Background: The monitoring of reproduction number over time provides feedback on the effectiveness of interventions and on the need to intensify control efforts. Hence, we aimed to compute basic (R₀) and real-time (Rt) reproduction number and predict the trend and the size of the coronavirus disease 2019 (COVID-19) outbreak in the center of Iran. Materials and Methods: We used the 887 confirmed cases of COVID-19 from February 20, 2020, to April 17, 2020 in the center of Iran. We considered three scenarios for serial intervals (SIs) with gamma distribution. R_t was calculated by the sequential Bayesian and time-dependent methods. Based on a branching process using the Poisson distributed number of new cases per day, the daily incidence and cumulative incidence for the next 30 days were predicted. The analysis was applied in R packages 3.6.3 and STATA 12.0. Results: The model shows that the R_t of COVID-19 has been decreasing since the onset of the epidemic. According to three scenarios based on different distributions of SIs in the past 58 days from the epidemic, R_t has been 1.03 (0.94, 1.14), 1.05 (0.96, 1.15), and 1.08 (0.98, 1.18) and the cumulative incidence cases will be 360 (180, 603), 388 (238, 573), and 444 (249, 707) for the next 30 days, respectively. Conclusion: Based on the real-time data extracted from the center of Iran, R_t has been decreasing substantially since the beginning of the epidemic, and it is expected to remain almost constant or continue to decline slightly in the next 30 days, which is consequence of the schools and universities shutting down, reduction of working hours, mass screening, and social distancing.

The confirmed and suspected cases of the 2019 novel coronavirus disease (COVID-19) have increased in the entire world. There is still no vaccine or definitive treatment for this virus due to its unknown pathogenesis and proliferation pathways. Optimized supportive care remains the main therapy, and the clinical efficacy for the subsequent agents is still under investigation. Enormous demand for handling the COVID-19 outbreak challenged both the health-care personnel and medical supply system. As outbreaks of COVID-19 develop, prehospital workers, emergency medical services personnel, and other emergency responders are potentially asked to follow specific practice guidelines to mitigate the effects of an escalating pandemic. In this article, we have summarized the current guidance on potential COVID-19 management options. The recent experience with COVID-19 provided lessons on strategy and policymaking that the government and ministry of health should be on the alert and concentrate more on capacity to manage an outbreak like COVID-19. It is important to consider the new data that emerge daily regarding clinical characteristics, treatment options, and outcomes for COVID-19.

Background: With the spread of COVID-19, treatment of diseases such as multiple sclerosis (MS) should be resumed with caution due to the disease-modifying therapies (DMTs) used in this subset of patients and the immunoregulatory effects of these drugs. We aim to assess the outcome of COVID-19 infection in MS patients receiving DMTs. Materials and Methods: This is a cross-sectional study involving 45 COVID-19-infected patients previously diagnosed with MS. The data regarding their MS status and the type of DMT taken by the patients were extracted from the Isfahan MS Institute registry and were summarized. Diagnosis of MS was based on the 2017 McDonald Criteria, and the diagnosis of COVID-19 was based on computed tomography scan and polymerase chain reaction of nasopharyngeal swabs. Results: Out of the 45 MS patients infected with COVID-19, 5 had unfavorable outcomes. Two patients deceased and the other three had persistent respiratory complications on the 4-week follow-up visit. Hypertension, diabetes, seizures, and rheumatoid arthritis were among the comorbidities that the patients reported. Both patients who died received rituximab as part of their MS treatment. All other patients recovered completely. Conclusion: Each different drug category may possess a distinct risk for infection, therefore until robust evidence are available, the safest drug should be utilized or the therapy should be postponed, if possible, to minimize patient risk. Disease-modifying therapy use in MS patients should be cautiously applied as their effect on COVID-19 infection prognosis is not yet studied.

The severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), a zoonotic infection, is responsible for COVID-19 pandemic and also is known as a public health concern. However, so far, the origin of the causative virus and its intermediate hosts is yet to be fully determined. SARS-CoV-2 contains nearly 30,000 letters of RNA that allows the virus to infect cells and hijack them to make new viruses. On the other hand, among 14 detected mutations in the SARS-CoV-2 S protein that provide advantages to virus for transmission and evasion form treatment, the D614G mutation (substitution of aspartic acid [D] with glycine [G] in codon 614 was particular which could provide the facilitation of the transmission of the virus and virulence. To date, in contrary to the global effort to come up with various aspects of SARS-CoV-2, there are still great pitfalls in the knowledge of this disease and many angles remain unclear. That's why, the monitoring and periodical investigation of this emerging infection in an epidemiological study seems to be essential. The present study characterizes the current epidemiological status (i.e., possible transmission route, mortality and morbidity risk, emerging SARS-CoV-2 variants, and clinical feature) of the SARS-CoV-2 in the world during these pandemic.

The COVID-19 epidemic is currently a global threat that has affected many parts of the world. Some patients require intensive care unit admission due to severe symptoms in the course of the disease. The severity of symptoms in this disease varies from person to person. The effectiveness of the immune response against viral infections depends on the number and activity of T-cells, which play an important role in eliminating virus-infected cells. In this study, we report two patients with COVID-19 pneumonia, one with moderate symptoms and the other with severe symptoms. Although a decrease of absolute lymphocyte count was seen in both patients, a more significant decline reported in the ICU-admitted patient. Expression of activated markers, HLA-DR, CD38, on CD8-positive T-cells was shown in a patient with more severe disease. On the other hand, partial loss of CD7 in the severe case was also observed. Hence, besides of the above parameters that already mentioned in other studies, loss of pan T-markers could be considered as a potentially valuable test for predicting disease severity. We suggest evaluating the predictability of these tests in COVID-19 in larger studies. This study was approved by the Ethics Committee of Isfahan University of Medical Sciences (IR.MUI.MED.REC.1399.238).

Background: Health-care workers (HCWs) as frontline soldiers are involved in the war against COVID-19. Not only their protection from COVID-19 is important but also their mental health is a concern. This study aimed to measure the psychological distress among HCWs in the time of COVID-19 in Isfahan, Iran. Materials and Methods: A cross-sectional study was conducted in the 2^nd month of the spread of COVID-19 in Isfahan, Iran (March 16 to April 3). A total of 321 HCWs participated in an online survey and answered the General Health Questionnaire, the Insomnia Severity Index, and the Medical Outcomes Study Social Support Survey. t-test and ANOVA were used for comparing variables between groups. Multiple linear regression was used to evaluate the predictive factors of psychological distress. Results: About 34% of our HCWs suffer from some levels of psychological distress. The result of multiple linear regression (R²: 0.41) shows that the predictive variables with the highest value were insomnia, working as a medical resident, and lack of social support (standardized coefficient of beta: 0.51, 0.25, and 0.16, respectively; P < 0.05). Conclusion: The result of our study shows that about one-third of HCWs in COVID-19 special hospitals have some psychological problems. Being a medical resident, suffering from insomnia, and lack of social support are predictive variables.

Background: Various studies have reported contradictory results regarding the relationship of total bilirubin and high-sensitivity C-reactive protein levels (hsCRP) with diabetes mellitus Type 2 (DM2). Therefore, we aimed to examine which one of them could be more convenient for the estimation of DM2 risk in postmenopausal women. Materials and Methods: A total of 150 healthy postmenopausal women (mean age 57[53–60] years) and 79 postmenopausal women with DM2 (mean age 66 [61–71] years) were enrolled in cross-sectional study. Examinees were recruited consecutively in the study during their regular check-up visit in the Primary Health Care Center in Podgorica, Montenegro, in a period from October 2012 to May 2016. Anthropometric measurements, biochemical parameters, and blood pressure were obtained. Multivariable logistic regression analysis was used to find the independent predictors for DM2 development in postmenopausal women. Results: Age, waist circumference, and total bilirubin were the independent predictors for DM2 development in postmenopausal women (odds ratio [OR] =1.224, 95% confidence interval [CI] [1.117–1.341], P < 0.001; OR = 1.137, [95% CI = 1.036–1.215], P < 0.001, and OR = 0.727, [95% CI = 0.611–0.866], P < 0.001, respectively), whereas hsCRP lost its independent predictive role (OR = 1.155, [95% CI = 0.854–1.560], P = 0.349). Conclusion: Unlike hsCRP, total bilirubin independently correlated with DM2 in postmenopausal women.

Background: It is hypothesized that increased inflammatory markers in keratoconus (KC) may be one of the causes of corneal damage. The aim of our study was to the measurement of tumor necrosis factor-alpha (TNF-α) and interleukin-6 (IL)-6 in tear of patients with KC and investigate their relationship with the severity of KC. Materials and Methods: The current study was performed on KC patients and healthy controls with a case-control setting. Tear levels of TNF-α and IL-6 were measured after collecting the tears from the tear lake using a filter paper via Schirmer I method without anesthesia. Results: Eighty-one KC patients (mean age 29.45 ± 5.06 years) and 85 controls (mean age 28.01 ± 5.14 years) were enrolled. The mean levels of IL-6 and TNF-α were 26.77 ± 8.16, and 34.58 ± 9.82 pg/ml in the healthy group and 103.22 ± 51.94, and 183.76 ± 54.61 pg/ml in the KC group, respectively (P < 0.001). There was a significant relationship between the severity of the KC and the mean levels of IL-6 TNF-α in the case group (P < 0.001). Conclusion: Our results indicated that the mean levels of IL-6 and TNF-α are significantly higher in KC than the healthy group, and the disease severity was significantly associated with TNF-α and IL-6.

Background: Increasing the level of emotional intelligence (EI) is seen as a strategy for improving both relational quality and efficiency at work. As of today, there was no validated Persian brief instrument for evaluating EI. To fill this gap, this article was aimed to investigate the validity and reliability of the Persian version of the Brief Emotional Intelligence Scale (BEIS-10). Materials and Methods: A methodological cross-sectional study was conducted among 201 Persian-speaking individuals. These individuals were selected from different parts of Iran using the convenience sampling method. Translation of the BEIS-10 was conducted by employed forward–backward method. Internal consistency was evaluated by Cronbach's α, and for test–retest reliability, the intraclass correlation coefficient (ICC) was employed. The construct validity was investigated by confirmatory factor analysis (CFA). Results: The Persian version of BEIS-10 indicates a good test–retest reliability (ICC = 0.612, 95% confidence interval: 0.384 and 0.769) as well as internal consistency (Cronbach's alpha = 0.748, ranging from 0.359 to 0.868 for different domains). The construct validity was evaluated by CFA and five factors from ten items were confirmed and all goodness-of-fit-indices were in acceptable levels. Conclusion: The article concludes that the Persian version of BEIS-10 in five factors from ten items was a reliable and valid instrument for measuring EI in the general population. As well, the article was suggesting that the Persian version of BEIS-10 may stand as a suitable alternative to time-consuming tools for EI measurement since this scale appears to be time-saving and applicable to Iranian society.

Background: Chemotherapy-induced nausea and vomiting (CINV) is considered as the most common complications of chemotherapy which has a detrimental influence on the quality of life of patients with cancer. We assessed the efficacy of Apple (Malus domestica) syrup for reducing CINV. Materials and Methods: This study was a randomized, double-blind, placebo-controlled trial carried out in a Hematooncology Clinic affiliated to Mazandaran University of Medical Sciences, Sari, Iran (from October 2017 to August 2018). Subjects were randomly allocated to receive apple syrup or placebo along with their previous antiemetic treatment and chemotherapy regimen, three times a day. Thirty-four patients received apple syrup (n = 16) or placebo (n = 18). Statistical analysis was conducted using SPSS software Version 21^® (SPSS Inc., Chicago, IL, USA). A P < 0.05 indicated statistical significance. Results: Both acute and delayed nausea grades were significantly lower in M. domestica syrup in comparison to placebo syrup (P = 0.001 and 0.001, respectively). The duration of nausea (P = 0.04) was lower in intervention group compared to placebo group. Conclusion: These findings demonstrated that M. domestica syrup can reduce the severity and duration of nausea in cancer patients who received chemotherapy.

Background: Eating disorders are complicated health problems that affect both the body and the mind. Eating disorders pose a serious challenge to mental health services because of their often chronic pathway. The current study was done to determine the psychometric properties of the Eating Disorder Examination Questionnaire Short Form (EDE-QS). Materials and Methods: Persian version of the EDE-QS was produced through forward-translation, reconciliation, and back-translation. The design of this research was cross- sectional. A sample of 302 Tehran university's students in 2019–2020 was selected through convenience sampling method and completed a set of questionnaires, including the EDE-QS, Eating Attitude Test (EAT-16), Eating Beliefs Questionnaire-18 (EBQ-18), Self-Esteem Scale (SES), and Self-Compassion Scale (SCS) Short Form. The construct validity of the EDE-QS was assessed using confirmatory factor analysis and divergent and convergent validity. Internal Consistency and test–retest reliability were conducted to evaluate the reliability. Data analysis was conducted using SPSS (version 22) software and LISREL (version 8.8). Results: EDE-QS was found to be valid and reliable measures, with good internal consistency and good test–retest reliability among students. Cronbach's alpha coefficient for the whole of scale was 0.85. Intraclass correlation coefficient for the whole of scale was 0.90. In terms of convergent validity, EDE-QS showed a significant positive correlation with self-report measures of EAT-16 and EBQ-18 (P < 05). EDE-QS showed a negative correlation with self-compassion and self-esteem, thus demonstrated a good divergent validity (P < 05). The results of this study also provide support for the one-factor model of the EDE-QS (root mean square error of approximation = 0.08, Normed Fit Index [NFI] = 0.90, Incremental Fit Index = 0.92, non-NFI = 0.90, and Comparative Fit Index = 0.92). Conclusion: The EDE-QS showed good validity and reliability and could be useful in assessing eating disorder psychopathology in a nonclinical population of students. The EDE-QS shows notable promise as a measure for use in eating disorder research and clinical settings.

There are hundreds of ventilator modes on different ventilators. Despite different names, many are similar in functions and options. Educational institutions only teach a limited collection of ventilator modes of a few numbers of models; therefore, graduates may have substantial difficulties encountering new ventilator models with unfamiliar mode names on them. In this article, an Android application for finding similar modes on different ventilators is presented. The aim is to help an intensive care practitioner to easily find a familiar mode on a new ventilator.

Extensive research in the past decades has evidenced differences in the psychomotor ability of individuals resulting from varying levels of experience, age, gender, response precision, compatibility, performance, and ability. Many studies have called for the need to identify psychomotor ability and appropriate tests that can assess it. This review article surveys the definition, categorization, and tests of psychomotor ability as well as training based on psychomotor ability in medical sciences. We searched the literature with no time limit, using the ProQuest, PubMed, and Eric databases, as well as the Google Scholar search engine. The keywords for the search involved psychomotor, psychomotor performance, assessment, psychomotor ability, motor learning, education, training, psychomotor ability testing, and psychomotor skills. Other relevant papers found through hand searching and snowballing were also included in the review. The EndNote X8 was employed as a reference manager tool. Only abstracts of the papers whose full texts were accessible were reviewed after repetitious papers were excluded. The documents were categorized into five groups: definition of psychomotor skills and ability, psychomotor ability components, psychomotor ability tests, identification of psychomotor ability (task analysis), and training. This review article revealed that there is not a single definition for psychomotor ability and its components. However, it can be said that motor abilities are the foundation for the rapid acquisition of skills and according to the neuroplasticity process are learned through training and practice. Given psychomotor abilities vary among individuals, training courses should also provide different levels of psychomotor training for learners. The literature introduces psychomotor tests as a selection tool, a predictor of future professional behavior, and a means to evaluate progress in performance, academic guidance (ability-oriented medical specialty), and curriculum implementation tailored to the needs of learners of varying graduate disciplines. The tests should be profession-specific because each profession entails its peculiar characteristics and abilities. On the other hand, the major problem in studying and analyzing underlying psychomotor skills and abilities is that the components are being investigated by researchers from varying, and usually unrelated, scientific fields. Therefore, it is necessary to have a holistic view through close interaction between the researchers of different sciences to better understand this area.