مجله علوم پزشکی رازی
سال بیست و نهم شماره 1 (پیاپی 215، فروردین 1401)

Rhinoplasty is one of the most popular types of cosmetic surgeries performed by otorhinolaryngologists. Rhinoplasty is a challenging and complex surgery because it is designed according to the unique needs of each patient (1). In 2013, men accounted for approximately 20 percent of all rhinoplasty procedures and non-whites accounted for nearly 30 percent of the patient population. In addition, the age of candidates for rhinoplasty was wide and about half of the patients were between 19 and 34 years old and the other half of the patients were under 19 years old or older (2). The existence of tools to measure patients' satisfaction with the results of their surgery can give surgeons a better view to optimize the methods and quality of their surgeries. One of the common methods for evaluating surgical results in terms of patients satisfaction is through the quality of life questionnaires. Especially in rhinoplasty, this method of evaluation aims to examine the direct effect of surgery on patient satisfaction with self-image and consequently self-esteem (3-5). As a result, the validity of such questionnaires is significant. Researchers can use these tools to assess the quality of surgery and optimize methods based on individual characteristics (6). Rhinoplasty Outcome Evaluation (ROE) is one of the questionnaires used today to assess patients' willingness and satisfaction with rhinoplasty (7, 8). In 2021, Mulafikh et al. published a study in Arabic aimed at translating, intercultural matching, and validating the outcome of ROE. This non-randomized prospective study included 50 patients and a control group of 89 healthy individuals who underwent primary rhinoplasty from January to October 2020 in the Department of Otolaryngology, King Saud University, Riyadh, Saudi Arabia. There was a significant difference in ranking between rhinoplasty patients and the control group on both individual questions and total scores. Significant improvement in patient group ranking was observed in 2 weeks and 3 months after surgery compared to preoperative score (P <0.0001). Based on the conclusion of this study, the Arabic version ROE showed good internal consistency, reliability, and credibility and can be used to evaluate the results of rhinoplasty in the Arab population (9). The questionnaire has been translated into German, Turkish, Arabic, and many other languages, but so far in Iran, there is no scale to measure patients' satisfaction with rhinoplasty (10-12). It can be used for many Iranian patients and surgeons. This study aimed to evaluate the validity and reliability of the translated ROE Questionnaire.

The ROE questionnaire was translated by two independent translators and then it was translated back into English and was compared with the original one. With the expert panel reviews, its Content Validity Ratio (CVR) and Content Validity Index (CVI) were calculated. Then, patients who underwent rhinoplasty in Firoozgar Hospital and a private center in Tehran in 2016, for the first time and without any simultaneous facial surgeries, were included in this study, and again two weeks after the operation. This research was done with the approval of the ethics committee of the research vice-chancellor of the Iran University of Medical Sciences (IR.IUMS.FMD.REC.1399.849).

Expert panel consisted of 10 experts that expressed their views on the questionnaire items. The CVR coefficient for all items except the second item was above 0.62, for which the coefficient was measured to be 0.564. The CVI coefficient was also reported to be 0.8 for all items. The mean total score of 87 patients at the first completion was 43.14 (±15.32), which two weeks later reached 41.58 (±15.60) (p > 0.05), this indicates that the Persian version of ROE has good reliability. The postoperative score was 68.48 (±12.49) which was significantly improved (p <0.05).

In our study, differences in gender, age, and education had did not affect postoperative satisfaction scores using ROE. The results of our study are consistent with previous studies (3, 7, 10, 11). This study had a lower item-total correlation coefficient for question 2 like the Arabic version of ROE because unlike the rest of the questions, the second question was related to the functional aspect of rhinoplasty and patients were worried about aesthetic aspects of rhinoplasty (10). Despite this, as the only question about nasal obstruction, and high total post-operative scores we found this question important and applicable for the Persian version of ROE. Izu et al. Introduced a cut-off point of 12 out of 24 or 50% for ROE to be used as a tool to evaluate surgical outcomes and to help predict outcomes (12). In our study, the mean total ROE score in individuals at the first time of completing the questionnaire and after surgery was significantly different (p-value <0.05). Patients reported a score lower than this incision point before surgery and more than 50% after surgery. This indicates the high satisfaction of patients with the surgical outcome. Other studies have used ROE to demonstrate the results of rhinoplasty and its high impact on quality of life, and have concluded that long-term follow-up increases patient satisfaction with rhinoplasty. For this reason, follow-up is important to help evaluate outcomes and long-term patient satisfaction (7, 13, 14). The limitations of the present study were the inability to examine patients in different medical centers, a relatively small sample size, and a short follow-up period. Also, the patients' satisfaction after long-term and medium-term surgery was not evaluated. To increase the accuracy of this questionnaire, this questionnaire should be repeated at different times and places. Also, the surgeon using this questionnaire should pay attention to long-term follow-up of rhinoplasty and ways to improve patients' quality of life.So far, no tool has been introduced to measure patients' satisfaction with the shape of the nose and the outcome of surgery after rhinoplasty, in Iran. The results of our study showed that the Persian version of ROE has good reliability, validity, and credibility, and its results are comparable to ROE questionnaires that have already been translated, adapted, and published in the literature review, as well as the original ROE. Therefore, this tool can be used to evaluate the results of rhinoplasty and many applications can be imagined for it.

Obesity leads to increased health risks and increased economic burden. Obesity, especially in the long term and visceral type, is the cornerstone of the pathogenesis of diabetes. Depending on race and gender, 50 to 90% of type 2 diabetics are overweight and obese, a rate that has been reported to be higher in older patients. The pathophysiological pathways behind this association are complex and ultimately lead to insulin resistance and secondary cell dysfunction. Adipose tissue accumulation produces a range of metabolic and hormonal changes that gradually disrupt the insulin signal transduction pathway and manifest as increased insulin resistance in adipose tissue, liver, and skeletal muscle. On the other hand, it should be noted that the reduction of insulin sensitivity at the cellular level is a natural result of aging. One of the most important compensatory mechanisms against insulin resistance is the increase in pancreatic beta cell mass. This increase in pancreatic cells regulates the dynamic balance between neogenesis, proliferation and apoptotic processes in the islets of Langerhans, which is age-dependent. Are, reflects. But genetic predisposition and aging contribute to beta-cell dysfunction, which, along with chronic glucotoxic and lipotoxic effects, manifests itself in the development of insulin resistance in obese individuals, resulting in impaired glycemic control and diabetes. Nowadays, the basic principles of diabetes control are knowledge and awareness, control of diabetes complications, diet, medication and physical activity, which the low cost and non-pharmacological nature of physical activity increase its therapeutic importance. On the other hand, the beneficial effects of exercise on aging and the side effects associated with it are not hidden from anyone. One type of exercise that has been considered in the control and management of diabetes is high-intensity interval training (HIIT). Due to the characteristics of HIIT and its effects on glucose, insulin, insulin resistance and weight, it has been considered by researchers today, although the same results are not reported, which requires further studies in this field. Dietary supplements, on the other hand, are a form of complementary and alternative therapies that are widely used by the general public, including diabetics. One of the best supplements available is Spirulina Supplement. Spirulina may be helpful in preventing diabetes; because it is low in calories, and contains large amounts of vitamin B1, which improves the metabolism of sugars in the body, it also contains vitamin B2, which helps burn calories, prevents obesity and contains Vitamin B6, which is effective in making the hormone insulin in the body. Increased inflammation due to aging, which also leads to diabetes, and the anti-inflammatory effects of regular physical activity and spirulina supplementation have led researchers to hypothesize that the two may have synergistic effects that could have an optimal effect on Reduce obesity and diabetic complications.The aim of this study was to investigate the effect of eight weeks of high-intensity interval training with spirulina supplementation on weight changes and glucose indices in obese elderly diabetic rats.

This research was of experimental and applied-developmental type. For this purpose, 40 old male Wistar rats (20 months) with an average weight of 280 to 325 grams were purchased and transferred to the laboratory. Then, the standard diet of field rats was calculated and based on that, a high-fat diet derived from soybean and animal oil was prepared and used. The rats were on a high-fat diet for eight weeks. Rats need 10 grams of pellets per 100 grams of body weight per day (standard diet of rats and 10-15 ml of water). The composition of rat pellets included carbohydrates: wheat flour, barley, bran and corn. Protein included: fishmeal powder and soybean meal and fat included soybean oil and a mixture of animal oils. However, in this study, rats had free access to the researcher's high-fat food and the amount of water they needed. The high-fat diet for weight gain consisted of 40% fat, 17% protein and 43% carbohydrates, which were prepared in this study according to livestock and poultry experts. After the weight of the rats reached more than 310 grams according to the Lee index; Diabetes was induced, then HIIT training began. To do this, after a 12-hour period of malnutrition, diabetes was induced by intraperitoneal injection of STZ (Sigma Germany). For this purpose, STZ was first dissolved in sodium citrate buffer solution with pH = 4 and injected into field rats at the rate of 40 mg / kg body weight. After five days, the rats' blood glucose levels were assessed and if the level was more than 300 mg / ml, the rats were diagnosed as diabetic. Blood glucose concentration was measured using blood samples collected from the tails of animals by a glucometer (Buerer GL42 model, made in Germany) and glucose oxidase enzyme method. The criterion for being diabetic was blood glucose concentration higher than 300 mg / 100 ml. The living conditions of the animals in the control group were similar to those in the exercise group except for daily exercise at other times. Then they were randomly divided into 5 groups of 8. Groups include HIIT, HIIT+spirulina, Spirulina, Sham and Control. Then, animals for 8 weeks, 5 sessions per week, HIIT (including running on a treadmill with a maximum of 90% VO2max for 30 seconds, the first week with 5 repetitions and one repetition was added every week) and throughout the training period, the control group did not do any training. Changes in weight, glucose, insulin and insulin resistance were measured by standard methods. Data analysis was performed by one-way ANOVA and Tukey post hoc test using SPSS software.

There was a significant difference in fasting glucose, insulin and insulin resistance between the groups (p = 0.0001). The results of Tukey post hoc test showed that HIIT and supplementation caused significant improvements in glycemic index values compared to control and sham groups. The most improvements were observed in the HIIT + supplement group, which showed the interactive effect of independent variables. HIIT and supplementation caused significant changes in weight between the studied groups. After the post hoc test, it was found that the HIIT + supplement group had more weight loss than the control and sham groups (p = 0.0001).

In general, weight gain and body fat percentage are directly related to increased insulin resistance, and the presence of these two factors increases the risk of diabetes. On the other hand, diabetes is one of the consequences of aging and for the treatment and control of diabetes, especially in old age, in addition to drug therapy, it has been shown that exercise with insulin-independent mechanisms activates muscle glucose uptake. Although the role of HIIT in diabetic and non-diabetic populations has received considerable attention among a variety of sports activities today, its prescription for diabetics has not yet been fully studied, including improving health and reducing complications. Diabetes depends on factors such as the intensity of exercise; For example, six months of moderate-intensity exercise and high-intensity exercise improved insulin sensitivity by 40 percent and 85 percent, respectively. HIIT also showed a greater increase in insulin sensitivity, which in turn Increases muscle glucose uptake in humans and healthy and obese animals. Also, this type of exercise has been useful in improving athletic performance, increasing the physical fitness of healthy people and treating and rehabilitating some diseases, and on the other hand, the energy cost of this type of exercise is higher and improves aerobic fitness. Research has shown that a lack of time to engage in regular exercise and lower blood sugar, even up to 48 hours after regular exercise sessions in people with diabetes, is one of the main reasons these patients do not engage in exercise. That all these cases have been resolved in HIIT. Spirulina can also be effective in weight control and diabetes due to its very rich composition. According to research on the effect of spirulina on blood sugar in research, the effect of this supplement is mainly attributed to the water-soluble part of this algae, which is composed of a protein called phycocyanin and acts as a hypoglycemic agent. In addition, the fiber in spirulina supplementation, which reduces glucose uptake into the gastrointestinal tract, is also shown to be effective in lowering blood sugar. Since the most appropriate dose and timing of intervention for a better response of the body to spirulina supplementation is still inconsistent in the research background, the present study may emerge as a new idea alone in interaction with HIIT for better treatment and control of the index. Sugar and weight should be considered in these patients. According to the obtained results, this study can be used by all researchers who are looking for appropriate and low-risk treatments to treat or control diabetes and weight loss, especially in the elderly.

Next-Generation Sequencing (NGS) is a massive parallel sequencing technology that offers ultra-high throughput, scalability, and speed. This technology is used to determine the order of nucleotides throughout the genome or target regions of DNA or RNA. NGS has revolutionized the biological sciences, allowing laboratories to perform a variety of applications and study biological systems at a level that was not previously possible. Next generation sequencing technology is used in many laboratories around the world to study genetic structure, but so far this technology has rarely been used to diagnose infectious diseases. Most next generation sequencing methods are based on the chain termination process. Thus, with the addition of deoxy-nucleotide labeled with fluorescent ends the PCR reaction and sequence reading is performed (1). This technology makes it possible to map the entire genome at an affordable cost. Currently, the COVID-19 pandemic and SARS-CoV-2, the causative agent of this disease, which has many genomic changes and causes unusual occurrences in the clinic, has increasingly attracted the attention of scientists to higher levels of genetic studies (2, 3). The next generation sequencing technique is useful in obtaining essential information about a pathogen at the beginning of an infectious outbreak and can be used as a diagnostic method for COVID-19 infection (4) and can also be useful in accurately identifying concurrent infections in COVID-19 patients. The genomic epidemiology of SARS-CoV-2 has led to the identification of several mutations in the Wuhan SARS-CoV-2 strain. During the spring of 2020, a non-synonymous mutation leading to the replacement of the D614G in Spike protein dominated the reported sequences, resulting in a higher affinity for the ACE2 receptor, enhancing viral replication. Since the summer of 2020, the emergence of major viral variants has been observed (5). These variants have been shown to be responsible for successive epidemics in different geographical areas. Cases of re-infection with SARS-CoV-2 genotypes different from genotypes that first infected patients have also been reported (6). In order to track the evolution of the virus over time, many laboratories have examined the genotype of the virus. Laboratories equipped with the ability to sequence the entire genome have reported a large number of mutations that have increased over time. However, there are significant differences between countries and in some cases, there is no database of circulating viruses (7). Analysis of SARS-CoV-2 mutations is especially important when the epitopes involved in inducing host immune responses affect the host, as they may lead to immune escape, with potential implications for vaccine (and immunotherapy) efficacy. Such an event could be evidence of an increase in transmission associated with a series of performance-related mutations for a given geographic area. SARS-CoV-2 species are defined by a set of mutations associated with the pathogenesis of the virus, and many species are now closely monitored by the World Health Organization and other public health agencies around the world (6). Variants may be directly related to lineage because they spread under the same conditions, but some species do not (e.g. B.1.1.7 - E484K is a variant, but does not conform to a particular lineage because it reproduces independently many times). A number of variants of concern (VOCs) have been categorized by the WHO, which can be recognized as the alpha variant (B.1.1.7), which has 23 mutations (13 non-synonymous mutations, four deletions, and six synonymous mutations), and more transferability and increased related mortality; beta variants (B.1.351), Gamma, Delta, and Omicron BA-1 and BA-2 with 30 mutations in Spike mentioned. Some of these mutations have recently been linked to low vaccine efficacy. Mu and Lambda can also be mentioned as variants of interest (VOIs). Co-occurring bacterial and viral infections are common, and recognizing co-infection can be helpful in applying the appropriate treatment process to overcome the disease. The next generation sequencing involves a variety of techniques, including Illumina, Ion torrent, Target enrichment, Nanopore, Metagenomics Shotgun. These techniques are considered a new approach in the diagnosis of coronaviruses (1). But it is worth noting that each of them has different advantages in the diagnosis process. For example, Shotgun Metagenomics can confirm the presence of a new pathogen that is not known, and based on this, genotypic analyzes and analysis of different variants on the new pathogen can be performed (8). Target enrichment, on the other hand, evaluates the target sample by identifying the presence of coronavirus and other key respiratory viruses in a sample using the respiratory virus panel (9). Nanopore assay, meanwhile, is a method used to correct the error by reducing the error rate of each reading by comparing multiple genome versions combined into a single combination and by analyzing readings generated from positive and negative strands. Gives. Ion torrent is another sequencing method that is a kind of semiconductor sequencing technology and has a chip that has a sensitive pH sensor and identifies the hydrogen ions released during the alignment of nucleotides for the synthesis of the genomic chain. However, the mentioned methods are different from some other aspects, one of the parameters that are different in the expressed methods is the detection threshold, which is called (LOD) (10). In Illumina method, the detection limit parameter is less than 500 copies per milliliter, and in ion torrent and Nanopore assay, the detection limit is 20 copies and 10 copies per reaction, respectively. The COVID-19 epidemic has sparked unprecedented efforts for nations. The development of effective monitoring strategies is based on sequencing the genome of the causative agent with more than 100,000 complete genomes deposited in dedicated repositories such as EpiCov, and scientists have developed this data. Studies on the evolutionary dynamics of the virus, and the identification of clinically relevant types with different techniques and equipment have been performed, and based on this, it can be concluded that the methods have different diagnostic sensitivities that depend on the purpose of the study, researchers can choose one. Pay attention to the mentioned methods. Although NGS has not been completely successful in diagnosing congenital glycosylation disorders in the past, given the enormous potential of next-generation sequencing applications, it is likely that the various next-generation sequencing techniques mentioned will soon become the first diagnostic approach in clinical laboratories, and since pandemic, we expect the next generation sequencing technology could be a promising diagnostic approach.

Precocious puberty is the appearance of secondary sexual characteristics before 8 years old in girls and 9 years old in boys. Precocious puberty is divided into 3 groups of central, peripheral and normal variants. Central precocious puberty is accompanied by activation of hypothalamic-pituitary-gonadal axis which causes increase in secretion of Gonadotropin Releasing Hormone(GnRH) and in turn increase in secretion of gonadotropins (LH and FSH) from pituitary and consequently increase in secretion of sexual steroids (estrogen or testosterone) from gonads. This results in premature closure of growth plates and shorter final height.   GnRH agonists via suppression of hypothalamic-pituitary-gonadal axis, causes decrease sex steroid production, prevention of bone age advancement and ultimately result in increasing final height  in patients. Central Precocious puberty is the most common type of precocious puberty, which has a higher prevalence in girls.  Use of GnRH agonists is the best treatment for central precocious puberty. This article reviews important factors affecting selection of patients with central precocious puberty, to be treated by GnRH agonists. Purposes of treatment with GnRH agonist: - The main objective of treating patients with central precocious puberty is to prevent  premature closure of growth plates and providing enough time for height growth to ensure normal final height.  -The other purpose of treatment of these patients is to lower their psycho-social stress, emanating from precocious beginning of pubertal signs in these children and their families. - Stoppage of menarche in patients with mental retardation or cerebral paralysis that are not able to manage their menarche. The level of increase in final height after treatment with GnRH agonists on patients with precocious puberty varies. Factors affecting final height of patients with central precocious puberty after treatment with GnRH agonists: - Pubertal beginning age: the sooner commencement of pubertal age happens, the shorter final height will be. - Advancement of bone age: this factor, at the commencement phase of treatment and its termination, is accompanied by shorter final height. This indicates that if treatment is delayed to after a specific bone age (advanced), then reviving the entire potential of final height is not feasible. Kauli and his colleagues indicated that if treatment starts prior to advancement of bone age to 12 years old, it would be more useful. - Height Standard Deviation Score (SDS): Higher SDS of patients height at the beginning or end of treatment, results in higher final height. - Target height: if target age is taller, then final height increases. Main factors for selecting patients with central precocious puberty, for their treatment with GnRH agonists: Age of patients at the beginning of pubertal signs: in patients with central precocious puberty, the lower is their age, the faster progresses their pubertal signs and bone age. This causes premature closure of growth plates and shorter final height. Rate of sexual maturation: patients with central precocious puberty, in terms of advancement of their pubertal signs, are divided into two groups of rapidly progressive and slowly progressive. In the latter group, pubertal signs and bone age progresses rapidly and this leads to shorter final height. Predicted adult height: the most common way of calculating predicted adult height is bayley-pinneau. In this method, final height is calculated on the basis of percentage of current height, bone age and relation between bone age and calendar age. Patients with precocious puberty, with lower predicted adult height, will have shorter final height. - Other factors that are needed to be taken into account in treatment of central precocious puberty are: family background of precocious puberty; small for gestational age and adapted child. Familial forms of precocious puberty are more advanced than sporadic cases. Small for gestational age children, early puberty (not precocious puberty) are turned to rapid progress in bone age and shorter final height. In summary, groups of patients with central precocious puberty benefit from treatment with GnRH agonists are: 1- Girls with central precocious puberty under the age of 6 years old and all boys with central precocious puberty under 9 years old; 2- Girl patients with rapidly progressive central precocious puberty, the one tanner stage of whom progresses in less than 3-6 month; their velocity of height growth is more than 6 centimeters in a year; and their bon age is 1.5-2 years earlier than their calendar age; 3- Girls with central precocious puberty, predicted adult height of whom is more than 150 cm, and boys with central precocious puberty, with their predicted adult height more than 160 cm, do not require treatment and will achieve their final height. GnRH agonists available for treatment of central Precocious puberty: Leuprolide: dose of 3.75 mg for monthly IM injection and dose of 11.25 mg for 3month IM  injection; Triptorelin: dose of 3.75 mg for monthly IM injection and dose of 11.25 mg for 3month IM injection. Also doses of 22.5 mg for 6 months IM injection; Histrelin: dose of 50 mg, subcutaneous implant for one year. Common side effects of treatment with GnRH agonists :  hot flashes, headache, pain at the place of injection, local skin reaction at the place of injection, an in an uncommon manner sterile abscess at the place of injection. After termination of treatment, hypothalamic-pituitary-gonadal axis, will revive again and pubertal signs appear.    Conclusion Nowadays, GnRH agonists are widely used for treatment of central precarious puberty. This happens while age of puberty has decreased in normal population. The lower, age of patients with Precocious puberty is, rate of progress in pubertal signs is faster, final predicted adult height is lower; these patients benefit more from treatment by GnRH agonists.

Obsessive-Compulsive Disorder (OCD) is a very serious psychological disorder characterized by obsessive thoughts and compulsive behaviors and can vary greatly in different geographical areas  so that its prevalence ranges from one percent to four percent. It has been recorded in different geographical areas Obsessions are anxious, unwanted, and stubborn thoughts, as well as impulses or images that are inconsistent with them, in the sense that they are disturbing, disturbing, and inappropriate and do not actually correspond to the person's apparent and perceived feelings. Practical obsessions are created in response to obsessions aimed at reducing anxiety; Which includes repetitive behaviors (such as washing or reviewing) or mental actions (such as counting) The main feature of these obsessions and compulsions (thoughts and behaviors) is that they are not pleasurable for the sufferer, but the patient continues to chew thoughts and repeat actions. To perhaps alleviate the inconvenience to him. Obsessive-compulsive disorder causes major problems in various areas for the individual. Among these problems and disabilities is the disorder in the emotional regulation of this group of patients. Problems with emotion regulation strategies are present in almost all patients, and OCD appears to be characterized by a wide range of emotion regulation problems, particularly fear of emotion or fear of accepting emotion Emotional regulation includes awareness, understanding and acceptance of emotions, the ability to control impulsive behaviors, behavior in accordance with personal goals in situations where negative emotions are experienced, and the ability to use flexible and appropriate emotional strategies appropriate to the situation. The absence of any of these can lead to disruption of this process. In fact, emotion regulation involves all the conscious and unconscious strategies that a person has to increase, maintain or decrease one or more components of the emotional response (experimental, behavioral). And physiological).The aim of this study was to compare the effectiveness of schema therapy and mindfulness-based cognitive therapy on the difficulty of emotion regulation in patients with obsessive-compulsive disorder.

For this purpose, 45 patients with obsessive-compulsive disorder were selected from obsessive-compulsive patients referred to psychological and psychiatric centers in Mashhad and randomly divided into three groups (15 in the control group, 15 in the schema therapy group). And 15 patients were replaced in the cognitive therapy group based on mindfulness). Analysis of variance with repeated measures and post hoc test were used to analyze the data. The results showed the effectiveness of mindfulness-based schema therapy and cognitive therapy (compared to the control group) on the difficulty of emotion regulation in patients with obsessive-compulsive disorder.

The results also showed that there was no significant difference in the effectiveness of these two types of treatments on the difficulty of emotion regulation in people with obsessive-compulsive disorder in the study sample and both treatments were equally effective.

Based on the findings of the study, mindfulness-based cognitive therapy and schema therapy help clients with obsessive-compulsive disorder to be able to effectively regulate and manage their emotions. Therefore, considering that emotions play an essential role in the persistence and exacerbation of this disorder, therapists can increase the effectiveness of treatment sessions by using any of these treatment methods. Mindfulness is one of the emotional therapy treatments that has a positive effect on obsession. Cognitive therapy based on mindfulness by focusing attention and awareness on the current situation and also by increasing the psychological capacity of people to accept events and experiences without judgment. Current life helps people with obsessive-compulsive disorder avoid negative predictions about the future and unpleasant events that await them, and pay too much attention to ordinary events that they find too disturbing. They give up and in this way help to find better emotional conditions and thus manage their emotions. Thus, as Leahy et al. (2014) point out, schema therapy, mindfulness, and commitment-based approaches are effective on coping strategies with undesirable emotions.Therefore, according to the results of several studies that indicate the important role of emotions and the inability to regulate emotion in patients with obsessive-compulsive disorder, it is important to note that therapies that can somehow modulate emotions in these patients. Set to be considered as effective and efficient treatments. Therefore, given that cognitive therapy based on mindfulness and schema therapy can help regulate the emotions of these patients, therapists can measure the inability of patients to regulate emotion, if necessary, these therapies to help manage this emotion.

The liver is one of the main and major organs of the body, which with the help of various enzymes is of special importance in regulating hormonal activities and metabolism, during rest, training, and returning to the original state of sports activities. Under normal circumstances, the liver and kidneys receive 27% and 22% of circulating blood, respectively, but as a result of heavy training, the blood flow to the liver and kidneys decreases to 5% and 3%, respectively. Prolonged reduction in blood flow to the liver and kidneys may have detrimental consequences, of which fatigue observed as a result of the constant sub-maximal activity is part of it. The liver is also one of the most sensitive tissues targeted by training-induced oxidative stress. Sports science coaches and professionals are working to find ways to reduce the effects of strenuous training and increase the effectiveness of training programs over a limited period. The liver has different functions in the body and different roles are considered for it. Metabolism, control of glycolysis, glycogenesis, and lipogenesis are the main functions of liver tissue. Many factors and proteins play a role in these processes, and two factors have recently been identified called E2F1 and E2F4.

The present study was approved by the ethics committee of Payame Noor University with the code IR.PNU.REC.1398.059. In terms of purpose, it is fundamental-applied, which was implemented experimentally. In the present study, 32 8-week-old male Wistar rats with an average weight of 237 ±33 g were purchased from the Pasteur Institute. After being transferred to the animal laboratory environment, these animals are housed in transparent polycarbonate cages in an environment with a temperature of 22 ± 1.4 °C, the humidity of 45 to 55%, four heads in each cage with free access to water and closed. Foods were maintained according to a 12-hour sleep-wake cycle. Animals were randomly divided into 5 groups: control group (Co) (8 heads), moderate intensity training (MIT) (8 heads), high-intensity training (HIT) (8 heads), and high-intensity interval training (HIIT) (8 heads) were divided.
The MIT protocol was performed in such a way that in the first week, 5 minutes of warm-up, 5 minutes of cooling, and 20 minutes of the main body of the exercise, including running at 65% VO2max at a speed of 20 m/min, was added to the training time every week. In the sixth week, the training time reached 37 minutes and remained constant until the end of the eighth. Also, the training speed was unchanged from the first week to the eighth week and was equal to 20 meters per minute.
The HIT protocol in the first week included: 5 minutes of warm-up, 5 minutes of cooling, and 20 minutes of running training with 65% VO2max at a speed of 20 m/min and an increasing slope of the treadmill. The training time was increased every week, so that in the sixth week the training time reached 30 minutes and remained constant until the end of the eighth. On the other hand, the slope of the strip was 2% in the first and second weeks and 2% was added to the slope every 2 weeks to reach 8% in the seventh and eighth weeks. Also, the training speed from the first week to the eighth week was 20 meters per minute and was kept constant. The HIIT protocol also included 10 minutes of warm-up before the workout, in the first to fourth weeks including 3 intense intermittent runs with an intensity of 90 to 100% VO2max and a speed of 30 meters per minute in 4 minutes and 3 low-intensity intermittent runs. With 50 to 60% VO2max and at a speed of 20 meters per minute in 3 minutes. From the fifth to the eighth week, it also includes 4 intense intermittent runs with an intensity of 90 to 100% VO2max at a speed of 30 meters per minute in 4 minutes and 3 low-intensity intermittent runs with 50 to 60% VO2max at a speed of 20 meters per minute. It took 3 minutes. The main body time of the exercise was 28 minutes per repetition. Mice in the control group did not participate in any exercise program but were placed on a stationary treadmill for 10 to 15 minutes per session to adapt to the environment to create the same conditions. After in vitro analysis of the samples, descriptive statistics including standard mean and standard deviation and inferential statistics were used to quantitatively describe the data. First, the Shapirovilk test was used to determine the normality of data distribution, and the Leven test was used to determine the homogeneity of variance. Due to the normal distribution of data, parametric tests including one-way analysis of variance and Tukey's post hoc test were used at a significance level of p≥0.05.

The results showed that there was a significant difference in the expression of the E2F1 gene in the liver tissue of male Wistar rats between the HIT group compared to the control group. There was also a significant difference between MIT and control groups (P = 0.003). Comparison between groups with post hoc test showed that there was no significant difference between HIT groups and MIT, HIIT, and control groups (P = 0.977, P = 0.917, P = 0.093, respectively). Post hoc tests in training groups showed that there was no significant difference in E2F4 gene expression between MIT and HIT, HIIT, and control groups (P = 0.977, P = 0.721, P = 0.202, respectively). On the other hand, a significant difference was observed between the HIIT group and the control group (P = 0.022, respectively).

In general, the results showed that there was no significant difference between IT MIT, HIT, and HIIT methods on E2F1 and E2F4 gene expression in liver tissue of male Wistar rats. However, there is a significant difference between training groups with control of differences.

Cooking with re heated oils result in the release of acrylamide from starch at higher doses than the recommended limits. Heterocyclic amine is another toxin that is produced in this process, which is formed through the heating and cooking process form the protein substances when amino acids and creatine simultaneously react at high cooking temperatures (barbecued/fried foods). Reheated oils contain oxidized monomers, dimers, polymers, free radicals, reactive oxygen species (ROS), hydroperoxidases and aldehydes. These products have detrimental effects on human health and can cause harmful changes in body organs. Mitochondrial dynamics and morphology have increasingly been shown to be regulated by ROS. ROS are central to redox homeostasis-the balance between reduction and oxidation reactions via the gain or loss of electrons. Mitochondrial dynamics factors include Opa1 protein (optic atrophy 1) and mitofusin 1 and 2 (Mfn1 and 2), dynamin-related protein (Drp-1) and fusion protein 1. Deviation towards fusion optimizes mitochondrial function and is useful in maintaining long-term bioenergy capacity. Conversely, deviation toward division leads to the removal of the damaged part of the mitochondria. Exercise has recently been recognized as an effective way to increase mitochondrial function, and the role of exercise in improving mitochondrial damage and oxidative stress in various diseases has been reported. On the other hand, Recently, attempts have been made to diminish the adverse effects of acrolein in the reheated oils through exercise training and its synergistic effects with supplementations. Today, herbal supplements are considered highly effective in the reduction of oxidative stress and inflammation. Octopamine supplementation has been reported to have antioxidant properties. Octopamine is used as a food ingredient, as well as medicinal and dietary supplementation. Octopamine is an adrenergic substance with a sympathetic function. Weight loss and adrenergic actions are associated with metabolic changes. Some of the main functions of octopamine are in antioxidant and anti-inflammatory processes, weight loss, fat burning, and anticancer treatments. On the other hand, recent findings have indicated that exercise training could decrease oxidative stress and inflammation and improve antioxidant enzymes. Meanwhile, some studies have reported that exercise training has no significant impact on inflammation and oxidative stress. The aim of present study was to investigate the effect of aerobic training and octopamine on the gene expression of mitochondrial fission and fusion markers of soleus muscle of male rats fed with repeated heated oil.

In an experimental study, 15 male wistar rats (age: 20 weeks, weight: 300-350 g) were randomly divided into five groups, healthy control (n=3), intoxication (DFO, n=3), aerobic training + intoxication (n=3), octopamine + intoxication (n=3) and aerobic training + octopamine + intoxication (n=3). The exercise training program was conducted for four weeks at moderate intensity every other day. The intensity of exercise training in the first week reached 50% of the maximum consumed oxygen, while it reached 65% of the maximum consumed oxygen in the last week. In order for the animals to adapt to the exercise protocol, an adaptation exercise training session was implemented at the speed of nine meters per minute for 20 minutes during one week before the main exercise training program. The duration of exercise training was 20 minutes, with the intensity set at 16 meters per minute on the first day and 26 meters per minute on the last day of the intervention. For supplementation, octopamine (Sigma-Aldrich, USA) was used for four weeks and was administered via intraperitoneal injection at the dose of 81 µmol/kg five days per week (IP solution with 9% normal saline). For preparation of the rations with hot oil, eight liters of sunflower oil was heated for four consecutive days eight hours per day at the temperature of 190-200°C (3), and every 30 minutes, foods such as chicken nuggets, potatoes, chicken, and protein products (e.g., sausages), were immersed in the oil. On the fourth day, the oil was preserved until the start of the experiment to be used as the intoxication agent and administered orally to the animals via gavage as the feed for four weeks. 48 hours after the last training session and 8 hours of fasting, all the rats were anesthetized with chloroform and then sacrificed. Soleus muscle tissue was immediately removed from the body and stored in a nitrogen tank at -80 ° C. Gene expression of Drp-1 and Mfn2 were measured by Real time & PCR and MDA concentration was measured by ELISA test. One-way ANOVA and Toky post hoc test were used to analysis the data. The significant level was set at p<0.05.

The results showed that consumption of reheated oil induced significant decrease in gene expression of Mfn-2 (P<0.05), significant increase in Drp-1 and MDA (P<0.05) compared to healthy control group. Aerobic training+ octopamine caused the significant decrease in gene expression of DRP-1 (P<0.05), no significant increase in Mfn-2 (P>0.05) and no significant decrease MDA concentration (P>0.05) in comparison with DFO group. Octopamine significantly decreased the gene expression of Mfn-2 than DFO group (P <0.05).

Mitochondrial oxygen species reduce the synthesis of new mitochondria and the mitochondrial network During the oil heating process, and since this reduction reduces antioxidant defense, it results in oxidative stress in the cell. In confirmation of this, the consumption of reheated oil led to an increase in MDA levels that indicates an increase in oxidative stress. Consumption of reheated oil impairs the mitochondrial dynamic and alter the balance between mitochondrial fusion and fission, as they cause oxidative stress, thus reducing mitochondrial content and disrupting mitochondria. Maintaining a balance between mitochondrial fusion and fission is important for maintaining mitochondrial health in muscles. However, direct comparisons between the effects of reheated oil consumption and mitochondrial dysfunction and the effect of aerobic exercise and octopamine on the gene expression of mitochondrial dynamic in muscle are difficult due to the lack of access to similar studies. Studies have shown that octopamine, with properties similar to epinephrine, can selectively and strongly bind to β3 adrenoceptors and increase lipolysis and fat metabolism in general. Fat loss is associated with a decrease in oxidative stress and subsequent improve mitochondrial dynamics. Aerobic exercise can also increase Mfn2 gene expression by stimulating epinephrine, increasing β3 adrenoceptor gene expression, increasing fat catabolism, and reducing fat-induced oxidative stress, all of which interact physiologically to increase Mfn2 gene expression. Therefore, the use of aerobic exercise and octopamine as a stimulant to reduce fat and subsequently reduce ROS and maintain mitochondrial activity and homeostasis. According to the results, aerobic training and octopamine supplementation might have significant effects on the improvement of mitochondrial dynamics dysfunction caused by the use of reheated oils in the muscle tissue. Given the scarcity of data in this regard and limitations of our study regarding the loss of the laboratory rats, it is recommended that the current study be replicated using more samples in order to obtain more generalizable findings in the future.

Today, sperm cell cryopreservation, as a suitable method, is widely used in infertility clinics to maintain sperm cell fertility potential. But sperm cryopreservation has deleterious effects on sperm parameters. For this purpose, there are various ways to protect sperm cells during cryopreservation like sperm cell encapsulation with alginate (ALG). Sodium ALG (C6H7O6Na) is sodium salt of alginic acid, which is a natural anionic and hydrophilic polysaccharide and is mainly extracted from the cell wall of brown seaweed (7). Due to its non-toxicity and high biocompatibility, ALG hydrogel can create semi-permeable membranes around the sperm cells (8). To the best of our knowledge, no study has been performed to optimize the method of encapsulation of sperm with ALG in human sperm for clinical use. The main purpose of this study was to find an optimal method for encapsulating human sperm for use in cryopreservation.

In this study, in four stages, the effect of different concentrations of ALG, calcium chloride, and how to add cryoprotectant agent (CPA) in the process of encapsulation of sperm by ALG were investigated. In this study, the direct swim-up method was used to prepare sperm samples. ALG hydrogels were prepared by dissolving sodium ALG powder in a water solvent (12). To evaluate the optimal concentration, the solutions were well homogenized at concentrations of 1 and 1.5% by volume (W/V) at room temperature. Calcium chloride was selected as a cross-linker for cross-linking and final hydrogel formation and was used with a concentration of 102 mM/L. For evaluation of the effects of ALG concentration, twelve normozoospermic samples were divided into the following groups after preparation and subjected to freezing and thawing: 1- ALG 1% + CPA, 2- ALG 1.5% + CPA, 3- control. To determine the best concentration of calcium chloride, which was used as a crosslinker to form ALG hydrogels, twelve normozoospermic samples after preparation were divided into the following groups and then subjected to freezing and thawing: 1- ALG + CPA + CaCL2 (100µL), 2- ALG + CPA + CaCL2 (150µL): 3- control. For evaluation of addition of CPA before encapsulation, twelve normozoospermic samples, were prepared and divided into the following groups and then subjected to freezing and thawing: 1- ALG + CPA, 2- ALG, 3- control. To investigate the effects of giving time before encapsulation twelve normozoospermic samples were divided into the following groups and then subjected to freezing and thawing: 1- ALG + (CPA + NaCl), 2- ALG + group (CPA + NaCl) 3 Min, 3- control. At each stage, the sperm samples were frozen by rapid freezing after encapsulation. To freeze the samples in the cryotube, they were first placed horizontally at a distance of three cm above the level of liquid nitrogen in the nitrogen vapor for thirty minutes and then immersed in the liquid nitrogen. During thawing, the cryotubes were placed at 35 °C for two minutes after leaving the liquid nitrogen. The samples were then transferred to a laminar hood and placed in the medium containing 150 μL of sodium citrate 119 mM/L solution at pH = 7.5. After 30 seconds, the pre-warmed Ham’s F10 with human serum albumin was added dropwise and after complete washing of the cryotube with the medium, the samples were centrifugated for 10 minutes at 300 g. After removing the supernatant, the final pellet was used for analysis. After thawing and dissolving ALG, sperm motility and viability were assessed for all groups. Eosin-nigrosin staining method was used to evaluate membrane integrity and sperm viability. The ultrastructure of ALG hydrogel was examined by scanning electron microscopy (SEM).

SEM showed that the prepared ALG hydrogel had a porous structure with interconnected porosity that could act as a semi-permeable membrane. The progressive motility in the 1.5% ALG group was zero. There was also a significant difference between total (progressive + non-progressive) motility of sperm between the 1% and 1.5% ALG groups (P˂0.001). Total sperm motility in ALG groups showed a significant decrease compared to the control group. Sperm viability rate in the 1% ALG group was significantly higher than the 1.5% ALG group (P˂0.01) and both ALG groups showed a significant decrease in viability rate compared to the control group. Progressive and total motility of sperm in the 150 μL calcium chloride group compared to the 100 μL group showed a decreasing trend while total motility in the 150 μL group compared to the control group showed a significant decrease (P <0.05). The rate of sperm viability in the 150 μL group compared to the 100 μL group of calcium chloride and the control group showed a decreasing trend. Regarding the adding CPA before encapsulation on sperm parameters, progressive and total sperm motility in the different ALG groups showed a significant decrease compared to the control group and there was no significant difference between the groups of adding CPA before encapsulation and after encapsulation. The rate of sperm viability after thawing in the group that received CPA before encapsulation showed a significant increase compared to the group that received before cryopreservation, but there was no significant difference compared to the control group. The group that did not receive CPA before encapsulation showed a significant reduction in sperm viability compared to all groups (P <0.001). Regarding the effects of giving time before encapsulation, progressive motility in both groups that used ALG for cryopreservation showed a significant decrease compared to the control group. However, the total motility in the group that had time was significantly higher than the group that did not have time (P <0.05). Sperm viability rate in the group without time did not show a significant difference compared to the group that had three minutes, but there was a significant decrease compared to the control group.

Encapsulation of sperm with ALG is a promising method that can prevent the side effects of cryopreservation. It seems that 1% ALG with 100 µL of calcium chloride and the use of CPA before and after encapsulation is a good way to encapsulate human sperm by ALG for freezing.

Cancer is one of the great human challenges in all countries, both advanced and developing. Cancer treatment management can include surgery, chemotherapy, or radiation therapy (1). Radiation therapy is done in two ways: Teletherapy and Brachytherapy. Brachytherapy involves the use of radiation sources to treat cancer by irradiating cancerous tissue from within the patient’s body (2). But the dose and how to use this method has always been questionable for researchers. Therefore, this study creates a new fuzzy approach to high-dose brachytherapy by optimizing the distribution of double roughness based on dosimetric criteria. The use of fuzzy logic itself has increased the accuracy of the mathematical model of the problem. This fuzzy model is a new study and innovation used in this paper. Due to the fuzzy nature of this method and its limitations, it is considered fuzzy. This makes the method more accurate and includes parameters such as the patient’s physical ability and age in the problem, which in itself increases the accuracy of the method for each patient. As a result, the obtained answer is improved and the executive program of brachytherapy method is more accurate.

In the present study, the dose prescribed for an organ was evaluated by dosimetric indices listed in Table 1 (18). For the present study, data from 20 patients in the age range of 50 to 74 and mean age 62 years with a wide range of prostate volume between 23 and 103 cubic centimeters, and for the treatment of prostate cancer by brachytherapy from the Academic Medical Center (AMC, Amsterdam, the Netherlands) had participated. To compare brachytherapy programs with high interstitial dose, the dose rate was calculated with 192Ir beam with a radiation dose of 13 Gy, according to the standard protocol TG-43.
To begin with, computed tomography (CT) scans or magnetic resonance imaging (MRI) were taken from the patients pelvis, and entered into the treatment planning software for use in treatment planning sessions. BT treatment planners and specialists then determined the input catheters, target volumes, and OARs obtained from the medical images. Depending on the size and exact location of the target volumes, between 14 and 20 catheters entered the patient’s body, reaching the target volumes. After designing and approving an acceptable treatment plan, the catheters inserted into the patient’s body were connected to a retractor 4 that controls the movement of the radiation source. After the treatment program, the source was returned to the retractor (8, 14). Then, an integer program model with fuzzy constraints was proposed for programming on high-dose brachytherapy. The description of infrastructures, parameters and variables in this model are in Table 2 (15). Finally, the dosimeter index is equal to the sum of all the index variables, as it turned out: The proposed model is a correct programming model called IP.
In general, three evolutionary algorithms (EP), (GA) and (ES) were used in this research. The algorithms stopped after creating 20 generations of desirable answers and the best answer of each generation was determined on the chart as a point. The resulting set of answers were connected in the form of graphs, which are used to analyze the results. Each point on the graph identifies the best answer from each of the generations generated by the respective algorithms. These three algorithms were performed independently for each patient and the obtained answers were identified as dots on the chart. The graph obtained for each patient indicates the capability of each of these algorithms.

According to this study, each of the three algorithms (EP), (GA) and (ES) are each run independently for each of the patients with prostate cancer. At first, the genetic algorithm showed the ability to get closer to the desired answer sooner, but as the optimization process continues, the rate of convergence to the desired answer decreases, so if the time parameter is very important, the genetic algorithm can be useful. Especially for patients whose prostate volume was larger than other patients. In patients 15, 12, 8 and 9, due to their younger age than other patients and better physical condition, as well as prostate volume less than 80 ml, they had much more promising results than other patients. In contrast, for patients 4 and 19 with an age of over 70, the results were not as favorable as for other patients. The * sign in the table indicates that there is no answer through that patient-specific algorithm that covers 95 or even more of the tumor volume. Therefore, according to Table 2, it can be concluded that the best algorithm that can be considered for the case where the shortest time to reach the target coverage above 95% is the genetic algorithm. According to Table 2, it can be concluded that the best algorithm that can be considered for the case where the shortest time to reach the target coverage above 95% is the genetic algorithm. Therefore, according to Table 3, the ES algorithm has better answers than the other two algorithms for the case in which the largest volume of the tumor is covered. According to the results, the ES algorithm has obtained the best results for patients under 60 years of age and normal prostate volume.

According to the obtained results, it can be stated that whether the main goal is the maximum coverage or the goal is the shortest possible time to reach the coverage above 95%, the best algorithm that can get a good answer for each patient is the evolutionary strategy algorithm.

Because of competitive and stressful nature of sports, competitive anxiety occurs that leads to emotional and fleeting reactions that assess the threat of some situations and therefore influences on the athlete's performance negatively. Early studies of anxiety assumed that anxiety was one-dimensional, but researchers in multidimensional theory of anxiety have recently proposed a set of two-dimensional connections between cognitive anxiety, physical anxiety, self- confidence and performance. Cognitive anxiety is a psychological component of anxiety and is recognized by negative expectations and cognitive concerns about oneself, situations and possible consequences, while physical anxiety is a physiological and emotional component of the anxiety and is associated with arousal of the autonomic nervous system. In addition, sports self-confidence is defined as the degree of confidence of individuals about their abilities and the challenges they face in order to succeed in sports. Many researchers have considered the study of competitive anxiety in the field of sports psychology due to its direct and threatening effects on the sports performance and success.In the past years, the science of sports psychology has used cognitive-behavioral methods to improve athletes' competitive performances. Recently, psychologists have stated that avoiding and suppression of negative thoughts has increased unwanted cognitive activity and therefore impaired their optimal execution.In this regard, the mindfulness approach has recently been used as an alternative strategy for practicing traditional mental skills.This approach is clearly different from the traditional practice approaches of mental skills, both in terms of theoretical assumptions and also intervention strategies. Although in many studies, the effectiveness of mindfulness trainings has been shown on many variables including exercise performance, flow, worry, thoughts unrelated to the tasks and physiological factors, but the results of the studies are contradictory.According to the current weakness of existing interventions and the inconsistencies associated with the role of traditional mental skills training and also the role of new interventions on the levels of competitive anxiety and self-confidence in the professional athletes, the aim of this study was to evaluate the effectiveness of six weeks of mindfulness-based cognitive intervention on the competitive anxiety levels and self-confidence of adolescent shooting athletes.

The present study is a quasi-experimental using a pretest and posttest design with a control group. The statistical population of this study who were voluntarily invited to take part in the study included all male shooters (guns and pistols) in Yazd province. All athletes had at least two years of regular shooting activity and experience in provincial and national competitions. After selecting the eligible individuals based on the questionnaire and explaining the purpose of the present study, 16 subjects were randomly divided into two groups, mindfulness intervention group and the control group. The subjects in the experimental group took part in six specified training sessions during six weeks (one session of 75-90 minutes per week).The Competitive Sports Anxiety Inventory-2 (Martens et al, 1990) was used to evaluate the research variables. The physical anxiety, cognitive anxiety and self-confidence subscales with Cronbach's alpha coefficients of 0.85, 0.75 and 0.83, respectively, show the high reliability of mentioned questionnaire. In this study, Shapiro-Wilk test was used to determine the normality of the data. Also independent t-test was used to compare self-confidence, physical and cognitive anxiety in the control and experimental groups. In all tests, the confidence level was considered 0.05.

First, the assumption of normality of measured variables was checked using the Shapiro-Wilk test. The results of the test showed that the distribution of data in the study groups is normal (P≤0.05). Also, the comparison of pre-test scores between two groups did not show a significant difference (P≤0.05), which indicated that the groups were homogeneous. To evaluate the effectiveness of the intervention, the data of CSAI-2 questionnaire of two groups, in the post-test, were compared using independent t-test. The results showed that there was a significant difference between two groups in the variables of cognitive anxiety and self-confidence (P≤0.05). However, there was no significant difference between two groups in the physical anxiety variable (P≥0.05).

The results showed that there is a significant difference between two groups in the variables of cognitive anxiety and self-confidence. Due to an increase in the negative emotions caused by anxiety and stress in the sports situations, these factors can increase the negative interpretations in athletes. Based on the assumption that unwanted thoughts are the core of anxiety and excitement, mindfulness actually makes the person less focused on repetitive thought patterns. Therefore, athletes can control their anxiety. The findings of the present study on the positive effectiveness of mindfulness approach on the reducing cognitive anxiety in athletes are in line with the findings of previous studies that showed that mindfulness reduces anxiety symptoms, pessimism and negative thoughts before competition. The finding showed that physical anxiety did not differ significantly before and after the intervention. There is a possibility that subjects couldn’t reflect emotions through a questionnaire. Also, in explaining on the distinction between the reducing physical and cognitive anxiety, (Martens, 1990) has demonstrated that physical and cognitive anxiety are affected in different ways. Cognitive anxiety has a direct and negative relationship with performance and should be minimal, while physical anxiety has an inverted U-shape relationship with performance and should be moderate. The posttest results showed a significant difference of self-confidence between two groups. Self-confidence means the ability to promote positive thoughts and self-efficacy in competition. As regards cognitive anxiety has decreased, therefore self-confidence has increased. In general, the differences between the present study and others may be due to the nature of their intervention, the location, duration and the type of programs, and so on. Since the research sample was limited to young male shooters, so the generalization of the results of this study should be followed with caution. According to the innovation and importance of this topic, the researchers should evaluate the effectiveness of mindfulness interventions on the competitive anxiety levels and Self-confidence of athletes in the other sports as well.

Personality and neuropsychological Coolidge test an assessment tool for children and adolescents is at risk of various mental illnesses. This study is aimed at checking psychometric properties personality and neuropsychological Coolidge test. A personality and neuropsychological questionnaire were designed to assess children and adolescents. There is a lot of evidence that if children and adolescents are assessed at a younger age, and be diagnosed as soon as possible. More likely they will become a socially active adult. The neuropsychological nerve is the study of the relationship between the brain and behavior, and the evaluation of psychological is the use of this knowledge to assess and intervene in human behavior that is associated with the normal and abnormal function of the central nervous system. The evaluation of neuropsychological is usually carried out with a set of approaches that involve different tests of cognitive ability. These areas of competence include skills such as memory, attention, processing speed, reasoning, judgment, problem solving, perception, and language performance. It is the source of neuropsychological assessment in neuroscience and psychiatry. The objectives of neuropsychological evaluation include of determining the overall level of the brain function and identifying the brain disorder and determining the location of the brain, Assessment to facilitate patient care and rehabilitation, The evaluation of neuropsychological can recognize the existence of mild disorders in cases where diagnostic checks have Doubtful results. Personality is made of traits or trends that lead to individual differences in behavior, consistency of behavior over time and persistence of behavior in different situations. The most incapable Personality disorders are characterized by psychological disorders that result in a complex interaction between individual and individual genetic fitness. Personality disorder is a long - term pattern of an internal and behavioral experience that is far away from the individual 's cultural expectations, is inflexible and has been established in adolescence or early adulthood, remains constant throughout time, causing discomfort or loss of performance. These disorders affect the areas of mental functioning, such as Self-control, behavioral, cognitive, emotional, interpersonal, and biological processes  and They show themselves in a few areas that include an intermediate or higher damage to the traumatic personality function. The history of personality disorders shows that it is always referred to neuropsychological. In the DSM – 5 was noted that all adult personality disorder groups may be applied to children or teenagers. But the maladaptive behavior must be stable and resistant and unlikely to be restricted to a particular growth stage or other clinical syndrome. Although the diagnosis of personality disorder may not be formally performed by the age of 18, strong symptoms of this disorder must be applied only after careful examination of other relevant clinical data. According to the DSM - 5 Personality Disorder must be performed only after careful evaluation of the extent to which social and school performance disorders exist. From the psychotherapy perspective, the treatment of personality disorders in children may be highly complex, and if neuropsychological function disorder is biologically related to personality disorders in children and adolescents, the traditional methods of psychotherapy may be useful. The sooner the adult personality disorder is diagnosed and the sooner the child begins healing, the better the child gives the child a better opportunity to overcome the disorder. CPNI diagnosis provides an assessment tool for children and teenagers at the risk of numerous mental illnesses. Thousands of mental disorders may be present in children and adolescents, but so far it has been necessary to use a number of different questionnaires to assess these disorders. The questionnaire was made to assess many disorders. This is particularly desirable in terms of efficiency, cost and conceptual integration. The questionnaire is completed by the supervisor or a teacher who is familiar with the child. the aim of this study is finding a tool for screening children with impaired children. due to the importance of the matter in this field, the study seems necessary. This test is used to find symptoms of disease and diagnosis. It can also be used to conduct psychotherapy and facilitate healing. considering the use of a tool with research and clinical goals, it is necessary to review the psychometric characteristics of that instrument in the population, and according to the importance of this instrument, an increasing interest psychometric test is observed. therefore, this study aims to determine the psychometric characteristics (validity and reliability) of the personality questionnaire and the neuropsychological of coolidge in the sample of iranian children and teenagers.

The present study is descriptive of the topic and goals of the descriptive type. the statistical population consists of all students ages 5 to 17 in the 1300-1400 s academic year, where 1203 were selected in a multi - stage cluster sampling technique to collect information. inorder to conduct the present study, each ofthe five provinces (mazandaran, isfahan, hamedan, Kerman and Shiraz) are selected from each section (pre secondary, primary, secondary and secondary) and the psychological and psychological questionnaire produced by coolidge in 2002 The students ' parents were provided. In the letter ,thanks to parents , they were asked to complete the questionnaires at a proper time and send their children to school.

The average variance extracted for all the dimensions was higher than 0.5, which demonstrates the appropriate internal validity of the measurement model. In addition, the reliability values of all the dimensions were obtained higher than 0.7, which is acceptablel and cronbach,s alpha for all the dimensions was higher than 0/7, which is an indication of the internal consistency of the measurement model.

According to the results of the third order confirmatory factor analysis of the reflective measuring model of personality and neuropsychological Coolidge test a comprehensive tool was used to measure these behaviors among children and adolescents. it can be said that the 50 mentioned components can adequately measure these behavior among children and adolescents.

Mobile phone addiction is considered as an important factor in causing a variety of psychological, behavioral and emotional problems.This study aimed to The aim of this study was to present a model of cell phone dependence based on social anxiety with the mediating role of Alexithymia in students.Today, technologies have completely disrupted the lives of people of all ages, especially young people and adolescents (1). Mobile phones have been expanding in recent decades due to the numerous benefits they offer, such as the ability to move and browse the Internet, as well as access to social networks, real-time information streaming, cameras and multimedia players (2). Researchers have recently shown how mobile devices give students access to learning resources at any time and place, as well as their use by teachers in teaching and interactive tutoring (3). However, although mobile phones have many benefits, especially in the field of education, especially in learning outcomes (4) and in increasing students' motivation and commitment (6), their excessive use can have negative consequences. In children and adolescents, whether personally or in their family, educational and social life (7). Mobile phones, on the other hand, are devices that are capable of processing information that includes access to the Internet and social networks, messaging and multimedia in addition to their main function as a means of communication (10) since people almost always have their own mobile phones. And can use their mobile phones several times during the day, using mobile phones may become an automatic behavior that is done without reflection (11).It seems that one of the variables that play a role in cell phone dependence is social anxiety. Researchers have proven that people use cell phones as a substitute for social interaction when they feel anxious in a real environment (13). Social anxiety disorder is a severe and persistent fear of situations in which a person is in the company of others or has to do something about them. People with this disorder are afraid of any situation in which they think they will be negatively evaluated by others and try. They can stay away from them (14). Finally, one of the structures that can play a mediating variable in cell phone dependence is Alexithymia. Alexithymia refers to the difficulty in identifying and describing one's own feelings and those of others and the inability to distinguish between one's own feelings and those of others and one's external stylistics (18). Because in previous studies, the framework of how a person is dependent on mobile phones has not been examined using social anxiety and alexithymia variables, and given the importance of young people's dependence on mobile phones both theoretically and practically and the many harms that This issue affects the psyche of students. By determining the relative share of each of these variables, it is necessary to address the underlying factors.

In this descriptive study, the statistical population included all students of Mohaghegh Ardebili University in the second semester of the academic year 2020. A total of 205 of these individuals were selected by available sampling method and individually answered the questionnaires on mobile phone dependence, social anxiety and alexithymia. Since according to many researchers, the minimum sample size required in structural models is 200 (29), the sample size in the present study was 250 considering the probability of sample loss, which after deleting the pert data, 205 questions. The letter was entered into statistical analysis. The sampling method used was also available. The method of data collection was that according to the coronary status and quarantine conditions and the lack of access to students in person, questionnaires in two parts, the first part includes demographic information (age, gender, marital status, degree, field of study The second part included questionnaires on cell phone dependency, social anxiety, and alexithymia online by linking them to class groups and channels created in virtual networks. University (provided to the subjects from June 10 to September 6), where 260 answers were completed and 55 questionnaires were removed due to incomplete completion. The data collected in this study were analyzed using descriptive statistical tools such as mean and standard deviation and Pearson correlation tests using SPSS software version 25 and structural equation modeling using Lisrel software version 8.8. Significance level in the tests was considered 0.05.

Out of 205 subjects whose data were included in statistical analysis, 125 subjects (60.98%) were girls with a mean age of 28.60 and the standard deviation was 5.47 and 80 subjects (39.02%) were boys with a mean age of 30.35 and Standard deviation of 5.85 participated in this study. In terms of educational level, 130 people (53.65%) had a bachelor's degree, 70 people (34.14%) had a master's degree and 5 people (2.43%) were studying for a doctorate. In terms of field of study, 80 people (39.09%) in psychology, 70 people (34.14%) in counseling and guidance, 15 people (7.31) in mathematics, 15 people (7.31%) in urban planning management, 11 people (36.5% were Persian literature, 7 (3.41) were chemists and 7 (3.41) were biologists. In terms of marital status, 95 (46.34%) were married and 110 (53.65%) were single. In terms of using virtual applications, 62 people (30.24%) Telegram, 81 people (39.51%) Instagram, 28 people (13.65%) WhatsApp, 18 people (8.78%) Facebook and 16 people (7.80%) reported mobile SMS and in terms of economic status, 49 (23.90%) reported good, 411 (68.78%) moderate and 15 (7.31%) poor.
The results of correlation coefficient showed that mobile phone dependence was positively associated with social anxiety and alexithymia. Alexithymia is also positively associated with social anxiety (p <0.001). To determine the adequacy of the proposed model fit with the data, normalized Chi-square indices, comparative fit index and the square root of the mean squares of the estimation error were used. The values of each of these indicators are between 0 and 1, and values close to or greater than 0.90 indicate that the model is desirable. The CFI for this model is 0.99, which is in the acceptable range. Since the square root of the mean squared estimation error (RMSEA) for the model is 0.057, on the other hand, the acceptable range for it is less than 0.08, so it can be said that the fitted model is a suitable model. The normalized chi-square index (CMIN / DF) and the comparative fit index (CFI) are within acceptable range.In general, model fit indices also confirmed the path of social anxiety towards cell phone dependence mediated by Alexithymia.

Considering the role of social anxiety and the mediating role of Alexithymia in the addictive use of mobile phones, holding practical workshops in universities by counselors, psychologists, and health agents to regulate and manage emotions and teach social skills and inform students of the consequences. Negative cell phone dependence is recommended. The use of questionnaires and lack of control over demographic variables (economic, social and cultural status) were the two main limitations of the present study. It is suggested that more objective tools be used in future studies to collect data and control demographic variables. Considering the role of social anxiety and the mediating role of Alexithymia in the addictive use of mobile phones in terms of application, holding workshops in universities by counselors, psychologists and health agents to regulate and manage emotions and teach social skills and inform students of the negative consequences of dependence Recommended for mobile phones.

The modern world today allows images to be received and stored digitally. To get better results, it is sometimes necessary to make changes to these images. These changes pursue three main goals: image processing, analysis, and comprehension. For this reason, computer image processing systems have been developed to perform these operations with better speed and accuracy. Four major processes occur in these systems: preprocessing, image quality enhancement, image conversion, and image classification and analysis. In these methods, using mathematics, rules have been created by the computer to simulate human visual elements, and it is an aspect of image analysis that is used for specific purposes. Skin imaging systems provide the ability to process images in high volume and with minimal time and cost, as well as increase the accuracy of diagnosis and classification of diseases. These systems, fatigue, human error and other weaknesses that the diagnostician can suffer. Do not have it (1). The first step in diagnosing skin diseases and analyzing digital images of patients with skin lesions is to take a color photograph of the lesion area. One of the most valid methods for this is the use of a dermoscopic device (2). Dermoscopy, also known as dermatoscopy, is an effective tool for dermatologists involved in early diagnosis. Using dermoscopically evaluated pigmented lesions, abnormal structural features are detected and the border of the lesions is accurately observed (3). Accordingly, benign lesions can be detected without the need for biopsy. Dermoscopy increases the accuracy of the diagnosis and helps GPs to correctly identify people with suspected lesions who need to be referred to a specialist. Dermoscopy is also effective in diagnosing non-pigmented skin lesions and inflammatory dermatoses. In dermoscopy, the skin is examined using a special microscope (4).

The proposed algorithm of this research can be divided into 7 separate steps (loading data set, data integration: data balancing with data amplification or data augmentation technique, data cleaning: clearing images to remove hair noise, slicing images to separate skin from skin Healthy, data conversion: data preparation, convolution neural network design (CNN) and training of the proposed model for image feature extraction, classification combination and mass learning by majority voting method). Which was implemented in Python language in Google Columbine environment and supervised. For this study, 25,331 dermoscopic images consisting of skin lesions were included (70% educational images, 15% experimental and 15% validation). In data preprocessing, the data were balanced, then the data cleaning operation was performed to remove hair noise, and the data reduction operation was performed to segment the images by separating the lesion from healthy skin. In the next process By designing the convolution neural network, training data were extracted for feature extraction, and by combining the classifiers, an automated system for diagnosing skin diseases was created and evaluated in dermoscopic images.

In the proposed method of hair noise removal, the quality of images is increased and also the separation of the lesion from healthy skin is optimally designed to accelerate image processing to extract high-level features in the convolutional neural network and increase the accuracy of diagnosis and classification to create An automated diagnostic system is a feature of this study compared to other studies. According to the research results, the use of an automated system for the diagnosis and classification of skin diseases and cancers for health-related care is recommended.

Today, the applications of artificial intelligence are not hidden from anyone. Among these, machine learning as one of the most important branches of this field has a special place in all sciences. Deep learning has proven its worth by using the basics of artificial neural networks in solving many issues in the field of medical image processing such as classification. Experts also based on various experiences of using training methods to conclude that there is no single specific training algorithm that can be successful for all applications and has the highest accuracy. Hence they suggest combined learning. According to the important results, although each of the algorithms had a successful performance individually, but combining several algorithms with each other has led to higher accuracy and less error-making decisions. This study is a step towards helping physicians and specialists in diagnosing skin diseases and benign and malignant skin cancers and can help GPs or other physicians to better manage high-risk lesions. Secondary triage as well as avoid unnecessary treatments and minimize biopsy, which is an invasive and costly procedure. This research helps to provide health-related care, forecasting and treatment, as well as cost savings for both patients and health care providers. Also, in deprived areas and far from the specialist, dermoscopic devices with the help of this algorithm can cause timely treatment and reduce patients' costs and time in the field of diagnosis and, if necessary, referral of patients to the desired specialist. Available as a commercial software package. This software package has the ability to connect to dermoscopic devices. By connecting this software package to dermoscopy, a device is created to quickly diagnose skin diseases and cancers. The greatest value of this dissertation is that it is used as a benchmark for designing future studies and evaluating skin cancer diagnosis techniques in patients who are usually examined by a general practitioner and specialist. The findings of the present study are also consistent with the results of Andre and Pachko (2019) research on the diagnosis of skin cancer based on deep learning and entropy for Perth samples (6).

The dimensions and characteristics of tendons and muscles are much related to each other and change according to each other. The reason for this phenomenon is probably due to the ability of the muscle to exert force. Therefore, the desired characteristics of the components of the load-bearing baffles are regulated by the amount of daily mechanical load. This concept is important not only for understanding the function of these tissues but also for understanding the mechanisms of damage and its causes. Muscle hypertrophy is also affected by the intensity and type of physical activity, especially resistance training. Nutritional and hormonal factors also play a key role in this. Testosterone is very important as one of the key anabolic hormones. Accordingly, the effect of 4 weeks of resistance training and testosterone on mTOR gene expression in male rat tendons was investigated.

In this experimental interventional study, 48 rats aged eight weeks, in the weight range of 220 ± 20 g at a temperature of (20-20) ° C, humidity (55%) and free access to water (300 ml bottle) Clear and graduated with autoclave capability and with a 1 cm cap made of stainless steel without thread) and enough food (produced by Behparvar Company, Iran) with a 12-hour dark / light cycle. After one week of adaptation, rats were randomly divided into four groups: control, resistance training, testosterone enanthate and resistance training - testosterone enanthate. At first, the rats in the training groups were introduced to climbing the ladder for a week. Rats' weights were calculated, and the training program was adjusted based on the initial weight. The rats then practiced resistance for four weeks and five days a week. In the first session, a weight equal to 50% of the weight of each rat was attached to the tail and the rats climbed the ladder. If the animal was able to climb, then 30 grams was added to the weight and the animal climbed the ladder again. Again, if the weight was able to lift 30 grams, it was added to the rat's tail. This was performed as long as the animal was able to climb. The highest weight that the animal could carry was the maximum muscle strength of the animal in the first session. In the next session, the rats performed four sets of climbing the ladder, so that in the first set they climbed the ladder with 50% of maximum muscle strength, in the second set 75%, in the third set 90% and in the fourth set with 100% muscle strength. After the fourth set, if each set was capable, 30 grams would be added to the amount of weight and the rat would climb the ladder. The program continued in one session until the inability to perform the climb. At the beginning of each week, the rats resumed training with the pattern of the first week, based on the maximum weight they had shifted at the end of the previous week. Expression levels of mTOR gene were measured by RT & PCR. One-way ANOVA and Tukey post hoc test were used for statistical analysis. Significance level was considered p <0.05.

The results of one-way analysis showed that the expression level of mTOR gene was significant in four groups (P = 0.014). Referring to Tukey post hoc test, the results showed that the resistance training group and testosterone showed a significant difference with the training and control group only (P <0.05). The other groups did not show significant differences in pairs (P <0.05).

The results of this study showed that resistance training activates the pathway of activation of collagen protein production in tendon tissue by increasing mTOR expression and possibly reduces apoptotic cells and the formation of new cells in the tendon, all of which indicate It has a positive effect on this tissue. Testosterone in combination with the resistance training process is also more effective in activating muscle hypertrophy pathways in the short term. It seems that the interaction effect of testosterone with resistance training can have a more favorable effect than either alone on improving the expression of mTOR gene in rat tendon tissue.

COVID-19 is a viral respiratory disease caused by SARS-COV-2, which affects the lower respiratory tract, and causes pneumonia in patients. The disease rapidly spread around the world after the outbreak in late 2019, and became one of the challenges of health care systems. Older adults and patients with underlying diseases such as cardiovascular diseases, hypertension, and diabetes are at a higher risk for COVID-19, and need more care. Due to its prevalence in older adults and normal population, diabetes is important in terms of putting a burden on intensive care systems during the COVID-19 pandemic. Diabetes is also one of the most common comorbidities in patients with COVID-19, which is considered a risk factor for these patients. In addition, the association between diabetes and respiratory distress syndrome is not yet fully understood. Some studies have suggested that diabetes is not associated with respiratory distress syndrome while some others suggest that pulmonary dysfunction follows diabetes. It is also unclear what factors are associated with disease prognosis and mortality in COVID-19 patients with diabetes. In the current study, we aimed to investigate the status of demographic factors, comorbidities, lifestyle and laboratory results in diabetic patients with COVID-19, and compare them with the non-diabetic population and determine the prognostic factors in diabetic patients with COVID-19.

This study is a cross-sectional study performed on 415 patients with COVID-19 in the COVID-19 ward of Shahid Mohammadi Hospital of Hormozgan University of Medical Sciences from February to September 2020. Based on their diabetes, these patients were divided into diabetic and non-diabetic groups. Then, data on demographic factors, smoking, opioids and alcohol consumption, comorbidities (chronic lung disease, asthma, obesity, chronic kidney disease, type 2 diabetes, dementia, malnutrition, chronic neurological disease, rheumatic disease, hypertension, hyperthyroidism, hypothyroidism, favism, hyperlipidemia, and malignant neoplasms), some personal lifestyle features were determined in diabetic patients and compared with non-diabetic populations. Also, the information on biochemical variables, including hemoglobin, white blood cells, lymphocyte, neutrophils, hematocrit, platelets, prothrombin time, alanine aminotransferase, bilirubin, aspartate transaminase, lactate dehydrogenase, blood urea nitrogen, creatinine, blood glucose, sodium, potassium, C reactive protein were measured patients of the two groups. Also, heart rate, respiratory rate, systolic blood pressure, diastolic blood pressure, temperature, and oxygen saturation were determined in diabetic and non-diabetic patients.Quantitative variables were described by number (n) and percentage (٪). Qualitative variables were described using mean and standard deviation (SD), median and interquartile range (IQR). The Shapiro-Wilk test was used to assess the normality of quantitative variables. Independent t-test or Man-Whitney U test, and Chi-square or Fisher's exact tests were used to compare variables. In all statistical analyses, a p-value less than 0.05 was considered statistically significant. Statistical analysis was performed by IBM SPSS version 22 (IBM Corporation, Armonk, NY, USA).

The findings of our study showed that in the diabetic patients’ group 82 patients (41.2%) and in the non-diabetic population 135 patients (55.32 %) were men. In the diabetic group, the mean age of recovered patients was 58.52 years and the mean age of those in the deceased was 57.73 years, which was not statistically significant. In the non-diabetic group, the mean age of patients recovered was 47.98 years and the mean age of those in the deceased was 62.58 years, which was statistically significant (p <0.001). In the diabetic population, 773 patients (42.69 %) and in the non-diabetic population, 132 patients (54.09 %) had positive PCR. In the diabetic population, 18 patients (10.59 %) and in the non-diabetic population, 10 patients (4.09 %) had chronic kidney disease. In the diabetic population, 11 patients (6.43 %) and in the non-diabetic population, 13 patients (5.32 %) smoked. In the population of diabetic patients, the mean level of hemoglobin (P = 0.002) and lymphocyte count (P = 0.043) in the living cases were significantly lower than those in the deceased. The mean levels of neutrophils (P = 0.012), aspartate transaminase (P = 0.020), lactate dehydrogenase (P = 0.041), blood urea nitrogen (P = 0.003), and creatinine (P = 0.011) in the diabetic population were significantly higher in the living cases than those in the deceased, but the comparison of these cases in the non-diabetic population did not show a significant difference.In diabetic patients, there was a significant difference between the number of survival and death in each group of positive and negative PCR (P = 0.011); While the difference in mortality and survival between PCR positive and negative groups in non-diabetic subjects was not significant. In diabetic patients, a significant difference was also reported between the number of survival and death in groups with CKD and without CKD; while in non-diabetic participants there was no significant difference between CKD and non-CKD groups in terms of survival and death. Corticosteroid treatment also significantly led to a difference in the number of survival and death cases among the diabetic population, but a comparison of these cases in the non-diabetic population did not show a significant difference.In the group of diabetic patients, respiration rate (number of breaths per minute) was significantly lower among the living cases compared to those in the deceased (P < 0.05), while our findings in this regard did not show a significant difference in non-diabetic individuals. Also, in diabetic patients, the amount of oxygen saturation was significantly higher among the living cases than those in the deceased (P < 0.05), in which case the same results were observed in non-diabetic patients (P < 0.05).

In this study, the mortality rate in diabetic patients was significantly associated with lymphopenia, elevated aspartate transaminase, lactate dehydrogenase, blood urea nitrogen, and creatinine compared to non-diabetic patients.  Our findings suggest that individuals with type 2 diabetes are more prone to complications of COVID-19 and its related mortality; therefore these patients need more medical attention in the COVID-19 pandemic. Also, considering that so far limited studies have focused on the possible differences in the complications of Covid-19 disease and its mortality in diabetic individuals compared to non-diabetic individuals, it is recommended that more studies with higher sample sizes in other populations be performed to confirm the results of the present study.