39 2228-7043 Iran University of Medical Sciences 6254 Clinical Psychiatry The Effectiveness of Applying the Coping Cat Protocol on Reducing Symptoms of Separation Anxiety Disorder in the Children (A Case Study) Yaghoobi Abolghasem b rashid khosro c Bayat Ahmad d b Faculty of Economics and Social Sciences, Bu-Ali Sina University, Hamedan, Iran c Mazandaran University d Faculty of Economics and Social Sciences, Bu-Ali Sina University, Hamedan, Iran 1 12 2021 28 9 1 11 25 05 2020 14 05 2021 Background & Aims: Early diagnosis and treatment of mental disorders in childhood is very important. One of the most common childhood mental disorders is separation anxiety disorder. Epidemiological studies showed that between 2.1 and 6.6 percent of children have this disorder. There are three signs of excessive separation discomfort, such as severe and persistent anxiety about being deprived and harmed, fear and helplessness of separation, physical complaints, recurring nightmares, fear of school, and sleep problems that last at least 4 weeks, is necessary for diagnosis of separation anxiety disorder. Three-quarters of school-leaving children suffer from separation anxiety disorder and if left untreated, they may develop generalized anxiety disorder. Therefore, it is very important to pay attention to the treatment of this disorder, especially in preschool and primary school ages. One of the most widely used methods of treating anxiety disorders in children is the Coping Cat method. Philip Kendall was the first person that offered the Cognitive-Behavioral therapy to children. He developed the first step-by-step method for treating children's anxiety based on a cognitive-behavioral approach called the “Coping Cat” method. Each session of this treatment includes goals, implementation instructions, and tips. Techniques used in this method include identifying feelings of anxiety and bodily reactions, relaxation, reviewing and changing anxiety self-expression, problem solving, performance appraisal, and practicing hierarchical exposure to anxious situations. The results of clinical trials support the use of cognitive-behavioral therapy for children and adolescents with anxiety. The aim of this study was to evaluate the effectiveness of using the coping cat method on reducing the symptoms of separation anxiety disorder in children. Methods: Method was single-case and experimental with baseline. The subjects included a 7-year-old girl and an 8-year-old boy who were diagnosed with separation anxiety disorder based on purposive sampling and after conducting a diagnostic interview and testing, and were selected according to the inclusion criteria and fulfilling the research conditions. After performing the baseline, participants entered the treatment and the coping cat method was performed during 10 sessions for them, individually. Therapeutic changes, recovery percentage, and effect size from the beginning to the last session were obtained using the Clinical Symptoms Index (SCI-4). This instrument has two forms: parent (97 items) and teacher (77 items). SCI-4 is applied for screening thirteen behavioral and emotional disorders including: Attention Deficit Hyperactivity Disorder (ADHD), Oppositional Defiant Disorder (ODD), Conduct Disorder (CD), Generalized Anxiety Disorder (GAD), Social Panic, Separation Anxiety Disorder (SAD), Obsessive-Compulsive Disorder (OCD), Specific Panic, Major Depression Disorder (MDD), Dysthymia, Schizophrenia, Pervasive Developmental Disorder, Vocal and Motor Tics, Post-Traumatic Stress Disorder (PTSD), Elimination Disorders (Enuresis and Encopresis). In this study, only parts related to anxiety disorders were used. Scoring is done in two ways. One is zero and one and the other is zero, one and two. For more accuracy, the second method was used in this study. The sensitivity and specificity of SCI-4 with Iranian samples have been determined by the psychiatrist's diagnostic agreement based on different cut-off points and the best score for each disorder. The intervention package used in this study included 10 sessions of training and cognitive-behavioral intervention that are included in Kendall's treatment protocol. Each session includes goals, implementation guides, and tips, and concludes with helpful tips on covering up associated disorders during treatment and managing issues that may complicate the treatment process. The techniques that used in this method are: identifying feelings of anxiety and bodily reactions, relaxation, examining and transforming anxiety self-expression, problem solving, performance appraisal, and practicing hierarchical exposure to anxious situations. Also, at the end of each session, an enjoyable activity is performed. Results: The results of this study showed that applying the coping cat protocol is effective in reducing the symptoms of separation anxiety disorder in children and reduces the severity, frequency, and complexity of the symptoms of separation anxiety disorder. The first subject (Mina) showed more changes than the second subject (Sepehr) in all indicators related to the rate of recovery. This finding may indicate that the coping cat method is more effective in school-age girls than boys. One month after the intervention and follow-up, the indicators related to the percentage of recovery indicated the persistence of therapeutic effects. Another finding of this study was the clinical efficacy obtained using Cohen's “d” formula. The intensity, frequency, complexity, and interference indices for the first subject were 1.52, 2.27, 1.69, and 1.54, and for the second subject were 1.08, 1.57, 1.22, and 1.42, respectively. The obtained scores indicate the optimal effectiveness of the coping cat method in reducing the symptoms of separation anxiety disorder. Also, the graphs related to the pattern of change in scores showed that changing scores on the scales of intensity, frequency, complexity, and interference in the process of educational-therapeutic sessions and follow-up (that mentioned in the coping cat method for cognitive-behavioral therapy of anxiety disorders) has been effective to reduce symptoms of separation anxiety disorder in the subjects. Conclusion: According to the results of this study, it can be said that applying coping cat protocol can be a useful intervention in reducing the symptoms of separation anxiety disorder and even treating it completely, along with other therapies. Because the results of baseline diagrams, recovery percentage, and effect size showed significant therapeutic changes in the rate of separation anxiety symptoms in the subjects. This finding is consistent with the results of previous research. The use of techniques and methods in this treatment reduces anxiety symptoms such as anxiety, restlessness, abuse, and abnormal reactions in children. Although some studies have emphasized the effectiveness of parent-centered interventions in reducing anxiety symptoms, but both treatments can be used simultaneously to achieve maximum recovery. Preschool interventions have special considerations due to the developmental characteristics of these children, such as lack of subjective thinking, inability to read and write, and being more affected by early relationships with family members. Therefore, due to the fact that separation anxiety disorder is very common in children and also due to its adverse consequences such as school attendance problems, its treatment is very important and children who experience the coping cat method, after treatment and also in the follow-up stage shows a significant reduction in their separation anxiety symptoms. According to the desirable efficiency and effectiveness of this method, its use is recommended for the treatment of children with anxiety.  
5917 Microbiology Prevalence of virulence genes in Escherichia coli isolates of patients with UTI Jamshidian-Mojaver Majid e Amiri Mohadese f Farzin Hamidreza g e Mashhad Branch, Razi Vaccine and Serum Research Institute, Agricultural Research, Education and Extension Organization (AREEO), Mashhad, Iran. f Master of Bacteriology, Faculty of Veterinary Medicine, Shahid Bahonar University of Kerman, Kerman, Iran g Mashhad Branch, Razi Vaccine and Serum Research Institute, Agricultural Research, Education and Extension Organization (AREEO), Mashhad, Iran. 1 12 2021 28 9 12 20 15 09 2019 01 09 2020 Background & Aims: Escherichia coli, which is naturally isolated from the digestive tract of humans and animals, is one of the most important members of the microbiota of this system and its pathogenic form causes very important complications in humans and animals. Escherichia coli is often harmless or low in severity and its presence as a common organism in the lower parts of the intestine is essential to maintain its ecosystem and health. Escherichia coli may cause opportunistic infections in extrauterine areas such as the mammary glands and urinary tract. Also, some strains are considered as the main pathogens by having or acquiring genetic factors of virulence. Strains that cause gastrointestinal diseases are usually not part of the normal human and animal flora, and infection results from the consumption of food, contaminated water, or direct contact with humans and animals that are clinically and subclinically infected with acute strains. It happens. Pathogenic strains have factors that allow bacteria to colonize mucosal surfaces and then cause damage. Predisposing factors involved in bacterial colonization include age, immune status, nutrition, and severe exposure to pathogenic strains. The pathogenic potential of strains is determined by the virulence genes in the bacterium. The expression of virulence genes leads to certain types of injuries and clinical syndromes. Pathogenic strains of Escherichia coli can be classified into two main groups based on the factors of severity, location and type of damage: intestinal pathogenic strains and extraintestinal pathogenic strains. In pathogenic strains, genes encoding virulence factors are often found in pathogenic islets, while commensal strains lack these pathogenic islets in their genomes. Many pathogens are also encoded by acquired genes in mobile genetic components such as plasmids, bacteriophages, and transposons. Extraintestinal pathogens, most commonly meningitis-causing strains (MAEC) and urinary tract infections (UPEC), have been isolated from patients with pneumonia, cholecystitis, peritonitis, and other infections. Among UPEC strains, some bind diffusely to tissue culture cells. In addition, diarrhea of some Escherichia coli strains (DAEC) has been isolated from urinary tract infections in addition to diarrhea. In the present study, 50 samples of positive cultures with urinary tract infections were referred to the laboratory located in Imam Reza Hospital located in Bojnourd city. Eosin methylene blue agar and McConkey agar plates containing bacteria with specific bacterial conditions (with green gloss in eosin methylene blue agar medium and in McConkey agar medium with smooth pink colonies) as suspected isolates of Escherichia coli Were selected and cultured in TSI, SIM, MRVP and citrate media to confirm these selected isolates after hot staining.Finally, gram-negative isolates whose biochemical tests were acid / acid in TSI , The manufacturer of indole, without producing hydrogen sulfide, with or without immobilization in SIM, MR-positive, VP-negative and without citratease, was approved as Escherichia coli. Methods: Boiling method was used to extract DNA in this study. In this method, the bacteria stored on the medium of Luria Bertani Agar were cultured and exposed to 37 ° C for 16-18 hours. After the incubation period, DNA was extracted from single colonies. Used. First, 350 μl of sterile distilled water was transferred into sterile microtubes and then a colony was dissolved in it. The microtubes were placed in a heating block device at 98 ° C for 11 minutes. The microtubes were then cooled in the freezer at -20 ° C for 5 minutes. Finally, the microtubes were centrifuged for 2 minutes at a speed of 12,000 rpm and 250 μl of the supernatant was removed and placed in the freezer at -20 ° C for subsequent steps. Identification of virulence genes was performed using specific primers from the study by Ewers et al. To prepare Mastermix polymerase chain reaction from ready mix Master in the amount of 12.5 microliters, 0.1 microliters (100 Picomoles per liter) of each of the primers, sample DNA 5 microliters and sterile distilled water up to the reaction volume (25 microliters) were used. Results: Based on the results of the above study, out of 50 isolates studied, 32 isolates (64%) had irp2 gene, 18 isolates (36%) had cvi / cvaC gene, 15 isolates had papC gene (30%), 15 isolates ( 30% had iucD gene, 8 isolates (16%) had astA gene, 8 isolates (16%) had iss gene and 3 isolates (6%) had tsh gene and 2 isolates had vat gene (4%). In this study, there were 17 profiles for the studied genes. Conclusion: Given the prevalence and presence of the studied genes, in the present study and other studies, it can be said that these genes play an important role in causing and exacerbating infections caused by extraintestinal strains. These genes are also present in some isolates at the same time, which can prolong the treatment period of the infection.   6260 Exercise Physiology Increased Serum BDNF Levels in Response to Estrogen and Nitric Oxide Changes in Postmenopausal Women (Effect of Moderate resistance Exercise) Sedighi Marziyeh Hosseinpour delavar Sedigheh i Behpour Naser Tadibi Vahid i Kermanshah Branch, Islamic Azad University, Kermanshah, Iran 1 12 2021 28 9 21 30 31 05 2020 21 06 2020 Background & Aims: Menopausal is a natural biological process which is happening during cessation termination of woman’s menstruation. In the menopausal duration women are suffering numerous physical and psychological changes that is associated with decreasing oestrogen secretion due to lack of follicular function. In addition physical strength and bone density decline along with weight gain. It has been shown that regular exercise without adverse of medical treatment preserves bone density, and also prevent cardiovascular diseases in menopause women. In addition it improves physical fitness and also life quality along with oestrogen decreasing in menopausal duration and disorders of the nervous system, like losing memory, learning disabilities, decline in brain processing speed are seen. Neurotrophins are growth factors set, that cooperate together in the growing, survival and also function of central and environmental nervous system. One of Neurotrophins is called BDNF which can be play an important role in the nerve activities.  Especially in the hippocampus,   Due to its abundance in the brain and it’s powerful effects on synapses with age that is related today neurological and cognitive analysis of elderly. One of the important factors in the changes of BDNF level in the woman blood is oestrogen (12) . oestrogen is one of major steroid hormones that produced by the women’s ovaries which is made in the brain when needed at presynaptic terminal. In addition the brain can make oestrogen (neurooestrogen) and this does not act as a hormone rather it works in the form of a neutral mediator or neurotransmitter. Due to the important role of oestrogen in the brain, reducing its level in women with age has become a significant problem in women health. Oestrogen levels drop suddenly during menopause and this may play an important role in the nerve function and also age-related neurocognitive diseases such as Alzheimer.  On the other hand fundamental research has shown that nitric-oxide (No) Can affects oestrogen levels by cellular mechanisms and simulation of gonadotropin-releasing hormone secretion and the hypothalamic-pituitary-ovarian pathway. In addition to the benefits of physical fitness exercise can be affective as a non-pharmalogical intervention in menopausal women. Due to the importance of factors affecting oestrogen changes and also nitric-oxide role on the oestrogen secretion chain that can affect the level of BDNF as a neutrophin effective in neuroprotection and reduction of menopausal in women ; according to said before; this research was designed to enquire the eight weeks of moderate intensity resistance training on serum levels of oestrogen, nitric-oxide and BDNF. Methods: In quasi-experimental research, 28 postmenopausal women from Kermanshah city were randomly selected and divided into two groups of resistance training (n = 14) and control (n = 14). Resistance training was performed for eight weeks, three sessions per week at intensity of 45-55% of a maximum repetition. Blood samples were taken in 24 hours before and 48 hours after the intervention in fasting. Data were analyzed using dependent and independent t-tests at the significant level (P < 0.05). Results: Results of dependent T-test showed that after eight weeks of training intervention, an important increase was observed in serum levels of oestrogen (P <0.001), BDNF (P <0.001) and Nitric-Oxide (P <0.001); however no significant difference was observed in any of the variables (P <0.05), in control group. Also results of independent T-test between the two groups showed there is a significant change in oestrogen (P <0.001), BDNF (P <0.001) and Nitric-Oxide (P <0.001) in the resistance training group compared to the other one. Conclusion: After eight weeks of training, a significant increase in serum oestrogen levels was observed in the resistance training group. Gonzalo et al.(2019) stated that exercise and changes in the body composition are associated with changes in female hormones and increased estradiol in postmenopausal women (20), which demonstrates the positive role of resistance training on improvement of hormonal condition in postmenopausal women(20). Resistance exercises as a non-pharmacological method, first reduce various menopausal complications (decrease in oestrogen secretion), second reduces oestrogen injection pharmacologically  requirement or treatment implementation that affect oestrogen secretion, which can save on treatment costs and prevent the side effects of oestrogen injection, by considering the 75% increase in serum oestrogen secretion in the training group. At the end of this resistance training, an 18% increase in serum Nitric-Oxide level was observed.  One of the effective communication factors between glands which affect in oestrogen secretion (hypothalamus-pituitary-ovary) is Nitric-Oxide(18), hence resistance training effect on increasing serum oestrogen in postmenopausal women is probably due to the increasing in Nitric-Oxide and stimulate the glandular path to affect oestrogen secretion. On the other hand, oestrogen secretion affects Nitric-Oxide levels.  In this regard, clinical and fundamental research has shown that oestrogen is mediated by an increase in Nitric-Oxide production by the endothelial isoform of Nitric-Oxide synthase (ENOS) due to an increase in ENOS expression and mediated activation levels (21, 22). In addition there was a significant increase in serum BDNF levels, So regarding the increase of BDNF, it can be said that resistance training causes positive changes in the structure and function of neuromuscular junction (NMJ) and hypertrophy of nerve endings (19, 23, 24). According to scientific studies, these changes are due to exercise in NMJ, associated with an increase in Neurotrophins such as BDNF, which is expressed in the nervous system and skeletal muscle (9, 19). Increasing the level of BDNF and its specialized receptor TRKB by exercise causes downstream changes and synaptic plasticity, which has a positive role on neuroprotection (23).  On the other hand, BDNF produced in skeletal muscle by moving backwards can be selectively transported by motor neurons from skeletal muscle and affect the function of nerve cells (9, 19, 23, 25). Considering the role of BDNF in neurogenesis and neurocognitive protection, it can be said that moderate intensity resistance training can play a protective role in reducing neurocognitive complications in postmenopausal women.  In general, the findings of the present study showed that moderate-intensity resistance training is a non-pharmacological method affecting hormonal changes in the form of increased serum oestrogen, which can play a protective role in reducing oestrogen-related complications in older women.  On the other hand, the results showed that resistance training increases BDNF by increasing the level of oestrogen and NO, and considering the protective role of BDNF on the nervous and cognitive system, Because of the protective role of BDNF on the nervous and cognitive system, it can be said that resistance training can prevent neurological-cognitive complications in postmenopausal women by increasing BDNF levels.   6364 Biology Evaluation of Graphene Quantum Dots Cytotoxicity on Breast Cancer MCF-7 Cells hoveizi elham l abdolali nejad peyman m l Shahid Chamran University of Ahvaz m Shahid Chamran University of Ahvaz 1 12 2021 28 9 31 44 27 07 2020 15 08 2021 Background & Aims: Breast cancer is one of the most common cancers today and how to deal with it is one of the challenges for oncologists today (1). One of the new treatment strategies is the use of nanotechnology in the field of cancer (1, 2). Nanoparticles are the most common elements in nanoscience and technology, whose interesting properties have led to a wide variety of applications (5). In this regard, graphene quantum dots (GQDs) can be used as an excellent option for nanomedical fields such as the release of anti-cancer drugs, cell culture, and tissue engineering (7, 8). Considering the role of nanoparticles as well as the antitumor effects of graphene compounds, it seems the use of these nanoparticles in 3D culture can be one of the useful strategies in suppressing cancer cells with fewer side effects (9). Therefore, the aim of this project was to compare the apoptotic effects of graphene quantum dots on the MCF-7 breast cancer cell line cultured in hydrogel scaffolds. Methods: In this study, the MCF-7 breast cancer cell line was used as  cancer cells. For cell culture in fibrin hydrogel scaffold, M199 medium containing 10% FBS serum and 1% penicillin/streptomycin and fibrinogen powder with a concentration of 3 mg/ml was used and it was added into each plate well of 24 wells and then cell suspension was added. Then, for 500 μl of scaffolding and cells, 15 μl of thrombin with a concentration of 120 u/ml was added in each well and it was immediately gently aspirated until the culture medium became gelatinous and the cell culture plate was transferred to the incubator. After 2 hours of cell incubation in the incubator (Sina, Iran), On the gelatinous scaffolding of each 24 well plates, 500 μl of M199 medium containing 10% FBS serum and 1% antibiotic was added and transferred to the incubator again. Cell treatment was performed by first removing the culture medium from each well and concentrations of 1, 5, 7, and 10 mg/ml of graphene quantum dots were added. But only the culture medium was added to the control group. The plate was transferred to the incubator and treated for 1, 3, and 5 days. In this study, MCF-7 cells were cultured on a fibrin hydrogel scaffold for SEM imaging and after 24 hours of incubation, the medium was gently removed on each well. 300 μl of PBS was added to each 24-well plate and wash three times and 300 μl of 2.5% glutaraldehyde solution was added to each well and maintained at room temperature for 2 hours. Dehydration was done with increasing concentration of alcohol (30, 50, 70, 80, 90, 100, 100%) and then close the door of the plate and maintained in the freezer for 2 hours and freeze it to dry and dehydrate the fibrin hydrogel. MTT method and acridine orange and DAPI stains were used to measure cell survival and morphology. One-way ANOVA and t-test were used for statistical analysis. The chart was drawn in Excel 2016. P<0.05 was considered a significant difference for samples. Results: The results of scaffold morphology study using SEM electron microscope, showing the desired mechanical properties and suitable porosity for the scaffold. Therefore, the presence, growth, proliferation, and proper adhesion of cells to the scaffold and the natural morphology of the cells were confirmed. The results of the MTT test showed that the viability and survival of MCF-7 cells after exposure to the mentioned doses of graphene quantum dots were recorded (98, 81, 50, and 31%) respectively. This indicates that the viability of MCF-7 cells is significantly dependent on the concentration of graphene quantum dots. IC50 concentration of GQDs affecting MCF-7 cells was determined to be 7 mg/ml and after 1, 3, and 5 days decreased in a time-dependent manner so that after 24 hours, the average cell survival decreased to 50%, after 3 days to 35% and after 5 days to 22%. These data also showed the cytotoxic effect of IC50 concentration of graphene quantum dots on cells in a time-dependent manner. Also, the results of acridine and DAPI staining in GQDs-treated groups showed compact, fragmented, single, and orange nuclei, which indicated the onset of apoptosis in MCF-7 cells being treated. While in the control group cells that did not receive GQDs, the nuclei were clear, round, large, and in the form of light green clusters, which was a sign that the control group cells were alive. Conclusion: In this study, the effects of graphene quantum dots on MCF-7 cancer cells cultured on fibrin hydrogel were investigated. The results showed that GODs had a cytotoxic effect on MCF-7 cancer cells, so these effects were dependent on the time and dose in the experiment. In fact, with increasing concentration and time, the toxicity of graphene quantum dots increased. In this study, the IC50 for GODs was calculated to be 7 mg/ml by MTT test. Examination of morphological changes with an inverted microscope and also, qualitative studies of the nucleus characteristics of control and treatment cells confirmed the induction of apoptosis in the treated cells. In addition, the results of acridine orange staining were another confirmation of these findings. As mentioned, graphene and its many derivatives, as well as graphene quantum dots, which is one of the newest products of graphene, have been used for valuable research. According to the results of this study, GQDs have a toxicity effect and induce dose-dependent and time-dependent apoptosis in cultured breast cancer cells on fibrin hydrogel. However, more studies are needed to determine the molecular mechanism involved. In addition, it is suggested that the effects of GQDs on other cancer cells and normal cell lines be investigated and compared. 6486 Genetic Evaluation and comparison of the frequency of Y-chromosome microdeletions in different ethnicities of Iranian infertile men Zamanian Mohammadreza n Asadi Fahimeh o Sedighi Gilani Mohammad Ali p Ghaheri Azadeh Borjian Boroujeni Parnaz n Reproductive Sciences Center, Royan Institute, Academic Center for Education, Culture and Research, Tehran, Iran o جهاد دانشگاهی p جهاد دانشگاهی جهاد دانشگاهی جهاد دانشگاهی 1 12 2021 28 9 45 57 22 09 2020 11 07 2021 Background & Aims: Infertility means that a couple does not become fertile after one year of sexual intercourse, which is faced by 10-15% of young couples, and in 50% of cases it is related to male defects. The spermatogenesis genes involved in male fertility are located in the proximal region of the long arm of the Y chromosome (Yq11) in the azoospermia factor region, which includes the AZFa, AZFb, and AZFc subunits. Microdeletion in AZF regions causes changes in testicular histology from Sertoli Cell Only Syndrome to hypospermatogenesis. Yq microdeletions are the most common molecular cause of male infertility and include three regions: AZFα, AZFb and AZFc. These regions contain different genes involved in spermatogenesis. Yq microdeletions have been reported in 5-10% of infertile men and 6-16% of azoospermic men. In some other studies, the prevalence of these microdeletions has been reported in 20 to 30% of patients with non-obstructive azoospermia and in 3 to 7% of patients with severe idiopathic oligospermia. So far, ethnic patterns in the distribution of these microdeletions in the Iranian infertile male population have not been extensively studied. Accordingly, considering that Iran is a geographically vast country and has a high population / ethnic diversity, the present study aims to investigate the overall prevalence of these microdeletions in the population of Iranian infertile men and compare its frequency distribution in it was designed and implemented between different ethnicities. Methods: In this study 1887 infertile men with severe oligospermia or azoospermia were referred to the Royan Institute beween 1391 to 1392 were evaluated for the presence of Yq microdeletions. At first, DNA was extracted from the peripheral blood by salting out method and multiplex PCR was performed based on the determination of six different STS markers. To identify Yq microdeletions in three regions of AZFa, AZFb and AZFc, six STS markers were used inside two separate mixes. Two STS markers were considered for each AZF region and sY14 marker was used to examine the SRY gene and the ZFX / ZFY marker were used as internal controls. Information about semen analysis (Spermogram) and the results of patients' hormonal tests for the three hormones LH, FSH and testosterone were also extracted from their files. The ethnic segregation and classification of the Iranian male population was based on latest version of the Encyclopaedia Britannica (2010) book from the Statistics Center of Iran. Accordingly, the men studied in this study were classified into the ethnicities mentioned in the Table 1. For the appointment of ethnicity in each of the men under this study, the place of birth and dialect of three consecutive generations of clients were determined and then were placed in one of the seven ethnic groups including Fars, Azeri (Turkish), Kurdish, Lor, Gilak/ Mazeni (northern), Arabic And non-Iranians (Afghans and Iraqis). Results: Among the 1887 studied infertile men, 100 were diagnosed with microdeletions (5.29%), 69 patients (68.3%) had azoospermia and 31 patients (30.6%) had severe oligospermia. Among men with microdeletions, 70% had deletion in AZFc, 25.4% had deletion in AZFb and 4.6% had deletion in AZFa. Combined deletions of AZFbc were observed in 18 patients and AZFabc in three patients. All men with AZFa, AZFb, AZFc, AZFbc, and AZFabc regions had non-obstructive azoospermia, and only men with AZFc and AZFb microdeletions showed evidence of sperm production.  Among the patients with microdeletions, 47 patients (46.5%) had normal hormone levels, 22 patients (21.7%) had higher than normal levels of FSH, two patients had high levels of LH and 14 patients (13.8%) had high levels of both LH and FSH. The results of hormonal tests were not available in 16 of them. Ethnic distribution in 100 patients showed that 38% were Azeri, 30% Persian, 11% Kurdish, 8% Lor, 6% Gilak/ Mazani, 2% Arab and 5% Iraqi and Afghan nationals. The results of chi-square test showed that the distribution of different Y chromosome microdeletions is not uniform among Iranian ethnicities (p <0.001). Conclusion: Ethnic and racial differences can also be influential factors in the prevalence of these microdeletions, which we examined in the present study. Such a complete study of Iranian ethnicities has not been done before, and in other parts of the world, studies have not usually been aimed at comparing ethnicities. The overall frequency and distribution pattern of Yq microdeletions in the population of Iranian infertile men is similar to other populations in the world. The pattern of distribution of different microdeletions among different Iranian ethnicities seems to be similar. This means that in all ethnicities that accounted for a significant number of deletion patients (Turks, Fars, and Kurds), Yq microdeletions were most common in the AZFc region. After that, AZFb and AZFa were more frequent, respectively. In fact, ethnicity did not have a significant effect on the distribution of these microdeletions and no significant results were observed in this regard. Regarding the frequency of different microdeletions (frequency of distribution) in various Iranian ethnicities, considering that the number of samples of some microdeletions in some ethnicities was less than the amount required for statistical analysis, the number of people studied in each ethnicity has been adjusted. Statistical analysis of these results using chi-square test showed that the frequency of microdeletions in ethnicities is not uniform (p <0.001), therefore, the ethnicity of the Iranian infertile man is influential in the frequency of distribution of these microdeletions. However, due to the insufficient number of people with microdeletions in some ethnicities, it is not possible to determine with sufficient statistical accuracy which microdeletions occurs more frequently in which ethnicity. In this regard, it seems that the referral of Royan Infertility Treatment Center and the existence of infertility treatment centers in the centers of some provinces have affected the ethnic composition of the client. Therefore, it is suggested that in future and supplementary studies, in order to create an appropriate ethnic distribution in the referring population, while increasing the sample size (especially for some ethnicities) if possible with the cooperation of infertility treatment centers in other provinces, comprehensive studies in this regard be used to achieve a more definite result in this regard. 6663 Exercise Physiology The effect of eight weeks of combined continuous aerobic training with inspiratory muscle training on maximal oxygen consumption, cardiac function indices and pulmonary volumes in patients with heart failure Talebifard Hamid Asgharpour Habib Rezaeeshirazi Reza Saiiari Abdulamir Department of Physical Education and Sports Science, Aliabad Katoul Branch, Islamic Azad University, Aliabad Katoul, Iran 1 12 2021 28 9 58 67 04 12 2020 11 01 2021 Background & Aims: Heart failure (HF) is a complex clinical syndrome caused by various structural or functional abnormalities of the heart and impairs the capacity to fill the ventricles (1). The prevalence of this disease in Iran is reported 8%, the highest rate of which is in Khuzestan and Gilan provinces (6). Despite numerous treatments depending on the pathology of the disease and the patient's condition, the mortality rate after the diagnosis of HF is still high (7). Although the pathogenesis of HF is largely unclear, it is widely accepted that neurohormonal changes and inflammatory processes are involved in the structural and functional destruction of vital organs including the heart, kidneys, and lungs (2). One of the clinical complications of HF is pulmonary diseases. The association between HF and COPD has been extensively investigated in recent years. It has been shown that about 30% of patients with HF have COPD and a similar HF prevalence has been reported in a large population of patients with COPD (9, 10). Impairment of aerobic function due to negative cardiopulmonary and muscular interactions is an important determinant factor in exercise intolerance in the heart failure patients with COPD (12). Considering heart and pulmonary disorders and problems of lack of oxygen in different tissues of the body, also considering the role of exercise in improving cardiorespiratory function and improving oxygen delivery to the body, it seems that exercise is very useful for these patients. On the other hand, due to the low respiratory capacity in patients with HF, one of the treatment priorities for these patients is to increase lung capacity in these people. It has been shown that the use of breathing exercises can be a complementary therapy to improve pulmonary function in patients with HF (16). Despite the relationship between pulmonary disorders in HF, so far no research has been conducted to investigate the effect of simultaneous combined exercise training (aerobic-resistance) on improving the structure and function of the heart as well as pulmonary volumes in these people, which shows the necessity of the present research. Therefore, the aim of this study was to determine the effect of eight weeks of simultaneous combined training (aerobic- inhalation resistance) on cardiovascular and pulmonary functional volumes in men with HF. Methods:  In the present semi-experimental study, 20 men with heart failure referred to the Cardiac Rehabilitation Center of Imam Khomeini Hospital in Ahvaz were selected by snowball sampling method. Randomly were divided into 2 groups of 10 people including exercise training group (mean age: 47.5 ± 7.84; body mass index: 29.27 ± 1.99) and control group (mean age: 48.8 ± 8.03; body mass index 26.93 ± 2.14). The training intervention consisted of eight weeks of training in three sessions per week. The training program included increasing continuous aerobic exercise with 40-85% of the subjects' reserve heart rate; Inhalation resistance exercises were performed 5 minutes after aerobic exercises with an intensity of 40-70% of the training load. No training intervention was performed in the control group. Cardiovascular and pulmonary variables were measured 48 hours before and 48 hours after the intervention period. Dependent t-test and analysis of covariance were used for statistical analysis of the obtained data. Statistical analysis was performed using SPSS software version 26 and a significance level of P <0.05 was considered. Results: In the study of intragroup changes, the results of dependent t-test showed that after exercise intervention, a significant decrease in the levels of systolic blood pressure and resting heart rate variables and a significant increase in SV, EF, VO2Peak, FVC and FEV1 variables were observed in the exercise group, but no significant difference was observed in diastolic blood pressure levels. In the control group, no significant difference was observed in any of the measured variables. In examining intergroup changes, the results of covariance test showed that changes in systolic blood pressure and resting heart rate, SV, EF, VO2Peak, FVC and FEV1 were significant in the exercise group compared to the control group. Conclusion: Due to the positive changes in cardiac function, which were seen as an increase in functional heart volumes (SV and EF) and a decrease in resting heart rate and systolic blood pressure, part of the improvement in exercise performance capacity (VO2Peak) can be attributed to cardiac adaptation to aerobic exercise (20). Also, after the training period, a significant decrease in resting heart rate was observed. Since high resting heart rate is associated with adverse consequences of HF with reduced mutations (23) and due to the increase in stroke volume after exercise, changes in resting heart rate can be justified. Other factors affecting the improvement of cardiorespiratory function include increased pulmonary functional volumes (FVC and FEV1) (24). FVC and FEV1 are two common indicators in assessing pulmonary function and are used in research and clinical therapy as indications for response to treatment and clinical research (28,29). Considering that the exercises used in the present study included both aerobic and inhalation resistance training exercises, so the increase in FVC and FEV1 volumes can be attributed to the interaction of the two training methods on increasing the strength of the respiratory muscles as well as the adaptations resulting from aerobic exercise. Overall, the results of the present study showed that a combination of continuous aerobic exercise and respiratory resistance training can improve cardiorespiratory function and performance capacity in men with heart failure through improving cardiovascular function by increase in cardiac function (SV and EF) and reduction in resting heart rate and systolic blood pressure with increased pulmonary function FVC and FEV1). Considering that one of the complications of chronic heart failure, in addition to structural and functional problems of the heart, is a decrease in pulmonary capacity as one of the serious complications of heart failure, so, a combination of aerobic exercise and respiratory resistance training can be used to reduce HF complications and cardiorespiratory rehabilitation in these people. In general, it can be said that combined training, including a combination of increasing aerobic training and inhalation muscles resistance training with improved cardiopulmonary function, plays an important role in the rehabilitation of patients with HF, and these patients can use this training protocol for cardiopulmonary rehabilitation and reduction in complications of the disease.   6743 Clinical Psychiatry The Effectiveness of parent-child interaction model correction Group training on mothers on the signs of confrontational disobedience in children malekzadeh Hoda deyreh Ezat Amini Naser Narimani Mohammad P.H.D Student of Psychology Department, Bushehr Branch, Islamic Azad University, Bushehr, Iran. Assistant Professor of Psychology Department , Bushehr Branch, Islamic Azad University, Bushehr, Iran. Assistant Professor of Psychology Department, Bushehr Branch, Islamic Azad University, Bushehr, Iran. Academic Tenure of Psychology Department, Mohaghegh Ardebili Univesity, Ardebil, Iran. 1 12 2021 28 9 68 79 20 01 2021 11 04 2021 Background & Aims: The study of psychological problems of children and adolescents has always been one of the main concerns of psychologists. Meanwhile, children and adolescents with behavioral problems pose more challenges for professionals. Children with behavioral problems and disorders also pose many challenges for their parents. These children show behaviors that hurt those around them. Common childhood disorders are usually classified into two broad areas: extrinsic disorders and intrinsic disorders. Outward disorders are characterized by behaviors such as aggression, disobedience, hyperactivity, and impulsivity that are more outward-looking. This category includes attention-deficit/hyperactivity disorder, behavioral disorder, and coping disobedience disorder. Introspection disorders are characterized by experiences and behaviors such as depression, social withdrawal, and anxiety that are more inward-looking. This category includes childhood anxiety and mood disorders. Disobedience disorder is one of the most common mental disorders that occurs with a prevalence of 2 to 16% in preschool or early school children and the pre-adolescent stage. Behavioral disorders in children pose challenging problems for teachers, families, and children themselves, and have raised concerns about mental health and its impact on children's development and performance. On the other hand, in the approach of modifying the pattern of parent-child interaction, special procedures are used to treat the behavioral disorders of children with confrontational disobedience; Practices such as improving parents 'selective attention skills, modifying parental commands, modifying children's play behavior, parents' use of deprivation, parenting planning and activity planning to prevent problems, especially before entering public places. In the method of modifying the pattern of parent-child interaction, the methods of communication and management of parental behavior are modified. Procedures to improve parents' selective attention skills, modify parental commands, modify children's play behavior, and evaluate will also be reviewed. Therefore, the main question of the present study is that group training to modify the pattern of parent-child interaction affects internalized behavioral problems, externalized problems, and general problems in the signs of confrontational disobedience in children? Methods: The present study was a semi-experimental study in which the pre-test-post-test design was performed with the control group by baseline assessment after the intervention and 3-month follow-up with the control group. 40 mothers of primary school male students in the school year of 2019-2020 in Shiraz, they were selected from 32 male public primary schools, were assigned randomly to two groups (modification of parent-child interaction pattern as exprimental group) (n = 20) and control group (n = 20). All participants completed the demographic questionnaire, the symptoms of disobedience questionnaire on Achenbach's behavioral Inventory in three stages. Hypotheses related to the effectiveness of research interventions were analyzed using mixed analysis of variance as well as Bonferroni post hoc tests. Results: The results of the present study showed that the mean of the symptoms of disobedience disorder in the pre-test stage was not significantly different between the two groups, which indicates the homogeneity of the two groups in the pre-test stage, but the difference between the four groups in the post-test and follow-up stages. There was evidence that the effectiveness of the intervention on the mentioned variables and the stability of effectiveness in the follow-up phase. Conclusion: This study aimed to investigate the effect of group training on parent-child interaction pattern modification on internalized behavioral problems, externalized problems, and also on the index of general problems in children with disobedience disorder. In the present study, it was observed that the results related to the demographic characteristics of the study units, which include mothers of children with confrontational disobedience disorder, were not statistically significant in the two groups of control and intervention in terms of demographic characteristics. The features were homogeneous; therefore, according to the intervention, the two groups were compared. In the experimental group, changes were made in internalized behavioral problems, externalized problems were also better in the index of the general problem. Therefore, the results of this study showed that the mentioned treatment can be used as a psychological intervention in reducing the symptoms of confrontational disobedience in children aged 8 to 11 years. Due to the effective effectiveness of the parent-child interaction model, this treatment can be prioritized. 6817 Clinical Psychiatry The effect of education based on positive psychology approach on psychological well- being, meaning in life and vitality in wives of war veteran and wives martyrs Rooitalab Asieh Maredpour Alireza Taghvaeinia Ali Department of Psychology, Yasooj Branch, Islamic Azad University, Yasooj, Iran 1 12 2021 28 9 80 91 06 03 2021 28 04 2021 Background & Aims: War has a profound and profound effect on the mental health and well-being of its soldiers, veterans and victims. War and military violence have led to communication malfunctions and disruption of family dynamics and mental health (1). The psychological problems caused by war usually affect the victims and their families for a long time after the war, and these psychological consequences can sometimes last up to 20 years after the war. The absence of the father or his injury in the family also causes the mother many problems and endangers her mental health (2-3). This is likely to be doubled for women who have lost their husbands or whose husbands have suffered serious physical or psychological harm. In this regard, it has been determined that the psychological well-being of the three groups of spouses of veterans, freedmen and martyrs is at the lowest level of mental well-being (5). From a positive psychology perspective, the absence of symptoms of mental illness is not an indicator of health and well-being. Rather, adaptation, happiness and self-confidence and such positive characteristics determine health and the main goal of a person in life is the flourishing of one's abilities, abilities and talents (8). In this regard, positive therapy can not only create positive resources but can also have a reciprocal effect on the negative symptoms and also prevent their recurrence. Two important factors related to the concept of psychological well-being are the sense of meaning in life and vitality. Several studies have documented this relationship in the research literature (13). For example, the existence of meaning in life predicts psychological well-being (14). In fact, the meaning in life and psychological well-being are important issues in positive psychology. The feeling of being alive is closely related to happiness and psychological well-being and is considered as one of the most important human experiences (17). Numerous studies have shown that living in the wives of veterans and martyrs for any reason reduces self-confidence and self-efficacy, which in turn can reduce the quality of life and psychological well-being. Therefore, interventions that reduce these factors and improve these psychological indicators are essential. Therefore, the purpose of this study was to investigate the effect of positive psychology intervention on psychological well-being meaning in life, and vitality of martyr and veteran spouses. Methods: The method of this study was quasi-experimental with a pretest-posttest design along with a control and experimental group. 28 wives of martyrs and veterans of Shiraz participated in this study who were randomly assigned into control group (n=14) and experimental group (n=14). This study was approved by the Research Ethics Committee of Shiraz University of Medical Sciences and was conducted according to the Helsinki Declaration (19). In this study, Ryff Psychological well-being Questionnaire, Meaning of Life Questionnaire and Vitality Questionnaire were used to collect data. Positive psychology intervention protocol was performed in 10 sessions for 90 minutes in the experimental group. This protocol is based on a study by Seligman et al. (2006) (11). After practice in the experimental group, post-test measurements were performed again in both groups. In order to compare the internal group (pre-test and post-test) and research groups, paired sample t-test and independent sample t-test were used at the significance level of α = 0.05, respectively. Results: The average age of participants in the control group was 41.57±9.96 years and this index for the experimental group was 44.21±10.28 years. The number of spouses of veterans and martyrs is equal in both groups. According to the paired sample t-test, there is no significant difference from pre-test to post-test in the control group in any of the indicators of psychological well-being, meaning of life and vitality (p ˃ 0.05). However, this difference in the experimental group in the overall score of mental well-being (p = 0.001, t = 6.034), self-acceptance (p = 0.007, t = 3.213), environmental dominance (p = 0.001, T = 4.323), positive relations with others (p = 0.001, t = 4.527), autonomy (p = 0.004, t = 3.513), presence of meaning (p = 0.041, There are t = 2.271), total score of meaning of life (p = 0.018, t = 2.652), and vitality (p = 0.017, t = 2.742). There was no difference in other variables (p ˃ 0.05). The results of independent sample t-test show that there is a significant difference in the overall score of psychological well-being (p = 0.001, t = 3.475). Moreover, among the subscales of the psychological well-being questionnaire, only self-acceptance was significant (p = 0.001, t = 3.677). Also the meaning of life (p = 0.047, t = 2.898) was significant. There was no difference in other variables (p ˃ 0.05). Conclusion: Positive intervention due to changes in the behavior, attitudes, beliefs and emotions of the wives of martyrs and veterans and enjoying them with characteristics such as being active and energetic, willingness to communicate with others, positive and having attitudes and perceptions Positive self and other people and controlling emotions helps to empower them (30). The result of such empowerment is the strengthening of positive emotions and greater success in life. It can be said that positive education activates positive emotions and prevents negative emotions that play a key role in reducing their mental well-being to replace positive emotions (31). In this intervention, the wives of martyrs and veterans learn to have a positive self-image instead of blaming themselves, to remember the past with satisfaction and hope for the future. These people can turn challenges into opportunities and use effective coping strategies to deal with negative thoughts and then accept positive thoughts instead, as well as to cope with problems more effective (33). Of note, Positive education leads to activities that take these people to a pleasant inner world and help them gain a sense of excitement, meaning in life, goal setting and motivation, and consequently it affects their well-being and mental health (34-35). As a result of such interventions, they tend to positive social aspects and feel more responsible for their behavioral and communication health in life. In general, the results of this study showed that education based on a positive psychology approach has an effect on well-being and the meaning of life but has no effect on vitality (37-38). Psychologists can use this intervention to increase mental well-being and, consequently, quality of life and increase mental health. Also, this intervention can be provided as a psychological package to the centers related to the families of martyrs and veterans so that the psychologists of these centers and counselors can use it.  It should be noted that future studies should be conducted in qualitative or mixed methods to obtain more accurate information. Comparison of the effectiveness of this intervention with other interventions should be evaluated to determine its effectiveness compared to other interventions.   6927 Clinical Psychiatry Identify the factors affecting violence and aggression Mafakher Leila Khatibi Amin hojabrnia Zahra Nadri Amir Department of Sport Management, Shahid Chamran University of Ahvaz, Ahvaz, Iran 1 12 2021 28 9 92 103 07 03 2021 26 06 2021 Background & Aims: Aggression and violence are known as global dilemmas and have destructive physical and mental impacts on social and individual levels (2). Experts have emphasized the need for research in the field of violence and aggression to identify the factors that cause and motivate it, as well as providing preventive solutions, and have stated that identifying and explaining violence and aggression or choosing location have provided the best intervention strategy to control and prevent them. (3) Violent and abnormal behavior by athletes, spectators, coaches, and officials of sports teams such as basketball, wrestling, volleyball, football, and futsal are one of the main problems of these sports, which in addition to economic problems and losses, in terms of moral, social, cultural and political also cause great harm (4) Regardless of whether it is a team or an individual, the sport has examples of social processes that include competition, aberration, status relations, sociability, social exchange, cooperation, control, conflict, resource allocation, adaptation, group performance, aggression, and violence (5). However, it should be noted that these processes have different quality and quantity among different sports. The atmosphere of sporting events and competitions puts spectators in an emotional state in which experiencing this type of emotion can lead to emotions and behaviors that are referred to as violence or aggression (7, 6). Stadium violence is both a crime and contrary to certain sports norms. Various factors such as security forces, athletes, coaches, spectators, referees, and club officials can play a direct and indirect role in causing violence in stadiums (11). Among the influential factors in causing stadium and spectator violence, they have attracted more attention and are more visible. Considering that wrestling is the most honorable sport in Iran and also it is a sport in which heroic ethics and character play the first role and the occurrence of violence and immorality can hinder the development and growth of this sport among those who are interested in it and that no research has been done on determining and prioritizing the factors affecting the violence of wrestling spectators, so the researcher has decided to design the effective factors of violence in sports stadiums according to quantitative and qualitative factors; thus, the aim of this study is to investigate the factors affecting the incidence of violence and aggression in wrestling competitions. Methods: The method of the present research is descriptive survey research and is applied in terms of purpose, which was conducted cross-sectionally. In accordance with the stages of the mentioned research strategy, the researcher has referred to the subject experts in the qualitative stage of the research to collect data; the statistical population of the qualitative stage included 12 experts and specialists aware of wrestling, including coaches, champions, referees and officials of the wrestling federation. Due to the fact that the researcher did not have direct access to the experts in question at the beginning, as a result, by identifying the first person, an attempt was made to identify and conduct interviews with other wrestling experts and specialists in the target cities. The statistical population also included a small number of spectators participating in the junior, youth, and adult wrestling championship teams across the country. In the sampling section, the provinces of Tehran, Khuzestan, Mazandaran, Khorasan, and Isfahan were randomly selected from the active provinces of the whole country. In order to test the obtained effectiveness model, the indicators obtained from the quality section were distributed among 220 spectators of the Premier Wrestling League in selected provinces (Tehran, Khuzestan, Mazandaran, Khorasan and Isfahan). The collection tool in this study was a researcher-made questionnaire that was based on the indicators extracted from the qualitative interviews. This questionnaire contains 73 items. To answer these items, a very low to very high Likert scale was used. Cronbach's alpha coefficient was used to assess the reliability of the research questionnaire using SPSS 24 software. To test the proposed measurement models to determine the dimensions affecting violence and aggression in wrestling competitions from exploratory factor analysis by principal component analysis and structural equations including first and second place confirmatory factor analysis by SmartPLS software used. Results: The proposed model extracted in the qualitative part by interview and coding including four factors (managerial, behavioral, social, and cultural) were used, respectively. In the validation stage, by Cronbach's alpha, for a sample of 220 people, 3 indicators were excluded from the general model due to low validity, and instead of 73 indicators, 70 indicators were evaluated. The results showed that behavioral, managerial, cultural, and social factors are among the causes of violence and aggression in wrestling competitions. In comparing the factor loads of the dimensions of violence, respectively, the importance of the impact of the behavioral management dimension is followed by the managerial dimension, the cultural dimension, and finally the social dimension. In the behavioral factors, the components had a greater effect on violence and aggression in wrestling competitions, respectively, the behavior of athletes and the behavior of spectators. In the managerial factors, the components, respectively, the management of the competition, the conditions of the competition, facilities and services, electronic equipment, and finally the security atmosphere system had a greater impact on violence and aggression in wrestling. Conclusion: One of the effective factors in the occurrence of violence and aggression is the behavior of athletes. According to the theory of instinctive aggression, internal aggression is a genetic component and exercise is an acceptable and effective means to get rid of factors related to violence and aggression. Those with a strong competitive nature are more likely to explore opportunities and have a greater motivation to reach them. It should be noted, however, that having a competitive personality trait cannot predict an individual's responses; thus, those with a winning personality behave more aggressively than other people. Therefore, it is believed that the more the athlete is able to understand, accurately express, regulate and identify emotions, the more he will have thinking habits that will make him more efficient and improve his performance (18). Other causes of violence and aggression are spectator behavior. According to the theory of instinctive behavior, aggression and violence by spectators during or after sports matches are a symbolic display of aggressive energy that, if suppressed, occurs in the context of society and rates, and will increase violent crime and violent behavior in other social arenas. In this regard, failure to achieve goals leads to various behaviors, one of which is aggression. According to this theory, the vandalistic and mobster behaviors of spectators are largely the result of their failure to achieve their goals during competitions (22). Finally, other factors influencing the occurrence of violence and aggression are psychosocial phenomena that can be manifested in emotional environments. Examining the favorable social contexts in wrestling can be considered as a sociological study that allows the identification of social factors affecting sports and violence (25). According to the theory of social learning, a person's behavior is formed through observation and during socialization and role modeling. According to Bandara, by observing violent and undesirable behaviors from family, media, peers, people learn what violence is and how to deal with it, then they are more likely to implement this behavior in their personal lives, even in social lives (26). Therefore, in order to prevent the occurrence of violence, in addition to creating a culture, it is possible to prevent the occurrence of violence in sports events by increasing the quality of competitions. 6845 Biology Review of surface proteins of SARS-CoV-2 virus causing COVID-19 Saedaei Jahromi Bahar Ahmadian Gholamreza Allahyari Fard Najaf National Institute of Genetic Engineering and Biotechnology (NIGEB), Systems Biotechnology Department, Tehran, Iran 1 12 2021 28 9 104 117 24 03 2021 17 10 2021 The COVID-19 pandemic is an urgent global health emergency and is an infectious disease caused by the SARS-CoV-2 virus. Severe Acute Respiratory Syndrome, which is the result of SARS-CoV-2 virus pathogenicity, has caused a worldwide pandemic and has affected all aspects of individual, social, and economic life. To date, millions of cases and thousands of deaths have been reported in more than 200 countries, and the outbreak continues. Preventive measures, drug design, vaccine design, and preparation of programs to combat the disease, require accurate knowledge of the nature, parts, and function of the surface proteins of SARS-CoV-2. Therefore, in this article, the diversity, structure, and mechanisms related to SARS-CoV-2 surface proteins were reviewed and presented based on the latest scientific findings published in the Web of Science, PubMed, Scopus, ScienceDirect, Google Scholar databases in 2020 and 2021. Results and Conclusion: Coronaviruses (CoV) mainly cause infections of the respiratory and gastrointestinal tracts and are genetically classified into four genera, Alphacoronavirus, Betacoronavirus, Gammacoronavirus, and Deltacoronavirus. human CoV can damage various tissues and activate apoptotic cascades. SARS-CoV, MERS-CoV, and some human CoV, including HCoV-OC43 and HCoV-HKU1, belong to the genus Betacoronavirus. SARS-CoV-2 particles have a spherical shape that their diameters are approximately 100 nm. Coronaviruses have the largest genome of all RNA viruses. SARS-CoV-2 has a positive single-stranded RNA of approximately 30 Kb. The first reading frame, which accounts for about 67% of the total genome, with approximately 20 Kb, encodes 16 nonstructural proteins (NSPs), and the remaining 10 Kb frames encode structural and peripheral proteins. SARS-CoV-2 has four surface proteins including surface glycoprotein called S protein, nucleocapsid protein (N), matrix protein (M), and coating protein named E. The S protein plays an important role in the first step of infections. The S protein has two domains, S1 and S2, and is most important in interacting with the receptor protein and the host entrance. The SARS-CoV-2 virus uses the Angiotensin-converting enzyme 2 (ACE2) as the major receptor and the CD209L protein as the lateral receptor to enter the host cell. RBD is the part of S1 that binds to the host receptor. Also, the RBM or receptor binding motif) has an important role in the binding. These proteins can be found in influenza viruses, human immunodeficiency virus (HIV), and Ebola virus. These proteins have 1273 amino acids and a molecular weight of 180-200 kDa. Furin protease binds S protein with high affinity and cleaves the S protein into S1 and S2 domains.  Spike proteins also have a polysaccharide coating that deprives the host immune system of the ability to identify itself as a foreign agent. The S protein is a trimmer protein that has two distinct structural modes, including pre-binding and post-binding. Pre-accession detection by the immune system, which is based on the glycosylated coating of the viral protein spike surface, is critical to eliciting an effective immune response. In the S domain, RBD, NTD, and CTD regions are known. One or both NTD and CTD domains have the potential to bind to the receptor and act as the RBD region. The N-terminal region binds to polysaccharide molecules. The role of the CTD region is to identify ACE2 and DPP4 receptors. The S2 domain consists of five domains that are responsible for fusion and entry into the host cell. These five domains include the FP, HR1, HR2, TM peptides, and the cytoplasmic region. The supplement peptide contains 15 to 20 protected amino acids. This amino acid is generally hydrophobic and glycine and alanine are among the many amino acids of this peptide. The nucleocapsid N protein is a structural protein. This protein binds to the RNA virus and is involved in processes related to the virus genome, such as genome replication and response to infectivity. This protein binds the RNA virus to the replicase-transcriptase (RTC) complex, which eventually encapsulates the genome after virions are prepared and help release virion particles. These proteins are highly phosphorylated, thereby increasing the strength of the protein to bind to RNA. M protein is another vital part of the virus that is involved in determining the structure of the virus coat. This protein can bind to all other structural proteins. M Protein, along with N protein, is involved in the assembly and release of virion particles. This protein is a dimer and can have two different structures. Since this protein is not similar in the human vital system and plays a role in the cell cycle of the virus, it can be a good target for drug design. In the SARS-CoV-2 construct, the smallest protein is protein E. In terms of number, these proteins are small in number, the coating proteins have ion channel activity and are membrane proteins. The main activity of this protein is in the assembly and release of the virus and it has no role in genome replication. By improving our understanding of the surface proteins of SARS-CoV-2, we may facilitate the development of appropriate antiviral drugs and vaccines to control and prevent diseases caused by known and potentially emerging Coronaviruses. 6432 Pharmacology The role of curcumin in ameliorating learning and memory disorders Amiri Shiva Jafari-Sabet Majid Hoormand Mahmood Kerman University of Medical Sciences Iran University of Medical Sciences, Tehran, Iran Iran Univetsity of Medical Sciences 1 12 2021 28 9 118 134 31 08 2020 14 05 2021 Curcumin is an active yellow substance extracted from the rhizome of Curcuma longa (turmeric). In recent years, curcumin has been reported to have anti-cancer, liver protection, thrombus inhibitor, cardiovascular and anti-arthritis effects. Curcumin has been also known to modulate intracellular signaling pathways that control cell growth, inflammation, and apoptosis (programmed cell death). Curcumin is a powerful antioxidant that reduces circulating free radicals and due to its antioxidant and anti-inflammatory activities can be a potential candidate for the prevention or treatment of neurological diseases and memory disorders. The results of studies in rodents (without induction of memory impairment) have shown that certain doses of curcumin improve memory function. It has been reported that curcumin can prevent and improve age-related memory impairment as one of the causes of irreversible memory impairment over time. However, the results of some studies have shown that in the absence of memory impairment, the effect of curcumin is similar to placebo and does not increase learning and memory. Since the identification of basic and potential mechanisms involved in memory enhancement for therapeutic use of this composition is very important, this article has been reviewed the role of curcumin in improving memory disorders as well as the involved molecular mechanisms. A summary of these mechanisms are outlined below: •• Modifying monoamines (serotonin, dopamine, and noradrenaline) levels, monoamine oxidase (MAO) activity, acetylcholine-esterase activity, and glutamate release. Animal studies have shown that curcumin inhibits low levels of monoamine oxidase A (MAO-A) in the brain, increasing serotonin and noradrenaline levels, and in high doses inhibits dopamine metabolism by inhibiting MAO-B enzyme. Biochemical studies have also shown that curcumin significantly increases serotonin and noradrenaline levels in both the frontal cortex and hippocampus. Studies have also shown that curcumin is effective in reducing cellular reactive oxygen species due to increasing glutamate levels. On the other hand, in the neuronal terminals of the hippocampus, curcumin can reduce the concentration of calcium in the synaptosomes, so this effect is the same as nimodipine as an L-type calcium channel blocker, and thus prevent the neurotoxicity caused by the influx of calcium into the cell. Also, curcumin plays a role in modulating muscarinic receptors. Moreover, studies have shown that curcumin treatment significantly increases acetylcholine-transferase and regulates acetylcholine-esterase expression which has a positive effect on cognitive function. •• Providing neuroprotection and enhances neuronal growth by influencing brain-derived neurotrophic factor (BDNF) levels, cyclic adenosine monophosphate (cAMP) activity, and extracellular signal-regulated kinase (ERK) activity. Increased BDNF plays an important role in brain growth and synaptic plasticity by inhibiting nerve damage and stimulating neurogenesis and cell survival. BDNF / tyrosine kinase B signaling re-leads to phosphorylation and activation of transcription factors such as CREB, which results in long-term gene expression and synaptic changes. In one study, curcumin administration significantly increased the expression of phosphorylated BDNF in the dentate gyrus. Another study showed that curcumin use in rats increased hippocampal neurogenesis by regulating and activating BDNF and 5-HT1A receptors. By activating BDNF, curcumin protects nerve cells from chronic stress and glutamate over-stimulation. In another study, long-term administration of curcumin showed a steady increase in BDNF levels in the amygdala and increased phosphorylation of ERK (Extracellular signal-regulated kinases). ERK1/2 phosphorylation has been shown to activate a set of protein signaling cascades, which in turn leads to a wide variety of cellular processes such as growth, survival, and neuronal cell formation. Activation of ERK signaling pathways leads to phosphorylation of CREB as a major mediator of cell function, survival, and differentiation. Besides, activation of CREB, in turn, leads to increase BDNF gene expression. Zhang et al. (2012) showed that the level of phosphorylated ERK proteins in the amygdala increased rapidly in curcumin-treated animals. •• Protecting against oxidative stress through activation of antioxidant enzymes, inhibition of lipid peroxidation, metal ion chelation and increasing inducible nitric oxide synthase activity. Glutathione peroxidase (GPx) and superoxide dismutase (SOD) are the most important antioxidant enzymes that protect against reactive oxygen species (ROS). Curcumin increases the activity of SOD, GPx, and GR enzymes and inhibits the increase of Malondialdehyde (MDA) in a dose-dependent manner which indicates the antioxidant effects of this substance. Moreover, curcumin can reduce beta-oxidation of fatty acids and lipid peroxidation in brain tissue, and given that the intensification of oxidation of such substances can impair learning and memory, so part of the beneficial effect of high-dose curcumin on learning and memory can be attributed to the inhibition of fatty acid oxidation. Studies have also shown that curcumin has a protective effect against damage caused by metal ions such as iron, lead, and cadmium in rat hippocampal cells by chelating them and, thus reducing their neurotoxicity. Studies have shown that increasing nitric oxide (NO) and activating the nNOS/NO signaling pathway in the rat hippocampus improves memory while inhibiting it with nNOS-specific inhibitors reduces it. Neurological, chemical, and behavioral evidence suggests that pretreatment with curcumin significantly increases nNOS/NO pathway activity in the peripheral cortex (PFC), amygdala, and hippocampus and thus improves memory in mice. On the other hand, 7-nitroimidazole (7-NI), a specific inhibitor of nNOS, reduces the effect of curcumin on improving long-term memory. •• Modulating inflammation by influencing cytokine gene expression, nuclear factor-κB (NF-κB) activity, tumor necrosis factor-α (TNF-α) levels. It has been observed that microglia, as the main immune cells in the CNS, can produce inflammatory cytokines to regulate homeostasis and fight pathogens. Overproduction of inflammatory cytokines can lead to neuritis, nerve damage and death. In addition, neuroinflammation is the first major step in neurodegenerative diseases. Curcumin inhibits and reduces the production of inflammatory factors by inhibiting microglia activation. Curcumin exerts its anti-inflammatory effect by inhibiting NF-ƙB activation. Curcumin also reduces and modulates the enzyme COX-2, various inflammatory cytokines such as TNFα, IL-1, IL-6, IL-8 and interferon γ. Conclusion: There is a lot of evidence that curcumin can play a role in the treatment of neurological diseases such as Alzheimer's, depression, and Parkinson's. Numerous studies have also shown that curcumin has a significant effect on improving learning and memory in various laboratory models and can play a preventive and therapeutic role in this regard. This may be due to its known antioxidant and anti-inflammatory properties, as well as the modulation of neurotransmitters or the regulation of homeostasis of proteins involved in signaling pathways. Although the use of curcumin seems safe according to the results of laboratory studies and clinical trials, it is necessary to prove the effectiveness and safety of curcumin in its short-term and long-term use in clinical trials to improve learning and memory.   6860 Neonatology A review of telemedicine in preterm infants in the corona pandemic Amini Zahra Askary kachoosangy Reihaneh Department of Occupational Therapy, School of Rehabilitation, Shahid Beheshti University of Medical Sciences, Tehran, Iran Department of Occupational Therapy, School of Rehabilitation, Shahid Beheshti University of Medical Sciences, Tehran, Iran 1 12 2021 28 9 135 145 04 04 2021 01 07 2021 Background & Aims: Neonatal care have changed dramatically over the last year by coronavirus epidemic in the world .Besides, the current situation seems to continue for a long time .in addition premature infants are at risk for various disorders in their motor and cognitive development compared to adult infants. Therefore, in order to minimize the developmental problems caused by prematurity, this community needs to receive timely interventions in the golden time of hospitalization in neonatal intensive care units and after discharge. Researches are looking for an alternative way to provide services in case the coronavirus has affected the outcomes of the parents and neonates and the necessity of providing early intervention .Therefore using telemedicine for giving services from distance can be a helpful method .Consequently, by considering the corona pandemic and limited studies about telemedicine in this field, the present study is a review of the history of telemedicine in neonatal care and it's uses, to collect related documents in a single article, as a result it can be helpful for cilinical use of this method. The use of telemedicine in the field of infants dates back to 1998, when equipment was used to communicate live with the parents of premature infants admitted to the NICU to see their infants (2).  After the outbreak of coronavirus, there has been a significant increase in the use of this method by therapist(3). The advantages of this method include the following:  1- Ease of providing medical services by doctors and therapists to clients at long distances without physical presence. 2. Improving the accessibility and usefulness of services  3- Ability to provide information in the form of multimedia and multidimensional (audio, text, photos, videos, etc.)  4. Cost-effectiveness and savings in resource use (4). Most of the published articles on telemedicine in the field of neonates are related to the diagnosis of premature retinopathy (2). As a result of this research, Isaac et al. Believe that depending on the location and number of premature infants, using telemedicine to diagnose ROP may be more cost-effective and a good economic choice compared to individual and face-to-face examinations (5). Another group of researchers preferred the video calling method to find the most effective way to provide information through telemedicine. (6, 7) Despite presenting the results of the effectiveness of telemedicine on parent-infant factors such as increasing mother-infant attachment, reducing maternal stress and parent-infant relationships, other researchers conducted clinical trials and compared the effectiveness of providing services on parental and neonatal factors through telemedicine. In contrast, the face-to-face approach encourages (8-10). Methods: This study is a review study that used domestic and foreign databases for collecting information between 2015 to 2020 . A total of 126 articles were found, which after reading the title and number of abstracts of 94 articles were excluded from the study due to lack of relevance or repetition of topics. Out of the remaining 32 articles, 15 were excluded from the study after reviewing their full text, which did not meet the inclusion criteria, and finally 17 articles were included in the present study. Results: Preterm infants are at risk of various disorders in their motor and cognitive development compare to term infants. Therefore, parental education is important because the main caregivers of infants are their parents. Due to the recent improvment of communication technologies, the use of telemedicine in the field of infants is developing day by day. The evidence of using telemedicine has shown that using this method increases the access of specialists to infants, reduces unnecessary transfer of infants, reduces referrals after discharge and thus reduces costs and mother_infant separation. In addition, the use of this method of treatment in the current situation leads to the observance of the principles of quarantine and social distance and also does not interfere with the use of golden time in the treatment of infants. Considering the increasing use of telemedicine in the field of infants and the importance of leading issues for organizations and institutions for the practical implementation of this program, further studies in the field of laws and regulations governing it, examining its effectiveness compared to face-to-face method, how to present the program Remote evaluations in the field of neonates, funding, and how to determine the target group are suggested. Conclusion: With the prevalence of coronavirus and emphasis on minimal interpersonal communication and avoidance of referrals to medical centers as much as possible and also considering the condition of premature infants and the importance of productivity of golden time in order to get the best results Health professionals are looking for an alternative way to provide services to parents of premature infants. It seems that one of these ways is to provide remote services by using new technologies. Telemedicine is a suitable platform for providing services and multi-purpose information This way makes it easier to work, increases access and reduces economic costs. So far, various specialists use this method in diagnosing neonatal retinopathy, parents education and home care training And other purposes. Therefore, due to the importance of this field and increasing use of it And the importance of leading issues for organizations and institutions to implement this program in practice, Further studies in the field of laws and regulations governing it, examining its effectiveness in comparison with the face-to-face method, How to provide programs and remote assessments in the field of infants, Funding and how to determine the target group is suggested.   6871 Pathology Evaluation of the toxic effects of lysine and nano-lysine amino acids on weight, growth and histopathological lesions of the fetus using a chick embryo model Derakhshanfar Amin Tavakkoli Hadi Moayedi Javad Poostforoosh Fard Ali Shiraz University of Medical Sciences Shahid Bahonar University of Kerman Shiraz University of Medical Sciences Shiraz University of Medical Sciences 1 12 2021 28 9 146 156 11 04 2021 17 05 2021 Background & Aims: Millions of people take dietary supplements for a range of health benefits, from weight loss to muscle building, but some supplements can be very harmful. Lysine is an essential amino acid for humans and has several physiological effects on body organs and the growth process. It is found in large amounts in the structure of most proteins like histones, but not produced enough in the human body and must be supplied through food intake. The use of food supplements containing lysine amino acids is increasing rapidly in the world; however, the toxicopathological effects of such amino acids have always been a major concern. Besides, the use of nanodrugs increases the permeability of compounds to body tissues; therefore, the use of various drugs, minerals, vitamins, and amino acids in nano forms have been considered in medical and nutritional sciences. Since the pathological and teratogenic effects of lysine and nano-lysine amino acids on human fetus have not been evaluated, the current study aimed to investigate the toxic effects of lysine amino acid and its nano-form in different concentrations using the chick embryo model. Due to ethical rules and regulations, no drug experiment on the human fetus is permitted; hence, the chick embryo model is used as an ideal opportunity to study the adverse effects of such amino acids. Methods: In this experimental study, a total of 70 fertile chicken eggs (Ross 308) with the similar average egg-weight were purchased from the Mahan Breeder Company, Kerman, Iran. The eggs were incubated at 37.5 ºC and 60% relative humidity in an incubator. On the 4th day of the embryonic growth, the chicken eggs were randomly assigned into seven equal groups, 10 eggs each. The wider end of the eggs was disinfected by ethanol 70% and the eggshell was punctured. Embryos received treatment by direct injection into the yolk sac according to the standard techniques. In the control group, 0.5 cc of phosphate buffer saline and in experiment groups, 0.5 cc of lysine and nano-lysine amino acids at doses of 30 mg/kg, 50 mg/kg, and 100 mg/kg egg weight were inoculated. After treatment, the exposed hole was sealed with warmed paraffin and the eggs were placed back into the incubator under the mentioned condition. The viability of the embryos was checked throughout the incubation period by candling. Embryos were allowed to develop until day 18, after which they were humanely killed by placing on ice and the eggs were opened at the wider end. After washing in normal saline solution, embryos were observed under stereomicroscope to study any gross abnormalities on the external body surface. The membranes and yolk sac were also inspected. The average embryo-weight/egg-weight in grams and the average body length in millimeters of each group were also computed. Body weight was measured by a digital scale and body length was measured by a digital caliper (from the front border of the head to the base of the tail including the tip of the uropygial gland). The tissues including brain, heart, lung, liver, and kidney were sampled and fixed in 10% neutral buffered formalin. Following routine preparation of tissues, serial sections of paraffin embedded tissue samples of 5 μm thicknesses were cut using a microtome, and stained with hemotoxylin and eosin. Tissue slides were evaluated under light microscope by a blinded pathologiest. Statistical analyses were performed using SPSS version 20. The Fisher's exact test was used to determine the significant differences in lesion occurrence between experimental groups. One-way analysis of variance followed by Tukey's test was applied to assess the significance of differences in embryos weight and body length. A p-value of <0.05 was considered as statistically significant. Results: All the embryos treated with doses of 30 mg/kg, 50 mg/kg, and 100 mg/kg egg weight of lysine and nano-lysine amino acids were normal; hence, there were no abnormality in color, feather, limb, and other external body features. Besides, there were no marked depression in the body length and the embryo-weight/egg-weight of lysine and nano-lysine amino acids treated groups; however, inoculation of nano-lysine amino acid at dose of 100 mg/kg was resulted in embryos weight loss and growth retard. Various pathological lesions were observed following the inoculation of doses of 30 mg/kg, 50 mg/kg, and 100 mg/kg egg weight of lysine and nano-lysine amino acids. In all experimental groups, congestion and edema were observed in the lung tissue but it was much more severe in those treated with doses of 50 mg/kg and 100 mg/kg egg weight of nano-lysine amino acid. Congestion and edema were also observed in the brain of all groups; however, microtrombosis was seen merely in those treated with doses of 50 mg/kg and 100 mg/kg egg weight of lysine amino acid. In liver tissues, congestion and fatty liver were obvious in those treated with doses of 30 mg/kg, 50 mg/kg, and 100 mg/kg egg weight of nano-lysine amino acid. However, the embryos treated with different doses of lysine amino acid showed severe dilation of central veins and sinusoids as well as hepatocellular degeneration. Although inoculation of lysine and nano-lysine amino acids at dose of 30 mg/kg lead to congestion in kidney tissue, the higher doses in both lysine and nano-lysine amino acids treated groups caused sever congestion, renal glomerular atrophy, dilation of vasculature, tubular dilatation, and tubular epithelial changes. The heart in those treated with 30 mg/kg egg weight of lysine amino acid was normal. Congestion and dilation of myocardial vasculature were observed in the heart tissues of other groups. Besides, rhabdomyolysis and replacement of cardiac muscle by myxomatous tissues were also seen in the heart of those treated with 100 mg/kg egg weight of nano-lysine amino acid. Conclusion: Based on findings of this study, inoculation of doses of 30 mg/kg, 50 mg/kg, and 100 mg/kg egg weight of lysine and nano-lysine amino acids are toxic to the chicken embryo in a dose dependent manner. Embryogenesis in chick is similar to human; therefore, the use of lysine and nano-lysine during the pregnancy might have adverse effects on the internal organs of the human fetus. Therefore, it is recommended that the use of these compounds during pregnancy be taken with caution. 6923 Clinical Psychiatry The effect of constraint manipulation (non linear method) on the level of intrinsic motivation and skills in girls aged 7 to 9 years Kordi Fatemeh Arsham Saeed Parvinpour Shahab Lotfi Gholamreza 1 12 2021 28 9 157 171 22 02 2021 07 07 2021 Background & Aims: Motor learning is one of the complex processes that affect many factors in this process. Among the factors influencing this process can be briefly mentioned the type of pedagogy, the type of skill and its complexity, and the psychological and motivational factors of the learner in the learning process. Targeting-Inhibition skills are a dynamic action that requires a close connection between a person's movement and the spatial and temporal constraints exerted by a moving target (e.g., "ball"). Through a process known as perception-action pairing, the "receiver" uses dynamic external information that changes the spatial / temporal properties of the ball (perceptual constants) to schedule and control the receiver's performance. These perceptual constants can be mathematically described as nonlinear algorithms; in this way, information can be extracted to guide the action. Using nonlinear algorithms, these nonlinear algorithms argue that the process of learning is not a continuous linear progression of behavior but a sudden and discontinuous change over time. The learner must consider a nonlinear dynamic system that includes many components that interact to execute a fixed pattern. The operational solution is facilitated by the interaction of individual, environment, and task constraints that form the boundaries of goal-oriented behaviors. In this approach, unlike previous approaches to motor learning, there is no central controller (such as a coach) to determine how a behavior should be performed. Chu et al. (2007) first coined the term "nonlinear pedagogy" so that educators could benefit from these theoretical concepts simultaneously. According to the constraint-led approach, the nonlinear teaching method defends the manipulation of key constraints to form the learner's boundaries and the learner can discover the motor solution. Therefore, the purpose of the current study was to compare the effect of linear and nonlinear pedagogy on intrinsic motivation and the success rate of receiving a interceptive skill in girls aged 7 to 9 years in Boroujerd. Methods: The strategy of this research was quasi-experimental and pre-test-post-test research design and 7-day follow-up period. The present study was also applied research in terms of purpose. Also, the present study was conducted in the field. The statistical population of the present study was 7 to 9 year old girls in Boroujerd. Participants in this study were 45 female students aged 7 to 9 years with normal vision who were selected in an accessible and purposeful manner based on obtaining a minimum score of 20 in the practical test of MABC-2. Based on the pre-test scores, participants were divided into three homogeneous groups of 15 people with linear pedagogy, non-linear pedagogy and control. Measurement tools included a MABC-2 and Ryan (2008) Internal Motivation Questionnaire. The task of this study included the simultaneous throwing and receiving test of MABC-2 test. In this task, participants stand 2 meters from the wall and then throw a tennis ball at the wall and try to catch the rebound. Participants were trained to use only their hands to catch the ball and not to use their chests. Also, participants should not allow the ball to hit the ground. According to the test instructions, the participants threw and received the ball in 10 attempts. Participants were introduced to the objectives of the research and how to score and perform the tests. The present study included pre-test, intervention (practice), post-test, retention and transfer phases. At first, participants practiced throwing and receiving skills 5 times to get acquainted with the task. In the pre-test phase, participants first completed an intrinsic motivation questionnaire, and then participants attempted to throw and receive 10 attempts. In the intervention phase (practice), which lasted for six weeks and 2 sessions per week, the linear and non-linear training groups performed the relevant exercises. It should be noted that during this period, the control group performed their usual and daily activities. In the post-test phase, which was performed exactly after the last training session, in the retention phase, which was performed after seven days of non-training, and in the transfer phase, by increasing the distance between throwing and receiving by half a meter, participants performed 10 tried to throw and receive. Data were analyzed by analysis of variance with repeated measures. Results: The results of intra group analysis of variance test with repeated measures on the last factor revaled that nonlinear pedagogy (P<0.05) and linear pedagogy (P<0.05) significantly increased participants' receiving scores. The results of Benferoni follow-up test showed that nonlinear pedagogy improved scoring from pre-test to post-test (sig = 0.001), retention (sig = 0.001) and transfer (sig= 0.001). Other results showed that linear pedagogy improved scoring from pre-test to post-test (sig = 0.0001), retention (sig = 0.0001) and transfer (sig= 0.001). Other results showed that the participants of the nonlinear pedagogy group had higher scores in all stages compared to the linear pedagogy group. The results of covariance showed that nonlinear pedagogy had a significant effect on participants 'intrinsic motivation and increased participants' intrinsic motivation. Conclusion: The results of the present study showed that linear and non-linear pedagogy improve interceptive skills (receiving) and internal motivation of 7 to 9 year old girls and non-linear pedagogy compared to linear pedagogy further improve receiving skills and intrinsic motivation of girl children. Therefore, according to the results of the present study, educators and specialists in the field of children's sports are recommended to use non-linear pedagogy when their goal is to increase and improve control skills (receiving). However, considering that the present study was conducted among 7- to 9-year-old girls in Boroujerd, therefore, caution should be exercised in generalizing the results to other primary schools in this city and other schools in the country.  Although the present study and previous studies in this field provide significant insights into the value of nonlinear pedagogy in understanding perceptual perception, note that these studies are almost exclusively using dynamic systems paradigms and constraint led approaches. Extensive use of neuropsychological or physiological models to determine the extent and depth of this effect is valuable. Therefore, it is suggested that in future research, the effect of nonlinear prdagogy on neural mechanisms, qualitative processes and variability of movements be investigated.   7000 Exercise Physiology The effect of resistance training and endothelial stem cell injection on skeletal muscle antioxidant enzymes in type 1 diabetic rats Mir Javadi Syed Reza Rahimi Alireza Aghaei Fariba Mohsenzadeh Mahsa Karaj Branch, Islamic Azad University Department of Physical Education and Sport Science, Karaj Branch, Islamic Azad University, Karaj, Iran Karaj Branch, Islamic Azad University Karaj Branch, Islamic Azad University 1 12 2021 28 9 172 183 23 03 2021 22 06 2021 Background & Aims: Type 1 diabetes is an autoimmune disease that destroys pancreatic β cells and accounts for 5-10% of all cases of diabetes. In type 1 diabetes, blood glucose levels are not sufficiently regulated and rise to abnormal levels for a long time. This chronic hyperglycemia is characteristic of diabetes and a major cause of many disease-related complications (1). Although many physiopathological aspects of diabetes are still unclear, it is well established that oxidative stress plays a major role in the development and spread of the disease (2). Catalase (CAT) is an antioxidant enzyme and is present in almost all living tissues that consume oxygen. This enzyme uses iron or manganese as a cofactor and catalyzes the degradation or reduction of hydrogen peroxide (H2O2) into water and molecular oxygen (4). The enzyme glutathione peroxidase plays an important role in inhibiting the process of lipid peroxidation and thus protects cells against oxidative stress (6). Recently, many attempts have been made to use stem cell transplantation in the treatment of type 1 diabetes (8-10). Recent studies have shown that stem cells reduce glucose levels further by acting on the paracrine glands rather than directly affecting insulin-producing cells (10, 12). On the other hand, the positive effects of regular exercise on various diseases such as type 1 diabetes have been identified (13). In the study of Pereira et al. (2016), the swimming exercise protocol for 8 weeks plays a role in controlling blood sugar and improves oxidative stress in the blood of diabetic rats by increasing the level of catalase (15). Also, a study showed that after 6 weeks of endurance training, glutathione peroxidase activity in the hippocampal tissue of rats with diabetes significantly increased (16). However, Farhangi et al. (2016) in a study investigated the effect of eight weeks of endurance training on the activity of some antioxidant enzymes and lipid peroxidation of cardiac tissue of streptozotocin-induced diabetic rats. Cardiac tissue catalase activity was not affected by endurance training (17). Recent studies have provided support for the use of resistance training to improve glucose control in type 1 diabetic patients (20). However, the effect of this type of exercise on skeletal muscle antioxidant factors has not been studied in type 1 diabetic subjects. On the other hand, in the field of changes in skeletal muscle antioxidant factors in response to endothelial stem cell injection, it can be said that no research has been done so far. Therefore, the aim of this study was to investigate the effect of resistance training and endothelial stem cell injection on skeletal muscle antioxidant enzymes in type 1 diabetic rats. Methods: In this experimental study, 36 male Wistar rats were divided into six groups of control (healthy), basal diabetic control, diabetic control, diabetes + stem cell injection, diabetes + resistance training and diabetes + stem cell injection + resistance training. In this study, rats became diabetic intraperitoneally using streptozotocin as a single dose of 40 mg/kg. Resistance exercises including climbing a one-meter ladder with weights hanging from the tail were performed for 17 sessions. 500,000 bone-derived stem cells were injected by a cell counter. Data were analyzed using independent t-test, 2-factor analysis of variance and Bonferroni hoc test at P<0.05. Results: The results showed that after the intervention, the levels of catalase, glutathione and glutathione peroxidase in the group of resistance training, stem cell injection and resistance training with stem cell injection were significantly higher than the control group (P<0.001). Also, the levels of catalase, glutathione and glutathione peroxidase in the rats of the resistance training group with simultaneous injection of stem cells were significantly higher than the resistance training and stem cell injection groups (P<0.001). Conclusion: The results of the present study showed that resistance training and endothelial stem cell injection resulted in an increase in skeletal muscle antioxidant enzymes in type 1 diabetic rats. The findings of this study were consistent with the results of Previous research (24, 25). A possible explanation for the increase in skeletal muscle antioxidant enzymes in post-exercise diabetic rats may be that the compensatory response to the combination of risk factors (diabetes-induced hyperglycemia) by overproduction of hydrogen peroxide by increasing the concentration of this Enzymes take place. This post-workout antioxidant enhancement is probably an attempt to balance the increase in reactive oxygen species under high blood sugar conditions. Therefore, exercise protects against oxidative stress by increasing the levels of catalase, superoxide dismutase and glutathione peroxidase in the skeletal muscle tissue of diabetic rats. The mechanism of changes caused by exercise has been investigated. The mechanism of change of antioxidant enzymes in training groups is to increase intracellular responses and reactions of different body tissues to oxidative stress produced during exercise and catabolism of synthetic components of proteins and cell defense structure (27). The results of our study show that stem cells with dose of 500,000 cells in rats muscle can significantly increase the protein level of catalase, glutathione and glutathione peroxidase in diabetic rats. The results can be elucidated by considering how STZ works, which increases reactive oxygen species, so that STZ causes cell DNA damage (29). stem cells have been shown to be resistant to oxidative stress production conditions such as ionizing radiation (34). In addition, stem cells are not susceptible to cell death due to oxidative stress. stem cells exposed to oxidative stress show low intracellular concentrations of reactive species with high expression of enzymes needed to control oxidative stress such as catalase and glutathione peroxidase (35). Because the definition of oxidative stress is the lack of an appropriate amount of ROS repellent tool (36) and previous research has shown that mesenchymal stem cells have the ability to reduce the severity of oxidative stress and increase the amount or activity of ROS neutralizing enzymes (35). It is thought that stem cell therapy may help increase antioxidant capacity in type 1 diabetes. There were some limitations in the present study, such as the lack of measurement of lipid peroxidation indices and antioxidant capacity of diabetic rats. Also, since the interactive effect of exercise and endothelial stem cells on the levels of antioxidant enzymes in type 1 diabetics, few studies have been performed, so more studies are needed to investigate the mechanisms affecting changes in these indices. Therefore, it is suggested that the interactive effect of other training methods and endothelial stem cells on the levels of antioxidant enzymes in type 1 diabetic subjects be investigated in future studies. It seems that the intervention of resistance training with simultaneous injection of stem cells can help improve the antioxidant enzymes of skeletal muscle in type 1 diabetes. 7021 Exercise Physiology The effect of immersion in cold water on muscle injury indices during and after repetitive sessions of simulated competition Agha fathi Ameneh Sarshin Amir Rahimi Alireza Alijani Eidi Department of Physical Education and Sport Science, Karaj Branch, Islamic Azad University, Karaj, Iran. Department of Physical Education and Sport Science, Karaj Branch, Islamic Azad University, Karaj, Iran. Department of Physical Education and Sport Science, Karaj Branch, Islamic Azad University, Karaj, Iran. Department of Physical Education and Sport Science, Karaj Branch, Islamic Azad University, Karaj, Iran. 1 12 2021 28 9 184 195 10 04 2021 03 08 2021 Background & Aims: The main goal of athletes and coaches is to reach the peak of athletic performance. Optimal and optimal performance of sports skills is the result of the complex interaction of physiological, genetic, biomotor, anthropometric factors and finally the selection of a desirable method for recovery (1). Taekwondo, like any other sport, requires proper recovery principles to reduce injuries and achieve optimal performance. One of the most important concerns of Taekwondo coaches and athletes is the limited distance between activities and sports competitions for physiological recovery and return to the pre-activity state)2). Exercise-induced muscle damage is characterized by decreased isometric muscle strength, changes in joint range of motion, changes in muscle diameter, and leakage of certain enzymes into the bloodstream [6). During muscle injury, creatine kinase (CK) and lactate dehydrogenase (LDH) leave the skeletal muscle and enter the bloodstream; Therefore, they are known as physiological indicators of muscle damage (7). Also, due to the role of AST and ALT enzymes in causing muscle damage after strenuous activity, these enzymes are considered as indicators of muscle damage (10). Injury to active skeletal muscle reduces energy resources, accumulation of metabolic products due to exercise, fatigue, and decreased performance (11). In these circumstances, the ground is prepared for the need for a proper recovery. Recovery in sports is an essential and important component of the overall training pattern (12). Cold water immersion is a popular recovery method used by coaches and athletes to accelerate the process of improving performance after exercise and competition. The potential benefits of the cold-water immersion method depend on the reduction in muscle tissue temperature associated with the effects of hydrostatic pressure (14). The two most important variables in the immersion method are water temperature and immersion time. Immersion temperature and time can vary depending on the type of exercise and the variable being measured (15). Mardnik et al. (2017) showed that immersion in cold water after strenuous exercise is effective in reducing the CK and LDH in the recovery process and improving the performance of the athlete (17). However, Farajnia et al. (2017) in the study of the effect of immersion in cold water and repetition of rapid activity on antioxidant indices in trained men showed that immersion in cold water has an effect on the return to the state. Primary did not have these factors (19). As can be seen, the contradictions observed in the research are due to different methods of immersion as well as differences in the research method in this field. Since Taekwondo athletes must participate in their competitions on a regular basis and do not have enough time to recover, this study, assuming the positive effect of immersion in cold water on the indicators of muscle damage, as well as this that no research has been done in this field, Therefore, the aim of this study was to investigate the effect of immersion in cold water on muscle injury indices during and after repetitive sessions of simulated competition. Methods: In this quasi-experimental study, 12 male taekwondo practitioners of Karaj city (mean height 1.76 ± 0.06 cm, weight 59 ± 4.6 kg and body mass index 19.2 ± 2.18 kg/m2) were selected in an accessible and purposeful manner and randomly divided into two Cold water immersion and control group (inactive recovery). Subjects performed three simulated taekwondo competitions at one-hour intervals. Immersion in cold water was performed as local immersion of feet in cold water at 11 ° C for 11 minutes. Data were analyzed using analysis of variance with repeated measures, dependent t-test and Bonferroni post hoc test at P<0.05. Results: The results showed that the simulated competition led to a significant increase in AST, ALT, CK and LDH indices in the cold-water immersion group compared to the control group. Also, the mean AST, ALT, CK and LDH indices of the cold-water immersion group in all stages of the research were significantly lower than the control group (P<0.001). Conclusion: The results of the present study show that the mean indices of AST, ALT, CK and LDH of the cold-water immersion group in all stages of the research were significantly lower than the control group and in the continuation of the study, the difference between the two groups increased. These findings indicate that cold water immersion is more effective than inactive recovery after several consecutive races. The findings of this study were consistent with the results of Previous research (24-26). Both muscle fatigue and muscle damage have been reported to have specific mechanisms (impaired glycogen storage, sarcomere destruction, increased muscle protein breakdown, and inflammatory responses) that reduce muscle strength and capacity. Also, muscle dysfunction in response to muscle injury and fatigue mechanisms, depending on the intensity of the exercise, may last from a few hours to seven days (31).  Vaile et al. (2008) suggested that immersion in cold water immediately reduces muscle metabolism immediately after the shuttle run test (32). The mechanisms associated with reduced enzyme release due to immersion in cold water after exercise are generally unknown. However, some studies have suggested that immersion in cold water may reduce the release of intramuscular proteins into the lymphatic system or the extent of post-exercise injury (26). In addition, changes in CK are associated with pain sensation, which can be reduced by immersion in cold water. `Also, water Physiological changes due to immersion in cold water may include parasympathetic reactivation, reduction of cutaneous blood flow, change in the direction of intracellular fluid movement into the arteries, decrease in muscle swelling, and increase in cardiac output. These factors can increase blood flow and increase waste transport (37). On the other hand, we must consider that a combination of physiological and psychological factors can play an important role in the perception and awareness of participants in the study, which in turn potentially enhances recovery (38). In particular, there may be a psychological benefit (reducing the feeling of tiredness when immersed in cold water) for athletes. Differences in body composition, such as body fat and body mass, should also be considered in the individual effects of cold-water immersion protocols (39). There were some limitations in the present study, such as the lack of measurement of other indicators of muscle damage. It can also be noted that the subjects did not have complete control over their mental state during the research. To make the most of the benefits of therapies (methods that are low-cost and require the least equipment) to recover from muscle fatigue, it is recommended that other indicators of muscle damage be examined in a similar study. Overall, the findings of the present study showed that immersion in cold water is more effective than inactive recovery after several consecutive Taekwondo competitions; Therefore, it seems that immersion in cold water can be used to minimize the period of muscle injury and contusion, as well as to have a better recovery in short periods of time. 7067 Genetic Serum RNA level of Stanniocalcin-2 gene in patients with gastric cancer Hosseini Asl Saeed Feizi Iraj Abhari Alireza Arabzadeh Amir Ahmad Assistant Professor, Department of Surgery, School of Medicine, Ardabil University of Medical Sciences, Ardabil, Iran 1 12 2021 28 9 196 203 12 07 2021 11 10 2021 Background & Aims: Cancer is the leading cause of death in developed and developing countries, respectively. Microscopic and endoscopic invasive procedures are not routinely suitable for screening gastric cancer, so the need for biomarkers with the ability to detect quickly, easily, and with high sensitivity in the early stages of cancer is strongly felt. This study aimed to evaluate the expression of the Stanniocalcin 2 (STC2) gene in the serum of patients with gastric cancer. Although the incidence of gastric cancer in the world, especially in developed countries such as the United States has decreased in recent decades (1), in Iran the incidence is increasing and this increase is particularly significant in western Iran (2). According to the latest research conducted in 1988 in Iran, the rate of gastric cancer is 9.3 percent and the third most common cancer in the country in the total number of women and men (2). According to research, Ardabil province has the highest incidence of cancer in Iran and the highest incidence of gastric cancer (49.1 cases per 100,000 in men and 25.4 cases per 100,000 in women), which is almost seven times higher than in southern parts of Iran and twice Is higher than the global average (3). Gastric cancer is a multifactorial disease and has a multi-stage process, including cancer-causing factors that can be attributed to multiple infectious, environmental, genetic, and epigenetic factors on genes that suppress and repair tumors, nutrition, lifestyle, age, and race Pointed out (4). In more than half of the advanced cases in people with this disease, no symptoms are observed and it is diagnosed when it has entered the advanced stage, and unfortunately, many of these people die after a short time. The fast and timely disease can increase the 5-year survival rate of infected people up to 60% (5). Methods: Peripheral blood samples were collected from patients with primary gastric cancer as well as volunteers in tubes containing EDTA anticoagulants. Samples were immediately isolated from serum. Total RNA was extracted from the serum of control and patient samples. The cDNA was then synthesized using the Omniscript Reverse Transcriptase enzyme produced by the German company Qiagen and from a pattern string. The concentration and quality of RNA extracted were measured by adsorption intensity (OD) readings by a spectrophotometer (Nanodrop). SPSS 22 software was used for data analysis and due to the lack of normal distribution of data, Spearman correlation coefficient and Mann-Whitney U test and Kruskal-Wallis tests were used for analysis. Levels less than 0.05 were considered significant. Results: There was no significant relationship between patients' sex and high expression of the STC2 gene (P = 0.73). The age of 32% of patients was more than 65 years. There was a significant relationship between patients' age and high expression of the STC2 gene (P = 0.031). Most tissue samples were moderate in differentiating cancer (21 cases, 42%). There was no significant relationship between cancer differentiation and high expression of the STC2 gene (P = 0.34). Most patients (18 patients, 36% of them) were in the T3 stage. There was a significant relationship between TNM classification of cancer and high expression of the STC2 gene (P = 0.001). A study entitled clinical significance of stanniocalcin2 expression as a predictor of tumor progression in gastric cancer was conducted in 2013 by Origami et al. In this study, a quantitative PCR test was used to evaluate the expression of STC2 mRNA in 4 gastric cancer cells and the blood samples of 93 patients with gastric cancer and 22 healthy volunteers. They concluded that the number of STC2 mRNA transcripts in gastric cancer cells and the blood of patients with gastric cancer was higher than that of healthy volunteer blood (P = 0.0002 and P = 0.01). STC2 gene expression was positive in 43 patients (46.2%) out of 93 patients with gastric cancer and its expression was significantly related to age, depth of tumor attack, lymph node metastasis, stage invasion and venous (P = 0.023, P = 0.045, P = 0.035, P = 0.007 and P = 0.027). The 5-year survival rate in patients with STC2 expression was significantly lower compared to patients without STC2 expression (P = 0.014). Our results suggest that STC2 by monitoring CTC in patients with gastric cancer can be a useful molecular blood marker for predicting tumor progression (17). The above study is also in line with our study. A study entitled clinical-pathological significance of stanniocalcin2 gene expression in colorectal cancer was conducted in 2017 by Ita et al. In this study, the expression of STC2 and clinical pathology were examined in 139 colorectal cancer specimens using PCR. They concluded that STC2 was more pronounced in colorectal cancer cells than in normal colorectal epithelial cells. The most common anatomical site was gastric trunk cancer and intestinal subtype was seen in most cases. Increased expression of STC2 was observed in 26 patients with gastric cancer (52%) and the control group 8 cases (16%). There was a significant association between high STC2 gene expression and gastric cancer. The present study failed to show a relationship between age, sex, tumor differentiation, anatomical location of gastric cancer, cancer subtypes, and increased STC2 expression. But it showed that there was a significant relationship between the frequency of cases with increased STC2 expression and age over 65 years and TNM classification of cancer. Conclusion: Our results showed that STC2 in patients with gastric cancer could be a useful molecular blood marker for predicting tumor progression.   7227 Clinical Psychiatry The Role of Childhood Abuse Experience with Aggression; the Mediating Effect of Early Maladaptive Schemas and Difficulty in Regulating Emotion in Students Farhang Esfahani Mitra Assistant Professor, Department of Educational Sciences, Bandar Abbas Branch, Islamic Azad University, Bandar Abbas, Iran 1 12 2021 28 9 204 214 10 10 2021 25 10 2021 Background & Aims: Abuse has a wide range that is severe and weak in different societies. Various studies have shown that the history of any kind of abuse in childhood is associated with negative consequences of adulthood, and abuse in any form, depending on the type, severity, duration, and frequency can lead to many disorders and psychological damage. Child abuse means doing or neglecting any action on the part of the child that could result in significant physical or psychological harm or threaten the child's health. Unfortunately, child abuse is not primarily perpetrated by strangers, but rather by the child's family, and especially the parents. In 2011, approximately 681,000 children across the United States were victims of parental and other neglect, of which more than 15 percent were victims of physical abuse, less than 10 percent were victims of sexual abuse, and less than 10 percent were children of child abuse. They were suffering from psychological behavior. The consequences of child abuse, in general, can be examined in terms of physical and psychological manifestations. Physical manifestations of abuse include fractures, bruising, physical disability, and eventual death of the child. Its psychological manifestations are mental disorders such as depression, anxiety, post-traumatic stress, substance abuse, and other mental disorders and disorders. These aggressive behaviors on the part of individuals can be the result of the pain and suffering they experience internally, and therefore with the occurrence of such behaviors, they may seek to have others experience the same inner pain and suffering. However, these aggressive behaviors may be overt or covert. Therefore, according to the literature, the experience of childhood abuse can lead to aggressive behaviors; but in the meantime, factors may cause severity or weakness, as well as improve aggressive behavior in these people. Given the concepts mentioned, it seems that early maladaptive schemas and emotion regulation skills can play a role in this regard. Therefore, to examine these relationships more closely, the present study sought to examine whether the experience of childhood abuse can lead to aggression in adulthood, and whether early maladaptive schemas and difficulty in regulating emotion can mediate this. Methods: The method of the present study was descriptive and path analysis. The statistical population of this study was all students of the Islamic Azad University of Shiraz in 1399. Due to the lack of an accurate list of the population, a sample of 300 people was selected from the statistical population through random and online sampling. It is also noteworthy that the criteria for inclusion in the present study included studying at the Islamic Azad University of Shiraz, lack of severe psychiatric problems, and the use of neuroleptics and baths, as well as complete satisfaction in responding to research tools. The instruments used were the Young Schematic Short Form Questionnaire (YSQ-SF), the Ahwaz Aggression Questionnaire (AAQ), the Emotion Difficulty Scale (DERS), and the Childhood Traumatic Incident Questionnaire (CTQ). Pearson correlation test, path analysis, and Preacher and Hayes method as well as SPSS-22 and AMOS-23 software were used to analyze the data. Results: The results showed that childhood abuse, early maladaptive schemas, and difficulty in emotion regulation can directly predict aggression. Childhood abuse can also directly predict early maladaptive schemas and difficulty in regulating emotion. The results of indirect effects showed that childhood abuse indirectly through early maladaptive schemas and difficulty in emotion regulation can predict aggression with a magnitude of 0.365 (p <0.005). Conclusion: The results of this study showed that the experience of childhood abuse can be a predictor of aggression in adulthood. In other words, people who have experienced more childhood abuse are expected to be more aggressive in adulthood. Examination of these results showed that there is a positive and significant relationship between early maladaptive schemas and aggression and schemas of exclusion and disruption, disrupted constraints, self-management, and dysfunction, other areas of orientation and excessive distraction and inhibition can be Predict a significant form of aggression. Accordingly, it is expected that the level of aggression will increase as the schemas intensify. Examination of these results showed that there is a significant relationship between difficulty in emotion regulation and aggression and difficulty in emotion regulation can predict aggression. When people can manage and control their emotions, they can easily manage their aggressive emotions, but if they have difficulty or difficulty in managing and regulating their emotions, they will overcome this emotion and will show aggressive behaviors. So emotion regulation is a way to manage destructive emotions such as anger, and weakness in it causes an outburst of aggression. Anger and negative emotional arousal play a key role in many cases of aggression; therefore, increasing a person's ability to control their destructive emotions will most likely be effective in reducing hostile aggression. Anger management approaches aim to provide skills to the individual so that the individual can manage the underlying emotions that produce the aggressive behavior. Based on the findings of this study, it can be concluded that people who have been abused as children form schemas and can not develop skills to regulate and manage emotions, and therefore by being in challenging and stressful situations from aggression to they use it as a strategy to deal with those situations. Due to the use of cross-sectional design in the present study, the use of longitudinal and long-term designs as well as experimental designs to investigate the effect of predictor variables on the criterion variable is recommended. Due to the limited sample size, future studies with a larger sample may study this study. Therefore, it is suggested that this study be performed on other populations and in other provinces to be more generalizable. It is suggested that studies investigate the role of childhood abuse mediated by maladaptive schemas and the difficulty of emotion regulation in the occurrence of marital violence and aggression. Due to the role of abuse in the occurrence of aggression, it is recommended to examine other factors and variables that can play a mediating role. 7202 Clinical Psychiatry Effectiveness of Lazarus-Based Multidimensional Therapy on Reducing Secondary Traumatic Stress and Generalized Anxiety in Nurses Sabzianpour Boshra Amini Nasser Azadi Shahdokht Direh Ezzat PhD Student in General Psychology, Department of Psychology, Bushehr Branch, Islamic Azad University, Bushehr, Iran Assistant Professor of Psychology Department, Bushehr Branch, Islamic Azad University, Bushehr, Iran Assistant Professor, Department of Educational Sciences, Islamic Azad University, Gachsaran Branch, Gachsaran, Kohgiluyeh and Boyerahmad Iran Assistant Professor of Psychology, Bushehr Branch, Islamic Azad University, Bushehr, Iran 1 12 2021 28 9 215 225 25 08 2021 25 10 2021 Background & Aims: Nurses in the hospital environment suffer a lot of psychological stress. These tensions include workplace pressure, shifts, type of services, nurses' care, communication with critically ill patients, and intra-organizational communication. Nurses are the mainstay of care in the treatment team, which makes up more than 75% of the treatment team and is the first group on the front line of the Covid-19 pandemic. The nurses' work environment leads to long-lasting stress, and this occurs in people who work as helpers who feel overwhelmed by the problems of others. One of the health problems of nurses is secondary traumatic stress. The term secondary traumatic stress refers to a problem in which the sufferer has not directly experienced the accident. It is associated with the survivors of a traumatic event. Therefore, stress, secondary trauma, is considered as an occupational injury due to providing direct services to people at risk. For more than forty years, the stress of the nursing profession has been proven worldwide. Stressful and stressful factors of life, such as job pressures, role conflicts, the existence of deprivations and social job inequalities, economic problems, low living standards of nurses cause or aggravate psychological stress on individuals. Anxiety, as a part of every human life, is present in everyone. Disseminated anxiety disorder is one of the most common anxiety disorders observed in the general population and clinical settings. The estimated prevalence of the disorder in general medical centers is 2.8% to 8.5% and in the general population from 1.6% to 5%. Another theory of psychotherapy, which is a kind of technical eclecticism, is the multifaceted treatment of Lazarus. In this type of treatment, the basic assumption is that patients have a special problem and should be treated using several special techniques. In this study, the process of changing and reducing secondary traumatic stress, psychosomatic disorders, and generalized anxiety in nurses was investigated by examining intrapersonal factors and emphasizing personal factors. One of the useful treatments to reduce stress and its side effects is Lazarus's multi-faceted treatment. Therefore, the main question of the present study is whether the multifaceted treatment based on the Lazarus approach affects reducing secondary traumatic stress and generalized anxiety in female nurses? Methods: The present study was a quasi-experimental controlled study in which a pre-test-post-test design with a control group was conducted. The statistical population of this study consisted of all female nurses working in Ibn Sina specialized hospital in Tehran during the months of January 2018 to August 2020, from which 30 people were selected and randomly replaced in experimental (15 people) and control (15 people) groups. . Inclusion and exclusion criteria of this study were: age range 30-55 years, no mental illness and history of hospitalization in the psychiatric ward, no history of neurological and mental illness and history of hospitalization, ability to participate in group therapy sessions, Willingness to cooperate, exclusion criteria for the experimental group: not attending the intervention sessions for more than two sessions, unwillingness to continue attending the intervention sessions. To collect the necessary demographic data as basic information including age, marital status, education, socio-economic status, secondary traumatic stress questionnaires, Spielberger anxiety questionnaire was completed. The effectiveness of the research intervention was assessed using repeated-measures analysis of variance. Results: The results of the present study showed that the mean of variables in the pre-test stage was not significantly different between the three groups, which indicates the homogeneity of the two groups in the pre-test stage, but the difference between the three groups in the post-test and follow-up stages was significant. Which can indicate the effectiveness of the intervention on the mentioned variables and the stability of effectiveness in the follow-up stage. Conclusion: Based on the hypotheses of the present study; Lazarus's multifaceted therapy is effective in improving psychological variables (secondary traumatic stress and generalized anxiety disorder) in female hospital nurses; The results of the present study showed that the hypothesis has been confirmed and the multifaceted treatment based on Lazarus approach in the experimental group on the improvement of secondary traumatic stress and general anxiety in female nurses working in The hospital has been effective and has had a lasting effect (stability) over the control group over time. In the present explanation, it can be said that since Lazarus' approach is a non-guided method of client-centeredness, which increases his inner motivation for change by discovering and resolving client skepticism; thus, client ambivalence plays a central role in Lazarus' approach and, unlike other therapies, directly addresses and addresses resistance and ambivalence to change. This problem is very common in nurses working in hospitals who have been involved with patients for a long time and witness the complications of treatment and physical changes in patients who have psychiatric symptoms without physical complications. Lazarus' approach is effective in reducing and strengthening treatment outcomes in the field of problems related to nurses working in the hospital due to reducing resistance and strengthening internal credentials and motivations, capacity and talent, increasing knowledge, motivational skills. It can be argued that Lazarus' approach increases the participation and success of subsequent pragmatic therapies, thereby reducing psychiatric symptoms in nurses. Some of the limitations of this research were due to costly problems and lack of sufficient time, which may be specific to current research studies that are conducted in the form of a doctoral research project without using the facilities of an organization. In the following, all the limitations will be mentioned and in the discussion of suggestions, we will try. Provide solutions to address issues that can be addressed, with the hope that future research will face fewer limitations.