Facilities built in areas affected by earthquake activity, such as tunnels, which have always been an integral part of human life, must withstand both dynamic and static loading. It has led to the need for practical studies on the effects of earthquakes on underground structures and the factors affecting their destruction. For this purpose, in this research, at first different patterns of tunnel’s excavation were investigated and by using Plaxis 2D software and based on Tabas earthquake in Iran, sensitivity analysis on geotechnical parameters of the soil surrounding tunnel such as cohesion, friction angle, unit weight and modulus of elasticity was carried out, and the parameters whose changes have the greatest and least effects on the bending moment changes on the tunnel lining are introduced. The results show that tunnel excavation patterns significantly affect the bending moment, axial forces, displacements, and surface settlement of the tunnel. Often, by dividing tunnel excavation area to small parts, the values of bending moment, axial forces, displacements, and surface settlement of the tunnel decreases in static analysis. Also, outputs of sensitivity analysis on geotechnical parameters of the soil surrounding tunnel showed that modulus of elasticity of the soil surrounding tunnel has the most effect and cohesion changes have the least effect on bending moment induced on tunnel lining..

Background: C-reactive protein (CRP) is a predictor of cardiovascular diseases in both normal people and patients on hemodialysis. This study aimed to assess the relationship of high-sensitivity C-reactive protein (Hs-CRP) serum level and peritonitis in patients on peritoneal dialysis.Methods: 113 patients on peritoneal dialysis in Isfahan city, Iran, participated in our study in 2015. Serum albumin and Hs-CRP levels were measured in each patient at three times (baseline, and 6 and 12 month after that) and the patients were followed up for 1 year. All the patients were evaluated for peritonitis in every visit. At the end of the study, two groups of patients on peritoneal dialysis with and without peritonitis were compared. Findings: Among 113 patients, 24 were excluded from the study because of death or kidney transplantation and 89 patients were included in final analysis. The mean Hs-CRP levels in patients with peritonitis were 4.83, 5.79, and 7.42 mg/l at baseline, and 6 and 12 month after it, respectively; these levels were 4.47, 3.19, and 2.69 mg/l in patients without peritonitis, respectively. In addition, the mean albumin levels in patient with peritonitis were 3.38, 3.29 and 3.40 mg/l at baseline, and 6 and 12 month after it, respectively; these values were 3.56, 4.05, and 3.51 mg/l in patients without peritonitis, respectively.Conclusion: Results showed that with increase in Hs-CRP level, the risk of peritonitis increased. Besides, the albumin level decreased among patients with peritonitis in comparison with patients without peritonitis; there was no significant correlation between albumin level and peritonitis.

Introduction: The effect of statins in reducing the risk of acute cardiovascular events is not only due to their effect on serum cholesterol level but also from their anti-inflammatory effects, particularly those resulting from reducing of C - reactive protein (CRP), is important. Atorvastatin dose and duration of treatment display different effects. This study compared the effects of high and low doses atorvastatin in reducing serum level of high sensitivity C reactive protein (hs-CRP).Methods: One hundred patients with unstable angina or Non ST Elevation Myocardial Infarction (NSTEMI) randomized into two groups. Group 1 (n=50) received atorvastatin 80, 20 and 20 mg in three days but group 2 (n=50) received atorvastatin 80 mg/day for three days. High sensitivity C-Reactive protein was measured at admission time and after three dose atorvastatin therapy.Results: Hs-CRP significantly decreased from baseline to end of three doses treatment in both groups (P=0.0001). However, the reduced level was greater in the group2 than group1 (-39.5% vs -31.2%, P=0.0185).Conclusion: We found that both treatment methods have significantly effect on hs-CRP in short term but high dose (80 mg/day) atorvastatin being associated with significantly greater reductions in hs-CRP concentration.

Given a metric space X, we consider the family of all normal upper semicontinuous fuzzy sets on X, denoted by F(X), and a discrete dynamical system (X; f). In this paper, we study when (F(X); b f) is (strongly) sensitive, where b f is the Zadeh's extension of f and F(X) is equipped with different metrics: The uniform metric, the Skorokhod metric, the sendograph metric and the endograph metric. We prove that the sensitivity in the induced dynamical system (K(X); f) is equivalent to the sensitivity in b f: F(X)! F(X) with respect to the uniform metric, the Skorokhod metric and the sendograph metric. We also show that the following conditions are equivalent: a) (X; f) is strongly sensitive; b) (F(X); b f) is strongly sensitive, where F(X) is equipped with the uniform metric; c) (F(X); b f) is strongly sensitive, where F(X) is equipped with the Skorokhod metric; d) (F(X); b f) is strongly sensitive, where F(X) is equipped with the sendograph metric.

ABSTRACT Today, climate change and its obvious negative effects on ecosystems have caused concern. This research seeks to test whether vegetation changes are sensitive to climate shocks and also how the ecosystem recovery process is through this index. In this regard, by using the GEE platform, Java coding, GIS and statistical analysis, vegetation and Palmer indices were calculated and based on time series climate data, vegetation and climate changes were presented. The results of Palmer's drought index show that during the statistical period (1985-2020) the study area is facing drought or is moving towards drought. Also, the results indicate the longest period of drought in the region from 2013 to 2020. Totaly from 420 evaluated months, the NDVI index is below the change threshold in 70 months. Among these, 31 months of the study period is below the acceptable threshold in green and non-reservoir seasons, which is ecologically worrying. The distribution of the vegetation index based on hexagons in 1985 and 2005 had a normal and almost normal distribution; But in 2020, the graph deviated from the normal state and skewed towards the vegetation cover index under stress or even thin covers. According to the analysis of the indicators, it is predicted that the Gorgan region is on the border of such ecological developments and the historical ecosystem of the region is moving towards new ecosystems or being in a new equilibrium state with climatic conditions and human disturbances Extended Abstract Introduction Today, climate change and its obvious negative effects on terrestrial ecosystems have caused great concern to humans. These changes are effective on vegetation performance, plant distribution patterns, and have economic and environmental consequences. Therefore, it is important to know the behavioral pattern of vegetation changes against climate changes. Reviewing the studies of scientists in the world shows many researchers have used the NDVI index to study temporal and spatial changes in vegetation and its relationship with the climatic index of precipitation in different parts of the world. Studies have shown that NDVI follows precipitation with different time scales. Surveys showed that there are very few studies on determining the threshold of changes in the vegetation cover index in the face of climate shocks. Determining these thresholds can provide a suitable solution for evaluating the state of the ecosystem, the consequences of climate shocks and the reversibility or disturbance in the ecosystem. This study was conducted with the aim of improving our understanding of the dynamics of vegetation in the forest city of Gorgan during 1985-2020 against climatic stresses.   Methodology The current research is a comparative and monitoring research and seeks to test whether changes in vegetation cover are sensitive to climate shocks and also how the ecosystem recovery process is through this index. To achieve the gole, first, NDVI index was selected among the optimal vegetation indices and its calculation process was done as a time series in the GEE system. In parallel with those climate shocks, the main elements including temperature, precipitation and storm were calculated during the historical process of 35 years and the average and standard deviation statistical indicators were calculated for them and the trend of changes in the thresholds was determined. The results of climate plots and climate changes show that in the years before 1985, 2005 and 2020, drastic changes have occurred in climatic elements and climatic factors. Therefore, these years can be considered as the periods when the climate shock happened.. Next, the region was divided into 436 hexagons and the NDVI index for each of the hexagons was calculated and modeled for the years 1985, 2005 and 2020 as selected years affected by climate shocks. In conclusion, to analyze the trend of changes in the time series of the vegetation index and compare the behavior of its changes with climatic indices, the Palmer index was calculated.   Results and discussion The results of climate change monitoring based on the Palmer index showed that during the statistical period the study area is facing drought in most years. The most severe climatic fluctuations and drought in the region were recorded in 2018 and in the months of October to December. The longest period of drought has also prevailed in the region from 2013 to 2020. During this period, rainfall, temperature and storm fluctuations have the most changes. The results of drought monitoring show that in 270 months, the region is facing climatic drought stress, 57 months of the study period, the region is facing severe and very severe drought stress. The results of the time series of the NDVI vegetation index showed that, out of the 420 evaluated months, 70 months of the year the NDVI index is below the change threshold, 31 of which are in the green and non-accumulating seasons, the seasons when the vegetation is expected to be at its maximum. Placing below the acceptable range means crossing the ecological thresholds and challenges the recovery and restoration of the ecosystem, also the ecological performance will be affected at this point. Based on the assessment of the Palmer index, from 2014 to 2019, the situation of the Palmer index is in the extreme drought range. Also, since 2015, i.e. with a one-year time delay, NDVI index has experienced the lower limit of the equilibrium threshold of vegetation cover. These conditions are also valid for the years 2008, 2009, 2002 and 1997. In general, it can be said that the vegetation cover index is dependent on climatic changes and fluctuations and shows high sensitivity to changes. The important point in this section is that in the years when the NDVI index changes are at the lower limit of the threshold, we witness the most climate shocks and temperature changes, the occurrence of severe storms and precipitation fluctuations. The distribution of the vegetation index based on hexagons in 1985 and 2005 have a normal distribution; but in 2020, the graph has deviated from the normal state and skewed towards the vegetation cover index under stress or even thin covers. The visual interpretation done on the vegetation cover index in 1985 confirms the condition of the vegetation cover in the southern and western limits of the region in a state with suitable dense and pasture vegetation and forest cover on the edges. However, in 2005 and 2020, this cover has been changed and mainly turned into agricultural land and poor rangeland. In such a way that in 2020, the situation of the region has revealed the critical state of vegetation. The vegetation cover index in the central areas of the city has also reached from a relatively favorable situation in 1985 to a critical situation with almost no dense and stress-free vegetation cover in 2020. The results of the present studies are consistent with the studies of Visentr Serrano et al. in 2013 and confirm the relationship between NDVI vegetation and climate change. In addition, the results of the studies are consistent with the studies of Alwesabi 2012, Xiai & Moody, 2005 and Yan et al. 2001. In such a way that the present study and the aforementioned studies all confirm the influence of the vegetation index on climate fluctuations and precipitation with a one-year time difference.       Conclusion In general, the threshold is defined as a border with different conditions. After crossing the thresholds, the stability and positioning of the NDVI in the equilibrium range is often difficult, and the ecosystem is constantly spending energy to restore itself or to position itself in a new stability state. The result of the mentioned disorders is the reduction of resilience and resistance in the region, which leads the ecosystem to alternative states or crossing the threshold or being in a new equilibrium state. The results showed that the areas where green vegetation is concentrated and denser are less affected by climatic stresses and show more resilience. However, the areas that have become spots and islands due to destruction in the urban areas are more affected by climatic stress and destruction and show less tolerance against the destruction factors. The results help managers to focus their management plans for the preservation and maintenance of urban green spaces as well as forest and pasture ecotones on the edge of the city by knowing the thresholds.   Funding There is no funding support.   Authors’ Contribution Authors contributed equally to the conceptualization and writing of the article. All of the authors approved thecontent of the manuscript and agreed on all aspects of the work declaration of competing interest none.   Conflict of Interest Authors declared no conflict of interest.   Acknowledgments  We are grateful to all the scientific consultants of this paper.

Background and Aim: Fibrosis and irreversible kidney damage that occur with inflammation are defined as renal parenchymal scar. Kidney scar occurs in children with pyelonephritis, and it is one of the major complications of urinary tract infection. DMSA is an excellent method to examine the renal cortex. It is also useful in making treatment decisions for these patients.  This study aimed to evaluate the diagnostic value of ultrasound in detecting renal scar compared with DMSA  in children from 2 to 10 years in Sanandaj in 2020-2021.                 Materials and Methods: This descriptive study was performed on 70 patients from 2 to 10 years old with a history of vesicoureteral reflux or urinary tract infection who had a kidney scar on the DMSA scan. These patients underwent renal ultrasound. Then ultrasound results were compared with the DMSA results of each patient. All data were entered in STATA-14, then frequencies, percentages, and standard deviations were calculated. Results: The results of this study showed that 60 percent of the subjects were female and 40 percent male. All scars were detected in all patients with DMSA scan, while only 41/4% were diagnosed by ultrasonography. Conclusion: In this study, the sensitivity of ultrasound in detecting renal scar was reported to be low. This research showed that ultrasound could not be an appropriate alternative to DMSA for detecting kidney scars in children.

Background: The American Diabetes Association in 1997 switched its recommendations regarding the screening of pregnant women from universal to risk factor-based screening. The ADA specifically recommended that screening is not cost-beneficial in women under the age of 25, with a normal weight and negative family history of diabetes. Methods: 910 pregnant women attending the diabetes clinic at Bushehr University of Medical Sciences were screening for gestational diabetes using a 50-gram glucose challenge test. All the women were 24-28 weeks pregnant at the time of testing. Women with a post-load blood glucose of >=140mgldl were referred for a 3-hour oral glucose tolerance test. The presence of ADA risk factors was recorded, as was the absence of all three risk factors, and compared with the results of 50-gram GCT. We evaluated the predictive value of different combinations of risk factors relative to the results of screening. Results: 66 women (6.9%) had a positive screening test, with 16 (1.75%) eventually diagnosed with GDM based on OGTT results. GCT was negative in 616 (95.3%) women, who had at least one of the three risk factors - age >25 years, BMI ≥27kg/m2, or a positive family history of diabetes - and in 231 (27.3%) women who had none of these risk factors [odds ratio=70.3, 95%-CI=2.23-22.21; p<0.0001]. Conclusion: Selective screening of pregnant women will detect most cases of gestational diabetes where resources to implement universal screening are limited. The most important factors in selecting screening candidates are age, body mass index, and family history of diabetes mellitus.