مجله علوم پزشکی رازی
سال بیست و هفتم شماره 8 (پیاپی 198، آبان 1399)

The concepts of Skin health and beauty, which are as ancient as mankind and civilization, are considered as the main factors of human health and well-being. Therefore skin anti-aging strategies as well as skin rejuvenation methods that prevent, delay, repair and combat skin aging and eliminate its symptoms and maintain the structural and functional integrity of the skin, are of particular importance. Skin aging is a complex and unpreventable biological process that occurs as a result of both intrinsic and extrinsic factors such as physiological, behavioral, geographical, and environmental and lifestyle factors. This dynamic and multifactorial process results from the formation and accumulation of reactive oxygen species (ROS) and the induction of matrix metalloproteinases. Skin aging is characterized by a progressive deterioration of the skinchr('39')s functional properties, linked to alterations in dermal connective tissue due to the changes at the cell, gene and protein levels. Different physiological and pathological processes involved in skin aging, are accompanied by clinical manifestations such as cumulative structural and physiological changes in skin structure and appearance, pigmentation changes, reduced elasticity, and increased wrinkles in the skin. Considering the increasing trend of aging in the world, and the growing interest to maintain a youthful appearance, the demand for skin rejuvenation practices has greatly increased to improve the quality of life (QOL), self-esteem, and improved body image among aging population. The skin rejuvenation process uses a combination of different methods of bio-revitalization and techniques for repairing and strengthening different layers of the skin, along with changes in some other factors such as lifestyle, emotional and health status in order to relieve the aging signs. Platelet-rich plasma (PRP), derived from fresh whole blood, is a biological product which contains platelets concentrated above baseline level. Activated platelet cells can be considered as vehicles for growth factors (GFs) and cytokine delivery, which play a crucial role in up-regulation of collagen production and controlling oxidative damage. Besides, GFs reduce the signs of aging by modulating cell migration, proliferation, differentiation, angiogenesis and chemotaxis. They can also stimulate collagen synthesis, reverse the effects of collagenases, increase extracellular matrix accumulation, and promote endothelial and epithelial regeneration. This issue has caused PRP to be used in multiple clinical fields such as orthopedics, regenerative sport medicine, plastic surgery, dermatology and aesthetic medicine, gynecology, ophthalmology, and dentistry, with remarkable results. Skin rejuvenation, dermal augmentation, hair restoration, and acne scaring, are some of PRP dermatological indications. Topical application or direct injection of PRP compositions into the dermis can be considered as one of the simplest biological interventions in the field of reconstructive medicine and aesthetic treatments because of their capability to function as vehicles for growth factors and cytokine delivery. GFs and cytokines have the potential to address skin aging through stimulation of cell regeneration. Different GFs including platelet-derived growth factor (PDGF), transforming growth factor (TGF), vascular endothelial growth factor (VEGF) and insulin-like growth factor (IGF), present in PRP, stimulate human dermal fibroblasts. In fact Topical application of PRP or its direct injection into the skin, augment dermal elasticity by stimulating the removal of photodamaged extracellular matrix and induces the synthesis of new collagen and other matrix components by dermal fibroblasts via various molecular mechanisms. The ability of PRP to stimulate hyaluronic acid synthesis is another possible reason for skin rejuvenation. It should be noted that the topical application of Cosmeceutical formulations, containing biologically active ingredients, is preferable to invasive methods or systemic treatments. Because it is a safe, non-invasive, fast and simple procedure with the ability of topical delivery of active ingredient and direct impact on the desired location, fewer possible side effects and toxicities, and high user acceptability. Furthermore topically applied cosmeceutical preparations have advantages such as more solubility and spreadability, less drug degradation and enhanced bioavailability. Biocompatibility and biosafety, high clinical efficacy, fewer side effects, ease of use, non-invasiveness and greater acceptance and satisfaction of consumers, easier legal requirements, minimal manipulation, access to different methods of preparation, the possibility of adding different compounds to their formulation, reduced recovery time and downtime for patients, better aesthetic outcome, having antimicrobial activity and regeneration effect are some of PRP therapy benefits. However customizing PRP formulations for different clinical situations is an important challenge and should be carefully considered to achieve optimal efficacy, safety, tolerability, and stability. This article briefly discusses the concepts of skin health and beauty, skin aging and its clinical manifestations, classification of skin aging according to its causative factors, Skin rejuvenation strategies, mechanism actions of growth factors and platelet-rich plasma in skin rejuvenation, benefits of PRP therapies, Platelet preparation method, factors affecting the quality of PRP products, and formulation challenges. antibiotic resistance characteristics are determined and appropriate antibiotics are prescribed.

Stroke is the leading cause of death in patients with kidney failure. Chronic kidney disease (CKD) is strongly associated with stroke with various purported mechanisms proposed and End-stage renal disease (ESRD) patients are in a condition where both kidneys are impaired and require kidney transplantation or dialysis, and unfortunately, the number of patients with ESRD has grown rapidly during the last several decades. Several conventional risk factors for atherosclerosis are more prevalent in patients with CKD and the risk of stroke is 5–30 times higher in patients with CKD. Especially, Diabetic kidney disease (DKD) is the leading cause of ESRD and a significant risk factor for progressive macro- and microvascular disease. The risk of hemorrhagic stroke (HS) has been reported to be higher than ischemic stroke (IS) in hemodialysis (HD) patients. Moreover, for doing HD, creating a connection point in the patient‘s body is necessary; this connection point is creating in a vascular access (VA) surgery and there are three usual methods for a VA: Arterivenous Fistula (AVF), Arterivenous Graft (AVG) and central venous catheter (CVC). In these three mentioned VA methods, if the status of patient be urgent, creating CVC is a common approach for providing patient to a fast HD and continuing his or her life, such that implantation of a CVC is one of the most common surgeries for VA as a requirement for HD. In United States (US), the prevalence of recognized CKD has steadily risen year after year across all stages of CKD. From 2016 to 2017, the proportion of recognized CKD patients increased from13.8% to 14.5%. Among those without a CKD diagnosis but with both diabetes mellitus and hypertension, 43.2% had urine albumin testing in 2017, and a large majority (80%) of HD patients started dialysis using an indwelling catheter. The standardized US rates for ESRD (ie, dialysis or transplantation) rank among the highest in the world. The prevalence of ESRD continues to rise and reached 746,557 cases in 2017 (vs 727,912 in 2016), representing a 2.6% increase since 2016, The published annual data report also highlights key findings regarding ESRD among children, adolescents, and young adults. From other hand, although there are various paths for inserting CVC, such as subclavian, jugular and femoral, but the important problem is that, there are some reports about high risk of stroke is both in CKD patients and far higher in patients with CVC implanted for HD! Given the risk of death after stroke and the problems it poses to the individual, others, and the community, it is important to evaluate the risk in patients with underlying conditions. Indeed, with greatly increased risk of stroke and poorer outcomes, in this vulnerable group of patients, it is important that preventive strategies be better applied to reduce stroke rates. Thereby, this article is a review of stroke in patients with DKD and approach to managing it.

In the present study, we analyzed totally data of 1566 patients, which included two datasets: at first, there are 1098 stroke patients from US and secondly, there are 468 Iranian HD patients, who have used CVC as a VA method for HD possibility. The first dataset is shared by the US researchers for completing their previous studies and second dataset gathered after designing a check list from the Hospital Information System (HIS), based on saved files of the under HD patients who accept by the study on their treatment data. The stroke populations were referred over two years and HD populations to US hospitals were referred over a five-year to Hasheminejad Kidney Hospital. For data analysis, we calculated correlation coefficients by SPSS software. Moreover, for targeting extract novel, useful and hidden patterns from the data, we executed data mining algorithms in both Rapid Miner Studio and SPSS tools. Indeed, with the help of data mining techniques, more details of association rules into the patient characteristics will be revealed. Therefore, we designed descriptive approaches of data mining, which were included: (a) Decision Tree Operator for data classification (by accuracy rate = 81.51%) which implemented in Rapid Miner Studio and (b) CHAID algorithm which executed in SPSS software (by accuracy rate of classification= 98.75%). These accuracy rates explain an acceptable result in their related decision trees which gives us the motivation to interpret them as a scientific idea and adapt to medical realities.

In the first data set, 891 patients had IS and 207 patients had HS; in these patients, where 388 patients had kidney problems and 64 patients had chronic kidney disease. Studies showed that there was a significant relationship between chronic kidney disease and ischemic stroke (Pearson correlation with p<0.001). The second data set consists 468 hemodialysis patients, including 324 females and 144 males, of which 368 patients had a permanent catheter and 100 had a non-cuffed catheter. By interpreting the exported decision tree, these results were evident: (a) the history of kidney diseases has an unmissable role in trouble patients to the stroke! This is because that the kidney variable was placed in the root of the extracted decision tree. (b) after history of kidney diseases, the second-high risk role in the case of stroke, was dedicated to history of heart diseases; (c) in both of recent results, the dominant type of stroke is related to IS. (d)

This study showed that the risk of stroke in patients who used catheters before venous arterial fistula was 84.21% and while there was no significant relationship between the age of dialysis patients and their stroke, but in addition to catheter implantation, they had a history of hypertension or diabetes were also at risk for stroke. Finally, we discuss a paradox with reference to what we presented at the WoCoVA 2020 Conference and suggest that for future research on the relationship between the various methods of VA - which are essential for hemodialysis and patient life - with stroke and investigate the increased risk of death.

Cervical cancer is one of the most common cancers in women. Genital carcinomas, especially cervical cancer, make up almost 12% of all cancers in women and are the second most common female genital cancer in the world. Cervical cancer is caused by specific papillomavirus (HPV) infections. Various factors, including regular exercise, reduce the risk of cancer. An active lifestyle can reduce the risk of developing cancer. Studies show that active women are 20 to 30 percent less likely to develop cancer than inactive women. Clinical evidence suggests that angiogenesis plays an important role in cervical cancer. Specifically, overexpression of VEGF is associated with unpleasant oncological consequences in cervical cancer tumors. VEGF is an important growth factor involved in neoangiogenesis and is expressed in glomerular pedocytes and renal endothelial cells. Also, Thrombospandine-1 (TSP1) inhibits tumor growth and metastasis and is a potent inhibitor of angiogenesis and tumorigenesis in vivo. Taxol is a compound of diterpene with a complex structure that is often extracted from the yew plant. This substance is currently the most important natural anti-cancer compound with a different mechanism from other similar drugs in this field, worldwide for the treatment of various cancers such as skin, lung, urinary tract, esophagus, lymph nodes and ... It is used effectively. To date, no study has examined the response of VEGF and thrombospandine-1 to aerobic exercise in patients with cervical cancer. On the other hand, today there is an increasing tendency to use plants and their compounds as potential anti-cancer drugs that have a direct toxic activity on malignant cells. The results of the present study can help to better explain the factors involved in cervical cancer; Therefore, the aim of this study was to investigate the effect of 6-Week Endurance training and Taxol extract on kidney tissue VEGF and Thrombospondin in C57 Mice with Cervical Cancer.

In this experimental study, 35 female C57 mice, eight weeks old, were randomly divided into 5 groups: control (healthy), control(cancer), Taxol extract, training(cancer), and Training-Taxol extract (cancer) with 7 mice in each group. The implantation of cancerous tumors was performed under the skin of the upper pelvis. The training group completed the endurance training protocol, which included 3 sessions per week, 50 minutes per session, at a speed of 14-18 m/s for six weeks. A dose of 60 mg/kg/day, a pure extract of Taxol was injected peritoneally Data were analyzed by t-test, One-way ANOVA and post hoc Bonferronchr('39')s at the significant level p<0.05.

The results showed that the use of taxol extract and endurance exercises significantly reduced the levels of VEGF in kidney tissues of C57 mice with cervical cancer (p=0.000). Also, the use of taxol extract and endurance exercises significantly reduced the levels of thrombospondin in kidney tissues of C57 mice with cervical cancer (p=0.000).

The findings of this study were consistent with the results of Previous research [19,20,25]. VEGF in response to exercise is due to the binding of VEGF to receptors on endothelial cells, which is a stimulus for the angiogenesis process. Also, Decreased VEGF can be due to binding to other proteins, including heparin sulfate and endothelial stem cells. It is possible that one of the reasons for the decrease in VEGF in response to the exercise is due to the increase of VEGF production inhibitors, namely ANP and CNP. Another reason for the decrease in VEGF to exercise can be explained from the perspective of somatostatin. Taxol is a diterpene compound with a complex structure. It is rich in isoflavones. Flavonoids such as 3,4 dihydroxyflavones, 1,3 dihydroxyflavones, Fisetin, Apigenin and Lutelin are able to inhibit angiogenesis in vitro in the micromolar concentration range. The results of studies have shown that taxol inhibits angiogenesis at low concentrations of picomolar by inhibiting the production of VEGF and inhibiting the protein expression of alpha factor induced by hypoxia. There were some limitations in the present study, such as the lack of measurement of other angiogenic factors and anti-angiogenic factors. According to the findings of this study, aerobic endurance training and Taxol extract may be effective interventions to reduce the progression of cervical cancer.

In recent decades, Iran has faced the problem of rapid fertility decline, which has changed the structure of the countrychr('39')s population and can eventually turn the countrychr('39')s young structure into an old structure. The results of population aging include include the decrease in the young and economically useful population and the labor force of the country, and will further lead to issues such as increasing the cost of caring for the elderly. One of the factors that affect fertility is the tendency to have children, which indicates a personchr('39')s interest in having children. Changing the lifestyle of Iranian women such as increasing the age of marriage, working outside the home and cultural and economic norms, etc. are factors that have reduced the tendency of women to have children. Examining the factors that affect womenchr('39')s tendency to have children can be a way to conduct scientific interventions to increase the tendency to have children. Undoubtedly, the tendency to have children can lead to an increase in fertility. In Islam, childbearing is recommended and pregnancy and breastfeeding are considered as worship for women. Therefore, one of the factors that have been measured in relation to the tendency to childbearing in this study is spiritual health. Another factor that has been measured in relation to the tendency to childbearing in this study is health literacy. We want to examine whether health literacy and spiritual health are related to the tendency to childbearing? The purpose of this study was to investigate the tendency to childbearing and its relationship with health literacy and spiritual health in women referring to the healthcare centers of Torbat Heydarieh in 2019.

This research is a cross-sectional study of analytical type that was conducted in the comprehensive health service centers of Torbat-e Heydarieh in 2019. 269 married women aged 15 to 49 years referring to comprehensive health service centers in Torbat-e Heydarieh were selected by cluster random sampling. The instrument used in this study was a four-part questionnaire, the first part was related to the personal characteristics of the participants and the second part was the childbearing tendency questionnaire and the third questionnaire was Helia Health Literacy Questionnaire and the fourth questionnaire was SWBS Spiritual Health Questionnaire. Questionnaires were provided to the samples and they were assured about the confidentiality of information and the optionality of the company and cancellation of the study at each stage of the research. Then the data analysis was performed using descriptive statistical analysis, Pearson correlation coefficient and linear regression in SPSS software version 23.0.

The mean age of women in this study was 28.9 ± 5.8 years and the mean number of children per household was 1.32±1.06. The mean age of the participantschr('39') spouses was 33.72 ± 6.44. The mean score of health literacy was 42.9±5.8, the mean score of childbearing tendency was 46.09 ± 6.9 and the mean score of spiritual health was 88.7±13.3. In 0.55 people, health literacy was at the border level and in 0.82 people, spiritual health was at the average level. The variables of age, number of children and level of education of the spouse were factors related to the tendency to childbearing. With increasing one year of age, the average score of tendency to childbearing increased by 0.33 (p = 0.02) and with the addition of one child, the mean score of tendency to childbearing decreased by 1.1 (p = 0.03). Pearson correlation coefficient was used to investigate the relationship between health literacy tendency to childbearing and spiritual health. The results showed that there was no significant relationship between health literacy and the tendency to childbearing and spiritual health. So that the correlation coefficient between health literacy and tendency to childbearing (p = 0.57, r = 0.04) and the correlation coefficient between health literacy and spiritual health were (p = 0.20, r = 0.08). There was a positive and significant relationship between the tendency to childbearing and spiritual health (p = 0.003, r = 0.18).

The results of the study showed that the level of womenchr('39')s health literacy had no effect on their tendency to childbearing and the two categories were unrelated in this study. But spiritual health had a positive and significant relationship with the tendency to childbearing. thatchr('39')s mean women with higher spiritual health were more interested in childbearing. Therefore, in planning educational interventions to increase womenchr('39')s tendency to childbearing, we must pay attention to the dimension of womenchr('39')s spiritual health and consider strengthening womenchr('39')s spiritual health.

Changes in drug concentration (release) in the body is one of the most important parameters affecting the health of patients, whose sharp increase or decrease can cause complications in patients. Therefore, it is very important to study the release of the drug and determine the concentration of the drug in the body. Drug release in the human body can be done through various mechanisms that by examining drug release at different times, effectiveness of each mechanism can be determined. Drug delivery systems can be divided into general categories: diffusion-controlled, swelling-controlled, and environmentally sensitive systems, each of which can release the stored drug under different conditions and through different mechanisms. Recently, drug release in swollen hydrogels has attracted many attentions from researchers, indicating the importance of this drug delivery system. Hydrogels are crosslinked polymeric networks that can absorb water more than twenty times their own weight. Depending on their environment, hydrogels can swell or release absorbed water. There are different types of hydrogels that can swell in response to changes in temperature, pH, glucose levels, etc. in the external environment. For example, environmentally sensitive hydrogels can be engineered to initiate drug release at a specific location.  Most of the studies on drug release from swollen hydrogels have been performed experimentally and its modeling has been limited and with many assumptions. Therefore, the aim of this study was to model the drug release kinetics in chitosan (CS), gelatin (Gel) and polyvinyl alcohol (PVA) hydrogels.

Drug release modeling in five hydrogels with different ratios of CS and Gel based on PVA with different swelling rates were compared. First, using Excel software, the swelling rate of each hydrogel was compared to time, then it was used to simulate drug release in each of the hydrogels. In this modeling, using MATLAB software and mass transfer relations, diffusion and bulk motion (hydrogel boundary swelling) mechanisms were numerically simulated and compared. The assumptions applied to solve the equations of changes in drug concentration were such that the concentration of drug around the hydrogel (drug discharge site) was equal to zero and the diffusivity coefficient was considered constant. The output of the modeling was in the form of two- and three-dimensional graphs showing the changes in drug concentration and swelling rate over time. One of the advantages of drug release modeling in swollen hydrogels is the independence of these results from the type of drug.

Modeling findings for all hydrogels showed that the mechanism of drug release through mass movement is very important, so that with increasing swelling rate in a hydrogel, less time is required to complete discharge of drug and then drug with higher dose is released in the body. Cs: Gel (1: 3) hydrogel, which is less swollen than other hydrogels, takes longer (150 minutes) to completely discharge the drug. In other hydrogels, the discharge time of the drug decreased with growth in the same way, which showed the effect of growth rate of the drug-carrying hydrogel on required time for drug release which decreased with increasing the ratio of chitosan to gelatin to make the hydrogel. For example, in the Cs: Gel (3: 1) hydrogel, which had the highest growth rate, the drug discharge time was approximately 90 minutes. Hydrogels with less chitosan in their structure had lower swelling rates leading to reduce the rate at which the drug was discharged through the mass movement in the polymer network of the hydrogel, and had a lower mass flux to discharge the drug. The findings of the modeling are consistent with the results of previous studies, so that in the research conducted by Islam et al., CP4 and HG2 hydrogels had highest swelling rate and release of progesterone, dexamethasone and aspirin at pH=6.8. However, at pH = 1.2, CP4 and HG2 had the lowest swelling and drug release rate. Considering the diffusivity coefficient in the equations, the expression of local volume changes in Equation (2) plays an important role in determining the time of complete discharge of the drug from the hydrogel. For drugs that need to be released at low flow rates and fluctuations in drug concentrations may cause side effects, hydrogels with lower growth rates can be used. Hydrogels with higher swelling rates can also be used for drugs that require high concentrations in the body.

From the modeling results obtained in this study and the results of previous researches, it can be seen that the mechanism of mass movement in swollen hydrogels is very important, so that in some hydrogels the contribution of drug discharge through the hydrogel boundary swelling is greater than the drug discharge through diffusion. In addition, to determine the contribution of each mechanism, different combinations of hydrogels can be used to produce the drug reservoir, and by reducing or increasing their swelling, the contribution of the mass movement mechanism can be reduced or increased, respectively. In this work, increasing the ratio of chitosan to gelatin increased swelling and consequently the role of mass movement mechanism in drug release. As a result, in order to increase the drug discharge time, the ratio of gelatin to chitosan should be increased, whereby the swelling rate and finally the discharge rate of the drug are reduced.

Pseudomonas aeruginosa is an opportunistic, gram-negative, non-fermented and catalase-positive pathogen that causes significant opportunistic infections such as urinary tract infection, pneumonia, and septicemia. P. aeruginosa is a unique bacteria that can make changes in the virulence genes expression and the rate of drug resistance in order to survive in different environments. Drug resistance resulting from beta-lactamases have been reported to be an important cause of various infections and are a critical therapeutic problem worldwide. Additionally, It has been reported that the clinical isolates of P. aeruginosa are challenging to treat because of their virulence factors and antibiotics resistances. This bacteria has a large number of pathogenic agents such as Exotoxin A, Exoenzyme S and Elastase, which causes resistance of bacteria against antibiotics. They are resistant to many antibiotics, including beta-lactams and third-generation cephalosporins. The objective of this study was to determine the prevalence of Exo A, and Exo S genes in clinical isolates of P. aeruginosa obtained from patients hospitalized in Urmia city hospitals. The other aim of this study was to evaluate the antibiotic resistance, and the prevalence of bla-SHV and CTX-M genes in clinical isolates of P. aeruginosa obtained from patients hospitalized in Urmia city hospitals.

Through this cross-sectional and experimental-applied study, one-hundred isolates of P. aeroginosa from diverse clinical sources, including blood, wound, trachea and urine samples, were collected from different Urmia city hospitals, Iran. The hospitals and private or public laboratories were included Motahari, Imam-Reza, Arian, Taleghani, Milani, Imam-Khomeini, and Arefian. Samples were incubated and cultured in a nutrient agar culture medium at 37°C for 24 hours, and then a slide of each sample was prepared for examination by Gram Staining. Biochemical tests were performed on the samples suspected of P. aeruginosa including catalase, oxidase, oxidation/ fermentation test, pigment production, arginine dehydrolase, and growth at 42°C. Approved samples were cultured on a Mueller-Hinton agar culture medium to evaluate drug resistance. After confirmation by biochemical tests, antibiotic susceptibility test was performed using the disk diffusion method. The disks were placed at regular distances on the plateschr('39') surface, and the size of the zone of inhibition was measured after 24 hours of incubation at 37 °C. CLSI reference tables were used to detect the rate of antibiotic resistance. The antibiotic disks used in this study were included: antibiotics from the family of aminoglycosides (gentamicin, ceftriaxone, imipenem, cefotaxime, colistin and amikacin) and the β-lactam family (ceftazidime), and ciprofloxacin. In order to determine the prevalence of Exo A, Exo S, bla-SHV and CTX –M genes, DNA of the samples was extracted using the boiling method and maintained in the TE buffer in 20°C for PCR reaction. The primer sequences of the desired genes were obtained from the valid articles to perform the PCR reaction. PCR cycles were optimized, and the prevalence of genes was determined using the standard PCR method and touchdown-PCR. PCR reaction was performed at a standard volume of 25 μl. In this volume, for each microtubule, a mixture of 1 μl of extracted DNA samples, one μl of each forward and reverse primers, 12.5 μl of Master Mix and 9.5 μl of deionized distilled water were mixed. Then the PCR reaction was performed in a thermocycler with a specific time and heat cycle for amplification of each gene as follows: For the Exo A gene, the first temperature range includes an initial cycle of denaturation at 95 °C for two minutes, repetition of 14 cycles for denaturation at 95 °C for 30 seconds, annealing temperature at 73/1 °C for 30 seconds, through which the temperature decreases half a degree at each cycle, the extension temperature at 72 °C for 40 seconds. The second temperature cycle was included the denaturation at 95 °C for 30 seconds that be repeated for 19 cycles, the annealing temperature at 66.1°C for 30 seconds and the extension temperature at 72°C for 40 seconds and a final expansion cycle at 72 ° C for 40 seconds. For Exo S, bla-SHV and CTX-M genes, the temperature program was one cycle of initial denaturation at 95 ° C for two minutes, denaturation temperature at 95 °C for 30 seconds was repeated for 25 cycles, the annealing temperatures were 64°C, 61 °C and 56.7 °C respectively for 30 seconds, the extension temperature at 72 °C for 50, 70 and 80 seconds, respectively, and a final extension cycle at 72 °C for five minutes for each gene. Finally, in order to qualify the PCR product, five microliters of each sample were transferred for electrophoresis on 2% agarose gel and finally stained with ethidium bromide. The obtained data were analyzed by the qualitative method as a percentage.

In this descriptive cross-sectional study, from 100 samples collected from different hospitals, 24 samples were obtained from the male patients (24%), and 76 samples were obtained from the female patients (76%). Clinical samples prepared from patients included 10% wounds, 4% blood and 86% urine. The antibiotic susceptibility test results indicated about 63% of resistance to β‐lactamases and exotoxin genes. The highest resistance was to cefotaxime, 86%, and the lowest resistance rate was to colisitin, 3%. The other antibioticschr('39') resistance rates were 28% for gentamicin, 61% for ceftriaxone, 28% for amikacin, 23% for ceftazidime, 24% for ciprofloxacin, and 30% for imipenem. PCR results showed 52/38% and 57/14% of the isolates contained exotoxin S and A genes, respectively. Positive genes of CTX-M and bla-SHV were detected in 7.93% and 4.76% of isolates, respectively.

The presence of genes encoding beta-lactamase and exotoxin enzymes and their transmission among gram-negative bacteria is a principal threat for consumers of broad-spectrum cephalosporins, especially when indiscriminate using these antibiotics. In recent decades, the emergence of resistant strains of this bacterium with multiple drug resistance has increased. Therefore, isolation and identification of P. aeruginosa from the clinical samples and reporting the results to health authorities is essential. The present study demonstrated a low occurrence of P. aeruginosa isolates carrying CTX-M and bla-SHV genes. Additionally, drug resistance and the presence of virulence factors such as exotoxins can be a severe warning for treatment centers in terms of control of disease caused by this bacterium.

The World Health Organization has identified COVID-19 as a public health priority of international concern. Due to lack of effective antiviral drugs or vaccines, it is necessary to discover effective treatment methods (1). Recently, there have been reports of SARS-CoV-2 infection indicating that the virus is found not only in the respiratory tract but also in the gastrointestinal tract. Although ACE2 has been shown to play a key role in protecting individuals against lung damage and intestinal epithelial inflammation, it is interesting to note that ACE2 protein expression decreases after infection with the virus (2). SARS-CoV-2, like SARS and Mers, is a beta-coronavirus. The SARS-CoV-2 genome has been sequenced, and according to the genomic sequence, SARS-CoV-2 has a 96% identity similar to bat coronavirus and 79.6% similar to SARS-CoV. Although there is no approved drug or vaccine for COVID-19, a number of clinical trials are ongoing (3). The development of new drugs is a time-consuming process and generally requires several years of clinical validation. In recent studies, viral proteins have been used as the target of molecular docking-based virtual screening. The predictions of these studies help us to select appropriate laboratory and clinical candidate drugs (4). On the other hand, the use of drugs that have been approved for some diseases and are safe for human consumption should be evaluated for effectiveness against the new disease. In life-threatening cases, such a drug strategy is highly desirable if there is an alternative drug or vaccine. However, clinical trials are needed to ensure that such treatment is appropriate (5).

The aim of this study was to review therapeutic candidates for the emerging COVID-19 disease. This study is a review study as a narrative review which has been obtained by searching in valid scientific databases such as Scopus, Google scholar, PubMed using the keywords virus, Corona, COVID-19, SARS-CoV-2, treatment of the latest information. Also, to receive the latest information from reputable sites in the field of health, such as the World Health Organization and the Center for Disease Control and Prevention have been used.

Recommended medications to combat viral infections are including of remdesivir, chlorquine or hydroxychloroquine, Methylprednisolone, combination of ritonavir and lupinavir, Favipiravir, fingolimod and bevacizumab. Remdesivir is a drug that is an adenosine analog used to inhibit the action of RNA polymerase and is used for Marburg and Ebola viruses (43). Chloroquine or hydroxychloroquine is effective in inhibiting endosomal acid fusion (33,34). Methylprednisolone is a synthetic corticosteroid that binds to nuclear receptors to reduce proinflammatory cytokines (26). The combination of ritonavir and lupinavir acts as a viral protease inhibitor (40). Favipiravir is a guanine analog and is an RNA-dependent RNA polymerase inhibitor (46). Fingolimod is an immunological modulator and is mostly used in patients with multiple sclerosis and by binding to sphingosine 1 phosphate receptors, it reduces the outflow of lymphocytes from the lymph nodes (30). Bevacizumab acts against vascular endothelial growth factor (VEGF) to prevent hypoxia and inflammation caused by this factor in the respiratory epithelium (21). In addition to the above drugs, many drugs are currently being studied in different countries to confirm their effectiveness in treating COVID-19, which are listed in Table 3.

Due to the time-consuming nature of the development and registration of antiviral drugs, available treatments for other diseases may be the fastest emerging treatment option for infectious diseases. Broad-spectrum drugs such as bevacizumab, methylprednisolone, fingolimod, flupinavir, ritonavir, chloroquine phosphate, remedicivir, and favipiravir are currently being studied in various clinical trials as candidates for treatment. Therefore, it can be concluded that the use of all these drugs, in turn, can have a significant effectiveness in combating this disease. Of course, it should be noted that none of these drugs is the definitive and specific drug COVID19, and efforts to find a specific drug for this disease should continue until the definitive drug is available.

Addiction and substance abuse is one of the most serious human problems in recent years and one of the most complex human phenomena that as a non-adaptive pattern of substance use leads to frequent occupational, social and legal problems. Today, drug use is one of the major medical, social, economic and cultural problems that despite the social unacceptability of opium use, different classes of people are seriously involved in this issue. The World Health Organization has described it as a worrying event in the world, and governments are incurring huge costs to combat it. From the perspective of psychology today, addiction or substance abuse is a mental disorder. This term, which is defined in psychiatric classifications as substance abuse disorders, is the second most common mental disorder. Substance dependence is a pattern of repeated substance use that usually results in tolerance, withdrawal, and compulsive drug behaviors. Also, the most important characteristic of substance dependence is the pattern of maladaptive substance use, which is characterized by significant adverse and recurrent consequences associated with repeated substance use. One of the problems caused by addiction that finds a social profile is the phenomenon of homeless people. The homeless people are to reach the end of the path of poverty and misery in which the injured person loses everything he had gained in his social life. Research shows that addiction, delinquency, family problems, and the like trigger the onset of sleep deprivation, and the concentration of sleep deprivation in certain areas of the city reduces social security in that area .The phenomenon of homeless people, which has been growing in Tehran in recent years, has attracted many people in Tehran, both immigrants and residents of Tehran, for various reasons; It is these consequences that make sleeping cartons a social issue. Addiction is one of the problems in the world today. To deal with this problem, an effective treatment approach is very important. One of the most important issues in addiction treatment and withdrawal is the factors affecting addiction withdrawal. The aim of this study was to identify the most important factors affecting quitting addiction of homeless people in the city of Tehran.

This research was conducted by qualitative method with data foundation approach. Data were collected through in-depth and semi-structured interviews, which were analyzed using open, axial and selective coding methods. The study population consisted of all homeless people that succeeded in quitting addiction in Tehran in 1397, which were selected using purposive sampling method. After 12 interviews and analysis of interviews, it was found that informants provide duplicate information. In this way, theoretical saturation was achieved and the interviews were stopped. To ensure the validity of the research, the criterion of scientific accuracy and reliability of the open test method was used. Also, all the sample people are male in terms of gender. The age of the sample was divided into two groups of 20 to 40 years and 41 to 60 years. Most of the sample people are over 40 years old. Regarding the education status component, 50% of the sample people are illiterate, which includes the largest number. 33.3% have less than a diploma and 16.7% have a diploma. Also, regarding the marital status component, 67% of the samples are single and 33% are married. So there are more singles.

A total of 4 selected codes and 7 central codes were formed through a combination of 31 open codes that are the causes of quitting addiction in sleep addicts. At this stage, the concepts have been edited in terms of naming, and an attempt has been made to distance the concepts of business operating space and bring them closer to the scientific space. The categories are named in the same way. In the meantime, an attempt has been made to observe the maximum apparent and essential similarity between the concepts introduced by the interviewees with the selected words that have a more scientific aspect. The results of the coding showed seven categories of helplessness and desire for change, independence in voting and rejection of coercion in individual choices, non-pharmacological interventions with pain, real knowledge and understanding of addiction and methods of quitting addiction, security, perception of spiritual issues in personal life and motivating factors are effective in quitting addiction of homeless people in Tehran. Finally, data analysis 4 selected codes (research theory): fatigue of the current situation and voluntary willingness to quit and change the existing situation, use of cognitive therapy methods and deep understanding of the problem of addiction, trying to receive social support and family support to cope With the problem of addiction, the use of motivational and spiritual factors to deal with the problem of addiction has been achieved.

The most important factors influencing the decision to leave addicts in the eyes of participants were fatigue from the status quo, lifestyle changes such as changes in nutrition and sleep and physical weakness, as well as fear of complications due to withdrawal due to previous experiences of failure to quit. . According to the participants, one of the effective solutions in this case is to use the experiences of successful people in quitting addiction. Other factors in the decision to leave the family readmission were the spousechr('39')s attention and love, which with the familychr('39')s awareness of the decision to leave their support and companionship can improve and accelerate the treatment process. Non-pharmacological treatments, counseling and cognitive therapies were also mentioned as factors affecting addiction withdrawal by participants. Feeling lonely along the way to recovery, guilt, mistrust, carrying labels such as delinquent, thief, and lack of family support, and the consequences of such behaviors that sever healthy ties to support networks such as family and community should be addressed by the mass media. To be trained to accompany the family and community during the treatment process and to become facilitators of the treatment process and not as deterrents. Attention to spirituality was also mentioned by the participants. Spirituality improves the guilt and shame caused by addiction and coping strategies to solve problems using spirituality was one of the factors influencing the decision to quit addiction. Other influential factors were motivation and envisioning a better future and returning to the family center and community acceptance mentioned by the participants. Educating families during the treatment process for their spiritual support during and after the treatment process has been one of the factors facilitating the treatment process for addicts. Therefore, in the recovery process, addressing the factors influencing the decision to quit is of particular importance, and by identifying these factors, we can help lead homeless addicts to take action to quit and stay on the path to recovery.

In 2019, a new type of infectious disease of the respiratory tract broke out caused by a new coronavirus that was genetically very similar to the SARS virus. The disease, which is caused by the Covid-19 virus, has spread rapidly around the world and is currently affecting many countries around the world (1). This epidemic has also caused physical health concerns; it also causes a number of psychological illnesses, including stress and anxiety (3), which can affect the quality of life of patients and even the general public. The part of the population affected by COVID-19 is children. Children of all ages are sensitive to COVID-19 and there is no significant sex difference between boys and girls. Although the clinical manifestations of COVID-19 cases in children are generally lower than in adult patients, young children, especially infants, were vulnerable to infection (10). Children are part of the population who spend most of their time in Covid-19 due to the protection and prevention of Covid-19 disease, as well as the change in education style towards virtual and distance education, as well as the closure of schools in some areas. They spend time at home. Due to the restrictions on the presence of children outdoors, such as schools and training centers and sports clubs, and on the other hand, changing the educational style and turning the educational system to using distance education methods, students also use From electronic devices such as phones, tablets and computers, as well as watching educational programs by radio and television, and the combination of these factors can promote sedentary lifestyle in children. However, due to changes in educational methods and parentschr('39') desire to control and protect children more, their presence in group activities and outdoors has decreased, which causes more inactivity of these children, which can cause some complications in this population.

The present study is a review study based on information collected from Internet sources such as Google Scholar and PubMed using the keywords COVID-19; Heath; Children; sedentary; Physical Fitness was performed.

Recent data from the China Centers for Disease Control and Prevention show that out of 44672 COVID-19-approved cases since February 112020416 (0.9%) are in the age range of 0-10 years and 514 people (1.2%) were in the age range of 10-19 years (9). Children of all ages are sensitive to COVID-19 and there is no significant sex difference between boys and girls. Most epidemiologists agree that many of the successes in controlling the virus in China and elsewhere have been due to the swift action taken by the authorities to impose quarantine on most people. Although a quarantine period is the best option and recommendation for stopping rapidly spreading infections, it may have side effects on other aspects of health in patients with health-related risk factors (13). Children are part of the population who spend most of their time in Covid-19 due to the protection and prevention of Covid-19 disease, as well as the change in education style towards virtual and distance education, as well as the closure of schools in some areas. They spend time at home. Due to the restrictions on the presence of children outdoors, such as schools and training centers and sports clubs; And also, changing the educational style and turning the educational system to using distance education methods also leads students to use electronic devices such as phones, tablets and computers, as well as watching educational programs by radio and television. These factors can promote sedentary lifestyle in children. Data from 27 countries show a decline in childrenchr('39')s global performance in the 20-meter shuttle test over the past few decades (17); which shows the role of sedentary behaviors in reducing the physical fitness of children around the world.  Regular physical activity has been accepted as an effective preventive measure for various types of health risk factors in all different age, gender, ethnic and socio-economic groups (21, 22). However, in all age groups, the level of physical activity is low (21) and the rate of obesity is still increasing (21, 23). Given that the Covid-19 epidemic increases sedentary behaviors, especially in the pediatric population, it can have negative and irreversible effects on their health, but given that the epidemic has recently spread. But so far, most researches have examined the descriptive and analytical results regarding the incidence and pathology of this disease and due to the short life span of this disease so far regarding the chronic complications of this disease such as chronic diseases and long-term complications due to light change. Life has not been studied on the level of health of different populations.

Due to the prevalence of Covid-19 virus and preventive measures against the spread of the disease, it may lead to increased sedentary behaviors and decreased physical activity and the presence of students outside the home. On the other hand, it has been found that spending time outdoors and playing increases metabolism as well as weight control in children (31, 32) and of course reducing it can lead to weight gain and obesity and diseases related to childhood obesity and Affect the level of health of children. On the other hand, sedentary and obese behaviors can reduce physical fitness and also impair motor development in children, which in addition to motor complications cause secondary problems such as metabolic diseases and cardiovascular diseases at older ages. Given that increased physical activity and play can improve health-related problems in children, there is a need for preventive programs to prevent sedentary lifestyle and increase mobility in this age population, which can have positive effects on childrenchr('39')s health. . Due to the problems associated with Covid-19 disease and the effects of behavioral change caused by this disease on physical fitness and health of children, no research has been done so far and our knowledge about the effects of sedentary behaviors due to lifestyle changes is limited. The amount of physical activity, the type of physical activity, the intensity and volume of exercises and how to implement physical education programs are limited according to modern teaching methods, and more research is needed in this regard.

Type 2 diabetes is a multifactorial chronic disease caused by the interaction between genetic and environmental factors. Genetic and environmental factors together are important factors influencing insulin resistance and pancreatic beta cell function. Although most research on type 2 diabetes focuses on macronutrients, but more recent research has shown that these patients also have disorders of micronutrient metabolism, such as vitamins and minerals. Iron is one of the most important micronutrients in the body that has a variety of biological roles in the body. However, the research has shown that high levels of iron in the body are associated with obesity and metabolic syndrome. Hyperferritinemia has also been found to have significant association between insulin resistance and high levels of glycosylated hemoglobin in patients with type 2 diabetes. Lifestyle intervention programs including physical activity and healthy diets are options for treating and managing type 2 diabetes, and the beneficial effects of exercise on the bodychr('39')s metabolism, especially insulin sensitivity, have long been recognized. One of the methods of aerobic training is interval training, which due to the possibility of rest and recovery of energy systems between training intervals, a person can perform a larger volume of training than continuous training and also due to the ability to perform higher-intensity interval training, workouts continuation of this type of training for people with lower physical fitness is recommended. Considering the role of iron in insulin resistance in patients with type 2 diabetes and as no specific research has been done to investigate the effect of aerobic interval training on iron metabolism in patients with type 2 diabetes, therefore, the present study was designed to determine the effect of aerobic interval training on iron stores and insulin resistance in men with type 2 diabetes.

In this quasi-experimental study, 20 men with type 2 diabetes were selected and divided randomly into two groups of interval aerobic training (age: 39.61±1.82; body mass index: 26.92±2.24 kg/m2) and control (age: 38.12±2.08; body mass index: 27.39±2.53 kg/m2). The training protocol consisted of aerobic interval training for twelve weeks, three days a week and each session 60-90 minutes that was performed with a 50-80% reserve heart rate with a 1: 1 rest-to-exercise ratio. Blood variables in the study protocol, 48 hours after the last training session was measured fasting. Insulin resistance was calculated using the Homeostasis model assessment: insulin resistance (HOMA-IR). Statistical analysis was performed using Paired sample t- test and independent t-test. Statistical analysis was performed at the significant level of (p≤ 0.05) by SPSS software version 22.

The results of independent t-test showed that at the beginning of the study there was no significant difference in the baseline values of the measured variables between the exercise and control groups (p> 0.05). The results of paired sample t-test showed a significant decrease were founded in serum Fe (p= 0.002), hematocrit (p= 0.001), ferritin (p< 0.001) and insulin resistance (p< 0.001) in the exercise group compared to baseline values; But no significant difference was observed in hemoglobin level in the exercise group (p= 0.091). No significant difference was observed in any of the research variables in the control group (p> 0.05). The results of independent t-test showed that changes in serum Fe (p= 0.003), hematocrit (p<0.001), ferritin (p< 0.001) and insulin resistance (p< 0.001) in the aerobic interval training group was significant compare to the control group; But no significant difference was observed in hemoglobin changes (p< 0.05).

In the present study, after a period of aerobic interval training, a significant decrease was observed in insulin resistance compared to the control group without exercise. Exercise primarily controls blood glycemic in these patients by increasing glucose uptake into active muscles and preventing the production of hepatic glucose. Muscle glucose uptake is improved by dependent and independent insulin signaling pathways, and these benefits persist for several hours after exercise. Then the aerobic interval training led to significant decrease in levels of serum iron, ferritin, hematocrit and ferritin as indicators of iron compared to the control group. Due to the fact that the measured basal levels of iron-related indices in the present study were in the normal range, and after exercise, the changes in these indices were in the normal range. And since insulin resistance is associated with iron stores in type 2 diabetes, it can be said that the effectiveness of aerobic interval training on reducing insulin resistance in patients with type 2 diabetes may be due to minor changes in iron stores (at normal levels) in these patients. Probably one of the possible mechanisms in the effectiveness of exercise is to improve insulin function by modulating iron stores and improving insulin signaling in patients with type 2 diabetes.

Infectious diseases significantly distress the physical and mental health as well as economic conditions of the societies. Understanding how a virus spreads, especially the dynamics of an epidemic is critical in order to make proper decisions and take proper measures. System dynamics approach is a scientific and appropriate method for modeling and studying the behavior of epidemics. There are many studies on system dynamics modeling of infectious diseases in the literature. However, in case of Coronavirus, there are few extensive studies on the behavior of this outbreak especially calibrated to the actual situation in a specific region. In this study, we develop an SEIR model of Covid-19 epidemic in Iran that is actually calibrated to the real data. More Importantly Most of the previous studies are focused only on projecting the number of infected people and deaths. In this study, in addition to projecting the simulation results under different scenarios, sensitivity analysis of the influential parameters are performed. Also studying the effect of quarantine measure for patients on the results and isolating the susceptible population as two different yet indirectly connected sections is not largely considered in previous studies. The developed model in this study includes Susceptible and Exposed population, identification and quarantine of infected individuals, number of Recovered cases and Deaths. The effect of asymptomatic infected people has been included as well. The quarantine itself has been expressed by several sub-variables such as required time for a person to be quarantined, the percentage of the infected who are quarantined (testing capabilities) and the efficiency of the process. There is a same decomposition for other variables such as Isolation of susceptible population and contact rate. Contact rate is defined by sub-variables: media impact, initial contact rate and a slope which determines the increase in contact rate based on the population density.  The media Impact also starts at a minimum level and gradually reaches its maximum. This definition demonstrates the gradual growth in public awareness which improves the hygiene and social distancing commitment among the individuals. Isolation process is highly depended on economic pressure. As isolation period last longer, the more resources are required to keep people fed and healthy in isolation. A simple variable to illustrate the economic pressure is defined which based on an assumed function table limits the isolation duration and percentage of the healthy people who remain isolated. Although this relationship requires more research to indicates the economic impact more accurately it is still useful and enough in order to demonstrate a limitation for isolation process.  After developing the model, it is validated through applying it for a previous real epidemic situation of H1N1 and the results are valid. Also, running the model in extreme conditions returns the expected results. It is assumed that infectivity of the virus is constant (the virus does not mutate during the period of the study) so that through a calibration process it can be obtained based on other parameters. The asymptomatic rate (the percent of people who get exposed to the infection but do not develop any symptoms) and the incubation period (average required time for a person from getting exposed to infection until developing the symptoms) are also assumed constant. After validating the model, it is used to study the spread of Covid-19 in Iran and is calibrated to official data. This stage generates a basic simulation in which the results for target variables produce real data pattern and numbers. As the official data are usually lower than the real cases, a variable to introduce the official data is considered. The official data is a portion of the real data and this portion is a given value for the model. Having the basic calibrated model, developing scenarios and performing sensitivity analysis is the next stage. In particular, we study the impacts of people isolation as well as media, quarantine rate and other given variables on spread of the virus. We investigate and advise the required conditions for controlling the spread of the disease mainly based on the testing capabilities and quarantine of the infected people and contact rate. This study includes several sensitivity analysis for important target variables such as number of daily deaths, total deaths, daily new infected, total infected, required hospital beds and ICU rooms. This analysis is based on changes in entry factors such as quarantine of patients, contact rate, media impact, asymptomatic rate, averaged required time for quarantine, recovery time, isolation of susceptible population and quarantine efficiency. The results show that total number of death and infected are highly sensitive to changes in two key factors: Quarantine of patients and contact rate. The sensitivity of mentioned target variables to isolation of susceptible population, however, is considerably less than those two key factors. We developed several scenarios with different values of isolation rate while other variables are constant. The results indicate that in absence of either reliable quarantine measure or desired contact rate level, isolating the susceptible population will only lead to continues oscillation in the target variables unless the isolation remains for a very long time. However, in scenarios where the quarantine rate or contact rate or both are below the desired level the sensitivity of deaths or infected to isolation rate is higher. Therefore, Isolation could help in providing time for applying proper quarantine measures or to reduce contact rate to desired level. These results indicate the priority level of launching the controlling measures. Also, through performing the sensitivity analysis a minimum level of quarantine rate is obtained. The results show a required contact rate level as well. In fact for both contact rate and quarantine, a lower level than the minimum level will cause the epidemic to get out of control. Another important outcome of the study is an important guidance about the contact rate controlling policy. The results show that the contact rate should be sustained at a desired level through media and public awareness. Most models link the contact rate to the daily deaths or total deaths. We developed two scenarios where in the first one contact rate is controlled by policy making and media and in the other one it is defined based on the feedback of number of deaths. The results show that in the latter the outbreak goes out of control and takes a very long time while in the first scenario it will be controlled in an acceptable time. Therefore, although this is true that practically feedbacks from deaths influences the contact rate, the model shows that if this behavior remains uncontrolled, the epidemic will not be controlled. In a third combined scenario the results show by securing the required contact rate through public awareness and media, feedbacks from deaths could be helpful for policy makers to control the outbreak even faster. Therefore, through performing several sensitivity analysis and developing different scenarios, controlling conditions for the epidemic are obtained. There are two main requirements: first a proper testing and quarantine practice in which more than 87 percent of infected are identified and quarantined within a day and a quarantine efficiency level more than 95 percent. Secondly, contact rate must be level downed and sustained at least to the desired level through media and policy making. This is especially important because reaching and sustaining these conditions will suppress the disease and prevent the next waves of the outbreak.

Infectious diseases such as tooth decay are a challenge to oral health in humans.Mouthwashes arean auxiliary tool and in addition to this, mechanical dental plaque control i.e. brushing and flossing, play an important role in controlling plaque. In the past three decades, the pharmaceutical industry has produced a significant number of antibiotics, but the resistance of microorganisms to these drugs has increased. Thus, the increasing spread of microbial resistance has made the treatment of infectious diseases difficult and costly. Much research has been done on chlorhexidine-containing solutions, which is a gold standard. Chlorhexidine belongs to the group of medicines called antiseptic antibacterial agentsand its only side effect is a change in tooth color. Therefore, now days it is sought to replace the products with herbal antimicrobial properties due to their availability and low side effects, instead of antibiotics. Ephedraguardianais an herbal medicine that has been used in the treatment of asthma, nasal congestion and disorders of the central nervous system. Almost all species of this plant are adapted to the environmental and climatic conditions of Iran and have significant antimicrobial effects. The aim of this study was to investigate the effect of aqueous and alcoholic extracts of Ephedra gerardiana with chlorhexidine on normal flora of oral bacteria and Candida albicans in vitro.

In this experimental study, the conical section of Ephedra gerardianawascollected and then approved by anexpert of medicinal plants of the Faculty of Agriculture department in Birjand University. Extraction was performed by soaking the conical parts of the plant after drying and grinding.To prepare hydroalcoholicextracts, the plant powder was boiled for one hourand then condensed in a rotary evaporator at a temperature of 60 degrees to reach a volume of 20 ml. The antimicrobial effect of the extracts was determined by broth microdilution method on Enterococcusfaecalis(ATCC29212), Streptococcus mutans (ATCC35668), Lactobacilli casei (ATCC39392) and Candida albicans (ATCC 10231).Thus, the concentrations of chlorhexidine 1%(0.03-10 mg/ml) and hydroalcoholic extractof Ephedra gerardiana(0.01-20 mg/ml)were prepared in 96-well plate wells, respectively.Bacterial cell suspensionwas adjusted to the turbidity of 0.5 McFarland standard and for Candida albicans and 5 × 103 cells mL−1was prepared by spectrophotometry and confirmed byhemocytometric counting.The extract-free wells were considered as positive control and extract control were considered as negative control.  A well microtiter platewas incubated in a 96- for 24 h at37 °C. At the end of this incubation,minimum inhibitory concentration (MIC) andminimum bactericidal concentration (MBC) and minimum fungicidal concentration (MFC) was determined by using colony count on blood agar medium.

The results showed that E. gerardiana aqueous extract did not affect the growth of Enterococcus faecalis and Streptococcus mutans. Enterococcusfaecalis and Streptococcus mutans were resistant to aqueous extractswhile aqueous extract showed an inhibitory effect on Lactobacilli casei and Candida albicans.Lactobacilli casei and Candida albicans had MIC 2.5 and 0.31 mg / ml, MBC/ MFC 0.62 and 5.0 mg / ml, respectively. Enterococcusfaecaliswas also resistant to alcoholic extracts.The results of the alcoholic extract showed that different concentrations of extract did not affect the growth of Enterococcusfaecalis. However, Streptococcus mutans and Lactobacilli casei and Candida albicans were susceptible to alcoholic extracts.Lactobacilli casei, Streptococcus mutans, and Candida albicanshad MICs at 0.07, 1.25, 2.5, mg / ml and MBC/ MFC at0.3, 2.5, 5.0 mg / ml, respectively. Also,chlorhexidine 1% showed an inhibitory effect on all bacterial strains and Candida albicans. All three bacterial strains (Enterococcusfaecalis, Streptococcus mutans and Lactobacillus casei) had MIC at 1.25 and0.07 mg / ml and MBC 2.5 and0.3 mg / ml to chlorhexidine 1%respectively. Furthermore, Candida albicans demonstrated MIC at 0.3 mg / ml and MFC at 0.62 mg / ml to chlorhexidine.

The results of the effect of hydroalcoholic extractof Ephedra gerardianashowed that it has antibacterial effects on some gram-positive bacteria of normal oral flora, including Streptococcus mutans,Lactobacillus casei and Candida albicans. Compared to the effect of different concentrations of chlorhexidine 1% and hydroalcoholic extractitdid not have a significant effect on the growth of Enterococcus faecalis. According to the study, with the exception ofEnterococcus faecalis, which was resistant to all aqueous and alcoholic extracts, Ephedra gerardiana extract has antibacterial and antifungal properties and therefore can be an effective antimicrobial agent compared with chlorhexidine 1% as a commercial mouthwash solution that has side effects of tooth discoloration;Ephedra gerardianaextract can be used alone or in combination with other antimicrobial agents as mouthwashes.To better identify the performance and antimicrobial properties of Ephedra, it is recommended that different species of Ephedra be collected from different areas and examined phytochemically.

Cardiovascular disease (CVD) is an important, leading cause of mortality and morbidity in patients with chronic kidney disease (CKD) as well as in renal transplant recipients. Cardiovascular complications become more important in children because of the improved life span of children after kidney transplantation (KT).  Recent research programs are looking into the initial stages of renal failure to diagnose early and subclinical cardiac impairment. It has been shown that abnormalities in LV geometry which start early during renal impairment are one of the key mechanisms for developing progressive cardiac complications. Despite improving LV function following KT, cardiac complications are still defined as the main risk factor for mortality in renal recipients. New echocardiographic techniques using Tissue Doppler Imaging (TDI) have been proven to be sensitive and accurate methods for recognizing the initial phase of ventricular dysfunction in a variety of diseases. To our knowledge, there is a little information on severity of cardiac involvement including structural and functional changes in children with KT who have a short duration of renal impairment. This study aimed to evaluate ventricular systolic and diastolic functions by using TDI parameters in a group of post-transplant children who had no symptoms of heart failure before KT.

Clinical and echocardiographic data were prospectively obtained from 18 patients with CKD before kidney transplantation. The inclusion criteria consisted of the following: (1) age under 18 years old, (2) no limitation in ordinary physical activities (NYHA functional class I), (3) LV ejection fraction ≥ 55%, and (4) absence of co-existing disease. The transthoracic echocardiographic study was performed within 3 months before the transplantation by an experienced physician, who was unaware of the status of the subjects. All patients of the study were followed up, and the post-transplant data were obtained during one to three years. The obtained echocardiographic data were analyzed and compared with the control group consisting of 37 age-matched, healthy children. LV hypertrophy (LVH) was defined as LV mass index >51 g/m2.7. LV systolic function was assessed by measuring ejection fraction (LVEF) using modified Simpson’s method. Tissue Doppler Imaging was used for the assessment of both systolic and diastolic LV functions, and the TDI derived MPI (TDI-MPI) was considered to be a marker of global LV function. In addition, tissue Doppler derived parameters were used for assessing regional longitudinal performances of the left ventricle. Peak early diastolic velocity (e’), peak late diastolic velocity (a’), and peak systolic velocity (s’) were obtained from the septal and lateral sides of the mitral annulus. According to the current guidelines, we evaluated the diastolic function by calculating E/e´ ratio.

The mean age at KT was 12.2+2 years. Five patients received maintenance dialysis before KT. Median follow-up after KT was 2.3 (1.3-3) years.  LVEF was within the normal range for all of the patients. LV mass decreased significantly after KT (51 ± 1.5g/m2.7 vs. 43.1±1.6 g/m2.7، p<0.05), but it was still greater than the controls (p<0.05). LVH was found in 8(44%) patients. We observed a positive correlation between pre-transplant hypertension and post-transplant LVMI (r=0.41, p<0.05). The TDI-MPI, as a marker of global LV function, was significantly greater in the post-transplantation patients than that in control group (0.36 ± 0.13 vs. 0.31 ± 0.01, p <0.05). Using ROC curve analysis, the TDI-MPI yielded an area under the curve of 0.86 to discriminate the patients against those without subclinical LV dysfunction. Using a TDI-MPI > 0.32 as the cut point, LV dysfunction was identified with a sensitivity of 75% and specificity of 48%. We observed a significant correlation between the values of TDI-MPI and the presence of LVH before transplantation (r=0.4, p<0.05). Regarding the LV longitudinal systolic function, the myocardial systolic velocity (s´) was significantly different between the post-transplantation patients and the ones in the control group (6.5 ± 0.9cm/s vs. 7.3±0.7cm/s, p<0.05), while the myocardial diastolic velocities did not differ between them. Moreover, an inverse relationship was observed between the values of s´ wave velocity and LVMI (r= -0.46, p<0.05). This association is in favor of the potential role of LV remodeling on the reduced longitudinal function of the myocardium. None of the patients had a ratio of E/e’> 14 as an index of high LV filling pressure. The values of E/e ratio were correlated to LV end- diastolic and systolic diameters (r= 0.36, r= 0.34, p<0.05, respectively). There was no relationship between E/e’ ratio and LV mass.

Assessment of the LV function with accurate echocardiographic methods showed subtle LV dysfunction in patients who were asymptomatic for heart failure and with a short pre-transplant duration of renal impairment. Moreover, LVH was the most commonly observed cardiac abnormality in post-transplant pediatric patients. In concordance with previous studies, we found that the restoration of renal function by renal transplantation improved global ventricular function and also reduced the LV mass. (7,8) However, a higher LV mass was often present in KT patients and may lead to a poor outcome. (2) Furthermore, the LV longitudinal systolic function, assessed by measurement of s’ wave velocity, improved significantly after KT. Our findings regarding a correlation of elevated LV mass with both of the TDI-MPI and impaired systolic indices of myocardial function highlight the basic role of LV remodeling on myocardial dysfunction even in the subgroup of the patients with a short period of renal failure. Moreover, its association with pre-transplant hypertension suggests that more complete control of the blood pressure in CKD patients is important for reducing cardiac risk factors. Subtle abnormalities of the LV systolic- diastolic function and LVH are present in children after renal transplantation who have no symptoms for heart failure within the pre-transplant period. Although our study is limited by the small group of the patients, the data might imply that high LV mass may substantially influence the post-transplant cardiac function. These findings confirm the importance of early initiation of therapeutic interventions to modify permanent cardiac dysfunction.

Organizational culture gives a sense of identity to members of the organization. Organizational culture is a set of basic assumptions that people in the organization, in dealing with problems, adapting to the environment and achieving internal unity and coherence, have created, discovered and developed and proved to be useful and valuable and therefore as a correct method of perception. , Thinking and feeling are transmitted to new members. In other words, a set of values, guiding beliefs, understandings, and ways of thinking that are shared among members of an organization and sought by new members as the right way to do things and think is called organizational culture. this research has developed to preparation a productivity model based on organizational culture and employees’ motivation in the department of youth and sport organization in Iran.

This research is applied in terms of purpose. Also, considering that in this study, the researcher sought to investigate the relationship between organizational culture and employee motivation and productivity, therefore, the research method was descriptive in terms of data collection. The statistical population of the study was the general managers, deputies, heads of groups and responsible experts and experts of the General Departments of Sports and Youth of 31 provinces, which numbered more than 9000 people. Statistical sample 26Study Based on the table -Kersey and Morgan, 269 people were considered and the same number of questionnaires were distributed among the statistical sample. Also, the research sampling method was selected as a cluster. Robbins (2000) organizational culture questionnaire consists of 56 items and the reliability of this questionnaire is 0.98 and validity is 0.88. Another research tool of the Employee Motivation Questionnaire, Ojaghi, was developed in 2010 with 30 closed-ended questions and its reliability was reported to be 85% and its validity was 0.86. Productivity questionnaire has been validated by AGIO (Jamshidi Ghahfarkhi, 2011). This questionnaire has 26 items that the reliability of this questionnaire is 0.87 and the validity is 0.88. In this research, descriptive and inferential statistics have been used. Considering that the purpose of this study is to determine the correlation between variables and to estimate the criterion variable from predictor variables; Therefore, according to the results of Pearson correlation coefficient, factor analysis and path analysis, and finally to provide a suitable model, the structural equation modeling (SEM) method using SPSS 21 and LISRL software. Results and

The results showed that among 269 statistical samples, 160 (57.6%) were male and 114 (42.7%) were female. People with a bachelorchr('39')s degree with 47.6% are the most people in the statistical population. On the other hand, people with a doctoral degree with 5.2 percent have the lowest number of the statistical population, as well as the employment status of officials with 44.8% have the highest number of the statistical population. The results of inferential statistics of multiple correlation coefficient in Table 1 show that there is a direct and significant relationship between the criterion variable (productivity) and predictor variables (organizational culture and employee motivation) (p<0.001 and rp = 0.80). This indicates that 20% of productivity changes are related to the above factors and 80% are related to other factors outside the model. Organizational culture has a more effect coefficient than employees’ motivation on productivity and can be concluded that organizational culture has a more important role in explaining productivity.

When Zone seeks organizational culture and moves toward it, management and employees must play a dynamic role in the implementation of human resource activities. According to research results, one of the key preconditions of productivity is employee motivation, which is largely under the control of organizational managers. This result was obtained in previous research which shows that today the organizational culture has penetrated into all parts of the organization and even the most important human resource has not been deprived of this effect. Organizational culture has enabled organizations to have a comprehensive and complete view of their resources, especially human resources. Using this system, it is possible to increase the level of employeeschr('39') authority and give them complete and necessary information so that they can perform the task or work of the organization in the best way. Organizational culture, as a kind of identity, gives members of the organization. Culture creates in individuals obligations beyond personal interests and plays a major role in human resources. Today, creating and expanding changes in human resources through organizational culture is easily done and motivates the employees of an organization.

Organizational culture has an effective role in institutionalizing employee motivation, increasing commitment, increasing competence and capability, cost efficiency and cohesion, and can lead to maximum organizational productivity. It should be noted that organizations and companies must move forward step by step, that is, they must go through the practical and communication stages that are part of the organizational culture and consider it according to the type of approach, their point of view and localize it. Proper and accurate

Due to the changes that exercise brings to the body in hypoxic conditions, today hypoxic exercise is one of the most common types of exercise among most athletes, coaches and sports professionals to improve performance at sea level (1). In this regard, various types of hypoxia exercises, such as speed training in hypoxia, have recently been considered. Hypoxia exercises are usually performed in which athletes live at or near the sea level but perform hypoxia exercises at an altitude of 2,000 to 4,500 meters (3). But simulated hypoxia training methods are also used. In this regard, various researches on performance and different variables in athletes of different disciplines in hypoxia have been performed and contradictory results have been obtained. However, changes in body systems due to hypoxic conditions depend on the severity and duration of hypoxia and the type of exercise. As there is still no general consensus in this regard. And researchers have used different training methods and contradictory results have been obtained. One of the training methods considered by researchers is the use of periodic exercises (repetitive speed exercises). In which athletes are exposed to hypoxia in a simulated environment while living in normoxic conditions with discrete and relatively short intervals (5-180 seconds) (11). This model of training can be used by athletes at rest or during core training sessions. The aim of this study was to determine the effect of 8 weeks of repetitive speed training in hypoxia and normoxia on erythropoietin and performance of female boatmen.

The present study is a quasi-experimental study that was conducted by field method with pre-test-post-test design with two experimental groups and one control group. The method of conducting the research was that the researcher first referred to the sailing federation and after explaining the purpose and importance of conducting the research and obtaining the consent of the officials during the sessions, explained the purpose of conducting the research to 14 to 20 year old female sailors in Tehran. In the next stage and after completing the consent form and general health questionnaire, eligible individuals to participate in the study (no history of acute mountain sickness in the last three months and musculoskeletal damage in the last six months) were identified and among the volunteers. 30 patients were randomly selected as a sample and divided into 3 groups: hypoxia (n = 10), normox (n = 10) and control (n = 10). Then, to collect data in the pre-test, all subjects were present in the physical education laboratory of the Faculty of Sports Sciences, University of Tehran for three consecutive days to perform the relevant tests and blood sampling. Blood samples were taken from the subjectchr('39')s left elbow at 8 ochr('39')clock in the morning on an empty stomach. On the second day, the maximum oxygen consumption of the subjects was calculated from the exercise test described by Savka et al. Using a Monarch handheld bicycle for aerobic tests. On the third day, the performance of 500 kayaks of the subjects was measured. Also, to determine the intensity of training in manual ergometer, the subjects were asked to do kayak paddling for 30 seconds. At the end of 30 seconds, the distance traveled and the subjectschr('39') heart rate were measured. Due to the improvement of the subjectschr('39') performance in the ergometer, this test was repeated every two weeks to determine the training pressure. The training program of the hypoxia group, which was performed using a hypoxia device and a mask, consisted of three repetitive speed training sessions on a rowing ergometer with an intensity of 80% of maximum performance in hypoxia conditions. For this purpose, first the subjects started warming up for five minutes with an intensity of 50% of maximum performance on the rowing ergometer, then performed 9 repetitions of 30 seconds with an intensity of 80% of maximum performance for eight weeks. Finally, to cool, the subjects paddled for five minutes at 50% of maximum execution. Also, two of the five sessions of the training program were dedicated to rowing exercises for 90 minutes. The training program of the normoxy group is similar to that of the hypoxic group, except that their activity was performed under normal oxygen conditions with normal oxygen pressure. The group also participated in rowing exercises five days a week. To describe the data from the central tendency indices, to evaluate the normality of data distribution from Shepiro-Wilk test and for inferential analysis of data from composite analysis of variance (2 × 2) and Bonferroni post hoc test using SPSS / 21 software and for The test of research hypotheses was considered a significance level of 0.05. Finally, Excel software was used to draw the charts.

The results of combined analysis of variance (3. 2) test showed that the main effect of the measurement steps and the interaction of the measurement steps and the group was on the record of 500 meters kayak for girls, but the main effect of the group was not significant. Due to the significant interaction between the measurement steps and the group, the results of one-way analysis of variance showed a significant difference between the groups in the post-test. Based on Bonferoni post hoc test, it was observed that the hypoxia group was significantly better than the normoxy and control groups, but there was no statistically significant difference between the other groups. It was also found that in the hypoxia group there was a significant decrease in 500 kppa, but in the control and normoxia groups there was no significant difference between pre-test and post-test.Regarding EPO, the results of combined analysis of variance test (3. 2) showed that the main effect of measurement steps, interaction of measurement steps and group and the main effect of group on EPO were not significant. In other words, there was no significant difference between the effect of repetitive speed training in hypoxia and normoxia on EPO.

In general, the results of the present study showed that training in hypoxic conditions improves the performance of rowing girls and has no significant effect on erythropoietin. Although there is evidence that hypoxia exercise is beneficial for competition at height, specific recommendations are currently difficult until more results on hypoxic exercise performance after hypoxia exercise are available. Therefore, more research is needed in this area..

Women are two to eight times more likely than men to tear the anterior cruciate ligament. The most common mechanism of anterior cruciate ligament injury is non-contact, which accounts for about 72% of all ligament injuries and occurs during activities such as deceleration, jump landing, and cutting. Among these, jump-landing is the most commonly reported mechanism of ACL injury in sports, as an inappropriate technique during jump-landing manoeuvres can cause considerable force on the ACL and result in rupture. Although exercise manoeuvres lead to excessive loads on the knee in both sexes, these manoeuvres cause more injury to women. This significant increase in the incidence of injuries in women has led to extensive studies on gender differences. Therefore, the purpose of this systematic review was to the studies that compared the electromyography activity of the lower limb muscles in the jump-landing task between men and women.

Papers in English were searched in the Google Scholar, Science Direct, PubMed, WOS, Scopus, ProQuest, and Cochrane Library databases without time limitation until 2020 and with keywords related to "electromyography", "jump-landing", and "gender". Inclusion criteria included cross-sectional and gender comparisons studies in which samples were male and female athletes with no history of sports injury, the task was one or two jump–landing and lower extremity electromyography activity was measured before or after ground contact. The modified checklist of Downes (1998) was used to evaluate the quality of the studies.

Searching for selected keywords in different databases led to finding 1018 articles. Then duplicate articles were removed (415) and 603 articles and their abstracts were reviewed, and after the screening, 66 articles were studied in more detail. Seventeen articles were excluded from the review process due to differences in the type of assignment or unrelated information provided. Some studies provided information only about female athletes or did not directly compare men and women (33, 34)or the task presented in them was not according to our criteria (35). Finally, Eight articles were selected for a comprehensive review. Quality index score was obtained for all articles above 6, so the included articles had a desirable level in terms of quality. Numerous studies have examined muscle activation in the feedforward and feedback stages (before and after foot contact with the ground) during the jump landing task to determine gender differences and the causes of ACL injuries. The jump landing conditions studied include two-legged landings from heights of 20 and 40 cm (36), 30 cm (38) and jump-landings that are normalized with respect to the maximum vertical jump of the subjects (39). Sex differences in rectus femoris muscle activation were seen in one study (43) out of 5 studies (36, 39, 41, 43, 44). However, Ebben (39) showed that this muscle is used significantly earlier in women. Only Ebben (39) reported significant sex differences in external hamstring muscle activation so that men showed more activity before and after contact. Four studies (36, 39, 40, 42) examined the mean and maximum activity of internal extensor muscle. The results of Ebben study (39),which examined the timing of activity, showed that the vastus medialis muscle was activated earlier in women. Few authors have studied the activity of the medial and lateral gastrocnemius muscles. Rozzi (40) examined the lateral gastrocnemius muscle, and Rozzi and Zazulak (40, 43)studied gastrocnemius medial and in neither of them was there a significant difference between the two sexes while performing the jump landing task in this muscle. Activation of the gluteus medius muscle was measured in 4 studies (38, 42-44), and no significant difference was reported in the activation of the gluteus medius between the two sexes. Zazulak (43)studied the mean and maximum activity of the gluteus maximus muscle which showed that the mean and maximum muscle activity after foot contact with the ground is higher in men than women (43)but before contact with the ground, there is a significant difference between the two sexes. The results of studies examining the activity of the muscles of the rectus femoris, vastus medialis, vastus lateralis, medial hamstring, lateral hamstring, gastrocnemius and gluteus medius in the feedforward and feedback stages during the landing task were performed at different altitudes. There is no difference between men and women in terms of the muscle activation pattern.

The results showed that men and women show similar patterns of muscle activation before and after jump-landing when the intensity of the task is appropriate to their ability. Therefore, the cause of womenchr('39')s greater vulnerability should be sought in other cases such as biomechanical and hormonal factors. It was also found that the type of exercise and the level of physical fitness of individuals can affect the pattern of muscle activation..

Studying the structural features of successful organizations is evidence of this claim that complementary organizational supportive system is the existence of managerial supportive approaches, desirable styles and patterns of behavior that have a direct impact on individual performance and consequently not to employee turnover. Meanwhile, the quality of the relationship between operational staff and human resources with senior managers of the organization, is a factor affecting the working quality of employees and consequently the emergence of professional work behaviors by employees in order to accept and align individual aims with organizational goals. On the other hand, many subcultures are formed in sports organizations, according to the nature of work; since these organizations are among the human-centered organizations, having an organizational culture that generates commitment and efficiency of employees will play an important role in acting as a successful entity. In this regard, the results of several surveys analyzing the relationship between supportive behaviors and the existence of justice-oriented patterns with staff turnover have shown that the emphasis on the significant role of distributive justice and procedural justice in the turnover tendency, stated that the managers’ fair behaviors promote employee participation in achieving organizational goals and is an important adjusting factor in the decision to turnover or not to turnover. In this study, the pattern of turnover tendency in sports and youth administration based on the role of organizational honesty, culture and commitment has been studied based on the conceptual model; and the goal of the study is to create an organizational supportive driving factors’ pattern of the turnover tendency.

The present research is a Sequential-Exploratory Mixed Method Design type and was implemented in two phases, qualitative and quantitative. The statistical samples of the study. based on the minimum statistical sample required in structural equation research, included (n = 115) employees and executives and staff of sports and youth departments Golestan province who were randomly selected for the purpose of the study. In the qualitative phase of the research, through semi-organized interviews with university professors in the field of management and organizational behavior and staff and senior managers of sports and youth departments (n = 15) using the Delphi method to achieve theoretical saturation. In the quantitative part, with confirming the optimal reliability of the questionnaire items was implemented using Cronbachchr('39')s alpha method, the modified version of Kim (2007) turnover intention questionnaire, the employee-employer relationship quality questionnaire of Grunig and Huang (2002), the organizational commitment questionnaire of Mayer et al. (1993), as well as a modified version of the Rupp and Cropanzano (2002) Organizational Integrity Questionnaire, which was set as a 5-point Likert scale. Finally, using KMO (Kaiser-Meyer-Olkin) test and Bartlett’s test of sphericity, in order to ensure the structural validity of latent variables and optimal fit of the research conceptual model, LISREL and SPSS software were used at a significance level of 0.05.

According to the results of the study, the quality component of employee-organization relations (β = 0.78) and managerial honesty (β = 0.77) had the greatest impact on the turnover tendency of employees, respectively. But structural analysis of the path regarding the component of quality of employee-organization relations, showed that among the four components: trust level, commitment, satisfaction and control, the occurrence of reciprocal control behaviors with factor load (β = 0.89), was the main explanatory factor. Also, the output of regression test in predicting turnover tendency showed that the regression coefficient of the quality component of the employee-organization relationship equal to (β = -0.63). A significant percentage of variance (R2 = 0.64), given the number of standard error, is explained by the quality component of the employee-organization relationship. Therefore, according to the significance of ANOVA test, the positive and significant effect of this component on the latent variable was explained (F = 11.67). Analyzing regression coefficient values (β = -0.53) and variance error (R2 = 0.57) of the supervisor honesty component also confirmed its significant effect on the latent variable of the survey (F = 17.26).

The quality of employee-organization relations and the honesty of the supervisor had the greatest impact on the turnover tendency, respectively. Also, fair behavior affected the turnover tendency. Not to use the abilities of all employees, lack of vision to improve the type and way of payments and inappropriate actions of managers lead to dissatisfaction and eventually turnover in the organization. Therefore, the adoption and implementation of policies and procedures by senior organizational managers, should be in accordance with motivational (transformational) management methods such as preparing an intimate and professional work environment, justice through fair behavior in the distribution of organizational resources, transparency and clarity of work procedures, equal job promotion opportunities along with participation of all employees in organizational decisions according to their job background, while maintaining the workforce and especially knowledgeable and specialized human resources, preparing the growth and development basis, and minimizing the variables affecting organizational departure and turnover.
  

Studying the structural features of successful organizations is evidence of this claim that complementary organizational supportive system is the existence of managerial supportive approaches, desirable styles and patterns of behavior that have a direct impact on individual performance and consequently not to employee turnover. Meanwhile, the quality of the relationship between operational staff and human resources with senior managers of the organization, is a factor affecting the working quality of employees and consequently the emergence of professional work behaviors by employees in order to accept and align individual aims with organizational goals. On the other hand, many subcultures are formed in sports organizations, according to the nature of work; since these organizations are among the human-centered organizations, having an organizational culture that generates commitment and efficiency of employees will play an important role in acting as a successful entity. In this regard, the results of several surveys analyzing the relationship between supportive behaviors and the existence of justice-oriented patterns with staff turnover have shown that the emphasis on the significant role of distributive justice and procedural justice in the turnover tendency, stated that the managers’ fair behaviors promote employee participation in achieving organizational goals and is an important adjusting factor in the decision to turnover or not to turnover. In this study, the pattern of turnover tendency in sports and youth administration based on the role of organizational honesty, culture and commitment has been studied based on the conceptual model; and the goal of the study is to create an organizational supportive driving factors’ pattern of the turnover tendency.

The present research is a Sequential-Exploratory Mixed Method Design type and was implemented in two phases, qualitative and quantitative. The statistical samples of the study. based on the minimum statistical sample required in structural equation research, included (n = 115) employees and executives and staff of sports and youth departments Golestan province who were randomly selected for the purpose of the study. In the qualitative phase of the research, through semi-organized interviews with university professors in the field of management and organizational behavior and staff and senior managers of sports and youth departments (n = 15) using the Delphi method to achieve theoretical saturation. In the quantitative part, with confirming the optimal reliability of the questionnaire items was implemented using Cronbachchr('39')s alpha method, the modified version of Kim (2007) turnover intention questionnaire, the employee-employer relationship quality questionnaire of Grunig and Huang (2002), the organizational commitment questionnaire of Mayer et al. (1993), as well as a modified version of the Rupp and Cropanzano (2002) Organizational Integrity Questionnaire, which was set as a 5-point Likert scale. Finally, using KMO (Kaiser-Meyer-Olkin) test and Bartlett’s test of sphericity, in order to ensure the structural validity of latent variables and optimal fit of the research conceptual model, LISREL and SPSS software were used at a significance level of 0.05.

According to the results of the study, the quality component of employee-organization relations (β = 0.78) and managerial honesty (β = 0.77) had the greatest impact on the turnover tendency of employees, respectively. But structural analysis of the path regarding the component of quality of employee-organization relations, showed that among the four components: trust level, commitment, satisfaction and control, the occurrence of reciprocal control behaviors with factor load (β = 0.89), was the main explanatory factor. Also, the output of regression test in predicting turnover tendency showed that the regression coefficient of the quality component of the employee-organization relationship equal to (β = -0.63). A significant percentage of variance (R2 = 0.64), given the number of standard error, is explained by the quality component of the employee-organization relationship. Therefore, according to the significance of ANOVA test, the positive and significant effect of this component on the latent variable was explained (F = 11.67). Analyzing regression coefficient values (β = -0.53) and variance error (R2 = 0.57) of the supervisor honesty component also confirmed its significant effect on the latent variable of the survey (F = 17.26).

The quality of employee-organization relations and the honesty of the supervisor had the greatest impact on the turnover tendency, respectively. Also, fair behavior affected the turnover tendency. Not to use the abilities of all employees, lack of vision to improve the type and way of payments and inappropriate actions of managers lead to dissatisfaction and eventually turnover in the organization. Therefore, the adoption and implementation of policies and procedures by senior organizational managers, should be in accordance with motivational (transformational) management methods such as preparing an intimate and professional work environment, justice through fair behavior in the distribution of organizational resources, transparency and clarity of work procedures, equal job promotion opportunities along with participation of all employees in organizational decisions according to their job background, while maintaining the workforce and especially knowledgeable and specialized human resources, preparing the growth and development basis, and minimizing the variables affecting organizational departure and turnover.

One of the serious diseases in the group of developmental diseases is autism spectrum disorders that appear in early childhood (usually before the age of 3). Autism spectrum disorder is a group of neurodevelopmental disorders. According to research results, children with autism have lower levels of basic motor skills, fine and gross motor skills, motor coordination, balance issues, performing daily skills, social and communicational skills, as well as anxiety. It is one of the most common disorders among these children. The results of research on laughter yoga indicate the positive effect of this exercise program on various diseases, but considering that the effect of laughter yoga on children with autism disorder have not been studied yet, same as the effect of sensory motors activities that is not been measured by the MABC_2 test. In this study, we measured the effect of laughter yoga on anxiety and the effect of sensorimotor activity on gross skills in children with high-functioning autism spectrum.

The statistical population of this study is all 7 to 10 years old boys with high-functioning autism spectrum disorder (referring to autism centers) in Mashhad. For statistical sampling, non-random sampling method available from 9 autism centers, 45 children with autism aged 7 to 10 years with high performance (with expert opinion and Garz test) were selected and divided into three groups of 15: first group Laughter Yoga, Group 2: Sensory-Motor Exercises, Group 3: Combination (Laughter Yoga and Sensory-Motor Exercises) were randomly divided and tested. The research is semi-experimental in terms of method and applied in terms of purpose with pre-test-post-test design. The exercises are held in 24 sessions of 45 minutes. At the beginning and end of the 24 training sessions, parents of children with autism were asked to complete the Spence Childrenchr('39')s Anxiety Scale - the parentschr('39') prescription and the MABC2 test to determine the effect of sensory-motor exercises on gross skills. Pre-test and post-test were taken. Group 1: Laughter yoga exercises: Laughter yoga exercises were performed in 24 sessions by a researcher who was an international laugh yoga instructor, and each session lasted about 45 minutes. Each session includes exercises in 5 stages: the first part: warming up, the second part: breaking the ice, the third part: beginning techniques, the fourth part: laughter meditation, the fifth part: relaxation exercises. Stretching and jumping movements are performed at the beginning and between the performances of laughter yoga technique and yoga (pranayama) breathing. In all exercises, people were trained to make eye contact with other groups during the exercises and to have a fresh face. Group 2: Sensory-motor integration exercises: The general objectives of sensory-motor exercises in this study were to strengthen motor planning, balance, bilateral motor coordination, tactile sense and deep sense. The list of activities generally includes the following: rope playing, walking on footprints, painting with pencil and magic whiteboard, dropping small balls or balloons into hollow containers and moving them hand in hand, various exercises with beads Coloring, making collages and crafts with glue, separating mixed beans, hitting a stationary object with your hand, throwing a bag of beans or a ball at each other and trying to get it successfully. Group 3: as a combination of exercises, for 45 minutes, the people in the group performed both types of exercises (5 minutes of general warm-up, 20 minutes of laughter yoga exercises, then 20 minutes of sensory-motor exercises).

Based on the level of significance in the analysis of variance test with repeated measures, it can be concluded that within-group changes in the anxiety variable are significant (p=0.001); Therefore, it can be concluded that laughter yoga exercises, sensory-motor activity, combined group have a positive effect on anxiety in children with high performance autism (p=0.001). Also, intra-group changes in gross motor skills are significant (p=0.001); Therefore, it can be concluded that laughter yoga exercises, sensory-motor activity, combined group have a positive effect on motor skills (large) in children with high performance autism (p= 0.001). The results of analysis of variance with repeated measures and Beferroni post hoc test showed that there was no significant difference in anxiety between the three groups (p<0.05). Also, the results of this test showed that there was a significant difference in gross motor skills between the three groups (p˂0.05), in gross motor skills, only a significant difference was observed between the two groups of laughter yoga and the combined group (p=0.034). At the same time, the percentage of improvement in post-test anxiety compared to the pre-test in the laughing yoga group (25.5%), the sensorimotor activity group (12.6%) and the combination group (27.7%) indicate this. The combined group experienced a greater improvement in anxiety. Also, the percentage of improvement of motor skills in the post-test compared to the pre-test in the group of laughing yoga (13.1), sensory-motor activity group (38.5) and combination group (33.6) showed that the group of sensory activity - The motor and hybrid groups experienced further improvements in motor skills.

The aim of this study was to investigate the effect of laughter yoga and sensory-motor activities on anxiety and gross motor skills in children with high performance autism. According to the results, the combined group on anxiety factor and sensory-motor activity had a higher effect on gross motor skills, which indicates that to improve gross skills, it is better to focus more on sensory-motor activities and Use laughter yoga to improve your anxiety factor. According to the results of our study on the positive effect of laughter yoga and sensory-motor activity on anxiety and gross motor skills in high-functioning autistic children, Health care providers and the educators can use the power of laughter to improve health, teaching and learning. This is important because teaching is not just about content but also about building relationships and strengthening human relationships. This can have a huge impact on the relationships of children with autism. Laughter improves the performance of children with autism by attracting and maintaining attention, reducing anxiety, increasing participation, and increasing motivation. Also, sensory-motor integration exercises should have a positive effect on children with high performance autism, considering that it has been able to play in a calm and friendly environment, along with playing and discharging emotions.

 Inflammatory bowel disease (IBD) is a group of diseases that cause inflammation of the walls of the large intestine and small intestine, the most common of which are ulcerative colitis and Crohn's disease. There are similarities in that both diseases cause inflammation of the intestinal wall, although there are many differences in the areas involved and the depth of inflammation between the two diseases. There are many similarities in the treatment plan for the two diseases. It is important to note that Crohn's disease, in addition to affecting the large intestine and small intestine, can also affect the esophagus, esophagus, stomach, and anus, while ulcerative colitis primarily affects the colon and rectum. Affects the intestines. It is hypothesized that IBD is more likely to occur in genetically predisposed individuals in environmental exposures that are associated with abnormal immune responses. While several environmental factors have been raised, there are many differences regarding the role of these potential factors (1, 3). It seems that in the last few decades due to the type of nutrition (which is one of the environmental factors) such as increasing consumption of cow's milk in infants instead of breast milk, increasing consumption of sugar, sweets, high fat consumption, reducing fiber consumption , The world has been associated with an increase in IBD. The incidence and prevalence of IBD is increasing in the world and has become common in Iran in the last 30 years. Inflammatory bowel disease is among the most common diseases increasing rapidly in some countries and Iran, especially in Gilan. Approximately 30000 cases of IBD have been recorded at Gilan Gastroenterology and Liver Research Center. It seems that genetic and environmental factors to be involved in this disease. The objective of this study is to investigate the relationship between environmental factors and the geographical distribution of inflammatory bowel disease (IBD) in Gilan province. The incidence of inflammatory bowel disease varies from region to region. The disease is more common in industrialized countries. The number of patients with this disease in Iran is close to 10,000. In Gilan province, a large number of about 3,000 people suffer from this disease. Therefore, the purpose of this paper is to investigate the relationship between contextual variables and frequency of inflammatory bowel disease (IBD) in Gilan province. With these details, the aim of this paper is to investigate the relationship between contextual variables and climatic elements with the prevalence of inflammatory bowel disease (IBD) in Gilan province.

 This research is applied in terms of purpose and in terms of library-field-to-field data collection tools. The volume of information on the prevalence of IBD disease registered in the Digestive and Liver Research Center of Razi Hospital Research and Training Center in Rasht Hospital in Gilan Province was from 2016-2017. Demographic characteristics, city of residence, types of inflammatory bowel disease with separation of ulcerative colitis and Crohn's disease and sex and climatic elements (humidity, temperature, pressure and rainfall) as independent variables and IBD disease as dependent variables. Descriptive statistics and Chi Square statistical test were used at a significance level of p <% 5 using SPSS software to analyze the data.

 The highest number of patients with inflammatory bowel disease - colitis based on the month of diagnosis of the disease in the city with 44 people (77.2%) and the lowest in September with 2 people (100%). The highest number of patients with colitis-men in summer with 41 patients (21.6%), the lowest number of colitis-men in spring with 4 patients (2.1%). The highest number of patients with colitis- Women in summer with 47 patients (24.7%), the lowest colitis-women in the fall with 7 patients (3.7%). There was a significant correlation in terms of correlation (p value = 0.01). According to Chi Square statistical test, there was no significant statistical difference between patients 'birth months, patients' hometowns and Crohn's disease and ulcerative colitis (p <0.05). In 6 cities, there was no significant relationship between the total number of patients, male and female patients with climatic elements: humidity, temperature, pressure and rainfall. From this study, the following results are obtained: Seasonal changes in patients with IBD by gender during the years 2016-2017 from 190 patients were done. The highest number of patients crohn -men in summer with 10 patients (5.3%), the lowest crohn -male statistics in winter and autumn with 2 patients (1.1%), the highest number of crohn -female patients in summer with 9 patients (4.7%) and the lowest crohn -female statistics in autumn with 1 patient (0.5%), there was no significant correlation (p = 0.5).

 In a study conducted by Stein et al. In 2016, the effect of geographical location, season and UV exposure on disease severity was measured by measuring the rate of hospital discharge of IBD patients nationwide. IBD hospitalization rates in the northern states were higher than in the southern states for both ulcerative colitis and Crohn's disease. However, there was no uniform difference between IBD admission rates by season versus study years. UV index was inversely related, although it was not proportional to the rate of discharge for both Crohn's disease and ulcerative colitis (11). The highest number of patients with inflammatory bowel disease was based on the month of diagnosis in the years between 2016-2017 in September with 57 people and the lowest in October with 2 people. The highest number of patients with inflammatory bowel disease based on the month of diagnosis in September with 11 people (8.5%) and summer with 13 people (22.8%) and the lowest in July, October and March with 0 people (0%). The highest number of patients with inflammatory bowel disease-colitis based on the month of diagnosis was in September with 44 patients (77.2%) and the lowest was in October with 2 patients (100%). However, there was no significant relationship in terms of correlation (p value = 0.9). It can be concluded that studies by scientists and researchers have confirmed the effect of climate change on the body's natural reactions based on the season and month of birth. Accordingly, any minor changes in air temperature, pressure and humidity can cause changes in behavior and physical and mental conditions of individuals.

 Cancer is a medical problem that has always been associated with pain. Because the experience of pain is associated with negative emotions such as anxiety, depression and anger, these negative emotions themselves reduce the quality of life, disrupt sleep habits and even people eating. Today, with the development of new technologies and pervasive influence of these technologies, the field of psychological therapies is also try to use the computer-based interventions. In this research, the effectiveness of conventional cognitive-behavioral pain therapy and its computer prescription on reducing the severity of pain and anger in children with cancer in Ahvaz was investigated.

 This research method was an experimental with pre-test, post-test and follow-up with the control group in which the effectiveness of two psychological interventions (cognitive behavior therapy of pain management and its computer version) were compared with the control group. The statistical population of the present study consists of all children with cancer who met the criteria for this study. There were about 73 subjects. The sample consisted of 45 children aged 8 to 12 years with various types of cancer, based on inclusion and exclusion criteria such as age, socioeconomic status, clinical diagnostic interview and other criteria among the cancer patients in the pediatric ward of Shafa Hospital. 2 Ahvaz were selected. Then randomly divided into three groups of 15 (two experimental groups and one control group). The research instruments included the Spielberger Anger Questionnaire (Brunner & Spielbeger, 2009) and the International Pain Measurement Scale (Wong & Baker, 2002). The first experimental group participated in routine cognitive-behavioral pain therapy sessions for 6 weeks and the second experimental group administered a computer-based training program for cognitive-behavioral pain management therapy for 6 weeks, but the control group did not receive any intervention. However, for ethical reasons, they were provided with a computerized training program, a computerized version of cognitive-behavioral pain therapy. This program was designed and developed by the researchers of this study, which includes a part of psycho-education, animation and computer games (Hamedy. & Et.al. 2017). After 6 weeks, all three groups were evaluated as post-test and finally after one-month follow-up period.

 The results showed that there was a significant difference between the intervention and control groups in terms of anger and pain variables (p<0.0001), the rate of anger and pain in the two intervention groups compared to the pretest and control groups decreased. These results were significantly continued after the follow-up period. During the follow-up period, the computer version of pain management was significantly more effective in reducing anger than the conventional cognitive-behavioral therapy of pain management, although computer intervention during the follow-up period reduced the pain better than the other intervention, but this reduction has not reached a significant level.

 Children with cancer face a lot of pain and anger. The introduction of psychological interventions based on new technologies will help these children to recover. The results of this study showed that the use of computer cognitive-behavioral pain intervention such as conventional cognitive-behavioral pain therapy has been effective to reduce pain and anger in children with cancer, but the therapeutic effect of cognitive-behavioral computer intervention program is effective in reducing pain and especially anger. Therefore, prescription of cognitive-behavioral pain management intervention and computerized prescription cognitive-behavioral pain management intervention, especially the recent approach, are recommended to reduce pain and anger in children with cancer along with drug therapies.

Cardiovascular disease (CVD) is one of the leading causes of death worldwide. CVD covers a wide range of diseases, including arrhythmias, idiopathic cardiomyopathy, heart failure, and atherosclerosis. These diseases can lead to potentially fatal heart events such as stroke, myocardial infarction (MI), or cardiac arrest. MI is associated with decreased oxygen delivery to the heart muscle, a process that leads to myocardial cell death, and inflammatory response. Many changes occur in the cardiovascular system due to MI. One of the things that researchers are studying to learn more about is changes in cardiac cytokines. Cardiac cytokines secreted by the heart muscle are called "cardiokines", which play an important role in homeostasis, function, response to myocardial damage, and myostatin and follistatin are two important cardiokines. Myostatin, also known as GDF8, is a member of the beta-transforming growth factor (TGF-β) family, whose most important function is to inhibit muscle growth. Fulostatin-1 (Fstl1), also known as TSC-36, is a glycoprotein that is a member of the follcostatin family. At the heart, Fstl1 is known as a cardiokine. Circulating levels of follcostatin increase due to heart failure. Overexpression of follistatin has been shown to have protective effects following heart damage such as myocardial infarction. Overexpression of follistatin reduces the area of myocardial infarction and apoptosis. On the other hand, exercise is one of the most important factors affecting inflammatory and anti-inflammatory cytokines, which have multiple effects in patients with MI. Today, special attention is paid to the role of sports activities as a physiological stimulus. Different sports activities come with a wide variety of responses and adaptations. The beneficial effects of sports activities have been documented in various studies; Especially in people with heart disease and MI, it increases maximal oxygen consumption, reduces inflammatory parameters, quality of life, and reduces heart disease-related disorders. In summary, an exercise in animal and human subjects - both after myocardial infarction - leads to improved cardiovascular function. In general, studies of exercise activity in the field of cardiac tissue change and the formation of new cardiomyocytes by MI have not reached a single result, but some studies have shown that cardiac tissue changes and its function have a high positive correlation with Intensity and duration of sports activities. On the other hand, according to the above, it can be said that myostatin and follistatin as the most important cardiokines have a significant role in regulating tissue homeostasis and heart muscle function, but a study in the extensive-expression of cardiac myostatin and follistatin protein in MI-affected species has not been studied in response to different intensities of exercise. Therefore, this study aimed to answer the question: Do different intensities of intermittent exercise affect the expression of cardiac myostatin and folate statins in rats with MI?

The present study with the code RHC.AC.IR.REC.1393.28 was approved by the ethics committee of Shahid Rajaei Cardiovascular Training, Research, and Treatment Center. In terms of purpose, it is fundamental-applied, which was implemented experimentally, and based on the degree of supervision and degree of control, is a type of laboratory research. In the present study, 55 10-week-old male Wistar rats weighing 250 to 300 g were purchased from the Pasteur Institute of Iran. Attempts were made to maintain and work with animals by the recommendations of the Laboratory Animal Protection Act (NIH). For this purpose, wistar rats were taken under surgery of closing LAD coronary artery coronary and then it was approved by MI echocardiography. Four weeks after surgery, the rats with MI were randomly divided to the following interval training groups: low-intensity training, moderate intensity training, high intensity training, no-exercise myocardial infarction (MI-SED) and Sham. They performed exercise protocols for six weeks and five sessions per week. The obtained data was analyzed using ANOVA one-way and Bonferoni tests.

The results showed that in training groups, values of EF and FS were significantly increased compared to MI-SED group, but their values were significantly lower than Sham group. In addition, value of follastatin protein in training groups was significantly increased compared to MI-SED group. On the other hand, value of myostatin protein in training groups was significantly decreased compared to MI-SED group. It was also observed that by increasing intensity of intermittent training, values of all variables were changed positively.

The results of the present study showed that in general, exercise improves cardiac function in rats with MI, and probably one of the main mechanisms of this improvement in cardiac function is rooted in changes in the factors that regulate heart muscle growth. As a result, it can be said that intermittent training, regardless of its intensity, increases heart performance of rats with MI; but it seems increasing intensity of intermittent training has a more pronounced effect on amounts of follastatin and myostatin proteins in heart tissue of rats with MI.