The Relationship between Knowledge Management and Competitive Advantage: A Case Study in Small and Medium-Sized Companies in the Packaging Industry of Khorasan Razavi

The purpose of this study is to examine the relationship between knowledge management and competitive advantage in small and medium enterprises in packaging industry of Khorasan Razavi. The 4-component model of knowledge management, knowledge acquisition, knowledge conversion, knowledge application support is made. The three components of the productdifferentiation and competitive advantage, cost leadership and focus on the market are made. The population consists of all managers, whether higher, middle and small and medium-sized companies operating in the packaging industryof Khorasan Razavi that their number was 330 and by the limited sampling of 74 Cochran sampling random was selected. The questionnaire was distributed among them. Inthis study, two questionnaires were used to collect data. According to this hypothesis, the present research is experimental. To analyze the data in the study, both descriptiveand inferential statistical methods were used. In cross-sectional analysis, thecentral tendency tables and indices such as mean and standard deviation iscalculated. In inferential statistics, to evaluate hypotheses, Pearsoncorrelation test was used for normality distribution. The results indicatedthat all components of knowledge management played a significant role

Accounting for the tongue-and-groove effect using a robust direct aperture optimization approach

Peer Reviewedhttp://deepblue.lib.umich.edu/bitstream/2027.42/98733/1/MPH001266.pd

Prevalence of Color Blindness in Iranian Students: A Meta-analysis

Color blindness (color vision deficiency) is a disorder that impairs the true perception of colors. Using the information in this study, appropriate policy can be made to identify high-risk groups, as well as educational policies for families to perform more effective genetic diagnosis methods. This study aims to examine the prevalence of color blindness in Iranian students through a meta-analysis. Articles related to color blindness published between January 1990 and December 2020 were searched in Scopus, Cochrane Library, Web of Science (WoS), Science Direct, Embase, SID, MagIran, IranDoc, Medline, and Google Scholar databases. The keywords used were based on medical subject topics (MeSH Terms) and, after careful review, articles were selected according to varied sections of Participants, Exposure, Comparison, and Outcomes (PECO). Participants: students; Exposure: students with color blindness were examined; Comparison: Students from multiple provinces and regions of Iran were surveyed for color blindness; Outcomes: the pooled prevalence of color blindness in Iranian students reported from different provinces. The prevalence of color blindness in Iranian students was 3.8% (95% CI: 2.7–5.4%). The pooled prevalence of color blindness in Iranian male and female students was 4.7% (95% CI: 3.5–6.4%) and 0.7% (95% CI: 0.3–1.3%), respectively. The pooled prevalence of red–green color blindness (Tritan) was 41.7% (95% CI: 18.9–68.8%). The pooled prevalence of red color blindness (Protan) was 13.9% (95% CI: 7.8–23.8%), and the pooled prevalence of green color blindness (Deutan) based on meta-analysis was 45.3% (95% CI: 29–62.7%). Due to the high prevalence of color blindness in students, especially male students, it is necessary to be screened for through genetic tests in couples before having children

Predictors of Self-Care Behaviors in Heart Failure Patients: A Cross-Sectional Study

Abstract Introduction: Adherence to self-care behaviors and determining its related factors in patients with chronic illnesses are mandatory. The objective of the present study was two-fold: first, to examine the self-care behaviors adherence among heart failure patients and second, to determine its predictors in a comprehensive study of various factors in patients with heart failure. Methods: This descriptive cross-sectional study was conducted on 239 patients with heart failure referred to Dr.Heshmat hospital as the only heart center in Guilan province (Northern Iran). The consecutive sampling method was used. Data were collected by Self-Care Heart Failure Index, Cardiac Depression Scale, Mini-Mental State Examination, and Charlson Comorbidity Index and were analyzed by descriptive statistics and analytical statistics in SPSS. Results: Results showed educational level, history of receiving information, and cognitive function as predictors of self-care maintenance. Also, monthly income, history of receiving information, and ventricular dysfunction were predictors of self-care management. Monthly income, admission status, number of hospitalizations, history of receiving information, and cognitive function are mentioned as predictors of self-confidence. Predictors of total self-care were monthly income, history of receiving information, and cognitive function. (P . 0.05). Conclusions: Promoting self-care behaviors could prevent the adverse effects of diseases such as readmission, prolonged hospitalization, and bed occupancy ratio. The majority of the participants had non-adherent self-care, and, according to the results, it is recommended that assessing predictors in these patients and planning. Also, it is suggested that more observational, qualitative, and mixed-method studies be done in the future

Optimal partial-arcs in VMAT treatment planning

Purpose: To improve the delivery efficiency of VMAT by extending the recently published VMAT treatment planning algorithm vmerge to automatically generate optimal partial-arc plans. Methods and materials: A high-quality initial plan is created by solving a convex multicriteria optimization problem using 180 equi-spaced beams. This initial plan is used to form a set of dose constraints, and a set of partial-arc plans is created by searching the space of all possible partial-arc plans that satisfy these constraints. For each partial-arc, an iterative fluence map merging and sequencing algorithm (vmerge) is used to improve the delivery efficiency. Merging continues as long as the dose quality is maintained above a user-defined threshold. The final plan is selected as the partial arc with the lowest treatment time. The complete algorithm is called pmerge. Results: Partial-arc plans are created using pmerge for a lung, liver and prostate case, with final treatment times of 127, 245 and 147 seconds. Treatment times using full arcs with vmerge are 211, 357 and 178 seconds. Dose quality is maintained across the initial, vmerge, and pmerge plans to within 5% of the mean doses to the critical organs-at-risk and with target coverage above 98%. Additionally, we find that the angular distribution of fluence in the initial plans is predictive of the start and end angles of the optimal partial-arc. Conclusions: The pmerge algorithm is an extension to vmerge that automatically finds the partial-arc plan that minimizes the treatment time. VMAT delivery efficiency can be improved by employing partial-arcs without compromising dose quality. Partial arcs are most applicable to cases with non-centralized targets, where the time savings is greatest

The inhibitory effect of 6-gingerol and cisplatin on ovarian cancer and antitumor activity: In silico, in vitro, and in vivo

© 2023 Salari, Khosravi, Pourkhandani, Molaakbari, Salarkia, Keyhani, Sharifi, Tavakkoli, Sohbati, Dabiri, Ren and Shafie’ei. This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). https://creativecommons.org/licenses/by/4.0/Background: Epithelial ovarian cancer is very common in women and causes hundreds of deaths per year worldwide. Chemotherapy drugs including cisplatin have adverse effects on patients’ health. Complementary treatments and the use of herbal medicines can help improve the performance of medicine. 6-Gingerol is the major pharmacologically active component of ginger. In this study, we compared the effects of 6-gingerol, cisplatin, and their combination in apoptotic and angiogenetic activities in silico, in test tubes, and in in vivo assays against two ovarian cancer cell lines: OVCAR-3 and human umbilical vein endothelial cells (HUVECs). Methods: The drug-treated cell lines were evaluated for their cytotoxicity, cell cycle, and apoptotic and angiogenetic gene expression changes. Results: The proportion of apoptosis treated by 6-gingerol coupled with cisplatin was significantly high. In the evaluation of the cell cycle, the combination therapy also showed a significant promotion of a higher extent of the S sequence. The expression of p53 level, Caspase-8, Bax, and Apaf1 genes was amplified again with combination therapy. Conversely, in both cell lines, the cumulative drug concentrations reduced the expression of VEGF, FLT1, KDR, and Bcl-2 genes. Similarly, in the control group, combination treatment significantly decreased the expression of VEGF, FLT1, KDR, and Bcl-2 genes in comparison to cisplatin alone. Conclusions: The findings of the present study demonstrated that the cisplatin and 6-gingerol combination is more effective in inducing apoptosis and suppressing the angiogenesis of ovarian cancer cells than using each drug alone.Peer reviewe

Multicriteria VMAT optimization

Purpose: To make the planning of volumetric modulated arc therapy (VMAT) faster and to explore the tradeoffs between planning objectives and delivery efficiency. Methods: A convex multicriteria dose optimization problem is solved for an angular grid of 180 equi-spaced beams. This allows the planner to navigate the ideal dose distribution Pareto surface and select a plan of desired target coverage versus organ at risk sparing. The selected plan is then made VMAT deliverable by a fluence map merging and sequencing algorithm, which combines neighboring fluence maps based on a similarity score and then delivers the merged maps together, simplifying delivery. Successive merges are made as long as the dose distribution quality is maintained. The complete algorithm is called VMERGE. Results: VMERGE is applied to three cases: a prostate, a pancreas, and a brain. In each case, the selected Pareto-optimal plan is matched almost exactly with the VMAT merging routine, resulting in a high quality plan delivered with a single arc in less than five minutes on average. VMERGE offers significant improvements over existing VMAT algorithms. The first is the multicriteria planning aspect, which greatly speeds up planning time and allows the user to select the plan which represents the most desirable compromise between target coverage and organ at risk sparing. The second is the user-chosen epsilon-optimality guarantee of the final VMAT plan. Finally, the user can explore the tradeoff between delivery time and plan quality, which is a fundamental aspect of VMAT that cannot be easily investigated with current commercial planning systems

APC and AXIN2 are promising biomarker candidates for the early detection of adenomas and hyperplastic polyps

Aberrant activation of the WNT/CTNNB1 pathway is notorious in colorectal cancer (CRC). Here, we demonstrate that the expression of specific and crucial WNT signaling pathway genes is linked to disease progression in colonic adenomatous (AP) and hyperplastic (HP) polyps in an Iranian patient population. Thus, we highlight potential gene expression profiles as candidate novel biomarkers for the early detection of CRC. From a 12-month study (2016-2017), 44 biopsy samples were collected during colonoscopy from the patients with colorectal polyps and 10 healthy subjects for normalization. Clinical and demographic data were collected in all cases, and mRNA expression of APC, CTNNB1, CDH1, AXIN1, and AXIN2 genes was investigated using real-time polymerase chain reaction (PCR). CTNNB1 and CDH1 expression levels were unaltered in AP and HP subjects, whereas mRNA expression of APC was decreased in AP contrasted with HP subjects, with a significant association between APC downregulation and polyp size. Although AXIN1 showed no changes between AP and HP groups, a significant association between AXIN1 and dysplasia grade was found. Also, significant upregulation of AXIN2 in both AP and HP subjects was detected. In summary, we have shown increased expression of AXIN2 and decreased expression of APC correlating with grade of dysplasia and polyp size. Hence, AXIN2 and APC should be explored as biomarker candidates for early detection of AP and HP polyps in CRC

The relationship between ultra processed food consumption and premature coronary artery disease: Iran premature coronary artery disease study (IPAD)

BackgroundUltra-processed foods (UPF) consumption may affect the risk of PCAD through affecting cardio metabolic risk factors. This study aimed to evaluate the association between UPFs consumption and premature coronary artery disease (PCAD).MethodsA case–control study was conducted on 2,354 Iranian adults (≥ 19 years). Dietary intake was assessed using a validated 110-item food frequency questionnaire (FFQ) and foods were classified based on the NOVA system, which groups all foods according to the nature, extent and purposes of the industrial processes they undergo. PCAD was defined as having an stenosis of at least single coronary artery equal and above 75% or left main coronary of equal or more than 50% in women less than 70 and men less than 60 years, determined by angiography. The odds of PCAD across the tertiles of UPFs consumption were assessed by binary logistic regression.ResultsAfter adjustment for potential confounders, participants in the top tertile of UPFs were twice as likely to have PCAD compared with those in the bottom tertile (OR: 2.52; 95% CI: 1.97–3.23). Moreover, those in the highest tertile of the UPFs consumption had more than two times higher risk for having severe PCAD than those in the first tertile (OR: 2.64; 95% CI: 2.16–3.22). In addition, there was a significant upward trend in PCAD risk and PCAD severity as tertiles increased (P-trend < 0.001 for all models).ConclusionHigher consumption of UPFs was related to increased risk of PCAD and higher chance of having severe PCAD in Iranian adults. Although, future cohort studies are needed to confirm the results of this study, these findings indicated the necessity of reducing UPFs intake