Iranian Case Research Articles

Ovarian mature cystic teratoma with malignant transformation: two case reports

BackgroundMature Cystic Teratoma (MCT) is a benign tumor that can lead to malignant transformation (MT) in 1–3% of cases. Management of MT is a big challenge for gynecologic oncologists due to the lack of specific diagnostic and treatment protocols.Case presentationWe reported two Iranian cases of MT of MCT with two different stages and prognosis. Our both cases presented the same symptoms, including chronic abdominal pain and distention, loss of appetite, and weight loss. In case number 1, despite the large size of the tumor, the disease was at stage Ia and had a good prognosis; while, case number 2 was at stage IIIc of the disease with a poor prognosis.ConclusionThe stage of the disease is the most important prognostic factor, and early diagnosis and treatment are very critical for better survival.

Optimisation of energy-efficient greenhouses based on an integrated energy demand-yield production model

The aim of this paper is to develop a simulation framework to minimise the cost associated with commercial greenhouse yields (production cost). Greenhouse energy demand and yield production models are coupled with a cost model to investigate the interaction between energy consumption costs and yield production benefits. The coupled model is defined as an optimisation problem to determine the optimal values of decision variables (e.g. cover material, heating and cooling technology, inside temperature and relative humidity set points, plant density, etc.), which result in minimum production cost as the objective function. The results show that the integrated energy demand-crop yield production model outperforms the “classical approach” of a separate energy consumption model where yield is not explicitly modelled but only considered by constraints warranting good growing conditions. In the case of a tomato greenhouse in Iran, the financial cost and environmental impact of producing a 1 kg yield based on integrated energy demand-yield production model were 49% and 29% lower than the energy-consumption model alone. Moreover, the impact of fuel prices on the optimisation results is investigated by use of the proposed framework. Considering real fuel prices instead of current subsidised fuel prices in the Iranian case study, 70% of energy consumption and 19% of climate change impacts could be eliminated while increasing the production cost by 17%. Selling the saved fuel at real prices to other customers would provide the government with more than enough money to compensate the farmers for the increased yield cost. • Greenhouse energy demand and yield production models are coupled with a cost model. • The coupled model is optimised to minimise the production cost. • Optimisation based on coupled model outperforms classical greenhouse energy-optimisation. • The resulted production cost is 49% lower than classical approaches. • Removing fuel subsidies would increase production costs by 17% and decrease CO 2 emissions by 19%.

Social Movements in Iran: How Well Does the Dominant Narrative Work?

In this paper, I apply the typical stages of social movements—emergence, coalescence, and institutionalization—to an Iranian environmental social movement. I show how each of the stages does, or does not, play out in the Iranian case, using interview data and documentary analysis. The first two stages of social movements are achieved in the movement. But, due to a centralized state that uses violence and repression, the movement cannot play on the stage of the dominant narrative’s institutionalization. However, the movement is not in decline. I suggest using the idea of “persistence/resistance” for the last stage rather than institutionalization, as institutionalization may be just a form to assure that social movements will persist. There are other cases like this movement around the world, but there is not a specific argument to challenge the limitations of the dominant narrative. My study helps scholars rethink this narrative according to the context of the countries in their research.

Metaphyseal Burst Sign; The First Case Report of Subchondral Insufficiency Fracture of the Knee in Iran

Metaphyseal burst sign, which is soft tissue edema in the metaepiphyseal region, is defined as a novel initial sign of subchondral insufficiency fracture of the knee (SIFK). We reported the first Iranian case of the SIFK in femoral medial condyle characterized by a metaphyseal burst sign which could be an early sign of the SIFK. Early diagnosis and treatment could dramatically relieve the sign and symptoms of patients with significant improvement of the MRI scan.

Giant axonal neuropathy: The first Iranian case with a variation in the gigaxonin gene and a glance to the other cases

Background: Giant axonal neuropathy (GAN) is a very rare fatal neurodegenerative disorder with clinical and allelic heterogeneity. The disease is caused by mutations in the GAN (gigaxonin) gene. Herein, we reported the clinical presentations and results of genetic analysis of the first Iranian GAN case. Methods: Phenotypic data were obtained by neurologic examination, brain magnetic resonance imaging (MRI), electromyography (EMG), electroencephalography (EEG), and sonography from the proband. Deoxyribonucleic acid (DNA) was isolated from peripheral blood leucocytes and whole exome sequencing (WES) was performed. The candidate variant was screened by Sanger sequencing in the proband and her family members. Results: The proband was a 7-year-old girl who was admitted with a chief complaint of ataxia, muscle weakness, delayed developmental milestones, and history of psychiatric disorders. She was very moody and had clumsy gait, decreased deep tendon reflexes (DTRs) of lower limbs, and kinky hair. The brain MRI revealed white matter abnormality. The EMG revealed that her disease was compatible with the chronic axonal type of sensorimotor polyneuropathy; however, her EEG was normal. Results of the WES revealed a homozygous variant; c.G778T:p.E260* in the GAN gene, indicating the GAN disorder. Conclusion: The present study affirmed GAN allelic heterogeneity and resulted in the expansion of the phenotypic spectrum of GAN pathogenic variants. Identification of more families with mutations in GAN gene helps to further understand the molecular basis of the disease and provides an opportunity for genetic counseling especially in the populations with a high degree of consanguineous marriage such as the Iranian population.

Ranking cost overrun factors in the mega hospital construction projects using Delphi-SWARA method: an Iranian case study

Completing a project according to the anticipated budget is one of the most important criteria in a successful construction project. As mega hospital construction projects face various kinds of limitation which affect the cost dramatically, many developing countries such as Iran have focused in these kinds of projects. Only a few studies have been conducted which are associated with cost overrun factors in hospital construction projects in developing countries. The aim of this study is to identify and rank cost overrun factors in mega hospital construction projects of Iran. Delphi and SWARA methods were used in order to align experts’ opinions in categorizing cost overrun factors and weigh the cost overrun factors, respectively. These factors were then allocated to consultants, employers and contractors. The results illustrated that “Unacceptable quality of work which leads to rework” with score of 0.458, “Not allocating sufficient budget from the government during the project” with score of 0.429 and “Lack of supervisors’ technical knowledge” with score of 0.44 were the most crucial factors in contractors, employers and consultant groups, respectively. The identified factors inform the main literature on hospital projects and results in decreasing cost overruns in the mentioned projects.

A GIS-based fuzzy-analytic hierarchy process (F-AHP) for ecotourism suitability decision making: A case study of Babol in Iran

Managing ecotourism through appropriate zoning is critical for land use planning. This study is the first to integrate a geographic information system (GIS) with a Fuzzy-Analytic Hierarchy Process (F-AHP) to evaluate the relative importance of physical, natural, environmental, and socio-economic factors for determining the suitability of ecotourism sites. Eleven factors were selected through questionnaire-based surveying of 35 ecotourism and land management experts. F-AHP was applied to weight these factors in order to index and map the suitability of an Iranian case study area for ecotourism using GIS data. A reliable model for the identification of zone suitability was developed which revealed that landform and distance to stream, followed by temperature and elevation were the most important factors for calculating the suitability index. This paper provides useful insights into this novel application of a GIS-based F-AHP for ecotourism planning relevant for policy-makers, planners and practitioners.

Prioritising sustainable supply chain management practices by their impact on multiple interacting barriers

ABSTRACT Sustainable development in supply chain management (SCM) is challenging to implement, so various studies have sought to identify appropriate practices that eliminate barriers and challenges’ effects on sustainable SCM (SSCM). To overcome previous investigations’ limitations, the present research developed a multi-attribute decision-making (MADM) framework for prioritising SSCM practices, which was applied to an Iranian case. A careful, systematic review of previous studies extracted a comprehensive list of SSCM barriers and practices. To shorten the long list of barriers identified, the fuzzy Delphi and fuzzy decision-making trial and evaluation methods were used to reduce the decision criteria list. These two approaches are particularly appropriate because of the criteria’s complex interactions. In addition, fuzzy sets are useful when dealing with uncertainties in decision-making processes and obtaining experts’ opinions. With the selected experts’ help, the extent of each practice’s impact on barriers was measured. The practices were then ranked by order of priority using six fuzzy MADM methods. The implemented methods’ weights were determined using the correlation coefficient and standard deviation (CCSD) approach in order to prioritise the practices for the final time. The proposed methodological framework combines different approaches’ results and increases the findings’ empirical robustness by applying the CCSD method, thereby eliminating previous studies’ limitations. Results show that ‘Lack of sustainable product and service promotion’ (B18) and ‘Weak social and society-related pressures’ (B34) are the top priority barriers and ‘Applying preventive and maintenance strategies to maximize equipment’s effectiveness’ (P5) and ‘Implementing reverse logistics’ (P3) have been identified as the most important SSCM practices.

The impact of international economic sanctions on national economies. The Islamic Republic of Iran - a case in point

Abstract This paper explores the impact of economic sanctions on national economies, with specific focus on Iran. It starts by conceptualizing sanctions in the set of economic policies and include them in the framework of economic statecraft, according to literature available. Several hypotheses that attempt to anticipate the form of sanctions are advanced, according to the intensity of geopolitical competition among the states. The analysis uses the case study of the regime of United States’ sanctions against the Islamic Republic of Iran. Tehran and P5+1 powers (the permanent members of the United Nations Security Council and Germany) agreed on a deal regulating the nuclear program of Iran - Joint Comprehensive Plan of Action, meaning that Iran would reduce its nuclear activities drastically in exchange of lifting economic sanctions. In spite of the initial enthusiasm, United States announced in May 2018 the unilateral withdrawal from the deal and reinstating the sanctions regime, spiking new tensions in the relation with Iran. As a result, the paper discusses the context in which Iran tries to pursue economic goals in order to ensure resilience, while the US imposes more pressure. In addition, the study also approaches the dilemma whether sanctions can ultimately generate political answers and at what costs. In this context, it is identifying several alternatives in the Iranian case, together with noting the limits of conceptual refinements in terms of sanctions’ theory.

Mendelian Susceptibility to Mycobacterial Disease (MSMD): Clinical and Genetic Features of 32 Iranian Patients.

Mendelian susceptibility to mycobacterial diseases (MSMD) is a rare congenital condition characterized by a selective predisposition to infections caused by weakly virulent mycobacteria and other types of intra-macrophagic pathogens. The 16 genes associated with MSMD display a considerable level of allelic heterogeneity, accounting for 31 distinct disorders with variable clinical presentations and prognosis. Most of MSMD deficiencies are isolated, referred to as selective susceptibility to mycobacterial diseases. However, other deficiencies are syndromic MSMD, defined by the combination of the mycobacterial infection with another, equally common, infectious, specific phenotypes. Herein, we described a series of 32 Iranian MSMD cases identified with seven distinct types of molecular defects, all of which are involved in the interferon gamma (IFNγ) immunity, including interleukin IL-12 receptor-β1 (IL-12Rβ1) deficiency (fifteen cases), IL-12p40 deficiency (ten cases), and IL-23R deficiency (three cases), as well as IFNγ receptor 1 (IFNγR1) deficiency, IFNγ receptor 2 (IFNγR2) deficiency, interferon-stimulated gene 15 (ISG15) deficiency, and tyrosine kinase 2 (TYK2) deficiency each in one case. Since the first report of two MSMD patients in our center, we identified 30 other affected patients with similar clinical manifestations. As the number of reported Iranian cases with MSMD diagnosis has increased in recent years and according to the national vaccination protocol, all Iranian newborns receive BCG vaccination at birth, early diagnosis, and therapeutic intervention which are required for a better outcome and also prevention of similar birth defects. Therefore, we investigated the clinical and molecular features of these 32 patients. The current report also defined novel classes of pathological mutations, further expanding our knowledge of the MSMD molecular basis and associated clinical manifestations.

Locating Millennial Feminism Beyond the Western Context: The Iranian Case

This article aims to contribute towards an understanding of the notion of feminism among young Iranians born after the Iranian revolution, and specifically in the 1990s. Building on an in-depth analysis of the literature and narrative individual interviews with young women and men belonging to the so-called Millennial generation, the paper aspires to shed light on how these youths interpret the feminist ideology today in connection with the history of the women's movement in the country. As the perceived lack of interest in feminism among the Millennials is a subject of continued debate in the international sociological literature, the paper captures a snapshot of the various definitions of feminism from the perspective of Tehran's middle-class youths. Indeed, it unravels some of the complexities of identifying with feminism for youths born and raised in the 1990s, such as the difficulty in accepting the feminist label, the criticisms made to the movement and the persisting differences between women and men.

Estimation of tropospheric wet refractivity using tomography method and artificial neural networks in Iranian case study

Using the observations from local and regional GPS networks, the estimation of slant wet delays (SWDs) is possible for each line of sight between satellite and receiver. The observations of SWD are used to model horizontal and vertical variations of the wet refractivity in the atmosphere above the study area. This work is done using the tomography method. In tomography, the horizontal variations of tropospheric wet refractivity are modeled with the polynomial in degree and rank of 2 with latitude and longitude as variables. Also, altitude variations are modeled in the form of discrete layers with constant heights. The main innovation is to estimate the tropospheric parameters for each line of sight by the artificial neural networks (ANNs). The SWD obtained from GPS observations for the different signals at each station is compared with the SWD generated by the ANNs (SWDGPS–SWDANNs). The square of the difference between these two values is introduced as the cost function in the ANNs. To evaluate, we used observations from October 27 to 31, 2011. The availability of GPS and radiosonde data is the main reason for choosing this timeframe. The correlation coefficient, root mean square error (RMSE), and relative error allow for evaluation of the proposed model. The results were also compared with the results of the voxel-based troposphere tomography method. For a more detailed evaluation, four test stations are selected and ANN zenith wet delays (ZWDANN) are compared with the ZWDGPS. Observations of test stations are not used in the modeling step. The correlation coefficient in the testing step for TomoANN and Tomovoxel is 0.9006 and 0.8863, respectively. The mean RMSE at 5 days for TomoANN and Tomovoxel is calculated as 0.63 and 0.71 mm/km, respectively. Also, the average relative error at the four test stations for TomoANN is 15.37% and for Tomovoxel it is 19.69%. The results demonstrate the better capability of the proposed method in the modeling of the tropospheric wet refractivity in the region of Iran.

A Hybrid Business Success Versus Failure Classification Prediction Model: A Case of Iranian Accelerated Start-ups

The purpose of this study is to reduce the uncertainty of early stage startups success prediction and filling the gap of previous studies in the field, by identifying and evaluating the success variables and developing a novel business success failure (S/F) data mining classification prediction model for Iranian start-ups. For this purpose, the paper is seeking to extend Bill Gross and Robert Lussier S/F prediction model variables and algorithms in a new context of Iranian start-ups which starts from accelerators in order to build a new S/F prediction model. A sample of 161 Iranian start-ups which are based in accelerators from 2013 to 2018 is applied and 39 variables are extracted from the literature and organized in five groups. Then the sample is fed into six well-known classification algorithms. Two staged stacking as a classification model is the best performer among all other six classification based S/F prediction models and it can predict binary dependent variable of success or failure with accuracy of 89% on average. Also finding shows that “starting from Accelerators”, “creativity and problem solving ability of founders”, “fist mover advantage” and “amount of seed investment” are the four most important variables which affects the start-ups success and the other 15 variables are less important.

Identification and prioritization of passive energy consumption optimization measures in the building industry: An Iranian case study

Optimizing building's energy consumption is a significant issue in cities. Due to the huge rate of energy usage, increase in fossil fuel, CO2 emissions and the environmental destruction, a satisfactory solution must be provided. The aim of this research is to identify and prioritize passive energy reducing measures in order to apply them on both existing and historical buildings, which are located in Shiraz, Iran, so that less energy is consumed. SWARA and COPRAS are used in this paper to achieve these objectives. Required data were collected by questionnaires, interviews with experts and literature review. Passive measures are categorized into three groups (thermal, lighting and acoustic) according to their nature. The results show that “Reduction of energy consumption”, “Compatibility” and “Durability” were the top three passive measure selection criteria. Finally, it was illustrated that “increasing building's thermal mass”, “using sunspaces” and “improving building's air tightness” were the most suitable passive measures in thermal, lighting and acoustic group, respectively. The obtained results of this paper would assist the members of construction industry to reduce energy consumption.

Efficacy and safety of rituximab in patients with refractory neuromyelitis optica spectrum disorders: A prospective observation in Iranian cases.

Background:Rituximab has been used successfully in the recent years for treatment of neuromyelitis optica spectrum disorders (NMOSD). However, a uniform treatment protocol for maintenance therapy and the best interval for evaluation and retreatment have not been postulated. We evaluated the efficacy and safety of rituximab treatment as second line therapy, in Iranian patients with refractory NMOSD, based on annualized relapse rate (ARR) and expanded disability status scale (EDSS).Methods:In this prospective before-after study, a total of 18 patients were treated with a loading dose of rituximab (375 mg/m2 weekly in 4 consecutive weeks). Flow cytometric determination of CD19+ B cell in peripheral blood sample was carried every 6 weeks and patients were re-treated based on B cell repopulation with a single dose of 375 mg/m2. Wilcoxon signed rank test was used to evaluate the ARR and EDSS before and after treatment. A p-value of <0.05 was considered statistically significant.Results:Of the 18 patients, 10 (55.5%) were relapse-free during the period of follow up. The EDSS scores were reduced in nine (50%) patients and stable in the remaining nine (50%). The mean EDSS score before and after treatment were 4.1±0.4 and 3.7±0.3, respectively, which was statistically significant. There was also a statistically significant reduction in median ARR after treatment (1.48 (range 0.47-5) vs. 0 (range 0-2)). Rituximab administration did not have significant adverse effect in 94% of patients.Conclusion:Repeated treatment with Rituximab is an effective and well-tolerated treatment in refractory NMOSD.

Profiling of Initial Available SARS-CoV-2 Sequences from Iranian Related COVID-19 Patients.

The etiologic agent SARS-CoV-2 has caused the outbreak of COVID-19 which is spread widely around the world. It is vital to uncover and investigate the full genome sequence of SARS-CoV-2 throughout the world to track changes in this virus. To this purpose, SARS-CoV-2 full genome sequence profiling of 20 patients in Iran and different countries that already had a travel history to Iran or contacts with Iranian cases were provided from the GISAID database. The bioinformatics analysis showed 44 different nucleotide mutations that caused 26 nonsynonymous mutations in protein sequences with regard to the reference full genome of the SARS-CoV-2 sequence (NC_045512.2). R207C, V378I, M2796I, L3606F, and A6407V in ORF1ab were common mutations in these sequences. Also, some of the detected mutations only were found in Iranian data in comparison with all the available sequences of SARS-CoV-2. The position of S protein mutations showed they were far from the binding site of this protein with angiotensin-converting enzyme-2 (ACE2) as the host cell receptor. These results can be helpful to design specific diagnostic tests, trace the SARS-CoV-2 sequence changes in Iran, and explore therapeutic drugs and vaccines.

Clinical Characteristics and Report of Seven Iranian Neonates Born to Mothers with Covid-19

The outbreak of Covid-19 infection is an actual public health challenge. Iran is fighting hard against the virus outbreak. Although at first it seemed that the disease does not affect infants and the neonates, But the population of affected infants and neonates appears to be increasing. This article is written to share some of the experiences about encountering with neonates born to mothers with covid-19. It describes the maternal, perinatal and neonatal aspects of the disease in seven Iranian cases. It also explains the outcome of delivery and follow up of mothers and their neonates after they discharged from hospital. According to our vague and incomplete knowledge about this novel disease and also hazardous side effects of its specific drugs which are not fully evaluated in neonatal population, in this article we just emphasize on routine and supportive care and avoiding unconventional therapy. In this case series we manage our patients according to their disease such as pneumonia, transient tachypnea of neonates or respiratory distress syndrome by using antibiotics, total parenteral nutrition and supplementary oxygen therapy with the preference of non-invasive methods. We didn’t use any novel treatment for Covid-19 disease. We also carefully considered isolation and personal protection issues.

Complexity of test preparation across three contexts: case studies from Australia, Iran and China

ABSTRACT Effective test preparation for high-stakes English language tests is crucial for candidates whose futures depend on attaining a particular score. An increasing number of studies have investigated the role of test preparation; however, these studies have been exclusively conducted in individual contexts and countries around the world. This study draws upon data from multiple sources (classroom observations, interviews, focus-group discussions) gathered from learners, administrators, and teachers within three unique instructional contexts of Australia, Iran and China. The Australian and the Iranian case studies focussed on IELTS and the Chinese case study was conducted with TOEFL iBT. The multi-contextual approach enables a nuanced understanding and insight into the teaching of high-stakes test preparation classes in context, and the ways in which the context and the test interact to influence instructional practices. As such, the findings of this study have important implications for understanding the nature and scope of test preparation.

Sex Determination from the Humerus Bone in Iranian Cases

Sex Determination from the Humerus Bone in Iranian Cases

Paradoxes of Dual Nationality: Geopolitical Constraints on Multiple Citizenship in the Iranian Diaspora

Despite suggestions that multiple citizenships offer enhanced access to security, mobility, and rights, dual nationals of countries like Iran may instead experience greater insecurity, immobility, and disruption of rights. This article offers a brief overview of recent literature and controversies surrounding dual citizenship and then focuses on the Iranian case, demonstrating the limits of dual citizenship as felt by diasporic Iranians. The winds of geopolitical change may affect which nation's dual citizens will be targeted in a given time period, but the impact of geopolitical constraints must be considered in any explanations of the costs and benefits of dual citizenship.