Zoning Zarand-Saveh watershed for artificial recharge of underground aquifers using ELECTRE method and Linear Assignment with GIS technique

In previous decades decision making in water management problems and selection of better option among suggested options to solve a watershed problems was only done based on economical criteria - profit in relation to cost- and on changing social and environmental criteria in to the economical criterion However today using Multi criteria decision making it is not necessary to use financial equivalent of social and environmental criteria to select the best option In fact various qualitative and quantitative criteria can be used to prioritize and select the best options for water resources management The purpose of this study is ranking the water resources potential in Zarand-Saveh watershed by two methods ELECTRE method and Linear Assignment ELECTRE method is one of the Multi criteria decision making which can compound the quantitative and qualitative criteria weight each criterion based on its importance and help decision makers to select the best option at the same time Electrical method is one of the available methods in compensatory methods In this method all options are analyzed and evaluated by non-ranked comparisons Whole stages of this method are based on coordinated and uncoordinated sets and thus it is called coordination analysi

Selection of most appropriate area to establish soil damp for the purpose of sustainable development of water resources using TOPSIS and ELECTRE methods ( A case study: Zarand-Saveh watershed)

Nowadays shortage and decrease in fresh water is approximately under increased all over the world Based on the statistics published by FAO Food and Agriculture organization need for fresh water has almost become double per 21 years while useful water resources have been reduced by half in relation to 30 years ago It seems that useful water resources will become one fourth up to 2025 than useful water resources in 1960 Meanwhile danger of various pollutions for water resources frequently increased the value and importance of them Due to mentioned cases if water resources aren t managed in better way the life of human being will be threatened by the shortage of water Thus it is necessary to acquire the exact and up to date information about the condition of water resources and prediction of their situation in future in order to achieve optimum management for water resource

Evaluating strategies for implementing industry 4.0: a hybrid expert oriented approach of B.W.M. and interval valued intuitionistic fuzzy T.O.D.I.M.

open access articleDeveloping and accepting industry 4.0 influences the industry structure and customer willingness. To a successful transition to industry 4.0, implementation strategies should be selected with a systematic and comprehensive view to responding to the changes flexibly. This research aims to identify and prioritise the strategies for implementing industry 4.0. For this purpose, at first, evaluation attributes of strategies and also strategies to put industry 4.0 in practice are recognised. Then, the attributes are weighted to the experts’ opinion by using the Best Worst Method (BWM). Subsequently, the strategies for implementing industry 4.0 in Fara-Sanat Company, as a case study, have been ranked based on the Interval Valued Intuitionistic Fuzzy (IVIF) of the TODIM method. The results indicated that the attributes of ‘Technology’, ‘Quality’, and ‘Operation’ have respectively the highest importance. Furthermore, the strategies for “new business models development’, ‘Improving information systems’ and ‘Human resource management’ received a higher rank. Eventually, some research and executive recommendations are provided. Having strategies for implementing industry 4.0 is a very important solution. Accordingly, multi-criteria decision-making (MCDM) methods are a useful tool for adopting and selecting appropriate strategies. In this research, a novel and hybrid combination of BWM-TODIM is presented under IVIF information

Studying Psychological and Organizational Factors’ Roles on Occupational Accidents among Nurses and Nursing Aids in Qom, Iran

It is clear that safety in healthcare centres in both fields of staffs and patients is under influence of various factors and needs considering organizational and psychological variables. This study aimed to find the effects of organizational citizenship behaviour (OCB), patient safety climate (PSC) and fatalism on occupational accidents among nurses and nursing aids in one of the non-governmental hospitals in Qom, 2017. Two hundred people from the study population were selected by simple random sampling method and entered the study. A researcher-made demographics questionnaire, Williamson et al. questionnaire for fatalism and valid questionnaires for PSC and OCB were tools to gather data. The relationship between the variables was analyzed using ANOVA and T-test through SPSS V20 and structural equation was done by AMOS V8.8. One hundred and seventy-seven questionnaires out of 200 ones were entered into the analysis phase. Women with 104 (58.8%) were the most frequent and 71.8% of participants were married. Participants had an average age of 34.2(±9.37) years. Reliability of the questionnaires was acceptable. Analysis depicted effects of fatalism on occupational accidents (β=0.15), the patient safety climate on OCB (β=0.13), and OCB on occupational accidents (β=-0.13) (

The Effect of Music Therapy on Anxiety and Vital Signs of Patients with Acute Coronary Syndrome: A Study in the Cardiac Care Unit of Vali-Asr Hospital, Eghlid, Iran

Background: Acute coronary syndrome is an emergency situation, characterized by a sudden decrease of blood flow to the heart and chest pain during a heart attack or unstable angina. High levels of anxiety increases mortality risk up to three times. The aim of this study was to determine the effect of music therapy on anxiety level and vital signs of patients with acute coronary syndrome admitted in the coronary care unit of Vali- Asr hospital, in Eghlid city. Methods: This clinical trial was conducted on 70 acute coronary syndrome patients who were eligible for the study during 2011-2012. Anxiety level was measured by the standard Spielberger Questionnaire and vital signs of patients were recorded before and after the intervention. Data were analyzed through SPSS18 and using mean, percentage, standard deviation, independent and paired t- test. Results: Music had no effect on vital signs but significantly reduced anxiety level (P=0.049). Anxiety was significantly higher in females, but showed no significant relationship with age and education. There was no significant relationship between age, sex and education with respiratory rate, heart rate and systolic or diastolic blood pressure. Conclusions: Music as an easy and low cost intervention without any complication can be used to reduce anxiety in patients in Coronary Care Units

Candidiasis in COVID-19 Patients

Based on previous studies, some comorbidities influence the morbidity and mortality of COVID-19 disease. Among these factors, opportunistic fungal infections could have a major impact on the mortality of COVID-19 patients

Fungal Central Nervous System Infections in Patients With COVID-19

Recent studies have indicated that fungal co-infections have a major impact on the morbidity and mortality of patients with COVID-19. In these patients, the excessive production of inflammatory cytokines and the reduction in CD4 + T and CD8 + T cell count entails susceptibility to fungal infections.1 In addition to impaired cell-mediated immunity, comorbidities and immunosuppressive medications have a significant role in the development of fungal infections and have serious impacts on clinical outcomes.1-

Thiamine can decrease Lactate and Creatinine level after Coronary Artery Bypass Surgery in Patients with Mild Systolic Dysfunction

Introduction: During cardiopulmonary bypass, oxidative stress happens in the patient's cells due to blood contact with various levels of synthetic materials. It can activate inflammatory process and release factors such as IL-6, CRP, and Neutrophils witch may hurt different organs. In recent years, many efforts have been made to prevent this type of damage, however, no single treatment has been proposed to reduce this risk. Antioxidant substances such as Thiamine is important in cell defense against free oxygen radicals. Regarding this issue, in this study, the effect of thiamine on lactate levels in patients undergoing coronary artery bypass graft surgery has been investigated.Materials and methods: In this study, 140 patients from 25 to 65 years old with mild systolic dysfunction (EF = 45-55%) who were candidates for elective CABG surgery in two groups: control and purpose (patients receiving Thiamine) were examined. All of these patients were anesthetized in an identical manner, and were subjected to a heart-lung pump. Serum lactate levels were measured before, during and 6, 12, 18, and 24 hours after surgery. All data collected in a questionnaire were recorded and evaluated using spss statistical software.Results: Study groups showed no significant differences regarding demographics and underlying diseases. Serum lactate was significantly lower in thiamine group during the first 24 hours after surgery (except before operation and 2 hours later) (p <0.05).Creatinine level in two groups before surgery was not significantly different ,However, it was significantly lower in case group 24 hours after surgery(1.54±0.14 vs. 1.24±0.19; p: 0.001).Also, dose of Inotropes in  patients who received thiamine, was significantly lower than the control group (p= 0.001). Extubation was longer in control group (15.4±4.9 vs. 13.15±4.1; p=0.003) while ICU stay was not different.Conclusion: It seems that thiamine administration before cardiopulmonary bypass, in patient with decreased left ventricular function, can decrease serum lactate as tissue perfusion marker and also improve kidney function

Candidemia in Febrile Neutropenic Patients; a Brief Report

Introduction: Febrile neutropenic patients are at risk of serious infections. The aim of the present study is to identify the frequency, species, and susceptibility patterns of candidemia in febrile neutropenic patients. Methods: This cross-sectional study was conducted on febrile neutropenic patients suspected with candidemia who had been referred to 3 educational hospitals during 9 months. Results: The blood samples of 80 febrile neutropenic patients with the mean age of 48§16.6 years were studied (60% female). Five (6.25%) episodes of candidemia were identified. The underlying disease was acute myeloid leukemia in 4 (80%) cases and all 5(100%) cases had central venous catheter and were receiving prophylactic ciprofloxacin and acyclovir. 100% of isolates were found to be susceptible to Voriconazole, 80% to Caspofungin, 60% to Amphotericin B, and 40% to Fluconazole. Conclusion: The frequency of candidemia among the studied febrile neutropenia patients was 6.25%, with 80% mortality rate, and themost frequently identified yeastwas Candida albicans (100% susceptible to Voriconazole)

Combination therapy with everolimus and tacrolimus in kidney transplantation recipients: A systematic review

Background and aims: Immunosuppressive regimens are a key component for successful kidney transplantation. This systematic review aimed to assess the efficacy and safety of combination therapy of everolimus with tacrolimus in kidney transplantation recipients. Methods: Results were limited to English-language articles. Trials where recipients received another regimen were excluded. The Cochrane Central Register of Controlled Trials and MEDLINE were searched via the optimally sensitive strategies for the identification of randomized trials, combined with the following MeSH headings and text words: Everolimus, Certican, Zortress, tacrolimus, prograf, and kidney transplantation. Results: Five relevant studies of everolimus in combination with tacrolimus were identified and results of them were interpreted. Two trials investigated Fix dose of everolimus in combination with low (1.5-3 mg) versus standard dose of tacrolimus (4-7 mg). One trial investigated variable doses of everolimus (1.5 mg/day or 3 mg/day) in combination with fix dose of tacrolimusand two trials compared fix dose of everolimus versus reduction or elimination of tacrolimus. Sample size of RCTs ranged from 20 to 398 and the follow up time ranged from six to 24 months. The quality score on the Jadad score was 3 in all five trials indicating moderate quality. Conclusion: Immune suppressive regimens including everolimus in combination with tacrolimus therapy show better safety and efficacy compared with single-mode but these differences were not significant in overall studies. In general, compared with a regimen without combination of everolimus with tacrolimus, the newer immunosuppressive regimen consistently reduced the incidence of short-term biopsy-proven acute rejection. However, evidence about impact on side-effects, long term graft loss, compliance and overall health-related quality of life is limited