hamid reza amiri

To evaluate the decision-making proficiency among medical residents at Tehran University of Medical Sciences in the year 2022-2023.

A structured online web-survey via national approved services Author’s designed questionnaire was used to collect the relative data based on variables of the study and was developed by the authors of the study by reviewing the previously conducted studies. The forms were sent to the medical residents at Tehran University of Medical Sciences as a link via electronic mail and social media; assistance was offered via direct or indirect contact upon request.

In this study, 88 medical residents of Tehran University of Medical Sciences were evaluated. Out of 88 participants, the frequency of females was 52(59.09%) and frequency of males was found out to be 36(40.91%). The frequency of the first- year residents was 28(37.50), second year residents was 33(21.59), third year residents was 19(9.09) and the fourth- year residents was found out to be 8(31.82). The frequency of different specialties were: Pathology 1(1.14%), Infectious diseases 1(1.14%), Cardio vascular diseases 1(1.14%), Emergency medicine 1(1.14%), Orthopedics2(2.27%), Psychiatry 3(3.41%), ENT 12(13.64%), Internal Medicine 13(14.77%), Pediatrics13(14.77%), OB&GYN 19(21.59%), Anesthesiology19(21.59%), Dermatology 2(2.27%), General Surgery 1(1.14%).

There is a significant relationship based on linear regression between not having self - reported availability bias and surgical residency specialties. The surgical specialty is less prone to the availability bias. A difference of communication exists between the surgical and nonsurgical speciality and the nonsurgical specialties need to confirm their decision using other methods to prevent the patient harm.

The excessive use of mobile phones significantly alters human thought patterns and affects individuals' behavior and psycho-social well-being. This study aims to explore the correlation between social intelligence and self-determination in adolescents, focusing on how mobile phone addiction plays a mediating role.

The research employed a descriptive-correlational approach and cross-sectional method, utilizing structural equation modeling (SEM) for analysis. The statistical population consisted of teenage boys and girls in Tehran who experienced mobile phone addiction from July to October 2023, with psychologist confirmation of addiction. A sample of 150 teenagers was selected through purposive sampling, with 17 individuals excluded due to incomplete or erroneous questionnaire responses. Research instruments included the Tromso Social Intelligence Scale, Self-Determination Scale, and Mobile Phone Addiction Questionnaire. Data analysis was conducted using SPSS version 27 for overall data and SmartPLS version 4 for path analysis between variables, with a significance level set at 0.05.

The results of the current study indicated that Social Intelligence had a significant negative impact on mobile phone addiction (β=-0.380, p <0.001). In addition, there was a significant positive effect of Social Intelligence on Behavioral independence (β=0.383, p <0.001), but no significant effect on Psychological Empowerment and Self-determination (p>0.05). Furthermore, the relationship between Social Intelligence and Behavioral independence, as well as Self-determination with the mediating factor of Mobile phone addiction, was found to be significant (p < 0.001). However, the association between Social Intelligence and Psychological Empowerment with the mediating role of Mobile phone addiction was not significant (P>0.05).

The findings of the current research indicate that social intelligence can decrease mobile phone addiction and enhance behavioral independence, while mobile phone addiction can diminish behavioral independence and self-consciousness. However, social intelligence and mobile phone addiction do not impact psychological empowerment. Additionally, mobile phone addiction serves as a mediator in the correlation between social intelligence and the aspects of behavioral independence and self-consciousness.

Postoperative nausea and vomiting (PONV) is one of the most common postoperative complaints of the patients that affects the surgical outcome, quality of life, length of hospital stay, and costs. The prevalence of nausea and vomiting is estimated at 52% and 25% within the first 24 hours after surgery. Many risk factors have been identified for PONV, including female gender, being a non-smoker, young age, general anesthesia, use of volatile anesthetics and Nitrous Oxide, and duration of anesthesia. Following receiving reports indicating an unusually high prevalence of PONV in the male orthopedic ward of Imam Khomeini Hospital Complex despite applying regional techniques, the present study was conducted to investigate its prevalence and possible reasons.

After obtaining informed consent, 300 patients admitted to male and female orthopedic wards of Imam Khomeini Hospital complex that had undergone surgery within the past 48 hours were interviewed in person and their medical records were reviewed.

Of 300 patients, 61 (20.3%) had nausea and 39 (13%) had vomiting. Three patients (1%) experienced recurrence of PONV after treatment. The risk factors associated with PONV were female gender, history of motion sickness, general anesthesia with sodium thiopental, atracurium, IV lidocaine, isoflurane, neostigmine, and postoperative administration of ciprofloxacin.

The prevalence of PONV was lower than other studies, which was in contrast to reports received from the ward, indicating a reduction in PONV following the use of regional techniques.

Pistachio is one of the most important agricultural products of the country, which is very important from various economic, social, environmental aspects and other. The production value of this precious and unique product is about 10% of the country's non-oil income. East Azarbaijan province is one of the regions where the cultivation of this product can become popular due to the favorable weather conditions in some of its regions and cities. Therefore, in this research, it has been tried to determine the areas prone to pistachio cultivation with geographic information system and the effective factors in identifying these places. The persistenc of drought in East Azerbaijan province has caused a decrease of available water resources, rapid reduction, of underground water, On the other hand, the cultivated area of gardens and agricultural lands, which highly depend on underground water resources, has been developed indiscriminately and disproportionatelywith the climatic conditions.  Therefore, improving the cultivation patterns is the basic solution to reducing water consumption in the agricultural sector and it is the only practical solution for the sustainable agricultural development of the region. The present research has been carried out with the aim of assessing the feasibility of suitable areas for of pistachio planting in East Azerbaijan province. The pistachio Cultivation areas are based on different climatic factors affecting different stages of plant growth, using modeling in the geographic information system.The results of this research showed that the criterion of precipitation (0.298) is the first priority, and other parameters are: temperature (0.226), altitude (0.162), slope (0.160), soil (0.134), land use (0.098), Evaporation (0.090) and slope directions (0.082) respectively have the greatest effect on the feasibility of pistachio planting in East Azerbaijan province Areas with high cultivation capability in the city of Mianeh in the southeast of the province and a wide area of the cities of Horand, Kalibar, Khodaafrin in the northwest of the province have great potential.

Time series prediction methods based on artificial intelligence have been widely developed in recent years. Given that these data have large dimensions in the field of investment and stock price forecasting, traditional data analysis methods have low predictive power. This study examines the predictive power of a variety of models based on machine learning in the Tehran Stock Exchange.

After collecting data from 150 large companies listed on the Tehran Stock Exchange from 2012 to 2021, we want to predict the stock price trend- the movement direction of the price- and then validate each method and compare their accuracy. In these methods, we allocate part of the data to the learning section and the rest to the test section. We take these periods as training and trading sets. These methods include linear models, autocorrelation models, trees, and neural networks.

Deep learning models show better performance than other models and have an accuracy of about 70 percent. Also, we show the time series of the best-performance model accuracy of portfolios of some large industries. The best-performance model of DL in this study is Recurrent Neural Networks. In addition, we show that shallow learning models have higher accuracy and most models perform better in predicting descending stock trends.

In this study, after trying to use the models very carefully, the result is that these models do not provide stunning results to investors.

The limitation and scarcity of groundwater resources in Darab Fars plain has caused this plain to be in a critical situation and in the forbidden group. With proper management, the capacity of available surface and groundwater resources can be well identified and studied to make a comprehensive plan for their proper use. The use of GIS along with observational data leads to easy and systematic estimation of groundwater recharge areas. The purpose of this study is to identify the potential of groundwater resources using AHP model and fuzzy functions in GIS environment. To assess the potential of groundwater resources, 10 geological criteria, fault density, altitude, slope, land use, soil, geomorphology, precipitation, drainage density and distance from rivers were studied and analyzed. The layers were prepared in a GIS environment and then the potential of groundwater resources was modeled using fuzzy logic functions. The results showed that the use of 0.98 gamma showed more favorable results than other numbers. Areas with high groundwater potential were determined with high accuracy. To validate the model, exploitation wells in the region have been used. About 63.62 percent of this type of wells are located in areas with good and very good potential. Areas with good and very good potential correspond to the terrace reserves, alluviums and sediments of the fourth period and have a low slope (0-5 degrees). About 31 percent of the watershed is in two categories of good and very good potential.

Despite the low rainfall, which is amplified by disordered time distribution, a large amount of rainfall in Hormozgan province is wasted as runoff due to highly intensive and shower rains. On the other hand, an important part of the reserves of surface water resources such as rivers and dam lakes are losing due to high evaporation potential. Determining susceptible areas for construction of underground storages in plains covered by quaternary deposits is a good way to develop water resources in these conditions. Determination of the proper areas for this purpose depends on various ecological and anthropogenic criteria. Based on the research literature, socio-economic factors (water need and access), underground dam axis (depth, length and lithology), underground dam reservoir (permeability, slope and surface of the reservoir) and water (quantity and quality of water) named as the most important effective criteria. In this research, the Analytic Hierarchy Process (AHP) used to weigh the main and sub-criteria affecting the determination of the potential of underground dam construction in the study area. Sub-criteria of water quantity with a weight of 0.833, water demand with a weight of 0.8 and axis depth and reservoir permeability with a weight of 0.637 are the most important indicators of the research. The information layers of each criterion were fuzzy. Then, using satellite data and field control 14 axes (options) were distinguished and selected. Then by compilation of information layers in the ArcGIS environment, indices were calculated and ranked for each axis. The results showed that options 14 in the northwest of the region has requirements and the capability to build an underground dam. The system sensitivity in the rankings was tested by changing the ±5 and ±10 percent in weight of the highest-grade criteria. The selected option has suitable permeability and the depth of its axis is 9-12 meters. In addition, it is located in sub-basin B1 with an average annual rainfall of 207.1 mm and a rainfall volume of 1.9 million cubic meters. These features are among the suitable potentials for the construction of an underground dam in the region. So the results showed that the model has the sufficient stability in the axes prioritization relative to each other.

Upper limbs deep vein thrombosis is a rare event in patients, although increasing incidence is seen due to higher cancer diagnosis rate and the use of various vascular catheters. A 58-year-old man with a history of anemia was scheduled for radical prostatectomy due to prostate adenocarcinoma. The patient underwent surgery under general anesthesia. After surgery, he was transferred to the intensive care unit. At the beginning of admission, right limb edema in the distal part of the right limb (hands and wrists) was observed that was accompanied by cyanosis and pain. The patient was diagnosed with deep vein thrombosis and was treated with anticoagulant drugs. He was discharged after 4 days in a good general condition and uneventfully. This report shows that patients with venous catheters, especially patients who are candidates for surgery, are at high risk of deep vein thrombosis and need careful monitoring after surgery.

In the present paper, the effect of transient fault location on voltage profile at different points of distribution network is investigated. Since fault occurrence is inevitable in the power grids, it is necessary to investigate various faults in the power grid to minimize their effects by protective equipment. Both the permanent and transient faults, as two categories of faults, have different effects on power grids; but, since the cause of the permanent fault is visible and can be rectified in most cases, this study will investigate transient faults in a 20 kv distribution network. Transient faults affect all components and equipment, but where this fault occurs in the network, it has a different effect on the distribution network and its components. Hence, these faults' effects on voltage profile as a critical characteristic of the power distribution networks are examined in this study. Then, the DIGSILENT software is applied to simulate the transient fault behavior at different distances on the voltage profile of a sample distribution network, and simulation results are presented in tables.

The use of Edge Notched Disc Beam (ENDB) sample has been proposed as a suitable geometry in performing fracture tests in different loading modes. The most important features of the ENDB samples include easy making, quick and easy sampling, simple testing, and the ability to examine a wide range of pure and combined loading modes. Using a wide range of fracture tests, a statistical model is proposed to predict the stress intensity factors of asphalt mixtures in terms of the pure torsion mode (mode III) loading in this study. To this end, the experiments were carried out at different temperature conditions (-5, -15 and -25 °C), different loading conditions (0.5, 1 and 5 mm/min), and on control and modified asphalt mixtures with different percentages of polyolefin-aramid fibers. The results showed that, with increasing the fiber content and loading rate, the fracture strength increased with average 25%, while an increase in fracture toughness due to lower temperature had an effect of less than 5%.  Using the Response Surface Method (RSM), the prediction model of stress intensity coefficients of asphalt mixtures was presented in the pure torsion mode. The results of the proposed models had a good correlation with the results of the conducted fracture tests.

This research deals with the buckling analysis of cracked column with fixed-fixed conditions. The crack is modelled with a unilateral elastic bending-stiffness behaviour, represented by a unilateral rotational spring. This model takes into account the crack closure effect on buckling behaviour of column. The governing equation of the problem is introduced by the variational approach based on energy arguments. Using the variational approach, the governing equation can be formulated as a function of damage index. Damage index is the stiffness of the equivalent rotational spring associated with the crack. A one-crack and a tow-crack are theoretically investigated to illustrate the effects of the crack on the buckling load. For the one crack column, the buckling load increases with the stiffness of the crack section. When the crack-stiffness parameter tends towards an infinite value, the structural model is reduced to the classical Euler column. It is observed that the buckling load increases as the crack get closer to the supports, for constant damage value of the crack parameter (constant crack depth). For the two crack column, the crack closure phenomenon is investigated. In order to two cases are considered. In the first case, the two-crack are located on the same side of column, and in the second case, the cracks are located on the opposite side of the columns. Comparison between two cases show that the crack closure influence on the buckling load. In other words the crack-closure phenomenon tends to increase the buckling load.

 Postoperative pain management can improve patients’ quality of life and decrease hospitalization rates. Preemptive analgesia may provide an effective approach for both pain control and opioid consumption decrease. A common approach for pain management after surgery is to relieve the pain that has already occurred.

 The aim of this clinical trial was to compare the preemptive analgesic effect of single-dose versus two-dose administration of pregabalin, acetaminophen, naproxen, and dextromethorphan (PAND) combination.

 This study involved 60 patients who had undergone one surgery (including nephrectomy, cystectomy, prostatectomy, colectomy, Whipple, and RPLND). They were randomly divided into two groups: The first group received a single dose of PAND, while the other group received a second dose within 6 hours after discharge from recovery. Pain intensity was assessed by the Universal Pain Assessment Tool (UPAT) in both groups 2, 4, 6, 8, 12, 24, and 48 hours postoperatively. The postoperative morphine dose in both groups was also recorded. Data were analyzed using SPSS version 25.

 Mean pain scores were significantly different between the two groups at 2, 12, 24, and 48 hours after surgery (P < 0.05). There was a statistically significant difference between the two groups in terms of opioid consumption (P < 0.001). The total opioid consumption in the second group (with the second administration of PAND) was lower than the first group.

 Preemptive analgesia with a second dose of PAND is an effective method for reducing pain and morphine consumption after surgery.

Resilient schools can warranty students’ health and survival at disasters. It is obligatory that schools be prepared for natural challenges through local programs. Considering the great population of students, disaster-resilient schools can be a safe and suitable environment for students at the time of disaster.

This study aims to identify certain operational strategies for establishing schools resilient to natural disasters.

This qualitative study was based onconventional content analysis. Using purposive sampling method, 24 experts in the fields of health in disasters, construction engineering, psychology, teaching, and administrative management participated in the study. Maximum variation sampling continued until data saturation was achieved. The data collected via unstructured interviews were analyzed with Graneheim and Lundmen’s conventional content analysis.

Content analysis resulted in four main categories as operational strategies for establishing disaster-resilient schools including: 1) “construction and non-construction optimization”, with four subcategories of construct risk management, optimization of construct architecture and physical structure, correct construct localization, andpromotion of non-construct safety, 2) “promotion of organizational coordination and interactions” with two subcategories, namely improvement in intra-organizational communication and improvement in extra-organizational communication, 3) “improvement ineducation” with three subcategories of holding educational courses for families and students, holding educational courses for managers and personnel, and holding simulated exercises, and 4) “process promotion” with four subcategories of increased preparedness, correct planning, creation of organizational structure, and rehabilitation facilitation.

Various factors affecting schools’response to disasters form operational strategies to establish disaster-resilient schools. These strategies influence pre-and post-disaster preparedness. Awareness of these components followed by preparedness prior to disasters can save students’ lives, improve school performance after disasters, and aid in establishing disaster-resilient schools as safe lodgings

School resilience is defined as risk‑reducing strategies used to create a safe environment for students when faced natural disasters. Resilient schools, in addition to their educational role, provide a suitable capacity for responding to disasters and rehabilitation after the incidence. This study determined the level of disaster resilience of schools in Yazd, central Iran.

This is a descriptive‑analytic study conducted among 400 schools and 367 participants in Yazd, 2018. To collect data, we used the school resilience in disasters questionnaire (α =0.95 and intraclass correlation coefficient = 0.97 [95% confidence interval: 0.96–0.98]) containing 48 questions. We also analyzed the gleaned data through the Pearson correlation coefficient, one‑way ANOVA, and independent t‑test.

The total score of school disaster resilience was 153.30 ± 29.57. In these schools, the function had the highest (47.76 ± 13.96), and safety had the lowest (6.74 ± 3.18) score among all areas of school disaster resilience. There was a positive significant correlation between total resilience and areas of function, education, structural, nonstructural, architecture, commute routes, safety, location, and equipment (P < 0.001). Location had the smallest (r = 0.424) and function had the greatest (r = 0.854) correlation with total resilience.

It can help the school management board in assessing the level of resilience of their school and determining the priorities for disaster risk reduction. Awareness of the status of resilience can help policy‑makers and experts create an effective program for increasing resilience.

Upper GI endoscopy is a diagnostic and therapeutic procedure widely used across the world. Some patients, however, experience a great deal of discomfort during the procedure, which is mainly due to activation of the gag reflex. Therefore, topical pharyngeal or general anesthesia is applied to reduce the gag reflex during endoscopy. This study aimed to compare the effect of IV lidocaine versus topical lidocaine spray in reducing the gag reflex in patients sedated with propofol.

This randomized clinical trial was conducted in Imam Khomeini Hospital in 2017. One group of patients received propofol at a dose of 0.5-1 mg/kg plus lidocaine spray and the other group received propofol at the same dose plus IV lidocaine at a dose of 1 mg/kg (maximum 100 mg). Patients in both groups also received 50 µg fentanyl. The variables of gag reflex (using the VAS), patient and physician satisfaction, length of endoscopy, vital signs, and adverse effects were compared between the two groups.

Ninety-three patients were evaluated in this study, of whom 42 (45.2%) were men and the rest were women (n=51, 54.8%). ANOVA was used to evaluate the effect of type of anesthesia on the final level of gag reflex and the results showed lack of any significant difference between the two groups (P>0.05). Patient satisfaction was higher in the IV anesthesia group (P= 0.036) and the physician satisfaction was higher in the topical anesthesia group (P= 0.027). Among vital signs, only SBP showed a modest difference between the two groups and was significantly higher in the topical anesthesia group (P=0.04). There was no significant difference in the rate of adverse effects between the two groups (P> 0.05).

Topical anesthesia using lidocaine spray is as effective and safe as IV lidocaine in decreasing the gag reflex in upper GI endoscopy in patients sedated with propofol.

Schools have many roles and capacities before and after disasters. Resilience plays an important role in maintaining schools’ performance after disasters. This study systematically reviewed the literature to identify the components of school resilience in emergencies and disasters.

In this study, Scopus, Web of Science, PubMed, and Google Scholar databases were systematically searched using “resilience”, “risk”, “disaster”, “emergency” and “school” as keywords. In total, 8,053 studies were reviewed in several stages and eventually, 26 articles were selected. Other articles were excluded due to the lack of inclusion criteria or being irrelevant. Five other articles were included in the study by reviewing the references. Finally, 31 relevant articles were analyzed. The quality of the articles was assessed based on the PRISMA checklist.

The evaluation of articles based on content analysis resulted in the emergence of 4 themes, 11 subthemes, and 99 codes. The themes included structural factors, non-structural factors, functional-process factors, and facilities. The subthemes included building standards, school environment, physical safety of the building, equipment and facilities, safety and retrofit of non-structural components, infrastructures, communication (internal and external), education, management, health, and human-financial resources.

The factors and dimensions affecting the resilience of schools were recognized. Different dimensions should be considered to increase the school’s ability, andmaintain its performance and appropriate response to disasters. The determined indices can be used by policy- and decision-makers when confronting emergencies and disasters to assess the resilience of schools against the risks.

Regional anesthesia is an expanding subspecialty and is gaining increasing popularity due to its significant benefits over general anesthesia if appropriately accomplished, which includes superior intraoperative pain control, attenuation of the surgical stress response, minimal systemic impairment, lower incidence of postoperative nausea and vomiting, excellent localized postoperative analgesia, and decreased hospital cost and stay. Needle conduction guide toward the targets always has a great importance. The most commonly used local anesthetics include lidocaine, ropivacaine, bupivacaine, and mepivacaine. The type of local anesthetic, the concentration, the volume administered, and the location of the block will affect the onset, duration and depth /type of block. Due to ineffectivity of neuraxial block in upper limbs, upper extremity blocks may be considered as the sole substitute or supersede method of anesthesia for upper limb surgeries.

Development of Carbon Capture and Storage (CCS) technologies in saline aquifers is a tool to reduce environmental effects of CO2 emissions and climate change. Dissolution of CO2 in water provides an option for storage in saline aquifers. When CO2 dissolves in the water, the density of the solution increases. Then it may cause natural convection which in turn, increases the rate of dissolution and safety of the storage. In this paper, dissolution process and storage of CO2 in saline aquifers is studied. Here, the main purpose is to investigate the effect of porosity and permeability and anisotropicity of reservoir rock on dissolution process, onset of natural convection, time of maximum Sherwood number. To this end, numerical simulation of convective mixing in both isotropic and anisotropic reservoirs has been reported. The results show the three effective period of CO2 storage in aquifers. Comparisons of the results reveal that permeability has significant effect on the onset of convection and convection mixing process. Therefore it is one of the main factors that should be considered in choosing the storage site.

Current industrial cities in terms of mining, ore crushing and production units located in that area could be contaminated with particulate matter, especially heavy metals such as lead, nickel -Zinc, copper, cadmium, etc. are various forms. On the other hand disrupt the daily lives of those residents near waste disposal sites are essential to prevent the need for waste disposal location. The researcher sought the appropriate location for solid waste landfill Khorram Bid Township in the province is using GIS. To achieve this objective, criteria such as slope, aspect, elevation, geology, land use, lines of communication, distance from the settlement, distance from the wells and aqueducts, distance from surface water is used. Then, for each of the factors at zoning cutting waste landfill was prepared in GIS data layers and each layer was weighted. Then, to modeling, to each of the data layers based on their importance in landfill zoning stonework using AHP model is assigned an appropriate weight. The following layers were normalized using fuzzy functions. The results of layers lands on the information to select suitable sites for landfill classified into five classesThus, according to research that the final map, the north and northeast of the city for which it is intended.

Gas condensate reservoirs are characterized by a distinctive retrograde behavior and potential for condensate drop out during production and sampling. Efficient modeling of gas condensate reservoir requires careful phase behavior studies of samples collected prior to and during the production life of reservoir. In this work, an integrated characterization and tuning algorithm is proposed to analyze the pressure-volume-temperature (PVT) behavior of gas condensate samples. Each characterization and tuning scenario is described by a “path” which specifies the class of fluid, splitting and lumping (if any), the type of correlation, and grouping strategy (static or dynamic). Different characterization approaches were tested for the effective description of heavy end. Meanwhile, dynamic and static strategies were implemented to tune the equation of state (EOS) through non-linear regression. The optimum combination of characterization and tuning approach was explored for each sample by a rigorous analysis of the results. It was found out that the exponential distribution function gives the best performance for heavy end characterization in a dynamic tuning strategy. Also, analyses indicate that using higher single carbon number may not necessarily make EOS tuning more accurate. In addition, the optimum step is reached in either the third or fourth step for most cases in a dynamic tuning approach, and is sensitive neither to the characterization path nor to the selected end carbon number.

Among existing methods for prevention, reduction of casualties and damage caused by fires in urban areas, urban planning through the establishment of relevant rules and regulations can make a significant contribution to reducing mortal and financial losses and providing security for citizens in the long run. The purpose of this study is to investigate the spatial-spatial location of fire stations in Bandar Abbas area. The research methodology is applied based on the descriptive-analytical nature of the research. To collect information, a questionnaire was used for data analysis. Supper Decisions software and GIS software and anp model were used to prioritize predisposing sites for the deployment of fire stations. The results of this study indicate that, considering the land use and the determination of the operational radius of the stations, the two existing stations can not provide the services of the entire urban area, and the need to locate and deploy the new stations. Also, using multiple layers in the ArcGIS10 environment and integrating it with the ANP model, suitable locations for the installation of new fire stations are identified.

Pain management after abdominal surgery is a critical issue in cancer patients undergoing laparotomy. Opioid analgesics commonly used postoperatively have significant side effects and can postpone restoring normal life. Administration of analgesics before the surgery by inhibiting pain cascades may be an effective method for more efficient pain control.
This study aimed to investigate the effect of the preemptive use of oral pregabalin-acetaminophen-naproxen on pain control and morphine consumptions in cancer patients undergoing laparotomy.
Patients and A total of 40 cancer patients scheduled for open abdominal surgery were randomized into the two groups. one group received combination of pregabalin 150 mg, acetaminophen 1 g and naproxen 250 mg (the PAN group) an hour before laparotomy. Following the surgery, morphine was administered on a protocolized schedule based on patients’ demand for pain control. Postoperative pain level was assessed using universal pain assessment tool (UPAT) at 0, 2, 4, 6, 12, 24 and 48 hours after the operation. The postoperative morphine dose and complications were noted. Data were analyzed using SPSS version 16.
Patients in the PAN group had significantly lower UPAT scores at 0, 2, 4, 6, 12, 24 and 48 hours after the surgery than those in the control group (P = 0.008, 0.021, 0.008, 0.047, 0.004, 0.001, and 0.001). The mean dose of postoperative morphine consumption in the PAN group was 37% less than the control group (P = 0.001). The complications were not significantly different between the two groups.
Preemptive use of pregabalin-acetaminophen-naproxen decreases intensity of pain and morphine consumption in the cancer patients after laparotomy without significant complications.

Municipal waste landfill site selection is important in the management of municipal solid waste. Locate the landfill needs to analyze location data, rules and standards are acceptable. The aim of this study was to impose a variety of spatial analysis by using network analysis process (ANP) and GIS technology to locate the optimal limits (with minimal environmental ill side effects) for municipal solid waste landfill. In this regard, in the first phase of weighted criteria, based on existing standards, the ANP model was done using Super Decisions. In the second phase of municipal waste landfill consists of layers required for the database using ArcGIS software was developed. In the third phase in order to achieve suitable areas for waste disposal, after layers and overall weight of the final zoning map of the region were presented. South of the city mixed land heavily worn, poor and weak in terms of agriculture and horticulture, including placed, the area is good. Another good area around the Robat Sang is detected.

Saddle-like (Khorjeeni) connections are formed in steel frames, when the beams are not cut at their intersection with columns, and they by-pass the columns continuously and are connected to them using top and bottom angles. This type of connection provides some benefits, such as ease of construction and superior behavior under gravity loads, however it has some disadvantages that can cause significant damage to the structure when subjected to seismic loads. Past studies have shown that saddle-like connections can be classified as semi-rigid connections, but they do not have the ductility capacity observed in those types of semi-rigid connections, which have been recommended in various codes for seismic resistant design.
In recent years several researchers have tried to propose details for improving the behavior of Khorjeeni connections. However, in the process of seismic evaluation and rehabilitation for existing structures, in which the conventional type of Khorjeeni connections are used, it is necessary to have typical behavior curves and acceptance criteria for different levels of structural performance. The aim of this paper is to develop parametric equations for behavior characteristics of the conventional saddle like connections.
Experiments and finite element modeling have been conducted on fourteen different specimens of the connections. The details have been selected based on what are normally found in medium rise buildings in Iran. The beam height and the angle length vary in the specimens. Six specimens have been tested in laboratory and then modeled by finite elements. FE analysis has considered the crack initiation and propagation using a micromechanical model originally proposed for predicting crack initiation in ultra-low cycle fatigue, ULCF. ABAQUS multi-purpose software has been employed for this work. As the Finite Element modeling of tested saddle-like connections has proved to be successful in predicting the behavior of this type of connection, additional samples have been modeled and analyzed using FE models. Based on the results of experiments and FE modeling, backbone curves representing moment rotation behavior of the connections have been determined following the FEMA recommendations Characteristic parameters of the backbone curve have been identified as initial stiffness, yield moment, ultimate moment and ultimate rotation of the connection. Also the parameters affecting these characteristic values have been found to be beam depth, top angle size, top angle length, and bottom angle length . Finally, using the regression methods, some relationships have been proposed for each characteristic parameter of the backbone curves. A comparison of the experimental and numerical results and the results of parametric equations shows good accuracy. The differences in initial stiffness, yield moment and ultimate moment are less than 10 percent for majority of the specimens. The differences in ultimate rotation are also less than 15 percent in majority of the cases. The proposed equations in conjunction with FEMA recommendations for acceptance criteria can be used in seismic evaluation and rehabilitation of steel structures with saddle like connections.

Preemptive analgesia may be considered as a method not only to alleviate postoperative pain but also to decrease analgesic consumption. Different regimens are suggested, but there is currently no standard.
The aim was to measure the efficacy of preemptive analgesia with pregabalin, acetaminophen, naproxen, and dextromethorphan in radical neck dissection surgery for reducing the intensity of pain and morphine consumption.
Patients and This study was conducted as a randomized double-blind clinical trial. Eighty adult patients (18 to 60 years of age) under the American society of anesthesiologists (ASA) physical status I and II undergoing elective radical neck dissection were enrolled. Patients were randomized into two groups of 40 with a simple randomization method. The case group received a combination of 15 mg/kg acetaminophen, 2.5 mg/kg pregabalin, 7 mg/kg naproxen, and 0.3 mg/kg dextromethorphan administered orally one hour prior to surgery. Postoperative pain was assessed with the universal pain assessment tool (UPAT) at 0, 2, 4, 6, 12, and 24 hours after surgery. Subjects received morphine based on postoperative pain control protocol. Total administered morphine doses were noted.
Postoperative pain rates at 0, 2, 4, 6, 12, and 24 hours after surgery were significantly lower for the case group than the control group (P values = 0.014, 0.003, 0.00, 0.00, and 0.00, respectively). Total morphine doses for the preemptive analgesia group were 45% lower than those of the other group. Side effects were similar for both groups.
A single preoperative oral dose of pregabalin, acetaminophen, dextromethorphan, and naproxen one hour before surgery is an effective method for reducing postoperative pain and morphine consumption in patients undergoing radical neck dissection.