Spirituality as a Neglected Core in Occupational Therapy Practice: An Iranian Exploratory Survey.

Spirituality has received more attention in recent decades from different health disciplines. Occupational Therapy (OT), as a health discipline, believes that all aspects of human experience, including physical, psychological, social, and spiritual, are considered essential aspects of health. OT supports the fact that incorporating spirituality can promote health, well-being, and quality of life. Various researchers have attempted to investigate and explain occupational therapists' views on spirituality. In Iran's OT curriculum, spirituality has not been incorporated directly. The purpose of this study is to acquire information about the knowledge and opinions of Iranian occupational therapists about spirituality. This is a cross-sectional exploratory descriptive survey study in which 125 occupational therapists participated through convenience sampling. Inclusion criteria were, namely (a) at least one-year clinical experience of OT, (b) being educated in Iran, and (c) working in Iran. The Occupational Therapy Assessment of Spirituality (OTAS) questionnaire was used for data collection. The answers to the quantitative questions were analyzed through descriptive statistics. Most of the participants believed that spirituality should be incorporated by occupational therapists, but more than half of the participants disagreed that formal education prepared them to pay any attention to spirituality in their practice. Analyzing qualitative data by frequencies of their repetitions, led to four categories and sixteen subcategories, accordingly. The four categories are (1) the barriers to applying spirituality in OT, (2) the need to acquire knowledge and apply spirituality in OT, (3) the benefits of incorporating spirituality for a client, and (4) the benefits of incorporating spirituality for the occupational therapist. The findings indicate that academic education has failed to prepare Iranian occupational therapists to meet spiritual needs of their clients. However, OTs tend to get information about spirituality from other sources and find it helpful for themselves and their clients. There are also barriers to applying spirituality; therefore, an educational package is needed to address these problems.

Smartphone addiction in children: patterns of use and musculoskeletal discomfort during the COVID-19 pandemic in Iran.

BACKGROUND: Smartphone use has increased significantly, especially during the period of global pandemic caused by the novel SARS-CoV2 coronavirus (COVID-19). Concurrently, smartphone addiction is a growing social problem in children and adolescents with the consequence of adverse health outcomes. This study assessed the prevalence of smartphone addiction, patterns of use, and the experienced body-region discomfort among Iranian school students during the COVID-19 pandemic. METHODS: A cross-sectional study with students from grades 1-9 recruited n = 585 participants (mean age = 14.49 (2.26 years); female = 65.8%). Data were collected from parents and students through the online 'Smartphone addiction scale-short version' (SAS-SV), self-reported demographic questionnaires, and extracts of the Nordic musculoskeletal questionnaire for the evaluation of musculoskeletal disorders. RESULTS: The prevalence rate of smartphone addiction (53.3%) was relatively high in the overall sample. Participants spent 6.85 (4.62) hours per day on their smartphones, which had increased 53.86% relative to the pre-pandemic period. The primary smartphone uses were for social networking (77.9%), web-surfing (53.3%), and camera activities (50.9%). There was a positive correlation between smartphone addiction as assessed with the SAS-SV and daily use time (r = 0.34, p < 0.001), and the percentage of change relative to the pre-pandemic period (r = 0.26, p < 0.001). Discomfort related to smartphone use was mostly reported as present in the eyes (39.7%) and neck (39.1%). A positive correlation was found (p < 0.001) between smartphone addiction and discomfort in the eyes, neck, wrists, shoulders, and upper-back. CONCLUSION: The more frequent usage of smartphones by students during the Covid-19 pandemic were associated predominantly with discomfort to the eyes and neck. Parents should consider the complications of musculoskeletal and postural changes during the child's future years and pay particular attention to the individual's patterns of smartphone use with an emphasis on posture and usage that reduces discomfort to the eyes and the musculoskeletal system, particularly the neck.

Confirmatory Factor Analysis, Reliability, and Validity of the Persian Version of the Coping Strategies Questionnaire for Iranian People With Nonspecific Chronic Neck Pain.

OBJECTIVE: The purpose of this study was to assess the reliability and construct validity of, and perform confirmatory factor analysis of, the Persian version of the Coping Strategies Questionnaire (CSQ) for Iranian people with nonspecific chronic neck pain. METHODS: We performed psychometric testing of the Persian version of the Coping Strategies Questionnaire. Participants were 123 native Persian speakers with chronic neck pain lasting at least 3 months. They were between 18 and 55 years old. The CSQ was administered by self-report. After 5 to 7 days, 94 participants completed the questionnaire in the retest session. Confirmatory factor analysis was done to assess the model fit (χ2 test, comparative fit index, and root-mean-square error of approximation) of the 7-factor solution of the Persian version of the CSQ. The Cronbach α was used for internal consistency; intraclass correlation coefficient, standard error of measurement, and minimal detectable change for reliability; and nonparametric tests of group differences and correlations for construct validity. To assess the construct validity, we examined the ability of the CSQ to discriminate people based on sex, level of education, and physical activity. Correlations with the Short Form Health Survey (SF-12), Tampa Scale for Kinesiophobia, visual analog scale, Fear-Avoidance Beliefs Questionnaire, Pain Catastrophizing Scale, and Neck Disability Index were also determined to test the validity. RESULTS: Confirmatory factor analysis measures-χ2 test, comparative fit index, and root-mean-square error of approximation-were 1.72, 0.76, and 0.07, respectively. Internal consistency was excellent (0.85). All intraclass correlation coefficients were above the acceptable level of 0.70, with the highest reliability obtained for the Praying subscale in both test and retest sessions. The standard error of measurement for the CSQ total score was 2.26, and the minimal detectable change was 6.25. The Cronbach α for the total score and for the subscales ranged from 0.75 to 0.93. Scores of the subscales of the CSQ and other questionnaires showed low correlation except for the physical component of the SF-12. The Catastrophizing subscale had a positive correlation with the Pain Catastrophizing Scale, Tampa Scale for Kinesiophobia, Fear-Avoidance Beliefs Questionnaire, and Neck Disability Index, and a negative correlation with the SF-12. CONCLUSION: The CSQ has acceptable and good measurement properties to assess coping strategies in Iranian people with nonspecific chronic neck pain. It is a reliable measure, though, for validity only The Catastrophizing subscale showed significant correlation with other scales, but the findings should be interpreted with caution because of the limitations of the study.

Asymmetry of Cervical Multifidus and Longus Colli Muscles Size in Participants With and Without Cervical Radicular Pain.

OBJECTIVES: The aim of this study was to determine the asymmetry of cervical multifidus (MF) and longus colli (LC) muscles in patients with unilateral chronic radicular neck pain (CRNP) and healthy subjects using ultrasonography. MATERIALS AND METHODS: Ninety five individuals (50 patients with unilateral CRNP and 45 healthy subjects) participated in this study. The size of the cervical MF and LC muscles; anterior posterior dimension (APD) and lateral dimension (LD); were bilaterally measured in a relaxed state using ultrasonography. RESULTS: Patients with CRNP showed greater asymmetry in the cervical MF and LC muscles size than the healthy subjects. The mean percentages differences between sides for MF and LC muscles size was higher in patients than that of healthy subjects (for both APD and LD; P<0.05). The ratio of smaller to larger dimensions of the cervical MF and LC muscles for patients were significantly less than that of healthy controls (for both APD and LD; P< 0.05). CONCLUSION: The results indicated that cervical MF and LC muscles showed higher asymmetry between sides and lesser ratio of smaller size to larger size in patients with CRNP as compared with healthy subjects. Current results confirmed the presence of MF and LC muscles atrophy in subjects with CRNP.

Application of additive hazards models for analyzing survival of breast cancer patients.

BACKGROUND: Survival rates for breast cancer (BC) are often based on the outcomes of this disease. The aim of this study was to compare the performance of three survival models, namely Cox regression, Aalen's, and Lin and Ying's additive hazards (AH) models for identifying the prognostic factors regarding the survival time of BC patients. MATERIALS AND METHODS: This study was a historical cohort study which used 1025 females' medical records that underwent modified radical mastectomy or breast saving. These patients were admitted to Besat and Chamran Hospitals, Tehran, Iran, during 2010-2015 and followed until 2017. The Aalen's and Lin and Ying's AH models and also traditional Cox model were applied for analysis of time to death of BC patients using R 3.5.1 software. RESULTS: In Aalen's and also Lin and Ying's AH models, age at diagnosis, history of disease, number of lymph nodes, metastasis, hormonal therapy, and evacuation lymph nodes were prognostic factors for the survival of BC patients (P < 0.05). In addition, in the Lin and Ying's AH model tumor size (P = 0.048) was also identified as a significant factor. According to Aalen's plot, metastasis, age at diagnosis, and number of lymph nodes had a time-varying effect on survival time. These variables had a different slope as the times go on. CONCLUSION: AH model may yield new insights in prognostic studies of survival time of patients with BC over time. Because of the positive slope of estimated cumulative regression function in Aalen's plot, metastasis, higher age at diagnosis, and high number of lymph nodes are important factors in reducing the survival BC, and then based on these factors, the therapists should consider a special therapeutic protocol for BC patients.

Development and psychometric properties of the physical rehabilitation services acceptability questionnaire.

Background: Access to rehabilitation services is considered to be a right for all people. One of the most important indicators for access to rehabilitation services is an individual's general acceptance of rehabilitation. This tool was designed based on relevant studies and experiences of rehabilitation specialists to design a questionnaire to specifically measure patient acceptability of physical rehabilitation services. Methods: In this study, an exploratory sequential mixed methods design was used. The first phase included a review of the literature and analysis of relevant studies, focus group discussions, and qualitative content analysis. In the second phase, construct validity was assessed by exploratory and confirmatory factor analysis. Also, convergent and divergent validity were measured. Reliability was evaluated by internal consistency (Cronbach's alpha and McDonald's Omega) and construct reliability. Statistical procedures were calculated by SPSS-AMOS24 and JASP0.9.2 software. Results: A total of 200 questionnaires were completed by members of Iranian Disability Campaign. Three factors and 25 items were identified according to results of the first phase of this study. In the second phase, face validity was confirmed. To assess the content validity ratio, 9 items, with the mean of content validity ratio (CVR) < 0.49, were deleted, while the content validity index (CVI) < 0.79 was revised. The kappa coefficient < 0.6 was fair and scale content validity index (SCVI) under 0.9 was considered appropriate. Results of exploratory factor analysis showed that 48% of the variance of the acceptability of physical rehabilitation services was based on patients' satisfaction, ethical behavior, and patient centered services. Confirmatory factor analysis confirmed the suitability of the final model. Convergent and divergent validity and reliability of the measure, the Physical Rehabilitation Services Acceptability questionnaire was fulfilled. Conclusion: Findings indicated that the proposed constructs that promoted the Acceptability of Physical Rehabilitation Services Questionnaire had good validity and reliability in participants with physical disabilities.

The effects of Vibro-medical insole on vibrotactile sensation in diabetic patients with mild-to-moderate peripheral neuropathy.

Peripheral sensory neuropathy seems to be the main risk factor for diabetic foot ulceration. Previous studies demonstrated that stochastic resonance can improve the vibrotactile sensation of diabetic patients. The aim of this study was to evaluate the effects of Vibro-medical insole on pressure and vibration sensation in diabetic patients with mild-to-moderate peripheral neuropathy. A total of 20 patients with mild-to-moderate diabetic neuropathy were included in the pre-test and post-test clinical trial study. Vibro-medical insole consists of medical insole and vibratory system. Medical insole was made independently for each participant and vibratory system was inserted in it. Pressure and vibration sensation were evaluated before and after 30-min walking with Vibro-medical insole. Semmes-Weinstein monofilaments and tuning fork were used to evaluate pressure and vibration sensation, respectively. Pressure sensation showed significantly improvement using Vibro-medical insole at the heel, first and fifth metatarsophalangeal heads, and hallux of both feet in all participants (p < 0.001). Vibration sensation also improved at the big toe of both feet with 256 Hz tuning fork (p < 0.05) but no statistically significant effect was found with 128 Hz tuning fork (p > 0.05). Vibro-medical insole significantly improved pressure and vibration sensation of the foot in diabetic patients with mild-to-moderate peripheral neuropathy. The results suggest that Vibro-medical insole can be used for daily living activities to overcome sensory loss in diabetic neuropathy patients.

Survival analysis of thalassemia major patients using Cox, Gompertz proportional hazard and Weibull accelerated failure time models.

Background: Thalassemia major (TM) is a severe disease and the most common anemia worldwide. The survival time of the disease and its risk factors are of importance for physicians. The present study was conducted to apply the semi-parametric Cox PH model and use parametric proportional hazards (PH) and accelerated failure time (AFT) models to identify the risk factors related to survival of TM patients. Methods: The data of this historical cohort study (296 patients with TM) were collected during 1994 and 2013 in Zafar Clinic in Tehran. Gompertz PH and Weibull AFT models were used for survival analysis (SA) of these patients. Data analysis was performed using R3.2.2 software. Results: 153 (51.7%) of patients were female; the mean (±SD) age of the patients was 29.11 (±0.47) years. One-year survival rate for males and females was 0.963±0.007 and 0.973±0.013, respectively; and 3-year survival rate for males and females was 0.711±0.057 and 0.733±0.114, respectively. In the Gompertz model, birthplace and age at onset of the disease were significant factors (p= 0.035, and p= 0.005) in survival time. Also, in the Weibull model, birth place and age at onset of the disease were significant factors (p= 0.013, and p= 0.008) in survival time. The Akaike Information Criterion (AIC) for Weibull model was 158.51, which was lower than other parametric models. Conclusion: According to the results, the Weibull AFT model was found to be a better model for identifying the risk factors related to survival of patients with TM disease. Informing parents, especially mothers and paying attention to blood screening for early diagnosis may increase the survival rate of patients.

Effectiveness of a Brief Psychosocial Intervention on Quality of Life of Primary Caregivers of Iranian Children With Cancer: A Randomized Controlled Trial.

UNLABELLED: Cancer in children has a great impact on primary caregiver quality of life (QOL). OBJECTIVE: This study examined the effectiveness of a brief psychosocial intervention (BPI) on QOL of Primary Caregivers of Children with Cancer (PCCCs). METHODS: Sixty-five PCCCs participated in a randomized controlled trial in Mahak Hospital and Rehabilitation Complex in Tehran, Iran. A 5-week long BPI (which comprised of counseling sessions and telephone follow-up) was delivered to the intervention group in addition to usual service, while the control group was provided with usual service. Data were collected using the Caregiver Quality of Life Index-Cancer-Persian version (CQOLC-P) prior to intervention, post-intervention, and at follow-up (i.e. 30days after the intervention). Repeated measures analysis of variance analysis (ANOVA) was used to evaluate outcomes. RESULTS: Majority of the participants were mothers (95%), between ages of 24-47 years (95%) with children between ages of 2-12 years. Most child cancer diagnoses were for brain tumors (n=31) and blood cancers (n=17). Significant improvement was found within the intervention group on QOL (p<0.001) including improvements on subscale measures of mental/emotional burden (p<0.001), disruption (p<0.001), and positive adaptation (p<0.001), compared with the control group over time. There was no difference between the intervention and control groups on the financial subscale measure after intervention (p>0.05). CONCLUSION: BPI was an effective strategy to improve the quality of life of PCCCs. Similar interventions can be planned by practitioners to reduce the burden of childhood cancer on PCCCs.

The effect of a family-based intervention with a cognitive-behavioral approach on elder abuse.

Elder abuse may become a health issue in developing countries, including Iran. The purpose of this investigation was to study the effectiveness of Family-Based Cognitive-Behavioral Social Work (FBCBSW) in reducing elder abuse. In a randomized clinical trial in Iran, 27 elders participated in intervention and control groups. The intervention groups received a five-session FBCBSW intervention and completed the Domestic-Elder-Abuse-Questionnaire (DEAQ), which evaluates elder abuse at baseline and follow-ups. Repeated measures of analysis of variance (ANOVA) and the Wilcoxon test were used to analyze the data. The repeated measures ANOVA revealed that FBCBSW was successful in reducing elder abuse. The Wilcoxon test indicated that emotional neglect, care neglect, financial neglect, curtailment of personal autonomy, psychological abuse, and financial abuse significantly decreased over time, but there was no statistically significant difference in physical abuse before and after the intervention. The findings from this study suggest that FBCBSW is a promising approach to reducing elder abuse and warrants further study with larger samples.

Exceptional expansion and conservation of a CT-repeat complex in the core promoter of PAXBP1 in primates.

Adaptive evolution may be linked with the genomic distribution and function of short tandem repeats (STRs). Proximity of the core promoter STRs to the +1 transcription start site (TSS), and their mutable nature are characteristics that highlight those STRs as a novel source of interspecies variation. The PAXBP1 gene (alternatively known as GCFC1) core promoter contains the longest STR identified in a Homo sapiens gene core promoter. Indeed, this core promoter is a stretch of four consecutive CT-STRs. In the current study, we used the Ensembl, NCBI, and UCSC databases to analyze the evolutionary trend and functional implication of this CT-STR complex in six major lineages across vertebrates, including primates, non-primate mammals, birds, reptiles, amphibians, and fish. We observed exceptional expansion (≥4-repeats) and conservation of this CT-STR complex across primates, except prosimians, Microcebus murinus and Otolemur garnettii (Fisher exact P<4.1×10(-7)). H. sapiens has the most complex STR formula, and longest repeats. Macaca mulatta and Callithrix jacchus monkeys have the simplest STR formulas, and shortest repeat numbers. CT≥4-repeats were not detected in non-primate lineages. Different length alleles across the PAXBP1 core promoter CT-STRs significantly altered gene expression in vitro (P<0.001, t-test). PAXBP1 has a crucial role in craniofacial development, myogenesis, and spine morphogenesis, properties that have been diverged between primates and non-primates. To our knowledge, this is the first instance of expansion and conservation of a STR complex co-occurring specifically with the primate lineage.

Telepractice Parent Training of Enhanced Milieu Teaching With Phonological Emphasis (EMT+PE) For Persian-Speaking Toddlers With Nonsyndromic Cleft Palate: Protocol for a Randomized Controlled Trial.

BACKGROUND: Children born with a cleft palate with or without a cleft lip (CP/L) are at increased risk for delayed language development and speech sound disorders. Enhanced Milieu Teaching with Phonological Emphasis (EMT+PE) is a recommended naturalistic intervention for toddlers with CP/L. The parents' role in providing naturalistic interventions is critical and they need training based on learning principles to implement these interventions. Telepractice is an appropriate method for training parents and children with various speech-related disorders. OBJECTIVE: This study aims to determine and compare the effectiveness of telepractice and the parent-implemented EMT+PE intervention on language and speech measures in toddlers with CP/L with usual interventions and determine the effectiveness maintenance of the intervention. METHODS: A randomized controlled trial (RCT) will assess the efficacy of telepractice and the parent-implemented EMT+PE intervention in enhancing speech and language measures in toddlers with CP/L. Eligible participants will be randomly assigned to one of 2 groups: the conventional intervention group and the EMT+PE intervention group. Participants' speech and language measures will be evaluated remotely by trained raters before and after the intervention and 2 months after the intervention. Parents of participants in the intervention group will receive 3 months of training in speech and language supportive strategies from trained therapists using telehealth fidelity scales. Parents of participants in the control group will receive the conventional speech and language intervention by cleft team therapists. Study outcomes will include language variables (mean length of utterance) and speech production variables (percent correct consonants). RESULTS: The protocol was approved by the Research Ethics Committee of the University of Social Welfare and Rehabilitation Sciences in February 2022. The selection process of participants, as well as training therapists and raters, commenced in January 2022, the therapy and follow-up period ended in June 2023, and pre- and postintervention assessments have been conducted. Data analysis is ongoing, and we expect to publish our results by the summer of 2024. Funding is yet to be received. CONCLUSIONS: The results of this study may help us develop a speech and language intervention with a different delivery model for toddlers with CP/L, and the cleft team care can use these results in service delivery. Consistent with our hypothesis, speech and language measures are expected to improve. INTERNATIONAL REGISTERED REPORT IDENTIFIER (IRRID): DERR1-10.2196/54426.

Prevalence of depression, stress and suicide tendency among individuals with long COVID and determinants: a protocol of a systematic review and meta-analysis.

BACKGROUND: It is well known that the COVID-19 pandemic has had a devastating impact on mental health, especially among individuals with long COVID. This systematic review and meta-analysis aims to investigate the prevalence of depression, stress and suicide tendencies among individuals with long COVID, as well as to explore the factors that contribute to these conditions. METHODS AND ANALYSIS: A comprehensive review of literature will be conducted in various databases of including PubMed, including Medline, Embase, PsycINFO, CINAHL and Cochrane Library. The studies to be included in this review will be published in the English language, and the time frame of included studies will be from the date of inception of COVID-19 until 30 December 2023. Two independent reviewers will identify studies for inclusion based on a screening questionnaire, and the JBI standardised critical appraisal checklist for studies reporting prevalence data will be used to assess the methodological quality. The strength of the body of evidence will be assessed using the Grading of Recommendations Assessment, Development and Evaluation approach. To analyse the data, a robust Bayesian approach will be applied using the STATA software package (V.14; STATA) and JASP software. The findings of this systematic review and meta-analysis will provide valuable insights into the prevalence of depression, stress and suicide tendencies among individuals with long COVID, as well as the factors that contribute to these conditions. ETHICS AND DISSEMINATION: There is no research ethics board approval required. The dissemination plan is to publish results in a peer-reviewed academic journal. PROSPERO REGISTRATION NUMBER: CRD42022346858.

Cost prediction of antipsychotic medication of psychiatric disorder using artificial neural network model.

BACKGROUND: Antipsychotic monotherapy or polypharmacy (concurrent use of two or more antipsychotics) are used for treating patients with psychiatric disorders (PDs). Usually, antipsychotic monotherapy has a lower cost than polypharmacy. This study aimed to predict the cost of antipsychotic medications (AM) of psychiatric patients in Iran. MATERIALS AND METHODS: For this purpose, 790 patients with PDs who were discharged between June and September 2010 were selected from Razi Psychiatric Hospital, Tehran, Iran. For cost prediction of AM of PD, neural network (NN) and multiple linear regression (MLR) models were used. Analysis of data was performed with R 2.15.1 software. RESULTS: Mean ± standard deviation (SD) of the duration of hospitalization (days) in patients who were on monotherapy and polypharmacy was 31.19 ± 15.55 and 36.69 ± 15.93, respectively (P < 0.001). Mean and median costs of medication for monotherapy (n = 507) were $8.25 and $6.23 and for polypharmacy (n =192) were $13.30 and $9.48, respectively (P = 0.001). The important variables for cost prediction of AM were duration of hospitalization, type of treatment, and type of psychiatric ward in the MLR model, and duration of hospitalization, type of diagnosed disorder, type of treatment, age, Chlorpromazine dosage, and duration of disorder in the NN model. CONCLUSION: Our findings showed that the artificial NN (ANN) model can be used as a flexible model for cost prediction of AM.

Economic Burden of HIV/AIDS in Iran: A Modelling Approach.

Background: HIV/AIDS is a leading cause of mortality and morbidity in Low-and-Middle-Income-Countries (LMICs). It might potentially lead to an economic burden on the health system. There is no certainty about the prevalence of HIV/AIDS in Iran. Therefore, we aimed to estimate the cost of illness of HIV/AIDS in Iran. Methods: We applied a societal perspective to capture the direct and indirect costs attributed to HIV/AIDS in Iran. We used data for age-standardized prevalence produced by the country HIV/AIDS Surveillance System for 2018. The study estimated both direct and indirect costs for a hypothetical cohort of the Iranian adult population (here equates to all registered cases with Surveillance System). For mitigating the uncertainty around the estimations, we have used an optimistic and pessimistic analysis. Results: The base case scenario showed that total direct costs and indirect costs attributed to the HIV/AIDS were US$7,946,530 and US$ 1,288,586 at the end of 2018. Moreover, the total cost is 8,785,116 US$. Conclusion: Direct costs have formed approximately 85% of total costs. The policymakers and planners should consider that these costs are only related to diagnosed or registered infected populations. These costs will be raised dramatically with increasing the diagnosed patients.

Maternal weight latent trajectories and associations with adverse pregnancy outcomes using a smoothing mixture model.

Class membership is a critical issue in health data sciences. Different types of statistical models have been widely applied to identify participants within a population with heterogeneous longitudinal trajectories. This study aims to identify latent longitudinal trajectories of maternal weight associated with adverse pregnancy outcomes using smoothing mixture model (SMM). Data were collected from the Khuzestan Vitamin D Deficiency Screening Program in Pregnancy. We applied the data of 877 pregnant women living in Shooshtar city, whose weights during the nine months of pregnancy were available. In the first step, maternal weight was classified and participants were assigned to only one group for which the estimated trajectory is the most similar to the observed one using SMM; then, we examined the associations of identified trajectories with risk of adverse pregnancy endpoints by applying logistic regression. Three latent trajectories for maternal weight during pregnancy were identified and named as low, medium and high weight trajectories. Crude estimated odds ratio (OR) for icterus, preterm delivery, NICU admission and composite neonatal events shows significantly higher risks in trajectory 1 (low weight) compared to trajectory 2 (medium weight) by 69% (OR = 1.69, 95%CI 1.20, 2.39), 82% (OR = 1.82, 95%CI 1.14, 2.87), 77% (OR = 1.77, 95%CI 1.17, 2.43), and 85% (OR = 1.85, 95%CI 1.38, 2.76), respectively. Latent class trajectories of maternal weights can be accurately estimated using SMM. It is a powerful means for researchers to appropriately assign individuals to their class. The U-shaped curve of association between maternal weight gain and risk of maternal complications reveals that the optimum place for pregnant women could be in the middle of the growth curve to minimize the risks. Low maternal weight trajectory compared to high had even a significantly higher hazard for some neonatal adverse events. Therefore, appropriate weight gain is critical for pregnant women.Trial registration International Standard Randomized Controlled Trial Number (ISRCTN): 2014102519660N1; http://www.irct.ir/searchresult.php?keyword=&id=19660&number=1&prt=7805&total=10&m=1 (Archived by WebCite at http://www.webcitation.org/6p3lkqFdV ).

Species diversity and geographic distribution of hard ticks (Acari: Ixodoidea: Ixodidae) infesting domestic ruminants, in Qazvin Province, Iran.

This report presents the results of the first faunistic study of hard ticks in Qazvin province of Iran. The primary objective was to determine the species diversity and geographic distribution of hard ticks that parasitize domestic ruminants. Information about the abiotic preferences of these species has been provided. A total of 286 cattle, 1,053 goats, and 2,050 sheep were examined in 13 villages in 28 flocks distributed throughout the studied areas. Total direct body collections of ticks were made from each domestic ruminant. A total of 228 Ixodid specimens belonging to nine species in three different genera were recorded in the areas, including Boophilus annulatus (Say, 1821), Hyalomma anatolicum Koch, 1844, Hyalomma asiaticum (Schulze and Schlettke, 1929), Hyalomma detritum Schulze, 1919, Hyalomma dromedarii Koch, 1844, Hyalomma marginatum Koch 1844, Hyalomma schulzei Olenev, 1931, Rhipicephalus bursa Canestrini and Fanz, 1878 and Rhipicephalus sanguineus (Latreille, 1806). The most abundant species on sheep was R. sanguineus (46.92%), while B. annulatus (6.6%) found only on cattle. A finding of great significance was that R. sanguineus, the main vector of babesiosis, is firmly established throughout the counties. A further objective of the study was to compare the abundance of the major tick species on domestic ruminants. This was carried out at 19 sampling sites. The highest number of ticks was collected in July-August during the hot season.

Human myiasis in Fars Province, Iran.

We evaluated the prevalence and consequences of human myiasis among people involved in animal husbandry and butchers among 6 counties in Fars Province, Iran using a descriptive cross sectional survey. A semi-structured questionnaire was used to evaluate knowledge, community perceptions and practices. Three hundred two herders shepherds and butchers were included in the study. Eighty-eight point three percent of subjects had experienced myiasis during their job experiences. Seventy-one point five percent had become infected in barns. Pharyngeal myiasis was reported by 87% of subjects. The most likely cause of myiasis in subjects was the sheep botfly, Oestrus ovis (Diptera: Oestridae). Age and job experiences did not have an effect on the knowledge and practice regarding myiasis of subjects. Academic educational level had no significant effect on knowledge but did have a significant effect on practices. A myiasis education program needs to be created to better control and prevent this problem.

Identification of gene signature in RNA-Seq hepatocellular carcinoma data by Pareto-optimal cluster algorithm.

Aim: This study aimed to detect gene signatures in RNA-sequencing (RNA-seq) data using Pareto-optimal cluster size identification. Background: RNA-seq has emerged as an important technology for transcriptome profiling in recent years. Gene expression signatures involving tens of genes have been proven to be predictive of disease type and patient response to treatment. Methods: Data related to the liver cancer RNA-seq dataset, which included 35 paired hepatocellular carcinoma (HCC) and non-tumor tissue samples, was used in this study. The differentially expressed genes (DEGs) were identified after performing pre-filtering and normalization. After that, a multi-objective optimization technique, namely multi-objective optimization for collecting cluster alternatives (MOCCA), was used to discover the Pareto-optimal cluster size for these DEGs. Then, the k-means clustering method was performed on the RNA-seq data. The best cluster, as a signature for the disease, was found by calculating the average Spearman's correlation score of all genes in the module in a pair-wise manner. All analyses were performed in the R 4.1.1 package in virtual space with 100 Gb of RAM memory. Results: Using MOCCA, eight Pareto-optimal clusters were obtained. Ultimately, two clusters with the greatest average Spearman's correlation coefficient scores were chosen as gene signatures. Eleven prognostic genes involved in HCC's abnormal metabolism were identified. In addition, three differentially expressed pathways were identified between tumor and non-tumor tissues. Conclusion: These identified metabolic prognostic genes help us to provide more powerful prognostic information and enhance survival prediction for HCC patients. In addition, Pareto-optimal cluster size identification is suggested for gene signature in other RNA-Seq data.

Comparison of the Modified Lumbar Pelvic Belt with the Current Belt on Low Back and Pelvic Pain in Pregnant Women.

Background: Low back pain is one of the most common problems for pregnant women during pregnancy. Most belts are designed for supporting the surface of the symphysis pubis or upper anterior iliac spine without any support in the lumbar region. Objective: This study aimed to compare the related effects between the new design and the current belt on the pain and function of pregnant women. Material and Methods: In this randomized control trial study, 48 pregnant women with pelvic and lumbar pain participated. The participants were randomly divided into three groups: current belt, modified belt, and control. Pain intensity assessment, pelvic girdle (PG), and Oswestry disability index (ODI) questionnaires were utilized at the beginning of the study and three weeks later. Results: The pain intensity decreased more in the modified belt group than in the current belt group. ODI and PG scores decreased in two belt groups after three weeks of follow-up. However, this decrease was greater in the modified belt group, there was no statistically significant difference. Conclusion: The disability decreased in both groups using the belts, and their function was improved. Accordingly, the use of a modified belt with lumbar and PG support can significantly reduce back and pelvic pain in pregnant women compared to the current pelvic belt.