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Studies show that economic sanctions have had major negative impacts on health systems during the past years. The aim of this study is to identify the impacts of US sanctions on the performance of public hospitals in Iran.

A qualitative research study was conducted between October 2019 and September 2020 in Kermanshah Province, Iran. Semi-structured, face-to-face interviews, lasting between 25 and 90 min, were carried out with 20 participants in seven public hospitals affiliated to the authors’ institution in Kermanshah Province. Inductive thematic analysis was used to identify themes in the data.

Five main themes emerged from the analysis: resource management challenges; financial restrictions; interruptions in planning; reductions in the quality of service delivery; and changes in organizational relationships.

The results of the present study demonstrate that US economic sanctions have considerably reduced access to necessary medical equipment and medicines for public hospitals in Iran. Policymakers should monitor the distribution of equipment and pharmaceutical products within public hospitals in Iran and take actions to ameliorate shortages during times of economic sanctions.

The main objective of this study is to consider how to benefit efficiently from the significant potential of humanitarian operations by individuals. For this purpose, this study aims to assess failure factors in humanitarian supply chain operations after the Kermanshah earthquake considering the role of all parties, focusing on individuals who did not wish to work with formal organisations on the whole. In the aftermath of the Kermanshah earthquake, which occurred on 12 November 2017, improvised groups of Iranian civilians from all over the country played an important role in humanitarian supply chain operations as individuals. Although most of these groups sincerely intended to help the affected society, victims could not benefit properly from these significant potential humanitarian actions. On the contrary, these potential actions caused some issues during humanitarian operations, such as blocking roads, inappropriate last-mile distribution, wasting resources and so on.

This research study considers mixed methods, including an on-site survey, semi-structured interviewing and a questionnaire designed for statistical analyses. The analysis included 140 responses to the questionnaire, semi-structured interviews with 32 affected families, interviews with 5 emergency managers from the Housing Foundation of the Islamic Republic of Iran and on-site survey reports.

This study presents a framework for humanitarian supply chain management to deal with future disasters in the same area or areas with similar characteristics to the case study. In general, the results of this study demonstrate that the nature of humanitarian supply chain operations makes it impossible to consider that these operations are free of challenges. However, several influential factors, such as training humanitarian actors and integrated management, might considerably increase the efficiency of humanitarian operations by individuals.

This study highlights the influential factors of inappropriate humanitarian operations by individuals, derived from an analysis of the Kermanshah case and literature review. The authors suggest a framework to benefit from the significant potential of individuals with wide-ranging experiences and proficiency, for future cases similar to the case study.

The purpose of this paper is to provide appropriate methods for reducing the abnormalities on the extracted fetal heart signal from the maternal electrocardiogram (ECG).

In this regard, the extracted signal of the fetal heart from the mother, improved using an active noise cancelation (ANC) system. It uses commonly adaptive algorithms of normalized least mean squares (NLMS). In the present paper, fetal extraction and denoising methodology are proposed. This methodology uses a combination of the NLMS algorithm with Savitzky–Golay (S-G) filter.

The obtained results show that a combination of NLMS algorithm with filter coefficient of 15 and µ = 0.02 and S-G filter has a better qSNR (qSNR = 3.6727) and good performance for fetal ECG extraction in comparison with the other works for average fmSNR in the range of −30 to −15 dB. Also, with considering the SNR value of −24.7 dB before filtering and SNR = 3.1861 dB after filtering; the SNR improvement of 27.8861 dB has been obtained.

A new method in the extract and noise reduction of fetal ECG from maternal ECG by the combination of NLMS algorithm and S-G filter is proposed.

It has been suggested that there is a link between the dietary intake of certain nutrients and the risk of prostate cancer. The aim of this study is to examine the associations between dietary intakes of all nutrients and the risk of prostate cancer in Kermanshah.

This case-control study was conducted in Kermanshah, a province in the west of Iran in November of 2016. The sample consisted of 50 patients with confirmed prostate cancer, and 150 healthy men who matched in age with these cases and did not have any symptoms of prostate disorder were chosen as controls. Dietary intakes were collected by a semi-quantitative food frequency questionnaire that contained 147 food items and were then analyzed by Nutritionist 4 software.

After adjustment for potential confounding factor, highest tertile compared to lowest tertile of dietary vitamin E intake [odds ratio (OR) = 0.21; 95% confidence interval (CI) = 0.05-0.89], lycopene intake (OR = 0.11; 95% CI = 0.01-0.86) and magnesium intake (OR = 0.02; 95% CI = 0.01-0.55) had a protective effect on the incidence of prostate cancer. However, there were no associations between dietary intakes of fiber, vitamin A, vitamin D, vitamin B₁₂, folate and calcium with prostate cancer.

The finding suggests that the dietary intakes of vitamin E, lycopene and magnesium could decrease the risk of prostate cancer. Nevertheless, dietary intake of other nutrients such as fiber, calcium, vitamins D, A, B₁₂ and folate was not associated with prostate cancer.

Education is a human right and access to high quality education is key to sustainable socioeconomic development. Improving the quality of higher education institutes is essential for generating the productive human resources. Assessing the quality of higher education from the students’ perspective can be considered a crucial factor in the monitoring of service quality in universities. The purpose of this paper is to evaluate the quality of educational services in a higher education institute, the Kermanshah University of Medical Sciences (KUMS), in the west of Iran.

A multistage sampling method was used to select 346 students from the KUMS, who were enrolled in the second semester of the academic year 2015-2016. The SERVQUAL questionnaire was used to gather data on students’ perceptions and their expectations about the quality of educational services. The authors used a statistical significance level of 0.05 to examine the gap between the students’ expectations and their perceptions of service quality in five dimensions, namely tangibles, responsiveness, reliability, empathy and assurance.

The results showed that there was a negative service quality gap in all five dimensions. The overall mean score of students’ expectations and their perceptions was 3.19±0.44 and 2.4±0.45, respectively. The score gap between the overall mean score of perceptions and expectations of students was −0.79, which was statistically significant (p<0.0001). The highest and lowest quality gaps were related to the assurance (−0.84) and tangible (−0.70) dimensions, respectively.

The study indicated that the quality of educational services provided in the KUMS did not meet students’ expectations in five dimensions of service quality. Thus, it warrants further investigations to determine how to improve the quality of educational services in higher education institutes such as the KUMS.

Financial protection of households against catastrophic healthcare expenditure (CHE) is defined as one of the main goals in health systems. The purpose of this paper is to measure and decompose socioeconomic inequality in CHE among households in Kermanshah province, Western of Iran.

This cross-sectional study was carried out among 1,188 households in 2017. Data were extracted from the Household Income and Expenditure Survey which is conducted by the Statistical Center of Iran. The CHE is defined as household healthcare expenditure greater than or equal to the 40 percent of household’s “capacity to pay.” The concentration curve and the Wagstaff (W) and Erreygers (E) indexes were used to illustrate and measure the extent of socioeconomic inequality in CHE. In addition, the authors decomposed the W and E indexes to identify the main determinants of socioeconomic inequality in CHE.

The results indicated that the prevalence of CHE among households was 4.12 percent (95% confidence interval (CI): 3.13 to 5.42 percent). The estimated value of the W and E indexes were −0.2849 (95% CI: −0.4493 to −0.1205) and −0.0451 (95% CI: −0.0712 to −0.0190), respectively; suggesting the concentration of CHE prevalence among the poor households. Decomposition analyses indicated socioeconomic status as the most important factor contributing to the concentration of CHE among the poor. In contrast, health insurance coverage was found to increase the concentration of CHE among the rich in Iran.

The current study demonstrated a higher concentration of CHE among the poor households in Kermanshah province. These results call for the government’s efforts to reduce healthcare expenditure among socioeconomically disadvantaged populations. Further studies are required to understand the mechanisms through which health insurance coverage increased the probability of CHE among rich in Kermanshah province.

Non-alcoholic fatty liver disease (NAFLD) is the most common liver disease which has become a public health concern, whose growing prevalence has been reported as around 33.9% in Iran. As oxidative stress plays a crucial role in the pathogenesis of NAFLD, antioxidant compounds such as quercetin could ameliorate the side effect of oxidative stress. The aim of the current study was to assess the effect of quercetin on lipid profile, liver enzymes and inflammatory indices in NAFLD patients.

In a randomized, double-blind, placebo-controlled trial conducted as a pilot study, 90 patients with NAFLD were supplemented with either a quercetin or a placebo capsule twice daily (500 mg) for 12 weeks. Both groups were advised to follow an energy-balanced diet with physical activity recommendations. Blood sample was obtained for laboratory parameters at baseline and the end of week 12.

At the end of the follow-up, quercetin group had significantly greater reduction in anthropometric parameters, cholesterol (−15 ± (−41, 0.00) in Q group versus −1± (−8, 2) in control group, p = 0.004), TG (−56.7 ± 22.7) in Q group versus −13.4 ± 27.7 in control group, p = 0.04), and tumor necrosis factor-α (TNF-α) (−49.5 ± (−99, 21) in Q group versus −5 ± (−21, 0.30) in the control group, p < 0.0001) compared to the control group. However, changes in fatty liver grade, liver enzymes, as well as high density lipoprotein-cholesterol and high-sensitivity C-reactive protein were not significantly different between the two groups.

To the best of the authors’ knowledge, this was the first study which assessed the effect of quercetin supplementation on liver enzymes, lipid profile and inflammatory indices of NAFLD patients as a double-blind placebo-controlled pilot study.

This paper identifies the challenges during a recent disaster relief operation in a developing country where the humanitarian response is dominated by national actors, with international actors having a minor role.

A case study design is used; the main data sources are semi-structured interviews with 43 informants involved in the 2017 Kermanshah earthquake relief operation.

The findings suggest that humanitarian practitioners deal with multiple challenges during disaster relief operations. One group of challenges relates to humanitarian logistics (HL) like needs assessment, procurement, warehousing, transportation and distribution, all widely discussed in the literature. Another involves the growing use of social media, legitimacy regulations and the engagement of new humanitarian actors (HAs) like social media activists and celebrities. These factors have not been extensively studied in the literature; given their growing influence, they require more scholarly attention.

The findings will help humanitarian practitioners and policymakers better understand the challenges involved in disaster relief operations conducted by multiple actors and thus help them improve their practices, including the creation of proper regulations, policies and logistics strategies.

The study uses primary data on a recent disaster to assess and extend the findings of previous studies regarding HL challenges. It also elaborates on the critical non-logistical challenges that influence aid delivery in emergency responses, including the growth of social media, regulations and the engagement of new HAs. The results may motivate future empirical and modelling studies to investigate the identified challenges and identify practices to mitigate them.

Present research focus on using solar energy as a renewable option for office buildings in different climatic conditions in Iran. To seeking a way to use clean solar energy and reduce current expense in buildings an investigation carried out. Nine office buildings in various climatic regions selected as case studies. Through a precise examination, buildings specifications, energy demand and climate information carried out. In the first step based on the buildings type and hot water demand, solar water heater systems designed for each case. In the second step, a cost-benefit analysis is done to detriment the economic aspects of implement aforementioned type of solar system. A cost-benefit analysis is done from saving energy and return time of investment point of view. Results indicate that solar water heater with low investment about US$500 and payback time between 2 and 5 years can be noticed as a desirable renewable option in case studies. Furthermore, analysis reveals that thermal load of building is more effective on fuel saving in building, while solar radiation intensity has more effective on the payback in solar water heater utilization.

In this study based on thermal load of nine building office and radiation of different part of Kermnashah province, the possibility of solar water system is investigated.

Analyses reveal that the thermal load of building is more effective on fuel saving, while solar radiation intensity has more effective on the payback in solar water heater utilization. The main originality goes back to consideration of different meteorological conditions in solar water heater selection.

The purpose of this paper is to examine the association between corporate environmental disclosure quality (EDQ) and earnings quality (EQ).

The paper uses earnings persistence and accruals quality as a measures of EQ. The paper also uses panel data regression to examine the association between EDQ and EQ for a sample of 107 Iran non-financial firms. Two different theoretical frameworks are used to clarify whether and to what extent an association may exist as an explicit relationship between EDQ and EQ.

After controlling for several firm-specific characteristics, the results show that between 2011 and 2016, there has been a significant positive relationship between EDQ and EQ.

This study sheds light on the relevance of regulating corporate reporting within a setting where companies are already voluntarily reporting on environmental information. Findings have implications for policymakers who have mandated or considering mandating environmental reporting. To the policymakers, in particular, this study highlights the need for incorporating, within the listing rules, minimum requirements in relation to the nature and content of environmental reports.

The findings have implications for stakeholders in terms of effective information quality. The findings are important as more environmentally responsible firms may provide higher quality, more reliable and more transparent information to meet the ethical expectations of stakeholders.

This is the first study in Iran that considered the impact of EDQ on EQ. This study contributes to the literature on the relationship between EDQ and EQ by showing that the EDQ in Iran is associated with the EQ.