score (MFI‒20) was 56.3 (13.9). Individual factors (Body Mass Index ‒ BMI), physical job demands (awkward working postures, frequent moving/lifting heavy objects and doing lots of physical efforts) and psychological job demands (task interruptions by other people and doing an excessive amount of work) were the main variables associated with different dimensions of fatigue in the multivariate models. While physical fatigue was only associated with the physical job demands, both physical and psychological job demands were significantly associated with mental fatigue in the multivariate context. The findings have possible implications for job design and implementation of intervention programmes to promote health and performance of the employees.

Objectives: The prevalence of fatigue in patients receiving hemodialysis is high. This study aimed to investigate the effect of Rosa damascena oil on fatigue severity in patients receiving hemodialysis. Materials and Methods: This randomized controlled trial was performed on 74 patients receiving hemodialysis in Tabriz, Iran from January 21 to February 21, 2019. The patients were conveniently recruited and assigned into two groups of intervention and control using a block randomization method with block sizes of four and six and a sequence of 1:1. Patients in the intervention group were trained to inhale three drops of R. damascena oil each night for one month. We used the Fatigue Severity Scale (FSS) for data collection and analyzed the data using the independent samples and paired t tests. Results: No significant difference was found between the two groups respecting the mean baseline fatigue scores (P=0.12). However, at the end of the study, the mean fatigue score was significantly lower in the intervention group compared to the control group (P=0.001). Conclusions: We witnessed that R. damascena oil aromatherapy significantly reduced the severity of fatigue in patients receiving hemodialysis. This useful and inexpensive technique can be utilized as a complementary method to relieve fatigue in patients receiving hemodialysis.

Background: Effective clinical care and identifying susceptibility to COVID-19-related mortality requires rapid recognition of risk factors and their relations with disease outcomes. This study aimed to cluster and identify various subgroups of COVID-19 patients and examine the relationship between these subgroups and the causes of death. Methods: This retrospective study assessed the risk factors contributing to COVID-19 patients’ death (n = 128) by evaluating deceased patients' demographic, clinical, and laboratory features and clustering various subgroups of individuals to investigate any correlation. Results: The mean age of deceived patients was 69.7 years, and the majority of them were male (65.6%). The levels of blood urea nitrogen, creatinine, alkaline phosphatase, erythrocyte sedimentation rate, lactate dehydrogenase, and C-reactive protein were high at admission and increased during the hospitalization. Shortness of breath (68%) and cough (62.5%) were the most common symptoms, and hypertension (50.8%) was the most common comorbidity among deceased patients. The clustering quality based on the underlying disease and symptoms was not acceptable. However, clustering based on vital signs showed significant differences in body temperature, pulse rate, respiratory rate and oxygen saturation (P

Background: Many nurses are uncertain when making clinical decisions, and this can lead to burnout and professional dissatisfaction. However, no study has addressed facilitators of uncertainty in clinical decision-making among Iranian nurses. Objectives: This study aimed to explore Iranian nurses' experiences of facilitators of uncertainty in decision-making. Methods: This qualitative content analysis study was conducted from June to December 2020. Participants were 17 nurses with bachelor's or higher degrees who were purposively recruited from three hospitals affiliated with Tabriz University of Medical Sciences. Data were collected through semi-structured interviews and analyzed through a content analysis method. Results: Participants' experiences were categorized into three main categories, namely, an unconfident nurse, complex situations, and unclear guidelines and policies. Each category included three to four subcategories. Conclusion: Nurses may experience uncertainty in clinical decision-making when confronted with ambiguous clinical situations or lack sufficient decision-making skills. Nurse leaders are suggested to develop educational programs and support interventions to promote nurses' decision-making skills and help them manage ambiguous situations.

Background: Given the potential anti-ischemic effects of allopurinol, we aimed to assess whether allopurinol administration may reduce myocardial injury following non-ST elevation myocardial infarction (NSTEMI). Methods: A randomized clinical trial (RCT) was conducted on 100 individuals with NSTEMI.The intervention group (n=50) received 600 mg oral allopurinol at the time of diagnosis ofNSTEMI, followed by 300 mg every day for two next days and the standard treatment of NSTEMI, while the control group (n=50) received only the standard treatment. Serum concentrations of cardiac troponin I (cTnI) were measured at baseline, and 8, 16, 24, and 32 hours after the treatment. Results: The baseline demographic and clinical data of the patients were not statistically different between the intervention and control groups (all P > 0.05). The comparing estimated marginal mean ± standard error for cardiac troponin I (cTnI) levels revealed no significant difference between the study groups (2.93 ± 0.27, 2.25 ± 0.27; P=0.082). The linear mixed model results showed that the interaction of time and group was not statistically different (P=0.751). Moreover, there was a decreasing trend over time for cTnI in both groups (P=0.039). Conclusion: The present pilot RCT did not support the potential cardio-protective benefits of allopurinol administration on decreasing myocardial injury following NSTEMI.

BackgroundType 2 diabetes mellitus (T2DM) is one of the most important risk factors for cardiovascular diseases, with a high economic burden on health care systems. Since gender and residency can affect people's lifestyle and health behaviors, this study was conducted to investigate the prevalence of T2DM and its determinants by gender and residency.MethodsA secondary analysis study was conducted on the survey data of the IraPEN (Iran's Package of Essential Non-Communicable Disease) pilot program conducted in 2017 in Naghadeh County, Iran. Data of 3,691 participants aged 30-70 years from rural and urban areas of the County were included into data analysis process. Sociodemographic factors, anthropometric measurements, and cardiovascular risk factors related to T2DM were assessed.ResultsThe overall prevalence of T2DM within the population was 13.8%, which was significantly higher among women (15.5%) than men (11.8%), and non-significantly higher in urban (14.5%) areas than rural (12.3%) areas. In both genders, age (male: OR 1.01, 95% CI: 1.00-1.03; P = 0.012; female: OR 1.03, 95% CI: 1.02-1.04; PConclusionGiven the higher prevalence of T2DM among females, risk reduction strategies at the community level should be more targeted at women. The higher prevalence of T2DM risk factors among the urban population is a wake-up call for policymakers to pay more attention to the consequences of unhealthy and sedentary lifestyles within urban communities. Future actions should be focused on appropriate timely action plans for the prevention and control of T2DM from early years of life.

PurposeThe relationship between the inflammatory and antioxidant potential of an athlete's diet and their oxidative biomarkers is an important area of investigation. Therefore, this study aimed to assess the excretion of 8-hydroxy-2-deoxyguanosine (8-OHdG) and F2alpha-isoprostane (F2a-IP) in the urine of male football players and healthy non-athlete controls. This study also aimed to examine the associations among the dietary inflammatory index (DII), the dietary total antioxidant capacity (DTAC), and the dietary phytochemical index (PI) with 8-OHdG and F2a-IP.MethodsIn this descriptive-analytical study, 45 male football players and 45 healthy non-athletes, who were individually matched based on age and body mass index (BMI), were recruited from Shiraz City, Iran. Fasted urine samples were analyzed for 8-OHdG and F2a-IP levels. Anthropometric measurements were performed, and body composition was assessed using a body composition analyzer. A valid food frequency questionnaire (FFQ) was used to calculate DII, DTAC, and PI scores. Data analysis was conducted using a generalized estimating equation (GEE) model.ResultsWe found that 8-OHdG (β = −6.96), F2a-IP (β = −82.58), and DII (β = −2.06) were significantly lower, while DTAC (β = 2.37) and PI (β = 0.084) were significantly higher in the football player group compared with the non-athlete group (P < 0.001 for all variables). In all participants, dietary indices were significantly associated with oxidative biomarkers. DII was positively associated with 8-OHdG (β = 2.25; P < 0.001) and F2a-IP (β = 38.34; P < 0.001). Furthermore, negative associations between DTAC (β = −1.42; P < 0.001) and PI (β = −35.37; P < 0.001) with 8-OHdG were found. Moreover, DTAC (β = −17.34; P < 0.001) and PI (β = −428.11; P = 0.003) were negatively associated with F2a-IP.ConclusionThe results of this study highlighted the importance of a healthy diet in reducing oxidative stress among football athletes. The levels of urinary biomarkers for DNA and lipid oxidation were found to be lower in football players compared to non-athletes. This suggests that following an anti-inflammatory and antioxidant-rich diet may help reduce oxidative stress in these individuals.

Background: Varicella-Zoster virus (VZV) is the causative agent of herpes zoster, or "shingles." Most cases of acute herpes zoster are self-limiting, although the pain can cause significant suffering, and experience postherpetic neuralgia (PHN), particularly in older adults. Early treatment of herpetic neuralgia in the subacute phase may prevent PHN progression. This study aimed to evaluate the efficacy of memantine in the treatment of subacute neuropathic herpes zoster. Methods: This randomized clinical trial was performed on sixteen patients aged 18-75 years with subacute herpetic neuralgia. Patients were randomly assigned to the intervention or control group according to the inclusion and exclusion criteria (8 in each group). The duration of the study was eight weeks. Patients in the memantine group received Gabapentin 300 mg per day and memantine 5 mg twice a day. Then, after one week, the memantine dose was tapered up to 10 mg twice a day. In the control group, patients received only Gabapentin from the first week to the end of the study. DN4 questionnaire is used to measure the severity of nerve pain. The patients of both control and intervention groups completed the questionnaire before starting the treatment and it was done again after the end of the treatment period (8 weeks). Results: The results showed improvement in pain in patients who received Memantine along with Gabapentin in comparison with Gabapentin alone (P =0.001). Moreover, the DN4 questionnaire score evaluation indicated a significant difference only for the intervention group's Q1 variable in within-group analysis (P =0.031). Conclusion: Co-administration of memantine with Gabapentin reduced the severity of subacute neuropathic herpes. In addition, memantine is expected to be a viable option for treating and relieving subacute and chronic nerve pain in patients.

Background: Insulin resistance has been suggested as one of the known metabolic disorders during cachexia. This study hypothesized that cachexia in cancer patients might be related to insulin resistance as early as cachexia development. Methods: This study was performed on 46 patients with metastatic gastrointestinal cancer. Anthropometric characteristics and biochemical markers were assessed at baseline, second and third month. Insulin resistance was assessed using the homeostasis model assessment-estimated insulin resistance (HOMA IR) method. SFQ-36 questions were used to assess the patients' quality of life at baseline, second and third months. Results: Anthropometric characteristic was significantly associated between pre-cachectic and non-pre-cachectic patients in third month. Cholesterol (P-value = 0.93), albumin (P-value: 0.82), and serum creatinine (P-value = 0.88) in pre-cachectic patients decreased over three months. There was an increasing trend of insulin resistance between pre-cachectic and non-pre-cachectic patients in third month. Cholesterol had an upward trend with a significant relation in cachectic patients [(P-value = 0.00), (P-value = 0.03), (P-value = 0.01)]. We detected a decreasing trend of insulin resistance between cachectic and non-cachectic patients from second to third month (P-value = 0.04). SFQ evaluation had no significant relation with cachectic status. Conclusion: Previous studies showed that the use of NSAIDs, progesterone’s, corticosteroids, COX-2 inhibitors, anabolic agents and drugs targeting inflammatory cytokines may be beneficial for improving of symptoms of cachexia. Significant relation between anthropometric variables with pre-cachexia and cachectic conditions was concluded. Patients' outcome and its relation with insulin resistance demonstrated a significant relation between the cachectic and non-cachectic patients in the third month. We also detected the increased serum cholesterol level in cachectic patients, moreover, higher cholesterol levels in expired cachectic patients than in the living.

Background: PIn air quality studies, it is very often to have missing data due to reasons such as machine failure or human error. The approach used in dealing with such missing data can affect the results of the analysis. The main aim of this study was to review the types of missing mechanism, imputation methods, application of some of them in imputation of missing of PM10 and O3 in Tabriz, and compare their efficiency. Methods: Methods of mean, EM algorithm, regression, classification and regression tree, predictive mean matching (PMM), interpolation, moving average, and K-nearest neighbor (KNN) were used. PMM was investigated by considering the spatial and temporal dependencies in the model. Missing data were randomly simulated with 10, 20, and 30% missing values. The efficiency of methods was compared using coefficient of determination (R2), mean absolute error (MAE) and root mean square error (RMSE). Results: Based on the results for all indicators, interpolation, moving average, and KNN had the best performance, respectively. PMM did not perform well with and without spatio-temporal information. Conclusion: Given that the nature of pollution data always depends on next and previous information, methods that their computational nature is based on before and after information indicated better performance than others, so in the case of pollutant data, it is recommended to use these methods.

This study aimed to examine the validity and reliability of a semi-quantitative food frequency questionnaire (FFQ) designed to estimate dietary vitamin D and Calcium (Ca) intakes in a sample of Iranian childbearing age women. An 87-item FFQ was developed and 84 healthy childbearing age women completed it. FFQ was validated by comparing its results with the 24-h dietary recall (24-h recall) and serum 25-hydroxyvitamin D (S-25(OH)D) as the references methods. The FFQ was completed for the second time after 4 weeks to assess the reliability of the questionnaire. Data were analyzed using spearman’s correlation, cross-classification analysis, Bland–Altman plots, the weighted κ, intraclass classification, and the method of triads. Spearman’s correlations between vitamin D and Ca intakes by the FFQ and 24-h recalls and between vitamin D intakes and S-25(OH)D were significant (r: 0.706, r: 0.959, and r: 0.682, respectively, all, P < 0.001). Cross-classification for vitamin D and Ca between two dietary methods and for vitamin D intake of FFQ and S-25(OH)D demonstrated that most of the quartiles were categorized into the same or adjacent quartiles. The Bland Altman plots for these nutrients also demonstrated good agreement. For vitamin D, the validity coefficients (VCs) calculated by the method of the triad for three methods were in the range of 0.808–0.843. The weighted κ for agreement of vitamin D and Ca by FFQ1 and FFQ2 were 0.18 and 0.638, respectively. The findings indicated that the developed FFQ has acceptable validity for estimating vitamin D and Ca. Its reliability for Ca was stronger than vitamin D.

Objective: Nowadays, loneliness is one of the foremost common issues among university students that may negatively affect their physical and mental states and academic performance. Accordingly, this research project intended to investigate the incidence of loneliness and its related risk factors among students studying at universities of medical sciences. Method: The participants in this cross-sectional study were 538 Tabriz University of Medical Sciences students, selected using a simple random sampling method. Loneliness was measured using the UCLA Loneliness questionnaire with 20 questions. Descriptive statistics, multiple logistic regression, and Chi-square were used to identify factors affecting loneliness. Results: The results showed that the mean loneliness score and the magnitude of the students' loneliness were 41.42 and 26.4%, respectively. The magnitude of loneliness was higher among female respondents (OR = 1.86, P = 0.005), cigarette smokers (OR = 0.39, P < 0.001), freshman students (OR = 2.76, P = 0.021), sophomore students (OR = 2.36, P = 0.040), those with low financial status (OR = 1.80, P = 0.037), and those residing in dormitories (OR = 1.73, P = 0.013). Conclusion: In general, loneliness was widespread among the students. Based on the findings, the magnitude of loneliness was higher among the first-year student group, female students, students with poor economic status, and those who smoked and lived in dormitories. Therefore, this study's findings underline the significance of making students aware of loneliness, investigating the circumstances and factors that exacerbate this sensation among first-year students (mainly between 18-21 years old), and devising intervention to alleviate it.

Abstract Background Smoking remains a leading public health challenge globally. As a psychosocial determinant of health, social capital can influence health attitudes and behaviors, and thus it may have the capacity to reduce smoking rates. The aim of this research was to examine the association between social capital and attitudes towards smoking among university students. Methods This cross-sectional study was conducted among 538 health and medical students, recruited using the proportionate sampling method. Participants’ social capital and attitudes toward smoking were assessed using the social capital questionnaire (SCQ) and the scale of cigarette smoking attitude (CSA). Data were analyzed using descriptive statistics, Pearson correlation coefficient, and the multiple regression analysis. Results About one in four health and medical students reported smoking, either currently or in the past, and 30% had either positive or indifferent attitudes towards smoking. The mean scores of the SCQ and the CSA were 105.1 ± 19.7 and 48.6 ± 11.2, respectively. There was a statistically significant negative association between the SCQ and the CSA scores (r = − 0.24; p

Abstract Background Identifying hidden patterns and relationships among the features of the Fatal Pedestrian Road Traffic Injuries (FPRTI) can be effective in reducing pedestrian fatalities. This study is thus aimed to detect the patterns among the fatally injured pedestrians due to FPRTI in East Azerbaijan province, Iran. Methods This descriptive-analytic research was carried out based on the data of all 1782 FPRTI that occurred in East Azerbaijan, Iran from 2010 to 2019 collected by the forensic organization. Categorical Principal Component Analysis (CATPCA) was performed to recognize hidden patterns in the data by extracting principal components from the set of 13 features of FPRTI. The importance of each component was assessed by using the variance accounted for (VAF) index. Results The optimum number of components to fit the CATPCA model was six which explained 71.09% of the total variation. The first and most important component with VAF = 22.04% contained the demographic and socioeconomic characteristics of the killed pedestrians. The second-ranked component with VAF = 12.96% was related to the injury type. The third component with VAF = 10.56% was the severity of the injury. The fourth component with VAF = 9.07% was somehow related to the knowledge and observance of the traffic rules. The fifth component with VAF = 8.63% was about the quality of medical relief and finally, the sixth component with VAF = 7.82% dealt with environmental conditions. Conclusion CATPCA revealed hidden patterns among the fatally injured pedestrians in the form of six components. The revealed patterns showed that some interactions between correlated features led to a higher mortality rate.