Pattern of contributing behaviors and their determinants among people living with HIV in Iran: A 30-year nationwide study

Introduction: A major shift in the routes of HIV transmission seams to be taking place in Iran. Our study aimed to investigate the 30-year trend of major HIV related behaviors in Iran. Methods: The national HIV/AIDS registry database (from September 1986 to July 2016 with data on 32,168 people newly diagnosed with HIV) was used to study the 30 years trend and demographic determinants of major HIV related behaviors. Results: The highest rate of drug injection (DI) among people living with HIV (PLHIV) was reported during 1996 to 1999 (p-for trend < 0.001) while the highest rate of sexual activity by minorities or hard to reach groups was during 2004 to 2011 (p-for trend < 0.001). Among males, drug injection was directly associated with being single (ORsingle/married = 1.34), being unemployed (ORunemployed/employed = 1.94) and having lower level of education (OR<highschool/≥highschool = 2.21). Regarding females, drug injection was associated with being housewife (ORhousewife/employed = 1.35) and lower level of education (OR<highschool/≥highschool = 1.85). In females, condomless sexual contact was more common among those younger (OR20−29/<20 = 6.15), and married (ORmarried/single = 7.76). However, among males those being single (ORmarried/single = 0.82), being more educated (OR≥highschool/<highschool = 1.24), and being unemployed (ORunemployed/employed = 1.53) reported more sexual activity by minoritised or hard to reach groups. Discussion: The pattern of major HIV related behaviors among Iranian males and females have been rapidly changing and people living with HIV (PLHIV) are being diagnosed at a younger age. Health education to younger individuals is an essential HIV controlling strategy among Iranian population. Implementation of surveys in hidden and hard-to-reach populations is also recommended. Copyright © 2023 Gheibi, Fararouei, Afrashteh, Akbari, Afsar Kazerooni and Shokoohi

Antioxidant effect of Linalool on testicular-injury induced by carbon tetrachloride in male rats

Background: The oxidative stress and generation of free radicals plays an important role in testicular impairment. The aim of this study was to investigate the protective effect of linalool on carbon tetrachloride (CCl4)-induced male reproductive system damage. Methods: In this study, 24 male rats were divided into four groups. Two of the groups were normal control group andCCl4 damage control group which received a daily dose of distilled water for 14 days. Two of the other groups were pretreatment groups; the rats in one of them received a daily dose of 25 mg/kg linalool and those in the other were administered with a daily dose of 100 mg/kg silymarin for 14 days. On the 14th day, the damage control group as well as the pretreatment groups was intraperitoneally injected with 1 ml/kg of the mixture of CCl4and olive oil (1:1). The rats in the normal control group were only administered with olive oil. 48 hours after the injection of CCl4, a part of the testis tissue was separated for conducting antioxidant and malondialdehyde (MDA) tests. Results: The injection of CCl4 into the rats caused a significant increase in the concentration of MDA and insignificant decrease in the level of antioxidants in the testicular lysate as compared to the normal control group (P<0.01). Treatment with linalool improved the level of MDA and enhanced antioxidant as compared to the damage control group (P<0.01). Conclusion: The results of this study indicated that linalool has antioxidant properties and can have a therapeutic effect against CCl4-induced testicular injuries

Viral infections in 47 CVID patients in allergy and immunology department of Rasool E Akram hospital in Tehran

Background: CVID is a heterogeneous primary immune deficiency with infectious, autoimmune and autoinflamatory features. It is most common symptomatic PID in Iran, with prevalence of 1 in 25000 to 50000 people. CVID has been divided into some phenotypes to produce more homogenized subpopulations. CVID is not a pure Ab deficiency .and because of both abnormalities in Tcell and innate immunity in combination with B cell dysfunction these patients are predisposed to viral and opportunistic infections. Method: prevalence of viral infections is reported in 47 CVID patients registered in Rasool E Akram hospital in Tehran. Patients have been diagnosed as CVID with the PAGID-ESID diagnostic criteria in our department or referred from other clinics for follow up and treatment. Diagnosis of viral germs has been made by clinical signs, pathological significances and in some cases by PCR. Cases: 9 patients (19%) had problems with viral infections. Infections occurred befor diagnosis of CVID in some cases or after that. Four patients (8.5 %) had problems with wart. Sever mucocutaneus HSV infection has occurred in 3 (6 %), recurrent zona in one (2 %) and CMV infection as colitis or pneumonitis in 3(6 %) patients. Sever progressive lethal CNS infection with JC virus occurred in one patient. Conclusion: evidences show that CVID is not a pure B cell defect, and we should be aware of opportunistic and viral infections that in some cases may be fatal

Application of Geographic Information Systems

The importance of Geographic Information Systems (GIS) can hardly be overemphasized in today’s academic and professional arena. More professionals and academics have been using GIS than ever – urban & regional planners, civil engineers, geographers, spatial economists, sociologists, environmental scientists, criminal justice professionals, political scientists, and alike. As such, it is extremely important to understand the theories and applications of GIS in our teaching, professional work, and research. “The Application of Geographic Information Systems” presents research findings that explain GIS’s applications in different subfields of social sciences. With several case studies conducted in different parts of the world, the book blends together the theories of GIS and their practical implementations in different conditions. It deals with GIS’s application in the broad spectrum of geospatial analysis and modeling, water resources analysis, land use analysis, infrastructure network analysis like transportation and water distribution network, and such. The book is expected to be a useful source of knowledge to the users of GIS who envision its applications in their teaching and research. This easy-to-understand book is surely not the end in itself but a little contribution to toward our understanding of the rich and wonderful subject of GIS

Acquiescence bias: exploring the applicability of ipsative scoring and acquiescence modeling

Acquiescence bias, defined as the tendency to agree with an item irrespective of the content is an important methodological issue in cross-cultural psychological research. The present study compared two methods to control for acquiescence bias, namely ipsatizing and modeling an acquiescence factor using confirmatory factor analysis (CFA). Simulated data sets are being used to compare raw data estimation methods, ipsative estimation methods and the acquiescence modeling method on how well they can reproduce the true theoretical correlations between underlying factors of an uncorrelated bidimensional model. Three conditions were manipulated: factor strength, acquiescence strength and factor intercorrelation. Depending on the specific model conditions, correlations and CFA using raw data and ipsative estimation methods show big under- or overestimations. The acquiescence modeling method reproduces the true theoretical correlations very well, irrespective of the specific conditions. Estimating relationships between constructs by means of acquiescence modeling in CFA is much more widely applicable than previously thought and is advised, even when unbalanced item sets are used to measure constructs

Social determinants and child survival in Nigeria in the era of Sustainable Development Goals: Progress, challenges, and opportunities

Introduction: Like in many low- and middle-income settings, childhood mortality remains a big challenge in Nigeria—being the second largest contributor to under-five mortality globally, after India. Currently, there is little local evidence to guide policymakers in Nigeria to tailor appropriate social interventions to make the Sustainable Development Goal (SDG) targets of child survival (SDG-3), gender equality (SDG-5), and social inclusiveness (SDG-10) achievable by 2030. In addition, lack of methodological rigor and theoretical foundations of child survival research in Nigeria limit their use for proper planning of child health services. Aims: The basis of this thesis is to understand the complex issues relating to child survival and recommend new approaches to guide policymakers on interventions that will improve child survival in Nigeria. The overarching goal of this thesis is to address the methodological and theoretical shortcomings identified in the previous studies conducted in Nigeria. Using robust interdisciplinary analytic techniques, this thesis assessed the following specific objectives. Objective 1: (a) Compare predictive abilities of the most used conventional statistical time-series methods—ARIMA and Holt-Winters exponential smoothing models, with artificial intelligence technique such as group method of data handling (GMDH)-type artificial neural network (ANN), and (b) estimate the age- and sex-specific mortality trends in child-related SDG indicators (i.e., neonatal and under-five mortality rates) over the 1960s-2017 period, and estimate the expected annual reduction rates needed to achieve the SDG-3 targets by projecting rates from 2018 to 2030. Objective 2: (a) Identify the social determinants of age-specific childhood (0-59 months) mortalities, which are disaggregated into neonatal mortality (0-27 days), post-neonatal mortality (1-11 months) and child mortality (12-59 months), and (b) estimate the within- and between-community variations of mortality among under-five children in Nigeria. Objective 3: Identify the critical pathways through which social factors (at maternal, household, community levels) determine neonatal, infant, and under-five mortalities in Nigeria. Objective 4: (a) Determine patterns and determinants of geographical clustering of neonatal mortality at the state and regional levels in Nigeria, (b) assess gender inequity for neonatal mortality between urban and rural communities across the regions in Nigeria, and (c) measure gaps in SDG-3 target for neonatal mortality at the state and regional levels in Nigeria. Methods: This thesis is a quantitative study which used two secondary datasets—aggregated historical childhood mortality data from 1960s to 2017 (objective 1), and the latest (2016/2017) Nigeria Multiple Indicator Cluster Survey (MICS) for 36 states and Federal Capital Territory (FCT) in Nigeria (objectives 2-4). To minimize recall bias, analysis was limited to a weighted nationally representative sample of 30,960 live births delivered within five years before the survey. The selection of relevant social determinants of child survival was primarily informed by Mosley-Chen framework. The candidate variables were layered across child, maternal, household, and community-levels. The analytic approaches include artificial intelligence technique (i.e., group method of data handling (GMDH)-type artificial neural network, and multilayer perceptron (MLP) neural network), autoregressive integrated moving average (ARIMA), Holt-Winters exponential smoothing models, spatial cluster analysis, hierarchical path analysis with time-to-event outcome, and multilevel multinomial regression. Results: Progress towards achieving SDG targets – Nigeria is not likely to achieve SDG targets for child survival and, within, gender equity by 2030 at the current annual reduction rates (ARR) under-five mortality rate (U5MR): 1.2%, and neonatal mortality rate (NMR): 2.0%. If the current trend continues, U5MR will begin to increase by 2028. Also, at the end of SDG-era, female deaths will be higher than male deaths (80.9 vs. 62.6 deaths per 1000 live births). To make child-related SDG targets achievable by 2030, Nigeria needs to reduce annual U5MR by 9 times and annual NMR by 4 times the current rate of decrease. Social determinants of childhood mortality – At each stage of early childhood development, there are different factors relating to survival outcomes. Surprisingly, attendance of skilled health providers during delivery was associated with an increased neonatal mortality risk, although its effect disappeared during post-neonatal and toddler/pre-school stages. The observed association requires cautious interpretation because of unavailability of variables on quality of care in MICS dataset to assess how skilled birth delivery impacts child survival in Nigeria. However, there is a possibility of under-reporting under-five mortalities at the community level. Also, it could indicate a functioning referral system that sends the high-risk deliveries to health facilities to a greater extent. There is a large variation (39%) of under-five mortalities across the Nigerian communities, which is accounted for by maternal-level factors (i.e., maternal education, contraceptive use, maternal wealth, parity, death of previous children and quality of perinatal care). Pathways to childhood mortality – Region and area of residence (urban/rural), infrastructural development, maternal education, contraceptive use, marital status, and maternal age at birth were found to operate indirectly on neonatal, infant and under-five survival. Female children, singleton, children whose mothers delivered at least two years apart and aged 20-34 years survived much longer. Specifically, women from Northern areas of Nigeria were less likely to reside in urban cities and towns than those in the Southern areas. This, in turn, limited their access to social infrastructure and acted as a barrier to maternal education. Without adequate education, women were less likely to use contraceptive methods. Women with no history of contraceptive use were more likely to have childbirths closer together (less than two-year gap), which in turn, negatively impacted child survival. Regional inequities in childhood mortality – There was significant state-level clustering of NMR in Nigeria. The states with higher neonatal mortality rates were majorly clustered in the North-West and North-Central regions, and states with lower neonatal mortality rates were clustered in the South-South and South-East regions. Gender inequity was worse in the rural areas of Northern Nigeria, while it was worse in the urban areas of Southern Nigeria. NMR was disproportionately higher among females in urban areas (except North-West and South-West regions). Conversely, male neonates had higher mortality risks in the rural areas for all the regions. Conclusions: This thesis provides more refined age- and sex-specific mortality estimates for Nigeria. At the current rates, Nigeria will not meet SDG targets for child survival. In addition, this thesis identifies the critical intervention pathways to child survival in Nigeria during the SDG-era. The new estimates may be used to improve the design and accelerate the implementation of child health programmes to attain the SDG targets. Also, it is important for stakeholders to implement more impactful policies that promote maternal education and improve living conditions of women (especially in the rural areas). To address gender inequities, gender-sensitive policies, and community mobilization against gender-based discrimination towards girl-child should be implemented. Further research is required to assess the quality of skilled birth attendants in Nigeria