Northeastern Iran Research Articles

A survey of Dysderella Dunin, 1992 (Araneae, Dysderidae), with a new species from Iran

The dysderid spider genus Dysderella Dunin, 1992 is surveyed. The genus currently comprises two species: D. caspica (Dunin, 1990) from Azerbaijan and North Caucasus and D. transcaspica (Dunin & Fet, 1985) from Turkmenistan and north-eastern Iran. Herein, D. elburzicasp. nov. is described based on male specimens collected in Tehran Province, northern Iran. All three species are illustrated and their distributions are mapped.

Rate of occult hepatitis B virus infection among individuals with tuberculosis in northeastern Iran: A molecular epidemiological study

One third of the world population has a history of exposure to the hepatitis B virus (HBV), and two billion people are infected with latent tuberculosis (TB). Occult hepatitis B infection (OBI) is defined as the presence of replicative-competent HBV DNA in the liver with detectable or undetectable HBV DNA in the serum of individuals testing negative for the HBV surface antigen (HBsAg). Screening with HBV DNA could identify OBI and significantly reduce carriers and complications of chronic hepatitis B (CHB). This study aims to assess HBV serological markers and OBI molecular diagnosis among people with TB in Mashhad, northeastern Iran. We have performed HBV serological markers (HBsAg, HBc antibodies (Ab) and HBs Ab) in 175 participants. Fourteen HBsAg+ sera were excluded for further analysis. The presence of HBV DNA (C, S, and X gene regions) was assessed by the qualitative real-time PCR (qPCR) method. Frequencies of HBsAg, HBc, and HBs Ab were 8% (14/175), 36.6% (64/175), and 49.1% (86/175), respectively. Among these 42.9% (69/161) were negative for all HBV serological markers. The S, C, and X gene regions were positive in 10.3% (16/156), 15.4% (24/156), and 22.4% (35/156) of participants, respectively. The total OBI frequency was estimated at 33.3% (52/156) when based on detecting one HBV genomic region. Twenty-two and 30 participants had a seronegative and seropositive OBI, respectively. Thorough screening of high-risk groups with reliable and sensitive molecular methods could lead to OBI identification and decrease CHB long-term complications. Mass immunization remains critical in preventing, reducing, and potentially eliminating HBV complications.

The epidemiology of traumatic brain injuries in northeastern Iran

The epidemiology of traumatic brain injuries in northeastern Iran

A Unique Painted Sherd from the Mid-Sixth Millennium BCE Neolithic Context of Northeastern Iran

Depicting animal motifs on pottery vessels of prehistoric cultures of the Iranian Plateau was begun as early as the turn of the seventh millennium BCE in the lowland Susiana Plain of southwestern Iran. Such motifs appeared in the Neolithic of northeastern Iran, known as Chakhmaq Culture, as early as the early sixth millennium BCE. During a stratigraphic excavation at a Neolithic site, dated to ca. 7000–5000 BCE, in the Shahroud Plain of northeastern Iran, a body sherd was found depicting a scene of mating goats rotating around the vessel. Regarding its early date, ca. 5650–5550 cal BCE, and its naturalistic way of representing the animal motifs, this sherd is unique among the contemporaneous Neolithic sites of the Iranian Plateau.

Predictors of sexual and reproductive health self-care based on demographic factors in adolescent girls.

Global access to sexual and reproductive health is an essential human right, especially to adolescent girls. For improvement sexual and reproductive self-care needs to determine the related factors on utilization and acceptance by adolescents. Therefore, the aim of this study was to examine the SRH self-care and its predictors among adolescent girls in Neyshabur city at Northeast of Iran. The present study was a cross-sectional correlational study performed on 265 girl students from 15 girls' high schools in Neyshabour, in Razavi Khorasan province, Northeastern Iran. The sampling method was multistage probability sampling. Data were collected using demographic information and female adolescents' sexual reproductive self-care scale. Data were analyzed using descriptive, frequency, percentage, mean, standard deviation, and ANOVA, Pearson correlation coefficient, and multiple linear regression model. The significant level was p<0.05 using SPSS16. The results of the present study showed that the mean score of the sexual reproductive health self-care was 61.23 of 100±10.5, it had a significantly relationship with fathers education high school [B=-7.241 CI: (-11.088 to-3.393)], diploma [B=-7.221 CI:-10.707 to-3.735] than academic. The rank of children birth in the family first [B=6.012 CI: (0.931-11.092)] second [B=4.436 CI: (1.437-8.309)] than third and above. Economic status of household Excellent [B=3.159 CI: (2.193-8.511)], Favorable [B=5.866 CI: (1.355-10.378)], relatively favorable [B=2.705 CI: (1.802-7.213)] than poor level economic. sexual and reproductive health is associated to father's education, the rank of children birth in the family, and economic status. So these variables will help to strategies and progress educational programs.

Prevalence, Antimicrobial Resistance, and Molecular Characteristics of Coagulase-Negative Staphylococci Isolated from Children’s Blood Cultures in Northeastern Iran Within 2013 - 2019

Background: Coagulase-negative staphylococci (CoNS) are rolled in severe infections in animals and nosocomial infections in humans. Given that staphylococci other than Staphylococcus aureus are often reported only as CoNS in medical diagnosis laboratories, this study aimed to determine the exact species of this type of staphylococci in clinical samples. Objectives: This study also aimed to evaluate antibiotic resistance, the ability to carry cfr, qacA/B, mecA, and vanA genes, and the diversity of staphylococcal cassette chromosome mec (SCCmec) elements in mecA-carrying isolates. Methods: Staphylococcus spp. strains were isolated from the blood samples of children admitted to Imam Reza Hospital in Bojnurd, Northeastern Iran, between 2013 - 2019. All CoNS isolates were evaluated for resistance to vancomycin and oxacillin using agar screening and other routine anti-CoNS antibiotics using the Kirby-Bauer disk diffusion method, based on the latest Clinical and Laboratory Standards Institute guidelines. The CoNS strains were isolated based on conventional methods and polymerase chain reaction (PCR)-restriction fragment length polymorphism. The PCR was applied to determine the diversity of SCCmec elements in the CoNS isolates. Results: In this study, 203 isolates were confirmed as CoNS belonging to nine staphylococci spp. S. capitis and S. epidermidis were the top two common CoNS. Type III was the dominant SCCmec type in mecA+ isolates. Conclusions: The findings of this study showed that CoNS isolated from blood cultures have a relatively high diversity and antibiotic resistance. Therefore, further attention should be paid to the isolation of these strains in laboratories, and they should not be easily considered as contamination.

Digital mapping of selected soil properties using machine learning and geostatistical techniques in Mashhad plain, northeastern Iran

Understanding the spatial variation of soil properties is essential for monitoring land capabilities as well as the sustainable management of soil resources. The aim of this study was to predict digital soil properties mapping using 23 environmental variables, i.e., terrain attributes and remote sensing (RS) indices, across 1500 km2 of Mashhad plain lands. To achieve this purpose, a total of 180 soil samples (0–10 cm) were taken. The random forest (RF) model combined with ordinary kriging (OK), as well as regression kriging (RK), were applied to relate environmental variables and the studied soil properties. The results revealed that RF-OK was the best model with R2 and RMSE for silt (0.89% and 0.10%), followed by calcium carbonate equivalent (0.88% and 3.30%), clay (0.87% and 2.26%), soil organic carbon (0.86% and 0.24%), sand (0.84% and 4.21%), and pH (0.82% and 5.42%). The RS covariates, including band 5 (B5), modified soil-adjusted vegetation index (MSAVI), difference vegetation index (DVI), band 2 (B2), carbonate rock index (CRI2), gypsum index (GI), and enhanced vegetation index (EVI), and terrain attributes, including topographic wetness index (TWI) and elevation (EL), and topographic position index (TPI), were the most important variables in modeling different soil properties. RF-OK showed the prediction and uncertainty maps related to high precision and low standard deviation in most study areas, which indicate low overfitting and overtraining in modeling processes. In general, the RF-OK model, with low cost and high accuracy, can be applicable to use for predicting different soil properties, as well as spatial information acquired from an effort to maps to managing agriculture in areas at different conditions. Finally, this method can be applied to other regions of similar properties and for similar purposes.

Biostratigraphy of Bajocian–Oxfordian strata based on dinoflagellate cysts and ammonites from the Dalichai Formation, northeastern Iran

The Bajocian–Oxfordian Dalichai Formation of the Binalud Mountains (northeastern Iran) consists of marls, marly limestones and limestones that were sampled and studied in detail for their palynomorph and ammonite contents. Palynological studies enabled differentiation of three marine biozones (Cribroperidinium crispum, Dichadogonyaulax sellwoodii, and Ctenidodinium continuum) within the lower interval of the formation. The palynofacies analysis shows a gradual sea-level rise during the depositional period of the rock unit, while terrestrial palynomorphs (spores and pollen grains) revealed a predominantly tropical climate for the time interval. Furthermore, a large number of ammonites were recovered from the formation, based on which 12 families, 22 genera, 30 species and 12 biozones (Zigzag, Aurigerus, Retrocostatum, Discus, Bullatus, Gracilis, Anceps, Coronatum, Athleta, Transversarium, Bifurcatus, and Bimammatum) were differentiated. When comparing the dinoflagellate cyst zones with the ammonite zones, the Dichadogonyaulax sellwoodii dinoflagellate cyst zone was correlated with the ammonite zones of Zigzag, Aurigerus, Retrocostatum, Discus, Bullatus, and Gracilis and the Ctenidodinium continuum dinocyst zone was correlated with the Gracilis and Anceps ammonite zones. The dinocyst and ammonite assemblages of the Binalud Mountains are similar to assemblages described from northern and northeastern Iran (Alborz and Koppeh-Dagh basins) as well as Northwest Europe. This suggests marine connections between these sedimentary basins during the Bajocian–Oxfordian. Consequently, the integrated dinocyst and ammonite zonation established here can be utilized also in other parts of the northern Tethyan Realm. The diachroneity of the upper boundary of the Dichadogonyaulax sellwoodii Zone between the Binalud Mountains and Northwest Europe is however revealed by comparison with the ammonite zones.

Genotyping of Mycobacterium tuberculosis complex isolated from humans and animals in northeastern Iran

The objective of this study was to genotype Mycobacterium tuberculosis complex isolated from humans and cattle in northern Iran. Over the course of one year, a total of 120 human and 21 cattle isolates were tested using region of difference (RD)-based polymerase chain reaction (PCR) and mycobacterial interspersed repetitive unites-variable number tandem repeats (MIRU-VNTR). In M. tuberculosis, out of 120 isolates investigated, the most common genotype detected was NEW-1 (53.3%), followed by CAS/ Delhi (24.1%), Haarlem (5%), Beijing (4.16%), Uganda I (4.16%), S (3.3%), Ural (0.83%), TUR (0.83%), Uganda II (0.83%), Lam (0.83%) and Cameroon (0.83%). The HGDI rate was 0.9981 and the clustering rate was 10.83. Of the isolates, QUB26 had the highest allele diversity (h: 0.76), while the loci Mtub29 and MIRU24 had the lowest (h: 0). In M. Bovis, out of 123 collected tissue samples, 21 (17%) grew on culture media. The HGDI rate was 0.71 and clustering rate was 85.7%. The locus ETRC had the highest allele diversity (h: 0.45). The findings of this study suggest that there is high genetic diversity among M. tuberculosis isolates in Khorasan Razavi Province, which is consistent with similar results from other studies in other provinces in Iran and neighboring countries. This indicates that the prevalent genotypes in this study are spreading in the Middle East region. Furthermore, considering that M. Bovis isolates were identified in two clusters, it seems that all of them have a common origin and are circulating among the livestock farms in the province.

The Effect of Analgesia with Ketamine, Morphine and Paracetamol for Burn Pain in North-Eastern Iran

Background: Pain is a common and challenging problem in burn patients. The severity of pain in these patients often requires multi drug therapy. On the other hand, with increasing the number and dosage of drugs, the complications increase, so finding an instruction that provides acceptable analgesia with minimal complications is necessary.&#x0D; Methods: Based on the dose and half-life, the initial dose for paracetamol was 15 mg/kg every 6 hours, this dose was reduced to 30% after three days of initiation of the treatment to prevent liver toxicity and was discontinued after one week. Morphine started with an initial dose of 0.01 mg/kg/h and for opioid-tolerant patients, the initial dose was 0.02 mg/kg/h. Morphine infusion dose raised by 30 percent every week. The continuous intravenous infusion of ketamine (0.15 mg/kg/hr) with continuous intravenous infusion of morphine was administered by a silicone pump.&#x0D; Results: The mean NRS was significantly reduced in the first visit after the intervention (three hours later) (8.5 ± 1.04 vs.3.9 ± 1.74; p &lt;0.001) and this decrease was observed in NRS in continuous observations (P&gt; 0.001). Pain reduction was independent of history of opioids use.&#x0D; Conclusion: Continuous infusion of ketamine, morphine and paracetamol showed an effective pain management program for burn patients.

The Entanglement of Philosophy, Politics and the Occult: The Hidden Secret of early Post-Avicennan Thought in the Islamic East

By the thirteenth century, philosophy, politics and occult science had become deeply entangled in the Persianate Islamic world. Two of the greatest luminaries in this intellectual milieu were Fakhr al-Dīn al-Rāzī (d.1210) and Shihāb al-Dīn Yaḥyā Ibn Ḥabash Ibn Amīrak al-Suhrawardī (d.1191/2), who at one point were fellow students of philosophy under a certain Majd al-Dīn al-Jīlī in Marāgha in northeastern Iran. Both subsequently sought royal patronage, the former travelling eastwards to Transoxania to secure the generosity of the Khwārazm-Shāhs, the latter travelling eastwards to the Levant to gain the intimate trust of Malik al-Ẓāhir, the son of the Ayyūbid sultan Ṣalāḥ al-Dīn—known in the West as Saladdin. Both composed works devoted to talismanic astral ritual. And crucially, both developed philosophical soteriologies coloured by their meditations on the “craft”—soteriologies with profound implications for the nature of political authority.

Geophysical sediment properties of a late Pleistocene loess–paleosol sequence, Chenarli, northeastern Iran

AbstractWe present stratigraphic, magnetic, diffuse reflectance spectrophotometric analyses, and chronologic data for the Chenarli loess–paleosol sequence in northeastern Iran. Eight loess units (LU) are identified, described, and constrained in time based on relative stratigraphy and luminescence dating from &gt;130 ± 9.1 ka to ~9.8 ± 0.7 ka. Our data indicate that pedogenic magnetite/maghemite formation gives rise to magnetic enhancement in modern soil and paleosols. The top of LU 7 is demarcated by the well-developed last interglacial soil in which magnetic depletion occurred. We infer that magnetic depletion in this paleosol was produced by reducing conditions in a seasonally waterlogged soil during a warm and wet phase within Marine Isotope Stage (MIS) 5e. Units LU 6 to 1 record several episodes of dust accumulation and soil formation during the last glacial and Holocene. Increased dust accumulation rates occurred during middle-late MIS 3 and lasted into the late MIS 2, with a peak during the last glacial maximum (LU 2). These findings could be applicable to understanding magnetic enhancement/dissolution mechanism in the loess–paleosol sequences in study area. We infer paleoenvironmental changes in northeastern Iran relative to northern Iran, Eurasia, and China.

Comparison of the Quality of Life of Physically Active and Inactive Grandmothers Caring and Non-caring for Grandchildren: A Cross-Sectional Study.

Nowadays, grandparents have a major role in taking care of their grandchildren. Also, caring for grandchildren is a common and normative experience for many Iranian grandparents. The present study aimed to compare the quality of life of physically active and inactive grandmothers caring and non-caring for grandchildren. This analytical cross-sectional study was conducted on 300 grandmothers at the age range of 50 to 70 years old, who lived in Bojnurd, northeastern Iran (2018). Data were collected using the questionnaires of 36-Item Short Form Health Survey (SF-36) and Baecke Physical Activity, and demographic information. The total scores of quality of life in caring physically active, physically inactive, non-caring physically active and non-caring physically inactive grandmothers were 76.95±6.33, 71.74±9.41, 75.56±5.9, and 56.06±11.23, respectively. There was a significant difference in the comparison of the quality of life score in caring grandmothers in two active and inactive groups (P<0.001). In addition, the quality of life score of non-caring grandmothers indicated a significant difference in physically active and inactive grandmothers (P<0.001). According to the results of this study, it seems that caring physically active grandmothers have higher quality of life. It can be suggested that the grandmothers who care for their grandchildren may improve their health and quality of life by incorporating the programs to increase physical activities in their daily life.

How does livestock graze management affect woodland soil health?

Soil is the fundamental component of each terrestrial ecosystem, so the consequences of land management regime on soil health and productivity should be evaluated. To this end, the long term effects of livestock grazing management on soil health were studied in three land management systems of north-eastern Iran, comprising unlimited grazing, managed grazing, and a rangeland where grazing was prohibited. First, properties including pH, EC, bulk density and contents of phosphorus, potassium and calcium in soils subject to the three grazing management regimes were compared. Then, seasonal variations of organic carbon, total nitrogen, microbial respiration (BR and SIR), carbon and nitrogen of microbial biomass (MBC and MBN), fungal biomass and AMF (Arbuscular mycorrhizal fungi) spore density were studied at the three sites. Several soil stoichiometric microbial indicators were also compared. Soil phosphorus contents were found to drastically decline (by around 40%) in response to long term unlimited grazing, while soil acidity and bulk density slightly increased under that grazing regime, in comparison with managed-grazing and grazing-excluded rangelands. Season and grazing management had significant impacts on all the studied variables. Although soil nitrogen content increased, presumably due to livestock urine, organic carbon content and all the soil microbial variables declined in grazed sites, which were also the ones with lower plant cover. A higher AFM spore density was observed around the rhizosphere of Artemisia aucheri, the most frequent plant, in lands with unlimited grazing. Based on these results, managed grazing is strongly recommended rather than any kind of unlimited or continuous grazing.

The Epipalaeolithic–Neolithic transition in north-eastern Iran: zooarchaeological evidence from the southern shores of the Caspian Sea

In Iran, studies of the transition from hunting and gathering to farming and herding have focused on early developments in the Zagros Mountains. Here, the authors present new zooarchaeological data from Hotu Cave, which throw light on sheep/goat management and domestication during the Epipalaeolithic–Neolithic transition on the southern shores of the Caspian Sea. Gazelle dominate the Epipalaeolithic levels, while sheep/goat are most abundant in the Neolithic. Large quantities of perinatal sheep/goat remains from the Early Neolithic indicate that these animals were actively managed in or close to the cave. The results point towards the importance in Iran of local developments beyond the Zagros, adding nuance to the general model of domestication in South-west Asia.

Generalized Anxiety Disorder, Alexithymia, and Defense Mechanisms Among Medical Students of Northeastern Iran

Background: Defense mechanisms are essential to personality and behavior that help individuals deal with stress. These mechanisms might act in different ways, rendering medical students caring physicians or egoistic individuals, and thus, a good understanding of defense mechanisms can contribute to the efforts made to improve the psychological well-being of medical students. Objectives: We studied the prevalence of generalized anxiety disorder (GAD) and alexithymia as determinants of psychological well-being and the mechanisms by which medical students might cope with stress and anxiety. Methods: The present cross-sectional study was conducted on 232 medical students, 126 (60%) females and 96 (40%) males, in northeast Iran. Data were collected through GAD-7, the Farsi version of the Toronto Alexithymia Scale (FTAS-20), and the Defense Styles Questionnaire (DSQ-40). Statistical analysis was performed with IBM SPSS 22.0. Pearson's chi-square test, bivariate correlations, and multiple linear regression analysis were used to identify associations between GAD, alexithymia, and defense mechanisms. Results: A total of 87 (37.5%) participants showed moderate to severe anxiety. Alexithymia was detected in 49 (21%) participants. Mature defense mechanisms had the highest prevalence among participants (56.5%), while immature mechanisms had the least (23.3%). A significant positive correlation was noted between GAD and alexithymia. Also, GAD was positively correlated with immature and neurotic defense mechanisms (P &lt; 0.05). A negative correlation was found between mature defense mechanisms and GAD (P &lt; 0.001). Suppression and humor (mature mechanisms) were the negative predictors of GAD. Reaction formation, somatization, autistic fantasy, splitting, passive aggression, displacement, and pseudo-altruism (an immature and neurotic mechanism) were the positive predictors of GAD. Conclusions: The statistically significant correlations found among GAD, alexithymia, and defense mechanisms suggest that a good understanding of these conditions and mechanisms can contribute to alleviating anxiety among medical students and improving their psychological well-being.

Prevalence of psychiatric disorders in the aging population in the northeastern of Iran

BackgroundThe prevalence of psychiatric disorders by demographic characteristics in elderly people is poorly understood, at least in the northwest of Iran. We aimed to estimate the prevalence of various psychiatric disorders in the elderly population in East Azerbaijan Province, Tabriz. A total of 1000 aging people were randomly selected from the general population. Data were collected using valid structured instruments and face-to-face interviews by trained psychologists. The Structured Clinical Interview for DSM-IV-TR (SCID-IV) and Abbreviated Mental Test Questionnaire were used. Chi-square (χ2) test was used for categorized variables, and an independent T-test was carried out for quantitative variables.ResultsOverall, 38.5% of the elderly had at least one mental disorder (47.2% women, 27.3% men). The prevalence of major depressive disorder (MDD) and any anxiety disorders was 16.6% (22.4% female and 9.3% male) and 16.7% (23.1% female and 8.6% male), respectively. Likewise, the overall prevalence of any depressive symptoms, post-traumatic stress disorder (PTSD), general anxiety disorder (GAD), obsessive-compulsive disorder (OCD), and panic disorders were 21.6%, 7%, 5.3%, and 5.9%, respectively. The prevalence of any mental disorder in the first, second, and third quartiles of the socio-economic level was 54.3%, 37%, and 17.8%, respectively. The prevalence of any mental disorders among the marginalized and the non-marginalized population is 55.3 and 31.5%, respectively.ConclusionsWe found 38.5% (47.2% women, 27.3% men) of the elderly people had any mental disorders, and 21.6% of them had any depressive disorders. The prevalence of mental disorders in elders was almost like adults and middle-aged people in this study. However, the prevalence of mental disorders was higher than in marginalized population and low socio-economic status.

Type 2 diabetes mellitus and In-hospital Major Adverse Cardiac and Cerebrovascular Events (MACCEs) and postoperative complications among patients undergoing on-pump isolated coronary artery bypass surgery in Northeastern Iran

BackgroundDiabetes Mellitus (DM) is a rapidly growing disorder worldwide, especially in the Middle East. A higher incidence of coronary artery diseases requiring coronary artery bypass graft (CABG) surgery has been reported in patients with diabetes. We assessed the association between type 2 diabetes mellitus (T2DM) and in-hospital major adverse cardiac and cerebrovascular events (MACCEs) and postoperative complications among patients who underwent on-pump isolated CABG.MethodsIn this retrospective cohort study, we used the data registered for CABG patients from two heart centers in the Golestan province (North of Iran) between 2007 and 2016. The study population included 1956 patients divided into two groups: 1062 non-diabetic patients and 894 patients with diabetes (fasting plasma glucose ≥126 mg/dl or using antidiabetic medications). The study outcome was in-hospital MACCEs, a composite outcome of myocardial infarction (MI), stroke and cardiovascular death, and postoperative complications, including postoperative arrhythmia, acute atrial fibrillation (AF), major bleeding (defined as reoperation due to bleeding), and acute kidney injury (AKI).ResultsDuring the 10-year study period, 1956 adult patients with a mean (SD) age of 59.0 (9.60) years were included. After adjustment for age, gender, ethnicity, obesity, opium consumption, and smoking, diabetes was a predictor of postoperative arrhythmia (AOR 1.30, 95% CI 1.08–1.57; P = 0.006). While it was not a predictor of in-hospital MACCEs (AOR 1.35, 95% CI 0.86, 2.11; P = 0.188), AF (AOR 0.85, 95% CI 0.60–1.19; P = 0.340), major bleeding (AOR 0.80, 95% CI 0.50, 1.30; P = 0.636) or AKI (AOR 1.29, 95% CI 0.42, 3.96; P 0.656) after CABG surgery.ConclusionFindings indicated that diabetes increased the risk of postoperative arrhythmia by 30%. However, we found similar in-hospital MACCEs, acute AF, major bleeding, and AKI following CABG surgery in both diabetic and non-diabetic patients.

A comprehensive evaluation of the satellite precipitation products across Iran

Study regionIran Study focusThis study evaluated three satellite precipitation products, including PERSIANN-CCS and TRMM-3B42RT V7 (near real-time satellites) and CMOROH (post real-time satellite), on hourly, daily, monthly, and annual time scales in 52 synoptic stations over Iran. This study aims to evaluate the accuracy of satellite- precipitation products over different return periods and durations as well as their performance in different climates and altitudes. The Pearson’s correlation coefficient (Rp), Relative Root Mean Square Error (RRMSE), and Relative Bias (RBias) as well as three probability indices including Probability of Detection (POD), False Alarm Ratio (FAR), and Critical Success Index (CSI) were applied to evaluate the accuracy of these products. In addition, the sub-daily IDF curves (6, 12, 18, and 24 h) were derived to evaluate the studied satellites precipitation for 5, 10-, 20-, 50-, and 100-year return periods. New hydrological insights for the regionThe results showed that the modification method could significantly improve all satellites' performance in precipitation estimation. The IDF curves derived from the CMORPH satellite as post real-time satellite precipitation product, showed the highest accuracy compared to synoptic stations. The TRMM and CMORPH underestimated precipitation by 56% and 8%, respectively, while PERSIANN-CCS overestimated precipitation by 143%. However, PERSIANN-CCS performed better in detecting the occurrence and non-occurrence of precipitation than other products. For Northeastern and Southwestern Iran, all products showed the same performance in accurately detecting occurrence and precipitation.

Ethical challenges in caring for healthy older adults: Qualitative perspectives.

Healthy aging is one of the essential aspects of a health promotion program in the elderly. Exploring ethical challenges in healthy elderly care from the perspective of nurses, older adults, and families in the Iranian context. This qualitative study was conducted using a content analysis approach in 4 health centers in northeastern Iran from 2017 to 2019. Semi-structured interviews, observation, review of elderly files, and focus groups were used to collect data. The ethics committee of the university approved this study in Iran. This study adhered to the principles of the Helsinki Declaration. Ethical principles autonomy, confidentiality, and anonymity were considered for the participants. Participants were informed about the purpose of the study and submitted written informed consent regarding their participation. The central theme was: An unfair approach to caring for healthy older adults. The three categories were as follows: Forgotten human care, disrespect, and lack of a meaningful and trustworthy relationship. The 14 subcategories highlighted the ethical challenges of healthy aging care in health centers. The findings showed that due to nurses' unfamiliarity with the concept of healthy aging, older adults are discriminated against in care centers. Creating a standard care program for healthy older adults ensures that ethical principles are followed for these clients. Various individual and organizational factors lead to an unfair approach to caring for healthy elderly in health centers. The following factors can help improve the care of healthy aging and reduce ethical challenges in this area: Introducing nurses to the concept of healthy old age and its dimensions, creating a community-based approach in health centers, prioritizing health issues over health issues, Involvement of families and older adults in needs assessment-goal setting-implementation and evaluation of health services, and design of home visit programs to provide services to healthy elderly.