Debating the Limits of Debate: Politics and Rhetorics of Dissent and Disagreement in the Islamic Republic of Iran

This dissertation evaluates the place of debate in contemporary Iranian political environment and discursive culture, the assumptions that ruling and opposition elites have about debate and about the opportunities it provides for politicking; and their ongoing negotiation over the definitions, configurations, and conditions of public debate and the discursive resolution of disputes. By studying three major sites of struggle – the print press, academia and the national television – the dissertation examines how the regime has tried to discipline various public spheres, maintain the appropriate form of discourse, and outline the condition of an institutionally mediated and contained dissent without being politically disruptive; and how dissidents have tried to utilize debate for their agenda and deployed rhetorical performances in state-controlled publics in order to navigate the limits, manifest dissent and disagreement, and expand the scope of subversive expression. The dissertation assesses the political circumstances, administrative decisions, governing ideas, habitual practices, and the social conditions that have constituted, and also become constitutive of, the advent and development of diverse forms and modes of public debate in the Islamic Republic of Iran. The dissertation contributes to the interplaying fields of rhetoric, media, religion and politics by exploring, critiquing and expanding the functions ascribed to debate usually manifested in and associated with Western democracies. It argues that debate and deliberation not only could be possible and permissible under nondemocratic settings, but could even be initiated and encouraged by authoritarian agents.Doctor of Philosoph

Self-administered Medications in Cardiovascular Ward: A study on Patients' Self-efficacy, knowledge and Satisfaction

Background: Self-efficacy of medication use and pharmaceutical knowledge are important factors for medical treatment completion. Aim: This study aimed to determine the effect of self-administration of medication program on pharmaceutical knowledge and satisfaction of patients with cardiovascular diseases. Methods: This randomized clinical trial was conducted on 60 patients with cardiovascular diseases (CVD) in Imam Reza hospital in Mashhad during 2018. Self-efficacy was examined using the standard scale of self-efficacy for appropriate medication use. Moreover, pharmaceutical knowledge was examined using the standard scale for the measurement of patients’ knowledge level before and after the intervention. Patients’ satisfaction with the medication use manner was also evaluated at the time of discharge from the hospital. Data were analyzed in SPSS software (Version 20). Results: According to the results, the mean ages of patients in the intervention and control groups were 40.9±8.6 and 44.4±8.5, respectively. In the pre-test, the self-efficacy and pharmaceutical knowledge scores obtained from independent t-tests and Mann-Whitney U test were homogeneous. However, self-efficacy scores in the post-test were 32.0±3.3 and 24.7±3.1 in the intervention and control groups, respectively. The mean satisfaction of patients with medication use manner was significantly higher in the intervention than that in the control group (

Precision Diagnostics in Cardiac Tumours:Integrating Echocardiography and Pathology with Advanced Machine Learning on Limited Data

This study pioneers the integration of echocardiography and pathology data with advanced machine learning (ML) techniques to significantly enhance the diagnostic accuracy of cardiac tumours, a critical yet challenging aspect of cardiology. Despite advancements in diagnostic methods, cardiac tumours' nuanced complexity and rarity necessitate more precise, non-invasive, and efficient diagnostic solutions. Our research aims to bridge this gap by developing and validating ML models—Support Vector Machines (SVM), Random Forest (RF), and Gradient Boosting Machines (GBM)—optimized for limited datasets prevalent in specialized medical fields. Utilizing a dataset comprising clinical features from 399 patients at the Heart Hospital, our study meticulously evaluated the performance of these models against traditional diagnostic metrics. The RF model emerged superior, achieving a groundbreaking accuracy of 96.25% and a perfect ROC AUC score of 0.99, significantly outperforming existing diagnostic approaches. Key predictors identified include age, echo malignancy, and echo position, underscoring the value of integrating diverse data types. Clinical validation conducted at the Heart Hospital further confirmed the models' applicability and reliability, with the RF model demonstrating a diagnostic accuracy of 94% in a real-world setting. These findings advocate for the potential of ML in revolutionizing cardiac tumour diagnostics, offering pathways to more accurate, non-invasive, and patient-centric diagnostic processes. This research not only highlights the capabilities of ML to enhance diagnostic precision in the realm of cardiac tumours but also sets a foundation for future explorations into its broader applicability across various domains of medical diagnostics, emphasizing the need for expanded datasets and external validation

Systematic review of effects of current transtibial prosthetic socket designs—Part 2: Quantitative outcomes

This review is an attempt to untangle the complexity of transtibial prosthetic socket fit and perhaps find some indication of whether a particular prosthetic socket type might be best for a given situation. In addition, we identified knowledge gaps, thus providing direction for possible future research. We followed the PRISMA (Preferred Reporting Items for Systematic Reviews and Meta-Analyses) guidelines, using medical subject headings and standard key words to search for articles in relevant databases. No restrictions were made on study design and type of outcome measure used. From the obtained search results (n = 1,863), 35 articles were included. The relevant data were entered into a predefined data form that included the Downs and Black risk of bias assessment checklist. This article presents the results from the systematic review of the quantitative outcomes (n = 27 articles). Trends indicate that vacuum-assisted suction sockets improve gait symmetry, volume control, and residual limb health more than other socket designs. Hydrostatic sockets seem to create less inconsistent socket fittings, reducing a problem that greatly influences outcome measures. Knowledge gaps exist in the understanding of clinically meaningful changes in socket fit and its effect on biomechanical outcomes. Further, safe and comfortable pressure thresholds under various conditions should be determined through a systematic approach

Systematic review of effects of current transtibial prosthetic socket designs—Part 1: Qualitative outcomes

This review is an attempt to untangle the complexity of transtibial prosthetic socket fit, determine the most important characteristic for a successful fitting, and perhaps find some indication of whether a particular prosthetic socket type might be best for a given situation. Further, it is intended to provide directions for future research. We followed the PRISMA (Preferred Reporting Items for Systematic Reviews and Meta-Analyses) guidelines and used medical subject headings and standard key words to search for articles in relevant databases. No restrictions were made on study design or type of outcome measure. From the obtained search results (n = 1,863), 35 articles were included. The relevant data were entered into a predefined data form that incorporated the Downs and Black risk of bias assessment checklist. Results for the qualitative outcomes (n = 19 articles) are synthesized. Total surface bearing sockets lead to greater activity levels and satisfaction in active persons with amputation, those with a traumatic cause of amputation, and younger persons with amputation than patellar tendon bearing sockets. Evidence on vacuum-assisted suction and hydrostatic sockets is inadequate, and further studies are much needed. To improve the scientific basis for prescription, comparison of and correlation between mechanical properties of interface material, socket designs, user characteristics, and outcome measures should be conducted and reported in future studies

Acute spontaneous isolated dissection of abdominal aorta

Aortic dissection occurs when the layers of the aorta separate as a result of extra luminal cavity of blood through an intimal tear. Dissection limited to the abdominal aorta is rare. Unfortunately, the appropriate management of dissecting aneurysm of abdominal aorta is not documented yet. A 43 years old man was admitted to Al-zahra hospital in Isfahan with sudden onset of periumbilical abdominal pain. CT scan confirmed infrarenal dissection of abdominal aorta. Performing laparotomy, aorta was repaired using bifurcate collagen-coated Dacron graft. Surgical intervention with synthetic graft is recommended in patients with dissecting aortic aneurysm of infrarenal segments where the extent of dissection is limited and accessible

Evaluation of New ELISA based on rLsa63 – rLipL32 antigens for serodiagnosis of Human Leptospirosis

Timely diagnosis of leptospirosis is essential for an effective treatment. Large diversity of clinical symptoms has led leptospirosis diagnosis difficult. Researchers have conducted many tests with wide-range of sensitivity and specificity to achieve novel diagnostic procedures which have higher sensitivity and specificity compared with previous tests and which are more reliable and available to public laboratories. This study aimed to introduce Lsa63 and LipL32 proteins-based ELISA tests with more sensitivity, specificity, accuracy and convenience for public laboratories.Recombinant forms of Lsa63 and LipL32 proteins were first generated. After coating these proteins, IgM and IgG ELISA tests were performed. 220 patients with suspicion of leptospirosis infection were selected for serum collection. The sera tests were carried out using MAT, IgM and IgG ELISA tests. In order to assess the performance of ELISA, the results of this test were compared with MAT.30% of serum samples (n=65) in MAT were positive for leptospirosis infection, while ELISA tests including rLipL32- rLsa63-IgM and rLipL32-rLsa63-IgG showed 40.45% (n=89) and 38.63% (n=80) positive reaction, respectively.Our results demonstrated that new ELISA tests based on mixing LipL32 and Lsa63 proteins, a novel mixture of recombinant antigens, are valuable to detect specific antibodies against pathogenic Leptospira in human serum and could be considered as helpful techniques in leptospirosis diagnosis

Diagnostic Value of Electrocardiogram in Predicting Exaggerated Blood Pressure Response to Exercise Stress Testing

Introduction: It is believed that an exaggerated blood pressure response (EBPR) to exercise stress test is associated with a higher risk of cardiovascular events. It is also assumed that QT dispersion (QT-d), which was originally proposed to measure the spatial dispersion of ventricular recovery times, may have a relationship to cardiovascular events. The objective of this study was to examine the difference of changes in QT-d, Maxi-QT, Mini-QT, and QT-c (corrected QT interval) of the electrocardiogram in two groups of patients with exaggerated blood pressure responses (EBPR group) and normal responses (control group) to exercise testing. Also, the diagnostic value of each of these criteria in the prediction of EBPR was studied. Methods: This cross-sectional study was conducted from May 2015 to February 2016 on patients suspected of coronary artery disease (CAD) undergoing exercise testing who had been referred to Ghaem and Imam Reza hospitals in Mashhad (Iran). All patients underwent a treadmill exercise test with the 12-lead ECG, which was optically scanned and digitized for analysis of QT-d, QT max, and QT min. Patients were divided into two groups of normal and EBPR to exercise testing. QT changes of ECG were compared between the two groups, and the diagnostic accuracy of QT variables for prediction of EBPR to exercise testing was studied. A multiple linear regression analysis (MLR), Pearson Chi-qquare, independent samples t-test, and receiver operating characteristic (ROC) curve were used as statistical methods in IBM SPSS version 19. Results: Sixty patients (55% male) with a mean age of 50.48 ± 10.89 years were studied in two groups of normal (n=30) and exaggerated blood pressure response (n=30) to exercise testing. Maximum QT and QT dispersion were statistically different in individuals’ exaggerated blood pressure response to exercise stress test (p < 0.05). The logistic regression analysis revealed that none of our parameters predicted the EBPR. The ROC curve showed that 50 and 345 milliseconds for QT dispersion and Maxi-QT were the optimal cut-off points for the prediction of EBPR. Conclusion: It seems that Maxi-QT and QT-d may be predictors of EBPR during exercise testing. Also, a significant difference in maxi-QT and QT-d was observed between two groups of patients with normal and EBPR during the exercise testin

Melatonin synergistically enhances protective effect of atorvastatin against busulfan-induced spermatogenesis injuries in a rat model

Busulfan, a chemotherapy drug, causes a variety of adverse effects, such as damage to the reproductive system of male cancer patients. The aim of this study was to investigate the protective effect of intra-peritoneal (IP) injection of exogenous melatonin and atorvastatin alone and in combination on busulfan-induced spermatogenesis injuries and oxidative stress activity in a rat model. A total of 36 male Wistar rats (220–250 g) (n = 6) were randomly divided into six different groups, including atorvastatin, melatonine, sham (received DMSO or busulfan solvent), busulfan, atorvastatin + melatonine, and control groups. Busulfan was diluted in DMSO and intra-peritoneally (IP) administrated in two doses of 25 and 10 mg/kg with a 14-day interval in all groups except the control and sham groups. Administration of atorvastatin and melatonin started 1 day after injection of busulfan. After 28 days, the animals were euthanized and the semen was collected from epididymis and the testicular tissues were removed for sperm parameter assessment and biochemical analysis, including super oxide dismutase (SOD), SOD/total protein (TP), catalase, catalase/TP, and MDA. The highest and lowest values of sperm parameters belonged to the control and busulfan groups, respectively, followed by sham, atorvastatin + melatonine, melatonin, and atorvastatin groups as well as antioxidant enzyme activity. However, MDA activity in the busulfan group was significantly increased compared to that in the other groups. In conclusion, the results of the present study indicated that co-administration of melatonin and atorvastatin and monotherapy can attenuate busulfan-induced spermatogenesis injuries in rats via reducing oxidative stress