Effectiveness of an Informal Home Care Support Intervention Program to Reduce Loneliness and Improve Quality of Life among Lonely Community-Dwelling Older Adults: A Feasibility Study.

Background: Establishing cost-effective informal care services for lonely older adults living at home in developing countries can be an innovative approach for improving their well-being. This study investigated the effectiveness of an informal home care support intervention program (HoSIP) reducing the loneliness and improving quality of life of lonely community-dwelling older adults. Methods: This quasi-experimental pre-post study employed a non-randomized control group design with a 12-week intervention period and three follow-up points at the end of the HoSIP. Questionnaires were used to measure feelings of loneliness (20-item UCLA Loneliness Scale), quality of life (Control, Autonomy, Self-Realization and Pleasure Scale), general health (12-item General Health Questionnaire), social network (six-item Lubben Social Network Scale), social support (12-item Multidimensional Scale of Perceived Social Support), and self-care ability (17-item Self-care Ability Scale for the Elderly). Repeated-measures analysis of variance was used to gauge the effect of the intervention program over time and in comparison to the control group. Data analyses were performed using the IBM SPSS Statistics software (IBM Corp., USA). Results: We found a significant relationship between the outcome variables, including feelings of loneliness (P<0.001) and quality of life (P<0.001), at different stages of measurement. Despite the positive feasibility results, the implementation of the HoSIP faced challenges due to a lack of facilities (e.g., place restriction for holding educational classes, educational facilities like computers, video projector, and whiteboard at daycare center) and the absence of supporting organizations. Conclusion: Utilizing the existing capabilities of older adults to provide online and face-to-face care services can be a cost-effective way to improve their quality of life and reduce loneliness. The process of facilitating such informal care services for lonely older adults should be managed by either governmental or non-governmental organizations to reduce the rate of social isolation among this vulnerable population.

Incidence and treatment outcomes of pulmonary tuberculosis in Islamic Republic of Iran.

Background: Pulmonary tuberculosis is the most common type of tuberculosis and few studies have investigated the incidence and treatment outcome of smear-positive pulmonary tuberculosis in Golestan Province, Islamic Republic of Iran. Aims: To estimate the cumulative incidence and trends in incidence of smear-positive pulmonary tuberculosis in Golestan Province between 2014 and 2019, and to determine the treatment outcomes. Methods: All smear-positive pulmonary tuberculosis cases between 2014 and 2019 recorded in the tuberculosis registry in Golestan Province, Islamic Republic of Iran, were included in this study. The yearly incidence and cumulative incidence were calculated, and differences by sex and residence were examined. Treatment outcomes classified as success and failure were determined. The Mann-Kendall test was used to assess the significance of the trend in incidence. Results: A total of 2047 smear-positive pulmonary tuberculosis cases were evaluated. The cumulative incidence was 18.52 [95% confidence intervals (CI): 17.72-19.33] per 100 000 population during 2014-2019. The incidence of smear-positive pulmonary tuberculosis declined from 23.84 (95% CI: 21.57-26.11) per 100 000 population in 2014 to 15.02 (95% CI: 13.29- 16.75) in 2019. Incidence rate was higher among men and among rural residents. Most patients (85.34%) were cured, 2.05% completed their treatment, 1.17% were lost to follow-up, 4.40% had treatment failure, and 6.45% died. Conclusion: The incidence of pulmonary tuberculosis in Golestan Province, Islamic Republic of Iran, declined during the period of study. However, the proportion of patients who were cured decreased and the proportion who died increased. Interventions are needed to improve the treatment success rate for pulmonary tuberculosis in the province.

3-D Transducer Mounted Shear Wave Absolute Vibro-Elastography: Proof of Concept.

Quantitative tissue stiffness characterization using ultrasound (US) has been shown to improve prostate cancer (PCa) detection in multiple studies. Shear wave absolute vibro-elastography (SWAVE) allows quantitative and volumetric assessment of tissue stiffness using external multifrequency excitation. This article presents a proof of concept of a first-of-a-kind 3-D hand-operated endorectal SWAVE system designed to be used during systematic prostate biopsy. The system is developed with a clinical US machine, requiring only an external exciter that can be mounted directly to the transducer. Subsector acquisition of radio frequency (RF) data allows imaging of shear waves with a high effective frame rate (up to 250 Hz). The system was characterized using eight different quality assurance phantoms. Due to the invasive nature of prostate imaging, at this early stage of development, validation of in vivo human tissue was instead carried out by intercostally scanning the livers of n = 7 healthy volunteers. The results are compared with 3-D magnetic resonance elastography (MRE) and an existing 3-D SWAVE system with a matrix array transducer (M-SWAVE). High correlations were found with MRE (99% in phantoms, 94% in liver data) and with M-SWAVE (99% in phantoms, 98% in liver data).

Household food insecurity and associated factors in the Northeast of Iran: a cross-sectional study : Household food security in Northern Iran.

BACKGROUND: Food Insecurity (FI) is a global health concern. For the first time, this study evaluated households' food insecurity and factors related to it in Golestan province, North of Iran. METHODS: This cross-sectional study was conducted on 5129 randomly selected households in the Golestan Province in 2016. Sociodemographic characteristics, including age, ethnicity, household size, education level, and occupation status, were collected via interview. The prevalence and severity of food insecurity were identified by the Household Food Insecurity Access Scale (HFIAS), whose scores are between 0 and 27, with larger values indicating more severe food insecurity. The prevalence of food insecurity based on the geographical area was presented using GIS. RESULTS: Out of 5129 households, 2216 (43.21%) had food security, and 2913 (56.79%) households had food insecurity, with a Mean ± SD HFIAS score of 4.86 ± 5.95. Out of 2913 households with FI, 1526 (52.39%), 956 (32.82%), and 431 (14.79%) had mild, moderate, and severe food insecurity, respectively. Among 14 regions of the province, three regions had the most cases of food insecurity. Food insecurity (moderate or severe) was significantly associated with mothers as the household head (adjusted OR = 1.67, 95% CI: 1.03-2.70) and lower education level of the household head. CONCLUSION: The prevalence of household food insecurity in the Golestan Province is higher than the national average. Factors such as literacy, employment status, and gender of the household head can be significantly associated with food insecurity.

Challenges in the implementation of an electronic referral system: A qualitative study in the Iranian context.

Referral chain reduces patient costs and results in more efficient use of workforce and equipment. Despite the implementation of the Family Physician Programme in Iran, the referral system does not function as intended. Therefore, this study was conducted to explain the challenges in the implementation of an electronic referral system in Iran. This qualitative study was performed in Golestan province in northern Iran. The participants were 46 family physicians, specialist physicians, healthcare managers, experts, and patients who were selected through purposive sampling. Data were collected using in-depth individual interviews and were analysed using content analysis. Implementation of the electronic referral system faces management challenges (planning, organisation, motivation, control), administrative challenges (scheduling, patient load and waiting time, visit and diagnosis, feedback), and educational, policy, sociocultural, technological, and economic challenges. Policymakers can adopt appropriate strategies to improve the quantity and quality of their electronic referral system according to the challenges identified herein.

RT-LAMP in SARS-CoV-2 detection: point to improve primer designing and decrease molecular diagnosis pitfalls.

BACKGROUND: Due to the high transmission rate of SARS-CoV-2, diagnostic tests have become tools for identifying patients. The key points were the virus genomes survey to design RT-LAMP primers; comparing the sensitivity and specificity of RT-LAMP and RT-qPCR; and determining the relationship among clinical symptoms, CT scan, RT-qPCR, and RT-LAMP results. METHODS: This cohort study included 444 symptomatic patients. The specificity and sensitivity of RT-LAMP were assayed. The five statistical models, simultaneously, by RapidMiner to find the best method for detecting the virus were done through the correlation between the clinical symptoms, RT-LAMP, RT-qPCR, and CT scan results. The chi-square test by SPSS 26.0 was used to calculate kappa agreement. RESULTS: The virus genome was detected in all the positive samples (198) by RT-qPCR and RT-LAMP. In addition, 246 samples were negative by RT-qPCR, while 88 were positive by RT-LAMP. Data mining analysis indicated that there were most associations between the RT-LAMP and CT scan data compared to RT-qPCR and CT scan data. CONCLUSIONS: RT-LAMP could detect SARS-CoV-2 with great simplicity, speed, and cheapness. Therefore, it is logical to screen, a large number of patients by RT-LAMP, and then RT-qPCR can be used on the limited samples.

Design, implementation and evaluation of informal home care support intervention program for lonely older adults in the community: Protocol for a feasibility study.

BACKGROUND: Providing lonely older adults with informal home care services is important to improving their health and quality of life. The study aims to evaluate the feasibility of design, implementation and evaluation of an informal home care support intervention program (HoSIP) for community-dwelling lonely older adults in Gorgan, Iran. METHOD/DESIGN: This feasibility study is a mixed-method with a concurrent nested design. Lonely older adults will be enrolled as the HoSIP intervention group and will receive 12-weeks of informal home care service by peer supporters. The purpose of this feasibility study is to determine the recruitment capability and resulting sample characteristics, data collection procedure and outcome measures, the acceptability and suitability of the intervention and study procedures, the resource and ability to manage the study and intervention, and preliminary evaluation of participant response to intervention. Primary outcomes including participant feelings of loneliness, quality of life, general health, social network, social support, and self-care ability, will be assessed at baseline and post-intervention for the intervention and control groups. Semi-structured interviews will be conducted immediately after the intervention using content qualitative approach to describe participants' experiences with HoSIP. DISCUSSION: Through this study we will examine the feasibility of delivering informal home care services to community-dwelling lonely older adults in a developing country through employing a concurrent nested mixed-method design. TRIAL REGISTRATION: IRCT20190503043455N.

Model-Based Quantitative Elasticity Reconstruction Using ADMM.

We introduce two model-based iterative methods to obtain shear modulus images of tissue using magnetic resonance elastography. The first method jointly finds the displacement field that best fits tissue displacement data and the corresponding shear modulus. The displacement satisfies a viscoelastic wave equation constraint, discretized using the finite element method. Sparsifying regularization terms in both shear modulus and displacement are used in the cost function minimized for the best fit. The second method extends the first method for multifrequency tissue displacement data. The formulated problems are bi-convex. Their solution can be obtained iteratively by using the alternating direction method of multipliers. Sparsifying regularizations and the wave equation constraint filter out sensor noise and compressional waves. Our methods do not require bandpass filtering as a preprocessing step and converge fast irrespective of the initialization. We evaluate our new methods in multiple in silico and phantom experiments, with comparisons with existing methods, and we show improvements in contrast to noise and signal-to-noise ratios. Results from an in vivo liver imaging study show elastograms with mean elasticity comparable to other values reported in the literature.

Tractor Ambulance: An Initiative of Emergency Medical Services Response to the Flood of Golestan, Iran in 2019.

Heavy rains in March 2019 led to severe floods in large parts of Iran, with severe financial and physical casualties (in the Golestan province, 11 districts were trapped in water). An increase in the EMS missions while serving a big portion of the needed population was a big problem for the health system during the flood; Therefore, a new solution was needed to overcome this problem. Using a farm tractor for transporting the patients and injured people was the first relief experience ever documented in the whole country. In the present report, despite the limitations and challenges, the tractor has been shown to be a proper and effective disaster relief vehicle. This report could help other similar countries face disasters, especially floods.

A multiparametric volumetric quantitative ultrasound imaging technique for soft tissue characterization.

Quantitative ultrasound (QUS) offers a non-invasive and objective way to quantify tissue health. We recently presented a spatially adaptive regularization method for reconstruction of a single QUS parameter, limited to a two dimensional region. That proof-of-concept study showed that regularization using homogeneity prior improves the fundamental precision-resolution trade-off in QUS estimation. Based on the weighted regularization scheme, we now present a multiparametric 3D weighted QUS (3D QUS) method, involving the reconstruction of three QUS parameters: attenuation coefficient estimate (ACE), integrated backscatter coefficient (IBC) and effective scatterer diameter (ESD). With the phantom studies, we demonstrate that our proposed method accurately reconstructs QUS parameters, resulting in high reconstruction contrast and therefore improved diagnostic utility. Additionally, the proposed method offers the ability to analyze the spatial distribution of QUS parameters in 3D, which allows for superior tissue characterization. We apply a three-dimensional total variation regularization method for the volumetric QUS reconstruction. The 3D regularization involving N planes results in a high QUS estimation precision, with an improvement of standard deviation over the theoretical 1/N rate achievable by compounding N independent realizations. In the in vivo liver study, we demonstrate the advantage of adopting a multiparametric approach over the single parametric counterpart, where a simple quadratic discriminant classifier using feature combination of three QUS parameters was able to attain a perfect classification performance to distinguish between normal and fatty liver cases.

Epidemiological and clinical characteristics of the COVID-19 epidemic and associated factors for mortality in Golestan province, Iran: a retrospective cohort study.

BACKGROUND: We aimed to further clarify the epidemiological and clinical characteristics of 2019-nCoV pneumonia and risk factors associated for mortality. METHODS: In this study, we included inpatient with acute respiratory distress syndrome at Golestan Hospitals who had been discharged or had died in 2020. Epidemiological, and clinical data were extracted from electronic medical records and compared between recovered and died cases. We used multiple logistic regression methods to explore the risk factors associated with in-hospital death. RESULTS: Overall 2,835 acute respiratory distress syndrome patients were included in this study, and 874 (30.83%) were positive for 2019-nCoV. Five hundred and sixty-three patients (19.86%) died, 1,687 patients (59.51%) were recovered. Of the total deaths, only 288 (10.15%) were attributed to COVID-19. The most common symptoms at onset of illness were respiratory distress [1,795 (63.32%)], fever [1,601 (56.47%)], dry cough [1,595 (56.26%)], sore throat [445 (15.70%)], and myalgia [342 (12.06%)]. One thousand and twelve (35.7%) had 1 or more coexisting medical conditions. In multiple logistic regression analysis, risk factors associated with the death included older age [OR (Odds Ratio) = 1.03; 95% CI; 1.02-1.04], blood oxygen level (SPO2 < 93%) (OR = 2.44; 95% CI; 1.79-3.31), comorbidities (OR = 2.15; 95% CI; 1.62-2.84), respiratory distress (OR = 1.74; 95% CI; 1.28-2.37), and headache (OR = 0.44 95% CI; 0.21-0.92). CONCLUSIONS: The 2019-nCoV infection caused collections of severe respiratory illness and was associated to a high ratio of hospitalization in ICU and high mortality. Older age and comorbidities were associated with more risk of death among patients with 2019-nCoV.

Three-Dimensional Multi-Frequency Shear Wave Absolute Vibro-Elastography (3D S-WAVE) With a Matrix Array Transducer: Implementation and Preliminary In Vivo Study of the Liver.

Magnetic resonance elastography (MRE) is commonly regarded as the imaging-based gold-standard for liver fibrosis staging, comparable to biopsy. While ultrasound-based elastography methods for liver fibrosis staging have been developed, they are confined to a 1D or a 2D region of interest and to a limited depth. 3D Shear Wave Absolute Vibro-Elastography (S-WAVE) is a steady-state, external excitation, volumetric elastography technique that is similar to MRE, but has the additional advantage of multi-frequency excitation. We present a novel ultrasound matrix array implementation of S-WAVE that takes advantage of 3D imaging. We use a matrix array transducer to sample axial multi-frequency steady-state tissue motion over a volume, using a Color Power Angiography sequence. Tissue motion with the frequency components {40,50,60} and {45,55,65} Hz are acquired over a (90° lateral) × (40° elevational) × (16 cm depth) sector with an acquisition time of 12 seconds. We compute the elasticity map in 3D using local spatial frequency estimation. We characterize this new approach in tissue phantoms against measurements obtained with transient elastography and MRE. Six healthy volunteers and eight patients with chronic liver disease were imaged. Their MRE and S-WAVE volumes were aligned using T1 to B-mode registration for direct comparison in common regions of interest. S-WAVE and MRE results are correlated with R2 = 0.92, while MRE and TE results are correlated with R2 = 0.71. Our findings show that S-WAVE with matrix array has the potential to deliver a similar assessment of liver fibrosis as MRE in a more accessible, inexpensive way, to a broader set of patients.

3D Global Time-Delay Estimation for Shear-Wave Absolute Vibro-Elastography of the Placenta.

The placenta is a vital organ for growth and development of the fetus. Shear Wave Absolute Vibro-Elastography (SWAVE) is a new elastography technique proposed to detect placenta disorders. Elastography involves applying a force on the tissue and measuring the resulting tissue deformation. All types of compression cause the tissue to expand in three directions given the biological tissues are nearly incompressible. Hence, 3D displacement estimation should lead to the most accurate elasticity reconstruction compared to the traditional 1D methods. Previous studies estimated 3D displacements over ultrasound volumes mostly for quasi-static compression to generate strain images. However, accurate displacement tracking of dynamic motion continues to be a challenge. In this work, a novel volumetric regularized algorithm, 3D GLobal Ultrasound Elastography (GLUE3D), is presented to estimate the 3D displacement over a volume of ultrasound data, following by a 3D Young's modulus reconstruction. The proposed method outperforms the previous 2D method over a volume and is compared with a 3D technique using phantom data for which the elasticity are provided by the values from magnetic resonance elastography on the same phantom and also the manufacturer reference numbers. We then present Young's modulus reconstruction results obtained from clinical data of placenta which shows more uniform elasticity maps compared to the traditional 1D displacement measurements over a volume of ultrasound data. Furthermore, the dependency of the elasticity values to the frequency is investigated in this study.

10-Year Trends in Dietary Intakes in the High- and Low-Risk Areas for Esophageal Cancer: A Population-Based Ecological Study in Northern Iran.

BACKGROUND We assessed dietary intakes in the high- and low-risk areas for esophageal cancer (EC) in Golestan province, Northern Iran. METHODS Considering the EC rates, Golestan province was divided into high- and low-risk regions. Data on households' food consumption were obtained from the Statistical Center of Iran. We used multivariable logistic regression to assess the relationships between consumption of main food and EC risk. Adjusted odds ratios (aOR) were calculated. Joint point program was used for time trend analysis and average annual percent changes (AAPC) were reported. RESULTS Overall, 11910 households were recruited during 2006-2015. 4710 (39.5%) households were enrolled from the high-risk region. There were significant positive relationships between high consumption of sweets (aOR = 1.62; 95% CI: 1.24-2.10), oil/fat (aOR = 1.36; 95% CI: 1.04-1.79), and red meat (aOR = 1.33; 95% CI: 1.07-1.65) with EC risk. We found significant negative relationships between high consumption of dairy products (aOR = 0.62; 95% CI: 0.46-0.82), vegetables (aOR = 0.66; 95% CI: 0.50-0.87) and fruit (aOR = 0.72; 95% CI: 0.55-0.95) with the risk of EC. Time trend analysis showed a significant increasing trend in the proportions of households with low consumption of vegetables (AAPC = 4.71, p = 0.01) and dairy products (AAPC = 5.26, p = 0.02) in the low-risk region for EC. CONCLUSION Dietary intakes may be important etiological factors for EC in Northern Iran. Further studies are warranted to assess the role of dietary factors in this high-risk population.

Vitamin D decreases CD40L gene expression in ulcerative colitis patients: A randomized, double-blinded, placebo-controlled trial.

BACKGROUND/AIMS: The interaction of CD40 ligand (CD40L) and CD40 triggers the induction of pro-inflammatory cytokines. It has been proposed that vitamin D deficiency might be an important factor, which causes or aggregates the autoimmune situations. The aim of the present study was to assess the effect of vitamin D on CD40L gene expression in patients with ulcerative colitis (UC). MATERIALS AND METHODS: Ninety mild-to-moderate UC patients were randomized to receive a single injection of 7.5 mg cholecalciferol or 1 mL normal saline. At baseline and 90 days following the intervention, RNA samples from whole blood were obtained. Fold changes in CD40L mRNA expression were determined for each patient using the 2-ΔΔCq method. The data were analyzed. RESULTS: The serum levels of vitamin D and calcium increased only in the vitamin D group (p<0.05). Relative to baseline values, the CD40L gene expression fold change was significantly lower in the vitamin D group compared with the placebo group (median±interquartile range: 0.34±0.30 vs 0.43±1.20, respectively, p=0.016). CONCLUSION: The results of this study showed that vitamin D administration in mild-to-moderate UC patients led to the downregulation of the CD40L gene, which is an essential part of inflammatory pathways.

Vitamin D Increases CTLA-4 Gene Expression in Patients with Mild to Moderate Ulcerative Colitis.

BACKGROUND Ulcerative colitis (UC) is a chronic inflammatory disorder of the large intestine. Cytotoxic T-lymphocyte-associated protein 4 (CTLA-4) is a member of the immunoglobulin superfamily, which binds B7-1 and B7-2 on APCs (antigen-presenting cells), and induces APCs to produce an inhibitory signal to T cells. The aim of this study was to investigate the effect of vitamin D on CTLA-4 gene expression in whole blood samples of patients with UC. METHODS 90 patients with mild to moderate UC were randomized to receive either a single injection of 7.5 mg vitamin D3 or 1 mL normal saline. 90 days following the intervention fold changes in CTLA-4 mRNA expression were determined and statistical comparisons between the two groups were performed. RESULTS Serum vitamin D increased significantly only in the vitamin D group. CTLA-4 fold changes were significantly higher in the vitamin D group compared with the placebo group (median ± IQR: 1.21 ± 2.3 vs. 1.00 ± 1.5, respectively; p = 0.007). CONCLUSION The results of this study revealed that vitamin D administration in patients with UC enhances the CTLA-4 gene expression.

An Exploratory Study of Units of Reporting Opium Usein Iran: Implications for Epidemiologic Studies.

BACKGROUND: Measuring the amount of opium use is a challenge in epidemiologic studies. Self-report of amount of opium use at each consumption, widely used in the literature, usually fails to provide a good estimate. The purpose of this study is to systematically study the perceived weight units of reported opium use in Iran, and compare them to the standardized units of weight measurement. METHODS: An exploratory descriptive study was conducted in six major cities of Iran. Study participants were interviewed and asked to use a Play-Doh-like material to demonstrate the amount of opium they use. To obtain an estimate of the weight of the material used, we multiplied the volume by the density of the opium product. We experimentally determined the density of the commonly used opium products. We used medians and inter-quartile ranges (IQRs) to report the typical amount of each unit. RESULTS: A total of 108 individuals participated in this study. The most frequently reported unit was "gram"; the median perceived weight for one gram (g) of opium was 0.24 (IQR: 0.16) g. The second most commonly used unit was nokhod with a median of 0.16 (IQR: 0.16) g, followed by mesghaal and hab/habeh, which were 1.28 (IQR: 0.81) and 0.16 (IQR: 0.16) g, respectively. The median perceived weight of mesghaal and gram in the studied cities was less than the expected standardized values. CONCLUSION: In conclusion, the reported amount of opium use is highly inaccurate and unreliable, and is mainly subject to underestimation.

Completeness and Accuracy of Death Registry Data in Golestan, Iran.

BACKGROUND: We aimed to evaluate completeness and accuracy of the Golestan Death Registry (GDR) to identify cancer-related causes of death (CCoD). METHODS: The GDR data (2004-2015) were compared with cancer data collected from clinical/pathological sources (the considered gold standard) by the Golestan Population-Based Cancer Registry (GPCR). Using a linkage method, matched cases, including subjects with CCoD and those with ill-defined cause of death (ICoD) (garbage codes), were identified and entered into the final analysis as study subjects. The completeness (percentage of study subjects with CCoD) and accuracy (number of subjects with correct CoD from the total number of study subjects) of the GDR were calculated. RESULTS: In total, 3,766 matched cases were enrolled. Overall, the completeness and accuracy of the GDR for identifying CCoD were 92.7% and 53.2%, respectively. There were variations by cancer site and age group, with completeness and accuracy highest for brain cancer (96.3%) and leukaemia (79.8%) while the lowest accuracy was observed for colorectal cancer (29.9%). The completeness and accuracy of GDR was higher in patients aged under 60 years (95.7% and 53.6%, respectively). We also found higher completeness (93.7%) and accuracy (55.8%) in residents of rural areas. CONCLUSION: Linkage of death registry data with cancer registry data can be a significant resource for evaluating quality of the death registry data. Our findings suggested that completeness of the GDR for identifying CCoD is reasonable, but accuracy is relatively low. Access to clinical and pathological data from other sources and enhanced training of death certifiers can improve the present situation.

Effect of Motivational Interviewing on Weight Efficacy Lifestyle among Women with Overweight and Obesity: A Randomized Controlled Trial.

Obesity and overweight have become increasingly a major public health problem across the world. This study aimed at exploring the effects of motivational interviewing on weight efficacy lifestyle among women with obesity and overweight. A single-blind randomized clinical trial study was conducted on 100 overweight and obese women who attended a nutrition clinic. The samples were selected based on the clinical records and assigned into two groups, namely motivational interviewing arm (50 samples) and nutrition education arm (50 samples). Data were collected using a standard validated questionnaire entitled "weight efficacy lifestyle". The intervention was designed according to five motivation sessions and four nutrition education programs, such that the participants of the nutrition education arm were also provided with the nutrition pamphlets related to weight control. Data were finally analyzed using the SPSS statistical software by performing the independent t-test, chi-square, LSD and repeated measures ANOVA tests. P<0.05 were considered statistically significant. The mean age of women was 39.9±9.1 and 36.3±8.9 years in the control and motivational interviewing arms, respectively. Compared with the control group, the score of the motivational interviewing group was statistically significant in terms of weight efficacy lifestyle P=0.0001) and all subscales including social pressure (P=0.0001), physical discomfort (P=0.005), food accessibility (P=0.0001), positive and entertainment activities (P=0.0001), as well as negative emotions (P=0.003). Motivational interviewing appeared to be effective in increasing weight efficacy lifestyle among women with overweight and obesity. TRIAL REGISTRATION NUMBER: IRCT2014051817736N1.

A Comparison of Finite Element-Based Inversion Algorithms, Local Frequency Estimation, and Direct Inversion Approach Used in MRE.

In quantitative elastography, maps of the mechanical properties of soft tissue, or elastograms, are calculated from the measured displacement data by solving an inverse problem. The model assumptions have a significant effect on elastograms. Motivated by the high sensitivity of imaging results to the model assumptions for in vivo magnetic resonance elastography of the prostate, we compared elastograms obtained with four different methods. Two finite-element method (FEM)-based methods developed by our group were compared with two other commonly used methods, local frequency estimator (LFE) and curl-based direct inversion (c-DI). All the methods assume a linear isotropic elastic model, but the methods vary in their assumptions, such as local homogeneity or incompressibility, and in the specific approach used. We report results using simulations, phantom, and ex vivo and in vivo data. The simulation and phantom studies show, for regions with an inclusion, that the contrast to noise ratio (CNR) for the FEM methods is about three to five times higher than the CNR for the LFE and c-DI and the rms error is about half. The LFE method produces very smooth results (i.e., low CNR) and is fast. c-DI is faster than the FEM methods but it is only accurate in areas where elasticity variations are small. The artifacts resulting from the homogeneity assumption in c-DI is detrimental in regions with large variations. The ex vivo and in vivo results also show similar trends as the simulation and phantom studies. The c-FEM method is more sensitive to noise compared with the mixed-FEM due to higher orders derivatives. This is especially evident at lower frequencies, where the wave curvature is smaller and it is more prone to such error, causing a discrepancy in the absolute values between the mixed-FEM and c-FEM in our in vivo results. In general, the proposed FEMs use fewer simplifying assumptions and outperform the other methods but they are computationally more expensive.