hossein akbari

Stigma is a critical social determinant of health, influencing individuals' access to resources, quality of life, and overall well-being. Despite its significant implications, bibliometric studies on stigma in the medical field remain sparse. We provide a comprehensive scientometric analysis of stigma research in medicine over the past 30 years, highlighting trends, key focus areas, and evolving challenges.

A bibliometric analysis was conducted using VOSviewer software, utilizing data from the Scopus database. The search included articles with the keyword "stigma*" in the title, published between 1992 and 2022, within the fields of Medicine, Nursing, and Professional Health. The initial search yielded 20,284 articles, narrowed down to 7,854 relevant publications for detailed analysis. Key metrics analyzed included co-authorship, co-occurrence of keywords, and co-citation patterns.

The analysis revealed a significant increase in stigma-related publications in the medical field, particularly since 2010, with a peak in 2022, largely driven by the COVID-19 pandemic. The research identified nine major keyword clusters, 40 associated diseases, and 36 target groups. Persistent diseases like HIV, mental illness, addiction, and cancer continue to be strongly associated with stigma.

The findings underscore the evolving nature of stigma research in medicine, with an increasing focus on intersecting stigmas and their persistent impact on public health. Future research should aim to develop comprehensive models and strategies to manage and reduce stigma, particularly for diseases with enduring stigmatic associations. Collaborative efforts among policymakers, healthcare providers, and society are crucial to address the social and economic consequences of stigma and improve health outcomes.

 Flexor tendon repair damage to both deep and superficial flexor tendons injuries, especially in zone II, has special importance that distinguishes it from other zones. This study evaluated the effect of atorvastatin, a cheap, available, and non-cytotoxic drug, on the adhesion phenomenon resulting from tissue repair.

 Overall, 52 patients were included in this study. Patients were randomly divided into two groups. In the first group, atorvastatin 20 mg was administered daily for three weeks. In the control group, a placebo was used for three weeks. After 3 months, the range of motion, extension gap, extension lag, and flexion gap for each finger were measured and compared in the two groups.

  Based on the results, using atorvastatin led to an increase in the range of motion in distal interphalangeal (DIP) injured patients. In addition, extension, flexion gap, and extension lag in both groups were the same. The rate of improvement in the range of motion in smokers was significantly lower.

 Using atorvastatin in surgical patients appears to be effective in increasing the range of motion of DIP and improving this adhesion. The negative effects of smoke on the rate of improvement that have been investigated in limited studies in this area should not be ignored either.

Human development, as a multidimensional concept, is one of the key foundations of a country's development and can be instrumental in achieving the country's economic, social, and cultural objectives. The present research, using a descriptive-analytical method and a deductive approach based on the theoretical framework of good governance, seeks to answer the main and subsidiary questions: What impact has transparency had on human development indicators in Iran during the period from 2013 to 2021? And what is the relationship and correlation between transparency and human development indicators? The existence of high and low levels of transparency in Iran during this period has had a significant impact on human development indicators in society, and these effects have changed over time. There is generally a direct and positive correlation between transparency and human development indicators. This research aims to explore the relationship between human development indicators and transparency in society and provide an empirical analysis of the impact and relationship between these indicators and transparency. The findings of the study suggest that by enhancing transparency in the country's economic spheres through the expansion of modern information and communication technologies, along with the development of e-government and increasing public participation, and digitizing public services, transparency in society can be increased, thereby accelerating and facilitating the improvement of human development indicators.

Patients with psychiatric disorders are particularly vulnerable to drug-drug interactions (DDIs), which can lead to significant fluctuations in blood concentrations of medications. This study aimed to assess the prevalence of potential DDIs (pDDIs) in prescriptions made by physicians using a straightforward software tool. This cross-sectional study was conducted in two phases. The first phase focused on creating a comprehensive database of drug-drug interactions related to psychiatric medications. The second phase involved identifying potential DDIs using SQL Server and Python (version 3.8). A total of 3,107 patients' prescriptions were analyzed, comprising 1,752 men (56.4%) and 1,355 women (43.6%). The average age of participants was 38.95 years (SD = 15.244), with an average length of hospital stay of 12.01 days (SD = 8.756). The majority of patients were diagnosed with mood disorders (n = 1,461; 47.0%). In total, 89,801 prescriptions were evaluated, revealing a prevalence of pDDIs at 34.46% (n = 30,953). Notably, male patients exhibited a higher risk for developing pDDIs. The most frequently encountered pDDIs were associated with mental retardation (55.93%) and mental and behavioral disorders (49.03%). The combinations of Clonazepam with Risperidone (11.93%), Lorazepam with Risperidone (6.87%), and Haloperidol with Lorazepam (6.58%) were identified as the most common pDDIs. In terms of risk classification, the majority fell into class C (n = 24,914; 80.49%), followed by class D (n = 6,033; 19.49%) and class E (n = 6; 0.02%). The findings of this study highlight the urgent need for greater awareness of potential drug-drug interactions among healthcare providers treating psychiatric patients. Implementing computerized prescription screening tools could significantly aid in identifying pDDIs and mitigating the risk of adverse events.

Since making accurate and timely decisions regarding human resources significantly impacts the performance of any organization, there is a clear necessity for a robust tool in this area. One of the most effective tools is the Human Resources Dashboard. Therefore, this study aims to identify and prioritize the requirements for the Human Resources Management Dashboard of the Iran Army.

This research is descriptive in terms of methodology and applied in terms of its objective. The study's statistical population consists of human resources experts within the Army. Due to the specific nature of the research topic, a judgmental sampling method was employed, gathering data through interviews and pairwise comparison questionnaires. The reliability of the questionnaire was assessed by calculating the inconsistency rate. In the first step, a list of requirements was identified within 5 components and 22 indicators, and in the second step, these were prioritized using the AHP and Expert Choice software.

Based on the findings, the human capital component is the most important among the others, with the indicators of the knowledge and skills of commanders and managers, specialized personnel in design and implementation, and the provision of necessary financial resources being the top three priorities.

Originality: 

The results indicate the high importance of leadership and management in the success of the management dashboard. Specialized personnel in design and implementation, as well as financial resources, also play a key role in this regard, as a successful design and implementation of the dashboard is impossible without them.

Understanding the strengths and limitations of imaging techniques is essential for accurate diagnosis and optimal management of patients with blunt abdominal trauma. This study assessed the diagnostic accuracy of Focused Assessment with Sonography for Trauma (FAST) ultrasound in pediatric blunt abdominal trauma.

This retrospective study analyzed the medical records of 314 pediatric patients from the trauma center at Shahid Beheshti Hospital, Kashan, Iran. Demographic data, FAST results, and computed tomography (CT) findings were collected and interpreted by a radiologist. The obtained data were analyzed using the Chi-square test or Fisher's exact test. Moreover, SPSS software (version 16) was used to examine sensitivity and specificity, as well as positive and negative predictive values. A p-value of 0.05 was considered statistically significant.

CT scans showed abnormalities in 70% of patients, with 154 (70%) male patients. No significant association of trauma mechanism, gender, age, and Glasgow Coma Scale (GCS) scores with CT results (P>0.05) was found in this study. However, abdominal tenderness was associated with CT results (P=0.004). Abnormal FAST correlated with abnormal CT (P<0.001). FAST demonstrated significant diagnostic value in pediatric blunt abdominal trauma, and abdominal tenderness emerged as a relevant indicator.

FAST can be a valuable initial screening tool, aiding in timely and accurate management decisions for patients with blunt abdominal trauma. Further investigation is needed to explore factors influencing the correlation between FAST and CT in critically ill patients with GCS<13.

The little finger permanent abduction is an annoying deformity usually along with Wartenberg's sign (a consequence of ulnar nerve palsy), but there are several ways to correct this condition in rheumatoid arthritis as well. We aimed to investigate the effect of surgical intervention on patients.   

The current study was a clinical trial which was done at Hazrat Fatima Hospital of Tehran, Iran from 2020-2022, where 15 patients with an age range of 21-48 years were investigated. All these patients had complications of ulna nerve damage. After the intervention (tendon transfer), the angle change of the fifth finger was compared with before the surgery.

A significant improvement in reducing the angle of the fifth finger after surgery was observed in patients (P<0.05)

  Tendon transfer is one of the best techniques for the treatment of ulnar injuries.

Brachial plexus injury (BPI), as one of the most devastating injuries in adults, has various negative consequences such as profound functional impairment, debilitating pain, significant mental health consequences, and economic impacts. We aimed to review the evaluation and diagnostic-treatment Approaches of BPI in adults through a review study.  

An electronic literature search was completed in Google Scholar, Springer, PubMed, and Science Direct databases from 1980 to 2023. Various keywords related to the purpose such as Brachial plexus, surgical strategy, adult were used.

1.2% of people with multiple traumas had BPIs. BPI is more common in young adult males. For brachial plexus palsy, preoperative evaluation of nerve root avulsion is helpful in surgical planning. . EMG is useful in confirming a diagnosis, localizing the lesion level, estimating the extent of axon loss, and determining whether the lesion is complete. There are different options available for BPI, such as coordinating care, rehabilitation and psychosocial support. In recent times, significant advancements have been made in surgical techniques for nerve repairs.

Although it is often not possible to prevent damage to the brachial plexus, it is possible to reduce the risk of further problems after the injury by taking some measures.

Adverse events of COVID-19 Vaccination in children are somewhat unknown, and limited population-based studies have been carried out in this age group. This study aims to determine the short-term Sinopharm and Soberana (PastoCoVac) vaccination adverse events in 5- to 12-year-old children. This study is an observational study with a control group. The cluster sampling method by considering health care centers and mass vaccination centers of Tabriz as clusters were used to recruit the study samples with a ratio of 2:1 for the vaccinated and unvaccinated groups, respectively. Information was collected by telephone calls and interviews with their parents. Data were analyzed by using a mixed-effect logistic regression model. In this study, 577 (63.2%) vaccinated and 336 (36.8%) unvaccinated children were investigated. Results demonstrated that the most frequent complication among vaccinated children was injection site pain (399 (69.2%, CI 95%: 65.2% to 72.9%)). The most frequently reported systemic adverse events among vaccinated versus unvaccinated children were fever (9.0% vs. 3.6% (0.003)), fatigue (5.5% vs. 0.9% (0.002)), and headache (2.9% vs. 0.6% (0.032)). No serious adverse events including myocarditis, multisystem inflammatory syndrome (MIS), and hospitalization were reported. The odds of having any symptoms in the vaccinated group adjusted for confounders were significantly higher than in the control group (adjusted OR=4.71, CI 95%: (3.04, 7.26), p-value<.001). According to the results, it can be concluded that Sinopharm and PastoCoVac vaccines did not have serious side effects. Also, it seems that some of the reported adverse events in other studies are overestimated due to the lack of a control group.

Given the importance of the employment status of graduates for countries, the current study aims to investigate the employment status of occupational health and safety engineering (OHS) graduates from Kashan University of Medical Sciences (KAUMS), from the establishment of the field in 1996 up until 2023

The cross-sectional study examined the employment status of OHS graduates of KAUMS using a researcher-developed Google form questionnaire. The questionnaire included demographic characteristics, five questions for unemployed individuals, and 60 questions for employed individuals. Finally, descriptive and analytical analyses of the study were performed using SPSS v16 software. 

A total of 229 graduates participated in this study. The results regarding the frequency of employed and unemployed participants showed that 198 (86.5%) participants were employed, and 31 (13.5%) were unemployed at the time of the study. Most employed participants (46%, or 90 individuals) work in the industry and mining sector. Evaluating the effectiveness of the educational course of employed participants in relation to their jobs revealed that 88 participants (44.4%) believe that the subjects taught in the courses are moderately compatible with work needs. 

With the advancement of industries and the expansion of production, the need to control harmful factors and improve workers’ health is more evident than ever before, making it likely that graduates of this field will have favorable job prospects in the future. On the other hand, the academic conditions should be improved, particularly regarding the quality of the educational and curriculum programs of KAUMS.

The growing use of treated wastewater in farming has raised concerns about the potential impacts on public health.

This study assessed the levels of the heavy metals lead (Pb), cadmium (Cd), and arsenic (As) in plants watered in greenhouse settings using both well water and synthetic wastewater. Synthetic wastewater with As at concentrations of 0.1, 0.2, and 0.4 mg/L, Pb at 1, 3, and 5 mg/L, and Cd at 0.01, 0.03, and 0.05 mg/L, as well as well water were used to irrigate radish, coriander, and grass. In the end, 144 vegetable samples were gathered, and inductively coupled plasma-optical emission spectrometry (ICP-OES) was used to determine the heavy metal concentrations in the samples. Risk assessment for consumers was determined based on the measured levels of heavy metals in the vegetables.

Even though the concentrations of heavy metals in the wastewater were within the limits for irrigation, the risk assessment showed that consumption of vegetables irrigated with treatment wastewater could pose risks to individuals’ health. The maximum concentration of Pb in radish leaves was observed at the Pb concentration of 5 mg/L, and the maximum concentration of As in cress irrigated with As effluent at the As concentration of 0.02 mg/L.

The consumption of vegetables containing Pb can pose a significant non-carcinogenic risk to consumers. However, well water may also be dangerous in the long run. Therefore, it is important to ensure about food safety when using treated wastewater for irrigation.

Determining and analyzing educational needs is a crucial aspect of curriculum development, especially when planning is based on duties and competencies. This study aims to identify and prioritize the technical needs of new graduates with Bachelor of Science in Anesthesia program at Paramedical School of Kashan University of Medical Sciences in 2022.

This cross-sectional study was conducted based on needs assessment  in two stages. The first stage involves identifying and prioritizing skill needs across six areas: professional communication, preparation and use of drugs, preparation and use of equipment, patient control and evaluation, safety and risk prevention, and management and patient care. This assessment was carried out with a focus group comprising two groups of faculty anesthesiologists and anesthesia faculty members and a group bachelor of science in anesthesia graduates from teaching hospitals in Kashan city. The Analytical Hierarchy Process (AHP) technique was utilized, and a researcher-designed questionnaire was employed to collect data.In the second stage, this questionnaire was distributed to 29 selected anesthesiology graduates, who were chosen using a purposeful sampling method. The data were then analyzed using SPSS (version 26). First, the mean and standardized mean of each item within the six domains were calculated. Next, the desired needs were prioritized based on the suggested scores from each of the three studied groups. The importance of each domain under study was determined using the AHP technique and Expert Choice software.

According to the final results of the AHP, the priority of technical needs has been established based on the opinions of the three studied groups. The domains are ranked as follows: 1) management and patient care, 2) preparation and use of drugs, 3) patient control and evaluation, 4) preparation and use of equipment, and 5) professional communication. The domain of safety and risk prevention received the lowest priority, coming in at sixth place.

The domains of management and patient care, and the preparation and use of drugs were identified as having the highest priority based on the findings of the needs assessment. Recognizing that the determination and analysis of educational needs can enhance the performance of graduates and improve the quality of anesthesia care and patient services, it is essential to focus more on implementing educational programs related to these domains.

Knowledge and expertise offer economic benefits to the actors of scientific communication and information network. If professionals are unable to interact with the members of their network, they may never get cognizant of job opportunities related to their expertise (especially in humanities fields). Therefore, the main purposes of this study are as follows: first, prioritize the general types of scientific communication and information networks in terms of informing about job opportunities through scientific collaboration with social contacts at various levels of knowledge diffusion. Second, determining the network to which the performance of the scientific collaboration network of sociology students correspond in terms of access to job information. The present paper draws on social network analysis approach in terms of theory, method, and technique. The study population includes all graduate students in the field of Sociology studying at Ferdowsi University of Mashhad (60 students). Data type is relational, which was collected using name-generator questionnaire, and data analysis was conducted by R software. Findings from network description showed that members prefer to forge scientific collaboration with people who are either famous or associated with renowned colleagues, as well as those with whom they are collaborating. Findings from network-based modeling suggested that small-world network demonstrated the best performance in terms of finding job opportunities on the account of scientific collaboration with social contacts followed by regular network, random network and scale-free network. However, the performance of the scientific collaboration network of sociology students such as a scale-free network is bipolar. According to the results, scientific communication and information network is deemed efficient when it not only generates knowledge, but also a provides job information.

Laboratories, due to their large workforce, diverse sample types, and contamination by various pathogenic agents, are considered high-risk environments for the transmission and spread of numerous diseases. This study aimed to investigate bacterial and fungal contamination of laboratory equipment in the educational laboratories at Kashan University of Medical Sciences.

This cross-sectional descriptive study was conducted in 2018 at Kashan University of Medical Sciences. A single consistent sampler performed a random sampling of 155 devices. After data collection, the frequency of microbial and fungal contamination was calculated for each laboratory and each piece of equipment. Frequency tables were constructed based on the type of bacteria or fungi and the colonies grown.

Among the 155 samples collected and cultured from laboratory equipment across various faculties, the highest percentage of contamination (83.22%) was observed with the Bacillus species (129 cases), followed by Pseudomonas species (17 cases, 10.96%) and Escherichia coli (17 cases, 10.96%). Only 7 samples were free of contamination, indicating widespread contamination across most equipment.

The results indicate that the majority of educational laboratory equipment at Kashan University of agents Medical Sciences is contaminated with both Gram-positive and Gram-negative bacteria, as well as fungal.  

Peripheral nerve damage is a very important factor in patients' quality of life and functionality for various reasons. We aimed to compare the functionality level, disability and quality of life in subjects with peripheral nerve repair in the upper extremity.

This cross-sectional study was conducted on patients with nerve injuries in 2019. Among those patients, Eighty-five were selected as the sample. The instruments used in this study included the health-related quality of life standard questionnaire (SF-36), and the disability of the arm, shoulder and hand questionnaire (DASH-38). Data were analyzed by SPSS software version 22 and one-way ANOVA and Kruskal-Wallis statistical tests.

Results of the Kruskal-Wallis test showed that the disability score in the groups of patients was not significant. In addition, according to the results of the one-way ANOVA test, the quality of life score was not significant among the patient groups.

Considering that peripheral nerve damage has a significant impact on patients' quality of life and functionality, apart from more research on the subject, it is necessary to provide support for patients to improve their quality of life.

Use of radiological equipment in dentistry is vital for the diagnosis and treatment of oral and dental diseases. However, concerns about the leakage of radiation from these devices and its impact on public health are inevitable. The present study aimed to investigate the extent of radiation leakage in dental clinics in the city of Kashan, Iran, and its results can significantly contribute to the improvement of the safety of these environments.

This cross-sectional descriptive study was conducted in 30 randomly selected dental clinics. Data collection was performed using the Smart Ion Mini_Instruments Ltd (UK) for measuring radiation leakage, along with observations and inquiries to obtain demographic and protective information. The collected data were entered into the SPSS 24  and analyzed using statistical tests.

Based on the findings, 6 out of the 30 sampled clinics had radiation leakage values higher than the permissible limit, while 24 clinics were within the safe range. Moreover, in assessing the relationship between variables and radiation leakage, no significant correlation was found between radiation leakage and the demographic information of radiologists, such as gender, specialty, and work experience. Among protective measures, the presence of lead shielding showed the highest significant correlation with radiation leakage.

The study showed that 20% of the sampled offices had a high radiation leakage rate and that protective measures, especially the use of lead shields, were very important in reducing the radiation leakage rate in dental offices. The results indicated that the offices that used lead shields had less radiation leakage than other offices. Lack of a significant relationship between the demographic information of radiographers and the amount of radiation leakage indicated that this phenomenon is more related to technical factors and radiation equipment rather than personal factors, such as gender or expertise. These results revealed the necessity of emphasizing education and retraining and the implementation of safety standards and guidelines related to the use of radiology equipment in dental environments, as well as the necessity of periodic visits to dental offices.

The outskirts of Mashhad are a collection of population centers that have expanded around the metropolis of Mashhad over the years. Which have created various problems for the metropolis of Mashhad; According to this, the present study was conducted with the main purpose of a sociological study of the process of formation and continuation of the Qala-e-Khiaban neighborhood in Mashhad as one of the essential informal settlementsThis research was conducted using an interpretive approach and qualitative research method and based on in-depth semi-structured interviews with 21 elites, residents, and informants from the Qala-e-Khiaban neighborhood. Data were collected using the snowball sampling method until the researcher reached theoretical saturation. Thematic analysis of the data collected in this research has confronted us with 82 sub-categories, 28 sub-categories, and 10 main categories. The results showed that the policies of the government, the policies of urban management, the policies of Astan Quds, and the existence of the village of Qaleh-e-Khayban had prepared the necessary conditions for the initial formation of the neighborhood of Qaleh-e-Khayban. At different historical stages and due to developments and land reform policies, the war in Afghanistan, policies of destruction by the city administration, and the non-integration of excluded people in the society and economy of Mashhad have created and strengthened the migration of social and economic groups to Qala-e-Khayban neighborhood. Along with the spread of drought, the existence of anonymity and kinship ties and the expansion of informal jobs have led to the continuation and consolidation of marginalization and ultimately the formation of one of the most important suburbs of Mashhad.

Frailty syndrome significantly impacts the health of older adults, and sleep quality is likely a pertinent clinical factor. Therefore, this study aims to investigate the relationship between sleep quality and sleep duration with frailty syndrome in the older adults of Naqadeh City.

This cross-sectional study enrolled 347 older adults aged 60 years and above in Naqadeh city in 2020 using 2-stage sampling (first, stratified, and then simple random sampling. Data collection tools included demographic questionnaires, the Edmonton Frail Scale, and the Pittsburgh Sleep Quality Index. Statistical analysis was performed using SPSS25 software.

The study revealed that 30.3% of older adults were frail. Furthermore, a statistically significant correlation was observed between sleep quality and duration with older adults' frailty (r=0.635, p<0.001 and r=-0.170, p<0.001, respectively). Additionally, all frailty domains exhibited a significant relationship with sleep quality, with the most notable associations found in mood, medication use, and cognition domains (r = 0.487, r = 0.397, r = 0.381, respectively).

Probably, the quality and duration of sleep affect the frailty syndrome, so it is necessary to design and implement effective interventions to improve the quality of sleep and ultimately reduce the frailty of older adults, especially in the domains of cognition and mood.

Using personal protective equipment, including masks, is one of the most important ways to prevent coronavirus disease 2019 (COVID-19). The aim of this study was to estimate the prevalence and pattern of mask use and its association with COVID-19-related morbidity and mortality in different areas of Tabriz, Iran.

In this population-based study, 6,600 pedestrians were selected by multi-stage proportional sampling method in nine areas of Tabriz in 2021. The data was collected using the observation method. For each participant, we recorded gender, approximate age, mask usage, type of mask, and correct or incorrect use. The data of COVID-19-related morbidity and mortality for six months (from 21 March 2021 to 22 September 2021) were obtained from the Integrated Syndromic Surveillance System (ISSS).

The overall prevalence of facial mask use was 56.8% (95% CI: 55.56 – 57.95). Out of 3,421 men, 1,599 (46.7%; 95% CI: 45.1-48.4) and out of 3,179 women, 2,147 (67.5%; 95% CI: 65.9-69.2) were used face mask (P<0.001). The correlations between mask use and morbidity (r=0.375, P=0.320) and mortality (r=0.219, P=0.571) rates were not statistically significant.

The percentage of using face masks in Tabriz was relatively low, especially among males and young people. Also, there was no significant relationship between COVID-19 morbidity and mortality and mask use.

Practical Implications:

The results of the present study showed that the percentage of mask use in men and the youth was relatively low. In times of disease epidemics, it is necessary to create the necessary sensitivity in these groups and to carry out the necessary training and interventions to increase the use of masks and protective measures.

This study aims to develop strategies for risk management and accurately model the potential outcomes in hazardous zones.

The initial step of this study involved conducting HAZOP studies to identify all process nodes and deviations in an urban water-treatment plant located in Markazi province. Subsequently, all risks associated with the identified deviations were evaluated using a qualitative risk matrix. To enhance the scientific accuracy of the risk assessment results, the fuzzy HAZOP methodology was employed. Finally, the assessed risks were prioritized with precision, and PHAST software was utilized to visualize critical scenarios and determine the zones of catastrophic consequences.

The initial findings from the HAZOP investigations conducted in the chlorination unit of the treatment facility reveal a total of 41 deviations out of 55 identified risks. Out of these risks, 47 (85%) were classified as high risk (HR), while 8 (15%) were categorized as medium risk (MR). The results of the risk assessment clearly demonstrate that the risks are of significant concern, despite the presence of existing controls. Ultimately, eight scenarios were identified and extracted from the analysis.

Based on the research results, it is imperative that all chlorination facilities undergo redesigning to prevent corrosion, erosion, leakage, and rupture and to conduct risk-based inspections (RBI). Furthermore, regular chlorine leakage drills should be included to enhance emergency response and preparedness.

With severe situation in road traffic safety, there is an urgent need to study the risk factors that determine driving violations and the severity of road accidents. The aim of the present study was to investigate the impact of driving violations and risky driving behaviors on the risk of accidents. In this descriptive cross-sectional study, 320 professional drivers participated. Data of this study were collected from Occupational Medicine Center of Kashan, Truckers’ Cooperative, and Aran and Bidgol Kavir Steel Company using the Persian version of the Driver Behavior Questionnaire (DBQ). Data were analyzed using structural equation modelling by IBM SPSS Statistics 22 and IBM AMOS 19. According to the results, the fit indices of the final model showed a good fit (X2/df=3.07, RMSEA=0.083, CFI=0.977, NFI=0.967, TLI=0.957). All three research hypotheses were confirmed in the final model. There was a positive and significant relationship between violating traffic laws and risky driving behaviors (β=0.56), and the risk of driving accidents (β=0.41). Moreover, there was a positive and significant relationship between risky driving behaviors and the risk of driving accidents (β=0.52, P>0.01). The results of this study reveal that if the traffic violation rate could be reduced or controlled successfully by strict law enforcement and continuous monitoring, then the rate of serious injuries and fatalities would be reduced accordingly.

In recent years, special attention has been paid to minimally invasive and conservative methods in addition to conventional surgical methods to repair tendon damage. In this regard, the effect of fat injection and graft has been of great interest due to its potential in accelerating tissue repair. We aimed to assess the clinical efficacy of fat injection along with conventional approach in patients with flexor tendon injury.

In this randomized clinical trial, 64 patients were randomly scheduled for tendon repair using the usual modified Kessler four-strand method alone or tendon repair using four-strand method and fat injection on the proximal and distal sides of the repair site in the Hazrat Fatemeh Hospital, Tehran Province, Iran in 2022 (IRCT20221206056723N1). Patients were followed-up for eight weeks regarding the function status of the repaired tendon (using Strickland grading test), range of motion (by physical examination) and flexion and extension gaps (by imaging).

In the eighth weeks after the treatment, the average Strickland score was significantly higher in the group receiving fat injection (P: 0.009 ). In the two pointed times, the mean range of motion was significantly higher and the mean flexion and extension gaps were significantly lower in those who received fat injection. None of the procedural side effects were observed in the fifth and eighth weeks after the treatment.

Fat injection along with usual surgical treatment for tendon repair accelerates and improves tendon function and range of motion.

Stigma is a sociological concept that is important in medicine and health because it threatens health as much as the disease itself. We aimed to explore the causes, stigmatizers, consequences and coping strategies related to the stigma of diseases by systematically analyzing relevant literature.

This systematic review examined 65 articles on Disease-Related Stigma by searching Noormags, Magiran, SID, Google Scholar, and PubMed databases. The articles were published in Persian and English between 2001 and 2022 and conducted in Iran. We used a three-step systematic review process to select articles that met the research criteria.

Conflict in society, lack of knowledge, specific characteristics of the disease, and the contagious nature of disease are the main causes of stigma, leading to stigmatization by different groups such as significant others, generalized others, institutional others, and macro others. Patients experiencing stigma face various psychological, physical, and social complications, and they may use concealment as a coping strategy, which can pose a potential threat to society's general health.

By knowing the causes and stigmatizers of disease-related, it is possible to reduce stigma with less cost and time.

Learning vocabulary seems to be a major focus of language instruction. The role of vocabulary knowledge in language learning has been studied by many researchers. The present study was conducted to investigate the effect of using online Quizlet flashcards and student-created Quizlet flashcards on learning and retention of receptive and productive vocabulary knowledge. Sixty Iranian elementary high school students who were randomly divided into 3 groups (twenty subjects per group) participated in this study. The materials and data collection instruments included the Quick Placement Test (QPT), the students’ textbook, Top Notch1 from which the vocabulary items were selected, a pre-test, an immediate post-test, and a delayed post-test. It should be mentioned that the control group was taught the words through the conventional method while the first experimental group received the words using online flashcards and the next experimental group worked on developing their own Quizlet flashcards. The results showed that in terms of receptive vocabulary knowledge learning, the students of the online Quizlet flashcards group significantly outperformed students of the control group and online Quizlet flashcards. In learning of the productive vocabulary knowledge, the learners of the control group performed significantly better than other two experimental groups. The results on vocabulary retention revealed that students of the student-created Quizlet flashcards group significantly outperformed students of the control group in terms of retention of the receptive vocabulary knowledge, and in terms of the productive vocabulary knowledge retention there were no significant difference between the groups of the study. These findings will be advantageous for English language teachers to choose the teaching techniques which can facilitate the process of language teaching and learning.

Geographical information science (GIScience) by possessing location-based technologies such as Global Positioning System (GPS), Remote Sensing (RS) and Geographic Information System (GIS), has contributed greatly to various studies in earth sciences, including the protection of ecosystems. In the present study, the application of this science was discussed in the 15 projects of the rehabilitation and balancing of groundwater resources in Iran (case study: Arak Plain), whose purpose is to protect ecosystems for the health of the environment. The projects of this plan are defined in three parts: 1- production and verification of data and information, 2- control, monitoring and exploitation, 3- water storage in aquifers. In each section, while introducing the project and related sub-projects, the application of GIScience was specified. Also, general and thematic layers as well as decision-making models were introduced in some of these projects. In a general summary, it can be pointed out that most of the rehabilitation and balancing projects are location-oriented in the protection of ecosystems and data management from collection to display steps requires geographic technologies that GIScience can well manage these projects for the health of the environment of humans, plants and other animals in order to provide the required water.