مجله علوم پزشکی رازی
سال بیست و هفتم شماره 12 (پیاپی 202، اسفند 1399)

Over the last decade, Laparoscopy is one of the most common operations performed in gynecologic surgery. Various methods have been described in literatures such as Veress needle, open access technique (OAT), direct trocar insertion (DTI), and visible entry method which can potentially cause visceral and vascular injury. It is estimated that most laparoscopic injuries occur at the time of trocar insertion. Although the complications of operative laparoscopy are in low rate, they can be severe and life threatened, so preventing the complications associated with initial abdominal entry is a primary concern for laparoscopic surgeons. A detailed well-training trocar insertion method such as Amen method in the present study, may lead to better patient’s safety and less complication in shorter time. To the best of our knowledge this initial trocar insertion method (Amen) in laparoscopy has not been introduced yet. This method could learned easily and surgeons could use any available instrument for trocar insertion. The aim of the present study is to compare the two methods of novel modified towel insertion method (Amen) and direct method, in terms of its complications and initial trocar time insertion, to provide and suggest new trocar insertion method (Amen) for surgeons.

A prospective case-control study conducted at Nikan hospital between December 2018 and March 2020.Four hundred four patients who underwent either new modified towel clip trocar insertion (Amen) method or direct entry approach in laparoscopic surgery. Participants were randomized to two groups of modified towel clip (Amen) (214) and direct trocar insertion methods (190), respectively. All method-related complications consisted of port site gas leakage, port site emphysema, intra-abdominal vascular injury, port site hematoma, port site infection, port site hernia were assessed. Although there is a significant statistical relationship between gas leakage and trocar technique in favor of control groups, the rate of other complications were the same in both groups which are not seen in both groups. In addition, port site emphysema in control group is less than the case group, however it is not statistically significant.Inclusion criteria were all patients who are candidates for gynecologic laparoscopic surgery. Firstly, 419 patients entered to study, however 11 patients who underwent both methods and 3 with palmers point insertion method were excluded from the study. Also, the trocar insertion method was failed in seven participants therefore direct method changed to modified one due to the following reason: three of them had high BMI (>38) and trocar was short for them, 3 patients had strong fascia and trocar was not sharp, so after 3 click and 2 times, insertion were failed, also in one patient with Sub-umbilical mesh due to the history of abdominoplasty and hernia, trocar insertion failed. Four patients had high BMI more than 38, so the Amen method changed to direct method. Therefore 14 patients were excluded from the study. Port site gas leakage, port site emphysema, intra-abdominal vascular injury, port site hematoma, port site infection and port site hernia were evaluated and compared in two methods of trocar insertion method in this investigation. Spss version 20, Independent T test and chi-square were used for performing analysis and P-value less than 0.05 was estimated as a significant difference.

In a total of 404 female patients with the range age of 15 to 65 years, there is no significant difference in terms of port site emphysema complication between case and control group. Although there is significant relationship between trocar technique and gas leakage complication (p=0.007), there is no other complication such as Intra-abdominal vascular injury, port site hematoma, infection and bleeding in both groups of case and control group. Although, the direct method is significantly less time consuming than Amen method (p=0.04), majority of initial trocar time insertion method in both case and control group was less than 1 minute Also, the size of scar and incision in the present technique is the same as the direct method (11-12 mm) which is smaller than open method that are previously reported,which can be significant in terms of beauty and less pain at the scar site.The most common type of surgery in case group (Amen method) was endometriosis (51.9%), and then hysterectomy (12.5%). Similarly, the most common type of surgery in control group (direct method) was endometriosis (41.5%) and then endometriosis accompanied with hysterectomy (16%).

The present data suggest that the incidence of complications in our new method is as much as direct method except for gas leakage. In addition, there is an advantage to apply the Amen method since it takes short time for trocar insertion. Furthermore this technique could be trained more easily than other previous trocar insertion methods. In addition, Amen method performed with any available trocar which could be salient in surgery. Therefore, we concluded that Amen technique is safe, reliable and easily trainable modified entry method which could be alternatively used instead of direct method for laparoscopic surgery.

Despite advances in medical sciences in recent years, tuberculosis remains a worldwide health problem. The World Health Organization (WHO) global tuberculosis report 2016 states that tuberculosis killed 1.4 million individuals (1.2 to 1.6 million) HIV-negative and 0.39 million (0.32 million to 0.46 million) HIV-positive people in 2015. The 30 high-tuberculosis burden countries represented 87% of all assessed incident cases around the world. Of these, China, India and Indonesia alone represented 45% of worldwide cases in 2015. Currently, the annual rate of decline in tuberculosis incidence is around 1–2% while the rate would need to be 4–5% by 2020 and over 10% by 2025 to achieve the goal of ending the epidemic by 2030. Although there are many laboratory methods to accelerate the diagnosis, a delay in the definitive diagnosis of the disease is still a major clinical problem. Due to the slow growth of the causative agent, (Mycobacterium tuberculosis), isolation, identification, and other clinically important mycobacteria can take several weeks or longer. During the past few years, many methods have been provided for direct detection, species identification, and susceptibility testing of tuberculosis agents. Understanding the effectiveness and practical limitations of these methods is important to improve diagnosis. This article describes recent advances in the diagnosis of tuberculosis based on molecular and non-molecular methods. In the current review, we aim to perform a literature review in different library databases and electronic searches (Science Direct, PubMed, and Google Scholar) which were randomly obtained. For each stage of diagnosis, there are new methodologies. New tests are accessible by level of laboratory and period of application. Overall, the innovation for the diagnosis of tuberculosis and antibiotic resistance in pulmonary specimens is all well advanced, with high particularity and progressively high sensitivity. Ongoing advances in molecular science and molecular epidemiology, and a superior comprehension of the molecular basis of drug resistance in tuberculosis, have given new devices to fast diagnosis; however, the high cost of most of these strategies, and their prerequisite for the high cost of most and skilled personnel have blocked their execution on a routine basis, particularly in low-income countries. Improving the process of identifying the spectrum of tuberculosis, including active, drug-resistant strains as well as latent tuberculosis, can have a profound impact on global health. For example, an experiment with and 85% sensitivity and a 97% specificity in identifying people with tuberculosis could prevent 392,000 deaths per year. New methods allow rapid detection of active tuberculosis in patients with negative sputum smear for fast acid bacilli and enable rapid and accurate identification of tuberculosis-resistant strains in respiratory samples. Rapid isolation and diagnosis of M. tuberculosis have improved the early detection of tuberculosis. Molecular methods play an important role in the diagnosis of M. tuberculosis and have many advantages such as reducing the detection time, rapid detection of mutations related to drug resistance and clinical use. Despite the obvious advantages of molecular detection methods, they have some disadvantages and some molecular methods have not yet been approved by the Food and Drug Administration. Molecular methods are mainly useful in cases of positive smear and are recommended in patients with negative smear when there is a high clinical suspicion of tuberculosis. On the other hand, despite the advantages of molecular methods, the genetic basis of drug resistance of any tuberculosis drug is not fully understood, so the results of molecular tests must always be confirmed by phenotypic methods. Tuberculosis control strategies are personally identified with the availability of powerful tests for the determination of active tuberculosis and the identification of inactive tuberculosis infection. Improved tuberculosis diagnostics, along with different interventions, are vital to arriving at the objective of entering the pre-elimination phase by 2035 in countries with a low incidence of the disease. At present that many of these techniques are only economically viable in the developed nations, it is hoped that recent advances will lead to the development of novel diagnostic strategies applicable to use in developing nations, where the burden of tuberculosis is maximum and effective intervention is most urgently required. Thus, more consideration and examination are needed to create effective and cheap methods in various settings to overcome this overall issue and more evidence is needed to survey the operational effect of noncommercial, low-cost, rapid diagnostic techniques in field conditions.

Total quality management is a management philosophy and constant change in method as well as slow and continuous process, integration of tasks and processes within the organization in order to achieve continuous improvement of quality of goods and services and its goal is comprehensive satisfaction and basically satisfaction All internal and external customers emphasize and at the management level also seek to improve and continuously dynamize all systems and processes. On the other hand, it is a technique that makes a significant change in the culture of the organization, which includes the goals, ideals, way of thinking and procedures in that organization. Inclusive quality management in higher education is: continuous process of improvement and transformation in educational management and manpower, organizational structure, educational and curriculum planning, teaching methods and techniques, equipment, resources and educational space, exam methods, needs identification Society and higher education in order to adapt to the demands and needs of knowledge or parents and society and the quality of educational goals with the participation of all educational members. Farhangian University needs changes and transformations. Currently, Farhangian University has nearly one hundred thousand students who are engaged in educational services on a large scale; Therefore, it is necessary to study the scientific quality of inclusive quality management in this large educational institution, and to identify its strengths and weaknesses that inclusive quality management is a constant change in the way that universities and educational centers can for Choose and be governed by it. The process of moving towards inclusive quality in universities and educational centers and institutions is a slow and continuous process. The condition for the success of a quality management, in other words, the establishment of comprehensive management, is to recognize the components of the establishment conditions and pay attention to those components and try to provide the desired conditions. These conditions include background conditions, causal conditions and mediating conditions. Universities and educational institutions, including Farhangian University, can be successful in performing total quality management when they first identify the components of the favorable conditions for the establishment of total quality management, but no research has been found in this field. Therefore, the purpose of this study is to investigate the causal conditions of total quality management in the countrychr('39')s universities. The aim of this study was to investigate the causal conditions required for the establishment of total quality management in universities, which was conducted as a case study in Farhangian University in 2009-2010.

The present study is applied in terms of purpose and quality and its statistical population includes experts and professors in the field of total quality management in Farhangian University in the academic year 1398-99. Experts were used to select the sample and purposive sampling method (exceptional or borderline cases) was used. In this regard, in a purposeful semi-structured interview with 14 people in the field of indicators and features of total quality management, theoretical saturation was obtained in the data. Based on a total of 14 sample people, 9 men and 5 women with experience Working 25 years and older and in the age range of 45 to 55 years, all had specialized doctorates in the field of educational sciences with a focus on educational management that have valuable information in the field of research and often have managerial positions, policy, and significant writings in The mentioned areas were obtained. Data were collected through semi-structured interviews. Content analysis method was used to analyze the interviews.

The findings of the study indicate that the most important causal conditions governing the organization are customer satisfaction, professional growth of teachers, innovation in the organization, trust and organizational participation to establish inclusive quality management in Farhangian University.

According to the results of research in the field of causal conditions, customer satisfaction through the obligation of responsibility and accountability, ethical obligation, competitive obligation for customer satisfaction and professional obligation in relation to customer satisfaction and professional growth of teachers through reduction Teacher burnout and professional growth, professional development, intimate relationships and interactions between teachers and innovation in the organization through the new structure of Farhangian University, new management methods, promotion of group learning, foresight and continuous improvement and reduction of development and time costs and Organizational trust and participation is achieved through intimate student-teacher relationships, organizational trust and partnership, collaboration, and flexible management. In this study, there were some limitations such as the reluctance of some interviewees to conduct interviews and the lack of resources related to total quality management at Farhangian University and experts in the field of total quality management. It is suggested to the university officials: while paying full attention to the provisions of the document of fundamental transformation of education in relation to training and providing human resources for education, strengthening and developing internship courses as well as revising in different sections in order to establish the system. Inclusive quality management first to consider the conditions of establishment and provide their realization in Farhangian University and finally to provide the establishment of a comprehensive quality management model in Farhangian University.

The theory of mind is the mental states, beliefs, intentions, desires, claims and knowledge of oneself and others and understanding that others have different beliefs and intentions from our beliefs and intentions. This ability consists of three levels; The first level or recognizing emotions and pretense, the second level of the theory of mind or primary misconception and the perception of misconceptions and the third level or the perception of secondary misconceptions or the perception of jokes. Having a theory of mind helps a person to attribute thoughts, desires and intentions to others and to be able to predict or describe their actions and understand their intentions. While research shows that autistic children disabilities in the theory of mind, autism spectrum disorder is a neurodevelopmental disorder characterized by qualitative deficits in social interactions, language, communication, and stereotyped behavior such as behavioral patterns, interests, and limited activities. Studies show that children with autism spectrum disorder, compared to normal children, have a significant defect in the development of the whole theory of mind and its different levels. People with mental disabilities have difficulty explaining the intentions of others and also do not understand how their behavior affects others, understanding oneself and others is essential for effective social relationships and interpersonal interactions. Theory of mind in practice gives the children a powerful tool which helps them to explore, predict and change the behavior of others. Through the theory of mind we can interpret the mental states (beliefs, desires, imaginations, emotions, etc.) that are the cause of actions. All human beings need to communicate and relate to others. Without effective social interaction and interpersonal communication, man can not achieve the desired growth and flourishing of his personality. Interpersonal relationships occur when people interact with each other. Therefore, the main purpose of this study is to investigate communication skills training on the development of theory of mind in autistic children, in order to understand the mental states of others and use it to communicate socially.

The method of the present study is quasi-experimental with a pretest-posttest design with a control group. The statistical population was all 9-12 year old male autistic students in Kermanshah. 12 students were selected by available sampling method and randomly divided into two groups of 6 experimental and control. Theory of the mind test was used as a data collection tool, which consists of 3 subscales from which a general score for the theory of mind is obtained. After performing the pre-test in the experimental and control groups, communication skills training based on Albert Ellischr('39')s rational-emotional-behavioral therapy method was performed in 13 sessions in groups in the experimental group. Data were analyzed using descriptive and inferential statistics (univariate and multivariate analysis of covariance). Considering that the present research design was a quasi-experimental pre-test-post-test with a control group, the inferential statistics section includes analysis of covariance (univariate and multivariate) to test the research hypotheses.

The mean of the whole theory of mind and each level of theory of mind of the subjects in the experimental group in the post-test increased compared to the pre-test. But there is not much increase in the mean of the control group after the test. The results of univariate analysis of covariance showed that there is a significant difference between the pre-test and post-test scores of the whole theory of mind (P <001) and this means that the intervention (communication skills training) on the total scores of the theory of the mind of subjects in the experimental group has had a significant impact. In order to find out the difference between the mean scores of post-test levels of theory of mind in the two groups, analysis of covariance was performed. According to the calculated effect size, 0.89% of the total variances of the experimental and control groups are due to the effect of the independent variable. Also, the statistical power of the test is equal to 89%, this means that the test was able to reject the null hypothesis with a power of 89%. The results of multivariate analysis of covariance of post-test scores showed that the value of F for level one was 10/50, which is significant at level (P <0.01), for level two, it was 26/34, which is significant at level (P <0.001), for level three, it was 1/69, which is not significant. Considering the effect size, 60% of the change in level one and 79% of the change in level two and 19% of the change in level three of the theory of mind was due to the effect of independent variable (communication skills training).

In this study, communication skills training with Albert Ellischr('39')s intellectual-emotional-behavioral therapy, increased the ability of understanding and interpreting  the mental states and behavior of oneself and others (whole theory of mind), the ability to recognize emotions and pretense (first level of the theory of mind) and misconception (the second level of the theorie of mind) in autistic boy children aged 9-12 years. Some new theories derived from Vygotskychr('39')s socio-cultural theory emphasize the experience and interaction with others in the evolution of the theory of mind. Studies have shown that children who had the opportunity to engage in conversations about mental health performed better in the theory of mind than children who did not. It can be inferred from theories and researches that communication, interaction and social dialogue can promote the theory of mind. But communication skills training did not have a significant effect on the ability to understand secondary misconceptions (3th level of mind theory) in autistic boys aged 9-12 years. Autism causes serious damage to the functions of social cognition, especially the theory of mind, and boys are more vulnerable. The reason for the lack of progress in advanced theory of mind (joking perception) may be the limitations of autistic children in conceptual developmental ability. It seems that in order to achieve high levels of theory of mind, more cognitive and mental processes and cognitive interventions are needed with more components in mind. In general, it can be concluded that teaching these types of communication skills can be included in the treatment programs of autistic children and can be used to improve the theory of mind and its levels in autistic children.

Knee pain is one of the most common pains complained of by military officer’s students. Musculoskeletal injuries due to increased load are the reason for the loss of a significant part of the useful time of basic military training and are one of the important reasons for reducing the use of military training. One of the important genetic indicators that SMAD3, GDF5, and asporin (ASPN) genes have been studied to predict the incidence of joint pain and osteoarthritis, especially in the knee joint. This study aimed to investigate the changes in the expression of genes that predict the incidence of pain in the lower extremities after 16 weeks of progressive exercise. D14 paid for the aspirin gene (ASPN).

The statistical population of the present study was the students of Imam Ali (AS) Military University. Inclusion criteria were no abnormalities in the lower limbs that could be seen by visual and functional assessments. He was in good health and had no history of surgery or trauma injuries in the past six months. A total of 100 students were randomly selected and volunteered to complete their research by completing a research application form. Subjects were randomly divided into three groups: training intervention, training intervention with booster session, and control. To determine the genotype of each subject, after 12 hours of fasting, 10 ml of venous blood was taken at 8 am in the University Medical Center by a laboratory science expert under the supervision of a physician and used to extract DNA. Blood sampling was taken twice, the first time before the start of the training intervention and the second time after 16 weeks of training, and one day after the last day of training. DNA was extracted from blood leukocytes by the salting-out method. After digestion of DNA with a type of shear enzyme, a large number of fragments of different lengths were obtained, and then these fragments were separated using agarose gel, which was possible to identify a specific fragment using direct and inverse primers. Some of the SMAD3, GDF5, and ASPN genes containing the studied polymorphisms were amplified by PCR technique.The exercises were held in four levels and each level was performed with a specific purpose for a period of one month. From the first to the fourth level, the exercises are progressive. The sessions were conducted three sessions per week and each session lasted for 60 minutes. In the group that did the + booster session, the subjects in the last training session of each week did the exercises of that week with twice the duration of each set in the first sessions. But the booster session group did the exercises without changing the time. To evaluate and determine the intensity of sports activity, a Polar telemetry clock was used for several subjects, which was used to control and monitor changes in subjectschr('39') heartbeats.

Results showed that SMAD3 gene expression in the training + booster session group was significantly different from the training group and there was no significant difference compared to the control group (P≥0.05). Also, the expression of the SMAD3 gene in the exercise group was significantly different from the control group (P≤0.05). ASPN gene expression in the training + booster session group was significantly different from the training group and the control group (P≤0.05). There was a significant difference in the expression of gene expression in the exercise group compared to the control group (P≤0.05). GDF5 gene expression in the training + booster session group was significantly different from the training group and the control group (P≤0.05). There was a significant difference in gene expression of the exercise group compared to the control group (P≤0.05).

Progressive training seems to have two special features that distinguish this type of exercise from other types of exercise programs. The first proposition is that in this type of exercise, stretching or stretching combined with resistance activities usually bears the weight of the body, which combines the characteristics of resistance training and stretching exercises. Also involved in this type of exercise are the tiny muscles, which in turn are important in the development of common deep pain. The second proposition is the activation of profundity receptors in this type of exercise. These receptors are activated during imbalance and protect the muscle and joint from injury when there is an imbalance of weight and joint angle. Given that the expression of ASPN and GDF5 genes in the exercise groups with booster session was significantly reduced compared to the group with the exercise program alone, it is possible that the intensity of the exercise program can be effective in changing the expression of genes predicting pain. . In the booster sessions, the intensity of the exercises increased with the increase of training sets. Studies that have reported booster sessions in training sessions have also reported improved patient rehabilitation and pain relief, especially in the lower extremities. Therefore, it can be concluded that progressive exercise can modulate the gene expression of polymorphisms associated with pain in the lower extremities, especially the knee joint. As a result, it is better to use a combination of progressive exercises with booster sessions, and in the military, including officer students, operational forces and even staff can be a factor to prevent pain in the lower extremities, especially in the area. Be on your knees.

Following to advent of obesity, Type-II diabetes has been converted into a pandemic disease during the recent decades and it has been introduced as one of the main reasons for mortality throughout the world more than ever. Hyperglycemia and rising glucose caused by diabetes is led to increase apoptosis in cardiomyocytes at left ventricle. Bax-gene is one of the key genes at this process in controlling start point of apoptotic process and Bc1-2 gene also inhibits apoptosis. Accordingly, researchers have always acknowledged that exercise training including HIIT may play protective role for heart against diabetic side-effects by reducing quantities of glucose and apoptosis in cardiac cells. Thus, the present study aimed to compare two HIIT methods concerning quantities of glucose and expression of apoptotic and anti-apoptotic Bax and Bcl-2 genes in cardiomyocytes of rats with type II diabetes.

In the current experimental study, 24 rats of Vistar species (8 weeks) and average weight (321±18g) were divided randomly into four groups of Normal Control (NC), Diabetic Control (DC), High Intensity Interval Training Type I (HIIT1:1) and High Intensity Interval Training Type II (HIIT2:1) after adaption to the environment for one week and familiarity with treadmill. Diabetes was induced to all groups, except Normal Control (NC) group, using Streptozotocin (STZ) and Nicotine Amide. Then, the trained groups exercised with different doses, but in identical distance 5 days a week for 4 weeks. The speed of reaching to the maximum consumed oxygen dosage (vVO2max) was measured at the sixth day once in both weeks. HIIT1:1 Protocol: Warm up and cool down for three minutes by intensity of (vVO2max= 40%); high intensity (Frequency= 2min); first week: vVO2max= 80% (Four times); second week: vVO2max= 85% (Four times); third and fourth weeks: vVO2max= 90% (Five times); low intensity (2min); vVO2max= 40% (Four times at first and second weeks and five times at third and fourth weeks). HIIT2:1 Protocol: Warm up and cool down for three minutes by intensity of vVO2max= 30%; high intensity (Frequency= 2min); First week: vVO2max= 80% (Five times); second week: vVO2max= 85% (Five times); third and fourth weeks: vVO2max= 90% (Seven times), low intensity (1min); vVO2max= 30% (5 times at first and second weeks and seven times at third and fourth weeks). Rats were anesthetized by inter-peritoneal infusion of Ketamine (90mg/kg) and Xylazine (10mg/kg) 24h after the last training session. The blood sample was collected directly from hearts of rats and plasma isolation was done by centrifuging at 15°C at 3000RPM for 15min. afterward, left ventricle was extracted immediately and frozen in nitrogen (-20°C) and stored in freezer (-80°C) to measure gene expression. QRT-PCR technique was utilized to analyze variance of Bax- and Bcl-2 genes expression. To conduct statistical data analysis, normality of data was primarily examined using Shapiro-Wilcox test. Given insignificance of this test (p>0.05), One-Way ANOVA statistical test was employed for determining difference between studied groups. Then, Tukey ad hoc test was used (Sig = 0.05) in order to determine significance position. Microsoft Excel-2007 software was utilized for drawing diagrams. All statistical tests were conducted by means of SPSS statistical software (v.21).

Variance of weight quantities was not significant after 4 weeks, but variance of glucose showed significance increase in all three groups (DC, HIIT1:1 and HIIT2:1 groups) compared to Normal Control (NC) group (p<0.005). Similarly, glucose quantities were reduced significantly in both trained groups versus DC group after four weeks (p<0.001). The results of one-way ANOVA indicated significant difference in Bax-gene expression between studied groups (p<0.05). The results of intergroup analysis derived from Tukey’s test showed that significant increase was observed in Bax-gene expression at DC group compared to HIIT2:1 (p<0.001) and NC (p<0.001) groups. Likewise, significant difference was seen in terms of gene expression of this variable between two trained models (p=0.038) so that further reduction and significance was observed in HIIT2:1 group. Similarly, results of one-way ANOVA suggest existing significant difference in Bcl-2 gene expression between groups (p<0.001). The results of intergroup analysis derived from Tukey’s test indicated significant reduction in Bcl-2 gene expression at DC group versus HIIT2:1 (p=0.005) and Normal Control (p<0.001) groups. Similarly, no significant difference was seen between two trained model in terms of gene expression in his variable (p=0.079).

The results of current study indicated that diabetic induction might increase glucose quantities, Bax-gene expression and reduce Bcl-2 gene expression in cardiomyocytes at all groups (HIIT1:1, HIIT2:1 and DC groups) versus Normal Control (NC) group. Likewise, both training interventions (HIIT1:1 and HIIT2:1) reduced significantly glucose quantities in cardiomyocytes compared to DC group. In addition, HIIT2:1 training intervention significantly inhibited apoptosis-inducing of Bax gene expression and induced significantly anti-apoptosis of Bcl-2 gene expression in cardiomyocytes of rats with diabetes compared to DC group while this variance was not significant in cardiomyocytes of HIIT1:1 group versus DC group. Similarly, we showed that Bax-gene expressions were significantly reduced in cardiomyocytes of HIIT2:1 group compared to HIIT1:1 group. The findings of current study may indicate importance of different effect of various frequencies of exercise on apoptotic mechanisms of cardiomyocytes at rats with type-II diabetes. These findings showed that various HIIT frequencies might be followed with different impacts and even noticeable differences in glucose absorption in cardiomyocytes at left ventricle and response of apoptotic variable in cardiac muscle so that more tangible and beneficial mechanism variance was observed in cardiac muscle at rats in HIIT2:1 group toward inhibition of cardiac disorders. In other words, we identified that further high intensity and shorter time frequency at lower intensity in HIIT2:1 versus HIIT1:1 group might doubly affect variance of glucose quantities absorbed by cardiac muscular cells and apoptosis mechanism in cardiomyocytes while both trained groups had passed through the same distance. The more efficiently increase in glucose quantities and subsequently more optimal reduction in apoptosis process by Bax/Bcl-2 axis signifies better and more beneficial effect in this training model. Therefore, these findings not only suggest further studies for analysis of most efficient and profitable HIIT model in patients with type-II diabetes, but also this exercise training model with shorter time and higher intensity than other models could be proposed as a potential therapeutic strategy in the clinical centers relating to type-II diabetes for cardiomyopathy prophylaxis and improvement caused by diabetes.

Cardiomyocytes proliferate and form the heart in the embryonic period, but proliferation stops soon after birth. Cardiac diseases stay the leading reason of death universal, both in developed and developing countries. Cardiac diseases can develop quickly, including acute myocardial infarction, or progress slowly, such as cardiac remodeling, which is determined by cardiac hypertrophy and myocardial fibrosis that can finally cause to heart failure. Stem cells are a good alternative for regenerative medicine because of their characteristics such as self-renewal and differentiation potential. They are classified into different types of stem cells including embryonic stem cells, induced pluripotent stem cells, multipotent stem cells, and ultimately uni-potent stem cells. Albeit embryonic stem cells are able to differentiate into cardiac cells and show powerful therapeutic potential for heart diseases, the ethical controversies surrounding the origin of embryonic stem cells hinder its broad usage in patients. Mesenchymal stem cells can be differentiated into a different of cell types including osteoblasts, chondrocytes, adipocytes, and stromal cells.  They can be extracted from different tissues including the liver, blood, bone marrow, synovium, umbilical cord blood, gut, lungs, adipose tissue, umbilical cord Wharton’s jelly, eye conjunctiva, dermis, dental pulp and amniotic fluid. Also, mesenchymal stem cells can be expressed CD105, CD73 and CD90, and lack expression of the haematopoietic markers CD45, CD34, CD14 or CD11b, CD79alpha or CD19 and HLA-DR surface molecules. Mesenchymal stem cells have various advantages of easy accessibility, strong capacity of proliferation, immune modulatory properties, and migration to damaged tissues. Due to the lack of graft loss, they are an appreciate option for cell therapy, especially ischemic heart disease. Nowadays, it is generally accepted that the observed therapeutic impact induced by mesenchymal stem cells is chiefly based on the secretion of paracrine factors rather than on the differentiation into cardiomyocytes.Many agents such as cytokines, growth factors, and small molecules have been shown to promote cardiac cell differentiation both in vivo and in vitro. Direct and indirect culture systems with myocardial cells and other cardiac cells in order to benefit from the factors secreted by these cells can increase the differentiation of mesenchymal stem cells into cardiomyocytes like cells. The cardiomyocytes differentiation is regulated by different transcription factors such as GATA4, and Nkx2.5. Also, different signaling pathways such as Transforming growth factor β1 (TGF-β), Fibroblast Growth Factor (FGF), WNT, and Notch play key roles in regulating proliferation, cardiomyocytes differentiation, and survival of mesenchymal stem cells. In this review, we focus on miRNAs and their roles on cardiomyocytes differentiation of mesenchymal stem cells. Following an introduction to the non-coding RNAs, micro-RNAs and mechanism of miro-RNA functions, we then discuss what is currently known about the expression of miRNAs in embryonic and mesenchymal stem cells. Finally, we discuss current knowledge of miRNAs regulatory role in mesenchymal stem cells differentiation into cardiomyocytes. microRNAs (miRNAs) are a class of non-coding small RNA (21–25 nucleotides) involved in regulation of cell behavior either through inhibition of mRNA translation or promoting mRNA degradation. Since its identification as a major component of a broadly conserved mechanism that regulates gene expression post-transcriptionally, the miRNA pathway has emerged as one of the most widely evaluated pathways of the past decade. miRNAs are both pleiotropic and redundant, and it has been suggested that at least 30% of human genes are regulated by the cooperation among miRNAs: one mRNA can be recognize by various miRNAs and one miRNA can recognize several mRNAs. miRNA profile studies have showed that miRNAs are selectively expressed in various tissues and at different developmental stages. miRNA signatures for mesenchymal stem cells of different origin have shown the expression of defined patterns of miRNAs involved in the maintenance of stem cell properties such as proliferation, self-renewal, and differentiation capacity. Many miRNAs are expressed in various tissues; they can be used as biomarkers in the diagnosis of certain diseases. Also, mi-RNAs have been studied more than other types of non-coding RNAs. The increasing evidence displays that miRNAs are involved in many pathological conditions, such as cancer, arrhythmias, cardiac infarction, virus infection, and Alzheimerchr('39')s disease, which has been suggested as a new target to cure these diseases. The regulatory function of the miRNA is mostly applied via, and controlled by, different transcription factors and other regulatory mechanisms of gene expression. These complex interactions between miRNAs and other regulators of gene expression at the epigenetic, transcriptional and post-transcriptional levels integrate miRNAs into the cellular network of regulation of gene expression that defines the stem cell fate and behavior. New studies have displayed that different of these key transcription factors directly regulate miRNA expression in embryonic stem cells. Known pluripotent related markers, such as miR-302a, b, c, and d, and miR-200c.Recently, different miRNAs were proposed to associate with cardiomyocyte differentiation of stem cells. Over-expression of some miRNAs such as mi-R1-2 in mouse bone marrow- mesenchymal stem cells could induce their differentiation into cardiomyocytes through Wnt/β-catenin signaling pathway. Also, the miR1 has been reported to be able to modulate cardiomyogenesis and preserve the expression of muscle genes via down regulating the Notch or STAT3 signaling pathways. Furthermore, except mir-1-2 over-expression of miR-499 in rat bone marrow- mesenchymal stem cells induces them toward cardiac differentiation via the activating the wnt/b-catenin signal pathway. Conversely, microRNA-133 blocks the cardiac differentiation of mouse and human mesenchymal stem cells. By modulating miR-1 and -499 expression levels, human cardiomyocyte progenitor cells function can be altered and differentiation directed, thereby enhancing cardiomyogenic differentiation. Overexpression of miR-499a-5p increased the expression of cardiomyogenic differentiation markers in human bone marrow mesenchymal stem cells. Down regulation of miR-199b-5p induced differentiation of bone marrow mesenchymal stem cells toward cardiomyocyte-like cells through the HSF1/HSP70 signaling pathway, and had no influence on bone marrow mesenchymal stem cells proliferation and migration. MicroRNAs affect cardiac cellular signaling and gene expression, and implicate miR-199b as a therapeutic target in heart failure. The cooperative association and reciprocal interactions between genetic and epigenetic regulatory factors and miRNAs regulate the self-renewal and differentiation of mesenchymal and embryonic stem cells.

Exercise is one of the factors that can be used to moderate the physical, mental, psychological and social pressures caused by life in the turbulent and stressful world of todaychr('39')s life. Research has shown that people who exercise regularly are less likely to suffer from cardiovascular disease, suffer less stress and have more self-confidence, are also more optimistic about life, and they are less likely to suffer from depression. Undoubtedly, recognizing the interests and motivations of the society, can be a good guide in studying the strategies to attract them as much as possible in sports and health activities and therefore in the field of health issues and problems of society and sports and physical education as an important software. The aim of the present study was to investigate the needs and accurate analysis of current challenges and problems and to orient the development of community health along with sports to provide a native model of health development with the use of sports in the country. Exercise as a multidimensional tool has a wide range of effects in various fields. Cross-sectional research has shown that regular exercise can improve health and improve the quality of life in healthy and sick people. Given that the development of public sports in society is of particular importance due to the breadth and diversity of programs related to public and recreational sports activities in the current context. Many sports organizations in the country have developed strategic planning so that they can set standards to facilitate control while determining the direction of reducing the impact of change, minimizing waste and damage. The purpose of this study is to develop health with the use exercise with a combination of design approaches and ISM modeling.

The research method was a two-step exploratory combination of instrument making. In the qualitative section, using targeted sampling method and theoretical saturation technique), 12 experts in the field of sports and health (to identify the model of health development with the use of sports were selected and interviewed with them). The tool used to identify the factors of the model development of health through the use of exercise, semi-structured interviews) with focus groups (and the study of documents. To ensure the validity and reliability of the study, the method of evaluation of Lincoln and Guba was used to conduct this research with a comprehensive study and also according to experts, eight factors that explain the development of health with the use of exercise were identified D. Then, using the interpretive structural modeling technique and using the questionnaire tool, the factors were grouped into five groups. According to the results, factors such as health promotion and healthy lifestyle, promotion and promotion of sports culture, the importance and impact of public sports and increasing the participation of individuals, are less effective in relation to health development with the use of sports. Also, in a small part, the research method was descriptive-survey. The statistical population studied is all faculty members of the faculties of medical sciences and physical education. The instrument used in the quantitative section was the researcher-made scale based on the qualitative section. For the study of formal validity, ten professors of sports management were used and for the content validity of the questionnaire questions, the carcass model was used (cvr = 0.88) and the content validity was confirmed. Cronbachchr('39')s alpha was also confirmed. Descriptive statistics and structural-equation modeling were used to analyze the fit of the research model to analyze the data.

According to descriptive and functional results such as health promotion and healthy lifestyle, promoting and promoting sports culture, the importance and impact of public sports and increasing peoplechr('39')s participation, are less effective in communicating on the subject of health development with exercise. The results of the quantitative section also showed that the amount of T corresponding to each factor had a significant effect and all the framework of the health development model was approved using exercise. The results also showed that the research model has a good fit.

Based on the results of the present study, it can be said that public sports is an important strategic program for health promotion and for health and human resource productivity in the personnel of Iran Oil Company, strategic and targeted programs are needed to achieve the following goals and objectives.

In the past decade, brown adipose tissue has been recognized as a key player in controlling the metabolism of energy and active organ and endocrine. Brown adipose tissue contains lipid stores that provide a rapid supply of fatty acids to produce heat and maintain body temperature, thermogenesis. Brown adipose tissue contains a large number of mitochondria whose abnormal function leads to lipid accumulation, insulin resistance, and oxidative stress. Modern life has led to an increase in the consumption of fast food, followed by the increase in use of deep-heated oils. The hydroperoxides formed in deep-heated oil are unstable and decompose rapidly to become free radicals. Free radicals and oxidative stress in heated oils affect the bodychr('39')s energy sources such as mitochondria. Reactive oxygen species (ROS) has a dual role in brown adipose tissue, its high amount suppresses antioxidant defense, but its small amount participates as a second messenger in cellular signaling processes at the physiological level. ROS induces apoptosis and cell death, reduces oxygen consumption in adipocytes, blocks the oxidation of fatty acids, and leads to lipid accumulation. Increased ROS also prevents the differentiation of adipocytes by the Peroxisome proliferation-activated receptor gamma (PPARγ). PPARγ, as a major transcription factor in the general differentiation program of brown adipocytes, induces the expression of UCP-1 during adipogenesis, is involved in lipid homeostasis, glucose regulation, and inhibition of insulin resistance. One of the side effects of using heated oils is obesity, which can play a role in reducing PPARγ expression. Octopamine is an amine and antioxidant that has a structure similar to the neurotransmitter neuroadrenaline that causes lipolysis, and this condition is more affected by the p-octopamine subset. Therefore the purpose of present study was to determine the effect of aerobic training and octopamine on stress oxidative and PPARγ gene expression in brown adipose tissue of male rats fed with deep frying oil.

In an experimental study, 30 adult male Wistar rats weighing an average of 300 to 350 g and aged 8 weeks were purchased. All rats were kept in polycarbonate cages (5 mice per cage) at 22 2 2 ° C, 55% humidity and under the light and dark cycle for 12:12 hours without restriction on water and food. Rats were randomly divided into five groups: healthy control (n=6), DFO (n=6), aerobic training + DFO (n=6), octopamine + DFO (n=6) and aerobic training + octopamine + DFO (n=6). Intraperitoneal injection of 10 ml/kg of octopamine and Gavage of deep frying oil were done five times a week and every day, respectively.In order to adapt the rats in the aerobic training group, before starting the main training program, the rats in this group ran at a speed of 9 m / min for 20 minutes for a week. The aerobic exercise protocol consisted of 4 weeks of aerobic exercise and 5 sessions per week. The training session included 5 minutes of warm-up at 7 m / min and 5 minutes of cooling at 5 m / min. The intensity of training started in the first week with 50% vo2max and a speed of 16 m / min, and in the last week it reached 65% vo2max and a speed of 26 m / min. To prepare deep frying oil, 8 liters of sunflower oil was heated for 190 consecutive days at a temperature of 190 to 200 ° C for 4 consecutive days.48 hours after the last training session and 8 hours of fasting, all rats were anesthetized with chloroform and then sacrificed. The brown adipose tissue was immediately removed from the body and stored in a nitrogen tank at -80 ° C. PPARγ gene expression was measured by Real time PCR and ROS concentration by ELISA. Independent t-test, two-way analysis of variance and Bonferoni post hoc tests were used to analyze the data. All the analyses were done by SPSS software version 21 and the charts were drawn using Microsoft Excel software version 16. The significance level was p<0.05.

The results showed that consumption of deep frying oil induced significant decrease in gene expression of PPARγ (p<0.05) and significant increase in ROS (p<0.05) compared to healthy control group. The aerobic training caused significant decrease in ROS and significant increase in gene expression of PPARγ (p<0.05) compared to DFO group. Interaction effect of aerobic training and octopamine caused the significant increase in ROS (p<0.05) and non significant difference in PPARγ gene expression (p>0.05) in comparison with DFO group.

According to the results of the present study, consumption of deep frying oil has significantly increased ROS and significantly decreased PPARγ gene expression. During the process of heating the oil, ROS is produced, which leads to oxidative stress, and because these products are absorbed by food and enter the circulatory system after eating, they disrupt mitochondrial function. Mitochondrial dysfunction increases the amount of ROS. As the increase in ROS prevents the expression and differentiation of adipocytes by PPARγ, the amount of expression of the PPARγ gene is also reduced. On the other hand, the intensity and duration of aerobic training may have been such that by adapting to brown adipose tissue and activating antioxidant pathway factors, including increased expression of Nuclear factor erythroid 2 [NF-E2]-related factor 2  gene (Nrf2) and its binding to Antioxidant responsive element (ARE) increases antioxidants enzymes such as glutathione peroxidase (GPx) and catalase (CAT) and reduces oxidative stress caused by deep heated oil in the mitochondria and further increases the expression of PPARγ gene. Also, exercise training is considered as a sympathetic stimulus and by stimulating the sympathetic system has increased the release of noradrenaline and increased the expression of PPARγ gene in brown adipose tissue. It seems that the interaction of aerobic exercise and octopamine can improve oxidative stress in brown adipose tissue. The octopamine, due to its antioxidant properties, has reduced ROS due to the consumption of deep-heated oils and in terms of its noadrenaline- like properties, has led to increased expression of PPARγ gene.

Research has shown that one of the variables that the mother of a mentally retarded child may be involved with is emotion management and regulation. Mental retardation is one of the biggest, most complex and difficult issues and problems of children and adolescents in todaychr('39')s human societies. Mental retardation is a heterogeneous and lifelong disorder that is mostly associated with specific problems related to brain or sensory function and includes genetic disorders that affect cognition and behavior (1). Mothers are more affected by the processes that the presence of a disabled child in the family system than fathers due to more involvement and companionship with their children (2). The results showed that there is a significant difference between the mental disorders of mothers of mentally retarded children with learning and late learning (3) and the quality of life (4) of mothers of mentally retarded children with mothers of healthy and normal children. Picat and Dolan (5) also suggest that short-term, short-term treatment is an appropriate intervention for adolescents and adults in many areas. In addition, Adigozel and Goktiork (6) consider the use of solution-oriented perspective as a more effective way to solve psychological problems; so the aim of this study was to evaluate the effectiveness of native solution therapy on self-efficacy and emotional regulation of mothers with mentally retarded children.

The present study was a quasi-experimental study with a pretest-posttest design with unequal control and experimental groups. Sample of this stage of research among mothers with mentally retarded children in Arak in the first quarter of 1398 who had referred to Arak Welfare who were available by voluntary sampling method Sampling was selected. For this purpose, after informing the mentioned community and informing them of the research objectives, the applicants were registered. After enrollment, 40 eligible mothers were randomly replaced in the experimental and control groups (20 in the experimental group, 20 in the control group) using the "individual assignment to group" method. Inclusion criteria include 1- one of their first-degree relatives is mentally retarded, 2- the minimum age of the participant is 18 years, 3- the maximum age of the participant is 55 years, 4- at least 5 years with a minor has mental ability in direct contact, 5- has no extreme love or hatred for the person with mental disabilities, 6- has no mental or physical illnesses such as paranoid that affect their narratives, 7- Be willing to cooperate and participate in the interview session and 8- Other members of their family are also willing to cooperate and participate in the interview. Exclusion criteria include 1- Whenever it is determined for the researcher that the participant does not meet the conditions to enter the research and has entered the research illegally, 2- If they do not attend the interview, 3- Other families Do not participate in the research and 4- refrain from providing information in the interview session. Protocol therapy was developed based on the De Shazer-based solution therapy method, ie strengthening strengths, defining and praising clients, examining exceptions, using the special question "somewhere", scaling questions, and miracle questions. 90 minutes per week were performed for the experimental group.

The results showed that There is a significant difference between the experimental and control groups in at least one of the dependent variables. To find out the difference, univariate analysis of covariance (ANCOVA) test was used. Also, there is a significant difference between the research groups in the variables of emotional regulation and self-efficacy and the value of the significant level obtained is less than the alpha value in both variables (α = 0.05), thus with 95% probability of solution treatment. Axial, affects emotional regulation. Also, the observed effect coefficient is equal to 0.229 for the emotional regulation variable and 0.470 for the self-efficacy variable. There is a significant difference between the control and experimental groups in the post-test stage of the variables of emotional regulation and self-efficacy and the value of the significant level obtained is less than the alpha value (α = 0.05), thus with a 95% probability between the two experimental groups. And control There is a difference in the post-test of the emotional regulation variable.

According to the results, after adjusting the pre-test scores, the difference in post-test scores between the experimental and control groups is significant for the self-efficacy variable. In other words, solution-oriented treatment, considering the mean of self-efficacy in the pre-test stage compared to the mean of self-efficacy of the control group, caused a significant increase in the self-efficacy of mothers with mentally retarded children in the experimental group. The effect or difference showed that the differences in the self-efficacy post-test scores were related to the effect of the solution-oriented treatment and this treatment caused the mean of the self-efficacy post-test scores to be higher in the experimental group than the control group. As a result, the increase in the mean scores of the experimental group compared to the control group in the post-self-efficacy test is due to receiving the solution-oriented treatment intervention in the experimental group. The result of this hypothesis is in line with the research of Zareinejad et al. (7), Moghaddamnia et al. (8), Fitzgerald et al. (9), Lloyd et al. (10) and Baldwin et al. (11). One of the techniques of solution-oriented treatment is problem normalization. This is a technique that assures the client that his problem is not unique. The therapist helps her to know that she is not the only one experiencing this problem, others have experienced this problem and there is hope for finding a solution to this problem. Finding exceptions to the problem as part of treatment allows clients to shift their focus from the problem to a time when there was no problem. The therapist asks the client to look for times when the problem was not in his life and how he did it. The exception question reminds the authorities that the authorities would have been difficult without it  (12).Therefore, it can be said that using the solution-oriented therapy technique, in which a person sets positive and negative goals, one can learn to evaluate the situation by relating to the environment and surroundings, and regulate emotion as a positive goal. Consider and choose low excitement as a negative goal; Therefore, solution-oriented therapy can be effective in regulating the emotions of mothers with mentally retarded children. In general, it can be said that the native solution-oriented intervention has an effect on self-efficacy and emotional regulation of mothers with mentally retarded children and it is recommended to use this intervention in different medical centers. It is also suggested that in similar cases it be placed in a relaxation plant to increase the external credibility of the research.It seems that the treatment of indigenous solution-based solutions has an effect on self-efficacy and emotional regulation of mothers with disabled children, so to increase the external validity of the research in other communities and with alarger number of samples should be examined. In general, it can be said that the native solution-oriented intervention has an effect on self-efficacy and emotional regulation of mothers with mentally retarded children and it is recommended to use this intervention in different medical centers. It is also suggested that in similar cases be placed in the resting plant to increase the validity of the outer larvae of the research.

Today, with the growth of government services and the increase in the workload of organizations due to population growth and increasing the number of citizens receiving services and the lack of government resources in providing manpower as well as the purchase of facilities and machinery The need has led executives to outsource services. Outsourcing is usually used as a way to outsource some of the activities to units outside the organization on a contract basis. Outsourcing strategy In addition to its benefits, like many other methods and strategies, it can also have risks and losses for the organization. Outsourcing as one of the tools for organizational development and product promotion in the form of downsizing has been considered by managers and officials of organizations in recent years and is implemented in various ways. But so far the term outsourcing has not been introduced in general and no special attention has been paid to the factors affecting outsourcing. Although organizations and management experts have paid special attention to deciding on the need for outsourcing as well as identifying the risks and challenges ahead, it seems to be the missing link. The process is continuous, systematic, and comprehensive. To the extent that sometimes the process of contractorschr('39') activities differs significantly from the ideals and ideologies of the client, as well as the objective and operational goals and plans of the employer. This does not necessarily indicate a lack of concern or carelessness on the part of those involved, but it can indicate a lack of tools and the right model for outsourcing. Undoubtedly, organizations have always tried to influence outsourcing projects and ensure their efficiency. But the lack of a codified model and framework for doing so has led to scattered, cross-sectional, and uncoordinated efforts, and sometimes tasteless and unscientific, and has simply wasted resources. Therefore, the present study intends to provide a systematic model for outsourcing based on empirical and scientific evidence. Due to the lack of a proper and logical scientific model, the relevant authorities in the field of outsourcing have often paid attention to some criteria, such as cost and the number of manpower. This study tries to provide a correct and comprehensive model for outsourcing and filling the mentioned gap so that managers and senior officials of executive agencies, especially health networks in Mazandaran province, have a specific model on controlling outsourcing processes. However, the question that this study seeks to answer is which appropriate model can be designed and presented for outsourcing in the executive apparatus, especially the health networks of Mazandaran province, and the degree and how and to what extent is the model fit?

The statistical population of the qualitative sector includes experts including heads, managers, and supervisors of outsourcing projects of health networks in Mazandaran province, as well as professors who have some experience in outsourcing projects. The statistical population of a small part of this research also includes senior managers, middle managers and, managers and employees of health networks in Mazandaran province who are mostly involved in outsourcing, whose number is 560 people. The number of samples in the qualitative section based on the snowball sampling method was 11 and the number of samples in the quantitative section was 228 based on the Cochranchr('39')s formula and selected by simple random sampling. In order to analyze the data, content analysis technique, Delphi, technique, and structural equation modeling were used in Lisrel software.

According to the results, the outsourcing model with four main dimensions is 17 criteria and 51 indicators, which were organizational, managerial, technical and structural dimensions, which are the most important in outsourcing health networks in Mazandaran province, respectively.

According to the results of data analysis, a model including 4 main organizational, technical, managerial, and organizational dimensions were identified. The organizational dimension of outsourcing model including criteria of outsourcing method, outsourcing goals, outsourcing motives, outsourcing location, management dimension including planning criteria, strategic analysis, cost analysis, negotiations and requirements, technical dimension Includes criteria for maintaining technical knowledge, information security, flexibility, and organizational capacity and dimension, including organizational culture, organizational security, internal processes, resources, and infrastructure, and strategic alignment. In explaining the results, it can be said that maintaining the information and trade secrets of companies has always been one of the concerns of managers. Industrial and commercial espionage is widespread and highly professional at the international level. Outsourcing specialized services require providing the most accurate information of a company to an individual or institution outside the organization. Given that organizations are inherently prone to obesity, without using the outsourcing method for any cross-cutting needs, the organization has begun to recruit staff who will often become permanent in the organization after performing the desired service. Outsourcing helps an organization increase its productivity. On the other hand, in some work packages that take place within the organization, there is no reference for control and usually, the approving unit is the same as the acting unit. In general, it can be concluded that outsourcing government duties can lead to the creation of new ideas for efficient and effective work and the use of limited knowledge and resources in the public sector. When governments do not have the capital to innovate, they outsource research and development. According to the obtained results, it is suggested that to properly and efficient outsourcing in the health networks of Mazandaran province, the necessary resources in the field of outsourcing in the organization should be prepared and the required infrastructure should be provided. It is suggested to create the necessary culture in the field of outsourcing and motivate managers and employees to accompany outsourcing projects in the organization. It is suggested that meetings be held to raise staff awareness of outsourcing so that employees do not consider outsourcing activities to be in conflict with their job security and to accompany it. It is suggested that the necessary negotiations be held with organizations and organizations related to outsourcing to create the least interference and parallel work in the field of outsourcing.

Parkinsonchr('39')s is the most common motor disease associated with neuronal damage that affects approximately 4 million elderly people worldwide. Neutrophins are important factors in neuronal cell growth, synapse maturation, and synaptic plasticity (plasticity) and include brain-derived neurotrophic factor (BDNF), nerve growth factor (NGF), glial cell-derived growth factor (CDNF), and conversion growth factor (TGF). α) are insulin-like growth hormone (IGF-I) and neurotrophins 3 and 4. BDNF and NGF are believed to be involved in the protection of the central nervous system through conservation and neuronal regeneration (4). The aim of this study was to evaluate the effect of ganodermalocidam extract and eight weeks of endurance training on plasma levels of brain-derived neurotrophic factor and nerve growth factor in men with Parkinsonchr('39')s disease.

The present study was a quasi-experimental clinical trial. In this study, out of 86 male patients with Parkinsonchr('39')s disease in Ardabil University of Medical Sciences, 24 subjects were purposefully selected and randomly divided into four groups of six (1 placebo, 2 exercises and placebo, 3 supplements and 4 exercises). Complement) were divided. Exercise program for 8 weeks, three sessions per week under the supervision of a physiologist, sports physician and neurologist with an intensity of 50 to 65% of the maximum heart rate in the gym. Blood samples of subjects; It was collected 24 hours before the first session and 24 hours after the last session of exercise and after spending about 10 hours of fasting at night. Special kits were used to measure plasma levels of NGF and BDNF factor by ELISA method. Ganoderma lucidum extract, manufactured by Bayes and approved by the Food and Drug Administration, was provided to the subjects according to their weight. Starch powder was also used as a placebo. One-way analysis of variance and Bonferroni post hoc test were used for statistical analysis.

The results showed that there was a significant difference for plasma levels of nerve growth factor and brain-derived neurotrophic factor in exercise, supplement and supplement-exercise groups. Also, the study of intergroup changes showed a significant difference in post-test compared to pre-test.

The results showed that there was a significant difference between plasma NGF levels in the drug, exercise and drug-exercise groups compared with the control group. Chai et al. (2012) in a study of the protective effect of two types of exercise including swimming and running on a treadmill on the level of NGF in the brain of mice. Five days a week at 20 meters per minute can increase NGF levels and thus be a protective factor against neurological diseases. Yam Sun Love et al. (2011) investigated the protective effects of forced exercise on a treadmill on Parkinsonchr('39')s subjects. In this study, DA, TH and NGF levels in the exercise group had a significant increase compared to the control group. One of the mechanisms of effect of Ganoderma lucidem supplementation on Parkinsonchr('39')s disease was an increase in NGF levels, which is a protective factor for neurons. Parkinsonchr('39')s disease causes oxidative damage to dopaminergic cells. Ganoderma has been reported to stimulate lipoxygenase, an ROS inhibitor. Ganoderma lucidum extract can also reduce ROS in the liver due to its ability to reduce lipid peroxidation (Sargazi, 2017). The combination of exercise effects with supplements can be explained by several mechanisms. First, exercise can facilitate the production of NGF by increasing the available energy of nerve cells and the maturation of NGF precursors. Second, supplementation of Ganoderma lucidum extract can affect the expression of NGF in nerve cells by nuclear or classical and non-nuclear or neoclassical pathways (Sargazi, 2017). It should be noted that exercise increases the effectiveness of this neurotrophic factor by increasing the expression of NGF receptors at the cell surface. On the other hand, supplementation with Ganoderma lucidum extract has the same role for the P75 receptor. Therefore, Ganoderma lucidem supplementation and exercise can also be complementary in the expression and effectiveness of NGF mechanisms of action in neurons.The results also showed that there was a significant difference between plasma BDNF levels in the drug, exercise and drug-exercise groups compared with the control group. BDNF, which protects neurons from damage and disease There areindications that BDNF also has antioxidant activity. Regulation of the additive activity of BDNF and 1TrkB has been shown to have an antioxidant effect in the brain (TSi et al., 2012). In other words, one of the roles assigned to BDNF is its antioxidant role and increase resistance to oxidative stress (Clamp et al., 2015). BDNF increases with exercise and affects neurons in the central nervous system. This factor increases the excitability of synaptic transmission and decreases inhibitory synaptic transmission. Animal studies have shown that daily exercise triggers the release of various neurotransmitters in the brain, such as dopamine, norepinephrine, and especially BDNF. 2017). Johnson et al. (2013) in a study that examined the effect of voluntary running on BDNF in mice found that following the 7-night running pattern in the experimental group showed a significant increase in BDNF. The results of this study suggest that exercise-induced neural variability is potentially increased. Another therapeutic property and benefits of Ganoderma lucidum coffee is that when you drink this coffee, a substance called brain neurogenic factor (BDNF) is released in the brain, which strengthens muscle strength. If BDNF is not secreted, the muscles become weak. In this way, it prevents the reduction of force due to old age and disease, and thus reduces the risk of muscle wasting, especially in people with Parkinsonchr('39')s disease (Keypour et al., 2013).The results of this study showed that exercise and consumption of Ganoderma extract cause a significant change in neurotransmitters in older men with Parkinsonchr('39')s disease. Of course, exercise alone did not have a significant effect on the values of these indicators. Therefore, it seems that exercise with the characteristics of the present study program alone has no effect on these indicators and should be accompanied by supplementation with Ganoderma lucidum extract to strengthen the neuroprotective effects. Therefore, to investigate the role of exercise on these variables in the plasma serum of Parkinsonchr('39')s patients, other studies are needed in which different intensities and periods are examined. As a result, it is possible that the protocol used in this study could be recommended to increase the neuroprotection of striated dopaminergic cells against Parkinsonchr('39')s disease predisposing factors and ultimately to improve brain health. Also, according to the results of this study, it is clear that the use of Ganoderma lucidum extract can be used as an uncomplicated and most effective pre-treatment tool compared to other chemical drugs.

In a society where there is the problem of sedentary lifestyle, overweight and related diseases, air pollution also exacerbates these conditions. One of the institutions that can be effective in this field along with the relevant organizations with its comprehensive and purposeful programs in improving the health of people in the community and sports enthusiasts, are the boards and the sports federation. If those in charge of sports affairs cultivate sports activities in the general public and also the culture of exercising even in a short period of time according to the available facilities and conditions of the people in the society, they will reduce diseases and increase the health of the people. Meanwhile, the main task of the Physical Education Organization and its related institutions is to invite people and attract athletes to perform physical activity, because one of the types of sports delegations in the world is the federation and public sports delegations. The difference between public and championship sports is that in public sports, the main goal is "health for all", while in championship sports, the goal is "gaining skills and competition", ie those who do public sports aim to gain health and vitality. It is for oneself and others, and in public sports, true victory occurs when all members of the group are healthy and happy. Also, if the heads of delegations and sports federations have the necessary motivation in this regard, they will play a very important role in increasing the health of athletes. Motivation is the factor that causes people to show the best quality of their work in doing things. Motivation is one of the main factors that determine the performance of employees. A personchr('39')s motivation includes all the reasons why a person acts in a certain way. The main issue in the field of motivation is the diversity of motivational factors and also their impact on the organization, according to the job and environmental conditions that must be considered by managers in order to achieve organizational goals. In other words, an unsatisfied need creates tension, and this stress causes sudden impulses to be aroused within the individual. These motivations are internal things that cause a person to display searching behavior in pursuit of specific goals. Attention to motivation in employees and the organization can affect all three components of creativity, namely expertise, creative thinking skills and motivation. But the reality is that influencing the first two components is much more difficult and time consuming. Intrinsic motivation can be significantly increased even with minor changes in the organizational environment. Employees who are internally motivated feel that they are impacted by the results of their work through their abilities, skills, and efforts, thus increasing their likelihood of creativity and innovation, while the perception of external control over them increases. Feelings of lack of influence over the work and its consequences, inability to perform activities and reduce their motivation. On the other hand, the study of motivational factors in organizations such as sports delegations that deal with the health of athletes and individuals in the community, is one of the most challenging research discussions and thinking in this area requires much study. Because the importance of sports and sports organizations is not hidden from anyone. Sport is one of the most important and fundamental factors in providing vitality and happiness of society and has an impact on national productivity, and as a result, has a positive effect on the economic prosperity and health of the country. According to previous research, no research has been done on the effect of individual and organizational motivational factors on the tenure of sports teams and its relationship with the health of athletes, so the results of this study can provide a model for future scientific selection. And more precisely, the candidates for the presidency of the provincial sports boards should be used and cause people to enter the boards whose personal and organizational motivations are in line and cause the development of sports and the health of athletes and members of the community. Therefore, this research has been done in order to answer the question whether individual and organizational motivation affect the tenure of provincial sports delegations? Is there a relationship between the individual and organizational motivation of the heads of sports delegations and the health of athletes?

This research was a descriptive-correlational study that was conducted by Delphi interviews and fieldwork. Also, the present study is applied in terms of purpose and retrospective in terms of data collection time. The statistical population of the study was divided into two parts:A) Qualitative section: including 15 managers and deputies of the General Directorate of Sports and Youth of the provinces, presidents of sports federations and professors of sports management were selected to achieve theoretical saturation by theoretical and judgmental sampling. B) Quantitative section: includes all the heads of active provincial sports delegations in the country, which was estimated at more than 1400 people in 1398, and by random sampling of two-stage clusters (based on geographical areas) first randomly from among the provinces 20 provinces and in the next stage 10 provinces (Tehran, Isfahan, Gilan, Mazandaran, Ilam, Hamedan, Hormozgan, Fars, Khorasan Razavi and South Khorasan) were selected and 400 questionnaires were distributed and sent, of which 384 questionnaires were completed and completed. Was analyzed.Data collection tools included the following questionnaires:A) Researcher-made organizational motivation questionnaire that by studying the research background, had 27 items and 7 subscales (interpersonal interaction, general working conditions, organizational growth, sports factors, political factors, economic factors and social factors); B) The researcher-made questionnaire was individual motivation with 37 items in 8 dimensions (interpersonal interaction, task, general working conditions, personal growth, reward, individual political factors, individual economic factors and individual social factors).The General Health Questionnaire (GHQ-28) developed by Goldberg is one of the most well-known screening tools available in Forms 12, 28, 30 and 60. In this set, a 28-question form was prepared in four dimensions of physical symptoms and general health status, anxiety, social dysfunction and depression. Due to the researcher-made two questionnaires of individual and organizational motivation, because it can not be done by face validity and Cronbachchr('39')s alpha reliability, the validity of divergent and convergent structures was reported by exploratory factor analysis and values with the help of statistical software SPSS 21 and SmartPLS.3. Were analyzed.

The results showed that individual and organizational motivation factors had an effect on the tenure of the provincial sports delegations and also the results showed that the individual and organizational motivations of the heads of sports delegations had a significant relationship with the health of athletes.

In general, individual and organizational motivation can affect the tenure of the head of sports organizations and also there is a relationship between individual and organizational motivation of sports heads with the health of athletes and individuals in the community, and this indicates that motivations Individual and organizational candidates for the presidency of sports delegations should be examined as much as possible to increase the level of health of individuals in the community and athletes.

Insecticides are a very important group of environmental pollutants and their greatest use is in agriculture to protect against diseases and pests, and to improve the quality of crops (1). The use of pesticides and their potential to enter the human diet has raised many concerns for researchers. Organophosphoruses are toxic compounds that people are constantly exposed to in varying concentrations, and its dangers include cancer. Chlorpyrifos is a type of organophosphorus that is widely used as an insecticide in the world. The results of studies have shown that chlorpyrifos has detrimental effects on various organs including the immune system, reproductive system, liver, biochemical and blood parameters. These studies also showed that this toxin increases oxidative stress in various tissues such as liver and kidneys. The role of oxidative stress in cardiovascular disease, Alzheimerchr('39')s, diabetes, and damage to tight junction has been confirmed. Tight junction proteins, as one of the important structural components, are essential for regulating the passage of ions and molecules in the heart. Claudin and occludin are the first densely integral membrane proteins in the blood barrier and have similar topography and function interactively with each other. The permeability of the junction and the function of the epithelial barrier are primarily caused by the claudins, and the types of claudin isoforms are expressed there and determine the specific properties of the tissue. Occludin and claudin are both reduced by oxidative stress. As mentioned, the use of agricultural pesticides such as chlorpyrifos causes oxidative stress in the body. Therefore, it seems necessary to use a method that can protect against the effects of oxidative stress and the side effects of this toxin. Eugenol or 4-ally-2-methoxyphenol is an aromatic molecule found in the oils and essential oils of various plants, including clove and cinnamon. Various studies have shown that natural antioxidants with phenolic structure play an important role in protecting body tissues against free radicals. Based on the evidence presented, eugenol has been shown to have an important protective effect against free radical lipid peroxidation (12) and its anti-inflammatory effect has been confirmed. Today, the use of exercise in increasing cardiovascular fitness and physical fitness, improving oxidative stress and vascular tissue has been approved. The aim of this study was to explain the effect of the interaction of moderate-intensity aerobic training and eugenol on the gene expression of occludin and claudin of the cardiac tissue of rats poisoned with chlorpyrifos

40 male Wistar rats were randomly divided into 5 groups (n = 8): healthy control, poisoned control (chlorpyrifos), moderate intensity aerobic training + chlorpyrifos, eugenol + chlorpyrifos and moderate intensity aerobic training + eugenol + chlorpyrifos. Intraperitoneal injection of 3 ml / kg chlorpyrifos and gavage of 250 ml / kg eugenol supplement were performed five times a week for 6 weeks and 4 weeks, respectively. In order to adapt, rats in the aerobic training group ran for 20 minutes at 9m/min speed for two weeks before starting the main training protocol. The aerobic training protocol consisted of 4 weeks of moderate-intensity aerobic training, 5 sessions per week running on a treadmill. Each training session consisted of 5 minutes of warm-up, 10-26 minutes of moderate-intensity aerobic training (starting at 11 m / s in the first session and reaching 20 m / s in the last session) and 5 minutes of cooling. Gene expression of claudin and occludin were measured by Real time-PCR. Independent t-test, Two-way ANOVA and Tukey post hoc test were used to analysis the data.

The results showed that the moderate-intensity aerobic training and eugenol caused significant increase in gene expression of occludin (p=0.001) and claudin (p=0.001) compared to Poisoned control group. eugenol caused significant increase in gene expression of occludin (p=0.001) whereas its effect was not significant on occludin gene expression (p=0.391). Interaction effect of moderate-intensity aerobic training and eugenol caused the non significant increase in claudin (p=0.973) and occludin (p=0.720)  gene expression in comparison with Poisoned control group.

Chlorpyrifos toxin increases oxidative stress in various tissues of the body and since oxidative stress affects the expression of claudin and occludin, it significantly reduces the expression of their genes in the blood barrier. However, moderate-intensity aerobic training and eugenol supplementation alone, possibly relying on their antioxidant and anti-inflammatory properties by increasing the activity of antioxidants such as SOD and catalase, reducing lipid peroxidation, activating and increasing ERK1 / 2, and MAPK, decreasing TNF-α, and decreasing beta-amyloid induced the increase the expression of claudin and occludin genes. The results of the present study showed that the interaction of moderate-intensity aerobic training and eugenol did not have a significant effect on the expression of claudin and occludin genes, but what is important is the increase compared to the poisoned control group, and physiologically this change is considered a feat, although the precise mechanism of insignificance cannot be clearly explained. In general, it seems that moderate-intensity aerobic training and eugenol can affect tight junctions.

Mental accounting is one of the new categories in accounting. Mental accounting is the study of how people interpret information to make decisions based on their analysis of the effects of events in their minds. The purpose of this study was to investigate the relationship between innovative methods and the impact of psychological factors and the level of risk tolerance with mental accounting in Iran.

The research method was descriptive correlation. The statistical population of the study included scientific experts and investment professionals who were selected from among academics and capital market professionals in a targeted and accessible manner. The research instrument was a researcher-made questionnaire whose reliability was 0.86 using Cronbachchr('39')s alpha. Correlation statistical method was used to analyze the data.

The results showed that there is a positive and significant relationship between innovative accounting methods and the level of risk tolerance with psychological factors and mental accounting in Iran (p≤0.05).

It seems that mental accounting requires initiative and high risk and in this regard, in order to externalize the research, it is suggested that more research be done in this regard. The topic of behavioral sciences in finance and investing field is one of the new topics that has recently emerged in investment and financial sciences. Behavioral finance can be seen as a paradigm in which financial markets are studied using models that eliminate the two main and limiting assumptions of the traditional paradigm, ie, maximizing expected utility and complete rationality. As such, concepts such as mental accounting that are addressed in the behavioral finance field have attracted more and more attention from researchers (Kian et al., 2017). Mental accounting is an economic concept first introduced by Thaler (1985). This concept implies that individuals divide their current and future assets into non-transferable and separate shares. In other words, individuals allocate different degrees of utility to each asset class. It is clear that the effect of such prioritization of utility over assets appears to be on consumer behavior. In mental accounting, the usual problem is maximizing expected returns by limiting the maximum likelihood of failure in achieving threshold returns. Investors may behave as risk avoids in the subjective accounts in the lower backing layers, while in the top layers they behave in a risk-seeking manner. Based on this behavioral error, individuals open a separate account in their mind in financial decisions to evaluate each decision and try to examine the consequences of each decision (positive or negative) on their own. As such, they are left out of their overall set of decisions (like portfolio) and may make decisions that do not maximize their wealth (Oula et al., 2017). Given the background of irrational reactions in the Iranian capital market as well as investorschr('39') non-compliance with classical financial models, this study attempts to investigate the relationship between mental accounting with technical analysis and prospect theory. In order to achieve the main objective of the study, technical analysis with 14 sub-criteria and prospect theory with 3 sub-criteria were considered that these criteria have presented in the section of the introduction of the research tool. The main research hypotheses suggest that there is a positive and significant relationship between technical analysis and mental accounting in Iranian society and between prospect theory and mental accounting in Iranian society. Expectancy theory suggests that individuals use mental accounting when making financial decisions. The practical implication of this is that, for example, when investing, they do not seek to optimize their investment portfolios, but rather buy the shares separately without regard to their relationship to each other. Mental accounting considers the way that investors evaluate outcomes. For example, do investors evaluate the whole results as a set (total) or individually?A few simple examples will reveal the dimensions of this behavioral bias (and some related bias). Many of us invest large amounts of our money in places that, for example, have a 17% return. This investment is in the hope of buying a car in the near future, or at the same time with investing (which may be in a bank or government bonds) receive a loan to buy a home from the bank, which we have to pay at 25% of its efficiency. not interesting? The fact is that we have a separate account in mind for a car purchase, and a separate account for a home purchase, and you try not to count the profits and losses of them together. In times of trouble, we usually do not dare to make many financial and investment decisions.A well-known example of this bias for investors active in the Iranian capital market are people who are saddened by losses in one share, screaming for brokers, advisers, land and time. These shareholders have forgotten that the same broker bought them another stake, which not only compensated for the loss of the first investment but also made a very good profit overall. Many shareholders have not yet become accustomed to looking at their portfolio total when evaluating performance. bias mental accounting not only causes us to lose immense sight of our investment portfolio, but also to build a relationship while enjoying the benefits of investing (or purchased goods or services) and the pain and discomfort of spending to get that good or service. This leads us to make decisions that are inconsistent with maximizing wealth (Liu & Chiu, 2015). Baker and Chui Yi (2017) examined the impact of psychological factors on investor decision making in the Malaysian stock market. The findings show that overconfidence, conservatism, and availability bias have significant effects on investor decision making. While behavior is mass like has no significant effect on investor decision making. Also, the results of their studies have shown that psychological factors are influenced by onechr('39')s gender. Delisle et al (2016) in a study on prospect theory, mental accounting, and bargain pricing stated that prospect theory argues that the human decision-making process tends to combine reference points and incorrect weighting of events with low probability of occurrence. The results of their surveys show that market investors of the right to trade prevent prices from rising and create a probabilities weighting function similar to the one presented by the prospect theory. When companies have relatively high or low implicit volatility, biases lead to inefficient prices for the bargain authority. In a joint study of Prospect theory and mental accounting, Ferris et al. (2014) showed that investors receive higher utility when dividing benefits multiple times. This study shows a strong and positive relationship between the frequency of interest payments and company value which by studying frequency changes of paying profits this relationship has been examined. They have shown in numerous empirical evidence-based studies that the existence of non-behavioral factors affecting the frequency of interest payments so remains a strong relationship between the frequency of interest payments and company value that has been shaped by behavioral factors such as mental accounting.  Kian et al. (2017) examined this problem in a study entitled evaluation of the Impact of mental accounting on investor behavior from financial reporting perspective. The results indicate a moderating effect of the loss report on the relationship between net profit and stock price, which is expected to support the theory of mental accounting in the case of profit and loss.Meskini and Mirzaei (2015) examined the behavior of investors in investment decisions in a study called mental accounting (a different approach to decision scenarios). The results of numerous surveys show that individuals open a separate account in mind to evaluate each decision in their financial decisions and try to investigate the consequences of each decision (positive or negative) on their own. As such, they are left out of their overall set of decisions and may make decisions that do not maximize their wealth. Individuals also evaluate decisions, not only by making decisions separately but also changing the type of decision and the time it takes to spend and profit has an effect on the outcomes of the decision. The main focus of previous studies has been on the functioning of financial markets in order to identify new ways of investing so that investors can achieve maximum returns with minimal risk (Fama, 1965; Lintner, 1965). A new and different discipline of literature has shown that emotional and psychological factors such as fear, greed, and self-confidence also play a significant role in investment decisions (Statman et al., 2006; Lo et al., 2005; Shefrin, 2002; Daniel et al., 1998). In the present study, through analyzing the responses of experts, analysts and market participants, it is examined whether technical analysis and prospect theory have a significant impact on the application of mental accounting.Traditional literature has assumed that investorschr('39') investment decisions are based on their rational expectations of updating their beliefs based on new information and maximizing the expected returns for a given risk level. In this regard, Krishnamurti (2009) has pointed to the limited ability of fundamental and technical analysis to determine the fair value of stocks. Therefore, there is a clear need to examine and evaluate changes in value, investor behavior, and factors influencing investment decisions. Thus, behavioral finance emerged to explain less rational changes in stock value and the influence of emotions and behavioral factors on investor decisions (Barberis and Thaler, 2003). Most previous studies have focused on the markets of developed countries in North America, Europe, or East Asia, and limited studies have been conducted on the behavioral finance of West Asian and North African countries (Metawa et al., 2018). Thus, the present study examines the relationship between prospect theory and technical analysis with the Iranian mental accounting model.

Weight gain during pregnancy can affect maternal mortality, pregnancy complications, and delivery, as well as healthy fetal growth and birth weight. Studies have shown that in addition to maternal obesity, which is associated with an increased risk of gestational hypertension, gestational diabetes, stillbirth, and large for gestational age, higher gestational weight gain has also adverse effects on maternal and fetal pregnancy outcomes. Besides, being overweight during pregnancy is associated with problems with breastfeeding in the postpartum period and causes postpartum weight gain, which can persist for up to three years after delivery. This, in turn, can leads to the unfavorable outcome of labor during subsequent pregnancies.Most weight gain during pregnancy is related to the uterus and its contents, breasts, and increased blood volume and extravascular fluid. Besides, the weight gain is due to metabolic changes that lead to an increase in cellular water. Between 20 and 30 weeks of gestation, weight gain is largely due to increased maternal fat stores, and between 30 and 40 weeks of gestation, most of the weight gain is due to fetal growth and increased extravascular fluid.Several factors such as pre-pregnancy weight, height, ethnicity, age, parity, smoking, socioeconomic status, and daily energy consumption affect the rate of weight gain during pregnancy. Also, metabolic factors such as fat biomarkers (adipocytokines) and less rest are associated with more weight gain.  Maternal thyroid function also appears to influence maternal weight gain and may have an adverse effect on maternal and neonatal outcomes. Maternal free thyroxine (FT4) has an important relationship with maternal fat stores so that in euthyroid individuals, maternal fat stores are associated with lower FT4. While this hormone is much less related to fetal growth and increased extravascular fluid, it is associated with weight gain between 30 and 40 weeks of pregnancy. Studies on the relationship between maternal thyroid function and weight gain during pregnancy are limited in this review study, we summarized the studies that assessed the effect of maternal thyroid function on maternal weight gain.

In this systematic review, the PubMed, Web of Science, and Scopus, as well as SID, Irandoc, and Magiran (Persian databases) were searched with appropriate keywords for the English and Persian related articles up to March 2020. The comprehensive electronic literature searching was conducted independently by two authors, who were familiar with search methods and information sources, without any restrictions. Furthermore, to maximize the identification of eligible studies, review articles and the reference lists of studies included were manually evaluated as well. We also excluded non-original studies including guidelines, review articles, case reports, animal studies, commentaries, editorials, letters to the editor, meeting abstracts, as well as studies that did not provide accurate and clear data. The quality of the studies was critically appraised for their methodology and results. Two authors, blinded to study author, journal name, and institution, evaluated the quality of the studies independently. The Newcastle-Ottawa scale was used to evaluate the quality of articles for cohort studies. This scale evaluates the quality of published nonrandomized studies in terms of selection, comparability, and outcomes. In the current review, out of 121 articles (115 English articles and 6 Persian articles) in the initial search, finally, 5 eligible studies were reviewed. The results of the quality assessment of the studies showed that all 5 studies had the desired (high) quality.

The results of some studies showed a strong association between maternal thyroid function and weight gain during pregnancy. Higher TSH levels and lower maternal FT4 levels in early pregnancy and lower FT4 levels in mid-pregnancy have been associated with an increased risk of overweight gain during pregnancy. The basic mechanisms associated with maternal thyroid function and maternal weight gain during pregnancy are still unclear. However, there seems to be a two-pronged effect in this regard.Maternal weight gain in early pregnancy largely reflects maternal fat deposition, and in mid-and late pregnancy reflects increased maternal fluid and amniotic fluid and fetal, placental, and uterine growth. Studies have shown that maternal thyroxin (FT4) levels have a significant relationship with maternal fat reserves. Adipocytes increase the level of the hormone leptin, which in turn affects neurons in the hypothalamus and thus the thyrotropic axis and TSH secretion. Both cross-sectional and longitudinal studies have shown that increased leptin levels lead to higher TSH levels above the upper limit of reference. Changes in leptin levels are associated with weight gain and may affect thyroid function via hypothalamic-pituitary-thyroid stimulation.Increased hCG levels stimulate the thyroid gland through stimulation of the TSH receptor, leading to increased FT4 and decreased TSH levels during pregnancy. Because hCG levels are highest at the end of the first trimester, TSH levels are lower early in pregnancy. However, maternal hCG levels may also affect maternal weight during pregnancy, and it has been suggested that the effect of hCG may somewhat explain the weaker association between maternal TSH levels and maternal weight during pregnancy. Studies of the association of high body mass index (BMI) with maternal FT4 may also be explained by the effect of human chorionic gonadotropin (hCG).

Maternal weight during pregnancy should be considered as one of the important variables in studies focusing on the effect of maternal thyroid function during pregnancy on pregnancy and child outcomes. There is insufficient data on the relationship between maternal thyroid function during pregnancy and maternal weight gain, and the underlying mechanisms are unclear. The effect of thyroid hormones on maternal weight gain seems to be implemented through several biological pathways and seems to be a two-way effect. While thyroid function has a clear effect on basal metabolism and can affect fat stores, on the other hand, maternal weight gain may lead to altered thyroid function. What is certain is that more studies are needed to gain more insight into the observed relationships and their underlying complex mechanisms, especially among pregnant women. Future research is also needed to review thyroid hormone intervention strategies in women with high pre-pregnancy BMI and low FT4, as well as their impact on lower weight gain during pregnancy and better outcome outcomes.

Infectious diseases remain one of the biggest threats to the health and well-being of the human race. Since December 2019, novel COVID-19 infection has spread rapidly all over China and internationally. The pandemic resulted in not only the risk of death from the viral infection but also psychological consequences among people. Particularly because of the long-term nature of the pandemic which is still developing. The psychological impacts of the COVID-19 pandemic on children and adolescents seem to be far greater than the impact on adults because they are more vulnerable to the negative effects of stress. One of these psychological impacts is obsessive-compulsive disorder (OCD). It is characterized by unwanted intrusive thoughts (obsessions) and repetitive compulsive behaviors or mental rituals (compulsions). The more effort put into controlling the obsession, the more frequently and intensely it intruded the patient’s mind. Compulsions can make intrusive thoughts become more frequent, repetitive, and disturbing. The performance of repetitive behaviors are generally related to a fear of negative events. Individuals manifest OCD symptoms only under certain situations that usually invoke a fear of negative events. Following the outbreak of COVID-19, national school closures had been implemented, and students were required to stay at home. Reduced social interaction, stay-at-home restrictions, difficulties in schoolwork, substantial changes to daily routine and boredom can create dramatic psychological effects on children and adolescents. Developmental motivations and hormonal changes make children and adolescents highly attuned to peer groups, making it challenging to isolate at home. All of these triggers repetitive behaviors to respond to an internal compulsion to reduce anxiety. In this study, the occurrence of obsessive-compulsive disorder among primary school students in Lenjan city in dealing with e-learning caused by the Covid-19 epidemic has been reported. Some major patterns of this disorder such as; ruminating thoughts, pathologic doubt, compulsive checking and obsession with order/symmetry, for a population of children in this city in dealing with virtual education mentioned by their parents with educational counselors in the comprehensive counseling center. The parents of this student population have stated; their child's homework stays unfinished because of repeats for fear of not doing something right. After sending homework, their child is not sure did it correctly. Their child feels compelled to check their homework over and over. Their child even when has answered the teacher's questions correctly is not sure has done it correctly. Their child does not throw away the crafts provided because afraid, it will be need in future. Their child is very worried about the homework cleanliness. Their child gathers things that really does not need while attending in the virtual classroom. Their child constantly thinks about the bad aspects of virtual education and can not stop them. Their child immediately aggressive when the order of equipment is disturbed while doing homework. Therefore, as children are the future owners of society, their health and illness will have significant effects on the health and illness of tomorrow's society. so, it is necessary to pay more attention to their mental health during this quarantine period, when the irritability of this important group increases due to the mentioned reasons.