ID in cardiomyocytes impairs mitochondrial respiration and adaptation to acute and chronic increases in workload. Iron supplementation restores cardiac energy reserve and function in iron-deficient hearts.

Aims Low cardiac iron levels promote heart failure in experimental models. While cardiac iron concentration (CI) is decreased in patients with advanced heart failure with reduced ejection fraction (HFrEF), CI has never been measured in non‐advanced HFrEF. We measured CI in left ventricular (LV) endomyocardial biopsies (EMB) from patients with non‐advanced HFrEF and explored CI association with systemic iron status and disease severity. Methods and results We enrolled 80 consecutive patients with non‐ischaemic HFrEF with New York Heart Association class II or III symptoms and a median (interquartile range) LV ejection fraction of 25 (18–33)%. CI was 304 (262–373) μg/g dry tissue. CI was not related to immunohistological findings or the presence of cardiotropic viral genomes in EMBs and was not related to biomarkers of systemic iron status or anaemia. Patients with CI in the lowest quartile (CIQ1) had lower body mass indices and more often presented with heart failure histories longer than 6 months than patients in the upper three quartiles (CIQ2–4). CIQ1 patients had higher serum N‐terminal pro‐B‐type natriuretic peptide levels than CIQ2–4 patients [3566 (1513–6412) vs. 1542 (526–2811) ng/L; P = 0.005]. CIQ1 patients also had greater LV end‐diastolic (P = 0.001) and end‐systolic diameter indices (P = 0.003) and higher LV end‐diastolic pressures (P = 0.046) than CIQ2–4 patients. Conclusion Low CI is associated with greater disease severity in patients with non‐advanced non‐ischaemic HFrEF. CI is unrelated to systemic iron homeostasis. The prognostic and therapeutic implications of CI measurements in EMBs should be further explored.

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Background and purpose: Services quality is an important factor of satisfaction, as well as a remarkable tool for marketing to achieve the competitive differentiation and promotion of customer's loyalty. The present study was aimed to analyze the quality gap using SERVQUAL approach at selected hospitals in Golestan Province at the year 2015. Materials and Methods: A cross-sectional survey was conducted on 361 patients of selected hospitals of Golestan Province. To determine sample size, Cochran's sample size formula was utilized. Also, to collect the data, SERVQUAL questionnaire was used. The collected data was analyzed through SPSS Software (version 18), and running statistical tests including paired t-test and Pearson correlation. The level of significance was also considered to be ≤ 0.05. Results: The most expectation of hospital services quality was related to reliability dimension (31.60 ± 4.00), while the lowest perception was about responsiveness aspect (13.36 ± 5.74). The greatest gap between perceptions and expectances was in the reliability dimension (-4.54), which was significant (P<0.001). In terms of responsiveness dimension, there was a significant correlation between perceptions and expectances (r = 0.174, P≤0.001). Conclusions: The largest gap between perceptions and expectances was about reliability and tangibles dimensions that can likely be reduced by the staff appearance, physical environment, and utilization of suitable equipment and assurance to patients.

Studying the role of employees as the base of an organization on achieving organizational goals has increased in recent years [1]. To have better organizational citizens, organizations should encourage their staff [2]. As the most powerful form of organizational behavior, organizational citizenship is more influential than organizational cooperation [3]. Studies have shown that cooperative behavior, such as the citizenship behavior results in easier organizational communication, promoting organizational planning, improving inter-personal cooperation and developing better organizational climate, directly influence staff satisfaction, work life quality, service-provision, job commitment and financial output [4]. As the most fundamental organizational behavior, the organizational citizenship behavior (OCB) causes so-called organizational effectiveness. This study Focused on the comparing organizational citizenship behavior components including conscientiousness, courtesy, altruism, sportsmanship and civic virtue among hospitals based on ownership. Research population included all therapeutic and non-therapeutic employees working in the five selected hospital located in Golestan province, Iran in 2016. This study is approved by Ethical committee of Islamic Azad Sari Branch. Based on Cochran׳s sampling formula, 312 employees working in different hospital sections and units (nurses and administrative personnel) were proportionally selected as the research sample. They completed the Persian version of Podsakoff׳s standard scale measuring organizational citizenship behavior. The data were analyzed using SPSS 22 and applying inferential statistics approaches such as t-test, Tukey, and ANOVA in the confidence interval of 95%.