Effective Factors Research Articles

Effects of Mask Usage During the COVID-19 Pandemic on Sign and Symptoms of Temporomandibular Joint Disorder: A Survey Study.

To evaluate possible temporomandibular disorders (TMD) symptoms that may occur due to mask use in dentists during the coronavirus disease-2019 pandemic period and identify potentially effective factors. An online questionnaire consisting of three parts was sent to dentists and clinical dental students. The first part included questions regarding sociodemographic information. In the second part, questions were asked to evaluate stress levels, TMD symptoms, and treatment of TMD, if any, before (T0) and during the pandemic (T1). In the last part, professional mask choice, mask-related parafunctional movements, and breathing patterns while wearing a mask were evaluated. TMD symptoms and stress levels were significantly higher at T1. An increase in mouth breathing and mask-related parafunctional movements was reported during the use of N95 masks compared with daily life in dentists whose professional mask selection was an N95 respirator. The change in temporomandibular joints pain and muscle pain at rest between T0 and T1 was higher in those whose professional mask choice was N95 respirators than in those who chose to wear one surgical mask. The increase in mouth breathing and mask-related parafunctional movements during the use of N95 respirators may increase TMD.

Working with Existential Inquiries in Art Therapy and Expressive Arts Therapy

The article discusses methods of working with existential inquiries within the framework of Art therapy and Expressive Arts therapy. The author analyzes the effectiveness of various approaches and techniques used in these therapy methods to help clients in the process of actualizing existential crises, making sense of their existence, personal growth, and addressing life problems. The article explores concepts of Expressive Arts therapy psychotherapy, the psychology of meaning in life, and therapy through practical use. Practical recommendations for working with clients using art therapy and intermodal expressive arts therapy are offered, and an analysis of effectiveness factors, advantages and disadvantages is carried out. Utilizing art therapy and intermodal expressive arts therapy, among other modalities, to address existential issues proves to be a significant and impactful approach in providing support and guidance to clients. The visibility, accessibility, and resourcefulness inherent in these approaches are key advantages for individuals seeking to explore and comprehend their own meanings and experiences.

المحيط الجامعي بالمغرب: البنية والرضا

The current study aims to know the structure and level of satisfaction of Moroccan students with their university surroundings based on the 70-phrase level measure of satisfaction with the university's surroundings, divided into 7 items, Of interest to the various aspects of the university environment, the research sample included 359 students; This made the measurement achieved to achieve a good internal consistency rate of 0.95 alpha Cronbach approach", demonstrating the appropriateness of adopting this measure to study the varying satisfaction with the university environment of this sample. In the same vein, the working analysis of the scale items assures us that the university surroundings are a compilation of two components, the first being a physical element linked to infrastructure, and the other, not a material element encompassing the relational and organizational aspect of the results that show that students are not satisfied with: Facilities and facilities, university services, pedagogical equipment, study process, curricula, and examinations. In return, we find them satisfied with the relationship that brings them together with other colleagues and educational and administrative staff. We have also found that satisfaction clauses are influenced by different sociodemographic variables studied, for example: the level of satisfaction in examinations varies by sex, as does the nature of the student's specialization, as the level of satisfaction with pedagogical methods and curricula changes. It is also clear that the level of education is an effective factor in the student's satisfaction with the quality of the relationship between him and other colleagues and educational and administrative staff, while the student's satisfaction with the teaching process is influenced by the age of the students.

Clinical value of Hemoglobin in Combination with Neutrophil-to-Lymphocyte Ratio and Platelet-to-Lymphocyte Ratio as a Prognostic Factor in Advanced Lung Cancer

The absence of effective prognostic factors for assessing the survival outlook of patients with lung cancer has not significant improvement. Thus, this study aims to investigate the potential of a combination of serum haptoglobin (Hp), neutrophil-to-lymphocyte ratio (NLR), and platelet-to-lymphocyte ratio (PLR) in blood as reliable prognostic markers for lung cancer patients. There were 62 lung cancer patients (male and female) at advanced stage (stage III and IV) with age mean (65.25) years, and 62 healthy participants with age mean 64.27 years. The levels of some hematological parameters were estimated by a hematology analyzer. Heptoglobin level was evaluated in serum by ELISA technology. There was significant increase in mean of haptoglobin, NLR, and PLR in SCLC (3.43 ±0.16, 2.47±0.88, and 221 ±23.21, respectively) and NSCLC groups (3.64 ±0.09, 3.68±1.3, and 210.26±12.6, respectively) compared with control group. Haptoglobin, NRL and PRL did not differ significantly between SCLC and NSCLC. The results indicate that the mean haptoglobin, NLR, and PLR were significantly increased in lung cancer group in contrast to controls and also showed a positive association with the severity of the disease, where they increased in patients at stage IV and receiving chemotherapy for 2 months. This makes them possible markers for prognostic advanced lung cancer and predictive responses to chemotherapy in lung cancer patients.

Filtered reaction rate and interphase mass transfer models in reactive gas‐solid flows

AbstractThis work pursues the closure for the effective reaction rate based on fine‐grid two‐fluid model (TFM) simulations in reactive gas‐solid flows. It is found that the mesoscale mechanism in the solid‐catalyzed reaction is constrained by the kinetic regime (KR) and the external mass transfer‐controlled regimes (EMTR). Thus, a filtered reaction rate model ηsubgrid considered two different regimes is proposed. The mesoscale effectiveness factor proposed in previous work is adopted in KR. A filtered interphase mass transfer model QM, which is constructed by analogy to the interphase heat transfer model, is used in EMTR. ηsubgrid shows a good predictability in two regimes via a priori test. The fidelity of ηsubgrid is also assessed via a filtered TFM simulation. The results indicate that the simulations incorporating corrections for the drag force and reaction rate yield better agreement with the fine‐grid simulations for both mass fraction and reaction rate profiles.

Spatio-Temporal Analysis of Erosion Risk Assessment Using GIS-Based AHP Method: A Case Study of Doğancı Dam Watershed in Bursa (Türkiye)

Soil erosion, one of the most serious phenomena in watershed management, can be estimated based on various criteria. Land use change is one of the most important factors affecting the susceptibility of soil erosion. In this study, the effect of land use change on soil erosion risk in two plan periods (2005 and 2017) was investigated using Analytical Hierarchy Process (AHP) and Geographic Information Systems (GIS) for the forest planning units in the Doğancı Dam Watershed, located in Bursa, Türkiye. Eight criteria were evaluated including erosion-related slope, bedrock type, land use/land cover, precipitation, relative relief, aspect, drainage frequency, and density. According to the results, the most effective factor in soil erosion was slope (0.29), while bedrock type and land use/land cover ranked second with 0.19. It was found that full closure forests were characterized by high erosion resistance (0.3), while bare land was characterized as the most sensitive area to erosion (0.39). In terms of spatio-temporal changes in a 12-year period, the areas in the medium and high erosion risk decreased, while low and very low-risk areas increased. The ROC method showed a satisfactory accuracy of 72.8% and 80.2% for the 2005 and 2017 erosion risk maps, respectively.

Land-sea contrast of vertical structure of precipitation over Sumatra revealed by GPM DPR observations

This study examines the land-sea contrast in the vertical structure of precipitation over Sumatra and its surrounding ocean using eight years (2014–2021) of dual-frequency precipitation radar (DPR) data from the Global Precipitation Measurement (GPM) mission. The study area is segmented into Ocean, Coast I (west coast), Land I (west of Barisan Mountains), Land II (east of Barisan Mountains), and Coast II (east coast). The effective reflectivity factor (Ze), rainfall rate (R), and two raindrop size distribution (DSD) parameters, namely the mass-weighted mean diameter (Dm) and the normalized intercept (Nw), were analyzed. Stratiform and deep convective rainfall were the most frequent types in Coast I, followed by Ocean, Land I, Land II, and Coast II. In contrast, shallow convective rainfall was the most common type in Ocean, followed by Coast I, Land I, Land II, and Coast II. The average rain top height (RTH) was found to be higher in Land II and Coast II than in Ocean, Coast I, and Land I, in accordance with the surface rainfall intensity pattern previously reported by other studies. Furthermore, the data on heavy ice precipitation demonstrated an increase from the ocean to the coast and land, with a significant number of instances observed in Land I, Land II, and Coast II, in addition to Coast I. This contrast in heavy ice precipitation and RTH influences DSD. The land-sea contrast of DSD is more pronounced for deep convective rains. Deep convective exhibited a lower frequency of large raindrops over the ocean than over the coast and land, as reflected in the Dm profile. Conversely, raindrop concentration, particularly small drops, was higher at sea. The percentage of Dm > 2 mm at sea was approximately 2%, rising to 4–6% in Land II and Coast II. The land-sea contrast in the vertical structure of precipitation over Sumatra exhibited apparent diurnal variation. Larger Dm and smaller Nw were observed over Land I and Coast I, particularly in the afternoon and evening, correlating with peak rainfall. This pattern aligns with heavy ice precipitation profiles, vertical relative humidity (RH), and wind profiles. This study highlights the complexities and potential discrepancies between vertical precipitation profiles and surface precipitation data, underscoring the nuanced nature of land-sea precipitation migration.

Core neutronic design of small modular molten salt reactor for submarine propulsion

Molten salt reactor (MSR) shows great promise as a Generation IV nuclear reactor concept with high thermal-electric conversion efficiency, inherent safety features, and online reprocessing capability. During operation, the molten salt reactor MSR does not require a long refueling shutdown owing to online fuel reprocessing, making it suitable for watercraft propulsion. This paper presents the neutronic design of the 250 MWt iso-breeder MSR concept for submarine propulsion. The reactor is fueled with LiF-BeF2-ThF4-233UF4 salt with a virtual one-and-a-half fluid configuration. The MSR core is moderated with beryllium oxide and equipped with a high-density graphite reflector to improve neutronic. All calculations on the reactor core design were performed using MCNP6.2 code with ENDF/B-VII.0 neutron cross-section library. As a part of the neutronic analysis, the calculated parameters were the effective multiplication factor (), temperature coefficient of reactivity (TCR), and breeding ratio (BR). The value of ± 1.005 was obtained using Th : U ratio of 98.42% : 1.58%. The TCR value was obtained at -2.56 pcm/K, while the BR value was 1.057. These initial values indicate that the marine propulsion MSR can achieve iso-breeding with inherent safety characteristics. By using MSR design, it is hoped that the submarines will be able to reach significantly longer operational range than its Diesel-powered counterpart..

Prediction of ovarian cancer using artificial intelligence tools.

Ovarian cancer is a common type of cancer and a leading cause of death in women. Therefore, accurate and fast prediction of ovarian tumors is crucial. One of the appropriate and precise methods for predicting and diagnosing this cancer is to build a model based on artificial intelligence methods. These methods provide a tool for predicting ovarian cancer according to the characteristics and conditions of each person. In this study, a data set included records related to 171 cases of benign ovarian tumors, and 178 records related to cases of ovarian cancer were analyzed. The data set contains the records of blood test results and tumor markers of the patients. After data preprocessing, including removing outliers and replacing missing values, the weight of the effective factors was determined using information gain indices and the Gini index. In the next step, predictive models were created using random forest (RF), support vector machine (SVM), decision trees (DT), and artificial neural network (ANN) models. The performance of these models was evaluated using the 10-fold cross-validation method using the indicators of specificity, sensitivity, accuracy, and the area under the receiver operating characteristic curve. Finally, by comparing the performance of the models, the best predictive model of ovarian cancer was selected. The most important predictive factors were HE4, CA125, and NEU. The RF model was identified as the best predictive model, with an accuracy of more than 86%. The predictive accuracy of DT, SVM, and ANN models was estimated as 82.91%, 85.25%, and 79.35%, respectively. Various artificial intelligence (AI) tools can be used with high accuracy and sensitivity in predicting ovarian cancer. Therefore, the use of these tools can help specialists and patients with early, easier, and less expensive diagnosis of ovarian cancer. Future studies can leverage AI to integrate image data with serum biomarkers, thereby facilitating the creation of novel models and advancing the diagnosis and treatment of ovarian cancer.

Assessing the exergy sustainability of a paddy drying system driven by a biomass gasifier.

Paddy parboiling in rice industries is an energy-intensive process that requires huge attention for energy conservation, fuel economy, and sustainability. Thus, several research initiatives have been undertaken to adopt a suitable energy conversion system in such industries to improve thermal efficiency and reduce environmental impact. In this study, exergy performance and exergy-based sustainability indicators have been investigated on a reversible bed paddy dryer coupled with a rice husk-fuelled downdraft gasifier. The experiment was conducted at the optimum operating conditions such as an equivalence ratio of 0.2 in the gasifier and a drying air temperature of 80℃ in the dryer. The exergy efficiency of the reversible bed dryer and the gasifier were 65.53% and 70.92% respectively. The lowest exergy efficiency of 35.29% was seen in the combustion chamber since a huge exergy destruction of 2.75kW occurred. Therefore, the combustion chamber has a high potential improvement of about 1.66kW. Due to less exergy destruction, the gas cooler and air duct showed high exergy efficiency of 62.36% and 76.2% respectively and the lowest values in exergy-based sustainability indicators. The assessment of environmental and sustainability factors on each component showed that the combustion chamber has a high waste exergy ratio of 0.688, environment effect factor of 1.95, exergy destruction coefficient of 0.69, and exergy sustainability index of 0.51.

A probabilistic coupled hardening model of double irradiation defects in iron

Irradiation hardening effect is of significance to the design and life extension of nuclear materials. Although various types of defects coexist under in-pile condition, most irradiation hardening models like the dispersed barrier hardening (DBH) model ignore their strength difference and treat them as a single defect type. In this work, the barrier strengths in presence of combined 〈111〉 and 〈100〉 loops in bcc iron are investigated using discrete dislocation dynamics simulations. Considering the coupling effect, the non-periodic distributed effect is preliminarily analyzed. A probabilistic model accounting for their coupled hardening effect is established based on dislocation depinning mechanism from simulation results, which can be also integrated into the modified DBH model using an effective barrier strength factor. The model presents good agreements with experimental results of iron alloy, and exhibits potential applicability in predicting the coupling effects of other defect types, including the dislocation loops and voids.

Enhanced thermal effectiveness of square duct with V-type double-baffles: Numerical study

The article puts forward three-dimensional computational research on heat transmission augmentation within a square channel containing 45o V-type double-baffles positioned on the lower and top parts at regular intervals in the turbulence zone for Reynolds numbers (Re) that vary from 3000 to 20,000. The primary goal of this research is to increase the thermal effectiveness and relative Nusselt number (Nu/Nu0), in order to conserve energy and reduce the size of the heating or cooling system. The simulations utilize a finite volume approach in common with the SIMPLE algorithm, whereas the turbulent model used is the realizable k–ε. The baffles are designed to be separated vertically for reducing pressure loss. Both single V-baffles and double V-baffles have four relative pitches (PR = 0.4, 0.5, 0.6, and 1.0) and height/blockage ratios (BR = 0.05, 0.1, 0.15, and 0.2), with a fixed attack angle (α) of 45o. The computational findings show that both V-baffles are capable of producing the primary vortices, but only the double V-baffles have the ability to provide the impinging streams onto the wall, cooling the region behind the baffles. This suggests that the double V-baffles not only boost heat transmission but also reduce frictional loss. When compared to a single V-baffle, the double ones enhance heat transfer by an average of 1.04–9.94% while decreasing frictional loss by an average of 9.88–31.73%. The thermal effectiveness factor (TEF) of the double V-baffles ranges from 1.03 to 3.21, and its peak value of around 3.21 is for PR = 0.4, BR = 0.05, at lower Re.

Effect of vertical implant position on marginal bone loss: a randomized clinical trial

ObjectivesOne of the most important factors that has influence on dental implants success rate is marginal bone loss. The purpose of this study is to investigate the effect of the implant’s vertical position and the soft tissue’s thickness on the rate of marginal bone loss of the dental implant.Materials and methodsIn this single-blind randomized clinical trial study, 56 implants placed in the posterior region of mandible of 33 patients (19 women, 14 men) were divided into two groups. The group of crestal (28 implants) and subcrestal (28 implants) implants, each group was divided into two sub-groups with soft tissue thickness of 2 mm and less than 2 mm (14 implants) and more than 2 mm (14 implants). The amount of marginal bone loss was measured by Scanora 5.2 program with radiographs Digital parallelism based on the effect of the vertical position of the implant, soft tissue thickness, three months after placement, and three months after loading implants (six months after implant placement).ResultsThe results showed that marginal bone loss in subcrestal implants is significantly more than crestal implants (p-value = 0.001), and also marginal bone loss in the soft tissue thickness group of 2 mm and less is significantly more than the group of soft tissue thickness more than 2 mm (p-value < 0.001). The amount of marginal bone loss three months after implant loading was significantly higher than three months after implant placement (p-value < 0.001).ConclusionThe implant’s vertical position and the soft tissue’s thickness around the implant are effective factors in the amount of marginal bone loss. Marginal bone loss is more in subcrestal implants and in cases with less soft tissue thickness. The time factor significantly affects the amount of marginal bone loss.Trial registrationthis clinical trial was registered at Iranian Registry of Clinical Trials, registration number IRCT20120215009014N415, registration date 20,220,110, (https//en.irct.ir/trial/60,991)

Developing a model of digital transformation of university libraries based on meta-synthesis

PurposeThe purpose of this study was to develop a model for the digital transformation of university libraries based on meta-synthesis.Design/methodology/approachThe approach of this research was qualitative and used the Sandelowski and Barroso’s (2007) seven-step meta-synthesis method to systematically review the literature. The statistical population of the research includes all the scientific publications related to the foundations and dimensions of the digital transformation of university libraries, counting the scientific publications retrieved from six scientific databases in the period from 2004 to 2022, and was based on the critical appraisal skills programme and a screening process.FindingsBased on the retrieved publications, 32 documents were selected for further review and analysis. First, a separate code was considered for all the factors extracted from the selected documents, and then, considering the concept of each of the codes, they were categorized into a similar concept. In this way, the research concepts were determined. Based on the analysis done with the help of the content analysis method, there are a total of seven main categories and 24 concepts, including digital culture (including: digital attitude, user-oriented, agility, participation and cooperation, creativity and innovation and learning digital skills of employees), digital librarian (containing: individual competence, knowledge competence, communication competence and skill competence), digital manager (comprising: individual competence, knowledge competence, skill competence), digital services and resources (including, optimally reorganizing library resources, providing digital services to users and providing digital services to the mother organization), digital technologies (containing: digital infrastructure, technological readiness and using digital technologies), support and cooperation of upstream institutions and the mother organization (dealing with: providing human resources, providing technological resources and equipment and making macro policies) and work process and development of digital strategies (comprising: digitalization of processes and development of library digital strategies).Originality/valueDigital transformation is a complex and multi-faceted process, yet it is an indispensable endeavour for university libraries, and managers and librarians cannot be expected to be familiar with these concepts without training or study and then be able to move in the right direction towards the digital transformation of libraries. To the best of the authors’ knowledge, this is the first study to develop a model for the digital transformation of university libraries. The results of this research indicate the effective factors and requirements needed for the digital transformation of university libraries and address the importance of understanding the concepts for managers and librarians.

Application of the path analysis model to evaluate the role of distress, mental health literacy and burnout in predicting self-care behaviors among patients with type 2 diabetes

IntroductionMental complications of diabetes are one of the main obstacles to the implementation of self -care behaviors that have been less studied. Therefore, this study was conducted to survey the effective factors in predicting burnout and self-care behaviors among patients with type 2 diabetes.MethodsIn this Path analysis, 1280 patients with type 2 diabetes were selected from Mashhad (Iran) in 2023 to 2024. Four scales, the mental health literacy (MHL) scale, diabetes burnout scale, diabetes distress scale, and self-care behavior scale were used for data gathering. AMOS software checked the direct and indirect paths between the variables.ResultsIn the path analysis, variables of MHL and diabetes distress predicted 25% variance of diabetes burnout (R2 = 0.25), and diabetes distress (total effect = 0.491) had the greatest impact on predicting diabetes burnout. Variables of MHL, diabetes distress, and diabetes burnout predicted 12% variance of Self-care behaviors (R2 = 0.12) and MHL (total effect = -0.256), age of onset of diabetes (total effect = 0.199), and diabetes burnout (total effect = − 0.167) had the greatest impact on prediction of self-care behaviors.ConclusionMHL could reduce diabetes distress and burnout and eventually promote self-care behaviors among patients with type 2 diabetes. Therefore, screening and identifying psychological problems (such as distress and burnout) and designing interventions to increase MHL can ultimately increase the health of patients with diabetes.

Effective provider communication for personal agency in mental health recovery: A cross-sectional study on Japanese users' perspectives.

INTRODUCTION: Recovery-oriented practice in community-based mental health services is crucial for individuals with mental illness, with communication with familiar individuals being important for recovery in Japanese and Asian cultures. This study aimed to examine effective communication factors for personal agency in recovery by investigating the association between perceived support provided through communication and personal agency of individuals with mental illness. A cross-sectional study was conducted among community-dwelling Japanese mental health service users, assessing subjective agency, decisional conflict, staff support for personal recovery, activation for mental health self-management, demographic variables and living difficulties. Multiple linear regression analysis identified factors predicting subjective agency, revealing characteristics of effective provider communication for recovery. Data from 222 users were analysed, revealing negative correlations between uncertainty about treatment choices and ineffective decision-making with higher subjective agency, while staff support for personal recovery positively correlated with higher subjective agency. In recovery-oriented practice, prioritizing users' emotional experiences during decision-making and supporting their self-determination in their unique recovery journeys is crucial. Providers should approach dialogue as carefully as medication prescriptions, prioritizing therapeutic partnerships with users. The findings extend beyond nursing to all mental health service providers, advancing the theory of recovery-oriented practice.

From plan to delivery: Machine learning based positional accuracy prediction of multi-leaf collimator and estimation of delivery effect in volumetric modulated arc therapy.

The positional accuracy of MLC is an important element in establishing the exact dosimetry in VMAT. We comprehensively analyzed factors that may affect MLC positional accuracy in VMAT, and constructed a model to predict MLC positional deviation and estimate planning delivery quality according to the VMAT plans before delivery. A total of 744 "dynalog" files for 23 VMAT plans were extracted randomly from treatment database. Multi-correlation was used to analyzed the potential influences on MLC positional accuracy, including the spatial characteristics and temporal variability of VMAT fluence, and the mechanical wear parameters of MLC. We developed a model to forecast the accuracy of MLC moving position utilizing the random forest (RF) ensemble learning method. Spearman correlation was used to further investigate the associations between MLC positional deviation and dosage deviations as well as gamma passing rates. The MLC positional deviation and effective impact factors show a strong multi-correlation (R=0.701, p-value<0.05). This leads to the development of a highly accurate prediction model with average variables explained of 95.03% and average MSE of 0.059 in the 5-fold cross-validation, and MSE of 0.074 for the test data was obtained. The absolute dose deviations caused by MLC positional deviation ranging from 12.948 to 210.235cGy, while the relative volume deviation remained small at 0.470%-5.161%. The average MLC positional deviation correlated substantially with gamma passing rates (with correlation coefficient of -0.506 to -0.720 and p-value<0.05) but marginally with dosage deviations (with correlation coefficient<0.498 and p-value>0.05). The RF predictive model provides a prior tool for VMAT quality assurance.

Identifying the Opinions of Students, Professors and Educational Managers Regarding the Factors Affecting the Improvement of the Quality of Education in Hamadan University of Medical Sciences

Introduction: Considering the importance of the quality of education in universities on the growth and development programs of the country, this study aimed to explain the opinions of students, professors, and educational managers regarding the factors affecting improving education quality at Hamadan University of Medical Sciences. Method: This qualitative study used conventional content analysis to understand the experiences of students, professors, and managers at Hamadan University of Medical Sciences. Participants were selected through purposeful sampling with diversity in considering faculty, educational group, level, age, and gender. The interviews in person included in-depth interviews with 20 students, 8 professors, and 3 educational managers. The responses were analyzed using the Graneheim and Lundman model. Results: The factors affecting the improvement of education quality from the students’ perspective were determined in four main contexts: the professor’s teaching method in class, modern teaching techniques, appropriate interactions between professor and student, and the availability of educational infrastructures. The effective factors from the educational managers’ perspective were identified in two prominent contexts: the professor’s teaching in class and appropriate interactions between professor and student. The effective factors from the professors’ perspective were identified in four main contexts: professors’ motivation, empowering professors, professors’ and students’ characteristics. Conclusion: Improving the quality of education depends on appropriate interactions between professors and students, professors’ teaching methods, modern teaching techniques, and educational infrastructures. Also, the motivation and empowerment of professors and the characteristics of professors and students play a significant role in this field. Therefore, to improve the quality of education, educational managers must pay attention to these factors.

Identifying Effective Policies in the Development of Knowledge-Based Companies in the Medical Field

Background: Considering the development of a knowledge-based economy in the world and Iran, identifying the effective components in the development of knowledge-based companies in the medical field is essential in line with the policy and economic development of the country. Methods: In this qualitative research, data was collected through in-depth and semi-structured interviews from faculty members, specialists and managers of organizations in charge of the country's knowledge-based ecosystem. The statistical population was selected by snowball sampling, and the scientific interviews continued until the theoretical saturation stage, and finally 19 interviews were conducted. All data were analyzed based on Brovan and Clark's six-step theme analysis method. Results: From data analysis, three main themes including the factors of " revision of the general policies of the country", "creating a suitable economic platform" and "revision of the performance of institutions in charge of knowledge-based economy" and 37 subthemes were extracted which were regarded as effective factors in the development of knowledge-based companies in the medical field. Conclusion: It is necessary to review the general and executive policies of the country for the development of knowledge-based companies, and the government must provide the basis for the development of knowledge-based companies by creating a suitable economic context, fighting economic rents, creating economic stability and reforming the banking network. It is also necessary to review the processes in the Deputy of Science, Technology and Knowledge-Based Economy and the Ministry of Health, Treatment and Medical Education.

Exploration of treatment strategies and susceptibility gene of postoperative nausea and vomiting in breast cancer patients: a randomised controlled trial.

A history of severe nausea and vomiting during pregnancy (SNVP) is a risk factor for postoperative nausea and vomiting (PONV). This study aimed to explore potentially effective treatment strategies and potential genetic factors underlying SNVP risk-related PONV. A total of 140 female patients undergoing breast cancer surgery were assigned to either the study group (70 with SNVP) or the control group (70 with mild to moderate nausea and vomiting during pregnancy (MNVP)). Patients in each group were randomly assigned to two different treatment subgroups and received either ondansetron plus dexamethasone (OD) or OD + TEAS (ODT) (transcutaneous electrical acupoint stimulation, TEAS). Blood samples were collected from patients before induction (D0) and 24h (D1) after surgery for growth differentiation factor 15 (GDF-15) evaluation. The primary outcome was the incidence of PONV within 36h. The secondary outcome was the serum GDF-15 level. The incidence of PONV in the SNVP group was significantly higher than that in the MNVP group within 24h (P < 0.005). In the SNVP group, ODT-treated patients had less PONV than those in the OD-treated group during the 6-12h (P = 0.033) and 12-24h (P = 0.008) intervals, while within 6h, there were fewer vomiting cases in the ODT-treated group (SNVP-ODT vs. SNVP-OD, 7/33 vs. 19/35, P = 0.005). The preoperative GDF-15 serum levels in patients with SNVP were significantly higher (P = 0.004). Moreover, higher preoperative GDF-15 serum levels correlated with a higher incidence of PONV (P = 0.043). TEAS showed significant effect on PONV treatment in patients with SNVP. A higher serum GDF-15 level was associated with a history of SNVP, as well as a higher risk of PONV.