The effect of echoes interference on phonon attenuation in a nanophononic membrane.

Nanophononic materials are characterized by a periodic nanostructuration, which may lead to coherent scattering of phonons, enabling interference and resulting in modified phonon dispersions. We have used the extreme ultraviolet transient grating technique to measure phonon frequencies and lifetimes in a low-roughness nanoporous phononic membrane of SiN at wavelengths between 50 and 100 nm, comparable to the nanostructure lengthscale. Surprisingly, phonon frequencies are only slightly modified upon nanostructuration, while phonon lifetime is strongly reduced. Finite element calculations indicate that this is due to coherent phonon interference, which becomes dominant for wavelengths between ~ half and twice the inter-pores distance. Despite this, vibrational energy transport is ensured through an energy flow among the coherent modes created by reflections. This interference of phonon echos from periodic interfaces is likely another aspect of the mutual coherence effects recently highlighted in amorphous and complex crystalline materials and, in this context, could be used to tailor transport properties of nanostructured materials.

Residues of non-phthalate plasticizers in seawater and sediments from Osaka Bay, Japan.

NPPs (Non-phthalate plasticizers) are used as alternative plasticizers to phthalate esters, but there is limited knowledge on environmental residues, and they have not been reported in Japan. A method to analyze NPPs in seawater using solid-phase extraction was developed, and the residual burden of Diisobutyl adipate (DIBA), Acetyl tributyl citrate (ATBC), Di-(2-ethylhexyl) adipate (DEHA), Di-(2-ethylhexyl) sebacate (DEHS) and Trioctyl trimellitate (TOTM) in seawater and sediment from the Osaka Bay was measured. Using an Oasis Max column and acetone as the eluting solvent, the recovery of the target substances in seawater is >68 %. In Osaka Bay, no NPPs were detected in seawater. On the other hand, ATBC and TOTM were detected in the sediment at 36-69 ng/g and 47-131 ng/g, respectively, from about half of the 14 sites, while DEHA and DEHS were detected at 83 ng/g and 181 ng/g, respectively, from only one site.

In Vitro Cytotoxicity of Antiresorptive and Antiangiogenic Compounds on Oral Tissues Contributing to MRONJ: Systematic Review.

BACKGROUND: Invasive dental treatment in patients exposed to antiresorptive and antiangiogenic drugs can cause medication-related osteonecrosis of the jaw (MRONJ). Currently, the exact pathogenesis of this disease is unclear. METHODS: In March 2022, Medline (Ovid), Embase (Ovid), Scopus, and Web of Science were screened to identify eligible in vitro studies investigating the effects of antiresorptive and antiangiogenic compounds on orally derived cells. RESULTS: Fifty-nine articles met the inclusion criteria. Bisphosphonates were used in 57 studies, denosumab in two, and sunitinib and bevacizumab in one. Zoledronate was the most commonly used nitrogen-containing bisphosphonate. The only non-nitrogen-containing bisphosphonate studied was clodronate. The most frequently tested tissues were gingival fibroblasts, oral keratinocytes, and alveolar osteoblasts. These drugs caused a decrease in cell proliferation, viability, and migration. CONCLUSIONS: Antiresorptive and antiangiogenic drugs displayed cytotoxic effects in a dose and time-dependent manner. Additional research is required to further elucidate the pathways of MRONJ.

Effects of Novel Dental Composites on Streptococcus mutans Biofilms.

With the phase-out of amalgam and the increase in minimally invasive dentistry, there is a growing need for high-strength composite materials that can kill residual bacteria and promote tooth remineralization. This study quantifies how antibacterial polylysine (PLS) and re-mineralizing monocalcium phosphate monohydrate (MCPM) affect Streptococcus mutans biofilms and the strength of dental composites. For antibacterial studies, the MCPM-PLS filler percentages were 0-0, 8-4, 12-6, and 16-8 wt% of the composite filler phase. Composite discs were immersed in 0.1% sucrose-supplemented broth containing Streptococcus mutans (UA159) and incubated in an anaerobic chamber for 48 h. Surface biomass was determined by crystal violet (CV) staining. Growth medium pH was measured at 24 and 48 h. Biofilm bacterial viability (CFU), exo-polysaccharide (water-soluble glucan (WSG) and water-insoluble glucan (WIG)), and extracellular DNA (eDNA) were quantified. This was by serial dilution plate counting, phenol-sulfuric acid microassay, and fluorometry, respectively. The biaxial flexural strengths were determined after water immersion for 1 week, 1 month, and 1 year. The MCPM-PLS wt% were 8-4, 8-8, 16-4 and 16-8. The normalized biomass, WSG, and WIG showed a linear decline of 66%, 64%, and 55%, respectively, as the PLS level increased up to 8%. The surrounding media pH (4.6) was all similar. A decrease in bacterial numbers with the 12-6 formula and a significant reduction with 16-8 compared to the 0-0 formulation was observed. The eDNA concentrations in biofilms formed on 12-6 and 16-8 formulations were significantly less than the 0-0 control and 8-4 formulations. Doubling MCPM and PLS caused a 14 and 19% reduction in strength in 1 week, respectively. Average results were lower at 1 month and 1 year but affected less upon doubling MCPM and PLS levels. Moreover, a 4% PLS may help to reduce total biomass and glucan levels in biofilms on the above composites. Higher levels are required to reduce eDNA and provide bactericidal action, but these can decrease early strength.

A trend of Medical Negligence in Laser Therapy in the Capital City: A Nine-Year Survey.

Introduction: The purpose of the present study is to investigate the common causes of injuries, claims, and decisions related to laser therapy medical malpractice during a nine-year survey. Methods: The legal documents in the Coroner's Office of Forensic Medicine were investigated in a national database from 2012 to 2020 in Tehran, Iran. The frequency and nature of the cases, including the year of litigation, the location and certificate of the provider, the injury sustained, and the cause of legal action and judgment were collected. Results: Three hundred and eighty-three cases related to injury from laser therapy were registered in the coroner's Office of Forensic Medicine during the study period. The incidence of litigation related to laser surgery showed an increasing trend, with a peak occurrence in 2020. Laser hair removal was the most common (51.2%) litigated procedure. General practice operators (48%) recorded the highest rate of laser-related medical complaints. Lack of skill was the most common reason for failure. Among 383 cases with public decisions, 62.4% of them were fault liability in paid judgment. Conclusion: Medical claims related to laser application are increasing. However, as it is clear, the growth of laser technology and the increasing demand for lasers in medical science require more surveillance to avoid probable injuries and improve patient safety, especially surveillance of the physicians who work outside the scope of their specialty.

Carotid Endarterectomy: A Single Institutional Experience of 28 Years From Pakistan.

BACKGROUND: Cerebrovascular event is the most common reason of acute neurological injury in the western world. There is an extensive literature and data available on its prognosis, outcomes and complications rates from the west, yet still, data regarding its safety and efficacy is scarce from the South Asian belt. OBJECTIVE: To elucidate the role of carotid endarterectomy in patients with carotid stenosis regarding prevention of stroke and safety of the procedure. METHODS: A descriptive case series of 335 consecutive patients from January 1990 till July 2018. All patients who underwent carotid endarterectomy were included. Patient having asymptomatic carotid disease (≥90%), history of a transient ischemic attack or patients with a recent or previous episode of ischemic stroke (≥60%) were selected for the procedure. All procedures were performed under GA. Post operatively patients were kept on antiplatelet therapy and followed on outpatient basis for any complications using carotid duplex scans. Data regarding 30-day postoperative parameters of the procedure were collected and evaluated. P< 0.05 is considered significant. RESULTS: A total of 335 carotid endarterectomies were performed. The majority of patients in our series were males 68.90% (n = 230) compared to 31.10% (n = 105) females (P< 0.05). There were no intraoperative mortalities in our patients. The 15-day perioperative mortality was 1.5% (n = 5), out of which 3 patients had concomitant CABG and died of cardiac complications. The mortality rate of CEA alone was 0.6% (n = 2). Six patients (1.8%) developed focal neurological deficits in the postoperative period during the hospital stay. Three patients developed wound infection after surgery. Neck hematoma formation occurred in 11.7% (n = 39) patients and 7 required immediate decompression. A total of 321 patients remained stroke free at 6 months follow up. There was no increased risk of stroke secondary to bilateral carotid disease (OR 1.9 CI 0.35-10.7 P= 0.44). CONCLUSION: Carotid Endarterectomy is a relatively safe and effective procedure in our large series from Pakistan. It remains the standard for management of carotid stenosis in symptomatic as well as asymptomatic patients with critical stenosis.

Microwave assisted sol-gel synthesis of bioactive zirconia nanoparticles - Correlation of strength and structure.

It is well known that long term stability in zirconia has been a problem because of the structural alteration from stabilized tetragonal zirconia to monoclinic that leads to fracture in implants. Microwave (MW) assisted sol-gel synthesis is employed in the present work to prepare stabilize zirconia nanoparticles. ZrOCl2.8H2O is used as a precursor whereas de-ionized water is used as a solvent. Power of microwave radiations is varied in the range of 100-1000W. Zirconia nanoparticles have been characterized under as-synthesized, 6- and 12-months' room temperature (RT) aged conditions. Metastable phase (MP) of zirconia, appearing under as-synthesized conditions, transforms to phase pure tetragonal zirconia (t-ZrO2) after RT aging that was prepared with MW powers of 100, 200 and 700-1000W. Whereas, MP transforms to mixed tetragonal-monoclinic phases at microwave powers of 300-600W after RT aging. XPS results show presence of oxygen-deficient state of ZrO2 lattice along with surface defects contributing towards the tetragonal zirconia phase under all conditions. Value of dielectric constant (i.e. ~11-12 at log f = 4.0), hardness (~13 GPa) and fracture toughness observed under all conditions are well in agreement to be used for biological implants. Disks of aged t-ZrO2 nanoparticles are checked for their biodegradation test by dipping in simulated body fluid for several weeks. ZrO2, with 26 weeks of immersion, shows small loss in hardness and weight. Stabilized tetragonal zirconia shows strong anti-oxidant activity. Stabilized ZrO2 nanoparticles presented strong antibacterial activity against both gram positive (S. aureus, Bacillus) and gram negative (E. coli) bacteria. Thus, structural and mechanical stability of zirconia (checked after 6 and 12 months) make this material highly beneficial for long term use in biomedical applications.

IpaD-loaded N-trimethyl Chitosan Nanoparticles Can Efficiently Protect Guinea Pigs against Shigella flexneri.

BACKGROUND: Shigella flexneri is a pathogen responsible for shigellosis around the world, especially in developing countries. Many immunogenic antigens have been introduced as candidate vaccines against Shigella, including N-terminal region of IpaD antigen (NIpaD). OBJECTIVE: To evaluate the efficiency of O-metylated free trimethyl chitosan nanoparticles (TMC NPs) in the oral delivery of NIpaD. METHODS: TMC was synthesized by a two-step method from high molecular weight chitosan. The recombinant NIpaD protein was used as the immunogen. The protein was overexpressed in E. coli BL21 (DE3) and characterized by gel electrophoresis. The NIpaD-loaded TMC NPs were synthesized by ionic gelation method and were characterized by electron microscopy. NPs were orally administered to guinea pigs and specific humoral and mucosal immune responses were assessed by serum IgG and secretory IgA, respectively. The protectivity of the formulation was assessed by keratoconjunctivitis (Sereny) test. RESULTS: The immunized guinea pigs showed a significant raise in rNIpaD-specific serum IgG and faecal IgA titers. Specific secretory IgA was detected in eye-washes. Sereny test results showed that immunized animals vaccinated with IpaD-loaded TMC NPS tolerated the wild type of Shigella flexneri 2a in Sereny test. However, in the group immunized with NIpaD antigen and non-immunized group, no increase was observed in antibody titer against NIpaD. These animals were infected following the challenge with Shigella flexneri 2a (p<0.0152). CONCLUSION: The recombinant rNIpaD formulated with TMC obtained from high molecular weight chitosan, can be considered as a mucosal vaccine against Shigella flexneri through oral route.

A case of Fragile X-associated tremor/ataxia syndrome (FXTAS).

Fragile X-associated tremor/ataxia syndrome (FXTAS) is a late onset neurodegenerative disorder associated with dysfunction of movement, memory, and the peripheral nervous system. We report an 82 years old male who presented with tremors and difficulty with balance that started at 65 years of age. His motor examination revealed decreased strength in left lower extremity. Tremors were seen in both the upper limbs at rest that worsened with movement. Bilateral lower extremities showed absent vibration and proprioception sensations, absent reflexes and upgoing toes. Electrodiagnostic studies revealed sensory predominant axonal sensory-motor peripheral polyneuropathy. Brain MRI revealed microvascular ischemic changes. The cervical and lumbar MRI showed diffuse degenerative changes. Genetic test for heritable causes of ataxia revealed a premutation in Fragile X gene (84 CGG repeats), confirming the diagnosis of FXTAS. On further genetic testing three out of his four daughters also tested positive for the FMR1 premutation. In appropriate clinical setting, Fragile X-associated tremor/ataxia syndrome (FXTAS) should be considered in every middle aged/elderly patient who presented with slowly progressive ataxia, tremor and peripheral polyneuropathy without any history of cognitive or neurological disabilities in childhood.

Sudden Death due to Hydatid Cyst Emboli; a Case Report.

Echinococcosis is an infection caused in human by complex parasites that causes cystic hydatid disease. These infections are prevalent in most areas where livestock is raised in association with dogs. These parasites are found in all continents. Slowly enlarging cysts generally remain asymptomatic until their size has expanded. Here we present a case of sudden death following cyst emboli to the large veins and right heart of a young adult female.

Quality of Life and Body Image of Individuals with Gender Dysphoria.

This study aimed to assess the body image and quality of life of individuals suffering from gender dysphoria (GD) who were undergoing different types of treatment or no treatment at all. This was a descriptive-comparative study of 90 patients with GD sorted into three groups: untreated (no hormone therapy or surgery) (n = 30), hormone therapy (n = 30), and gender-reassignment surgery (n = 30). They were recruited using convenience sampling from a hospital in Tehran, Iran. The tools for data collection were three questionnaires to assess quality of life, body image, and demographic characteristics. The results showed that scores of quality of life and body image were significantly higher in the surgery group compared to the untreated singular (p < 0.001). A significant correlation was found between the quality of life and body image of the patients (r = 0.49; p < 0.001). We concluded that gender-reassignment surgery is the most effective treatment in improving body image and quality of life among individuals with GD.

The comparison of hospitals' performance indicators before and after the Iran's hospital care transformations plan.

INTRODUCTION: Hospital care transformation plan (HCTP) was implemented, in 2014, with the aim of ensuring all Iranians have fair access to hospital care, mainly in the public sector. It was assumed that HCTP would lead to increased quality and effectiveness of health care in public hospitals. To explore whether HCTP has achieved its aim, this study has investigated the impact of this plan on performance indicators (PIs) of the public hospitals. MATERIALS AND METHODS: This cross-sectional descriptive study was conducted in 2016. The study population included all hospitals in the Isfahan City. Data (10 selected PIs) were collected through formal reports which were available at the Isfahan University of Medical Sciences and analyzed using Statistical Package for Social Sciences (version 17). The statistical significant level analysis was 0.05. RESULTS: After HCTP, it was shown an increase of (1) Bed occupancy, bed turnover, occupied bed-days, inpatients visits, and number of surgeries in all types of hospitals, (2) Outpatients' visits in all hospitals except private ones, (3) Emergency visits in public and social security hospitals, and (4) Natural deliveries in public and semi-public hospitals. Furthermore, the average length of stay and hospital mortality rate has decreased in all types of hospitals after HCTP implementation. DISCUSSION AND CONCLUSION: Although, improving PIs of hospitals were not directly stated and known objectives of HCTP implementation, it seems HCTP could improve the performance of all hospitals, including involved and noninvolved ones.

Promoting the Medical University's Governance: Content Analysis of Decisions Made by the Medical University's Governing Bodies.

BACKGROUND: Decisions made by the governing body of a university would overshadow university governance. This study aimed to analyze the quantity and quality of decisions made by the three governing bodies (Board of trustees, Board of Chancellors and University council) of a medical university in Isfahan, Iran. METHODS: A mixed qualitative and quantitative approach was employed, with the quantitative part in cross-sectional format and the qualitative part in content analysis format. In the quantitative part, the number of meetings and resolutions of the governing bodies were collected through Isfahan University of Medical Sciences. In the qualitative part, the content of 3121 resolutions that were selected using stratified sampling method was analyzed. RESULTS: The results indicated the defensible numbers of meetings and resolutions of the boards of trustees and chancellors. The governing bodies' resolutions were mostly operational in domain, administrative (boards of trustees and chancellors) and educational (university council) in nature, financing (board of trustees) and providing services (board of chancellors and university council) in function with the aim of responsiveness. The share of specific and single-department resolutions was greater compared to others. CONCLUSION: Better monitoring and evaluation of the activity of governing bodies, redirecting the decisions made by governing bodies, reminding the position of the governing bodies and revising their duties and responsibilities are recommended for better governance of the medical university.

Crack Propagation Versus Fiber Alignment in Collagen Gels: Experiments and Multiscale Simulation.

It is well known that the organization of the fibers constituting a collagenous tissue can affect its failure behavior. Less clear is how that effect can be described computationally so as to predict the failure of a native or engineered tissue under the complex loading conditions that can occur in vivo. Toward the goal of a general predictive strategy, we applied our multiscale model of collagen gel mechanics to the failure of a double-notched gel under tension, comparing the results for aligned and isotropic samples. In both computational and laboratory experiments, we found that the aligned gels were more likely to fail by connecting the two notches than the isotropic gels. For example, when the initial notches were 30% of the sample width (normalized tip-to-edge distance = 0.7), the normalized tip-to-tip distance at which the transition occurred from between-notch failure to across-sample failure shifted from 0.6 to 1.0. When the model predictions for the type of failure event (between the two notches versus across the sample width) were compared to the experimental results, the two were found to be strongly covariant by Fisher's exact test (p < 0.05) for both the aligned and isotropic gels with no fitting parameters. Although the double-notch system is idealized, and the collagen gel system is simpler than a true tissue, it presents a simple model system for studying failure of anisotropic tissues in a controlled setting. The success of the computational model suggests that the multiscale approach, in which the structural complexity is incorporated via changes in the model networks rather than via changes to a constitutive equation, has the potential to predict tissue failure under a wide range of conditions.

Need assessment of staffs' welfare services at tehran university of medical sciences: a cross-sectional study.

BACKGROUND: Reviewing the human resources management literature shows an absence of attention given to the employee's benefits. Taking a look at functions of the Tehran University of Medical Sciences' wellbeing services system, it uncovers a gap between employees' real needs and what is delivered to meet their needs. So it requires an improved comprehensive system for delivering wellbeing services (financial, insurance, health care services, educational and training services, etc). Wellbeing need assessment can helps planners to identify vital needs of employee and response to them effectively. Moreover it can be used to evaluate the effectiveness of the current services which are delivered. Thus, the aim of this study is to assess wellbeing services of staffs working in TUMS to (1) evaluate the satisfactory rate of services which are delivered, and (2) exploring those wellbeing needs which were not fulfilled by the organization. MATERIAL AND METHODS: Being a cross-sectional and analytic-descriptive survey including 98 responding participants, it is conducted by a questionnaire collecting employees' demographic information, their satisfactory rate of the implemented services, and determines unfulfilled wellbeing needs which were not already covered. RESULT: Results indicated that services related to financial, educational, non-financial, insurance, occupational health and tourism/recreational services were the most satisfactory services successively. 'Staff's unwillingness to receive services' and 'poor announcement' (unawareness on the wellbeing services),' were found to be the most frequent reasons for not receiving the existing wellbeing services. CONCLUSION: To increase the satisfaction rate and responsiveness to the real needs of the staff, the current delivery system of wellbeing services in the TUMS should be redesigned by defining new wellbeing packages.

Evaluation of board performance in Iran's universities of medical sciences.

BACKGROUND: The critical role that the board plays in governance of universities clarifies the necessity of evaluating its performance. This study was aimed to evaluate the performance of the boards of medical universities and provide solutions to enhance its performance. METHODS: The first phase of present study was a qualitative research in which data were collected through face-to-face semi-structured interviews. Data were analyzed by thematic approach. The second phase was a mixed qualitative and quantitative study, with quantitative part in cross-sectional format and qualitative part in content analysis format. In the quantitative part, data were collected through Ministry of Health and Medical Education (MoHME). In the qualitative part, the content of 2,148 resolutions that were selected by using stratified sampling method were analyzed. RESULTS: Participants believed that the boards had no acceptable performance for a long time.RESULTS also indicated the increasing number of meetings and resolutions of the boards in these 21 years. The boards' resolutions were mostly operational in domain and administrative in nature. The share of specific resolutions was more than the general ones. CONCLUSION: Given the current pace of change and development and the need to timely respond them, it is recommended to accelerate the slow pace of improvement process of the boards. It appears that more delegation and strengthening the position of the boards are the effective strategies to speed up this process.

Combining displacement field and grip force information to determine mechanical properties of planar tissue with complicated geometry.

Performing planar biaxial testing and using nominal stress-strain curves for soft-tissue characterization is most suitable when (1) the test produces homogeneous strain fields, (2) fibers are aligned with the coordinate axes, and (3) strains are measured far from boundaries. Some tissue types [such as lamellae of the annulus fibrosus (AF)] may not allow for these conditions to be met due to their natural geometry and constitution. The objective of this work was to develop and test a method utilizing a surface displacement field, grip force-stretch data, and finite-element (FE) modeling to facilitate analysis of such complex samples. We evaluated the method by regressing a simple structural model to simulated and experimental data. Three different tissues with different characteristics were used: Superficial pectoralis major (SPM) (anisotropic, aligned with axes), facet capsular ligament (FCL) (anisotropic, aligned with axes, bone attached), and a lamella from the AF (anisotropic, aligned off-axis, bone attached). We found that the surface displacement field or the grip force-stretch data information alone is insufficient to determine a unique parameter set. Utilizing both data types provided tight confidence regions (CRs) of the regressed parameters and low parameter sensitivity to initial guess. This combined fitting approach provided robust characterization of tissues with varying fiber orientations and boundaries and is applicable to tissues that are poorly suited to standard biaxial testing. The structural model, a set of C++ finite-element routines, and a Matlab routine to do the fitting based on a set of force/displacement data is provided in the on-line supplementary material.

Hepatic PEComa: a potential pitfall in the evaluation of hepatic neoplasms.

Perivascular epithelioid cell tumour (PEComa) of the liver is very uncommon and may be overlooked in the clinical and histological differential diagnosis of a liver tumour. We report the case of an incidentally discovered liver mass suspicious for hepatocellular carcinoma, which on biopsy was suggestive of a pseudocyst but after resection was found to be hepatic PEComa with some of the usual characteristics of this neoplasm as well as several less familiar features. We have also reviewed cases of hepatic PEComa from the literature in order to provide insight into recognising possible PEComa preoperatively and assessing its risk of malignancy after diagnosis.

Prefailure and failure mechanics of the porcine ascending thoracic aorta: experiments and a multiscale model.

Ascending thoracic aortic aneurysms (ATAA) have a high propensity for dissection, which occurs when the hemodynamic load exceeds the mechanical strength of the aortic media. Despite our recognition of this essential fact, the complex architecture of the media has made a predictive model of medial failure-even in the relatively simple case of the healthy vessel-difficult to achieve. As a first step towards a general model of ATAA failure, we characterized the mechanical behavior of healthy ascending thoracic aorta (ATA) media using uniaxial stretch-to-failure in both circumferential (n = 11) and axial (n = 11) orientations and equibiaxial extensions (n = 9). Both experiments demonstrated anisotropy, with higher tensile strength in the circumferential direction (2510 ± 439.3 kPa) compared to the axial direction (750 ± 102.6 kPa) for the uniaxial tests, and a ratio of 1.44 between the peak circumferential and axial loads in equibiaxial extension. Uniaxial tests for both orientations showed macroscopic tissue failure at a stretch of 1.9. A multiscale computational model, consisting of a realistically aligned interconnected fiber network in parallel with a neo-Hookean solid, was used to describe the data; failure was modeled at the fiber level, with an individual fiber failing when stretched beyond a critical threshold. The best-fit model results were within the 95% confidence intervals for uniaxial and biaxial experiments, including both prefailure and failure, and were consistent with properties of the components of the ATA media.

Performance evaluation of the suggestion system.

UNLABELLED: This cross-sectional research evaluated the suggestion system of Isfahan University of Medical Sciences (IUMS) using CIPP model. METHODS: The population consisted of all members of executive committee of suggestion system and the members of professional and general committee of IUMS; regarding to some limitations, sampling was not done. The tool of gathering data was a self-constructed questionnaire that its content validity approved by the professors' ideas, and calculating Cronbach's alpha confirmed its reliability. Collected data was analyzed using SPSS software. RESULTS AND DISCUSSION: Analyzed data showed that the average score of the performance of the mentioned system was 50.47 +/- 14.8; based on this result it can be claimed that most of the participants (about 91%) evaluated the performance of the system moderate. The comparison of the average score of the four dimensions of CIPP model showed that the input dimension had the highest score and process, product and context dimensions were next on the hierarchy. CONCLUSION: Planning some programs for paying awards, facilitating and accelerating the personnel's and notifying the procedures of the suggestion system implementation are some useful strategy that could be used to increase the staff's participants.