The Factor Structure and Generalizability of the Iranian Socioeconomic Status (SES) Questionnaire Administered in a Nationally Divergent Population.

Background: Measuring socioeconomic status (SES) as an independent variable is challenging, especially in epidemiological and social studies. This issue is more critical in large-scale studies on the national level. The present study aimed to extensively evaluate the validity and reliability of the Iranian SES questionnaire. Methods: This psychometric, cross-sectional study was conducted on 3000 households, selected via random cluster sampling from various areas in East Azerbaijan province and Tehran, Iran. Moreover, 250 students from Tabriz University of Medical Sciences were selected as interviewers to collect data from 40 districts in Iran. The construct validity and internal consistency of the SES questionnaire were assessed using exploratory and confirmatory factor analyses and the Cronbach's alpha. Data analysis was performed in SPSS and AMOS. Results: The complete Iranian version of the SES questionnaire consists of 5 factors. The Cronbach's alpha was calculated to be 0.79, 0.94, 0.66, 0.69, and 0.48 for the occupation, self-evaluation of economic capacity, house and furniture, wealth, and health expenditure, respectively. In addition, the confirmatory factor analysis results indicated the data's compatibility with the 5-factor model (comparative fit index = 0.96; goodness of fit index = 0.95; incremental fit index = 0.96; root mean square error of approximation = 0.05). Conclusion: According to the results, the confirmed validity and reliability of the tool indicated that the Iranian version of the SES questionnaire could be utilized with the same structure on an extensive level and could be applicable for measuring the SES in a broader range of populations.

Comprehensive infectious diabetic foot ulcer repair through multiple dressing methods, maggot therapy, and vacuum therapy after amputation: A case report study.

INTRODUCTION AND IMPORTANCE: Diabetic foot ulcers are a prevalent and challenging issue among diabetes patients, frequently leading to notable health concerns and reduced quality of life. Effectively addressing diabetic foot ulcers necessitates a comprehensive treatment strategy. CASE PRESENTATION: The 69-year-old patient with Type 2 diabetes, complicated by illiteracy and poor glycemic control, developed a foot wound that escalated to cellulitis and abscess due to diabetes and peripheral vascular disease. After angioplasty and midfoot amputation, treatment focused on wound healing with antibiotics, local anesthesia, larval therapy, vacuum-assisted closure (VAC), platelet-rich plasma (PRP) injections, and specialized dressings. A multidisciplinary team approach facilitated successful wound healing and functional improvement, highlighting the importance of comprehensive care and innovative treatments in complex diabetic foot ulcers. DISCUSSION: Diabetic foot ulcers, a frequent complication of diabetes, present notable hurdles in treatment and care. Comprehensive strategies are typically essential for managing these ulcers efficiently and averting additional issues. Recently, there has been increasing attention towards employing various dressing techniques, maggot therapy, and vacuum therapy as integral components of a holistic diabetic foot ulcer treatment approach. CONCLUSION: Employing a comprehensive method involving various dressing techniques, maggot therapy, and vacuum therapy for diabetic foot ulcers can significantly boost wound healing, curb infections, and lower the chances of additional complications.

Economic burden of type 2 diabetes in Iran: A cost-of-illness study.

Background and Aims: Type 2 diabetes mellitus (T2DM) is a prevalent public health problem worldwide, and the economic burden of the disease poses one of the main challenges for health systems in low- and middle-income countries. This study aimed to estimate the economic burden of T2DM in Iran, in 2018. Methods: This was a cost-of-illness study. Three hundred and seventy-five patients with T2DM who were referred to Imam Reza and Sina's educational and therapeutic centers and Asad Abadi clinic in Tabriz, Iran, in 2018 were included. A researcher-constructed checklist was used for data collection. Data were analyzed using EXCEL and SPSS software version 22. Results: Total economic burden of diabetes was estimated at 152,443,862,480.3 (purchasing power parity [PPP], Current International $) (approximately 7.69% of GDP, PPP, Current International $). The mean total direct and indirect costs were 11,278.68 (PPP) (62.35% of mean total cost) and 6808.88 (PPP, Current International $) (37.64% of the total cost), respectively. The mean total direct medical cost and the direct nonmedical cost were 10,819.43 (PPP, Current International $) (59.81% of mean total cost) and 459.24 (PPP, Current International $) (2.53% of mean total cost) per patient, respectively. Besides, the mean direct medical cost was 6.18 times the total per capita expenditure on health, and the total direct medical cost was 8.9% times the total expenditure on health. Conclusion: Diabetes imposes a substantial economic burden on patients, health systems, and the whole economy. Besides, since the cost of the disease in patients treated with insulin and those with diabetes complications is significantly higher, the reinforcement of self-care measures and focusing on modifying lifestyle (dietary modification and physical activity) in patients with T2DM can significantly reduce the costs of the disease.

Key Indicators Affecting Hospital Efficiency: A Systematic Review.

Background: Measuring hospital efficiency is a systematic process to optimizing performance and resource allocation. The current review study has investigated the key input, process, and output indicators that are commonly used in measuring the technical efficiency of the hospital to promote the accuracy of the results. Methods: To conduct this systematic review, the electronic resources and databases MEDLINE (via PubMed), Scopus, Ovid, Proquest, Google Scholar, and reference lists of the selected articles were used for searching articles between 2010 and 2019. After in-depth reviews based on the inclusion and exclusion criteria, among 1,537 studies, 144 articles were selected for the final assessment. Critical Appraisal Skills Programme (CASP) Checklist was used for evaluating the quality of the articles. The main findings of studies have been extracted using content analysis. Results: After the final analysis, the Context/Input indicators that were commonly considered by studies in analyzing hospital technical efficiency include different variables related to Hospital Capacity, Structure, Characteristics, Market concentration, and Costs. The Process/Throughput indicators include different variables related to Hospital Activity or services-oriented process Indicators, Hospital Quality-oriented process indicators, and Hospital Educational processes. Finally, the Output/Outcome indicators include different variables related to Hospital Activity-related output variables and Quality-related output/outcomes variables. Conclusion: This study has identified that it is necessary to mix and assess a set of input, process, and output indicators of the hospital with both quantitative and qualitative indicators for measuring the technical efficiency of hospitals comprehensively.

Setting research priorities to achieve long-term national road safety goals in Iran.

Background: Road traffic crashes (RTCs) and its associated injuries are one of the most important public health problems in the world. In Iran, RTCs rank second in terms of mortality. To address this issue, there is a need for research-based interventions. Prioritizing researches using a variety of approaches and frameworks to determine the most effective interventions is a key nodal point in the RTCs' research policy planning cycle. Thus, this study aims to generate and prioritize research questions in the field of RTCs in Iran. Methods: By adapting the Child Health and Nutrition Research Initiative (CHNRI) method, this study engaged 25 prominent Iranian academic leaders having role in setting Iran's long-term road safety goals, a group of research funders, and policymakers. The experts' proposed research questions were independently scored on a set of criteria: feasibility, impact on health, impact on the economy, capacity building, and equity. Following the prioritization of Research Questions (RQs), they were all classified using the 5 Pillar frameworks. Results: In total, 145 Research Questions were systematically scored by experts against five criteria. Iran's top 20 road traffic safety priorities were established. The RQs related to "road safety management" and "road and infrastructure" achieved a high frequency. Conclusions: The top 20 research questions in the area of RTCs in Iran were determined by experts. The majority of these RQs were related to "road safety management". The results of this study may contribute to the optimal use of resources in achieving long-term goals in the prevention and control of road traffic crashes and its related injuries. Considering these RQs as research investment options will improve the current status of Road Traffic Injuries (RTIs) at a national level and further advance toward compliance with international goals. If these research priorities are addressed, and their findings are implemented, we can anticipate a significant reduction in the number of crashes, injuries, and deaths.

Piroxicam Analogs: Design, Synthesis, Docking Study and Biological Evaluation as Promising Anti-HIV-1 Agents.

OBJECTIVE: In this study, we describe the synthesis, docking study and biological evaluation of 1,2-benzothiazines 1,1-dioxide derivatives. METHODS: Taking the well-known drug, Piroxicam as a lead compound, we designed and synthesized two series of 1,2-benzothiazines 1,1-dioxide derivatives to assay their ability in inhibition of HIV-1 replication in cell culture. RESULTS: Most of the new compounds were active in the cell-based anti-HIV-1 assay with EC50 < 50 µM. Among them, compound 7g was found to be the most active molecule.Docking study using 3OYA pdb code on the most active molecule 7g with EC50 values of 10 µM showed a similar binding mode to the HIV integrase inhibitors. CONCLUSION: Since all the compounds showed no remarkable cytotoxicity (CC50> 500 µM), the designed scaffold is promising structure for the development of new anti-HIV-1 agents.

Design, Synthesis, Docking Study and Biological Evaluation of 4-Hydroxy-2H-benzo[e][1,2]thiazine-3-carboxamide 1,1-dioxide Derivatives as Anti-HIV Agents.

A novel series of benzothiazine-3-carboxamide 1,1-dioxide derivatives by modifying the piroxicam scaffold was designed, synthesized, and evaluated as anti-HIV agents. The 1,2-benzothiazine-3-carboxamide 1,1-dioxide scaffold consists of hydroxy and carboxamide groups as a chelating motif to form an interaction with Mg2+ ions within the integrase active site as a target. Most of the compounds displayed encouraging anti-HIV activity in a cell-based assay. Among them, compounds 13d, 13l and 13m were the most potent with EC50 values ranging from 20-25 µM and SI > 26. Docking study of compounds in integrase active site proposed that the mechanism of action of compounds might be through Mg2+ chelation within integrase active site. The lack of severe cytotoxicity and favorable anti-HIV activity of benzothiazine-3-carboxamide 1,1-dioxide derivatives support further modifications to improve the potency.

Bacteria bioaerosol in the indoor air of educational microenvironments: Measuring exposures and assessing health effects.

Exposure to bioaerosols has been identified to be linked the incidence of various health effects, i.e., infectious diseases, acute toxic effects, allergies, and cancer. The aim of this study was to determine the bacterial bioaerosols in the indoor air of the educational environments of Ardabil universities and to evaluate the exposure and to determine its health risk. In this cross-sectional study, different sections of the educational environments of Ardabil universities were studied. For differential diagnosis of bacteria, methods such as gram staining and biochemical detection methods including DNAse, catalase, oxidase, coagulase, bile esculin hydrolysis test, urease, citrate test, antibiotic resistance to novobiocin and Bacitracin, optochin, glucose uptake, and other differential tests were used. For sampling, a single-stage Anderson sampler was used at a flow rate of 28.3 l at a duration of 10 min per minute. The results showed that, in medical school of Ardabil University of Medical Sciences, the average concentration of bacteria in the outdoor air of school, halls, classes and rooms of professors and staff were 18, 88.4, 76.6, and 77.4 CFU/m3, respectively, and, in Ardabil Islamic Azad University, the average bacterial concentration was 103, 97, 124, and 132 CFU/m3 in the outdoor air of the schools, halls, classrooms, and rooms of professors and staff, respectively. The predominant bacterial species in indoor air are S. aureus, S. epidermidis, Actinomycetes, and Bacillus, respectively. As results indicated, the concentration of bacterial bioaerosols in indoor air is within the standard levels, but due to frequency of bacterial species, occurrence of different in lung and intestinal diseases can be expected among faculty, staff and students in the long-term.

Effect of vasopressin on electrocardiographic changes produced by ischemia-reperfusion in rats.

The present study was conducted to identify the effect of vasopressin (AVP) on electrocardiographic changes produced by ischemia-reperfusion. Male rats were divided into seven groups (n=8-13) subjected to 30min ischemia and 120 min reperfusion. In protocol I (control group), saline was administered before ischemia. In protocol II, different doses of AVP (0.015, 0.03, 0.06 and 0.12µg/rat) were infused 10 min before ischemia. In protocol III SR49059 (1 mg/kg), was injected 20 min prior to ischemia with and without the effective dose of AVP (0.03 g/rat). Ischemia-induced arrhythmia and myocardial infarct size (IS) were measured. Different doses of vasopressin decreased IS. There were no significant differences in PR, QRS duration and &DGR;T/amp;DGR;ST ratio between control and intervention groups in ischemia. ST elevation was significantly increased in control and AVP 0.015, 0.03, 0.06 groups during ischemia. In AVP 0.12 group there was no significant difference in ST deviation between the baseline and ischemia phase. JT interval was significantly increased in control and antagonist group during ischemia. AVP 0.12µ/rat prevented the increase of JT interval in ischemia compared to the baseline. In summary, AVP mediated preconditioning improved ST resolution, prevented prolongation of JT interval and decreased the likelihood of subsequently ventricular arrhythmia.

Assessment of medical equipment maintenance management: proposed checklist using Iranian experience.

BACKGROUND: Effective maintenance management of medical equipment is one of the major issues for quality of care, for providing cost-effective health services and for saving scarce resources. This study aimed to develop a comprehensive checklist for assessing the medical equipment maintenance management (MEMM) in the Iranian hospitals. METHODS: This is a multi-methods study. First, data related to factors which affect the assessment of MEMM were collected through a systematic review in PubMed, ProQuest, Scopus, Embase, and web of science without any time limitation until October 2015, updated in June 2017. Then, we investigated these factors affecting using document review and interviews with experts in the Iranian hospitals. In the end, the results of the first and second stages were combined using content analysis and the final checklist was developed in a two-round Delphi. RESULTS: Using a combination of factors extracted from the systematic and qualitative studies, the primary checklist was developed in the form of assessment checklists in seven dimensions. The final checklist includes 7 dimensions and 19 sub-categories: "resources = 3," "quality control = 3," "information bank = 4," "education = 1," "service = 3," "inspection and preventive maintenance = 2" and "design and implementation = 3." CONCLUSIONS: Developing an assessment checklist for MEMM provide a comprehensive framework for the proper implementation of accurate assessment of medical equipment maintenance. This checklist can be used to improve the profitability of health facilities and the reliability of medical equipment. In addition, it is implicated in the decision-making in support of selection, purchase, repair and maintenance of medical equipment, especially for capital equipment managers and medical engineers in hospitals and also for the assessment of this process.

Vitamin D3 protects against lead-induced testicular toxicity by modulating Nrf2 and NF-κB genes expression in rat.

Lead (Pb) is an environmental toxin that has the ability to alter biological processes by inducing oxidative stress (OS) and inflammation. Nuclear factor erythroid 2-related factor 2 (Nrf2) and nuclear factor-kappa B (NF-κB) are two transcriptional factors that participate in the regulation of cellular responses against OS and inflammation. This study was conducted to evaluate the effects of vitamin D3 (VD) on the prevention of testicular damages of Pb and its association with Nrf2 and NF-κB gene expression levels and their downstream molecules. Forty male Wistar rats were divided into four groups and treatments were performed as following for four weeks: control group received no treatment, VD group were injected intramuscularly with 1000 IU of VD/Kg every other day, Pb group received 1000 mg of Pb/L of drinking water, and Pb + VD group were exposed to Pb and VD simultaneously. The results demonstrated significant decrease in the levels of tissue antioxidants, and increase in inflammatory cytokines in the Pb-intoxicated group, with increased Nrf2 and NF-κB mRNA levels. A remarkable reduction in sperm criteria and a significant disruption in serum hormones were also observed. Anyhow, VD supplementation during exposure to Pb showed a significant protective effect against all pathophysiologic alterations caused by Pb. Furthermore, VD affected the expression of Nrf2 and NF-κB and mitigated the harsh effects of Pb. In conclusion, our findings indicate that VD attenuated the toxic impacts of Pb on testis through modulation of Nrf2 and NF-κB gene expression levels which further regulated the OS and inflammatory responses.

The catastrophic out-of-pocket health expenditure of multiple sclerosis patients in Iran.

BACKGROUND: The present study was designed and conducted to evaluate multiple sclerosis (MS) treatment costs and the resulting economic impact imposed on MS patients in Iran. METHODS: This was a cross-sectional study, among randomly selected 300 MS patients, registered in the MS Association of East Azerbaijan Province, Iran (1 year after their treatment began). The regression analysis, ANOVA, T-test, and chi-square were used. RESULTS: The average amount of out-of-pocket payments (OOPs) by MS patients during the previous year was 1669.20 USD, most of which was spent on medication, rehabilitation care, and physician visits. Their mean annual income was 5182.84 USD. Fifty four percent of families with an MS patient suffer from catastrophic health expenditure (CHE) and 44% experience poverty caused by the OOPs. Occupational status, having supplemental health insurance, and being residents of Tabriz significantly affect OOPs, CHE, and the resulting poverty (P < 0.05). CONCLUSION: The catastrophic financial burden of health care costs on MS patients and their families justifies health policymakers to promote pre-payment systems and provide subsidies to less well-off patients to protect them from the unfairness of OOPs and its resulting CHE and poverty.

Novel Derivatives of diphenyl-1,3,4-oxadiazol as Ligands of Benzodiazepine Receptors; Synthesize, Binding Assay and Pharmacological Evaluation.

Benzodiazepines (BZD) are among the main classes of tranquilizing drugs, bearing much less toxicity compared to other drugs acting on the CNS. Considering the pharmacophore model of BZD binding to GABA-A receptor, novel diphenyl 1,3,4-oxadiazole compounds as BZD ligands were designed. The compounds were synthesized and structurally confirmed using LCMS, IR and NMR techniques. We investigated the affinity of the compounds to BZD receptors using radioligand [3H]-flumazenil by in-vitro studies. In addition, sedative-hypnotic, anxiety, anticonvulsant, muscle relaxant, memory impairment, and motor coordination activities of the synthesized compounds were evaluated using in-vivo studies. Based on in-vitro studies, compounds 7i and 7j were the most potent with IC50 values of 1.54 and 1.66 nM respectively. In-vivo studies showed that compound 7i has the highest impact on increased sedation, muscle relaxation, and decreased anxiety and these observations were antagonized by flumazenil. Compounds 7e and 7i were the most potent anticonvulsant agents among synthesized compounds in both MES and PTZ induced seizure tests. All synthesized compounds significantly decreased latency to fall in the Rotarod test but none of them had a significant impact on the memory impairment test.

Economic costs incurred by the patients with multiple sclerosis at different levels of the disease: a cross-sectional study in Northwest Iran.

BACKGROUND: Multiple sclerosis (MS) causes significant economic burden to the patients, families, health systems and society. This study aimed to estimate the annual economic costs incurred by patients with multiple sclerosis (pwms) at different levels of the disease. METHOD: This was a cross-sectional study, using the Expanded Disability Status Scale (EDSS) tool for assessing the disease level of 300 (=N) pwms in East Azerbaijan province, Iran. To estimate the cost of MS, a questionnaire with its validity and reliability (CVR 92% and CVI 87%) and pilot test (Cronbach's alpha score 0.89) was used. The data were collected by interviewing pwms and reviewing their clinical records. Multivariate linear regression was used to assess the relationship between disease levels and incurred costs. RESULTS: The results revealed that the mean annual cost for pwms in Iran is 97,521,740 IRR (equivalent to 2321.94 USD; 1978.93 EURO) and the mean score of EDSS in pwms was 3.14. The annual cost incurred by pwms with mild, moderate and severe levels of disease were 83,918,150 IRR (1998.05 USD; 1702.88EURO), 137,772,660 IRR (3280.30 USD; 2795.71 EURO) and 119,962,670 IRR (2856.25 USD;2434.30 EURO), respectively. Also, on average, each increase in EDSS score in pwms in Iran led to increase 8,139,260 IRR (equivalent to 193.79 USD; and 165.16 EURO) in total annual cost which must paid from pwms and their households exclusively. Also, there was a significant relationship between total annual cost and disease severity in such a way that any increase in EDSS degree is led to 8,139,260 IRR (193.79 USD; 165.16 EURO) added cost for pwms. CONCLUSION: The study results could be helpful for Iranian health managers to solve problems which are facing by the patients with multiple sclerosis and their families.

Readiness for diet change and its association with diet knowledge and skills, diet decision making and diet barriers in type 2 diabetic patients.

AIMS: to investigate stages of change for dietary in type 2 diabetics and its associations with diet knowledge and skills, diet decision making and diet barriers. MATERIALS AND METHODS: This was a cross-sectional study which was conducted on 1139 diabetics aged>18 years in East Azerbaijan, Iran. Data were collected through a Personal Diabetes Questionnaire (PDQ) and analyzed through SPSS version 22 software using descriptive statistics, Chi-square and one-way ANOVA tests. Tukey's HSD post hoc tests were applied to illustrate ANOVA findings. RESULTS: 59.3% of patients do not follow a diet plan to control their blood glucose. 44.7%, 5.5%, 13%, and 36.8% of patients, respectively, were in the stages of pre-contemplation, contemplation, preparation and action. Patients who had shorter disease duration and those whose current treatment was lifestyle change were more likely within the action stage. Also, patients who had a higher score in diet knowledge and skills and diet decision making and those who had a lower score in diet barriers were more likely in the action stage of change. CONCLUSION: Based on the results of this study, a considerable proportion of diabetic patients were in the pre-contemplation stage. Diet knowledge and skills, diet decision making and diet barriers were factors contributing to diet readiness to change. Therefore, taking necessary measures to increase diet knowledge, skills and diet decision-making and a reduction in diet barriers can help people with type 2 diabetes to change diet.

Stewardship as a Fundamental Challenge in Strategic Purchasing of Health Services: A Case Study of Iran.

OBJECTIVE: To understand the stewardship challenges in strategic purchasing of health care in Iran's health system from the viewpoints of experts, policy makers, and decision makers. STUDY DESIGN: This was a qualitative study. METHODS: Researchers used interviews and FGDs for collecting and framework analysis for analyzing data. RESULTS: Stewardship challenges were classified into three themes and nine subthemes. A lack of management information systems, a lack of enforcement for rules and laws, a lack of stewardship units, and the conflict of interest between the Ministry of Health and insurers as care purchasers in the health system are among the main challenges identified in the implementation of the strategic purchasing of health care in Iran. CONCLUSION: A strong stewardship is needed for implementing strategic purchasing of health care, which requires participation of all stakeholders.

Effective coverage as a new approach to health system performance assessment: a scoping review.

BACKGROUND: Delivering interventions is the main task of health systems whose accurate measurement is an essential input into tracking performance. Recently, the concept of effective coverage was introduced by World Health Organization to incorporate into health system performance assessment. The aim of present scoping review was mapping the key elements and steps of effective coverage assessment in practical efforts including kinds of interventions, criteria for selecting them and the need, use and quality estimation approaches and strategies of each intervention. METHODS: We conducted a scoping review of health system/program assessments which assessed effective coverage till May 2017. Seven databases were systematically searched with no time and language restriction through applying combined keyword of "effective coverage". RESULTS: Eighteen studies contributed findings on monitoring effective coverage of health interventions and they all were included in the review. Only 4 contributed findings on health system and the others were related to specific intervention(s) assessment. The interventions monitored by effective coverage were mainly in child health, prenatal and antenatal care and delivery, and chronic conditions areas. Potential impact on the burden of disease, leading causes of mortality and morbidity, and high occurrence and prevalence rate were among the main intervention selection criteria. Availability of data was the critical prerequisite, especially, in all of the studies applied ex post approach in estimating effective coverage. Estimation based on a norm, self- reporting from surveys and biomarkers were the main strategies and methods of need, utilization and quality measurement, respectively. CONCLUSIONS: More studies are needed to contribute to the ongoing improvement in the development of effective coverage concept and increasing practical efforts, especially through defining prospective approaches and strategies into estimation of composite measures based on the effective coverage framework. Also, further attention needs to be paid to quality measures of effective coverage in a manner that better conceptualizes and measures the connection between coverage rates and interventions' effectiveness. At the administrative system level, more innovation is needed to develop data systems in order to enhance capacity of routine health service information.

Transcriptome profiling of fully open flowers in a frost-tolerant almond genotype in response to freezing stress.

Spring frost is a major limiting abiotic stress for the cultivation of almonds [Prunus dulcis (Mill.)] in Mediterranean areas or the Middle East. Spring frost, in particular, damages almond fully open flowers, resulting to significant reduction in yield. Little is known about the genetic factors expressed after frost stress in Prunus spp. as well as in almond fully open flowers. Here, we provide the molecular signature of pistils of fully open flowers from a frost-tolerant almond genotype. The level of frost tolerance in this genotype was determined for all three flowering stages and was confirmed by comparing it to two other cultivars using several physiological analyses. Afterwards, comprehensive expression profiling of genes expressed in fully open flowers was performed after being exposed to frost temperatures (during post-thaw period). Clean reads, 27,104,070 and 32,730,772, were obtained for non-frost-treated and frost-treated (FT) libraries, respectively. A total of 62.24 Mb was assembled, generating 50,896 unigenes and 66,906 transcripts. Therefore, 863 upregulated genes and 555 downregulated genes were identified in the FT library. Functional annotation showed that most of the upregulated genes were related to various biological processes involved in responding to abiotic stress. For the first time, a highly expressed cold-shock protein was identified in the reproductive organ of fruit trees. The expression of six genes was validated by RT-PCR. As the first comprehensive analysis of open flowers in a frost-tolerant almond genotype, this study represents a key step toward the molecular breeding of fruit tree species for frost tolerance.

Correction to: Transcriptome profiling of fully open flowers in a frost­tolerant almond genotype in response to freezing stress.

In the original publication of the article, the affiliation of the third author has been incorrectly published as University of Yazd. However, the correct affiliation is Yazd University.

An Epidemiological Study of Road Traffic Accidents in Guilan Province, Northern Iran in 2012.

OBJECTIVE: To determine the epidemiological characteristics of the road traffic injuries (RTIs) in Guilan province, northern Iran. METHODS: This study was a cross-sectional study which included all of RTIs admitted to medical centers of Guilan province (northern Iran) during 2012. ICD-10 was used as diagnostic criteria. Demographic variables also injury circumstance and in hospital variables such as length of stay, time of admission, type of surgery, ICU admission, final outcome and mechanism of injury, anatomical part of injury according to Abbreviated Injury Scale (AIS) classification were derives from records by trained research team. Descriptive data is reported. The predictors of mortality were also determined. RESULTS: The prevalence of road traffic injuries in Guilan province was 31 in 10,000 populations. Of total 7671 accidents, 5976 (77.9%) were men and 1695 (22.1%) were women. Mean age of these victims was 33.3 ± 17.289 years (32.64±16.939 for men, 35.62±18.312 for women). Most of them (32.5%) were 20-29 years old. Motorcycle-car accidents had the highest frequency followed by car-car crashes and car accidents involving pedestrians. Most of the patients (85.9%) were hospitalized and 280 injured died (3.7%). Upper extremities were the most sites of injuries. Male sex, length of hospital stay, multiple injuries and increased age were associated with road traffic accident associated mortality. CONCLUSION: RTIs cause enormous death and disability in this area and more road traffic preventive programs should be enforcement in these areas to reduce incidences RTI.