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In this study, aqueous extract of saffron petal was used to synthesize gold nanoparticles (GNPs) and silver nanoparticles (SNPs). The antioxidant activity, phenol, flavonoids, anthocyanin, and carotenoids were measured in methanol, ethanol, and water extracts to assess the reducing potential. After extracting, for the phytosynthesis of GNPs and SNPs, the extract was added to the solutions of gold (III) and silver nitrate at a concentration of 1 mM. The effective parameters for the synthesis, i.e., pH of reaction solution, extract volume, metal ion concentration, and reaction time, were optimized by UV-Vis spectroscopy technique, and the nanoparticles (NPs) were characterized by transmission electron microscopy (TEM) and X-ray diffraction (XRD). Antimicrobial activities of extracts, GNPs, and SNPs were investigated against Staphylococcus aureus, Bacillus cereus, Escherichia coli, Aspergillus, and Candida albicans. The results shown that the aqueous extract although exhibiting less antioxidant activity than other extracts, but have a high potential for reducing and stabilizing of metal ions to synthesis NPs. In addition, the NPs had a uniform spherical shape with an average of 17-22 nm for GNPs and 10-14 nm for SNPs. These sizes are useful for inhibiting many bacteria, so that according to the results of this study, phytosynthesized nanoparticles could inhibit all bacteria that had used, and this inhibitory effect on SNPs was greater than GNPs. According to the results of this study, plants are high potential for the synthesis of metal NPs, which can be used as an antibiotic to inhibit many pathogenic bacteria and fungi.

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Background: Given the importance of the Intensive Care Unit (ICU), it is necessary to monitor the performance of this department to provide the urgent information required for clinical and managerial decision making. Its use can play an important role in improving the performance of the ICU. The aim of this study was to develop a clinical dashboard to monitor key performance indicators in ICU of Imam Khomeini Hospital affiliated to Urmia University of Medical Sciences. Methods: The current study was carried out as a descriptive study in 4 main phases, in 2019. In the first phase, key performance indicators were determined through an electronic questionnaire. In the second phase, the dashboard was designed based on the user and technical requirements. In the third Phase, the dashboard was implemented in ICU of Imam Khomeini Hospital at Urmia. In the final phase, the dashboard usability was evaluated through the think aloud method. Results: A total of 28 key performance indicators in 3 categories were considered essential for the ICU dashboard from the perspective of intensive care professionals. The dashboard was created using the PHP programming language and MySQL database management system. The dashboard was implemented in the ICU, and information of 400 patients was entered online. Based on the data entered for each patient, the indicators were automatically calculated. After the physicians and nurses worked with different sections of the dashboard, their comments were used to improve visual features of the dashboard. Conclusion: The designed dashboard in the present study can be a useful tool for better understanding of the patients’ clinical conditions. It also enables managers to monitor the healthcare quality of the ICU department in real-time based on the key performance indicators.

BackgroundChronic plantar heel pain (CPHP) is one of the common, disabling, and painful problems in the foot. Obesity is one of the known causes of CPHP. The aim of this study is to investigate the relationship between the body mass and the treatment of chronic plantar heel pain.MethodsIn a cohort study, 80 CPHP patients, including 16 men and 64 women, who referred to orthopedic clinic from 2014 to 2016, were investigated. All the patients were initially treated by corticosteroid injections. A total of 80 studied patients were classified according to their body mass index (BMI) in 3 groups: obese, overweight, and ideal weight. Their pain severity, symptoms recurrence, and foot performance were examined.ResultsThe severity of morning pain was 6.6 ± 1.2 in the obese patients while it was 5.6 ± 1.7 and 5.9 ± 1.7 in overweight and ideal weight patients, respectively, which had significant difference (P = 0.005). In 57% of obese patients, symptoms recurrence was observed; this rate was 12% and 5.3% in overweight and ideal-weight patients, which showed significant difference (P = 0.001). Obese people had higher relative risk of CPHP recurrence (OR = 7.52, 95% CI = 4.28 to 16.53, P < 0.001).ConclusionsHigh BMI is a strong risk factor in recurrence of chronic plantar heel pain. There is a strong relationship between the BMI of the patients and the severity of pain in the morning.

Background: Nephrotic syndrome (NS), like any other chronic illness, may affect the health-related quality of life (HRQoL) of children, so do the complications related to the disease, and its treatment. A better understanding of the (HRQoL) of people with nephrotic syndrome may help to better guide their treatment. Methods: Sixty children with nephrotic syndrome were assigned as the first case group, besides 81 healthy children as the first control group and 98 children with other chronic illnesses as the second control cohort. The participant and his or her caregiver were asked to fill in the standard HRQoL questionnaire. The patient's demographic data were also collected and analyzed using SPSS version 26 software. Results: 60 patients with nephrotic syndrome (mean age 9.8 ± 3.7) scored lower grades in physical, social, educational fields as well as total scores than the healthy controls (mean age 9.5 ± 2.7) and higher than the controls with other chronic diseases (mean age 9.7 ± 3.9) (P < 0.05). The emotional QOL score was close to that of the non-healthy control group. No correlation was found between the clinical phenotype of disease regarding the response to steroids and HRQOL (P > 0.05). Conclusions: The study shows that nephrotic syndrome can affect all aspects of the quality of life of patients. We suggest that comprehensive care of patients with NS be routinely managed in a multidisciplinary clinic with filling HRQOL questionnaires integrated as a common practice.

Abstract. Let G be a weighted digraph and s and t be two vertices of G. The reachability assurance (RA) problem is how to label the edges of G such that every path starting at s finally reaches t and the sum of the weights of the labeled edges, called the RA cost, is minimal. The common approach to the RA problem is pathfinding, in which a path is sought from s to t and then the edges of the path are labeled. This paper introduces a new approach, the marking problem (MP), to the RA problem. Compared to the common pathfinding approach, the proposed MP approach has a lower RA cost. It is shown that the MP is NP-complete, even when the underlying digraph is an unweighted directed acyclic graph (DAG) or a weighted DAG with an out-degree of two. An appropriate heuristic algorithm to solve the MP in polynomial time is provided. To mitigate the RA problem as a serious challenge in this area, application of the MP in software testing is also presented. By evaluating the datasets from various program flow graphs, it is shown that the MP is superior to the pathfinding in the context of test case generation.

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