مجله علوم پزشکی رازی
سال بیست و نهم شماره 9 (پیاپی 223، آذر 1401)

Performing physical activity and having a healthy body is one of the most essential life needs of people with fatty liver. In recent years, studies have been performed on the relationship between fatty liver and arthrosclerosis. The results of these studies indicate the relationship between the Non-alcoholic fatty liver and arthrosclerosis of coronary artery disease. Non-alcoholic fatty liver disease is associated with a sedentary lifestyle and poor eating habits around the world Fatty liver is associated with an increased risk of cardiovascular disease and the formation of atherosclerotic plaques in the carotid arteries and coronary artery stenosis can affect extracellular matrix factors such as CTGF and RXFP1, which play a role in the formation or non-formation of fibrosis. Studies have shown that fatty liver disease can be effective in causing atherosclerotic changes in arteries and increasing the thickness of the carotid artery as an indicator of atherosclerosis, which can be seen even in mild degrees of fatty liver. Relaxin in all parts of the body can have different expressions of RXFP1 receptor in different arteries, so in rats this receptor is strongly expressed in aortic endothelial cells and RXFP1 activates cAMP, cGMP and cAMP signaling pathways in ERK1 / 2 endothelial cells On the other hand CTGF is mainly synthesized by liver cells in the liver and is strongly induced in liver fibrosis CTGF is induced by fibroblast TGF-β cells and mediates the growth and secretion of extracellular matrix. These results indicate that CTGF is the mediator of many TGF-β-probiotic activities Therefore, the aim is to investigate the effect of this disease on two extracellular matrix genes of the heart.

In this experimental study, 24 male Wistar rats weighing 200-250 g were randomly divided into 3 groups: control, healthy and fatty liver steatosis. The control group was initially performed in the victim and tissue study And the two healthy and fatty liver groups spent two weeks in the same condition There was a healthy group from the beginning to the end of the study and they did not receive any intervention. Mice in the fatty liver group received oral tetracycline at a dose of 100 mg / kg at a dose of 1.5 ccs per mouse for two weeks. The average weight of the mice was 300 g, of which 100 mg / kg was used for 3 mice, of which 100 mg was dissolved in 4.5 cc and each rat was gavaged 1.5 cc. Fatty liver was modified by measuring liver enzymes (SGPT) and a number of biochemical variables. At the end of the second week, rats two groups were healthy and fatty liver48 hours after the last day (10 to 12 hours of fasting), the studied rats in each group were anesthetized by intraperitoneal injection of a mixture of 10% ketamine at a dose of 50 mg/kg and 2% xylosin at a dose of 10 mg/kg. became were sacrificed and heart tissue sample were taken to test for RXFP1 and CTGF gene expression. In each group, tissue analysis was performed by Real Time PCR technique. First, primer design was performed and then total RNA was extracted from tissues and converted to cDNA. Then cDNA was Replicated by PCR and examined for the expression of the mentioned genes.

After the second week and examining expression level of RXFP1 and CTGF genes between control, healthy and fatty liver groups, ANOVA test results showed that the expression level ofRXFP1 and CTGF genes (p = 0.0001 and p = 0.0001, respectively) In the fatty liver group, significantly increased compared to the healthy and control groups Considering the value of P<0.05, the null hypothesis that there is no significant difference between the level of RXFP1 in different research groups was rejected with 95% confidence. The results between the steatosis group and the other two groups were significant in increasing the level of RXFP1 gene expression. Therefore, it can be said that in the presence of fatty liver, the expression of RXFP1 gene increases in the heart tissue of male rats in order to inhibit fibrosis. Also, in terms of significance, the results between the steatosis group and the other two groups were significant in increasing the level of CTGF gene expression. Therefore, it can be said that in the presence of fatty liver in the steatosis model, the CTGF gene expression increases in line with the increase in cardiac fibrosis.Overall, our results showed that with the onset of fatty liver disease, both connective tissue growth factors and relaxin increased in the heart, and an increase in connective tissue growth factor indicates cardiac tissue damage, which can lead to heart tissue fibrosis. Therefore, these findings can help new therapies aimed at modulating the effects of CTGF and the use of RXFP1 as a new direction for further clinical studies. Our other findings showed that with induction of fatty liver, the level of RXFP1 in heart tissue increased from the beginning and did not change until the end of the two weeks. The expression level of RXFP1 gene in steatosis fatty liver groups (BS, CS) was significantly higher than the other 2 groups on the other hand the increase in connective tissue growth factor (CTGF) in this study was probably to produce extracellular matrix and compensate for their degradation, and the increase in RXFP1 was to prevent collagen deposition in ECM connective tissue growth factor (CTGF) in cardiac tissue increased sharply, such that its rate increased up to 7 times in the first two weeks compared to the control group, and this increase continued until the end of the two weeks, that increased 10 times However, this method should be considered with more caution because high expression of CTGF increases the level of fibronectin, collagen I and III proteins in the extracellular matrix, followed by myocardial infarction

The fatty liver model of steatosis increases the expression of cardiac CTGF gene and fibrosis, and also increases the RXFP1 gene, which has anti-fibrosis activity. CTGF (CCN2) in response to tissue damage initiates signaling pathways of connective tissue regeneration Therefore, and cardiac tissue fibrosis. RXFP1, which is a component of the extracellular matrix and is most commonly expressed in aortic endothelial cells exerts most of its physiological effect on the cardiovascular system through NO (Nitric oxide).

Self-concept is one of the most important factors for success in people's lives. If a person knows his abilities and talents and has a positive perception of his abilities and believes that he can achieve something with it, he has talent. This increases efficiency and effectiveness and achieves goals. The value of a person is the most definite factor in the process of mental development. If a person feels positive about himself, he is healthier and perceives life more positively as natural. Self-concept includes the real and ideal self. Research has shown that his weakness. Conception can play an important role in the development of emotional and psychological disorders. Emotional and behavioral disorders of children are closely related to psychological problems of parents, especially mothers. No matter how severe their mental problems are, the incidence of this type of disorders in their children increases or low mental health of mothers and their stress, anxiety and depression is a family factor. It affects the incidence of emotional and behavioral disorders in children. In fact, certain characteristics of family relationships, especially parental deviations and inconsistencies, strict and unpredictable disciplinary methods, and lack of emotional support from parents can increase the risk of children with these disorders.. In a study in 230 people in Tehran as a sample, it was found that there is a significant negative correlation between conduct disorder and self-concept. Self-concept as a human personality trait is a unique quality. According to Aristotle and Plato, thinkers and philosophers of other ages have commented on the idea of self. Self-concept is instructive, and it is of great importance to both the individual and those who are involved in his upbringing in childhood, and no One is not born with a self-concept, but a self-concept is gradually emerging and at the same time has a dynamic, structured process. Happiness increases with age, education, artistic activity, sports, religion, physical and mental health, and social, family, optimism about the future, and attitudes toward happiness. A study conducted on self-concept and family communication model showed that these two have a significant relationship with each other and self-concept is based on family communication model, dialogue and harmony in high school students. The child's self-concept has a great impact. In such families, approval, love, caressing, encouragement, trust, and a sense of security are seen, and children receive less social problems due to receiving love, security from their parents, and more empowerment, and this process creates a positive self-concept in the child. Becomes. Findings showed that there is a relationship between parents' relationship with children and emotional-behavioral problems and there is a relationship between self-concept and family communication pattern. The present study also seeks to answer these questions: Does family performance have a significant relationship with behavioral disorders? Do behavioral disorders have a significant relationship with self-concept in adolescents? The aim of this study was to predict and evaluate family through self-concept on behavioral disorders of adolescent girls and boys aged 12 to 15 years in Tehran.

The research was a descriptive survey. The sampling method was cluster sampling and available. The statistical population of the study included all adolescent girls and boys aged 12 to 15 years in Tehran who were studying in the first year of high school. The questionnaire was completed by 629 people (309 boys and 320 girls) online. The research tools are: family assessment questionnaires, behavioral disorders, self-concept. In order to analyze the data, Pearson correlation coefficient was used. Structural equation modeling of relationships between variables was analyzed using spss.26 and Amos.24 software.

The indirect effect of family assessment by self-concept, empathy and happiness on behavioral disorders was 0.08 and the total effect was 0.15. Among the dimensions of family functioning, there was no significant relationship between roles with attention problems, social aggression and anxiety-isolation (P <0.05). There was no significant relationship between emotional association with attention problems and social aggression (P < 0.05). However, positive and significant relationships were seen between other variables (P < 0.05) and the indirect effect of family functioning on behavioral disorders with mediating the role of self-concept is also significant (P < 0.05, IE = 0.03). Family performance can reduce behavioral disorders by increasing self-concept.

Based on the results of the study, family performance has a direct and significant effect on adolescent behavioral disorders. Because higher scores on family functioning mean a more unfavorable situation, behavioral disorders in adolescents appear to decrease as family performance improves, and vice versa. The indirect effect of family functioning on behavioral disorders is significant and family functioning can reduce behavioral disorders by increasing self-concept.

All human beings have a basic need for intimate relationships. To achieve this need and develop intimacy, marriage provides a unique and appropriate opportunity for human beings. One of the important aspects in marriage is marital satisfaction and marital compatibility. Marital adaptability is a process that occurs throughout life and refers to the characteristics of a harmonious marital relationship and having a good performance in marriage. The other important aspect is happiness. Happiness is an emotion that everyone wants and strives to achieve. The level of marital happiness implicitly indicates low levels of conflict and has positive effect on behavioral (such as adjustment) and communication (such as a desire to remarry your current spouse if possible to return to the early days) features. While marital relationship can be a source of many pleasurable experiences, it can also bring the most painful consequences. Researches has shown that two of the variables with which couples can have negative conflicts are marital adaptability and happiness. The aim of this study was to determine the effectiveness of Emotionally-focused couple therapy training on marital adaptability and couple happiness. This research was a quasi-experimental study with pretest-posttest method with control and experimental groups.

The sample size consisted of 60 people (30 couples) who were selected by available sampling method from counseling centers in Ahvaz in the year 1400 and were assigned to two experimental and control groups by simple random sampling. The statistical criterion for entering the subjects of this study were couples who had a kind of marital adaptability problems and lack of happiness in their lives. First, the couples answered the Oxford Happiness Questionnaire developed by Michael Argyle and Peter Hills and the Dyadic Adjustment Scale (DAS) 1976 by Graham B. Spanier, then the experimental group was trained in an approach-based emotion management (EFT) strategy for 8 sessions. At the end of 8 sessions of therapeutic intervention, post-test was performed and the necessary results were collected using SPSS 24 and processed. Then, in order to observe justice in the research, the control group underwent 8 sessions of treatment as the experimental group.

Based on the comparison of pre-test and post-test between the two groups, the results showed that teaching emotion management strategies based on Emotionally-focused couple therapy (EFT) approach has a significant effect (p≤0.05) on increasing marital adaptability and couple happiness. Levene homogeneity test, Regression slope test (T), Kolmogorov-Smirnov and Shapiro-Wilk test, Multivariate analysis of covariance (MANCOVA) and ANKOA confirmed the validity and reliability of the data and analysis.

The main purpose of this study was to evaluate the effectiveness of Emotionally-focused couple therapy on marital adaptability and happiness of couples. The results showed that Emotionally-focused training is effective in increasing marital adaptability of couples. These results are consistent with the results of studies by Soltani et al. (2012), Zia-ul-Haq et al. (2012), Najafi et al. (2014) and Ramezanzadeh et al. (2010). One of the reasons that Emotionally-focused couple therapy is effective on couple's marital adaptability is that compared to other therapies, in Emotionally-focused couple therapy, targeting both couples simultaneously in psychological intervention can be very useful. Emotionally-focused couple therapy will improve couples interactions by solving their emotional problems, identifying unexpressed and repressed emotions, and identifying their spouse's emotional and emotional needs, thus increasing the couple's expression of love and marital adaptability. Emotional couple therapy, based on the correct and appropriate release of emotions, stabilizing the couple's attachment style and reducing the couple's emotional, feelings and anxiety problems, and also increases their physical health. In Emotionally-focused couple therapy, people learn to understand their spouse's feelings and emotions, to talk about their own positive and negative feelings and emotions, and to be a good listener to their spouse. Correcting these seemingly simple things is a very important step in the mutual understanding of couples and improving the marital compatibility of couples. In the family, marital relationship can be a source of joy or a great source of suffering. Hence, one of the components of the quality of marital relations is marital happiness, which shows the general level of happiness of the individual from different dimensions of the marital relationship. The level of marital happiness implicitly indicates low levels of conflict and has behavioral (such as adaptability) and communication characteristics (such as the desire to remarry the current spouse if possible and return to the early days). Happiness is contagious, meaning that one person's happiness can bring happiness to others. Another is that it expands one's dependence on the environment and makes life more enjoyable. There is evidence to support this view, showing that people are happier in a successful marriage. A marriage in which people speak respectfully and frankly, in a safe environment expressing their emotions and forgiving each other's mistakes is usually accompanied by higher levels of satisfaction. So, this communication is more likely to lead to happiness. Therefore, recognizing and managing emotions can be effective in increasing the happiness of the experimental group after the test. Emotionally-focused couple therapy approach can change the couple's attachment styles and also change the cycle of defective marital interactions and create a safe communication environment, emotion planning and control the couple's behavior and increase marital satisfaction and consequently happiness. Also, negative emotions lead to a decrease in spouse's satisfaction with each other and positive emotions will increase spouse's satisfaction and peace with trust and ultimately cause their happiness. Based on the results of the present study, Emotionally-focused couple therapy can improve couple's adaptability and increase happiness in their lives. Therefore, this type of intervention is recommended to increase adaptation and happiness in couples.

Bacillus cereus is a Gram-positive, rod-shaped, facultative anaerobic, motile, beta-hemolytic, spore forming bacterium commonly The bacteria is commonly found in the environment, is often found in soil and vegetation, and can be present in foods. It can cause foodborne illness worldwide. B. cereus illness is related to many foods - beef, turkey, rice, beans, and vegetables. Specifically, the diarrheal illness is often related to meats, milk, vegetables, and fish. This product may be contaminated with many bacterial pathogens, including Bacillus cereus (4). There are several ways to store vegetables; one way is drying, which is important for several reasons: long-term storage, reducing the volume for the storage, and move products more easily and faster The emetic-type illness is most often associated with rice products, but it has also been associated with other types of starchy products such as potato, pasta, and cheese products (5). Some food-mixtures (sauces, puddings, soups, casseroles, pastries, and salads, have been associated with food-borne illness in general. There are two types of food-borne B. cereus illness. In the first, contaminated food (many types of food, often left at room temperature) makes its way to the small intestine where the toxin, in this case, a large-molecular-weight protein, is released. This can lead to diarrhea, cramps, and sometimes nausea. Usually, vomiting is not present in this form of illness (6, 7). Incubation for the first type is 6 to 15 hours. In the second type, affected food, most often starchy food, and classically, rice, contains a different type of toxin (cereulide, an ionophoric low-molecular-weight dodecadepsipeptide that is pH-stable and heat and protease-resistant). This toxin causes emetic-type B. cereus illness. The incubation period for this type is 30 minutes to 6 hours (9). Bacillus cereus is caused by the ingestion of food contaminated with either the enterotoxigenic B. cereus or with the emetic toxin. In non-gastrointestinal illness, reports of respiratory infections similar to respiratory anthrax have been attributed to B. cereus strains harboring B. anthracis toxin genes (10). The spore of this bacterium is resistant to severe environmental conditions including heat, freezing, drying, and radiation, and may be considered an infectious agent for this bacterium. Changes in diet and lifestyle in recent years and the growing trend of using ready-made products (4). In the gastrointestinal tract (small intestine), vegetative cells, ingested as viable cells or spores, produce and secrete a protein enterotoxin and induce a diarrheal syndrome, whereas emetic toxin, a plasmid-encoded cyclic peptide (cereulide), is produced in food products and ingested as a formed toxin. Dry vegetables it is suitable for the survival quickly multiply at room temperature (12). There are two main types of intestinal illnesses caused by B. cereus. One is diarrheal, and one leads more to nausea/vomiting. B. cereus has also been implicated in infections of the eye, respiratory tract, and in wounds. The pathogenicity of B. cereus, whether intestinal or nonintestinal, is intimately associated with the production of tissue-destructive exoenzymes. Among these secreted toxins are four hemolysins, three distinct phospholipases, an emesis-inducing toxin, and proteases. The specific name, cereus, meaning "waxy" in Latin, refers to the appearance of colonies grown on blood agar.Bacillus cereus is one of the most important causes of spore-bearing bacteria such as Bacillus (5, 7, 11). The aim of this study was to isolate and identify Bacillus cereus in bulk and packaged dried vegetables by culture and PCR.

This is a cross-sectional descriptive study from February 2019 to October 2020. In total 160 samples (80 from each of open and packed dried vegetables) were evaluated for the contamination of Bacillus cereus. 25 g of the sample was poured into 225 ml of peptone water and incubated at 37 ° C for 24 hours and then one ml of 0.1 dilutions of the suspension was inoculated into on the specific medium of Bacillus cereus (Scharlau, Spain). (MYP Agar) Mannitol Egg Yolk Polymyxin Agar. For the total count, 10 g of each dried vegetable was added into 90 ml of 0.1% peptone water and then 1 ml of dilutions (10-1, 10-2, 10-3), were inoculated into MYP Agar medium and incubated at 37 ° C for 24 hours.Large pink colonies (no fermentation of mannitol) with a precipitated halo (due to lecithinase production) were considered suspicious colonies. The identification was carried out by catalase and biochemical tests. anaerobic conditions, growth at 45 ° C, lestinase C test, hemolysis B in blood agar with 5% sheep blood, MR-VP test, penicillin sensitivity 10 IU test,and nitrate reduction(13). For molecular analysis, the polymerase chain reaction for the internal transcribed spacer (ITS) gene was used to confirm Bacillus cereus. In order to extract DNA from a pure colony of bacteria, it was cultured in an LB medium and after incubation, the resulting culture was precipitated and the genome was extracted using phenol-chloroform. The quality and quantity of DNA extracted were evaluated by spectrophotometry and electrophoresis. The extracted DNA was frozen at -20 ° C for later use (14). The PCR program consisted of an initial temperature of 94 ° C for 5 min, then 35 cycles consisting of 94 ° C for 30 s, 52 ° for 30 s, and 72 ° for 30 s. PCR reaction was performed in Thermal Cycler (Primus 96, Peqlab Biotechnologie GmbH, Erlangen, Germany). The standard strain of 11778 Bacillus cereus was used as a positive control. The PCR product was electrophoresed in 1% agarose gel at a voltage of 100-80 volts and after staining with ethidium bromide 1 mg/ml was observed and photographed by a gel dock device. Initially, the PCR gradient for the gene was placed in the annealing temperature range of 50 to 60 degrees, which was finally selected at an optimum temperature of 52 degrees (15). Using SPS software, data were analyzed by chi-square test. p<0.05 was considered significant.

The B. cereus contamination were found in 21 (26.25%) and 13 (16.25%) of open and packed dried vegetable samples respectively. There was no statistically significant difference (p>0.05) between contamination rate of B. cereus in open and packed dried vegetable samples. Also, contamination rate of B. cereus was not significantly different (p>0.05) among various kinds of vegetable samples. The results of this study showed that 34 (21.25%) out of 160 samples of dried vegetables were infected with Bacillus cereus by the phenotypic method. PCR results of the ITS gene showed that all 34 strains isolated by culture were also identified by molecular method. In total 7 (4.37%) dill, 5 (3.12%) tarragon, 5 (3.12%) parsley, 5 (3.12%) mint, 6 (3.75%) soup, 4 (2.5%) coriander and 2 (1.25%) turmeric were identified as Bacillus cereus respectively.

Our study showed that despite the supply of packaged dried vegetables, there is still the possibility of microbial contamination, especially by anaerobic bacteria. Although the rate of contamination of dried vegetables in open packaged (13.2%) was more than dried packaged (12.8%).This percentage of contamination probably indicates a lack of hygiene in the drying process in both traditional and industrial forms.

Non-Alcoholic Fatty Liver Disease (NAFLD) is one of the main causes of abnormal liver function, and the prevalence of this disease is reported to be around 20% in the world (1). NAFLD is often associated with obesity, dyslipidemia, and insulin resistance in metabolic syndrome (2). NAFLD includes the accumulation of triglycerides, necrosis, and apoptosis in fat cells, which are associated with inflammatory responses in the liver. In total, these cases increase the possibility of liver cirrhosis (4). The large family of transforming growth factor beta (TGF-β) together with TGF-β1 and activin-A is a part of bone morphogenic proteins and is considered a multipurpose cytokine in a wide range of tissues and cells. These factors play a role in cell differentiation, cell number homeostasis and tissue repair, inflammation, cell proliferation, and apoptosis (5). Activin-A increases the expression of collagen and TGF-β1. It causes mitochondrial β-oxidation and downregulation of fatty acid synthase activity. In addition, activin-A inhibits proliferation and stimulates apoptosis of liver cells, which helps complete liver regeneration; Hepatocyte proliferation and liver regeneration are controlled by activin-A (7). Today, for the management of NAFLD, lifestyle modification techniques through changes in diet and physical activity are considered. Physical activity, including aerobic, resistance, and interval, reduces NAFLD disease by regulating intrahepatic fat status, reducing oxidative stress and inflammation, apoptosis, and autophagy process (8).There are various medicinal agents for the treatment of various diseases. The combination of using herbal medicines and engaging in physical activity has attracted the attention of researchers. Among these substances is resveratrol, which is found in purple and red plants, especially in the skin of red grapes and the berry family (9). Resveratrol has antioxidant, anti-cancer, and anti-inflammatory uses, and was first extracted from an Asian plant called Polygonum capsidatum (10). Resveratrol has inherent protective properties to prevent the spread of disease. Its anti-inflammatory effect has been determined by reducing pro-inflammatory cytokines and preventing the production of nitric oxide in macrophages. Reservatol also regulates lipid metabolism and prevents lipid oxidation and platelet aggregation (11).

In this experimental study, 56 old male Wistar rats with an age of 40-50 weeks and an average weight of 250-300 grams were selected. At first, the rats were divided into two groups: control and NAFLD patients. The rats in the control group were fed a standard diet (including 12% fat, 57% carbohydrates, 28% protein, and 3% other items) for 6 weeks. To induce NAFLD, rats in the experimental group were subjected to a high-fat diet (including 22% fat, 50% carbohydrate, 24% protein, and 4% other items) for 6 weeks. Then, the rats of the patient group with NAFLD were divided into 7 groups, and each group included 7 rats. Seven groups include (1) patient group, (2) group receiving saline, (3) group receiving resveratrol supplement, (4) continuous training group, (5) intermittent training group, (6) continuous training-resveratrol group, and (7) intermittent training-resveratrol group. The rats in the training group and the supplement+training group were familiarized with the treadmill for 5 minutes at a speed of 8-10 m/min with zero inclines for one week during 5 sessions. The main continuous training program was carried out for 8 weeks and 5 sessions per week, in the first week, the speed was 15 meters per minute and the time was 5 minutes. Every week, the speed increased by 1-2 meters per minute and the time increased by 1-2 minutes. In the eighth week, the speed reached 20 meters per minute and the time was 60 minutes (12). The interval training program started in the first week with a speed of 10 meters per minute and a time of 10-15 minutes with a zero-degree slope. In the following weeks, training consisted of 10 minutes daily (2:30 x 4) at a speed of 50 m/min and a 10-degree incline with periods of 2:30 minutes (more than 90% of maximal oxygen consumption), separated by 3-minute rest periods. The number of sessions was 5 sessions per week (13). In the supplement and supplement+training groups, they were injected intraperitoneally with a dose of 20 mg per kilogram of body weight. After completing the research period, all rats were anesthetized by intraperitoneal injection of ketamine and xylazine 48 hours after the last training session. Liver samples were kept at -80 C. Serum activin-A and TGF-β levels were measured using a kit and ELISA method. The Shapiro-Wilk test was used to determine the normality of data distribution. If the data were normal, one-way variance analysis and Tukey's post hoc statistical tests were used. The significance level for all calculations was considered p≥0.05. All statistical operations were performed using SPSS version 20 software.

Data analysis shows that there is a significant difference in the mean and standard deviation of TGF-β and activin-A serum levels between different groups (P=0.0001). It was also observed that aerobic training and red grape extract (resveratrol) have a significant effect on the serum levels of TGF-β and activin-A in elderly rats with NAFLD in different groups (P=0.0001).

The findings of the present research showed that the lowest serum levels of activin-A were observed in the resveratrol+continuous training group and the highest levels were observed in the patient and saline groups. Fatty liver increased activin-A levels in the patient group, and aerobic training and red grape extract (resveratrol) significantly decreased serum activin-A levels in elderly rats with NAFLD in the resveratrol+continuous training group; Of course, in the supplement group, continuous training and interval training+resveratrol also had a decreasing trend, but it did not reach a significant level. NAFLD appears to result from an imbalance between hepatic fatty acid synthesis and oxidation (5). Our findings suggest that NAFLD should be added to the list of liver disorders that could be activin-A-mediated mechanisms. Previously, activin-A was reported to inhibit liver growth by inhibiting hepatic proliferation and inducing apoptosis, as well as by inducing extracellular matrix production during liver fibrosis (14). The results of the present study showed that the levels of TGF-β increased in the high-fat food consumption group; while training and resveratrol supplementation decreased the level of TGF-β in the experimental groups. Studies have shown that the TGF-β1/Smad signaling pathway may play an important role in activating HSCs and regulating the production, degradation, and accumulation of ECM proteins (19). Therefore, inhibiting the TGF-β/Smad signaling pathway can be an attractive therapeutic target for the prevention of liver fibrosis (20).Finally, the findings of the current research showed that the serum levels of TGF-β and activin-A increased in rats with NFALD. The reason for the increased levels of cytokines may be related to the cirrhosis process itself. In previous research, it has been shown that poor liver function leads to cirrhosis secondarily and disrupts the metabolism of TGF-β and causes the accumulation of this multifunctional cytokine in the body.

Recent findings suggest that type 2 diabetes is associated with abnormal production of adipokines (2). Impaired circulating levels of adipokines are associated with multiple cardiovascular complications in diabetes (3). Lipocalin-2 is one of the adipokines that increases in diabetic patients and its secretion is associated with insulin resistance and hyperglycemia in these patients (4). also, Omentin-1 concentrations have been reported to decrease in patients with type 2 diabetes (11).Many efforts are being made to develop a drug that improves metabolism and prevents the complications of diabetes. Canagliflozin is an SGLT2 inhibitor drug that acts by inhibiting glucose reabsorption by the body, lowers plasma glucose levels, and improves insulin resistance (13). Prescribing this drug to type 2 diabetes can help improve blood glucose control and reduce body weight in these patients (14, 15).On the other hand, exercise has been used as an adjunct in drug therapy in the management of diabetes complications. Resistance training has been reported to be associated with significant increase in lipocalin-2 concentration in men with type 2 diabetes (16). However, the results of Hosseini et al showed that eight weeks of combined training did not have significant effect on lipocalin 2 in diabetic women (18). Also, significant increase (19) and no change (20, 21) of omentin-1 has been reported in patients with type 2 diabetes after exercise.Since no research has been done on the effect of combined exercise with medication on adipokines in type 2 diabetics, Therefore, the aim of this study was to investigate the effect of combined training with Canagliflozin on lipocalin-2 and omentin-1 in type 2 diabetic men.

This is a semi-experimental study. The statistical population of this study consisted of all patients with type 2 diabetes in the Tehran city in 2019. 44 men with type 2 diabetes (mean age 25-40 years) were randomly divided into four groups (n=11) of control, drug, exercise and exercise-drug groups. Subjects were given 200 mg of canagliflozin for 12 weeks (25). Combined exercises were performed 3 sessions per week, 45 minutes for 12 weeks (26). Blood samples and anthropometric characteristics were obtained before and 24 hours after the intervention at 12-hour fasting. Data were analyzed using two-way ANOVA with repeated measures, t-test and Tukey post hoc test at P<0.05.
 

The results showed that combined training and combined training with canagliflozin significantly reduced lipocalin-2 and significantly increased omentin-1 in type 2 diabetic men (P=0.001). Also, after the combined training intervention, canagliflozin and combined training with canagliflozin, the levels of lipocalin-2 and omentin-1 were lower and higher than the pretest, respectively (P=0.001).

The findings of the present study show that combined training and combined training with canagliflozin significantly reduced lipocalin-2 and significantly increased omentin-1 in type 2 diabetic men. The findings of this study were consistent with the results of Previous research (19, 26-28, 33). Various studies have examined the mechanisms of change in lipocalin-2 induced by exercise. Perhaps one of the reasons for the decrease in lipocalin-2 levels in the present study is the intensity of exercise. also, exercise has been reported to reduce the activity of the NF-κB and inflammatory markers such as TNF-α, IFN-γ, and interleukin-1 beta, which activate lipokalin-2 expression (31), therefore It is possible that combined training in this study reduced lipocalin-2 by reducing the above factors. Some studies have reported that the reduction of lipocalin-2 is highly correlated with the reduction of adipose tissue, so that with the reduction of adipose tissue after exercise, the amount of lipocalin-2 decreases (28). also, Omentin-1 changes are largely a function of changes in body composition, including weight loss, fat mass, and body mass index and adipocyte size (35). In addition, in a study, changes in inflammatory levels have been reported to be an influential factor in regulating the expression of omentin-1 (36). Therefore, it is possible that in the present study, combined training increased the amount of omentin-1 in patients with type 2 diabetes by improving the composition of the body and inflammatory agents. The pharmacological effects of canagliflozin in the produced doses cause a significant increase in urinary glucose excretion and a decrease in hyperglycemia. Therefore, in explanation the results obtained in the present study, it can be said that canagliflozin with exercise, by lowering fasting blood glucose and also increasing insulin, may significantly improve the levels of adipokines in type 2 diabetic men. combined training was the strengths of the present study; because this type of exercise can have different responses and adaptations than other exercise programs. There were some limitations in the present study, such as the lack of measurement of other adipokines. According to the results, it seems that diabetics can benefit from combined exercise with canagliflozin to improve adipokines levels.

Since ancient times, medicinal plants have been used to treat a wide range of diseases. In recent decades, despite the progress of chemical pharmacy, the use of medicinal plants is still considered. Different parts of the plant contain many compounds with different properties, and some plants have antidiabetic properties (1). Although reasons such as cheapness, fewer complications, and easier access are considered for using herbal drugs (1), this class of drugs is not completely safe (2). Moshgak with the scientific name Ducrosia anethifolia has beneficial properties, including antioxidant properties (10) and the ability to reduce the activity of enzymes interfering in the metabolism of carbohydrates, such as alpha glycosidase ( 11). Moshgak is native to Iran and is widespread in the southern regions of the country, including Fars province (12). This plant is used raw and cooked in the diet, especially in the southern regions of the country. In addition, many useful properties have been reported for it, which can be pain-relieving, antimicrobial (13), and antifungal (14). The effect of the leaf extract of this plant on the nervous system and its anti-depressant (15) as well as the enhancement of spatial memory and learning level in mice (16) has also been reported. The presence of flavonoid compounds, monoterpenes, and coumarins such as pangolin, myrcene, and limonene in it have given antioxidant properties to this plant (11). The many benefits reported for this plant, which fortunately has widespread in Iran, become an incentive for further research about its effect on living beings. Maybe by confirming its positive effects as a complementary medicine, it will be suggested to the pharmaceutical industry. Regarding the use of herbal remedies in the treatment of diabetes mellitus, this study aimed to investigate the effect of an aqueous-alcoholic extract of Ducrosia anethifolia on the brain protection of diabetic rat embryos.

In this study, 48 rats after fertilizing were made diabetic with a single dose of 80 mg streptozotocin. To prepare the aqueous-alcoholic extract of mashgak leaves, 40 g of dried powder of the moshgak’s leaf was poured into a flask, 400 ml of ethanol was added to it, and it was mixed with a shaker at 250 rpm for 48 hours. Then it was filtered and concentrated in a rotary (17). To determine the appropriate dose of treatment, the lethal dose was estimated. Then the dose of 500 and 1000 mg/kg/bw of mashgak extract was determined as the minimum and maximum dose, respectively. The rats were diabetic by intraperitoneal injection of a single dose (80 mg) of streptozotocin in citrate buffer and pH = 4.5 kg/bw of rat on the first day of pregnancy. The rats with fasting glucose of more than 130 mg/dL were considered diabetic rats. Rats were divided randomly into 6 groups: control group (healthy rats without any treatment), Sham group1 (healthy rats which receiving meshgak extract), Sham group 2 (diabetic rats without treatment), Sham group 3 (diabetic receiving 5 mg/kg/bw of glibenclamide), treatment groups 1, 2 (diabetic rats receiving 1 ml meshgak extract at doses 500 and 1000 mg/kg/bw respectively). Treatment was done from the 6th to the 20th day of gestation, and blood sampling was done at the end of treatment. 2 cc of blood was taken from the heart of the rats, and centrifuged at 3000 rpm for 10 minutes. The separated serum was analyzed to determine the level of glucose, insulin and malondialdehyde enzyme by enzymatic method and using specific kits in the lab. Then the embryos were dissected, and their brains were removed and fixed in formalin 4%. After tissue passage in the automatic Tissue Processor (model 2000 DS) according to the standard method, sections (5μm) were prepared and their slides were stained with hematoxylin-eosin. About 30 slides of 10 series of longitudinal, sagittal, and cross sections were examined by light microscope. The thickness of the brain layers was measured using the Image analysis software on the micrographs, and counting the cells in each layer using the disector technique and  Grids-stero lite software was determined (18). Obtained data were analyzed by SPSS software (15), and the groups were compared by Duncan test.

There was a significant (p < 0.05) increase in maternal blood glucose, malondialdehyde, and reduction of insulin in sham 2 compared to the control group, while it was compensated significantly in the treatment groups. Although these groups had significant differences from the control group (Fig 1-3). The thickness of the cerebral cortex, white matter, and especially gray matter in the diabetic group showed a significant decrease compared to the control group and sham 1, and it was significantly compensated in the treated group with Glibenclamide (sham 3) and Moshgak extract (Fig 4, 5). The observed changes in the different layers of the gray matter also follow the trend of decreasing the number of cells in the control group 2 (diabetic) and a significant increase in the number of cells in the same layers in the rats which received Glibenclamide (sham 3), and Moshgak extract (Fig 6-8). The results indicate a greater effect of the aqueous-alcoholic extract of Moshgak on the brain tissue compared to the antidiabetic drug Glibenclamide, although none of them were able to adjust the changes completely.

According to obtained results, the extract of Moshgak leaf can partially compensate for the adverse effects caused by diabetes on the brain tissue in the embryo. The decrease in blood glucose along with the increase in insulin as well as the decrease in malondialdehyde enzyme indicates the decrease in the complications of diabetes on the brain tissue of the fetus, which is obtained as a result of the consumption of Moshgak extract. The compensation of the tissue changes including the changes observed in the thickness of the cortical layers as well as the number of cells in each layer of the cortex also confirms the biochemical results. Therefore, it is possible to mention the Moshgak extract of marigold as a factor in improving the effects of maternal diabetes on the cortical tissue of the fetus. For a definitive statement regarding the anti-diabetic properties of this plant, it is suggested to conduct more studies on the effect of the compounds of this extract, especially on the beta cell line in the pancreas.

Diabetes is a metabolic disease characterized by chronic hyperglycemia and impaired metabolism of carbohydrates, lipids and proteins. This disease is caused by defects in insulin secretion, insulin function, or both (1, 2). This chronic disease can have serious short-term and long-term consequences that affect the health and quality of life (QOL) of patients (3). Type 2 diabetes accounts for approximately 90% of all cases of diabetes and is associated with a variety of immutable and modifiable risk factors (4). QOL refers to a person's individual perception of physical, emotional, and social status (5, 6). Patients with type 2 diabetes have a lot of stress to treat and their QOL is lower than healthy people (7, 8). Also, for chronic diabetics, complete cure cannot be achieved and clinical interventions can provide a good estimate of disease control, but the ultimate goal of diabetes care is to prevent the patient's QOL from worsening (3). It is important to understand the predictors and identify risk factors for QOL, and these factors may be targeted for prevention (5). Since the improvement of QOL is one of the important goals of treatment of diabetic patients (3, 10) and studies have shown that diabetes can have negative effects on physical function, development of complications, mental and psychological and personal, family and social relationships (15, 16); Therefore, understanding the factors related to QOL is of particular importance in the treatment programs of these patients (5). Cardiorespiratory endurance is one of the health-related physical fitness factors (2). Cardiorespiratory endurance is defined as the ability of the circulatory and respiratory systems to supply oxygen during physical activity and is usually defined as the maximum oxygen consumption (VO2max) during submaximal or maximal tests. The main determinants of VO2max are cardiovascular function, cardiac output, pulmonary diffusion capacity, oxygen carrying capacity, liver function, and other environmental constraints such as muscle diffusion capacity, mitochondrial enzymes, and capillary density, all of which are examples of determinants. Are VO2max (2, 21). VO2max is associated with functional capacity and human function and has been shown to be a strong and independent predictor of mortality from all specific causes and diseases (22). Physical activity and the resulting cardiorespiratory fitness are associated with several health benefits, including reduced risk of diabetes, cardiovascular complications, and mortality (23). In view of the above, cardiorespiratory fitness is a variable related to mortality prediction and as a health-related variable in diabetic patients (23); Therefore, cardiorespiratory fitness can be considered in determining the strategies of primary and secondary prevention programs of cardiovascular diseases in patients with type 2 diabetes; Considering the importance of factors related to the prediction and identification of risk factors for QOL (5); It is necessary to measure the relationship between cardiorespiratory fitness as a health-related physical fitness variable with QOL in patients with type 2 diabetes. In view of the above, the aim of this study was to investigate the relationship between QOL and cardiorespiratory endurance in patients with type 2 diabetes.

In this cross-sectional correlational study, 150 patients with type 2 diabetes mellitus were randomly selected from patients that had referred to health centers in Zabol city, which included 75 women and 75 men. QOL, demographic characteristics and history of diabetes in patients were measured using a questionnaire. Blood variables were measured on an empty stomach. Cardiorespiratory fitness was also measured using the Tecumseh step test. Pearson correlation coefficient was used for statistical analysis.

There was a positive and significant relationship between cardiorespiratory endurance and QOL in patients with type 2 diabetes. There was also a significant negative relationship between cardiorespiratory endurance with glycemic control, age and history of type 2 diabetes.

In the study of the relationship between cardiorespiratory endurance and QOL, the results showed that there was a positive and significant relationship between cardiorespiratory endurance and QOL in patients with type 2 diabetes. In a study of patients with type 2 diabetes, Leite et al. (2009) reported that a decrease in VO2max is associated with impaired insulin sensitivity, and that the most common abnormality in the population is at risk for insulin resistance and type 2 diabetes, and a decrease in VO2max is one. Is an important risk factor for disease progression (28). Low resting heart rate and VO2max are associated with a reduction in cardiovascular events (29). Cardiorespiratory disorders are more common in diabetic patients and may partly explain the morbidity and mortality in these patients. There are several potential causes for dysfunction in diabetics: hyperglycemia, insulin resistance, endothelial dysfunction, inflammation, microvascular dysfunction, myocardial dysfunction, and skeletal muscle changes. These changes are somewhat reversible, and improvement in each of these components may increase functional capacity in diabetic patients (30). Interventional studies indicate an increase in VO2max in adaptation to exercise in patients with type 2 diabetes (2, 31, 32). It can be said that with increasing cardio-respiratory endurance, the level of health increases and with increasing health, patient satisfaction with treatment and satisfaction with QOL improve (27). Also, The results of the present study showed that there was a significant negative relationship between aerobic fitness and HbA1c levels in patients with type 2 diabetes. Jekal et al. (2010) in a study that examined aerobic fitness and HbA1c levels, stated that people with higher cardiorespiratory fitness had better weight and lower HbA1c levels than people with lower endurance (25), which It was consistent with the results of the present study. Abushamat et al. (2020) also stated in their research that diabetes leads to decreased cardiorespiratory function, which is associated with poor glycemic control and its complications (35). Physical activity is effective in controlling blood glucose in diabetics; because it increases insulin sensitivity and glucose tolerance and decreases the level of hyperglycemia in these patients (36). Adaptations in insulin signaling as well as insulin receptors can lead to better blood glucose uptake by muscles. Increasing the number of GLUT4 carriers and increasing muscle mass, which plays a major role in blood glucose uptake, increases the body's response to insulin (38). The results of the present study also showed that there was a significant negative relationship between aerobic fitness and history of diabetes in patients with type 2 diabetes. Hadipoor et al. (2014) also introduced the years of diabetes as one of the factors affecting the physical dimension and QOL of these patients (45). Due to the fact that type 2 diabetes is associated with aging (46) and also the complications of diabetes, including cardiovascular complications with a history of diabetes and poor glycemic control are increased (47); with an increased history of diabetes, it reduces cardiorespiratory endurance in these people. On the other hand, due to having an active lifestyle and higher level of physical fitness, in addition to controlling blood sugar, the potential benefits of physical activity on reducing the complications of diabetes can be enjoyed (44, 50), which can improve QOL in patients with Type 2 diabetes is effective (50, 51). Overall, the results of our study showed that cardiorespiratory fitness was associated with improved QOL in patients with type 2 diabetes, which was negatively associated with age, duration of diabetes, and HbA1c levels.

Chronic diseases such as diabetes have a complex origin, slow onset, and unpredictable deterioration and recovery that requires self-care due to the long process. Diabetes, especially type 2 diabetes, is one of the major threats to human health in the 21st century. This disease is one of the global problems and the main cause of death and disability. Uncontrolled diabetes often leads to complications such as heart disease, stroke, high blood pressure, blindness, kidney disease, and amputation. Despite the cost of preventing and controlling diabetes, the number of patients is increasing every day, which seems to be a weakness in the psychological and self-care variables of these patients. Diabetes is at the heart of behavioral issues and psychological factors. And society plays a vital role in its management. Therefore, the study of psychological factors affecting this disease can be effective in controlling it. One of the most important psychological factors associated with diabetes that has been considered by researchers is the meaning of life. The meaning of life deals with the category of purpose or goals of human life in this world. A goal is a location and time that the person or other creature is looking for. Having a goal and using it among people helps them to seek the meaning of life in life. Research shows that there is a significant relationship between low hope and depressive symptoms. One of the effective treatments for people with chronic diseases is self-care. In this treatment, instead of focusing on changing people's self-esteem, people's relationship with their self-esteem changes. Self-improvement exercises emphasize relaxation, calm mind, self-compassion, and mindfulness, which will play an important role in calming the mind, reducing stress and negative spontaneous thoughts. In addition, compassion-focused therapy helps reduce clients' psychological problems by increasing internal awareness, acceptance without judgment, empathy, and constant attention to inner feelings. The effectiveness of this therapeutic approach on improving coping with stressful situations and reducing self-criticism, self-destructive thoughts, and rumination in patients has also been confirmed. Another therapeutic approach used for patients is positivist group therapy. Comparing different therapeutic interventions and finally choosing the best type of intervention based on the research results can be helpful. Among these, according to studies, the therapeutic approaches in the present study, ie positive psychotherapy due to focus on strengths and abilities on the one hand and compassion-focused treatment due to creating a sense of responsibility and self-worth on the other hand, can be effective in the field that for more certainty and to determine a stronger type of intervention in the present study, we seek to compare these interventions. In general, the results of this study can be used both theoretically and practically in medical science health centers, diabetes research centers, doctors, psychiatrists and psychologists, and scientific research centers such as universities.

The method of the present study was quasi-experimental with pre-test-post-test design with control and follow-up groups. The statistical population of the study consisted of all patients with type 2 diabetes in Bushehr in 1399, from which 45 people were selected by available sampling method and randomly in two experimental areas (15 people in each group) and The control group (15 people) was replaced. One experimental group was taught 8 sessions of the self-compassion therapy program and the second experimental group was taught 6 sessions of positive psychotherapy. The data collection included the meaning of life questionnaires of Steger et al. (2006), Hurts life expectancy (1992), and self-care behaviors of Diabetes Tobert, Hampson, and Glasgow (2000). Data were analyzed by multivariate analysis of covariance and Bonferroni post hoc test.

The results showed that both self-compassion and positive psychotherapy treatment programs increase the meaning of life, life expectancy, and self-care behaviors in patients with type 2 diabetes (P<0.05).

The results showed that both treatments cause significant changes in the meaning of life, life expectancy, and self-care behaviors in patients with type 2 diabetes in the post-test and follow-up period and differ in the effectiveness of both. There is no intervention type. In other words, both types of treatment are beneficial for patients with diabetes. The findings will be explained below: The first finding of the study showed that both treatments increased the meaning of life in patients in the experimental groups. In this regard, it can be said that compassion itself has appropriate coping resources that help people to face the negative events of their lives. Self-compassion enhances the ability to interact with others and provides a clearer quality of dealing with emotions. Therefore, it can be said that injured people, by learning new sources of coping, can effectively and efficiently deal with the negative events of their lives and show good adaptation. Self-compassion is one of the most important components of mental health and has capabilities that people can achieve happiness and psychological well-being by learning and performing related skills. The second finding of the study showed that both treatments increased the life expectancy of patients in the experimental group. In the present explanation, it can be stated that although the presence of illness causes major psychological damage to the individual, but in the meantime, self-compassion training can act as a motivating force for the individual. Compassion in itself leads to increased social communication and reduced self-criticism, reduced rumination, reduced thought suppression, anxiety, and stress, as well as psychological balance, all of which play a key role in increasing their life expectancy. Thus, flexibility in thoughts and kindness to oneself causes people to have a realistic judgment about themselves, to analyze their functional shortcomings, and to make appropriate decisions to address them. The third finding of the study also showed that there was a significant difference between the self-care behaviors of patients in the experimental and control groups. In the present explanation, it can be stated that negative ideas and attitudes about themselves are the main part of the change, and through the treatment of compassion, individuals learn to apply new experiences that this It promotes ideas such as alternative and more adaptive burdens; adaptive adaptation to unpleasant events such as chronic illness by focusing on assessing that situation increases patients' ability to make new connections. See ideas, organize information, integrate, and come up with new solutions to problems. In other words, increasing self-compassion leads to more self-care.

Performing normal daily activities requires sufficient muscle size and strength, and atrophy has a negative effect on the overall quality of life; So that the decrease in skeletal muscle mass leads to a decrease in human performance, long-term health and low quality of life. Diabetes is associated with the development of secondary complications in various organs, especially skeletal muscle atrophy. The aim of this study was to evaluate the effect of aerobic training and Tribulus terrestris extract on muscle atrophy indices and oxidant-pro-oxidant balance in extensor digitorum longus muscles of type 2 diabetic desert rats. Skeletal muscle is an important organ for glucose storage and metabolism, apart from being a power-producing machine. Considering the important role of exercise and physical activity along with herbal supplements in health and prevention and treatment of complications caused by diabetes, especially in the vital organs of the body such as skeletal muscles, it seems that investigating the effects of sports activities and herbal supplements on The markers of muscle atrophy are of great importance, but according to the investigations, the data in this regard are very limited.

For implementation of this experimental research, 42 male wistar desert rats 2 months old (average weight 180±20 g) were randomly divided into 7 groups. In order to induce muscle atrophy, Dexamethasone (750 μg/kg/day) was injected intraperitoneally into desert rats. desert Rats were diabetic using peritoneal injection nicotinamide-STZ. desert Rats in supplemented groups received Tribulus terrestris hydroalcoholic extract with doses of 5 and 10 mg per day by gavage method. Aerobic training was performed on a treadmill at a speed of 23 m/min, 30 min/day, 5 days/week for eight weeks. Using Real Time PCR and PAB methods, plantar muscle tissue was measured using immunoassay method. Shapiro-Wilk test was used to ensure the normal distribution of variables. Two-way analysis of variance and Bonferroni's post hoc test were used to compare the average changes of the investigated factors in the groups. The significance level was considered as p≤0.05 in all cases. All statistical operations were performed with SPSS software version 23.

Thistle plant extract (F=136.305, P=0.001, µ=0.901) and the interaction between training and thistle plant extract (F=419.949, P=0.001, µ=0.966) had a significant effect on the level of MURF-1 in extensor digitorum longus muscle. . Also, the amount of MURF-1 in the long extensor muscle of the toes with the 5-gram dose was significantly lower than the 10-gram dose group (P=0.0001). The results showed that aerobic training, Tribulus extract and combined intervention of Tribulus extract with aerobic training resulted in a significant decrease in the expression genes of Atrogin-1, MURF-1, MiR-29b (p=0.001) and significant increase in methyl guanine (p=0.001) and oxidant-pro-oxidant balance (PAB) levels in male wistar desert rats exposed to dexamethasone (p=0.001).

The findings of this research show that aerobic training led to a significant decrease in Atrogin-1, MURF-1 and MiR-29b gene expression and a significant increase in methylguanine levels and oxidant-prooxidant balance in type 2 diabetic rats. Aerobic exercise has been shown to reduce DNA damage caused by oxidants. Decreased insulin and increased oxidative stress seem necessary for protein breakdown and muscle atrophy. Therefore, negative regulation of anabolic processes as well as oxidative stress occurred in STZ-treated animals can activate muscle proteolysis and increase MuRF1 expression. Regarding the effect of exercise on the expression of MuRF1 in type 2 diabetic samples, there have been few studies that have expressed different mechanisms in the interpretation of the results; The response of MuRF1 to sports activity can change under the influence of various factors, including the subjects' training history, the intensity and duration of the activity, or the effect of repeated activities. On the other hand, it seems that Hsp25 is one of the mediators that regulate the atrophy pathway, which plays an important role in dealing with atrophy in diabetic conditions, so that increasing its amount due to exercise reduces atrophy and decreases the expression of MuRF1. The mechanism of MiR-29b changes due to exercise training is not well defined. However, miR-29 targets have been found to include IGF-1, p85a, and myeloblastosis-related protein B (B-myb) in mouse muscle tissue. IGF-1 and p85a are important regulatory proteins for protein translation via miR-29 to inhibit myogenin and protein synthesis, thereby reducing protein components during muscle atrophy. The effect of exercise on redox status depends on many factors, such as type of exercise, exercise load, as well as age, gender, risk factors, and physical condition. Short-term exercises may increase oxidative stress and imbalance between ROS production and antioxidant agents and ultimately lead to mitochondrial dysfunction.However, long-term exercise may enable ROS detoxification by increasing cellular antioxidant activity or stimulating the expression of genes such as Mn-SOD. Other findings of the research show that milk thistle extract and the interaction of exercise andmilk thistle extract reduce Atrogin-1, MURF-1 and MiR-29b gene expression and increase methylguanine levels and oxidant-prooxidant balance in the extensor toes long muscle tissue in rats. He had type 2 diabetes. Other findings of the research show thatmilk thistle plant extract and the interaction of milk thistle plant extract with the reduction of Atrogin-1, MURF-1 and MiR-29b gene expression and the increase of methylguanine levels and the oxidant-prooxidant balance of the extensor digitorum longus muscle tissue in diabetic rats. Type 2 was included. It has been determined that the extract of this plant has hypoglycemic and hypolipidemic properties in the experimental model of diabetes mellitus induced by streptozotocin. In the present study, the hydroalcoholic extract of thistle plant with doses of 5 and 10 mg per kilogram of body weight per day was able to help reduce muscle atrophy in type 2 diabetic rats, and the lower dose brought more benefits. Due to the presence of large amounts of alkaloids, polyphenols, flavonoids, as well as the antioxidant, hypoglycemic and hypolipidemic properties of milk thistle, and based on the findings of this research, it can be said that the presence of antioxidants in milk thistle can reduce muscle atrophy. The inhibitory effect of regular exercise is also at least partly due to adaptation to oxidative stress. The process of adaptation related to exercise is not only related to the production of ROS levels, but also causes an increase in antioxidants and the activity of enzymes that restore the damage caused by oxidative damage (43). Therefore, the interaction of exercise and milk thistle extract with antioxidant effects and reduction of lipid peroxidation helps to improve muscle atrophy indicators in diabetic subjects. In general, according to the few studies conducted in this regard, research on the effect of sports activity and milk thistle plant extract on muscle atrophy indicators in type 2 diabetic subjects needs more research. There were also limitations in the current research, among which we can mention the lack of measurement of other indicators of oxidative damage. In summary, the results of this research showed that aerobic exercise, milk thistle plant extract and the combined intervention of aerobic exercise and milk thistle plant extract can probably be effective in the treatment of muscle atrophy caused by type 2 diabetes and the intervention of a lower dose of this plant extract can give better results. to be accompanied.Aerobic training, Tribulus extract and combined intervention aerobic training and Tribulus extract can probably be effective in treating muscle atrophy due to type 2 diabetes and lower dose intervention of this herbal extract can have better results. Diabetes leads to changes in cellular proteins, oxidative stress and disruption of the cellular defense system. It seems that the reduction of oxidative stress caused by exercise in diabetic subjects in the present study has a positive effect on the negative regulation of MuRF1 expression at the end of the exercise period. The mechanism of Atrogin-1 changes following exercise is not well defined. Therefore, the interaction of exercise and milk thistle extract with antioxidant effects and reduction of lipid peroxidation helps to improve muscle atrophy indicators in diabetic subjects. In general, according to the few studies conducted in this regard, the research on the effect of sports activity and milk thistle plant extract on muscle atrophy indicators in type 2 diabetic subjects needs more research. There were also some limitations in the current research, including the lack of measurement of other indicators of oxidative damage.

Influenza is one of the leading causes of respiratory illness in children and adults with underlying disease and the elderly. The virus kills large numbers of people annually, and dangerous types of the virus are associated with pneumonia and complications. Muscle pain is one of the most common findings in this disease, which is associated with myoglobinuria and increased levels of creatine phosphokinase (CPK). Patients with high CPK levels are associated with more complications and a higher risk of hospitalization. There has been a lot of research on the high levels of CPK in these patients, but the association of this enzyme in the blood of hospitalized patients with influenza has not been done and it is important to pay attention to the levels of this enzyme in hospitalized people. Serum CPK levels in the flu can be used as a diagnostic marker and predict the effects of the flu. Therefore, the aim of this study was to evaluate the level of CPK in patients with influenza and its differences in different ages.

In this descriptive-analytical study, 264 patients with influenza resulting in hospitalization with an age range of one month to 90 years who were referred to Hazrat Ali Asghar and Hazrat Rasoul Akram Hospital in Tehran in autumn and winter of 1398, were Were examined. The clinical signs of influenza were evaluated in these patients and the frequency of lymphopenia, thrombocytopenia, neutropenia, myoglobinuria, positive blood culture and blood CPK level were measured in vitro. The relationship between influential variables such as myalgia and myoglobinuria and platelet status with high CPK levels was investigated. The obtained data were analyzed by SPSS software version 23.

The mean age of patients was 24.99 years. 54.2% were male. Prevalence of clinical symptoms of patients based on age groups showed that 176 (66.7%) had chills, 179 (67.8%) had myalgia, 115 (43.5%) had pharyngitis, 242 (98.4%) Cough, 119 patients (45%) had sputum, 58 patients (22%) had headache, 66 patients (25%) had shortness of breath and 68 patients (25.6%) had diarrhea. Among these, the highest and lowest prevalence of myalgia were in the age group of 21-40 years and children under 5 years, respectively, which was statistically significant (P = 0.027). There was also a significant difference in the prevalence of pharyngitis (P ˂0.001), sputum (P = 0.004) and shortness of breath (P ˂0.001) in patients. CPK levels were about 50% higher than normal and did not differ between age groups and sexes. Lymphopenia, thrombocytopenia and neutropenia had a prevalence of 41%, 25% and 20%, respectively. Myoglobinuria had a prevalence of 82%, which was more common in the under-5 age group. In the group with normal CPK, the prevalence of myoglobinuria was nearly 30% higher. Also, the prevalence of high CPK in the group with myoglobinuria was almost 35% higher than the group without it, which indicates the relationship between the prevalence of high CPK and myoglobinuria (P = 0.02). There was a significant relationship between patients' blood platelet status and high or normal CPK (P = 0.01). The prevalence of myalgia in the group with high CPK was 52% higher than the group without myalgia and in the group with myalgia, the prevalence of high CPK was 16% higher and the prevalence of myalgia symptom was statistically significant (P = 0.004). Positive blood cultures were higher in adults and the elderly than in youth and children, and among the clinical signs, CPK was associated only with myalgia.

High levels of CPK were observed in half of the patients and our findings showed that high levels of CPK were significantly associated with myalgia and myoglobinuria and platelet status. This indicates that the increase and decrease of this enzyme can affect the fate of the disease. It is suggested that future studies investigate the association of CPK levels with lymphopenia and leukopenia and immune cells. Examination of CPK levels in future patients can be effective in identifying the risk factor for disease severity and help in better treatment and reduction of disease complications.

Today, cancer is considered as a major health problem and affects the health of society. Breast cancer is the second leading cause of cancer death in women after lung cancer. According to epidemiological studies, cancer is the second most common cause of death after cardiovascular disease worldwide and the third leading cause of death after cardiovascular disease and accidents in less developed countries. Cancer occurs as a result of uncontrolled cell division, which is the result of environmental factors and genetic disorders. The four key genes involved in cancer cell development include oncogenes, tumor suppressor genes, DNA repair genes, and programmed death genes. The prevalence of breast cancer varies from about 8 to 12 women in different communities. About 30% of all monogenic breast cancers are due to mutations in the BRCA breast cancer genes, which will eventually lead to breast cancer with a dominant inheritance pattern. Repair genes naturally make proteins and enzymes that repair damaged genes. When these genes are mutated, they cannot repair the defects of other genes. One of the repairing genes is BRCA-1 gene, which has a hereditary role in the production and growth of cancer cells in female breasts when it has a mutation.MicroRNAs are a group of short, single-stranded (between 19 and 23 nucleotides) and non-coding conserved RNAs that act as post-transcriptional regulators of gene expression in a wide range of animals, plants, and viruses. The FOXO1 gene is one of the targets of miR-183, which is involved in the maturation of lymphocytes, and increased expression of miR-183 in cancer patients will interfere with immune function. Studies on miR-183-3p in breast cancer have shown that this microRNA is a Tumor suppressor-mir (Ts-mir) that prevents tumor formation and differentiation and has an inhibitory role. Another feature is the inhibition of cell proliferation and metastasis and stops the cell cycle in the G1 stage. miR-183 can play a role in other cancers in addition to breast cancer, depending on the type of target and location of activity. The aim of this study was to evaluate the expression changes of miR-183 in nuclear nuclei of breast cancer patients.

The study was performed on 60 samples including two groups of patients and healthy people. All actions and tests performed in this research and sampling have been approved by the work instructions of the ethics committee of Qom branch of the Azad University (ethics code: IR.IAU.QOM.REC.1397.010). Study steps include: extraction of peripheral blood mononuclear cells (PBMCs), extraction of RNA from PBMCs obtained from patients, design of specific primers for target genes, synthesis of cDNA from RNAs obtained, quality control of cDNA synthesized with Use of beta-actin and 5SrRNA housekeeping genes and ensure cDNA health, Real Time PCR to study changes in FOXO1 gene expression, changes in miR-183 and finally statistical analysis. In this study, the results obtained from Real-time PCR (Ct) were analyzed using LinReg software by examining the amount of fluorescence read by the device for each sample and the efficiency of each sample, the Ct of the reference gene and the target gene in both patient and healthy groups The data were then used and analyzed by Rest 2009 to determine whether the P-value was less than 0.05.

The results of analysis of data obtained from Real time-PCR show that the expression of FOXO1 gene in peripheral blood cells significantly decreases in samples of breast cancer patients compared to healthy individuals (P < 0.05). While in the expression of miR-183 gene, a significant increase was observed in the samples of people with breast cancer compared to the group of healthy people (P <0.001).

Decreased expression of FOXO1 gene reduces the maturation of lymphocytes and this function weakens and suppresses the immune system, which results in the proliferation and differentiation of cancer cells and tumor spread, which can be used as a biomarker. Limitations of the study include the small number of patients, the lack of classification of patients based on markers such as Her2nue, BRCA-1 and other diagnostic markers.

Autism disorder is a neurodevelopmental disorder whose symptoms are mainly in the early months of life, especially between 12 and 24 months and in general, up to 3years of age, and due to severe and persistent deficiencies in communication and interactions. Social, communication skills, limited, inflexible, and repetitive patterns appear in behavior, activities, and interests, as well as cognitive and functional disorders.However, what has been studied so far has shown that mitochondria play an essential role in degenerative diseases, and its various effects are mainly through the cellular redox mode by mitochondria and through oxidation and reduction of NADH. H+ and NAD + are maintained; Are interconnected. Abnormal accumulation of oxygen/nitrogen reaction species and superoxide formation can lead to oxidative stress and their accumulation may damage cellular structures. Superoxide is also immediately converted to hydrogen peroxide by superoxide dismutase enzymes. The presence of hydrogen peroxide may be toxic to cells.The brain, on the other hand, is one of the main consumers of oxygen, and mitochondria are the largest source of energy for the normal functioning of brain cells, and as a result, large amounts of reactive oxygen species accumulate in several areas of the brain. However, at least in some cases, there are relatively weak protection mechanisms. Because of this, the brain may be very sensitive to attacks related to the accumulation of radicals. In addition, mitochondria play an important role in calcium homeostasis, signaling, and regulation of apoptosis.Also, growing nerve cells have a vital need for oxidative phosphorylation for important growth processes, and the immature brain is uniquely vulnerable to defects in bioenergy capacity; Thus, mitochondrial disorders may lead to a variety of developmental neurological disorders .In general, conducting such research is of particular importance, especially given the growing number of patients with autism spectrum disorders and the various challenges in the timely and accurate differential diagnosis of these disorders. In this regard, after reviewing the literature and the existing research background, it was found that so far in our country, no research has been conducted to evaluate the biomarkers of mitochondrial function in people with autism spectrum disorder.

To conduct the present applied research, among children and adolescents with autism spectrum disorder in Tehran, among patients with nausea (51people), 10affected children and 10healthy children were randomly selected and divided into two experimental and control groups. Were divided. The required data were then used through demographic information questionnaires, history and medical records, Gilliam-2 Autism Rating Scale and laboratory kits. Finally, the data were analyzed using the rock curve.

The results presented in Table2 and the value of AUC= 0.890, it can be said that the ability to test or test creatine phosphokinase (CPKMB) in the diagnosis of ASD disorder is in the category or "good and close to excellent level." Also since the probability value is equal to 0.0032; It can be said that this result is significant and can be cited at the level of significance of five percent (and even one percent). Based on the findings, the number of cutting points is also equal to>24.0, which shows; Based on the diagnostic test (CPKMB), people with creatine phosphokinase levels greater than 24.0 units can be identified; He was considered a person with symptoms of autism. Individuals whose test scores are less than 24.0 are also identified as asymptomatic or healthy.Based on the information in Table3 and the value obtained for the curve surface (AUC= 1.000), it can be said that the ability of the Lactate test to diagnose this disorder is complete and "excellent" and shows that this test has a very good performance in the field. It is the correct identification and determination of healthy people with disorders. The numerical value of the cutting point is also equal to>21.5, which shows; Based on the Lactate diagnostic test, those whose lactate level is more than 21.5 units can be identified; Considered people with autism spectrum disorder. Those whose test results are less than 21.5 units are also considered healthy.Based on the data in Table4 and the value obtained for the subsurface (AUC= 0.790), it can be said that the ability of the Pyruvate test to diagnose ASD is "relatively good". Accordingly, since the probability value of Pvalue is equal to 0.0284, it can be saidthat this result is significant and can be cited at the level of significance of five percent and even one percent. The numerical value of the cut-off point for this experiment is equal to <0.865, which indicates; Based on the Pyruvate diagnostic test, people with a pyruvate score of less than 0.865 can be considered a person with ASD. Those for whom the number obtained is more than 0.865 units are also recognized as healthy. Based on the information in Table5 and the value obtained for the cut-off point (AUC= 0.970), it can be said that the ability of the L:P test to diagnose this disorder is "excellent" and efficient. Accordingly, at the significance level of five percent and one percent, since the probability value or Pvalue is equal to 0.0004; It can be said that this result is meaningful and worthy of citation. The numerical value of the cut-off point in this test is equal to>31.05, which shows; Based on the L:P diagnostic test, those with a lactate to pyruvate or L:P ratio greater than 31.05 can be considered as having symptoms of ASD. Those with an L: P score of less than 31.05 are also considered healthy. Based on the results of Table 6 and AUC = 0.765, it can be said that the ability of Creatinine test to diagnose autism spectrum disorder is in the category of "relatively good". Since the probability value P for this test (creatinine biomarker test) is 0.0452; It can be said that this result, at the level of significance of five percent, is significant and worthy of citation. Obviously, this result, at a significance level of one percent, is not worthy of citation and significance.

The studied biomarkers have high and very good diagnostic power and efficiency in the field of accurate and early assessment and diagnosis of autism spectrum disorders (especially in severity levels 2 and 3), and they can be used along with other diagnostic biomarkers, along with other measurement methods. Evaluated and diagnosed this disorder, and in the first three years of the child's development, as a golden and very sensitive and important period of diagnosis and treatment of autism, achieved a more accurate differential diagnosis and education, rehabilitation and treatment or improvement of symptoms at the most appropriate time. Possibly, he started and achieved better results in this regard.Also, according to the results of evaluation and measurement of biomarkers of mitochondrial function in each diagnosed individual, based on the new and valuable approach of "Molecular Psychology and Molecular Psychiatry", one of the new and appropriate methods for each individual (including individual or personal molecular medicine) to modify And used to improve mitochondrial dysfunction (for example, drug therapy to regulate serum levels of the aforementioned molecules in the patient to a normal level and reduce related symptoms), and finally, to reduce the symptoms and relative treatment of the person with autism.

Epidemics of human viruses began during the period of Neolithic around 12,000 years ago. Humans developed more densely population which allowed viruses to spread rapidly among communities. Also, plant and livestock viruses increased along with human viruses (2). At the January 2020, the coronavirus disease (COVID-19 7th human coronavirus) was discovered in Wuhan, Hubei province of China. COVID-19 virus caused six million deads in the world to date and cussed infection of more than seven million of cases in Iran (1). This infectious disease caused by the SARS-CoV-2 virus. This virus was contagious and fast-spread. Despite the aquarantine politics, SARS-CoV-2 virus caused many permanent economic and health damages in most countries. Coronaviruses are positive-sense, single- stranded enveloped RNA viruses with helical capsids that infect a wide range of hosts including humans, bats, other mammals, and birds (2). Coronaviruses are belonging to Nidovirales order, Coronaviridae family, Coronovirinae subfamily and four genera of alpha, beta, delta, and gamma. Alpha and beta coronaviruses are known as human infection agents. SARS-COV-2 virus abilities are including: high mortality number, short period of incubation, widespread transmission protocols, asymptomatic infection and affecting on most vital organs (heart, brain, lungs and …) which have attracted the health system attention and caused neglect to the other chronic and non-communicable diseases (4). Therefore, the disease incidence, prevalence and prioritization around the world may change in the future. From the beginning of COVID-19 pandemic, some symptoms and risk-factors have been introduced to the world as the increase elements of morbidity and mortality. Studies have shown that having any kind of underlying diseases and risk factors will be effective in the COVID-19 disease severity and mortality (6). Some of these important risk factors are including of chronic kidney disease, hypertension, age, gender, obesity, obstructive pulmonary diseases, diabetes, lung diseases, cardiovascular diseases, cancer, and liver disease. Also, each risk factors have different impact in different geographic areas (7). Some factors, such as different viral load kinetics in each individual person, epidemiological history, therapeutic or pharmacological effects and immune response have some major impacts on the laboratory diagnostic results. Due to the successive mutations of the SARS-CoV-2 virus and the high incidence disease, it seems that the vaccination alone cannot prevent the COVID-19 (9). On the other hand, the World Health Organization has warned about the vaccination as the only pandemic control protocol. Therefore, the prevalence of morbidity and mortality have become the public health concerns in the world since the beginning of the COVID-19 epidemic and the vaccination. Recognizing of the risk-factors and symptoms on COVID-19 in different geographic areas can be a helpful source to prevent the mortality. Understanding risk factors can help the world to control of the coronaviruses pandemic period and similar situations in the future. Therefore, the aim of this study was to determine the risk-factors of mortality of COVID-19 patients in three cities of Khuzestan province, Iran.

This research was an analytical cross-sectional study. Some details of 27963 COVID-19 patients such as clinical symptoms, individual characteristics and underlying diseases were gathered from hospitals in Abadan, Shadegan and Khorramshahr cities in Khuzestan province, Iran, from 20 February 2020 to November 2020. All the under-study population was previously investigated in terms of COVID-19 infection by the medical examinations and laboratory methods. This under-study population was categorized into three different groups such as hospitalized, outpatients and dead patients. Hospitalized patients have admitted in general or ICU (Intensive Care Unit) sector. Obtained database of COVID-19 patients was analyzed by IBM SPSS version 22.0 under regression, logistic model (univariable and multivariable logistic regression models) with 95 percent confidence level. Also, the neural network method was used for prioritizing of significant risk factors for mortality. At the end of the analysis, the models of multiple logistic regression and neural network were evaluated for Goodness of Fit. In this study, the anonymity principle and patient's preservation of personal information was considered during analytical method.

The mean of age was 40 years. The sex ratio was higher for men. That ratio for dead patients were approximately 63 years (from 62.7597 to 64.9854). The number of hospitalizations and deaths was occurred in May-July 2020 and the greatest number of deaths reports was belonged to Abadan city. The most recognized prevalent symptoms were cough, fever, hard breath and sickness which observed more within dead patients. Prevalent underlying diseases were diabetes, hypertension and blood diseases. The mortality risk factors of the multivariable logistic regression model were diabetes, age, blood diseases, cardiovascular diseases, neurological diseases, respiratory diseases and cancers. Also, variables such as diseases related to blood lipid, gender and thyroid diseases were removed from the model of multivariable logistic regression according to the model univariable logistic regression under 0.2 confidence level because they had no statistical significance for entering to the model of multiple regression. According to neural network analysis, age was the most important mortality risk factor. Other important risk factors were neurological diseases, blood diseases, respiratory diseases, cardiovascular diseases, diabetes and cancers respectively. The odds ratio of mortality increased with increasing number of underlying diseases among COVID-19 patients. The presence of at least one risk factor increased the odds of mortality approximately 8.3 times. Variables as kidney diseases, hypertension, Immunodeficiency and obesity were not recognized as mortality risk factors in the model of multivariable logistic regression.

This study investigated the effective risk factors for mortality among patients with COVID-19 in southern of three cities of Abadan, Khorramshahr and Shadegan of Khuzestan province, Iran. According to the prioritizing in neural network and risk factors of mortality, we recommend that after attention to age as the most important risk factor for mortality, COVID-19 patients with blood and neurological disease history should receive more public health care services than the others till the end of COVID-19 pandemic period. Although, antigenic mutations of COVID-19 virus have reduced the effectiveness of recent vaccines. However, risk factors for mortality of COVID-19 patients as the important disease prevention levels are need more attention from health politicians. Understanding risk factors of mortality, can be useful for future researches and similar epidemic or pandemic of any coronaviruses.

Background & Aims :

The development of the brain as the most complex structure of the human body is a long process that begins in the third week of pregnancy and continues until adulthood and even until the end of life (1). Human brain myelination begins one to two months before birth in the visual system and eventually lasts until the age of two in other sensory systems and then the motor systems (4). Processes associated with normal brain development involve a wide range of molecular events, including the expression of genes and environmental events (1). If the brain is exposed to some environmental factors, its normal development will be disrupted (2) because the fetus is very sensitive to physical and chemical disruptive factors in different stages (5). Generally, factors that upon exposure during pregnancy lead to changes in the growth or structure of the developing fetus and ultimately cause defects in the physical structure or abnormalities in fetal behavior are called teratogens (6). Some viral infections have devastating impacts on the developing fetal brain. Viruses like Zika and cytomegalovirus can pass directly through the placenta to the fetal brain. These viruses cross the blood-brain barrier of the developing fetus, infecting and damaging brain tissue (9,10). Other infections including the influenza virus that do not cross the placental barrier have been associated with adverse effects on neural growth in offspring, mainly through mechanisms involved in activating the immune system of the mother, placenta, and subsequently the fetus (11,12). Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) is a new type of coronavirus that emerged in late 2019 and its related disease is known as coronavirus disease 19 (COVID-19). Nowadays, great attention is paid to COVID-19 infection in pregnant women and possible damage to their offspring. Although studies on COVID-19 are progressing rapidly, the effects of SARS-CoV-2 on fetal growth are unclear (16). In this review, we discussed evidence on the impact of SARS-CoV-2 infection during pregnancy on neurodevelopmental outcomes. Moreover, potential mechanisms by which prenatal SARS-CoV-2 exposure might impact the developing fetal brain were explored. These mechanisms are as follows: (1) direct fetal infection of neurologic tissues via transplacental transmission of the virus (2) impaired placental function resulting in adverse pregnancy outcomes associated with an increased risk of neurologic harm (e.g. fetal growth restriction and preterm birth) (3) via MIA (maternal immune activation) during neurodevelopment in pregnancy (16,17,18). A growing body of evidence suggests that SARS-CoV-2 infection can cause acute and chronic neurological complications in adults and children (19,20,21). There is no definite link between prenatal SARS-CoV-2 exposure and developmental neurological disorders in offspring, which may be partly due to the fact that most children born to infected mothers, are still very young for diagnosis of many developmental neurological conditions. However, epidemiological and clinical data indicate the potential of SARS-CoV-2 exposure during pregnancy to influence early neurodevelopmental outcomes. Preliminary data on the immune and inflammatory response to SARS-CoV-2 in pregnancy showed proinflammatory cytokines in pregnant women with SARS-CoV-2 that IFN-γ and IL-6 play the most important role (33,34). Significant infiltration of maternal immune cells into the placenta has been observed in cases of severe maternal COVID-19 and high SARS-CoV-2 viral load in the placenta (38). In placental specimens without evidence of direct SARS-CoV-2 infection, upregulation of the inflammatory pathways of natural killer cells (NK cells), T cells in mothers infected with SARS-CoV-2, and interferon-stimulated genes (ISGs) in villi tissue of placenta were shown (35,36). The placenta is the primary source of serotonin for the developing fetal brain. Studies show that activation and inflammation of the maternal and placental immune systems alter placental serotonin signaling, which in turn affects fetal brain development through impaired synaptogenesis, neuronal migration, and axonal targeting (40,41). Activation of the maternal and placental immune systems is also associated with other changes in fetal brain neurotransmitter signaling, including dopaminergic, cholinergic, GABA, and glutamatergic systems, which affect fetal brain development conditions (42,43). Activation of the maternal and placental immune system is associated with mitochondrial dysfunction of the placenta and fetus, oxidative stress, and impaired protein homeostasis (44,45). Maternal and infant gut microbiome may also be important modulators of the effect of MIA on the developing brain. Given the extent of synapse formation in the fetus and infant, the microglial function is a critical goal for research to better understand the effect of SARS-CoV-2-induced immune activation on the developing fetal brain (46). Transmission of the virus through the placenta, which can infect neural tissue, can have lasting and devastating consequences for the developing fetus's brain. A key factor in understanding the risk of possible fetal infection is whether maternally acquired SARS-CoV-2 can be transmitted from the placenta (a primary physiological and immune barrier that prevents the virus from being transmitted from mother to fetus) (48). Most of the evidence to date shows that the negative effects of neurodevelopment of SARS-CoV-2 infection occur mostly through activation of the mother and placenta's immunity rather than direct fetal infection with SARS-CoV-2 in utero. The data showed that the rate of SARS-CoV-2 positivity in infants in pregnancies exposed to SARS-CoV-2 is between 1% and 3%, and placental infection is a relatively rare event. A meta-analysis of case reports and case series estimated the placental infection rate at 7% (49). Mechanisms of protection against placental infection include low maternal SARS-CoV-2 viremia, maintenance of immune defense at the syncytophoblast border, and failure to express the molecules required (ACE2 and TMPRSS2) to bind and enter SARS-CoV-2 into the syncytrophoblast (36,37). Due to the small number of cases of placental infection and vertical transmission, data on completed pregnancies exposed to SARS-CoV-2 are now available throughout the developmental period (first to third trimesters). To date, no specific congenital syndrome has emerged following prenatal SARS-CoV-2 exposure indicating direct fetal infection (50,51). All of these data point to the activation of the maternal and placental immune systems and the subsequent activation of the fetal nervous system as the primary stimuli of neurodevelopmental complications in children exposed to SARS-CoV-2. Instead, direct infection of the placenta and fetal brain with Zika virus or cytomegalovirus infection has been observed. The data presented demonstrated the potential for maternal SARS-CoV-2 infection to stimulate maternal, placental, and fetal immune activation. Future studies will need to evaluate whether the fetoplacental immune responses in maternal SARS-CoV-2 infection are associated with neurodevelopmental morbidity in offspring. The Effect of infection time, different strains of the virus, fetal gender, and prenatal status (eg, maternal cardiac metabolic status, substance use, stress, drug use) on offspring's neurodevelopment is important in the next generation for a comprehensive understanding of the potentially lasting impact of the COVID-19.

Bioavailability is a good alternative to conventional physical and chemical methods for removing toxic metals from groundwater and wastewater. Selenium is a non-metallic substance. Although large amounts of selenium are toxic, proper consumption is essential for specific cellular functions. In the seasons when there is a maximum spawning rate, due to the excretion of high levels of selenium through the eggs from the body, the balance of selenium in the body is disturbed and its amount is reduced to a minimum and the body becomes susceptible to virus attack. Laying birds are more common (1, 2).Reproduction of viruses, especially avian influenza, also requires selenium, which is higher due to the high proliferation of viruses, but the selenium required for a virus is very low, and if there is enough selenium in animals, the virus enters the body. In other words, the virus poisons itself with selenium, and this is a schematic example of the fight against toxins, as well as a way to fight and defend the type of prevention, not when the disease occurs. falls down. Numerous microorganisms such as bacteria, yeasts, molds, algae and higher fungi that are grown on a large scale can be used as a rich source of protein for humans and animals. Yeasts are among the organisms that are widely used to produce protozoan proteins, and the most important of them are Saccharomyces, Torulopsis, Candida, Didium, etc. (5).

  In this research, phenotypic and genotypic study was carried out on the use of isolated yeast from industrial effluents with the aim of eliminating Selenium biological and the production of biomass as a feed for livestock and poultry. In the present study, yeast strains were isolated from wastewater and after confirmation by using the replication of the ITs region and their evolutional correlation with S1 strains (Candida albicans NG67) and S2 (Candida albicans m48a) selenium removal was performed. Sequencing: To confirm the sequences obtained by PCR, the sequencing reaction was performed according to Sanger method by Gene Fanavaran Company. In this sequencing, the Cycle Sequencing Kit Big Dye Terminatorv3.1 from Applied Biosystems and the ABI Sequence Analyzer 3130xl from the same company were used. The sequence of each DNA strand was analyzed using the corresponding chromatogram and Chromas (Technelysium) software. The questionable bases were examined by careful examination of the chromatogram and comparison with the chromatogram of the reverse string sequence.
Chromas (Technelysium) software was used to analyze and compare all genetic changes.

  The ability of these isolates to tolerate selenium was performed using PYT agar medium containing different concentrations of 4-15 mM of Se2 +. Selenium-capable strains of reddish colonies contained Selenite in PYD Agar medium. These strains were selected as superior strains.Enrichment and Determination of Selenium Resistance Pattern in Yeast Strains: After optimizing the reaction conditions of bilenium selenite removal reaction by single factor method and finding appropriate values of reaction parameters, the effect of heating time on removal efficiency was investigated. Based on the results obtained after 72 hours of heating, the resting yeast cells were able to remove more than 93% of the selenium in the conversion medium, indicating the potential potential of the microbial catalyst to remove toxic selenium from the reaction medium.

The MFC test was conducted to select the best yeast strain for performing desulphurisation tests. The resistance pattern of isolated yeast strains according to MFC showed that the highest resistance to toxic selenite ions (tolerance greater than 22 g / l) was related to strain S1. The microbial protein produced in this study is widely used and can be used as an additive and probiotic in the diet of livestock, poultry, and aquatic animals.In the present study, yeast strains were isolated from wastewater and after confirmation, selenium removal was performed by replicating the ITs region and investigating their evolutionary relationship with strains S1 (Candida albicans NG67) and S2 (Candida albicans m48a). For this purpose, selenium-capable strains of red colonies in PYD agar medium contained selenite. These strains were selected as the top strains. Then, in order to select the best efficient yeast strain for selenite removal experiments, MFC test was performed. Resistance pattern of isolated yeast strains according to MFC showed that the highest resistance to toxic selenite ion (tolerance above 22 g / l) was related to S1 strain. These results are consistent with the study of Ashnagarov et al. Protozoan protein can be produced from various sources. Researchers have conducted various studies on the production of protozoan proteins from substrates such as agricultural wastes (molasses, rice, citrus), chemical by-products (methane and petroleum derivatives), and fishery wastes (such as shrimp skin). Each of the studies used different microbes or microbes and the conditions for preparing the growth medium of the microorganisms used were different. The results of studies by Scholes et al. Showed that the amount of crude protein in SCP produced from yeasts was between 39-68%, while this amount in bacterial SCP was about 82%. The amount of essential amino acids of yeast protein was between 6.4-6.4% per gram of protein. However, the amount of total fat in protein with different microbial origins has been variable. The results of the present study also confirm the above results.The results of a study by Samuel et al. In 1992 showed that when using microbes, the average crude protein in fish and crab waste was 60.4% and 44.1%, respectively. Ferrer et al. Used shrimp shells to produce microbial protein and used marine yeast to achieve this goal. The results showed that the specific growth rate and crop production coefficient were 0.398 per hour and 447% kg dry cell weight, respectively. Recently, due to the lack of protein, efforts have been made to discover alternative sources of common food and feed. SCP is cheap for everyone and safe to eat. Genetically modified, high-yielding non-toxic microbes can also be used to increase SCP production. During a study, scientists coated medical lenses with selenium to prevent bacteria from growing and multiplying on the lenses (11).

Following a serious injury, microtrauma and as a result of microscopic damage in joint surfaces, pain disorders in the skeletal and muscular system develop over time. Pain in the musculoskeletal system, in addition to injury, causes secretion and fatigue in the pastoral structure, which leads to disruption of the neuromuscular system. Although the foot is the last part of the lower limb chain and resists the incoming forces, it is expected to cause movement pathology, pathokinesiology and increased stress and thus injury due to improper distribution of forces. It reaches the tissues and muscles of the leg, and as a result, the risk of joint pain increases. In futsal, which is one of the vulnerable sports, most of the injuries of the lower limbs are assigned to the wrist and knee, According to the report of the National Association of American Sports Science Colleges, ankle injuries compared to other body joints in disciplines such as; It has basketball, volleyball, futsal, etc. Ankle pain can be caused by aspirin, instability, arthritis, gout, tendonitis, fracture, nerve compression and infection in this joint. In this popular field, due to the fact that players have to withdraw from this sport due to pain and injury in their basic ages, and as a result, talents are not lost, attention was paid to movement sciences and rehabilitation. Familiarity with biomechanical principles in injury or disease is a very important part of air and treatment activity. If we can provide a targeted ability in ankle pain and evaluate and perform the tasks they do in static and dynamic conditions, it will allow athletes and even non-athletes to return to sports faster and more confidently. And they do everyday, was a witness The first step in this field is to know the rehabilitation method that optimally minimizes the frequency of pain and re-injury. As a result, biomechanical principles and evaluations become reliable in treatment and help to increase better performance. Research shows that mechanical proprioception movements with ultrasound supplements improve and increase neuromuscular function and balance of the plantar pressure center, as well as a significant reduction in pain, in the same direction, from existing changes and the degree of impact on foot posture or position. in which the patient is located, by using biomechanical evaluations in the initial or final stages of the rehabilitation period, it helps the treatment to increase the effectiveness of the methods used with higher validity and to use better methods with higher effectiveness. take. Take, Therapeutic strategies to prevent and increase the return to daily and sports activities include: external supporters, manual therapy, and deep sensory exercises, which generally divide rehabilitation into two types, mechanical and physical. Studies have shown that deep sensory exercises and orthoses and tapings reduce the amount of damage by 50%. In addition, the postural changes or the condition in which the patient or the injured person is located, recovery during the rehabilitation phase helps the specialists to take appropriate actions to have a better effect. In the meantime, examining the amount of electrical muscle activity and the pressures on the person in the biomechanical analysis of the person will give valuable information about treatment and rehabilitation strategies. According to the available documents, foot and ankle problems even cause pain in the upper limb areas such as the back due to its effects on the posture and the way the forces interact in walking over time. Considering the increasing trend of basic ages in futsal, in order to avoid re-injury or to prevent it, it is necessary to take preventive measures. In this approach, the use of proprioception exercises and the use of ultrasound waves on the injured area of the ankle have a significant effect on the walking process, the sense of the position of the ankle joint, and the function of the muscles around the joint. Failure to use proprioception exercises reduces performance and ankle sprains, which is the result of instability followed by chronic ankle pain. is looking for To get a better result, the use of ultrasound therapy modality by applying a length of heat in the ankle along with deep sensory exercises will be useful in controlling and improving the function of the device and foot posture. In rehabilitation planning, understanding the mechanism of applied forces will help professionals to provide the appropriate protocol to increase the function of the device and joints. Because a period of rehabilitation before and after the changes in the posture or the condition in which the patient or athlete is located, can have a great help in the therapeutic methods of care and treatment of its effectiveness in the treatment protocol. it shows. In most cases, in the field of rehabilitation, the therapist is unwilling and according to the conditions of the teams and the pressure of the coaches and sports managers upon the player's return, he trains and competes with the speed of action of the fields. But this athlete's return is mostly temporary and causes joint injuries and choices in the future. Therefore, in the evaluations and screenings at the beginning and end of the season, as in the field of football, in this field as well, the amount of injuries can be minimized by taking into account clinical evaluation tests. In this study, our aim was to investigate the effects of deep sensory training with ultrasound therapy on the chronic ankle pain of young players along with the evaluation of the center of pressure and the changes in the activities of the 2 specialized muscles, tibialis anterior and peroneus longus during walking, in response to changes in their activity can help people with ankle injuries.

The statistical sample of this study included 24 people (12 people in the experimental group and 12 people in the control group). Pain intensity in both groups was assessed through the standard Visual analogue scale form, which is characterized by a pain scale of 1 to 10, and the selection criterion was a score of 7 (high pain intensity). Also, for analysis and evaluation of electrical muscle function by electromyography system of anterior tibialis and peroneus longus muscles, subjects of both groups were recorded using UK Biometrics system in stance phase in 14-meter path of both groups (pre-test). The experimental group then received a deep sensory training protocol with 3 MHz ultrasound for three weeks. The control group performed its normal activities during this period. After the treatment period, both groups re-tested and checked the pain and recorded the electrical activity of the muscles as a pre-test (post-test). For statistical analysis, correlated T-test was used for intra-group comparison and independent for inter-group comparison (p<0.05).

The results showed a significant difference only in the activity of Peroneus longus muscle in comparison with pre- and post-test of the experimental group. Also, a significant difference in the amount of pain in the experimental group before and after rehabilitation interventions was observed in the comparison within the group.

Based on the results of this study, it can be mentioned that the use of deep sensory exercises with ultrasound waves as an effective method in the rehabilitation of the musculoskeletal system in chronic pain can be used by physiotherapists and other sports rehabilitation specialists. Because its effectiveness was effective in reducing the amount of pain and normal function of selected muscles in static and dynamic positions (walking).

Although mental, emotional and social variables play an important role in the general health of teenagers, but without a doubt, the meaning that teenagers find for themselves in life, i.e. spiritual vitality, can also affect their lives. In fact, vitality and spiritual health is the newest dimension of health, which is placed next to other aspects of health such as physical health, mental health, and social health. In a comprehensive definition, it can be said that spiritual vitality is having a sense of acceptance, morality, a sense of positive mutual connection with a sovereign and superior holy power with others, which comes about through a dynamic and coordinated cognitive, emotional, action and personal consequence process (7).Since the family is the center and core of care, the most effective services are those that emphasize the role of the family and strive to empower families, because the family-centered approach is effective for children, parents, families, and service providers. It improves medical services and increases families' satisfaction with the services provided. This is despite the fact that the performance of each person within the family system, especially the guardian, who is a mental-behavioral model for continuing, maintaining and changing the behavior of other family members, affects the psychological and social well-being of children (9). Therefore, family-oriented educational intervention means providing information to families about various issues or mental disorders and methods of prevention, coping and facing them. The main goal in family-oriented educational interventions is to improve the attitude and change the behavior of family members, especially spouses (10). According to the mentioned materials, the use of effective psychological interventions can provide the ground for the normal social and emotional development of teenagers. However, it should be noted that teenagers should assume professional and social roles upon entering adulthood. Therefore, weakness in effective emotional components such as mental health and weak spiritual vitality can make them face many problems. Therefore, considering the strong role of mental health and spiritual vitality in adolescence and its extensive effects on the personal, social and professional life of adolescents, it is necessary to take appropriate measures to improve this component. At the same time, it is necessary to address the research gap. As such, conducting family-oriented research in order to reduce the psychological and emotional problems of adolescents in the high-risk period of puberty has been largely neglected. Now, considering the research gap (lack of similar research) and considering the effectiveness of family-oriented interventions, the main problem of the present study is to evaluate the effectiveness of family-oriented spiritual-respectful psychological intervention on the mental health and spiritual vitality of adolescents during puberty.

In order to conduct the present semi-experimental research, which was conducted with a pre-test-post-test design with a control group and a two-month follow-up period, among adolescent boys (13 to 15 years old) present in the first secondary schools of the 5th district of Tehran in the academic year 2018-2019, whose score less than 65 in the mental health questionnaire and less than 70 in the spiritual vitality questionnaire, 25 teenagers were selected by purposeful sampling and randomly divided into two experimental groups (13 people) and control group (12 people). In the following, the samples of the mental health questionnaire of Goldberg and Hiller (1979) which has 28 questions, 14 of which measure psychological well-being and 14 of which measure psychological helplessness in a five-point Likert scale from 0 (completely disagree) to 4 (completely agree) The range of scores is between 0 and 112. Scores lower than 65 indicate the presence of damage in the mental health process of a person (4), and the spiritual vitality scale of Polotzin and Ellison (1982) which has 20 questions, 10 of which are religious health and 10 Another question measures existential health. The range of religious and existential health score is 10-60, each separately. For religious and existential health sub-groups, there is no leveling and judgment is based on the obtained score. The higher the obtained score, the higher the sign of spiritual and existential vitality. The score of spiritual vitality is the sum of these two subgroups, the range of which is 20-120. Answers to the questions were categorized on a six-point Likert scale from strongly disagree to strongly agree. In negative questions, scoring is done in reverse. Obtaining scores less than 70 indicates a person's lack of spiritual vitality. Finally, descriptive statistics of mean and standard deviation and Shapiro-Wilk tests were used to check the normality of the distribution of variables, Levine's test to check the equality of variances, Mochelli's test to check the assumption of sphericity of the data, and mixed analysis of variance and Bonferroni's post hoc test were used to test the research hypothesis. became.

According to Table 3, the effect of the factor of group membership (respectful-spiritual family-oriented psychological intervention) on the scores of mental health and spiritual vitality of male adolescents during puberty is significant (p<0.001). The effect size shows that group membership (respective-spiritual family-centered psychological intervention) explains 44 and 42 percent of the difference in mental health and spiritual vitality scores, respectively. Also, the results indicate that the interaction effect of the type of treatment and the time factor on the mental health scores and spiritual vitality of male adolescents during puberty is significant (p<0.001). As the results of Table 4 show, there is a significant difference between the average scores of the pre-test, post-test and follow-up in the variables of mental health and spiritual vitality. This means that family-centered religious-spiritual psychological intervention has been able to significantly change the post-test scores and follow-up mental health and spiritual vitality of adolescent boys in the puberty period compared to the pre-test stage. Another finding of this table showed that there is no significant difference between the average scores of the post-test and follow-up stages. This finding can be explained by the fact that the scores of mental health and spiritual vitality of adolescent boys in the puberty period, which underwent a significant change in the post-test phase, were able to maintain this change during the follow-up period as well. In a summary, it can be stated that family-centered religious-spiritual psychological intervention has been able to lead to a significant change in the mean scores of mental health and spiritual vitality of adolescent boys in the post-test phase, and this effect has maintained its stability in the follow-up phase.

The results showed that family-centered religious-spiritual psychological intervention had a significant effect on the mental health and spiritual vitality of male adolescents during puberty and was able to improve the mental health and spiritual vitality of these adolescents. In the present explanation, it can be said that family-oriented psychological intervention improves the management of emotions and feelings (19). Based on this, family-oriented psychological intervention by improving the skills and management of emotions, cognitions and cognitive processing causes adolescents to show better mental health. In addition, during the family-centered religious-spiritual psychological intervention training sessions, parents were taught to familiarize themselves with the psychological, emotional and cognitive characteristics of adolescence and learn ways to establish healthy relationships with adolescents. Such a process made it possible for parents to establish normal psychological and emotional relationships with their children and in this way prevent the occurrence of challenges between them. Based on such a trend, the amount of mental and emotional disturbance of teenagers is reduced and they show better mental health.The second finding showed that family-centered religious-spiritual psychological intervention had an effect on the spiritual vitality of adolescent boys during puberty. In the present explanation, the concepts taught during the sessions should be addressed. First of all, it should be mentioned that family-based education is able to strengthen the communication of family members with each other by promoting the culture of mutual thinking and negotiation, and in this way, it helps to improve the mental, emotional and cognitive health of the people present in the family (25). This process can also prepare the ground for improving the cognitive and emotional processing of children, and in this way, their mental and spiritual vitality increases.

The quality of life in terms of people's perception of their position in life and in the cultural context and value system in which they live and in relation to their goals, expectations and concerns and including the individual's physical health, psychological health, level of independence and self-adherence. Social relationships, personal beliefs and their relationships with important aspects of the environment and... quality of life is related to the mental evaluation that takes place in the environmental, social and cultural context (2). On the other hand, considering the importance of women's role in the family, and their impact on raising children and the subsequent development of society, the quality of life of working women is of great importance.Therefore,the identification of factors related to the quality of life in different strata of society has always been of interest to researchers, and in this field, various researches have been conducted and various variables have been identified.In this regard, one of the important factors in the quality of life is social support. A person who has social support is aware that there are others who will support him in difficult situations. Certainly, a person who has high social support has less tension in his life and different aspects of his life have a higher quality. In general, social support is one of the components that is of great importance for mental and physical health (4).Daily courage is another important factor related to the quality of life. Bold behavior is an interpersonal behavior that includes honest and relatively honest expression of thoughts and feelings, in a way that is socially appropriate and takes into account the feelings and comfort of others. In general, boldness can be the ability to honestly express opinions, feelings and Knowledgeable attitudes without feeling anxious. Courage also includes defending one's own rights, so that the rights of others are not violated (11). In this regard, in a study by Hodgis (2018) in the study of nursing students, they showed that a higher level of assertiveness is related to a lower level of depression. In such a situation, a person's life is associated with fewer conflicts and chaos and, of course, with a higher level of relaxation and quality (4). Therefore, the researcher is trying to answer the question whether it is possible to predict the quality of life based on the components of social support with the mediating role of assertiveness in working women in Tehran?

In order to conduct the present applied research, which is descriptive and correlational, 500 people were selected as a sample from among the people who worked in Tehran between 1399-1400, and after explaining the purpose of the research, the questionnaires were selected. Gambrill and Reiji's assertiveness and the Multidimensional Scale of Perceived Social Support (MSPSS) complemented Zimmet et al. Finally, the data were analyzed using Pearson's correlation coefficient and path analysis and AMOS software.

According to the results of Table 2 and Figure 1, the coefficient observed at the level of P≥0.01 shows a positive and significant correlation between the components of friends, family and others in women with high quality of life. Examining the fit indices obtained from the structural model test showed that the model has a good fit with the collected data (df = 126, N = 448, df = 414.103, CFI = 0.99, GFI = 0.98, GFI = 0.89). = AGFI and RMSEA = 0.071). Table 1 shows the total and direct path coefficients between research variables in the structural model.According to Table 2, the total effect (sum of direct and indirect effects) of friends, family and others on the quality of life is positive and significant at the 0.01 level (P<0.01, β=0.222). And the total effect of friends, family and others on the quality of life is significant at the level of 0.05. Also, the indirect effect of friends on quality of life is positive and significant at the 0.01 level (P<0.001, β=0.190). The indirect effect of psychological family on quality of life is positive and significant at the 0.01 level (P<0.001, β=0.15). And the indirect effect of others on the quality of life is positive and significant at the 0.01 level (P<0.001, β=0.14).

The results of this research showed that the components of social support (friends, family, and others) have a direct and indirect effect on the quality of life of working women in Tehran, and the quality of life can be predicted based on these components.
In explaining this finding of the present research on the effect of the quality of life of working women, it can be noted that the difficulties of working at home and outside the home at the same time put additional pressure on working women. Housewives have more opportunities to take care of housework and rest than working women, while working women, in addition to doing household activities, must also be responsible for the tasks and demands of their workplace, so there is less opportunity for them to rest. In such a situation, the work pressure is doubled and of course it reduces the time and energy needed to deal with personal and marital affairs. In general, it seems that stressful and emotional factors in the work environment, especially therapeutic jobs, increase the feeling of irritability and tension in women, and this unwanted group may carry this amount of pressure home with them, which causes women to show signs of distress and show involvement, which naturally reduces the quality of life affected by these troubles (17).On the other hand, family support and other people are positively related to mental and physical health that is evaluated by the individual himself. The family is considered a refuge and a powerful source of support for the individual against changes and plays an important role in how its members deal with stress. and members can have a positive influence on each other in stressful situations. It is possible that working women refrain from expressing their stress and problems to their friends because their friends avoid communicating clearly about stressful factors. Also, working women may ask for help from people who are not able to help them. Also, due to cultural and personal reasons (negative sense of self-identity), most female heads of the household do not want to express their problems to their friends, so they do not receive much help from them (12). In general, social support as a positive factor can increase a person's perception of the quality of life, and as a result, this research has shown that women who have received social support received higher scores in quality of life.

Melanoma, caused by gene mutations of melanocytes, is the most aggressive skin cancer (1). The pathogenesis of melanoma is complex and involves genetic and environmental factors. The increased incidence of melanoma in developed countries is mostly due to excessive exposure to sunlight (ultraviolet light), which is the main risk factor for cutaneous melanoma (2). The interaction of melanoma cells with other cells residing in the tumor microenvironment significantly affects tumor biology such as proliferation, differentiation, and growth (3). Collective action of molecular chaperones is also necessary to maintain cellular homeostasis leading to survival (4). In human cells, stress-induced Hsp70 is expressed in the cytosol of many tumors, where it performs a wide variety of chaperone functions such as folding-unfolding and translocation of polypeptides across cell membranes, cloning and dissociation of protein complexes, and regulation of protein activity (5). High expression of Hsp70 is associated with tumor initiation, progression and survival in various types of cancer (7,8). Molecular studies show that subunits of the HSP70 protein family reduce the stability of extracellular matrix metalloproteinase-inducible protein (CD147) by increasing ubiquitin-proteasome degradation, thereby inhibiting lactate and glycolysis, and ultimately metastasis and cell migration (9). On the other hand, the tendency of melanoma cells to invade distant tissues depends on their interaction with tumor microenvironment cells and the efficiency of the immune response (10). CD147, also known as Basigin, is a highly glycosylated type I membrane protein of the large family of immunoglobulins (11). A previous study has shown that CD147 plays a key role in cell apoptosis (12).In recent years, due to fewer side effects of herbal medicines, the use of plant-derived compounds as anti-cancer drugs has increased significantly. Clinical studies show that nettle species contain compounds that show activity against cancer cells (16,17). Exercise can also reduce the risk of cancer by changing the response of immune factors (18). Wennerberg et al. (2020) found in a breast cancer model that incorporating 30 minutes of treadmill running five days per week during the anti-PD-1/radiotherapy course reduced tumor-infiltrating myeloid-derived suppressor cells and increased the infiltration of tumor cells. becomes CD8+ T, which is more useful for the function of immune cells (19). However, in Crosby et al.'s (2021) research, there was no statistically significant change in quality of life, fatigue, physical performance, cardiorespiratory fitness, body composition, psychological distress, cognitive performance, or treatment-related side effects compared to physical activity or exercise (20). Previous reports have shown the antitumor activity of nettle in various human malignancies, such as breast, lung, and prostate cancers (17,22). However, despite the therapeutic benefits of nettle plant, the effects of nettle extract on changes in immune and growth factors in melanoma cancer are not clear. Considering the therapeutic benefits of nettle plant as well as the positive effect of exercise in reducing the effect of interval training and consumption of Urtica dioica hydroalcoholic extract on Heat shock protein 70 (HSP70) and Extracellular matrix metalloproteinase inducer (CD147) in C57 rats with melanoma cancer.

In this experimental study, 20 C57 rats were randomly divided into four groups include control (cancer), Urtica dioica (cancer), and Urtica dioica - interval training (cancer). One week after the induction of melanoma cancer, the experimental group consumed 30 mg/kg/day nettle ethanol extract orally for 8 weeks. The interval exercise program included running on a treadmill 60 minutes at a speed of 28 meters per minute, five days a week for six weeks. The HSP70 and CD147 ranks were measured by Real time PCR. The data were analyzed and analyzed by One -way variance analysis and the Toky's test at the p<0.05.

The results showed that interval training, Urtica dioica hydroalcoholic extract and interval training with Urtica dioica hydroalcoholic extract consumption led to significant increase in the amount of HSP70 and significant decrease in the amount of CD147 in C57 rats with melanoma cancer (P<0.001).

The findings of the present research show that interval training led to a significant increase in the level of heat shock protein 70 and a significant decrease in the level of extracellular matrix metalloproteinase inducer in C57 mice with melanoma cancer. The findings of the present research are consistent with some results of previous studies (19,25). HSP70 induction depends on exercise intensity. High-intensity exercise has a greater effect on stimulating heat shock reactions (26). It seems that one of the effective mechanisms of exercise training on the levels of heat shock proteins is the increase in body temperature and the occurrence of oxidative stress during physical activity, which can be the reason for the increase of these markers after exercise. One of the important mechanisms of CD147 effect in promoting cancer metastasis is the metabolic regulation of the tumor microenvironment through interaction with specific MCTs, such as MCT4, which helps to facilitate lactate transport and tumor glycolysis (29,30). Little is known about the regulation of heat shock proteins in CD147 expression. In one study, it was shown that the reduction of the HSP70 protein family was associated with the increase of CD147 protein expression in human cancer cell tumors, suggesting that the negative regulation of the HSP70 protein family maybe It can increase the migration of cancer cells by upregulating CD147. This hypothesis is supported by findings that the HSP70 protein family negatively regulates the abundance and membrane expression of CD147 protein in cancer cells (9). Also, the results of our study show that nettle hydroalcoholic consumption led to a significant increase in the level of heat shock protein 70 and a significant decrease in the level of extracellular matrix metalloproteinase inducer in C57 mice with melanoma cancer. Stinging nettle extract may exert biological anticancer activities through various mechanisms, including antioxidant and antimutagenic properties, induction or inhibition of key processes in cellular metabolism, and the ability to activate apoptotic pathways (17). The most likely explanation for the significant anticancer effect of nettle is its content of flavonoids and other known molecules and/or as yet unknown substances. In addition, the findings of our study show that interval training with the consumption of nettle hydroalcoholic significantly led to a further decrease in the level of extracellular matrix metalloproteinase inducer in C57 mice with melanoma cancer. Therefore, it is possible that intermittent exercises in combination with nettle hydroalcoholic consumption may lead to a more effective regulation of immune factors in melanoma cancer, but a definitive statement requires more research in this field. The main strength of the present study is to compare the effectiveness of several interventions to identify the best intervention. The current approach results in more informed decisions. There were also limitations in the present research, among which we can point out the small number of samples in the present research, therefore, a similar study with the measurement of these indicators in a high number of samples is suggested. It is also suggested that similar research be done by measuring immune growth factors following other exercise protocols. The results of the present study showed that interval training, nettle hydroalcoholic consumption and interval training combined with nettle hydroalcoholic consumption were associated with a significant increase in heat shock protein 70 and a significant decrease in extracellular matrix metalloproteinase inducer in C57 mice with melanoma cancer. Therefore, it seems that intermittent exercises and nettle hydroalcoholic consumption can help regulate growth and immune factors in melanoma cancer.

This study aims to identify the effective components on professional competencies of faculty members in a distance education platform.Today universities compete in multi-dimensional markets (national and international student, research, enterprise) they are required to maintain solvency and comply with benchmarks and legal frameworks, to produce high quality research work, keep student consumers happy, produce good graduates—the list of imperatives grows. Since the role of higher education is decisive in economic, social, technological and cultural development of the country and the specialized manpower required by different sectors are trained by higher education. Therefore, the strengthening and development of higher education is the basis for the development of other sectors. Among these, one of the main and important factors of the country education system are faculty members. So, their ability and competencies have a direct impact on the performance of higher education.  New missions in the university system and understanding the multi-semantic concept of the university have always been the necessity of paying attention to the subject of faculty members by policy makers and higher education managers. Therefore, the reaction of universities to the issue of faculty members' competencies as one of the main assets of the university has always become an attractive and significant subject in academic circles, so that over time universities and higher education institutions have found that they need programs that essentially help them in managing, developing and improving this capital. This attention comes at a time when confrontation with the developing global economy, global communication through new technologies and systems, the growth of higher education costs, the emergence of new knowledge and research capabilities, the rise of global education and literacy, and the emergence of trans-competitiveness in the fields of higher education have made it inevitable to increase organizational efficiency for universities and higher education centers.Experts believe that faculty members' quality and competence level is one of the important factors in students' success. Therefore, lack of necessary skills and competencies by professors can affect the faculty members and students' performance. Given the importance of the subject over the past decade, the study of faculty members' competencies, especially at the graduate level, has been considered by many researchers in the field of education, teaching and professional development. The importance of this issue is that the students' fate depends on their professors and their level of competence in various fields. Competencies refer to a person's knowledge, skills, abilities, or personality traits that directly affect his or her job performance. The concept of competency has a long history in the field of management and is more applicable to leaders and managers. Competency is a combination of explicit and implicit knowledge, behavior, and skills that give individuals the potential and capacity to perform tasks effectively.The current situation of the country's universities, which with the increasing demand for higher education and increasing degree of degree, along with the increasing tendency of the private and semi-private sector to establish universities and higher education institutions, often of poor quality, can have a negative impact on university faculty performance. Criticisms such as the reduction of quality, the incompatibility of university output with the needs of the labor market, business and the sacrifice of education and research, have targeted these organizations with severe criticism that the lack of attention to it at the micro level, A number of undocumented and unqualified citizens want to occupy top positions at the macro level and will slow down the process of moving towards sustainable development. What are the qualifications of faculty members to affect the development of the distance education system and how vital and sensitive the contribution of each factor is an issue that will be studied in the present study. Currently, one of the most important challenges facing Iran's higher education is the little and brief development of faculty members of universities.The present study seeks to identify the components affecting the professional competencies of faculty members in the context of distance education in order to consider them in policy making and planning to improve the quality of human resource development.

The research design is descriptive survey. The qualitative section was used to deduce the model. In the quantitative stage, the Delphi method based on experts’ judgement was used to indexing the model. The statistical population (N=190) in this research was the faculty members of Payam Noor University of Khorasan Razavi who were selected and navigated based on Krejcie and Morgan (1970) Table of determining sample size (N=120). The data collection instrument was a researcher-made questionnaire that was edited and modified in several stages. The validity of the questionnaire was measured through construct validity and its reliability was calculated through Chorenbach α (94%) Obtained. Based on literature and research history, the components were identified. The identified and effective components on professional competencies of faculty members including knowledge, skills, behavior, attitudes and sub-factors are relevant to each factor.In this paper, recent articles, theses and sources were studied and 120 items related to the professional competencies of faculty members, were extracted and given to the experts in the first stage. Out of this number, 20 items with standard deviations above one and below average were removed based on analysis.In the second stage, the items were examined for re-examination in the form of a questionnaire by 15 experts. In the second stage, 93 items, out of 110, were finally approved.
The professional competency questionnaire of the faculty members has construct validity based on the experts’ view and the reliability of the questionnaire was determined to be 0.943.

To find the effective fundamental variables which affect e-learning, the Delphi method was used. The effectiveness of knowledge factor (0.314), skill factor (0.219), behavior factor (0.125) and attitude factor (0.255) were obtained. In this study, knowledge factor with specific value (6.66) and explained variance (12.40) had the highest share among factors affecting faculty members' competencies. Cultural knowledge with factor load (0.80), computer literacy with factor load (0.78), information literacy with factor load (0.75) and job knowledge with factor load (0.70) are the most effective variables of knowledge factor, respectively. According to the obtained results, it can be stated that the highest value is related to knowledge dimension and the lowest value is related to behavior dimension.

The value of human resources capital in the development and use of main competencies and capabilities cannot be underestimated. For maintaining and following developments in human resources’ tasks and functions, experts in human resource must acquire and develop a new set of competencies to complete their changing roles and responsibilities. Developing learning culture, improving communication channels, developing team skills and creating an organizational climate combined with meaningful feeling, competence, independence, trust and participation can play an important role in promoting faculty members' performance.

People who report low psychological well-being due to the experience of unpleasant emotions and negative evaluation of life events affect their level of commitment in married life and lead to a tendency to betrayal. Given that the conditions underlying betrayal are provided among students and due to the consequences of the tendency to betrayal in the young generation, identify the factors associated with it and on the other hand study specific treatment approaches in this field that their effectiveness in different samples It has been shown to be an effective step in reducing the tendency to betray. People who report low psychological well-being due to the experience of unpleasant emotions and negative evaluation of life events affect their level of commitment in married life and their quality of life. This study was conducted with the aim of the effectiveness of treatment based on acceptance and commitment on psychological well-being and quality of life in married students with a tendency to infidelity.

The present study is a quasi-experimental study with an expanded research design (pretest-posttest with two experimental groups and a control group). The statistical population in this study included all married students aged 20-47 years with an average age of 33.5 studying in the Sirjan University in the number of 700 people. Available sampling method was used to select married students with a tendency to betrayal. In the first stage, in order to determine the cut-off point, considering that the scores of the questionnaires are in the range, 30 married students aged 20-47, studying in technical and humanities colleges, were randomly selected as a pilot and then they were asked to Complete the questionnaires of attitudes toward betrayal, psychological well-being and quality of life. After calculating the scores of these thirty people and estimating the mean and standard deviation of the components, the cut-off score was defined. In other words, the cut-off score was found to be two standard deviations above the mean in the attitude to betrayal attitude scale and one standard deviation below the average of the pilot group in the welfare scale. Then, in the first phase of the study, 500 couples aged 47-20 years were selected by convenience sampling method and the attitude toward infidelity questionnaire was administered as the first screening. A total of 183 people who obtained a cut-off score in the Betrayal Attitude Questionnaire were selected and entered the second stage of screening and completed the Psychological Well-Being and Quality of Life Questionnaire. Then, 45 of them were randomly selected and randomly assigned to two groups (experimental group and control group). It should be noted that the members completed the profile form containing the contact number to coordinate the meeting, the location of the meetings, completing the questionnaires in the post-test and follow-up phase, as well as the informed consent form to participate in the research. The two experimental groups underwent 8 sessions of two two-hour sessions (once a week) at the Sirjan Branch of Azad University in the second semester of 1997-98. At the end of the sessions, members of all three groups completed the questionnaire as a post-test. In order to remind up to three months, one session was held for the experimental groups every month and after three months in the follow-up phase, they completed the welfare questionnaire. ACT treatment courses were performed in 8 2-hour group sessions per week for experimental groups. For data collection, the short form of Reef Psychological Well-Being and Quality of Life Questionnaire of the World Health Organization was used. Data were analyzed by repeated measures analysis of variance and Beferroni post hoc test.

Based on the results, the difference between the adjusted means of the two groups in the variables of psychological well-being and quality of life and its dimensions in the post-test and follow-up stages compared to the pre-test stage was statistically significant (p≤0.05). The findings also showed that there were significant changes in psychological well-being scores and quality of life in the post-test and follow-up stages in the ACT group.

These findings indicate the usefulness of ACT treatment on psychological well-being and quality of life in married people with a tendency to betrayal. These findings can be promising in planning preventive and therapeutic interventions. However, more controlled studies are needed in this area. This research, like any other research, had limitations in generalizing and interpreting the results as follows. In acceptance and commitment therapy, the emphasis is on increasing the individual's desire to experience internal events as they are. Here, the goal was to help people experience the thought of betrayal only as a thought and instead of responding to it by doing what it is. Life is important for him and in line with his values, that is, the existence of a thought with the content of betrayal was not an issue in itself, but the main issue was the person's attempt to respond to the betrayal thought (ie the act of betrayal). Horror events (such as thoughts of betrayal) are what is called psychological resilience. When a person constantly reminds himself that his life in the present moment requires a behavioral effort in line with goals and values and not focusing on disturbing and imposed thoughts, no doubt reducing the focus on the intensity and frequency of thoughts. Will also be reduced One of the main consequences of the end of this process is to improve the quality of life. Acceptance and commitment therapy enhances the level of psychological flexibility and it is believed that if people have the appropriate psychological flexibility, they can easily overcome their psychological and even social problems. When every human being is trapped in psychological inflexibility, the quality of life declines because the person feels trapped in a context in which valuable things are replaced by thoughts and efforts focused on avoiding worry and negative thoughts. Will not have a favorable living conditions. Continuing a negative assessment of living conditions that are accompanied by inflexible behaviors will simply weaken the quality of life in people. From this perspective, it is natural for married people with a tendency to betrayal to feel that their quality of psychological and social life is poor and undesirable, but when they entered the process of commitment and acceptance of treatment, they learned this type of treatment by relying on metaphorical techniques. To spend less energy on experiential avoidance and instead focus their energy on more flexible behaviors. This path to self-transformation and life in the end provided the basis for improving the quality of life of married students. In this study, compassion-focused therapy increased the quality of mental, social and physical life of the subjects. Creating a non-judgmental, compassionate, flexible and moment-by-moment relationship using mindfulness techniques in interpersonal relationships of couples with the potential for infidelity can Useful forms of mindfulness and creating a satisfied view in people caused them to enjoy their existing relationships and use all their efforts in the marital relationship environment based on value-based goals and thus the quality of their psychological and social life.

Educational organizations are one of the main pillars in human society and the development and survival of societies depends on the good performance of these organizations. Universities are among the social systems. In which real power arises from recognizing patterns of change, measuring and seizing opportunities. In this type of environment, human resources need many competencies for survival, because they operate in an atmosphere of confusion, uncertainty and instability due to the complexities of the environment. What is defined as situations of multiplicity and contradiction is pressure, anxiety, unhappiness, or responding to difficult situations and ultimately responding appropriately to difficult choices in order for the organization to grow and prosper. In these circumstances, identifying cognitive strategies leads to increased organizational performance. And while reducing the emotions caused by dealing with paradoxical phenomena, tensions and ambiguities arising from thinking and expressing organizational experiences, manpower agility by creating a balance between influential factors such as Cognitive abilities, an emotion that reinforces a positive attitude in employees to confront the organization with a turbulent environment to increase productivity and consequently a competitive advantage. Therefore, the aim of this study was to investigate the effect of paradoxical cognitive strategy on human resource agility.

In this mixed research (qualitative-quantitative), in the qualitative section, the statistical population was selected from among the professors of universities in Mazandaran province in 2020 and the information was obtained through purposeful sampling and interviews. Semi-structured items were collected considering the theoretical saturation law. In a small part of the statistical population consisting of heads of units, faculties, deputy heads of units, faculty members and all administrative, educational, research, financial and student officials, 341 people using stratified random sampling method and based on Cochran's formula 181 people were selected as a statistical sample. Also, the validity of the researcher-made questionnaire in this section was confirmed by the content and structure and the reliability of the questionnaires was estimated and confirmed by Cronbach's alpha 0.91 and 0.94, respectively. Data were analyzed using SPSS and lisrel 8.8 software.

The results showed that paradoxical cognitive strategies have a positive and significant effect on human resource agility. The results also showed that the elements and components of the paradoxical cognitive strategy are effective in manpower agility of 38% in the free universities of Mazandaran.

In general, it can be acknowledged that the human resources in the university should accept the paradoxes, understand and avoid the potential for anxiety in order to strengthen the defensive responses that prevent the rapid and adaptable agility of the human resources. Slowly Educational organizations are one of the main pillars in human society and the development and survival of societies depends on the good performance of these organizations. Universities are among the social systems. In which real power arises from recognizing patterns of change, measuring and seizing opportunities. In this type of environment, human resources need many competencies for survival, because they operate in an atmosphere of confusion, uncertainty and instability due to the complexities of the environment. Organizational complexity shows the degree of differentiation within the different elements of the organization, and in the current situation, unprecedented, dynamic and nonlinear changes in the environment of organizations have increased. Changes that have led to unexpected, unforeseen and surprising issues. Organizations have to increase their internal complexities to cope with these complexities. Increasing internal complexities create the ground for the emergence of puzzles, multiplicities and contradictions in the organization that can not be eliminated due to external and internal dynamics of organizations. In addition, organizations pursue contradictory results in order to survive and maintain themselves in the competitive arena. What is defined as situations of multiplicity and contradiction is pressure, anxiety, unhappiness, or responding to difficult situations and ultimately responding appropriately to difficult choices in order for the organization to grow and prosper. Paradoxes are paradoxical yet interconnected elements that exist simultaneously and persist over time; These elements are logical when considered individually, but seem irrational, inconsistent, and tolerable when put together. Theorists have turned their attention to how to withstand the stresses hidden in paradoxes, because it is very difficult to constantly balance or create the desired level that relieves stress. Practical perspectives on conflicting stresses show that stresses are created at the micro level where individuals face stresses over identity, conflicting roles, and performance expectations. What is defined as stressful situations is the stress caused by physical, emotional, and psychological conditions resulting from prolonged engagement with difficult emotional conditions that gradually accumulate over time and, as a combination of unstable emotions, the inability to cope. Relaxation, feelings of discomfort, loneliness, sleep problems, excessive smoking, high blood pressure and gastrointestinal disorders are experienced. In these situations, identifying cognitive strategies with the ability to understand and express emotions as much as possible, self-regulation, self-awareness, spontaneity and social ability all lead to increased organizational performance. And while reducing the emotions caused by dealing with paradoxical phenomena, tensions and ambiguities created by thinking and expressing organizational experiences, manpower agility by creating a balance between influential factors such as capabilities Cognitive, the emotion that strengthens the positive attitude of employees to confront the organization with the turbulent environment to increase productivity and consequently provides a competitive advantage. In other words, the role of psychological beliefs allows people with high levels of perception of emotional abilities to be able to deal with paradoxical stress, report less perceived stress, and job satisfaction, feelings. They should be more successful and motivated. So, the cognitive strategy of paradox can be considered from social, psychological and medical dimensions, because in recent years in the country, there are moves to pay attention to the effect of psychological therapies in reducing stress. And a number of occupational counselors, psychologists, psychotherapists and psychiatrists in counseling clinics use coping techniques.

The rapid development of organizations is highly dependent on the development of knowledge, technology and information and one of the basic and important components for the development of any organization is the knowledge and science in the organization. In knowledge-based and leading organizations, human resources are the most important asset of the organization and the realization of assigned goals and missions and gaining superiority is closely related to the competence and capability of human resources. On the other hand, today behavioral issues play an important role in various human fields. Behaviors can have desirable functions in organizational areas and lead to improved organizational status in various fields, including knowledge. Structural factors are one of the factors that can analyze organizational phenomena and management and psychology in people based on them. Structural factors are paths, channels and vessels in which organizational processes and operations are ongoing and have been formed and almost fixed during organizational changes and include components such as organizational structure, methods improvement, mechanized information system, payment system, Selection and employment, job appointment and promotion and performance appraisal. In this regard, one of the important issues in today's environment is the development of knowledge-based human resources. Due to its relationship with community health, the University of Medical Sciences needs to share as much knowledge and use efficient methods in providing quality services, reduce health costs, and meet the needs of clients in a timely manner. New information management and establishment of human resource system is knowledge-based and ultimately knowledge management. Lack of establishment of knowledge-based human resources in the University of Medical Sciences, on the one hand can reduce the motivation and job satisfaction of employees and consequently reduce the efficiency and effectiveness of the health system. On the other hand, the lack of a knowledge-based human resources system can prevent the formation of smart networks and knowledge sharing professions, the departure of experienced and specialized personnel from the university, weak creativity and organizational innovation, and weaken participation and team spirit. Lack of attention to behavioral and structural issues for the development of human resources, especially in the University of Medical Sciences, has caused a great deal of readiness to develop knowledge-based human resources in this university. These ambiguities have led to the lack of operational solutions for the development of knowledge-based human resources in the University of Medical Sciences. Therefore, the aim of this study was to the role of behavioral and structural factors in the development of knowledge-based human resources in the University of Medical Sciences of one country.

The research method is descriptive correlation which was applied in terms of purpose. The statistical population of the study included all managers and experts of the University of Medical Sciences in one country (150 people) who were selected as sample. The method of data collection in the present study was field. The instruments of the present study included 3 questionnaires of knowledge-based human resource development, behavioral factors questionnaire and structural factors questionnaire. The face and content validity of the questionnaire was confirmed by 10 professors and the construct validity was examined based on confirmatory factor analysis. The reliability of the questionnaire based on Cronbach's coefficient of score is 0.82, respectively; 0.86 and 0.85 were obtained. To analyze the data, descriptive statistics and inferential statistics (structural equations with partial least squares approach) with PLS and SPSS software have been used.

The results showed that the model of the effect of behavioral and structural factors on the development of knowledge-based human resources has the necessary and desirable fit. Also, according to the research findings, behavioral factors have an effect on the development of knowledge-based human resources by 0.601 and structural factors have an effect on the development of knowledge-based human resources by 0.304.

The findings of this study were consistent with the results of Previous research. Knowledge-based human resources can have the necessary efficiency in forming a competitive advantage in any environment and organization. Organizations are witnessing the arrival of new forces that have different demands and expectations from previous generations of workers. These people try to reach a logical solution to organizational problems and issues with their comprehensive knowledge of the issues around them. There was a fact in the past that knowledge-based people do not fit well with the context of Iranian organizations, and it was observed that the confrontation between the forces of students and other forces that are in the majority, in major organizations cause intellectual conflict and sometimes unpleasant psychological dimensions to knowledge. In most organizations, the effort to stabilize and maintain the status quo prevailed over the effort for dynamism and change, and leadership did not have a high position alongside coaching, which is a basic need of knowledge-based forces. Other issues in organizations were worn-out structures and bureaucracies in them, which combined with the low quality and quantity of information access tools posed many problems for knowledge-based forces. Today, attention to knowledge-based human resources is one of the important pillars of organizations. The results of the present study showed that behavioral factors have significant effect on the development of knowledge-based human resources in the University of Medical Sciences of one country. Improving behavioral factors can provide the basis for the development of knowledge-based human resources in the University of Medical Sciences in one country. The results of the present study also showed that structural factors have a significant impact on the development of knowledge-based human resources in the University of Medical Sciences of a country. So that the improvement of structural factors can provide the basis for the development of knowledge-based human resources in the University of Medical Sciences. In today's turbulent world and complex competitive environment, the existence of knowledge and knowledge-based human resources as a valuable, strategic and assuring resource is a superior strength for organizations. The knowledge of employees about their country's market in terms of language, legal system, international market information and business operations is obvious. Today, organizations are trying to become knowledge-based. They are using their brains more than their hands and the need to use knowledge is increasing. The increasing importance of knowledge in modern organizations has necessitated the need to focus on knowledge management as an organizational asset. In the meantime, knowledge-based employees are of far greater importance; Because they are the bearers of tacit knowledge of organizations. The University of Medical Sciences, as one of the important centers of the country, must always have an experienced human resource in order to succeed. Knowledge-based human resources in this university can meet the needs of this university in the field of expert manpower as well as sufficient knowledge. It seems to Behavioral factors play a greater role than structural factors in the development of knowledge-based human resources in medical universities.

One of the important challenges of teachers in classrooms is to focus students' attention on subjects and help them learn. One of the factors affecting the academic progress of students is the presence of variables such as mental health that can affect learning. Students are considered the main assets of any society, and improving the level of mental health and reducing mental disorders in these people is an important matter, and having healthy students, both physically and mentally, can achieve the main goals of society's health, because one of the important goals in society is to have healthy people physically and mentally. Many factors are involved in reducing mental disorders such as depression, anxiety, and stress, which are spiritual health and spiritual care. Spiritual health leads to the improvement of the level of emotional and physical needs of the disease among patients, reducing pain, stress, and negative emotions and reducing the risk of depression and suicide. It has been reported that people who receive adequate spiritual care have a higher level of life expectancy. When people's spiritual needs are not met, lower levels of life satisfaction are observed. It seems that unfulfilled spiritual needs have a profound effect on people's mental health. These adverse outcomes include decreased quality of life, increased risk of depression, and decreased perceived spiritual well-being. The necessity of the existence of spirituality in human beings is like the necessity of the existence of inhaling and exhaling for the body to be alive. Spirituality can be identified for all human beings in all societies and all over the world. Spirituality is one of the life-giving principles of human existence and has been accepted by many religions, cultures, and traditions all over the world. On the other hand, there are still opinions that consider spirituality to be internal from birth and in a static state, and that spirituality is acquired through life experiences. Spirituality is considered to be an inner experience and both a connection to a transcendent power and a reality for increasing awareness and connection with oneself and others and a greater reality. Spiritual health is considered a protective factor in promoting health and preventing diseases, while spiritual health can be mentioned as a successful and helpful strategy for human life in all stages and areas of life, including situations full of stress, diseases, and even death. Considering the importance of the role of students in the future of any country and the lack of studies regarding the role of spiritual care on the level of mental disorders, the present research was conducted with the aim of investigating the relationship between spiritual health and the improvement of mental disorders in students.

The statistical population of this descriptive-correlation study included all female students of the second secondary level of Miandoab city who were studying in 1400 and their number was equal to 1800 people, and the sample size was 317 people through Morgan's Kargesi table. , was selected by a simple random sampling method. In this research, Polotzin and Ellison's spiritual health questionnaire and mental disorders (depression, anxiety, stress) Lavibond et al. (1995) were used. Data were analyzed using Pearson's correlation test and multivariate regression.

The results showed that the correlation coefficient calculated between spiritual health and stress (0.438) and spiritual health and anxiety (-0.324) as well as spiritual health and depression (-0.282) is smaller than the error level of 0.5 is 0.0, so it can be concluded that there is a relationship between spiritual health and stress, anxiety, and depression of students, and since the value of the calculated correlation coefficient is negative, therefore the relationship between them is negative and inverse.

Spiritual health leads to the improvement of the level of mental disorders (stress, anxiety, and depression) in students, so it is suggested that teachers and educational staff as well as parents take measures to increase the level of spiritual health in students. The current research, like any other research, has limitations that can clarify the findings and suggestions of the research and help future researchers to adopt effective measures to deal with the threat of internal and external validity of research projects. to give The basic limitations of the current research are as follows: the bias of people towards answering the questions of the questionnaires, which reduces the accuracy of the results to some extent, the presence of unwanted variables that affect the results of the research, and the lack of use of other research tools such as observation and interview. It has been associated with the subjects and only using the questionnaire. This research was conducted only on the population of secondary school female students of Miandoab city, and caution should be taken in generalizing the results to other regions and cities. The level of honesty of the respondents to the questions in the questionnaires is one of the uncontrollable limitations. Also, several questionnaires were completed at home, and the existing conditions may affect the way of answering. It is suggested that at the beginning of the academic year, by referring to the students' files, they should try to identify those who have a low level of spiritual health, and with the cooperation of the director and vice-chancellor, to adopt strategies to increase the level of spiritual health, for example, encouraging and persuading students. Parents and educators should conduct regular and continuous religious activities. To reduce the problems of students who have mental disorders, help from the school staff and parents, because a working group gives better results. In briefing sessions with families, problems such as mental disorders and complications of lack of spiritual health level and methods of identifying students with such problems should be pointed out and we ask parents to continuously monitor the behavior of students and communicate with the relevant teachers in In this field, they should cooperate as much as possible so that if these cases are identified, they can quickly prevent and treat such problems.

The global epidemic of the disease caused by the coronavirus, a severe acute respiratory syndrome that emerged in December 2019, was not only considered a threat to the health and lives of millions of people around the world. In many countries, including our country, various solutions were presented so that the education of students is not interrupted during the period of social distancing and that the curriculum continues according to the pre-determined schedule. In fact, with the beginning of the closure of schools to help eliminate this virus, the concern of developing and implementing educational programs to continue education at home and in the conditions of home quarantine is one of the biggest challenges of educational systems, including education. In such a way that international institutions and organizations, such as the United Nations Children's Fund (UNICEF) and the World Health Organization, were forced to work hard to develop curricula, instructions, and educational guides for these conditions. Although Covid-19 could have negative effects on educational activities, social distancing has stimulated the growth of online educational activities so that there is no disruption in education. The electronic learning system has created educational environments that are not dependent on any specific location or time and allows teachers to teach a course simultaneously or asynchronously or use a combination of these two modes. In this way, electronic education or education through virtual space was chosen as one of the important and serious programs in education. Electronic education and learning are one of the achievements that have transformed our world. E-learning is a new method in education that deals with providing and managing learning opportunities to improve knowledge and skills through the Internet and computer technology. Meanwhile, online electronic learning is described as a learning experience using various electronic devices (tablets, laptops, smartphones, etc.) with access to the Internet in simultaneous or asynchronous environmental conditions. Online e-learning can be a platform that makes the education process inclusive, creative, and flexible. Electronic learning as an educational medium in the classroom is a new experience for the teacher and students, which can be an effective step towards stabilizing and accelerating students' learning. On the other hand, the most important characteristics of secondary school learners that teachers should pay attention to can be classified into three types: cognitive, emotional, and social. The elementary course is one of the most important and sensitive academic courses, and it is very important for teachers and trainers to pay attention to the different characteristics of students' growth, and to know that electronic learning requires a series of hardware tools and its extensive use may affect the level of health. Mental Health Mental health is an issue beyond the absence or absence of mental illness. The positive dimension of mental health, which the World Health Organization relies on, is included in the definition of health: "Health is a state of physical, mental and social well-being, not just the absence of disease or disability". Therefore, mental health is a state of well-being in which a person recognizes his abilities and can adapt to the normal stresses of life and be useful and productive in terms of work. Since there are no social interactions (compared to the common and usual form in the real environment) in the context of electronic learning, learners must be able to maintain their mental health level. As a result, students who have more mental health and the necessary abilities to deal with common academic challenges can be more self-regulated and self-efficient than other students, and as a result, they are more successful. They achieve more success in subjects in which they are more interested and motivated, and more success provides more motivation for learning, academic progress, academic performance, and continuing education. According to research findings, there is little information on the relationship between electronic learning and students' mental health. Therefore, the current research was conducted to investigate the relationship between electronic learning and the mental health of secondary school students, and it will seek to answer the question of whether there is a significant relationship between electronic learning and the mental health of secondary school students.

The present study is descriptive and correlational, and the statistical population of this study included all male students in the second year of high school in Isfahan, who were studying in the academic year 2001-2001. The statistical population according to the inquiry from the statistics unit of the Isfahan city education department was equal to 850 people. According to the table of Karjesi and Morgan, 265 people were selected through a simple random sampling method. Research tools included two electronic learning questionnaires by Watkin et al. (2004) and Goldberg's mental health questionnaire (1972). Pearson's statistical method was used for data analysis.

The research results showed that there is a relationship between e-learning and students' mental health.

In general, all these topics indicate that there is a significant relationship between e-learning and mental health during the epidemic, or that the increase in e-learning increases the level of mental health. The results showed that there is a significant relationship between e-learning and mental health. The Department of Education is one of the most basic and important organizations in the world today, and students have a direct relationship with this organization, and this shows the key and vital role of this department in their complex lives. Knowledge of electronic learning and its better use can facilitate and predict the quality and continuity of mental health and lead to the implementation of programs scientifically and avoiding unwise actions. Mental health refers to the possession of understanding and decision-making and positive psychological characteristics that facilitate the growth and development of a person and enable the achievement of goals. While students are thinking about their survival, they should take a step beyond this view and pay attention to the consequences and effects on society. E-learning is considered an important issue for education and the factor of its survival, in this, paying attention to the mental health of students and using an effective solution for it is discussed. An office like the education department should pay attention to all educational levels (in-person and out-of-person) properly. One of the most important concerns of the producers and presenters of online learning courses is the integration of traditional and non-attendance educational strategies in these courses to retain learners and improve their learning, which can affect the mental states of learners. Be effective for this reason, school officials and workers have made a lot of efforts to develop and promote this learning style in their students, and they are trying to make this type of learning along with reducing its disadvantages. Students who are deprived of being in the space must have a level of self-efficacy to be able to use this technology, and if they are not taught, they will get confused and reduce the quality of education.

Measuring the learning environment is one of the necessities to improve the quality of students' learning. Therefore, in the curriculum planning based on competence, it is necessary to use the measurements to ensure the quality of education. Nowadays, international centers pay special attention to the issue of cultural competence, and since the beginning of the 1960s, they have investigated the theoretical foundations and definitions of the issue and have designed various models for quantitative and qualitative evaluation of cultural competence in world’s reputable medical sciences universities. Despite that the international scientific community has addressed this issue and in spite of the cultural diversity in Iran, it was only in the last few years that some review articles have emphasized the necessity of cultural competence in medical education and some studies have investigated and evaluated the learning environment using international tools.Also, reviewing the studies on new teaching approaches in Iran shows that although cultural competence is not considered in clinical education and they are not academically trained in the field of culturally competent care, the medical team fulfill the cultural needs of their patients based on their cultural intelligence and initiative. In this situation, only a small part of this culture would be officially transferred to students during the curriculum hours, and the acceptable values, beliefs and behaviors would be transferred through the covert curriculum.Accordingly, considering its importance and necessity, it is recommended that this issue should be taken into consideration in clinical education approaches, especially new approaches, and quantitative and qualitative studies should be used to measure and improve the education of this important notion.Therefore, the purpose of this research is to evaluate the cultural competence status of medical graduates in Tehran in order to provide a model that is appropriate for the background and context of Iran’s universities.

This research is descriptive and analytical. The data collection tool in this research was a valid and reliable researcher-made questionnaire. The first part of the questionnaire included demographic information and the second part had 64 valid and reliable questions in 4 main subgroups as: cultural awareness, cultural knowledge, cultural skills and transcendental motivation. This questionnaire was conducted on a statistical sample of 800 graduates of medical sciences, working in hospitals and medical centers in Tehran, using random sampling method. Quantitative data was analyzed using SPSS-24 and internal correlation, independent t-test and analysis of variance were analyzed.

Out of 800 questionnaires, 542 were returned, of which 507 questionnaires were thoroughly completed; which is an acceptable 67% return rate. Also, 82.6 percent of the respondents were women which indicates that women cooperate more in filling out the questionnaires as they participate more in the activities and were more in number.Cronbach's alpha coefficient for the whole instrument (64 questions) was 0.96. The highest value for the domain of transcendental motivation was 0.89 and the other domains were 0.88.The results of the independent t-test show that although there is no significant difference between male and female medical students regarding the status of cultural competence, the average scores of men were higher than women in the domains of transcendental motivation, knowledge and cultural skill. But women had a higher score in the domain of cultural awareness. Also, the results of the independent t-test based on marital status show that there was a significant difference between the average scores in 4 domains (transcendental motivation, cultural awareness, knowledge and skills) in which the average scores of married people were higher than single respondents.The results of the one-way ANOVA analysis showed that there is no significant difference between cultural competencies based on the university, but there is a significant difference in accordance to age, field of study, degree, work experience andworkplace. According to age, in all the 4 domains, the average score increases while aging. Also, based on the field of study, the average of 3 domains (cultural awareness, knowledge and skills), nursing students had a higher average, and in the domain of transcendental motivation, midwifery and then nursing students had a higher average than other fields. Finally, the average score increases with the increase in work experience.The final average of the questionnaire was calculated as 3.92+0.48 out of 5, in which the highest score was for the domain of transcendental motivation with a score of 4.15+0.48 out of 5, followed by awareness and skill; the knowledge domain had the lowest average with a score of 3.68±0.59 out of 5. According to the averages obtained in different domains, the general statue of cultural competence of medical students in Tehran is higher than average and is acceptable.In the field of the transcendental motive, respecting values and beliefs, giving priority to humanity and paying attention to God's consent had the highest average, and to enjoy serving different people had the lowest average. In the domain of cultural awareness, the awareness of one's own cultural beliefs and attitudes had the highest average, and familiarity with the differences in health behaviors of different cultures had the lowest average; in the domain of cultural knowledge, knowing spiritual and religious beliefs had the highest average, and knowing common methods of traditional treatments, knowing the history of traditions and knowing the nutritional beliefs of different cultures had the lowest average. In the domain of cultural skills, serving without bias and practicing communication skills had the highest average, and generating new knowledge had the lowest average.

This study showed that the graduates' evaluation of the cultural competence of the educational environment is positive, therefore, it is recommended to emphasize using appropriate methods to enhance the factors that have positively affected the evaluation of students.

Stress is derived from the Latin word stringer, which means to hug, squeeze, and squeeze.In today's medical science, there are different equations and perceptions of it: "urgency" and "compulsion" to stimuli, excitement to the psychological reactions that occur, urgency and compulsion to physiological changes resulting from these perceptions. In general, stress refers to the force that causes some significant changes in a system when applied to it. The term refers to physical, psychological, social forces and pressures.In this case, stress in this sense is a cause and is the prelude to some disabilities. On the other hand, stress is a state of psychological stress that is caused by the types of forces or pressures mentioned above, and therefore stress in the second sense of a disability. Pressure and stress may be perceived differently by people. People's physical and emotional status, lifestyle, financial status determines the level of being affected by these changes. In today's society, stress-related diseases increase day by day, so the people and institutions are confronted with an important problem to be faced. Since they provide service to intensively stressed individuals and also the staff encounters with stressful situations very often, the field of legal medicine considered as a work environment a lot more stressful than the other work environments. While providing the service, legal medicine workers, they see a lot of patients and patient relatives with many different levels of health problems. These situations threatening an individual's health and causing stress due to uncertainty and obscurity affect the legal medicine workers as well as the clients. According to the definition of the National Institute for Occupational Safety and Health (NIOSH), job stress occurs when there is no coordination between job needs and abilities, capabilities and desires. The level of this stress varies in different professions and occupations, and professions and occupations that deal with human services create a lot of stress. Stress is also directly related to job satisfaction and performance and is one of the components of health, safety and comfort. Since it is completely impossible to eliminate stress, it seems necessary for different people to learn how to deal with and manage it . Various factors affect the physical and mental condition of medical staff. Some of these factors are related to the work environment and some are related to outside the work environment such as their quality of life, problems and social issues.Among the factors related to the work environment, we can mention the presence in different departments of forensic medicine with different working conditions. Identifying areas that bring more stress or less job satisfaction to staff will lead to better planning and more attention to these areas.Different departments of forensic medicine have their own working conditions and characteristics, including the number of clients, the condition of the injured, the type of disease, the number of staff, the status of colleagues and encountering bodies, and so on. Accordingly, different variables such as stress and job satisfaction can be present in them to different degrees.Therefore, it seems that research is needed to determine the strategy for legal medicine workers to deal with stress based on working conditions.This study was conducted to determine the stress level of legal medicine workers in the workplace, the factors affecting it and their coping strategies.

In this descriptive study, it is aimed to identify the stress factors and the strategies in coping with stress of the tehran legal medicine workers. The statistical population of the study included all workers in four departments of legal medicine, including clinical examinations Necropsy, commission and laboratory, which was selected based on Cochran's table, 217 of which completed 210 questionnaires. Besides the questions about the demographic features, 8 questions about the work life of the staff, 3 questions about the resources about the resource of stress, 10 questions about the change in their behavior under stress, 1 question about measuring the reactions to stress, totally 27 questions are included in the survey. The obtained data were analyzed by SPSS program. Data were evaluated by using number percentage calculations and chi-square importance test.

It’s found out that among the legal medicine workers in the study, 53% of them are male, 32.8% of them are between 45-49 years old, and 41% of them have an undergraduate degree. 60% of respondents are active in the clinical examination department, 52% of them have an experience between 10-19 years. Among the legal medicine professionals in the study, 83% was determined to have a source of stress. Major causes of stress are; by 53% the work ignored by others, by 37% inequitable distribution of tasks, by 31% the widespread use of gossip in the workplace, by 30% relations with management, and by 28% injustice in performance evaluation. The legal medicine professionals expressed their methods of coping with stress as follows: 42% of them say “I endure in silence and burn myself out”, 36% say “I try to solve it on my own”, 36% say “I share it with my best friends or family and try to find a solution”, 27% say “I direct myself to another thing and try not to occupy my mind with the problem”, 26% say “I yell at people around me and take out my anger on them”.

It has been determined that among the workers of Tehran legal medecine, 83% have a source of stress. The most common stress factors are; work ignored by others, inequitable distribution of tasks, the widespread use of gossip in the workplace, relations with management, injustice in performance evaluation, fear of patient dissatisfaction and complaints. These results are consistent with the findings of several studies. that examined job stress in different jobs and confirms that today everyone in any place and situation feels some degree of stress in their work environment and this It is a tangible and undeniable thing in modern organizations. Some differences are shown between the results of the study and the results obtained.The difference between the stressors is noticeable.The number of legal medecine clients, lack of workers and equipment and excessive workload are not determined as stressors.Instead, our research has shown that stressors are caused by an organization's management style.In addition, it is thought to be due to policies implemented over the years   Recently, great importance has been given to the client and the created salary puts a lot of pressure on the staff of different legal medicine departments.When assessing the stressors of legal medicine practitioners, we saw some statistical differences.For physicians, the highest stress factor can be classified as fear of client dissatisfaction, and neglect of work by others. Some differences have been identified between our results and those of other studies.The biggest reason is that recently the policy of honoring clients has caused a bit of stress to legal medicine workers due to the protection of the client.