فهرست مطالب mohammad reza maleki

Measuring the seed and fertilizer mass flow rate in drill delivery tubes is an essential tool for real-time monitoring of the application rates. In the present study, a non-contact capacitance measuring system was implemented to monitor the granular discharge rate in seed and fertilizer applicators. The set-up consisted of a fluted-roller feeding mechanism and the capacitance measuring system incorporated in the discharge tube. The set-up was mounted on a custom-built vibratory stand to simulate the field condition during the measurement. Then, triple super phosphate, wheat, and alfalfa granular discharge rates were measured over 30 s intervals in both static and dynamic conditions from 3.42±1.22 to 19.3±0.95 g/s in 5 rates, from 2.55±0.23 to 19.02±0.86 g/s in 8 rates, and from 0.42±0.02 to 1.6±0.08 g/s in 7 rates, respectively. The results revealed that the mass flow was effectively correlated with sensor signals for all examined materials. However, the capacitance sensor failed to measure the sudden change in mass flow rate synchronously with the digital scale. This phenomenon was predictable because it is attributed to the feature of a digital balance, which is always accompanied by an initial lag. Also, the results revealed that the vibrating stand had no effect on the sensor accuracy.

The social security is one of achievements of development and business activists bear an important part of burden of economic development. Hence, in long term both sectors (the social security and business activists)would encounter some problems. This issue necessitates the interaction between them. The purpose of this study is to recognize challenges of the interaction relying on entrepreneurs’ viewpoints. Experts in social security field and business activists were interviewed. The qualitative data were analyzed. The findings show that the main challenges for interacting with the social security organization are as follows: weakness of processes related to incorporation of a company, problems related to present list of insurance, lack of unity in procedure and transparency in calculating insurance premiums for contractual agreements, weakness of processes and structures related to insurance inspection, lack of enough attention to branches and votes by boards, reconsideration of votes by Administrative Court of Justice, weakness of administrative, financial, and legal structures and process of account settling. Therefore, it has been tried to consider both exogenous and endogenous factors in solutions.

Ascites is a prominent example of the pathophysiological interaction between the heart and lungs in broilers. Previous experiments have shown that the amount of apoptosis increases in heart failure and pulmonary hypertension. In the current study, the effect of vitamin C on apoptosis was investigated by measuring the expression of the CASP3 gene in the heart and lungs of chickens with ascites. For this purpose, 90 one-day-old meat-type chickens were divided into three groups (sham (basal diet), control (basal diet +1.5 mg/kg of triiodothyronine (T3)), and treatment group (basal diet + 1.5 mg/kg of T3 + 1200 ppm of vitamin C)) and bred for 49 days. On the 21st and 49th days after rearing, 15 chickens from each group were selected randomly, and the right ventricle/ total ventricle weight ratio (RV/TV), as well as the expression level of CASP3 genes in the lung and right ventricle of all groups were measured and compared. The amount of mRNA related to CASP3 gene at the age of 21 and 49 days demonstrated a meaningful decrease in the treatment group compared to the control group (P<0.05). This significant difference indicates the reduction of apoptosis in the group treated with vitamin C. Also, RV/TV as an index of the induction of this syndrome improved in the treatment group at the age of 21 and 49 days (P<0.05). Finally, according to the current study's findings, vitamin C has ameliorating effects in treating ascites in meat-type chickens.

Students can play an effective role in protecting the environment by changing environment-related beliefs and strengthening responsibility and self-efficacy. The use of behavior change models is a reasonable approach to identifying psychological factors effective on pro-environmental behavior (and is an undeniable necessity before designing cognitive-behavioral interventions. The current study aimed to determine the variables affecting pro-environmental behaviors in elementary school students in Qazvin City using the theory of planned behavior (TPB).

Using a multi-stage sampling method, 184 fifth- and sixth-grade students of public elementary schools participated in a cross-sectional study in 2022-2023. The data collection tool was a self-report questionnaire including demographic information, a knowledge scale, and a 20-item questionnaire to assess pro-environmental behaviors and TPB-related subscales. The data were analyzed using LISREL 8.80 software and statistical tests, such as the Chi-square test, independent T-test, one-way ANOVA, Pearson correlation, and path analysis at a significant level of less than 0.05.

The status of some behaviors, such as warning about environmental issues, controlling the ambient temperature, using public transportation, and the pattern of watching TV programs were inappropriate. The strongest correlation coefficient was reported between knowledge and attitude (r=0.675, P<0.05) and the weakest between subjective norms and behavior (r=0.235, P<0.01). Moreover, perceived behavioral control (β=0.49, P<0.05) and attitude (β=0.31, P<0.05) formed the most important constructs affecting intention, and 66.7% and 28.5% of the variance of pro-environmental intentions and behaviors was explained by TPB, respectively.

The TPB is considered a suitable and logical theoretical framework for understanding and evaluating psychological variables effective on pro-environmental behavior in students. It is recommended to focus on attitude and perceived behavioral control in designing educational interventions to encourage pro-environmental behaviors.

The rapidly changing world, necessitates new demands which forces the governments to change the game in terms of policies to support entrepreneurs to fasten the development of new technologies in response to the needs. The success rates of the policies are monitored and reported by GEM. Iran’s entrepreneurship development indicators have a downward trend in recent years. This study is conducted to analyze the content of Iran's entrepreneurship development policies to uncover the weaknesses for policymaker.

Quantitative and qualitative content analysis of Iran’s entrepreneurship development policies (2016) is the focus of our criticism; using the basic theory of the global alphabet model of entrepreneurship as our target. The data is analyzed by Max QDA 2020 software.

The regulatory policies in Iran's entrepreneurship development document are not consistent with the global alphabet model of entrepreneurship quantitatively and qualitatively. The most attention has been paid to behavior instead of perception and attitude and no policy has been formulated in the field of entrepreneurial intention, innovation for production of goods and qualified services.

There is an asymmetry in dealing with entrepreneurial ecosystem which is probably one of the most important causes of our failure and breakdown.

Context:

 Growing needs mandates economic growth. Entrepreneurship policies play a significant role in achieving productive employment and sustainable development for the health and wealth of society. Aims: This study is conducted to find the accordance of this document with the basic theory of the global alphabet model of entrepreneurship on the one hand and a comparison to the real entrepreneurial and economic achievements as social determinants of health (SDOH) on the other hand.

Methods and Material: 

This research is a quantitative and qualitative content analysis of entrepreneurship documents in the health sector of Iran, using the basic theory of the global alphabet model as our target. We reviewed the Work Bank and Global Entrepreneurship Monitor (GEM) reports as world indicators to compare whether our entrepreneurship policies have been successful.

Statistical Analysis: 

MAXQDA is a software program designed for computer-assisted qualitative and mixed methods data, text and multimedia analysis in academic, scientific, and business institutions.

Results:

 The findings showed that the retelling of the word employment is more dominant than entrepreneurship. Imbalanced attention is paid to the components of the standard global alphabet model, and a downhill regression is seen in almost all aspects of entrepreneurial results.

Conclusions: 

The written health policies have not been effective in promoting the development of health by wealth.

This article develops an integrated model of transmitting strategies and operational activities to enhance the efficiency of supply chain management. As the second objective, this paper aims to improve supply chain performance management (SCPM) by employing proper decision-making approaches. The proposed model optimizes the performance indicator based on SCOR metrics. A process-based method is utilized for high-level decisions, while a mathematical programming method is proposed for low-level decisions. The suggested operational model takes some major supply chain properties such as multiple suppliers, multiple plants, multiple materials, and multiple produced items over several time periods into account. To solve the operational multi-objective optimization model, a goal programming approach is applied. The computational results are explained in terms of a numerical example, and a sensitivity analysis is performed to investigate how the performance of the supply chain is influenced by strategic scenario planning.

The aim of this research was to develop a model for the professional development of pre-school principals in the education. The study used a qualitative approach with a grounded theory approach. A group of experts, including senior education managers, university professors in the field of educational management, and prominent human resources consultants, were selected using the snowball sampling method. The selection of experts and interviews with them continued until theoretical saturation was reached, which occurred after the eleventh interview. The method of data collection was semi-structured interviews. Based on open, axial, and selective coding of the data, the research model was developed. In the developed model, the professional development of pre-school principals was identified as the core central concept. Causal conditions included the internal motivation of pre-school principals for professional development, their job commitment, ethical behavior, and their level of education and qualifications. The research results also showed that psychological and technical empowerment of education principals, satisfaction of pre-school education staff, parents, and students were identified as strategies and outcomes, respectively. In the developed model, parental concerns about the quality of pre-school educational management and competition between pre-school centers were identified as contextual variables, while standardization and updating of the conditions for the appointment of pre-school principals and the requirements of higher-level organizations for the professional development of pre-school principals were identified as intervention factors. The findings provide practical implications for the designing the professional development programs for pre-school principals.

The high reliance on out-of-pocket (OOP) payments for health financing in Iran have been led to different inequity problems such as catastrophic health expenditure (CHE) and impoverishment. This scoping review has been conducted to understand the variations in CHE and impoverishment, the underlying determinants of CHE, and its inequality in the past 20 years.  

This scoping review is guided by Arksey and O’Malley’s scoping review framework. systematically PubMed, Scopus, Web of Science, ProQuest, Scientific Information Database, IranMedex, IranDoc, Magiran Science, Google Scholar, and grey literature were searched systematically from 1 January 2000 to August 2021. We included studies that reported the rate of CHE, impoverishment, inequality, and its influencing factors. Simple descriptive statistics and narrative synthesis were used to present the review findings.  

From 112 included articles, the average incidence of CHE was 3.19% at the 40% threshold, and about 3.21% of the households had impoverished. We found an unfavorable status of health inequality indices, including the average of fair financial contribution (0.833), concentration (-0.01), Gini coefficient (0.42), and Kakwani (-0.149). The most widely applied key drivers influencing the rate of CHE in these studies were household economic status, place of residence, health insurance status, household size, head of the household’s gender, education level and employment status, having a household member under 5/ above 60 years old, with chronic diseases (in particular cancer and dialysis), disability, using inpatient and outpatient and dentistry services, medicines and equipment, and low insurance coverage.  

The result of this review calls for intensifying health policies and financing structures in Iran to provide more equitable access to all populations, especially the poorest and vulnerable. Moreover, the government is expected to adopt effective measures in inpatient and outpatient care, dental services, medicines, and equipment.

Within the public sector, health managers occupy positions that are typically filled by individuals with a medical, clinical, or nursing experience who are entrusted with assuming an additional role. The primary objective of this study was to employ a scoping review methodology to ascertain a cluster of prevalent subjects encompassing the development of a proficient health care manager.

The purpose of this scoping review study was to identify critical components in the field of management professionalization, as described by Arksey and O'Malley. A total of 13 studies, characterized by predefined keywords, were meticulously culled from Scopus, Web of Science, PubMed, and Embase, Magiran, and SID databases. The inclusion and exclusion criteria considered factors such as language, temporal relevance, redundancy, thematic alignment with the professionalization domain, and congruence with the overarching objectives and methodologies of the present investigation. Subsequently, the contents of the selected studies were subjected to rigorous thematic analysis and judicious categorization using a framework analysis approach.

From a total of 10,117 articles, a rigorous selection process yielded 13 articles to be included in this study. The identified dimensions are classified and elucidated across 6 overarching domains; namely, the science of management, educational trajectory, and curriculum, cultural infrastructure and ideologies, standards, professional institutions and associations, and licenses and certifications.

To enhance the efficacy of health management, policymakers and planners ought to adeptly incorporate these dimensions within the framework of the country's health system.

In some applications, the number of quality characteristics is larger than the number of observations within subgroups. Common multivariate control charts to monitor the variability of such high-dimensional processes are unsuitable because the sample covariance matrix is not positive semi-definite and invertible. Moreover, the impact of gauge imprecision on detection capability of multivariate control charts under high-dimensional setting has been clearly neglected in the literature. To overcome these shortcomings, this paper develops a ridge penalized likelihood ratio chart for Phase II monitoring of high-dimensional process in the presence of measurement system errors. The developed control chart departures from the assumption of sparse variability shifts in which the assignable cause can only affects a few elements of the covariance matrix. Then, to compensate for the adverse impact of gauge impression, the developed chart is extended by employing multiple measurements on each sampled item. Simulation studies are carried out to study the impact of imprecise measurements on detectability of the developed monitoring scheme under different shift patterns. The results show that the gauge inability negatively affects the run-length distribution of the developed control chart. It is also found that the extended chart under multiple measurements strategy can effectively reduce the error impact.

Hyperbilirubinemia is the most common cause of neonatal hospitalization in the first month after birth. Understanding the underlying causes of jaundice helps identify newborn at risk faster. The aim of this study was to determine the prevalence of jaundice in neonates with diabetic mothers on the 3rd to 5th day of after birth. 120 pregnant mothers aged 18 to 40 years who had diabetes during pregnancy (familial or gestational diabetes) and were treated with insulin were included in this descriptive epidemiological study. All demographic information of the mother and infant is recorded in the checklists and after delivery, mothers are advised to visit the clinic on a routine checkup for jaundice (jaundice visible in the sclera) on the third to fifth day after birth. After a thorough neonatal examination, a total bilirubin test will be performed. Of 120 diabetic mothers, 54 (45%) had no jaundice, 24 (20%) had clinical jaundice, and 42 (35%) needed phototherapy. Statistical analysis showed that there were no significant differences between the three groups without jaundice, clinical jaundice and need for phototherapy in terms of gender, gestational age and Rh factor incompatibility but there was a significant difference between type of feeding, birth weight and incompatibility of ABO system. . Further statistical analysis showed that only birth weight factors and blood group incompatibility were associated with icterus. Maternal diabetes and neonatal jaundice appear to be associated.

It is difficult to accurately measure the flow rate of seeds and fertilizers in grain drills, because the granules move in a continuous dense state. The purpose of this research was to monitor the mass flow of granular materials in the fall tube of the drill using a piezoelectric sensor. The laboratory system consisted of a repository box, a fluted roller metering device, a fall tube, and a piezoelectric sensor. To simulate the drill movement in the field, a vibrating stand was designed to oscillate the set-up in two perpendicular directions. The maximum amplitude stand was 8.99 cm according to the peaks and depressions available in a field after plowing. The sensor was evaluated in two static and dynamic modes for wheat seed, alfalfa seed, and triple superphosphate fertilizer with the usual drilling rate. The results showed the output signal of the sensor was proportional to all different mass flow rates in both static and dynamic states. The correlation coefficient was 0.95, 0.99, and 0.98 in static mode and 0.93, 0.86, and 0.98 in dynamic mode for wheat, alfalfa seed, and triple superphosphate fertilizer, respectively. In addition, the piezoelectric sensor could instantaneously monitor the sudden changes in the mass flow according to the reading of the digital scale. The results showed that the developed sensor can be used to monitor the mass flow rate of seeds and fertilizers in drills for calculating the drilling rate in real time.

Neonatal jaundice is a common problem that leads to many problems such as encephalopathy and hearing loss, kernicterus and death. Due to the importance of preventing the potential complications of hyperbilirubinemia, the present study was performed to determine the level of total cord bilirubin in neonates and to compare with bilirubin three days after birth in Kowsar hospital in Qazvin.

In this prospective cross-sectional study, 100 neonates were evaluated in Kowsar hospital maternity ward and required information was prepared in checklists containing maternal variables (blood group,taking medicine) and the infant's data (name, sex, birth weight, gestational age, breast feeding and formula milk feeding, Apgar score, cord blood bilirubin level, and serum bilirubin level on the third day after birth) were obtained with informed consent and entered into a file by a trained individual. Cord blood samples were also taken to measure the level of bilirubin and to determine the blood group of neonates and venous blood samples were taken on the third day after birth. Data analysis was performed by using descriptive and statistical analysis(P<0.05).

The mean levels of total and direct bilirubin of neonates in birthday and third day were 2.8 ±1.00 and 0.31±0.10 and 13.13±2.53 and 0.29±0.14 mg/dl, respectively. In addition, cord albumin was also reported to be 3.2±0.64. The mean level of total bilirubin at birth and third day was not significantly different between boys and girls (p.value=0.92). There was a significant and direct correlation between maternal age and total cord blood bilirubin level (p.value=0.04), and also total bilirubin level at the third day of birth had a significant and direct correlation with the number of abortions (p.value=0.05). Moreover, the level of total bilirubin and third day of birth were inverse correlated with albumin level.

High risk neonates need more accurate follow-up for jaundice, because timely diagnosis and very simple treatment can reduce the potential risks of neonatal jaundice. The present study showed that cord total bilirubin levels compared with bilirubin three days after birth can be used as a suitable diagnostic method to accurately track neonates at risk of jaundice.

In recent years, there have been many non-teaching hospitals that have become teaching hospitals. Although the decision to make this change is made at the policy level; But the unknown consequences can create many problems. The present study investigated the experiences of hospitals in changing the function of a non-teaching to a teaching hospital in Iran.

A Phenomenological qualitative study was conducted using semi-structured interviews with 40 hospital managers and policy makers who had the experience of changing the function of hospitals in Iran through a purposive sampling in 2021. Thematic analysis using inductive approach and MAXQDA 10 was used for data analysis.

According to the results extracted 16 main categories and 91 subcategories. Considering the complexity and instability of command unity, understanding the change of organizational hierarchy, developing a mechanism to cover client’s costs, considering increase management team’ legal and social responsibility, coordinating policy demands with Providing resources, funding the teaching mission, organizing the multiple supervisory organizations, transparent communication between hospital and colleges, understanding the complexity of processes, considering change the performance appraisal system and pay for performance were the solutions for decrease problems of changing the function of non-teaching to teaching hospital.

Important matter about the improvement of university hospitals is evaluating the performance of hospitals to maintain their role as progressive actors in hospital network and also as the main actors of teaching future professional human resources. In fact, in the world, hospital becoming teaching is based on the performance of hospitals.

 Infectious hospital waste, including needles and sharp instruments, is one of the most important causes of needle sticks.

 The study aimed to investigate the factors affecting the disposal of special medical waste with needle sticks among healthcare workers in hospitals at the Iran University of Medical Sciences.

 This descriptive-analytical, retrospective, and cross-sectional study were done regarding the data in the autumn of 2019. Among 6119 medical-service staff, 180 subjects have been exposed to the needle stick at least once. Data were collected in two parts. The data were analyzed using correlation tests by SPSS software version 25.

 The most devices leading to injury were needles (58%), angiocatheter (21%), ampoules (17%), suture needles (12%), scalpels (9%), other tools (8%), and razor blades (7%). The five wards with the highest needle sticks were the operating room (24.44%), surgery (22.22%), emergency (15%), internal wards (10%), and paraclinical (8.33%). Also, several factors, such as work shifts and the amount of work experience of individuals, can play an essential role in the rate of needle stitching of medical personnel. Importantly, we found a significant relationship between the volume of medical waste and employee needlestick rates.

 According to the results, we found a significant positive relationship between the volume of medical waste and employees' needle sticking rate. The observance of standard guidelines and the development and increase of occupational safety protection training courses have the most significant role in reducing needle sticks.

In this study, a hybrid method based on Decision Making Trial and Evaluation Laboratory (DEMATEL) technique, analytical network process (ANP), and factor analysis is developed to prioritize economic, social, and environmental indicators of sustainable development in free. For this purpose, first, the indicators are classified into two internal and external ones and their latent factors are identified and named using the factor analysis method. Then, the DEMATEL technique is employed for identifying the internal relationship among the indicators as well as determining the intensity of their influential indicators and influence. Moreover, the causal diagrams, the internal relationships of internal and external indicators, and the cause or effect of the indicators are explained by the DEMATEL technique. Finally, the relative importance of the indicators is obtained based on the ANP method, and by calculating the weighted and limit super matrixes, the ranking of sustainable development indicators in both internal and external parts is obtained. The results obtained from 44 internal and 24 external indicators show that "welfare and services" and "culture making" factors are the most important internal and external ones, respectively, while "providing conditions for investment and support for investment" and "prevention of marine pollution by ships" indicators are the most important internal and external ones in the sustainable development of free zones.

Aim and introduction. Today’s business leaders are seeking to achieve sustainable development in order to succeed in the competitive market. Based on the theoretical framework, research background and experts' opinions, it can be concluded that despite the increase in the number of free zones in Iran, they have mainly focused on importing different products to the country. In other words, there is not a balanced growth in these areas in terms of sustainable development indicators, including economic, environmental and social indicators. In addition, the performance of the free zones has not been satisfactory from attracting foreign investment and employment viewpoints. Therefore, considering the high potential of free trade-industrial zones in economic growth of the country, it is necessary to take the all dimensions of sustainable development into account. Methodology.The main purpose of this study is to identify and analyze the indicators of sustainable development in  free zones of Iran. To accomplish that, considering three main areas including commercial, industrial and tourism, the sustainable development indicators of free zones under both internal and external dimensions from three aspects of environmental, economic and social are studied using fuzzy Decision Making Trial and Evaluation Laboratory (DEMATEL) technique. This technique is a structural method that is able to represent the causal relationships among factors which uses a straightforward diagram and some matrices. This technique contains eight steps of 1) defining appropriate scales, 2) establishing the direct-influence matrix, 3) normalizing the direct-influence matrix, 4) constructing the total-influence matrix, 5) deriving the influential relation map (IRM), 6) designing a scatter diagrams, 7) setting the threshold values, 8) building cause and effect relationship diagrams.In this regard, a DEMATEL questionnaire based on the 5-choice verbal values ​​scale consisting of 44 internal and 24 external indicators is designed. Then, the results received from eight experts are analyzed in MATLAB and Excel software. The obtained results show that the variability of internal indicators is more than the that of external indicators which implies that the internal indicators have a wider range of relationships than the external indicators. Moreover, the dispersion of internal effect indicators is more than that of internal cause ones while there is a slight difference between the dispersions of external cause and effect indicators. Besides, the existence of complex relations among both internal and external indicators is confirmed. The obtained results from internal indicators show that three indicators: 1) separation, collection, transportation, recycling and disposal of industrial waste, 2) reducing the use of hazardous industrial waste, and 3) Satisfaction of supply chain stakeholders, respectively, have the most relationship with other internal indicators. In other words, focusing on the mentioned indicators can make a significant improvement in other internal indicators. Furthermore, three internal indicators of 1) providing interest and services for stakeholders, 2) proper strategy to increase market share, and 3) encouragement of employees to participate in sustainable development, respectively, have the least relations with other internal indicators. Consequently, concentrating on these indicators leads to little changes in other internal indicators. The results obtained from external indicators confirm that three indicators of 1) culture of compliance with safety and environmental standards by companies, 2) prevention of marine pollution by ships, and 3) raising the awareness of tourists and customers regarding traffic issues, respectively, are the most related indicators to other external ones. As a result, changes in these indicators can significantly affect the other external indicators.Discussion and Conclusion.In addition, three indicators of: 1) encouraging tourists and customers to buy eco-friendly products, 2) cooperating with charities and organizations to support the local community, and 3) informing tourists and customers to respect the customs, traditions and comfort of the local community, respectively have the least interaction with the other external ones. Hence, paying attention to these three indicators results in a little changes in other external indicators. As another important finding, it can be referred to the influential internal and external indicators. In this regard, the indicators: 1) providing sustainable development policies, 2) air quality monitoring and reduction of greenhouse gas emissions, and 3) establishment of industries are the most effective internal indicators, respectively, while 1) educating local community regarding sustainable development, 2) reducing energy consumption by companies, and 3) cooperation with international companies are the most influential foreign indicators, respectively.Finding. Although, this study determines the complex causal structure and identifies influential and influenced internal and external indicators, it does not calculate the relative importance of the indicators. Besides, despite the internal relation among internal and external indicators of sustainable development, the proposed method ignores the multiple relations among them. Therefore, future researchers can be directed to use of multi-criteria decision-making techniques to quantify the relative importance of sustainable development criteria of free trade-industrial zones.

In the present study, an electro-hydraulic system for repositioning the soil shield of a rotary tiller was designed, developed, and evaluated to make it automated for performing variable rate tilling operation. The reposition of the soil shield was studied in the opening and closing stages from 0° to 80° and vice versa, with a 10° and 20° increment under laboratory and field conditions, respectively. Under laboratory conditions, the speed average of soil shield reposition in the opening and closing stages were 102.0±9.2 and 79.0±8.7 deg/s, with the time average in opening and closing stages of 0.11±0.02 and 0.15±0.01 s, respectively. The correlation coefficients between the requested position for the soil shield and the position created by the hydraulic actuator under laboratory conditions in both opening and closing states were R2 = 0.99 (RMSE = 0.7 deg). Under field conditions, the speed average of the soil shield reposition at three travel speeds of 2.6, 3.5, and 4.8 km/h in the opening stage were 97.7, 99.1, and 99.1 deg/s and in the closing stage were 77.3, 78.3, and 78.7 deg/s, respectively. The correlation between the requested position for the soil shield and the position created by the hydraulic actuator in both opening and closing states were R2 = 0.99 (RMSE = 1.2 deg) and R2=0.99 (RMES=1.3 deg), respectively. The soil shield repositioning system can be performed in less than 0.3 s in-field, making it an effective and practical tool for performing variable rate tillage.

Hospitals, similar to other organizations, are complex social systems influenced by elements, such as staff, resources, and structures, that work to achieve specific goals. In terms of goals and missions, hospitals are divided into teaching and non-teaching categories. There are many differences in the nature and needs of these two types of hospitals that must be considered for proper operation by policymakers and managers.

The present study compared issues between non-teaching and teaching hospitalsin Iran.

A qualitative study was conducted using semi-structured interviews according to an interview guide with 40 Iranian hospital managers and policymakersselected through purposivesampling in 2021. Data were analyzed through thematic analysis with an inductive approach using the MAXQDA software (version 10).

According to the results, the main categoriesof differences between non-teaching and teaching hospitals in Iran were as follows: legal and social responsibility, cost-effectiveness and efficiency, supply of resources, empowerment of human capital, goals and missions, external and internal communications, revenue-cost management, organizational structure, customer satisfaction, organizational behavior, clinical and support departments, hospital processes, type and level of services, manpower, performance evaluation, and the organization of the teaching mission.

Practical findings of this study include understanding the complexity and instability of command unity in teaching hospitals, understanding the differences in organizational hierarchy, developing a mechanism to cover costs for clients, increasing the legal and social responsibility of the management team, prioritizing organizational goals, coordinating policy demands with providing resources, funding the teaching mission, organizing multiple supervisory organizations, establishing transparent communication between hospitals and colleges, understanding the complexity of processes, considering the change of individual and group communication, changing the performance appraisal system, and paying for performance. It is suggested that policymakers consider these issues in providing the resources and facilities needed for hospitals based on their function.

Rare diseases-related services, care, and drugs (Orphan Drugs) in a lower-middle-income country such as Iran with international limitations due to the sanctions is a challenging issue in terms of their financing and providing. This study aims to address financing issues related to rare diseases in a lower-middle-income country that is under international sanctions.  

This is a qualitative study that has been conducted through 14 interviews with experts from different stakeholders in the country to find the challenges of financing rare diseases and orphan drugs in Iran through a content analysis according to Mayring’s approach. We accomplished this study based on the World Health Organization’s universal health coverage model.  

We achieved four themes and 12 sub-themes. The themes are the unstable and sanctioned economy including 4 sub-themes; extending the covered population by the social security net in the country including 2 sub-themes; reducing the cost-sharing for the covered population including 4 sub-themes; including more orphan drugs and services including 2 sub-themes.  

The financing of rare diseases and orphan drugs in Iran is challenged by several contextual and internal factors. The political issues seem to have the main contribution of the challenge to develop an efficient and effective financing mechanism for rare diseases and orphan drugs. This is especially can be related to the politicians’ commitments and pursuing an effective plan to allocate the financial resources to rare diseases. However, the country’s economic situation, especially at the macro level because of international limitations, has intensified the problem.

Estimates and available statistics indicate that, on average, 20% to 30% of the costs of a hospitalized patient are related to drugs and consumables, and on the other hand, more than 95% of treatment processes depend on drugs and medical supplies. Consumption requirements for the inpatients are divided into two main categories: 1) Consumption requirements are mentioned with the same name and with a specific number and price in the patient's invoice. 2) Hoteling consumption requirements that the number and amount of this consumption requirements are not recorded anywhere in the patient's file, and the costs of this consumption are covered by three percent of the six percent of nursing services.

This descriptive cross-sectional study was performed as a prospective observation in the inpatient emergency department of 'Hazrate Rasoole Akram Hospital in Tehran in the second half of 2018, and 898 patients were monitored.

The study ward had 40 inpatient bed counts, where 898 patients were admitted and hospitalized. The Inpatient Bed Occupancy Rate was over 100%, and the inpatient bed count day was 1706. The frequency distribution of hospitalized patients was 47 different diseases. The cost of their hoteling consumables was 976,776,808 Rials that 186,909,360 Rials of those costs were collected from various insurance deposits and cash receipts, and the rest of the costs, which was equivalent to 81% of the cost of hoteling consumables in December, remained uncollected.

Considering that the cost of Hoteling consumption requirements is provided as 3% of the 6% of nursing services, and on the other hand, the list of Hoteling consumption requirements in different insurances and hospital revenue units is not clear, it is suggested: Firstly, a complete and telling list of hoteling medical consumables should be prepared and communicated, and secondly, according to the existing inflation and the inadequacy of the daily bed tariff and market conditions, the relevant percentage should be adjusted to cover the costs.

In terms of missions, hospitals are divided into teaching and nonteaching. In addition, differences in health‑care systems in countries will lead to differences in hospitals’ operation. Iran, as a specific health‑care system, is different from other countries. Hence, the present study investigated differences between teaching and nonteaching hospitals and their differences in Iran and the world.

A concurrent mixed‑methods study was conducted in two stages. The first stage was a narrative review of studies (2000–2020). Using narrative inquiry and reflective analysis, the content was analyzed and the categories were extracted. The second stage was a qualitative study conducted using semi‑structured interviews with forty Iranian hospital managers and policymakers through a purposive sampling in 2020. Content analysis was made using deductive approach, and MAXQDA 12 was used for data analysis.

According to the first stage, categories were extracted as follows: service quality, type of cases, patient satisfaction, efficiency, performance indicators, patient safety, personnel, use of drugs, access to services, technologies, justice in the type of services received, using guidelines, processes, and number of services. In the second stage, 8 main categories, 17 categories, and 45 subcategories were extracted. The extracted main categories were as follows: mission and target, management and behavioral organizations, supply chain and chain of results, human resources, costs and budget, policy demands, clients’ satisfaction and patients’ right, and integration of medical education.

Unlike other countries, in Iran, the combination of missions and the complete dependence of teaching hospitals on the government has caused differences. Reducing the treatment mission of teaching hospitals; differences in the budget and development of its indicators; lower tariffs for teaching hospitals; developing a cost–income management model and supply chain; preventing uncertainty other than medical students except medicine; considering the clients’ right to choose hospital; and organizing research missions in hospitals were the solutions for decrease differences.

The growing trend of renal failure has focused clinical therapy on the cost-effective alternatives such as peritoneal dialysis. Therefore, the present study has investigated the effectiveness of two methods of continuous and automatic peritoneal dialysis in the patients with end stage renal disease.

This study was conducted in the form of a systematic review. Advanced search was done in PubMed, Cochrane Library, Scopus databases, and in title, abstract, and keyword fields without any restrictions. The inclusion criteria included clinical trial research focused on two methods of peritoneal dialysis. The process of data extraction was performed, using a standard checklist. The quality of the studies was evaluated by the Cochrane quality assessment checklist and the results of the indicators were analyzed in the form of meta-analysis.

A total of 5 clinical trials, including 311 patients, were included in the study. All studies had high quality. Automated method has the advantage of continuous procedure in terms of complications such as mortality (RR 1.42, 95% CI 0.48 to 4.21), peritonitis (RR: 0.80, 95% CI 0.50 to 1.29), exit-site (RR:1.07,95% CI 0.52 to 2.15) and tunnel (RR 1.01,95%CI 0.18 to 5.67). The kt/v index was better in the automatic method than the continuous method (SMD 0.37, 95%CI 0.01 to 0.73), on the other hand, creatinine clearance in the continuous method was better than the automatic method (SMD -0.40, 95%CI 0.78 to 0.02).

The side effects of the two treatment methods did not differ, but considering the indicators of dialysis adequacy, creatinine clearance was performed better in the continuous outpatient method, while the results of the kt/v index in the automatic method were better. In terms of cost items, along with clinical indicators, it seems that final decision-making for macro-health policies has helped.