Search published articles
Showing 27 results for Zare
Ehsan Zarei, Kheyrollah Chavosh Sani, Mohammad Saadati, Soheila Khodakarim,
Volume 16, Issue 4 (Oct 2022)
Volume 16, Issue 4 (Oct 2022)
Abstract
Background and Aim: In recent years, public trust in health system has been considered one of the performance evaluation indicators of health systems. However, most of the research on public trust in health system is related to developed countries, and research in this regard is limited in Iran. A better understanding of trust in health system and some influential factors helps to develop targeted interventions to increase trust. The present study was conducted to investigate the level of public trust in health system in Rasht County.
Materials and Methods: In this cross-sectional study, 680 households (510 urban and 170 rural) were included. The data collection tool was a questionnaire to measure public trust in health system with 30 items and six dimensions, whose validity and reliability were confirmed. Mann-Whitney and Kruskal-Wallis tests were used to compare and analyze the difference in public trust in health system between groups.
Results: The overall score of trust in health system was 66.7 out of 112. The highest score for the quality-of-care dimension was 16.38 out of 28, and the lowest for the cooperation quality of providers dimension was 7.47 out of 12. Among service providers, the highest trust was in nurses and specialist doctors, and the least was in traditional medicine service providers. Women, government employees, people without health insurance, people with excellent and good health status, those who had used hospital services, and those who were satisfied with the last service received had a high level of trust in the health system (P<0.05).
Conclusion: The results showed that despite people’s trust in the expertise and knowledge of physicians and other providers, public trust in health system was relatively moderate, indicating deficiencies in the health system’s performance. Focusing on physician-patient communication and improving communication skills, establishing electronic records and sharing patient information between health service providers, and respecting patient rights can build greater trust in the health system.
Materials and Methods: In this cross-sectional study, 680 households (510 urban and 170 rural) were included. The data collection tool was a questionnaire to measure public trust in health system with 30 items and six dimensions, whose validity and reliability were confirmed. Mann-Whitney and Kruskal-Wallis tests were used to compare and analyze the difference in public trust in health system between groups.
Results: The overall score of trust in health system was 66.7 out of 112. The highest score for the quality-of-care dimension was 16.38 out of 28, and the lowest for the cooperation quality of providers dimension was 7.47 out of 12. Among service providers, the highest trust was in nurses and specialist doctors, and the least was in traditional medicine service providers. Women, government employees, people without health insurance, people with excellent and good health status, those who had used hospital services, and those who were satisfied with the last service received had a high level of trust in the health system (P<0.05).
Conclusion: The results showed that despite people’s trust in the expertise and knowledge of physicians and other providers, public trust in health system was relatively moderate, indicating deficiencies in the health system’s performance. Focusing on physician-patient communication and improving communication skills, establishing electronic records and sharing patient information between health service providers, and respecting patient rights can build greater trust in the health system.
Mohammad Jalali, Ehsan Zarei, Ali Maher, Soheila Khodakarim,
Volume 16, Issue 5 (Dec 2022)
Volume 16, Issue 5 (Dec 2022)
Abstract
Background and Aim: With the outbreak of the COVID-19 pandemic, the performance of hospitals were affected, and changes were made in the utilization of hospital services. Analyzing hospital performance data during the COVID-19 pandemic can provide insights into service utilization patterns and care outcomes for managers and policymakers. This study was conducted to investigate the impact of COVID-19 on selected outcome indicators in the hospitals of Shahid Beheshti University of Medical Sciences, Tehran.
Materials and Methods: This research was descriptive-analytical and of the time series analysis type. Six outcome indicators were considered: hospitalization rate, bed occupancy rate, the average length of stay, emergency visits, laboratory tests, and imaging requests. Related data from 12 affiliated hospitals from 2017-2019 (pre-COVID) and 2020 (post-COVID) were obtained from the hospital's intelligent management system. The data were analyzed using R software's interrupted time series analysis method.
Results: The hospitalization rate (P=0.015), bed occupancy rate (P=0.04), and the number of laboratory tests (P=0.003) significantly increased immediately after the outbreak of the pandemic. In contrast, emergency visits (P=0.034) have significantly decreased. The bed occupancy rate and the number of imaging requests showed no significant change. The decrease in emergency room visits within one year after the pandemic was significant, but the changes in other outcome indicators were non-significant (P>0.05).
Conclusion: Understanding the changes and impact of a major event on hospital outcome indicators is necessary for decision-makers to effectively plan for resource allocation and effective pandemic response. The outbreak of COVID-19 has caused a change in performance and hospital outcomes by affecting the supply and demand of services. In a year after the pandemic's beginning, except for emergency visits, the other indicators have not experienced significant changes. Preservation of essential services such as emergency room visits is recommended in the strategy of rapid response to an epidemic outbreak and public campaigns to encourage people to seek medical care if needed in future waves of the pandemic.
Materials and Methods: This research was descriptive-analytical and of the time series analysis type. Six outcome indicators were considered: hospitalization rate, bed occupancy rate, the average length of stay, emergency visits, laboratory tests, and imaging requests. Related data from 12 affiliated hospitals from 2017-2019 (pre-COVID) and 2020 (post-COVID) were obtained from the hospital's intelligent management system. The data were analyzed using R software's interrupted time series analysis method.
Results: The hospitalization rate (P=0.015), bed occupancy rate (P=0.04), and the number of laboratory tests (P=0.003) significantly increased immediately after the outbreak of the pandemic. In contrast, emergency visits (P=0.034) have significantly decreased. The bed occupancy rate and the number of imaging requests showed no significant change. The decrease in emergency room visits within one year after the pandemic was significant, but the changes in other outcome indicators were non-significant (P>0.05).
Conclusion: Understanding the changes and impact of a major event on hospital outcome indicators is necessary for decision-makers to effectively plan for resource allocation and effective pandemic response. The outbreak of COVID-19 has caused a change in performance and hospital outcomes by affecting the supply and demand of services. In a year after the pandemic's beginning, except for emergency visits, the other indicators have not experienced significant changes. Preservation of essential services such as emergency room visits is recommended in the strategy of rapid response to an epidemic outbreak and public campaigns to encourage people to seek medical care if needed in future waves of the pandemic.
Rahil Nahari, Saeed Hashemzadeh, Ehsan Zarei,
Volume 16, Issue 6 (Feb 2023)
Volume 16, Issue 6 (Feb 2023)
Abstract
Background and Aim: Medical tourism refers to travel for receiving health services abroad. The COVID-19 crisis affected a wide range of tourism-related businesses, including medical tourism, and caused a decrease in the supply and demand of health services in this market. This study aimed to investigate the impact of the COVID-19 pandemic on Medical Tourism in Iran.
Materials and Methods: This cross-sectional study was conducted in Iran in 2021. The data used in this study were extracted from the information system of the Ministry of Health from 2018 to 2021, which includes the number, origin, and destination of medical tourists, per capita revenue, and monthly revenue two years before and one and a half years after the COVID-19 pandemic. For data analysis, t-tests of independent groups and interrupted time series regression were used in SPSS and EViews 10 software.
Results: The COVID-19 pandemic has caused a 42% decrease in the average monthly number of medical tourists, a 45% decrease in the monthly revenue, and a 10% decrease in the per capita income per tourist (P<0.05). The arrival of medical tourists from the Republic of Azerbaijan, Bahrain, Iraq, and Oman has decreased by more than 80%, and the largest decrease in the number of tourists has been related to Ahvaz, Urmia, Tabriz, and Shiraz. In all diagnostic groups except obstetrics and gynecology, there has been a decrease between 50 to 70% The declining trend of medical tourism indicators was stopped in the second year of the COVID-19 pandemic and has continued as a constant trend.
Conclusion: The COVID-19 crisis has hurt the number of international patients and their revenue in Iran. Relative success in controlling COVID-19 can return to a pre-pandemic situation that requires appropriate policies and administrative measures by government and industry players, such as policies to facilitate patient entry, marketing measures, branding and creating a positive image of the country to potential clients, use of telemedicine facilities for consultations and follow-up, etc.
Materials and Methods: This cross-sectional study was conducted in Iran in 2021. The data used in this study were extracted from the information system of the Ministry of Health from 2018 to 2021, which includes the number, origin, and destination of medical tourists, per capita revenue, and monthly revenue two years before and one and a half years after the COVID-19 pandemic. For data analysis, t-tests of independent groups and interrupted time series regression were used in SPSS and EViews 10 software.
Results: The COVID-19 pandemic has caused a 42% decrease in the average monthly number of medical tourists, a 45% decrease in the monthly revenue, and a 10% decrease in the per capita income per tourist (P<0.05). The arrival of medical tourists from the Republic of Azerbaijan, Bahrain, Iraq, and Oman has decreased by more than 80%, and the largest decrease in the number of tourists has been related to Ahvaz, Urmia, Tabriz, and Shiraz. In all diagnostic groups except obstetrics and gynecology, there has been a decrease between 50 to 70% The declining trend of medical tourism indicators was stopped in the second year of the COVID-19 pandemic and has continued as a constant trend.
Conclusion: The COVID-19 crisis has hurt the number of international patients and their revenue in Iran. Relative success in controlling COVID-19 can return to a pre-pandemic situation that requires appropriate policies and administrative measures by government and industry players, such as policies to facilitate patient entry, marketing measures, branding and creating a positive image of the country to potential clients, use of telemedicine facilities for consultations and follow-up, etc.
Fatemeh Esmaili, Najmeh Ashouri, Seyedeh Mahboobeh Hosseini Zare,
Volume 17, Issue 1 (3-2023)
Volume 17, Issue 1 (3-2023)
Abstract
Background and Aim: Antibiotics are one of the most commonly used drugs that help to heal and treat diseases, but improper administration and excessive use of them can increase length of stay and cost of hospitalization. The purpose of this study was to analyze relationship between experimental use of antibiotics and duration of stay of premature infants admitted to Mahdiyeh hospital in Tehran.
Materials and Methods: This descriptive-analytical and cross-sectional study was carried out in 2019 on 159 premature infants admitted to intensive care ward of Mahdiyeh hospital in Tehran were investigated. The study tool was a questionnaire that validity of questionnaire was measured by content analysis method and reliability of questionnaire was measured by Cronbach’s alpha method. Data analysis was done using SPSS software, with help of descriptive statistics of frequency and percentage and statistical test of one-way analysis of variance and independent t-test.
Results: The results showed that 52.2% of infants were girls and 79.9% of deliveries were performed by cesarean section. The average length of stay of infants was 31.47 days and average birth of infants was 30 weeks. According to results of study, there was a significant relationship between length of hospitalization of infants with duration of antibiotic treatment and number of periods of receiving antibiotics (P<0.05). The duration of hospitalization of infants with a period of receiving less than 14 days of antibiotics was almost half of duration of hospitalization of infants with more than 14 days of receiving antibiotics. Also, there was a significant relationship between number of antibiotic courses and length of hospitalization of patients (P<0.05). With increase in number of antibiotic sessions, duration of hospitalization of infants increased significantly. The results of study showed that there was a significant relationship between birth weight of babies, cost of bed, and total cost of experimental administration of antibiotics (P<0.05).
Conclusion: Considering that rational use of antibiotics reduce length of stay of hospitalized infants, Ministry of Health should develop an updated and transparent antibiotic adminstration protocol for premature infants and awareness physicians to inform particularly prescription of antibiotics and implementation of stewardship antibiotic programs in neonatal intensive care unit. Also the publication of standard treatment guidelines, instructions including importance of prescribing antibiotics with correct dose and clinical education of physicians are necessary.
Materials and Methods: This descriptive-analytical and cross-sectional study was carried out in 2019 on 159 premature infants admitted to intensive care ward of Mahdiyeh hospital in Tehran were investigated. The study tool was a questionnaire that validity of questionnaire was measured by content analysis method and reliability of questionnaire was measured by Cronbach’s alpha method. Data analysis was done using SPSS software, with help of descriptive statistics of frequency and percentage and statistical test of one-way analysis of variance and independent t-test.
Results: The results showed that 52.2% of infants were girls and 79.9% of deliveries were performed by cesarean section. The average length of stay of infants was 31.47 days and average birth of infants was 30 weeks. According to results of study, there was a significant relationship between length of hospitalization of infants with duration of antibiotic treatment and number of periods of receiving antibiotics (P<0.05). The duration of hospitalization of infants with a period of receiving less than 14 days of antibiotics was almost half of duration of hospitalization of infants with more than 14 days of receiving antibiotics. Also, there was a significant relationship between number of antibiotic courses and length of hospitalization of patients (P<0.05). With increase in number of antibiotic sessions, duration of hospitalization of infants increased significantly. The results of study showed that there was a significant relationship between birth weight of babies, cost of bed, and total cost of experimental administration of antibiotics (P<0.05).
Conclusion: Considering that rational use of antibiotics reduce length of stay of hospitalized infants, Ministry of Health should develop an updated and transparent antibiotic adminstration protocol for premature infants and awareness physicians to inform particularly prescription of antibiotics and implementation of stewardship antibiotic programs in neonatal intensive care unit. Also the publication of standard treatment guidelines, instructions including importance of prescribing antibiotics with correct dose and clinical education of physicians are necessary.
Farid Ghaffari, Seyed Amir Hosein Pishgooie, Armin Zareiyan, Simintaj Sharififar, Somayeh Azarmi,
Volume 19, Issue 3 (9-2025)
Volume 19, Issue 3 (9-2025)
Abstract
Background and Aim: CBRN incidents Chemical, Biological, Radioactive and Nuclear are often unpredictable and invisible, leading to fear, anxiety, and disruptions in the provision of healthcare services in the community. The potential consequences and costs of unpreparedness for CBRN incidents can be significant. Rapid and appropriate responses to CBRN incidents play a crucial role in mitigating adverse physical health effects and reducing mortality rates. These factors heavily depend on the preparedness of hospital emergency staff. This study aimed to explore the experiences of hospital emergency clinical staff regarding their preparedness for responding to CBRN incidents in 2024 in Tehran.
Materials and Methods: The present study was a qualitative research employing a conventional content analysis approach. The study population consisted of clinical emergency staff from four hospitals, including one educational-specialized hospital, two public-general hospitals, and one private-general hospital. Participants were selected purposively and through snowball sampling, ensuring maximum variation among clinical emergency staff of hospitals in Tehran Province. Data were collected via in-depth, semi-structured interviews with 13 participants, and sampling continued until data saturation was achieved. For data analysis, the qualitative approach proposed by Graneheim and Lundman was employed, and MAXQDA software version 2022 was used for qualitative data management.
Results: In this study, 13 hospital emergency clinical staff members, including nurses, nursing managers, physicians, and laboratory science experts (8 males and 5 females), with an average work experience of 13 years and 11 months, were interviewed. Findings were extracted in the form of 7 main categories (resources, training and practice, contamination control, coordination, planning and instructions, management and treatment of casualties, structure), 13 subcategories, and 35 semantic codes. The results showed that the lack of specialized training, the absence of appropriate infrastructure for decontamination, and weak intra- and extra-departmental coordination are among the most important challenges to the preparedness of emergency staff in dealing with CBRN incidents. Participants also emphasized the need to provide personal protective equipment, develop specific instructions, and hold periodic drills.
Conclusion: Currently, the level of preparedness of hospital emergency clinical staff in responding to CBRN incidents is limited. Emergency staff play a vital role in responding to CBRN incidents. To ensure their preparedness and response efforts are fully effective, and considering the rising global threats of CBRN incidents, it is recommended to adopt strategies, policies, programs, coordination efforts, funding, and other necessary measures to enhance the preparedness of emergency staff for CBRN incidents.
Materials and Methods: The present study was a qualitative research employing a conventional content analysis approach. The study population consisted of clinical emergency staff from four hospitals, including one educational-specialized hospital, two public-general hospitals, and one private-general hospital. Participants were selected purposively and through snowball sampling, ensuring maximum variation among clinical emergency staff of hospitals in Tehran Province. Data were collected via in-depth, semi-structured interviews with 13 participants, and sampling continued until data saturation was achieved. For data analysis, the qualitative approach proposed by Graneheim and Lundman was employed, and MAXQDA software version 2022 was used for qualitative data management.
Results: In this study, 13 hospital emergency clinical staff members, including nurses, nursing managers, physicians, and laboratory science experts (8 males and 5 females), with an average work experience of 13 years and 11 months, were interviewed. Findings were extracted in the form of 7 main categories (resources, training and practice, contamination control, coordination, planning and instructions, management and treatment of casualties, structure), 13 subcategories, and 35 semantic codes. The results showed that the lack of specialized training, the absence of appropriate infrastructure for decontamination, and weak intra- and extra-departmental coordination are among the most important challenges to the preparedness of emergency staff in dealing with CBRN incidents. Participants also emphasized the need to provide personal protective equipment, develop specific instructions, and hold periodic drills.
Conclusion: Currently, the level of preparedness of hospital emergency clinical staff in responding to CBRN incidents is limited. Emergency staff play a vital role in responding to CBRN incidents. To ensure their preparedness and response efforts are fully effective, and considering the rising global threats of CBRN incidents, it is recommended to adopt strategies, policies, programs, coordination efforts, funding, and other necessary measures to enhance the preparedness of emergency staff for CBRN incidents.
Fatemeh Najafi, Hooman Shahsavari, Golnar Ghane, Zahra Zare,
Volume 19, Issue 3 (9-2025)
Volume 19, Issue 3 (9-2025)
Abstract
Background and Aim: Ensuring the quality of care and maintaining patient safety are fundamental challenges within the nursing profession. Having a culturally relevant and valid tool to assess the phenomenon of “missed nursing care” can significantly assist in identifying actions and conditions that result in negative patient outcomes or situations where care is inadequately provided. Therefore, the aim of the present study was to culturally adapt and validate the Iranian version of the Missed Care Survey tool.
Materials and Methods: The translation and psychometric testing were carried out in six stages: 1) translation from the original language to the target language, 2) comparison of the two translated versions, 3) back-translation, 4) comparison of the back-translated versions with the original, 5) pilot testing of the pre-final version with a monolingual sample, and 6) full psychometric validation of the pre-final version. These stages were conducted with a sample of 330 nursing staff from hospitals affiliated with Tehran University of Medical Sciences.
Results: A total of 330 participants were included in the present study, the majority of whom were female and worked rotating shifts. Approximately half of the participants were aged between 25 and 34 years, and the longest duration of employment in the nursing profession was more than ten years (100 participants, 30.3%). In addition, more than half of the participants held a bachelor’s degree in nursing, and the majority worked more than 30 hours per week (316 participants, 95.8%).The Cronbach’s alpha for the entire instrument was 0.89, and for the subscales of Part B it ranged from 0.79 to 0.93. Moreover, the test–retest correlation coefficients for Part A (missed nursing care, including a list of nursing activities) and Part B (reasons for missed nursing care) were 0.83 and 0.80, respectively. The results of confirmatory factor analysis indicated an acceptable and satisfactory model fit for the three-factor structure of Part B based on overall goodness-of-fit indices. Collectively, these findings provide evidence for the instrument’s robust construct validity and reliability, supporting its suitability for assessing missed nursing care in clinical settings.
Results: A total of 330 participants were included in the present study, the majority of whom were female and worked rotating shifts. Approximately half of the participants were aged between 25 and 34 years, and the longest duration of employment in the nursing profession was more than ten years (100 participants, 30.3%). In addition, more than half of the participants held a bachelor’s degree in nursing, and the majority worked more than 30 hours per week (316 participants, 95.8%).The Cronbach’s alpha for the entire instrument was 0.89, and for the subscales of Part B it ranged from 0.79 to 0.93. Moreover, the test–retest correlation coefficients for Part A (missed nursing care, including a list of nursing activities) and Part B (reasons for missed nursing care) were 0.83 and 0.80, respectively. The results of confirmatory factor analysis indicated an acceptable and satisfactory model fit for the three-factor structure of Part B based on overall goodness-of-fit indices. Collectively, these findings provide evidence for the instrument’s robust construct validity and reliability, supporting its suitability for assessing missed nursing care in clinical settings.
Conclusion: Given the critical role of nurses in the healthcare system, providing high-quality and safe nursing care becomes increasingly important. The growing diversity of populations worldwide highlights the pressing need for researchers and healthcare providers to access valid tools across different cultural groups and languages. The Iranian version of the “Missed Nursing Care Survey” is a reliable tool with acceptable internal consistency, good test-retest reliability, and sufficient validity due to its correlation with the original version. Therefore, this tool can be utilized in studies aimed at generating deeper insights into the factors influencing or moderating this complex phenomenon.
Shiva Mohajel Nayebi, Azra Daei, Vahideh Gavgani Zarea,
Volume 19, Issue 5 (12-2025)
Volume 19, Issue 5 (12-2025)
Abstract
Background and Aim: The continuous specialization and rapid evolution in medical and health sciences, combined with the growing influence of information and communication technologies, have created an urgent need for specialized education in Medical Library and Information Science (MLIS). As universities transition toward the fourth and fifth-generation models, characterized by innovation, networking, and entrepreneurial orientation, academic disciplines are expected to become more dynamic and responsive to technological and societal change. This study aimed to identify emerging community-based educational specializations, explore the related challenges and enabling factors, and develop policy recommendations for establishing a new specialization in MLIS.
Materials and Methods: This multi-methods research was conducted with the goal of informing educational policy and curriculum development. In the first phase, a scoping review following the Arksey and O’Malley framework and guided by the PRISMA-ScR checklist was carried out to identify existing and emerging specializations in health-related information sciences. In the second phase, a focus group discussion (FGD) involving eight domain experts explored perceived challenges, influencing factors, and potential strategies for specialization development. Finally, in the third phase, a simple Delphi technique was applied with ten policymakers in Medical Library and Information Science to prioritize the proposed specialization options. Qualitative data were analyzed thematically, using coding and categorization to identify recurrent patterns and themes.
Results: The scoping review included 22 eligible studies, from which 11 educational specializations related to health information and librarianship were initially extracted. After merging overlapping domains, eight distinct specializations remained. Following expert and policymaker prioritization, four educational specializations were selected as feasible and necessary for integration into the MLIS curriculum. The main challenges identified were: Ensuring disciplinary sustainability in the face of rapid scientific and technological change; Promoting structural and curricular reform to align educational programs with real-world health information needs; Overcoming institutional and cultural resistance to organizational change. Policymakers emphasized curriculum modernization, specialized educational tracks, and needs-based program design as essential strategies for strengthening MLIS education and its alignment with health system priorities.
Conclusion: The study recommends that universities establish new educational specializations or formal short-term programs tailored to national and regional needs in health information science. Implementing the proposed policy options can enhance the long-term sustainability, relevance, and innovation capacity of the MLIS discipline while increasing the employability and professional competence of graduates. Strengthening educational responsiveness to societal and technological transformation will position Medical Librarianship and Information Science as a key enabler in evidence-based health systems and digital health development.
Materials and Methods: This multi-methods research was conducted with the goal of informing educational policy and curriculum development. In the first phase, a scoping review following the Arksey and O’Malley framework and guided by the PRISMA-ScR checklist was carried out to identify existing and emerging specializations in health-related information sciences. In the second phase, a focus group discussion (FGD) involving eight domain experts explored perceived challenges, influencing factors, and potential strategies for specialization development. Finally, in the third phase, a simple Delphi technique was applied with ten policymakers in Medical Library and Information Science to prioritize the proposed specialization options. Qualitative data were analyzed thematically, using coding and categorization to identify recurrent patterns and themes.
Results: The scoping review included 22 eligible studies, from which 11 educational specializations related to health information and librarianship were initially extracted. After merging overlapping domains, eight distinct specializations remained. Following expert and policymaker prioritization, four educational specializations were selected as feasible and necessary for integration into the MLIS curriculum. The main challenges identified were: Ensuring disciplinary sustainability in the face of rapid scientific and technological change; Promoting structural and curricular reform to align educational programs with real-world health information needs; Overcoming institutional and cultural resistance to organizational change. Policymakers emphasized curriculum modernization, specialized educational tracks, and needs-based program design as essential strategies for strengthening MLIS education and its alignment with health system priorities.
Conclusion: The study recommends that universities establish new educational specializations or formal short-term programs tailored to national and regional needs in health information science. Implementing the proposed policy options can enhance the long-term sustainability, relevance, and innovation capacity of the MLIS discipline while increasing the employability and professional competence of graduates. Strengthening educational responsiveness to societal and technological transformation will position Medical Librarianship and Information Science as a key enabler in evidence-based health systems and digital health development.
Related Websites
Site Keywords
Health Information Management, Health Care Management, Medical Laboratory Sciences, Medical Library & Information Sciences, Radiation Biology (Radiobiology and Radiation Protection), Operating Room, Anesthesiology
Site Statistics- Registered users: 3343 users
- Online users: 0 users
- Guest users: 245 users
- All visits: 6373866 visits
- Visits in 24 Hours: 14401 visits
- Total articles: 3228 articles
- Published articles: 831 articles
© 2026 , Tehran University of Medical Sciences, CC BY-NC 4.0
Designed & Developed by: Yektaweb