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Evaluation of Satisfaction with the Health System Transformation Plan in the Seventh Axis of Promoting Natural Childbirth
Ehsan Ameri, Ali Farhadi Mahali, Mojtaba Tabari, Alireza Matoufi,
Volume 9, Issue 4 (12-2021)
Abstract
Background and Objective: The rate of cesarean section has been increasing in many regions of the world, including Iran in recent years. Therefore, the seventh axis of the health system development plan was dedicated to promoting natural childbirth at hospitals of Iran to improve the health of mothers and infants and reduce the rate of cesarean section. The present study aimed to analyze the policy gap of the health system development plan in the axis of promoting natural childbirth.
Material and Methods: This cross-sectional, descriptive-analytical study was conducted in 384 employees, medical staff and physicians in the field of education, health and treatment at Golestan University of Medical Sciences using simple random sampling. The data collection tool included a 35-item researcher-made questionnaire. After confirmation of its validity by supervisors and advisors, its reliability was obtained to be 0.84 by Cronbach's alpha test, indicating the reliability of the questionnaire. We distributed and collected the questionnaires in 6 months from the September to the December of 2020, and analyzed data using SPSS 22.
Results: In the seventh axis of the health system development plan, there was a gap of
-0.004 between the current and desired status, indicating that the gap between the current and desired status was close to the center axis and in the field of cooperation in the statistical population of the study.
Conclusion: Implementation of a plan to promote natural childbirth was effective in reducing the rate of cesarean section and encouraging pregnant mothers to give natural childbirth but the effectiveness was not enough to achieve the goals of the seventh axis of the plan. Therefore, the factors, which caused the lack of cooperation between the executive departments of the University of Medical Sciences, must be eliminated for creating effectiveness.

The Communication Style of the Elderly during COVID-19 Pandemic
Nasrin Kheibar , Hossein Nasiri,
Volume 10, Issue 1 (3-2022)
Abstract
Although social isolation could be easily implemented during COVID-19, it affects the elderly and increases their loneliness. Our experience of the COVID-19 pandemic has been unpleasant, changes in the style of social communication in the elderly and their using of new technologies indicate resilience and adaptation in the face of crises in the elderly, which is a valuable lesson learned from the circumstances.

Assessment of Health-promoting Lifestyle among Medical Students of Mashhad University of Medical Sciences in 2018-2019
Nafiseh Mousavi Bazaz, Masoumeh Haghighi, Roya Boujaran, Vida Vakili, Mojtaba Mousavi Bazzaz, Gholamreza Haghighi,
Volume 10, Issue 1 (3-2022)
Abstract
Background and Objective: The young adults, especially the students of medical fields, as the health ambassadors of every community, play a vital role in health maintenance and improvement of society. Promoting the lifestyle behaviors of this group leads to the better health status of other society members. This study was set to asses the Lealth-promoting Lifestyle (HPL) of medical students in Mashhad, Iran. 
Material and Methods: This descriptive cross-sectional study was performed on 120 medical students of Mashhad University of Medical Sciences in 2018-2019. The data were collected by the self-reported Persian version of HPL profile II which has been validated in former studies. SPSS package (version 20) was used to analyse data, and two independent samples t-test to compare data.sampling was done in two stages, including random selection of the classroom and the clinical ward, and then random selection of students in each.
Results: 50.2% of all participants were male in gender and 77.5% were single. The overall score of HPL profile II among all the participants was moderate. According to the scores of Health-promoting Lifestyle Behaviors (HPLB), stress management scored the highest (29.62±4.45), spiritual growth and physical activity were at the lowest levels (10.84±2.07 and 16.55±4.97, respectively). Two dimensions of HPLB showed a significant difference base on the gender of the participants (better physical activity in men (p-value= 0.04) and self-responsibility for health in women (p-value=0.05)). There was not a statistical difference between HPL subscales by the participants` marital status.
Conclusion: The HPL profile II total score is moderate, but not desirable; therefore, admitting appropriate programs for lifestyle improvement, especially in the field of mental development, physical activities and nutrition, regarding student gender is recommended. Our findings can attribute the health policymakers to develop the health programs among the students and adding related courses to the educational curriculum.

Protective Effect of Aerobic Training with Blue-Algae spirulina Supplementation on Endothelial Dysfunction and Insulin Resistance in Overweight Adults Men
Ammar Raoufi Sangachin, Ahmad Abdi, Alireza Barari,
Volume 10, Issue 1 (3-2022)
Abstract
Background and Objective: Aging is the major risk factor for the development of cardiovascular diseases as aging increases plasma levels of pro-inflammatory mediators and endothelial dysfunction. Physical exercise and spirulina improve the endothelial dysfunction and chronic inflammation that accompanies aging. This study aimed to evaluate the effects of Aerobic Exercise (AT), with blue-algae Spirulina Supplementation (SP) on the indicators of endothelial dysfunction and insulin resistance in overweight adult men.
Material and Methods: In this clinical trial study, 40 overweight adult men (age 57.50±4.84 years, Body mass index: BMI 26.90±2.85 kg/m2) were selected from Bandar-e-Anzali and randomly allocated into five groups; including Control-Normal (CN), Overweight (OW), Overweight-Aerobic Training (OWAT), Overweight-Spirulina (OWSP) and Overweight-Aerobic Training -Spirulina (OWATSP). Training groups participated in an aerobic exercise program for eight weeks, five sessions per week (with an intensity of 65 to 85% of peak heart rate, 40 minutes). The OWSP and OWATSP groups were provided with two 500 mg SP tablets daily in the morning and evening. Data were analyzed using an independent t-test and ANCOVA at a significance level of
P <0.05.
Results: The levels of endothelin-1(ET-1), Intercellular Adhesion Molecule 1 (ICAM-1), Selectin-E, and HOMA-IR index in the OW group were higher than CN (P≤0.05). AT and SP significantly reduced ET-1, ICAM-1, Selectin-E, and HOMA-IR (P≤0.05). In the OWATSP group, the levels of ET-1, ICAM-1, Selectin-E, and HOMA-IR were significantly lower than OW and OWSP (P≤0.05). NO levels significantly decreased in OWATSP and OWAT (P≤0.05).
Conclusion: Aerobic training and spirulina supplementation could improve the endothelial function in overweight adult men, by altering the levels of ET-1, ICAM-1, Selectin-E, and NO. However, the simultaneous effect of AT with SP on these indices was better. Improved endothelial function was associated with an improvement in insulin resistance index.

Acknowledgement to referees 2021

Volume 10, Issue 1 (3-2022)
Abstract
On behalf of our Editorial team at Jorjani Biomedicine Journal, my heartfelt recognition for the commitment and contributions of those who served as reviewers for Jorjani Biomedicine Journal in 2021 is listed below. The high quality of their reviews is an extraordinary asset to ensure the quality of the articles published in the Jorjani Biomedicine Journal. I want to express my most sincere and deepest appreciation to all of you exceptional scientists, researchers, and clinicians, for being part of this community as reviewers.

Hesamaddin Shirzad-Aski, Infectious Diseases Research Center, Golestan University of Medical Sciences, Gorgan, Iran.
Mahdieh Hasani, Genetics Research Center, University of Social Welfare and Rehabilitation Sciences, Tehran, Iran.
Navisa Sadat Seyedghasemi, Department of Biostatistics and Epidemiology, School of Health, Golestan University of Medical Sciences, Gorgan, Iran.
Roya Nikbakht, Biostatistics and Epidemiology Dept., Faculty of Health, Golestan University of Medical Science, Gorgan, Iran.
Ezatolah Kazeminejad, Department of Midwifery, Tabriz Branch, Islamic Azad University, Tabriz. Iran.
Mahin Nomali, Department of Epidemiology and Biostatistics, School of Public Health, Tehran University of Medical Sciences, Tehran, Iran.
Mohamad Asghari Jafarabadi, Department of Statistics and Epidemiology, School of Medicine, Zanjan University of Medical Sciences, Zanjan, Iran
Sara Cheraghi, Department of Molecular Medicine, Faculty of Medical Sciences, Qazvin University of Medical Sciences, Qazvin, Iran.
Maliheh Moradzadeh, Rheumatology Research center, Golestan University of Medical Sciences, Iran.
Seyed Mostafa Mir, Metabolic Disorders Research Center, Golestan University of Medical Sciences, Gorgan, Iran.
Zahra Hesari, Laboratory Sciences Research Center, Golestan University of Medical Sciences, Gorgan, Iran.
Seyed Ali Hosseini, Department of Sport Physiology, Marvdasht Branch, Islamic Azad University, Marvdasht, Iran.
Milad Khorasani, Laboratory Sciences Research Center, Golestan University of Medical Sciences, Gorgan, Iran.
Nazanin Mortazavi, Assistant Professor, Department of Oral and Maxillofacial Medicine, Dental School, Golestan University of Medical Sciences, Gorgan, Iran.
Seyed Mehdi Jafari, Department of Biochemistry and Biophysics, School of Medicine, Golestan University of Medical Sciences, Gorgan/ Metabolic Disorders Research Center, Golestan University of Medical Sciences, Gorgan, Iran.
Iman Fathi, Department of Sport Sciences, Faculty of Literature and Humanities, University of Vali-e-Asr, Rafsanjan, Iran.
Motahareh Kaboodsaz Yazdi, Department of Oral and Maxillofacial Radiology, School of Dentistry, Shahid Sadoughi University of Medical Sciences, Yazd, Iran.
Fatemeh Owlia, associate professor. Department of Oral and Maxillofacial Medicine, School of Dentistry, Shahid Sadoughi University of Medical Sciences, Yazd, Iran/ Social determinants of oral health -research center, shahid sadoughi university of medical sciences, Yazd, Iran.
Ali Khajelandi, Department of Physical Education and Sport Sciences, Gachsaran Branch, Islamic Azad University, Gachsaran, Iran.
Majid Kashef, Department of Exercise Physiology, Faculty of Sport Science, Shahid Rajaee Teacher Training University, Tehran, Iran.
Morteza Oladenabi, Ischemic Disorders Research Center, Golestan University of Medical Sciences, Gorgan, Iran/Gorgan Congenital Malformations Research Center, Golestan University of Medical Sciences, Gorgan, Iran.
Maryam Chehrehgosha, Department of Surgical Technology, Paramedical School, Golestan University of Medical Sciences, Gorgan, Iran/ Laboratory Sciences Research Center, Golestan University of Medical Sciences, Gorgan, Iran.
Mina Pakkhesal, Dental Research Center, Community Oral Health Department, School of Dentistry, Golestan University of Medical Sciences, Gorgan, Iran.
Fatemeh Seifi, Dental Research Center, Community Oral Health Department, School of Dentistry, Golestan University of Medical Sciences, Gorgan, Iran.
Sedigheh Moghassemi, Counseling and Reproductive Health Research Centre, Department of Midwifery, School of Gorgan Nursing and Midwifery, Golestan University of Medical Sciences, Gorgan, Iran
Ali Bazzi, Guilan University of Medical SciencesBeheshti School of Nursing and Midwifery, Guilan, Iran.
Marie Saghaeian, Metabolic Disorders Research Center, Golestan University of Medical Sciences, Gorgan, Iran.
Fatemeh Bagheri, Department of Industrial Engineering, K. N. Toosi University of Technology, Pardis Street, Molla Sadra Ave, Tehran, Iran.
Ebrahim Kohsari, Laboratory Sciences Research Center, Golestan University of Medical Sciences, Gorgan, Iran.
Elham Fakhari, Dental Research Center, Golestan University of Medical Sciences, Gorgan, Iran.
Hashem Heshmati, Department of Health Education and Promotion, School of Public Health, Tehran University of Medical Sciences, Tehran, Iran.
Sakineh Gerayllo, Department of Health, School of Public Health, Golestan Faculty of Medical Sciences, Gorgan, Iran.
Saeed Mohammadi, Stem Cell Research Center, Golestan University of Medical Sciences, Gorgan, Iran/ Infectious Diseases Research Center, Golestan University of Medical Sciences, Gorgan, Iran.
Mehdi Yadegari, Khaje Nasir Toosi University of Technology Faculty of Industrial Engineering, Mashhad, Iran.
Kamyar Khoshnevisan, Medical Nanotechnology, and Tissue Engineering Research Center, Shahid Beheshti University of Medical Sciences, Tehran, Iran/ Department of Tissue Engineering and Applied Cell Sciences, School of Advanced Technologies in Medicine, Shahid Beheshti University of Medical Sciences, Tehran, Iran.
Haleh Zokaee, Department of Oral and Maxillofacial Medicine, Dentistry Research Center, Golestan University of Medical Sciences, Gorgan, Iran.
Yashar Bagherizadeh, Department of Microbiology, Kazeroon Branch, Islamic Azad University, Kazeroon.
Fatemeh Mehravar, Ph.D. Candidate in Epidemiology, Department of Epidemiology and Biostatistics School of Public Health, Tehran University of Medical Sciences (TUMS).

Evaluation of Microleakage of Self-Adhesive Composite Resin in Pits and Fissures of Extracted Premolar Teeth: An in Vitro Study
Zahra Bahrololoomi, Fateme Mehravar, Niloofar Halvani, Hamed Saeid,
Volume 10, Issue 2 (5-2022)
Abstract
Background and objectives: Microleakage at the interface of tooth structure and fissure sealant plays a crucial role in failure of the treatment. This in vitro study aimed to determine the microleakage of self-adhesive flowable composite resins as pit and fissure sealants.
Material and Methods: 60 healthy extracted premolar teeth were randomly divided into the 4 groups (n=15), group 1) clinpro sealants (control), group 2) flowable composite resin with bonding agent (total-etch), group 3) flowable composite resin with self-etch bonding agent, and group 4) self-adhesive composite resin. After thermocycling the specimens were immersed in 2% methylene blue for 48 hours and then sectioned in the buccolingual direction. The microleakage was assessed by dye penetration using a stereomicroscope at 15X magnification. Data analysis was performed using SPSS version 18.0 as well as Mann-Whitney and Kruskal-Wallis tests.
Results: There was a statistically significant difference in microleakage score between the groups (P-value = 0.006). The lowest mean of microleakage level was observed in the flowable composite group with total-etch bonding (group 2) 1.26±0.96, followed by the Clinpro sealant group (group 1) 1.62±1.20, and then the self-adhesive composite group (group 4) 1.85±1.00.
Conclusion: Based on the results of this study, the microleakage of self-adhesive composite resin revealed no significant difference with conventional fissure sealant; however, the microleakage of these composite resin was higher than flowable composite resin with total-etch bonding agent.

Ameliorative Impact of Silymarin on the Male Reproductive System: An Updated Systematic Review
Fahimeh Hosseinabadi, Tayebeh Faraji, Mahdi Malmir, Hanieh Mohamadi,
Volume 10, Issue 2 (5-2022)
Abstract
Background and objectives: Numerous studies have evaluated the effects of silymarin on sperm quality and its neutralization impact of various toxins on the male reproductive system. However, these studies as a whole have not been summarized and categorized yet. Silymarin is a flavonoid and known as a powerful antioxidant compound in the treatment of many diseases including liver disorders, rhinitis, diabetes, and testis disorders. The aim of the study was to discuss the impact of silymarin on the male reproductive system.
Material and Methods: From Apr 1998 to Feb 2020, related articles were extracted from databases of Web of Science (WOS), PubMed, Google Scholar, Science Direct, Scopus, EBSCO and grey literature by seeking MeSH words including Silymarin, Milk thistle, Silybum marianum, testis, Spermatogenesis, and Sex hormones.
Results: Silymarin withholds damage to the testicular germinal epithelium and comforts the spermatogenesis process by amplification the antioxidant system, decrease lipid peroxidation and oxidative stress, preventing the expression of pro-apoptotic genes, increases testosterone and gonadotropins.
Conclusion: In outcome, based on the results, silymarin can boost fertility in sterility males by its talented antioxidant features.
 

The Effect of Interval and Continued Trainings with Citrus Aurantium on Pain Threshold and Motor Balance in Elderly Rats
Omidreza Salehi, Mayam Kheirdeh, Fatemeh Farkhaie, Mehdi Noura, Rasoul Jamali Fashi, Abdolali Rakhshanizadeh,
Volume 10, Issue 2 (5-2022)
Abstract

Background and objectives: Aging is a natural phenomenon associated with a decrease in physical fitness factors and increases in chronic pain. The present study aimed to investigate the effect of High Interval Intensity Training (HIIT) and Moderate Intensity Continued Training (MICT) with Citrus Aurantium (CA) consumption on pain threshold and motor balance in elderly rats.
Material and Methods: Forty-nine elderly rats were randomly divided into 1) control, 2) MICT, 3) HIIT, 4) MICT+CA, 5) HIIT+CA, 6) CA and 7) sham groups. Groups 3 and 5 performed HIIT at a speed of 25-25 m/min, and groups 2 and 4 performed MICT at a speed of 25-20 m/min; also, groups 4-6 received 300 mg/kg/day CA peritoneally. The pain and motor balance tests were evaluated using a hot plate and rotarod devices respectively. The Kolmogorov-Smirnov test was used to investigate the normal distribution of findings and one-way ANOVA with Tukey’s post- hoc tests was used to analyze of findings (P≤0.05).
Results: CA, MICT, HIIT, MICT+CA, and HIIT+CA significantly increased pain threshold and motor balance (P<0.05); MICT+CA (P<0.05) and HIIT+CA (P<0.05) significantly increased pain threshold compared to CA, MICT, and HIIT, and HIIT+CA significantly increased pain threshold compared to MICT+CA (P<0.05).
Conclusion: Although CA, MICT, and HIIT alone can enhance pain threshold and motor balance nevertheless it appears that MICT+CA and HIIT+CA have a better effect on the increase of pain threshold, so the effects of HIIT+CA can be higher than MICT+CA.


The Effect of four Weeks of Continuous Aerobic Training and Starvation on the Expression of Gene Pink1 and Bnibp3 in liver Tissue, liver Enzymes and lipid profile in Wistar Fatty Model Rats
Hamzeh Bayani, Habib Asgharpour, Asra Askari, Reza Rezaeeshirazi,
Volume 10, Issue 3 (10-2022)
Abstract
Background and Objective: Regular exercise along with calorie intake promotes mitochondrial function by promoting healthy mitochondrial regeneration. The aim of the present study was to investigate the effect of four weeksof continuous aerobic training and starvation on the gene expression of pink1 and bnibp3 (liver mitophagy) in Wistar fat rats.
Materials and Methods: The present study used an experimental design. Thirty 18-week-old fatty, maleWistar rats with an average body weight of 348±25.53 purchased from the Pasteur Institute of Iran were selected as the research sample. After one week of familiarity with the laboratory environment, these fatty animals were randomly divided into 6 groups of 5, control (n=5) and experimental (n=25), including control, starvation, starvation and 3 days of exercise, starvation and 5 days of exercise, 3 days of exercise, 5 days of exercise groups.
Results: According to the statistical results of one-way analysis of variance, there was a significant decrease in triglyceride, cholesterol, liver enzymes ALT, AST in all groups compared to the control group. Furthermore, there was a significant increase in pink1 and bnibp3 gene expression in starvation group and starvation groups of 3 and 5 days of training compared to the control group.
Conclusion: Four weeksof continuous aerobic training and starvation combined and alone were able to significantly reduce the status of blood lipids and liver enzymes in fatty model rats. Also, the starvation group and starvation groups along with exercise increased the activity of removing damaged mitochondria by increasing the activity of pink1 and bnibp3 genes compared to the control group.
 

The Oral Cavity Moisturizing Effects of Lemon and Aloe Vera Extracts in Patients with Xerostomia: A Comparative Study
Leila Rajaei-Behbahani, Shahla Afshar, Sara Rajaei-Behbahani, Maryam-Sadat Sadrzadeh-Afshar,
Volume 10, Issue 3 (10-2022)
Abstract
Background and Objectives: Xerostomia has been defined as the dry mouth sensation due to hyposalivation or change in saliva composition. Many herbal medicines have been used as treatment options. Since the combination of aloe vera extract and honey, and Lemon is suggested as a potent oral moisturizer, limited studies have been done in this field. Therefore, we decided to compare the effects of these two moisturizers in cases of xerostomia.
Material and Methods: a combination of aloe vera extract and honey, lemon extract, and placebo mouthwashes were provided to 30 participants suffering from xerostomia. Each patient used three types of mouthwash in the following order: For the first mouthwash, the patients were asked to express their sensation of dry mouth using VAS on the first, third, and fifth days. This was followed by a one-week rest period in which patients did not use mouthwash. The same process was repeated to measure the second and third mouthwashes.
Results: Lemon and a combination of aloe vera extract and honey were both found to be significantly effective in reducing the dry mouth sensation. However, lemon was significantly more effective in this regard. Placebo was significantly less effective than both extracts and overall had no statistically significant impact on the dry mouth sensation (p<0.001)
Conclusion: Lemon mouthwash was significantly more effective than a combination of aloe vera and honey. Thus, it is recommended to improve dry mouth sensation.

Designing Model to Identifying Optimal Services, Integrated System, Registration of Pharmaceutical
Kobra Sharifiyan, Mohammad Jafar Tarokh, Seyed Alireza Hashemi Golpayegani,
Volume 10, Issue 4 (12-2022)
Abstract
Background and Objectives: One of the complicated processes in the Ministry of Health is the process of registering pharmaceuticals .Since there are different soft wares for registration of products, and since parallel services concuss waste of time and money, it is necessary to provide integrated software in the form of services. This goal can be achieved when services are identified and combined in integrated soft wares.
Material and Methods: present study is an applied research, In order to identify the services of an integrated system for recording pharmaceutical supplies, first the Gray-Wolf multi-objective optimization (GWO) algorithm was proposed. Then the values of the algorithm parameters were extracted by the goal-based requirements analysis method and the algorithm was implemented. Finally the best services were extracted by the hierarchical analysis process.
Results: Considering that the results of present study are an operational project in the Ministry of Health, by implementing the algorithm proposed by Gray Wolf, services were identified, which can be used to create integrated software for registering pharmaceutical supplies.
Conclusion: Creating an integrated system for registering pharmaceutical supplies is one of the important challenges of the Ministry of Health. This can be achieved by identifying services and combining these services to create an integrated system.

Study the Effect of Swimming Training and Curcumin on Reduction of BAX and P53 proteins and Increase in BCL2 protein in Heart Tissue of Rats During Withdrawal of Excessive Ethanol Consumption
Mona Abdolhamid Tehrani,
Volume 10, Issue 4 (12-2022)
Abstract
Background and objectives: Epidemiological studies have shown that high dose of ethanol can lead to apoptosis. On the other hand, the consumption of medicinal plants such as turmeric in the diet and performing physical activities are considered as factors to control apoptosis. Therefore, this article aims to mainly evaluate the anti-apoptotic effects of swimming and curcumin interactively during withdrawal of binge ethanol exposure in heart tissues.
Material and Methods: In this study, 40 rats were received ethanol (25% W/V) as gavage for four days every eight hours. Then, 7 days after ethanol withdrawal, they were classified in 5 groups, including: (1) control, (2) curcumin, (3) swimming, (4) swimming with curcumin, and (5) sham. Groups 3 and 4 performed swimming five sessions a week for two weeks, and groups 2 and 4 received 50 mg/kg of curcumin five times a week for two weeks. The amount of BAX, BCL2, and P53 protein and BCL2/BAX ratio were measured using western blot technique. The data were tested using the independent t-test at a significant level (p≥0.05) and two-way ANOVA.
Results: Swimming had a significant effect on reduction of p53 (F=60.051, P<0.0001, η2=0.741), Bax (F=62.594, P<0.0001, η2=0.887) and Bax/Bcl-2 ratio (F=290.591, P<0.0001, η2=0.973), and increase of Bcl-2 (F=150.940, P<0.0001, η2=0.950); Curcumin had a significant effect on decrease of p53 (F=5.513, P=0.029, η2=0.208), Bax (F=66.146, P<0.0001, η2=0.892) and Bax/Bcl-2 ratio (F=260.655, P<0.0001, η2=0.970), and increase of Bcl-2 (F=73.274, P<0.0001, η2=0.902). The results from two-way ANOVA showed the interactive effect of exercise and curcumin on the decrease of BAX (F=35.847, P<0.0001, η2=0.818) and BAX/BCL-2 ratio (F=175.887, P<0.0001, η2=0.956), and the increase of BCL-2 (F=21.205, P=0.002, η2=0.726) were significant; but it had no significant effect on p53 (F=0.000, P=0.999, η2=0.000).
Conclusion: Swimming and curcumin consumption simultaneously can significantly moderate apoptosis caused by ethanol in the heart tissue.

Applying a Qualitative Approach in Designing the Model of Business Sustainability of Hospitals and Medical Centers
Alireza Shirmohammadi, Farhad Vafae, Farshid Namamian, Mohammad Taban,
Volume 10, Issue 4 (12-2022)
Abstract
Background and Objectives: Little attention to sustainability in business, particularly in the healthcare sector, together with the absence of a model within acceptable limits for this purpose, were among the main objectives to design a business sustainability model for healthcare facilities (viz., hospitals and medical centers) in the present study.
Material and Methods: The qualitative meta-synthesis approach was implemented in this study, and the most significant factors shaping sustainability in business were identified. The statistical population included the articles, books, and research reports published and retrieved from the reliable journals and databases, between 2002 and 2021. Moreover, the experts, i.e., the university professors and specialists involved in healthcare at Ilam University of Medical Sciences, Ilam, Iran, were consulted. At this stage, snowball sampling was done based on the model proposed by Sandelowski and Barroso, until theoretical saturation was reached. In total, 26 articles were selected and finalized for the meta-synthesis. The Critical Appraisal Skills Programme (CASP) was correspondingly utilized to assess the quality of the study samples, and Cohen's kappa coefficient (κ) was employed to measure the validity of the extracted codes.
Results: The study findings demonstrated that the business sustainability model for the healthcare sector comprised of 3 categories (viz. environmental, social, and economic), 12 concepts, and 65 codes, with a very goodness of fit.
Conclusion: In sum, business sustainability in healthcare facilities could be achieved if all environmental, social, and economic components developed in the give model as well as the effective indicators within each category were taken into account.

The Health-Related Biological Effects of Date Palm Pollen (DPP) along with Physical Activity: A Narrative Mini-Review
Soheil Abdollahi, Mohammad Ali Azarbayjani, Maghsoud Peeri, Saleh Rahmati-Ahmadabad,
Volume 10, Issue 4 (12-2022)
Abstract
Date Palm Pollen (DDP), which is found in the male date tree, actually fertilizes the female date tree, which is necessary for the growth of date fruit. It is consisting of sugarcane, protein, calcium, vitamins (B, C and E) and minerals. It has long been used in traditional medicine as a medicinal plant with fertility effects and increased libido. The information obtained from the studies shows that this pollen, due to its antioxidant and gonadotropin-stimulating compounds, can increase fertility and sexual potency in both women and men with two main mechanisms. The first mechanism is this effect on the stimulation of gonadotrophic hormones and the second is a reduction of oxidative stress in the testicular tissue and consequently a protective effect on the testicular tissue. Due to the presence of antioxidant compounds, the consumption of this pollen also applies its health-enhancing effects to other tissues such as the liver, intestines, and heart. As same as DDP, regular Physical Activity (PA) stimulates gonadotrophic hormones and also beneficially affects antioxidant status and redox balance. In recent years, researchers have paid attention to this pollen as an important factor to strengthen the health-enhancing effects of PA, and researchers have investigated the simultaneous effect of this pollen and PA. Despite the few studies done, it seems that this pollen can enhance the antioxidant and anti-inflammatory effects of regular PAs. Nevertheless, it seems necessary to further studies in this area.

Development of Psychological Intervention guideline topics for Management Type 2 Diabetes in the Primary Health Care System (PHC) of IRAN: A Qualitative Study, Content Analysis of Expert Opinions
Tahereh Ziadlou, Ahmad Hajebi, Fahimeh Fathali Lavasani, Mohammad Reza Seirafi, Addis Kraskian Moujembari,
Volume 10, Issue 4 (12-2022)
Abstract
Background and Objectives: As a health emergency of the 21st century, Diabetes is associated with an increased risk of cardiovascular diseases, stroke, diabetic nephropathy, neuropathy, retinopathy, pregnancy complications, psychological problems, lower quality of life experience, as well as a high economic burden and high risk of premature death. This study aimed to develop psychological interventions headings for patients referring to healthcare service centers based on local needs assessment through content analysis method of experts' opinion to provide services in the primary healthcare system.
Material and Methods: This study was conducted on 19 mental health specialists, professors, and the health team providing services in healthcare service centers (family doctor and mental health expert) in 2018-19. The data obtained from the semi-structured interviews were analyzed using the directed content analysis technique.
Results: The essential finding themes related to the closed headings of psychological interventions in diabetes for improving disease management included "collaborative care," "psychological assessment," the importance of "diabetes coexistence with psychiatric disorders," "creating health behaviors," "self-management training," and "intervention" In crisis" for the management of type 2 diabetes.
Conclusion: This qualitative study was conducted with the participation of mental health experts. Therefore, the mentioned themes and categories can be used in developing the headings of psychological intervention programs for type 2 diabetic patients, focusing on the needs of Iranian patients and the structure of the health system.


Aerobic Training and Curcumin can Improve Adiponectin Gene Expression in Adipose Tissue and Body Mass Index of Rats Fed with High-Fat Diet
Zahra Hashemi Shiri, Tahereh Bagherpour, Nemtallah Nemati,
Volume 10, Issue 4 (12-2022)
Abstract
Background: Obesity has been recognized as a global problem that is increasing day by day. Although t Background: Obesity has been recognized as a global problem that is increasing day by day. Although the favorable effects of training and herbal supplements have been reported in this regard, the synergistic effects of the two are still a challenge for researchers. The purpose of this study was to investigate the effect of six weeks of Aerobic Training (AT) and Curcumin (Cu) consumption on adiponectin gene expression in the visceral adipose tissue and some anthropometric indicators of rats fed with High-Fat Diet (HFD).
Material and Methods: In this experimental study, 40 rats with HFD (1.5 mg/kg/day high-fat emulsion) were randomly divided into five groups, including: (1) Healthy Control (HC), (2) High-Fat Diet Control (HFD), (3) HFD+Cu, (4) HFD+AT, and (5) HFD+Cu+AT. Aerobic training was carried out for six weeks, five sessions per week and each session of training was performed 10-50 minutes at a speed of 25-30 meters per minute and a slope of 15 degrees. Also, curcumin was fed to rats by gavage in the amount of 1.5 mg/kg/day. One-way analysis of variance with Tukey's post hoc test was used to analyze adiponectin and ANCOVA test with Bonferroni's test was used to analyze BMI. Data were analyzed in Prism GraphPad PRISM 3.8.3 software (P≤0.05).
Results: Adiponectin gene expression levels in the HFD+AT, HFD+Cu and HFD+AT+Cu groups were significantly higher than the HFD group (P≥0.05). Weight and BMI levels in the HFD+AT and HFD+AT+Cu groups were significantly lower than the HFD (P≥0.05). Also, in the HFD+AT+Cu group, the weight and BMI levels were significantly lower and the adiponectin levels were significantly higher than the HFD+Cu group (P≥0.05).
Conclusion: It seems that exercise training and curcumin consumption both individually and synergistically can be effective in improving anthropometric characteristics by affecting adiponectin levels.he favorable effects of training and herbal supplements have been reported in this regard, the synergistic effects of the two are still a challenge for researchers.

Investigating the impact of aerobic training on myokine gene expression in the skeletal muscle of wistar rats
Seyed Rafie Shafabakhsh, Yaser Kazemzadeh, Hossein Shirvani, Sanaz Mirzaiyan Shanjani, Saeed Sedaghati,
Volume 11, Issue 1 (7-2023)
Abstract 
Background: Skeletal muscle is a tissue that secretes myokines from muscle cells in response to training stimuli and muscle contractions. Therefore, this study aimed to investigate the effect of 4-week moderate-intensity aerobic exercise on the expression of three genes: apelin, decorin, and musclin in the skeletal muscle fibers of Wistar rats. In addition, the study examined the changes in gene expression levels during the training period.
Methods: The present study enrolled 16 male Wistar rats with an approximate age of eight weeks and a weight range of 200-220 grams. They were randomly divided into two equal groups: An aerobic exercise group (n=8) and a control group (n=8). During the four-week training period, the experimental group performed aerobic exercises on a treadmill with an intensity of 50-70% of their maximum power, for three sessions per week, while the control group did not engage in any activity. After completing the training period, the rats were sacrificed 48 hours later to evaluate the gene expression of the study variables using the real-time PCR method for tissue analysis. An independent t-test was used to examine the difference between groups, and statistical significance was set at P <0.05.
Results: The independent t-test results indicated that the gene expression levels of all three variables: Musclin, decorin, and apelin, were significantly higher in the aerobic exercise group compared to the control group.
Conclusion: The study findings suggest that aerobic exercise can potentially to increase the gene expression of three specific myokines:  apelin, decorin, and musclin in skeletal muscles. These myokines are known to play an essential role in energy homeostasis, and their increased expression levels could have potential health benefits for individuals engaged in aerobic exercise.

Effects of high-intensity functional training and circuit resistance training on the serum levels of IFN-γ in obese women
Samaneh Jadidi , Seyed Mohsen Avandi, Ali Khaleghian ,
Volume 11, Issue 1 (7-2023)
Abstract
Samaneh Jadidi, Seyed Mohsen Avandi , Ali Khaleghian
Background: Obesity is one of the most serious health problems associated with inflammation. It has been found that functional and resistance physical activities improve obesity and inflammation. The aim of this study was to investigate the effect High-intensity Functional training (HIFT) and Circuit resistance training (CRT) on serum levels of the pro-inflammatory factor interferon gamma (IFN-γ) in obese women.
Methods: Thirty-six obese women of Semnan city (age: 32.66 ± 3.91, weight: 86.97± 9.08 and BMI> 30) were selected and divided into three groups of HIIF (n =12), CRT (n = 12) and control (n = 12) were divided. HIIF was performed in the form of cross-fit exercises and Circuit exercises in the form of weight training for 6 weeks. Finally, the IFN-γ was measured using the Human IFN-g Elisa kit 96t-zellbio. To examine the data, one-way analysis of variance and dependent t-test at the level of p≤0.05 were used and all calculations were performed using SPSS software version 24.
Results: The results showed that there was no significant change in IFN-γ level in training groups compared to before training (P>0.05). Also, the results between groups did not show a significant difference in serum IFN-γ between HIIF and CRT (P>0.05).
Conclusion: Therefore, it seems that of exercise does not affect the dependent variable of serum interferon gamma levels.
Comparison of twelve weeks periodized circuit resistance training and traditional resistance training on calprotectin levels in obese men
Fatemeh Mirzaei Ashrafi, Seyed Mohsen Avandi, Ali Khaleghian,
Volume 11, Issue 1 (7-2023)
Abstract
Fatemeh Mirzaei Ashrafi http://jorjanijournal.goums.ac.ir/files/0allsites/images/orcid.png, Seyed Mohsen Avandi  http://jorjanijournal.goums.ac.ir/files/0allsites/images/orcid.png , Ali Khaleghian http://jorjanijournal.goums.ac.ir/files/0allsites/images/orcid.png

Background: Obesity has become a significant health concern in recent decades, characterized by increased body fat. This study aimed to compare the effects of circuit and traditional resistance training on serum calprotectin levels in obese men.
Methods: A pre-test-post-test design was used with thirty-three sedentary young obese men (age 21.33±2.49 years, weight 92.23±14.39 kg and BMI 30.71±4.63 kg/m²) who were randomly divided into two groups: experimental and control. The experimental group underwent a 12-week periodized resistance training program consisting of three sessions per week, gradually increasing in intensity from 50% to 80% of their one-repetition maximum (1RM) using a wave pattern. Resting serum calprotectin levels were measured before and after the intervention. Data were analyzed using analysis of variance (ANOVA) and paired sample t-tests, with statistical significance at p < 0.05.
Results: Both periodized circuit and traditional resistance training resulted in increased plasma levels of calprotectin compared to the control group (p = 0.001). Additionally, the periodized circuit resistance training group demonstrated a greater increase in plasma levels of calprotectin than the traditional resistance training and control groups (p = 0.01).
Conclusion: These findings suggest that twelve-week periodized circuit and traditional resistance training programs can effectively increase calprotectin levels in obese men.

Protective effect of L-carnitine on sperm motility and membrane integrity in men asthenoteratozoospermia: An in vitro study
Samira Naderi Noreini, Roya Ahmadi Nia Tabesh, Mahdi Malmir, Ali Asghar Ghafarizade,
Volume 11, Issue 2 (10-2023)
Abstract
Background: Sperm preparation is a time-consuming process that makes a contribution to oxidative stress induction in assisted reproductive techniques.
Objective: This study aimed to evaluate the effect of L-carnitine on sperm parameters during semen preparation at different time intervals.
Materials and Methods: In this in vitro study, the semen samples of 50 asthenoteratozoospermic men were divided into the control and the L-carnitine groups (incubated with 0.5 mg/mL L-carnitine) (n=25/each). Total motility, progressive motility, sperm membrane integrity (by Hypo-osmotic swelling test), and lipid peroxidation (by Malondialdehyde level) were assessed in each group after 2, 4, and 6 hours. Afterward, samples were analyzed by the World Health Organization (2010) criteria.
Result: The results showed that in the control group total and progressive motility, and membrane integrity of the sperm were significantly decreased after 2 hr (P= 0.028, p= 0.019, and p= 0.025, respectively), while Malondialdehyde levels increased significantly after 4 hr (P= 0.018). Sperm parameters in the L-carnitine group increased significantly after 2 hr (P= 0.002), while Malondialdehyde levels decreased significantly compared to the control group in 6 hr (P < 0.001 vs. P =0.045).
Conclusion: Based on these results, L-carnitine can manage to conserve motility and sperm membrane integrity of sperm from the hazardous impact of oxidative stress and lipid peroxidation during sperm preparation.
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