Effect of dehydroepiandrosterone on meiotic spindle structure and oocyte quality in mice

Objective(s): Dehydroepiandrosterone (DHEA) has been reported to improve pregnancy chances in women with diminished ovarian reserve (DOR) and to reduce miscarriage rates by 50–80%. This study, therefore, assesses effects of DHEA on number of retrieved oocytes and meiotic spindles.Materials and Methods: A randomized, prospective, controlled study was conducted on eight groups, four groups of young mice and four elderly. All young and old groups received different oral doses (35, 50, 75 mg/kg) of DHEA for 3 months. Meiotic spindle assessment was done by immunocytochemical techniques using a confocal laser microscope (Leica TCS-4D).Results: Statistical surveys showed that in control young groups 80% (P=0.0845) and in the old control group 73.3% (P=0.000) of the meiotic spindles have a normal shape and structure; the difference was meaningful. The young with 50 mg/kg of DHEA in 85.4% and the young with 75 mg/kg of DHEA in 84.2% were normal in shape and structure. Statistical analysis showed that the difference was meaningless (P=0.845). The old group with 30 mg/kg of DHEA in 81.1%, the old with 50 mg/kg of DHEA in 83.9%, and the old with 75 mg/kg of DHEA in 79.0% showed normal shape and structure. The meiotic spindle disruption ratio in old mice showed a significant difference (P=0.000) in comparison with others in young groups. Statistical analysis showed that difference between DHEA and control groups is meaningful. But this difference was meaningless between DHEA groups.Conclusion: Results showed that DHEA has a positive and improvement effect on the meiotic spindle in old mice

Global injury morbidity and mortality from 1990 to 2017 : results from the Global Burden of Disease Study 2017

Correction:Background Past research in population health trends has shown that injuries form a substantial burden of population health loss. Regular updates to injury burden assessments are critical. We report Global Burden of Disease (GBD) 2017 Study estimates on morbidity and mortality for all injuries. Methods We reviewed results for injuries from the GBD 2017 study. GBD 2017 measured injury-specific mortality and years of life lost (YLLs) using the Cause of Death Ensemble model. To measure non-fatal injuries, GBD 2017 modelled injury-specific incidence and converted this to prevalence and years lived with disability (YLDs). YLLs and YLDs were summed to calculate disability-adjusted life years (DALYs). Findings In 1990, there were 4 260 493 (4 085 700 to 4 396 138) injury deaths, which increased to 4 484 722 (4 332 010 to 4 585 554) deaths in 2017, while age-standardised mortality decreased from 1079 (1073 to 1086) to 738 (730 to 745) per 100 000. In 1990, there were 354 064 302 (95% uncertainty interval: 338 174 876 to 371 610 802) new cases of injury globally, which increased to 520 710 288 (493 430 247 to 547 988 635) new cases in 2017. During this time, age-standardised incidence decreased non-significantly from 6824 (6534 to 7147) to 6763 (6412 to 7118) per 100 000. Between 1990 and 2017, age-standardised DALYs decreased from 4947 (4655 to 5233) per 100 000 to 3267 (3058 to 3505). Interpretation Injuries are an important cause of health loss globally, though mortality has declined between 1990 and 2017. Future research in injury burden should focus on prevention in high-burden populations, improving data collection and ensuring access to medical care.Peer reviewe

Global, regional, and national cancer incidence, mortality, years of life lost, years lived with disability, and disability-Adjusted life-years for 29 cancer groups, 1990 to 2017 : A systematic analysis for the global burden of disease study

Importance: Cancer and other noncommunicable diseases (NCDs) are now widely recognized as a threat to global development. The latest United Nations high-level meeting on NCDs reaffirmed this observation and also highlighted the slow progress in meeting the 2011 Political Declaration on the Prevention and Control of Noncommunicable Diseases and the third Sustainable Development Goal. Lack of situational analyses, priority setting, and budgeting have been identified as major obstacles in achieving these goals. All of these have in common that they require information on the local cancer epidemiology. The Global Burden of Disease (GBD) study is uniquely poised to provide these crucial data. Objective: To describe cancer burden for 29 cancer groups in 195 countries from 1990 through 2017 to provide data needed for cancer control planning. Evidence Review: We used the GBD study estimation methods to describe cancer incidence, mortality, years lived with disability, years of life lost, and disability-Adjusted life-years (DALYs). Results are presented at the national level as well as by Socio-demographic Index (SDI), a composite indicator of income, educational attainment, and total fertility rate. We also analyzed the influence of the epidemiological vs the demographic transition on cancer incidence. Findings: In 2017, there were 24.5 million incident cancer cases worldwide (16.8 million without nonmelanoma skin cancer [NMSC]) and 9.6 million cancer deaths. The majority of cancer DALYs came from years of life lost (97%), and only 3% came from years lived with disability. The odds of developing cancer were the lowest in the low SDI quintile (1 in 7) and the highest in the high SDI quintile (1 in 2) for both sexes. In 2017, the most common incident cancers in men were NMSC (4.3 million incident cases); tracheal, bronchus, and lung (TBL) cancer (1.5 million incident cases); and prostate cancer (1.3 million incident cases). The most common causes of cancer deaths and DALYs for men were TBL cancer (1.3 million deaths and 28.4 million DALYs), liver cancer (572000 deaths and 15.2 million DALYs), and stomach cancer (542000 deaths and 12.2 million DALYs). For women in 2017, the most common incident cancers were NMSC (3.3 million incident cases), breast cancer (1.9 million incident cases), and colorectal cancer (819000 incident cases). The leading causes of cancer deaths and DALYs for women were breast cancer (601000 deaths and 17.4 million DALYs), TBL cancer (596000 deaths and 12.6 million DALYs), and colorectal cancer (414000 deaths and 8.3 million DALYs). Conclusions and Relevance: The national epidemiological profiles of cancer burden in the GBD study show large heterogeneities, which are a reflection of different exposures to risk factors, economic settings, lifestyles, and access to care and screening. The GBD study can be used by policy makers and other stakeholders to develop and improve national and local cancer control in order to achieve the global targets and improve equity in cancer care. © 2019 American Medical Association. All rights reserved.Peer reviewe

Mapping 123 million neonatal, infant and child deaths between 2000 and 2017

Since 2000, many countries have achieved considerable success in improving child survival, but localized progress remains unclear. To inform efforts towards United Nations Sustainable Development Goal 3.2—to end preventable child deaths by 2030—we need consistently estimated data at the subnational level regarding child mortality rates and trends. Here we quantified, for the period 2000–2017, the subnational variation in mortality rates and number of deaths of neonates, infants and children under 5 years of age within 99 low- and middle-income countries using a geostatistical survival model. We estimated that 32% of children under 5 in these countries lived in districts that had attained rates of 25 or fewer child deaths per 1,000 live births by 2017, and that 58% of child deaths between 2000 and 2017 in these countries could have been averted in the absence of geographical inequality. This study enables the identification of high-mortality clusters, patterns of progress and geographical inequalities to inform appropriate investments and implementations that will help to improve the health of all populations

Morphometric cranial standards for sex estimation of a population in two ethnic groups in Southwest Iran

Background: This study aimed to evaluate the cephalometric landmarks, cranial measurements, and cephalic index based on geographical and ethnic characteristics to make a database for the southwest Iranian population. Method: In this analytical cross-sectional study, different anatomic criteria were collected from head MRI images. The anthropometric measures taken included the maximum cranial length, maximum cranial height, maximum cranial breadth, cranial base length, foramen magnum length, upper facial height, lower facial height, foramen magnum breadth, bizygomatic breadth, orbital breadth, nasion-opisthion. The categorization of the head shape was based on the cephalic index. The cranial index was calculated using the equation ([maximum cranial breadth/maximum cranial length] × 100). These assessments were compared to define sexual dimorphism and inter-population variation in size and shape. Results: Sexual dimorphism existed in all cephalometric data except the cephalic index. The measurements comparisonin ethnicities showed that only (eu–eu) differs significantly between the two groups, which is 2,253 mm less in the Arab population compared to the Lur population (P value = 0.022). The cephalic index in males and females was found to be 73.66 and 75.08, respectively. Accordingly, 53.99% were dolichocephalic, 30.06% were mesocephalic, 14.11% were brachycephalic, and 1.84% were hyperbrachycephalic. The shape of the head had no relation to ethnicity but was related to sex (P value = 0.045). Conclusion: It is shown that cephalometric data can be used as diagnostic criteria to determine sex and ethnicity in the southwest Iranian population. It should be further verified on a greater sample size that evaluates more study age distribution

Evaluation of vertebral artery variations and arterial dominance in cervical CT angiographic images in Iranian population

Purpose: The aim of the present study was to determine the characteristics and variations in the origin of vertebral arteries (VA), its level of entry into the transverse foramen, VA diameter, Length of VA, and VA dominance. Methods: A total of 250 adult patients (143 males and 107 females) were enrolled (Mean age: 60.92±13.44) and scanned with Computerized Tomography angiography (CTA). Results: The VA entered the C6 transverse foramen in 97.8% of specimens. Abnormal entrance of VA was observed in 4.4% of specimens. The mean length of prevertebral (V1) right and left VA was 81.38±14.38 mm and 82.49±14.16 mm. The mean length of the intraforaminal segment (V2) of the right and left VA was 81.38±14.375mm and 82.49±14.162mm and showed sexual dimorphism. The mean diameter of the right and left VA was 3.297±0.85 and 3.676±0.88, respectively. We found 1(0.4%) left and 1(0.4%) right VA emerging from the aortic arch. The mean right and left VA diameters were 3.28 ± 0.83 mm and 3.6±0.88mm, respectively. A total of 90(0.36) patients were right dominant and 160(0.64) patients were left-dominant. The right VA of aortic arch origin entered the 4th cervical transverse foramina, whereas the left VA entered the 7th cervical transverse foramina. We found that 22(8.8%) of the right and 1 (0.4%) of the left vertebral arteries had distal origin. The results did not show any relationship between gender and origin of VA, diameter of VA, and level of entry. A significant relationship was observed between gender and VA length (P=0.0001). Discussion: The present study confirms the presence of anomalous in the VA route. Knowledge of such anatomical variations is important in interpreting CTA and may reduce the risk of intraoperative VA injury

Effects of Mono-(2-Ethylhexyl) Phthalate and Di-(2-Ethylhexyl) Phthalate Administrations on Oocyte Meiotic Maturation, Apoptosis and Gene Quantification in Mouse Model

Objective: Phthalates, which are commonly used to render plastics into soft and flexible materials, have also been determined as developmental and reproductive toxicants in human and animals. The purpose of this study was to evaluate the effect of mono-(2- ethylhexyl) phthalate (MEHP) and di-(2-ethylhexyl) phthalate (DEHP) oral administrations on maturation of mouse oocytes, apoptosis and gene transcription levels. Materials and Methods: In this experimental study, immature oocytes recovered from Naval Medical Research Institute (NMRI) mouse strain (6-8 weeks), were divided into seven different experimental and control groups. Control group oocytes were retrieved from mice that received only normal saline. The experimental groups I, II or III oocytes were retrieved from mice treated with 50, 100 or 200 μl DEHP (2.56 μM) solution, respectively. The experimental groups IV, V or VI oocytes were retrieved from mouse exposed to 50, 100 or 200 μl MEHP (2.56 μM) solution, respectively. Fertilization and embryonic development were carried out in OMM and T6 medium. Apoptosis was assessed by annexin V-FITC/Dead Cell Apoptosis Kit, with PI staining. In addition, the mRNA levels of Pou5f1, Ccna1 and Asah1 were examined in oocytes. Finally, mouse embryo at early blastocyst stage was stained with acridine-orange (AO) and ethidium-bromide (EB), in order to access their viability. Results: The proportion of oocytes that progressed up to metaphase II (MII) and 2-cells embryo formation stage was significantly decreased by exposure to MEHP or DEHP, in a dose-dependent manner. Annexin V and PI positive oocytes showed greater quantity in the treated mice than control. Quantitative reverse transcriptase-polymerase chain reaction (qRT-PCR) revealed that expression levels of Pou5f1, Asah1 and Ccna1 were significantly lower in the treated mouse oocytes than control. The total cell count for blastocyst developed from the treated mouse oocytes was lower than the controls. Conclusion: These results indicate that oral administration of MEHP and DEHP could negatively affect mouse oocyte meiotic maturation and development in vivo, suggesting that phthalates could be risk factors for mammalians’ reproductive health. Additionally, phthalate-induced changes in Pou5f1, Asah1 and Ccna1 transcription level could explain in part, the reduced developmental ability of mouse-treated oocytes

Distribution of modic changes and its relation with age, sex and body mass index in Iranian population

Background: Suspected as a cause of low back pain (LBP), Modic changes (MCs) have received increasing attention in spine research and care. Knowledge of MCs based on the general population, which may provide an important clinical reference is limited. Moreover, fewer studies have examined whether MCs are related to other structural features of LBP, such as age, gender and body mass index (BMI). The aim of present study was to determine the prevalence and clinical distribution of MCs in patients with LBP and to explore the related factors such as age, gender and BMI. Method: A total of 159 adult subjects (74 males [46.2%] and 85 females [53.5%]) were enrolled in the study (Mean age: 46.15 ± 10.36) and scanned with 1.5 T Magnetic Resonance Scanner. Age, gender, disk degeneration, herniation, involved segments, Lumbar lordosis (LL) angle, Sacral sloop (SS), MCs, and endplate concave angle (ECA) were recorded. Disk degeneration was graded using a Pfirrmann scale. MCs were classified into Type I (MCI), type II (MC II), type III (MCIII). Results: There were a total of 13 patients (8.2%) with MCI, 145 patients (91.2%) with MC II, and 1 patient (0.6%) with MCIII. Among all patients, the L4/L5 lumbar level was most likely to suffer MCs (56.0%). Greater age [odds ratio (OR) = 2.44 for each 10-year increase] and BMI (OR = 1.07) were associated with the presence of MCs. Logistic regression showed that age, LL, L5/S1 segment lordosis angle, and L5 upper and lower ECA were related with different types of MCs. The OR values were A = 1.08, L = 0.88, D = 1.12, E = 0.88, O = 1.10, respectively (A means age, L means L5/S1 segment lordosis angle, D and E means L5 upper and lower ECA and O means Lumbar lordosis). Conclusion: Type II MCs are predominant, mostly occur in lower lumbar region. Age, LL, and L5 ECA were associated with type II MCs. L5 Lower concave angle and LL were the most relevant factors for different types

The global burden of childhood and adolescent cancer in 2017. An analysis of the Global Burden of Disease Study 2017

Force LM, Abdollahpour I, Advani SM, et al. The global burden of childhood and adolescent cancer in 2017. An analysis of the Global Burden of Disease Study 2017. Lancet Oncology. 2019;20(9):1211-1225.Background Accurate childhood cancer burden data are crucial for resource planning and health policy prioritisation. Model-based estimates are necessary because cancer surveillance data are scarce or non-existent in many countries. Although global incidence and mortality estimates are available, there are no previous analyses of the global burden of childhood cancer represented in disability-adjusted life-years (DALYs). Methods Using the Global Burden of Diseases, Injuries, and Risk Factors Study (GBD) 2017 methodology, childhood (ages 0-19 years) cancer mortality was estimated by use of vital registration system data, verbal autopsy data, and population-based cancer registry incidence data, which were transformed to mortality estimates through modelled mortality-to-incidence ratios (MIRs). Childhood cancer incidence was estimated using the mortality estimates and corresponding MIRs. Prevalence estimates were calculated by using MIR to model survival and multiplied by disability weights to obtain years lived with disability (YLDs). Years of life lost (YLLs) were calculated by multiplying age-specific cancer deaths by the difference between the age of death and a reference life expectancy. DALYs were calculated as the sum of YLLs and YLDs. Final point estimates are reported with 95% uncertainty intervals. Findings Globally, in 2017, there were 11.5 million (95% uncertainty interval 10.6-12.3) DALYs due to childhood cancer, 97.3% (97.3-97.3) of which were attributable to YLLs and 2.7% (2.7-2.7) of which were attributable to YLDs. Childhood cancer was the sixth leading cause of total cancer burden globally and the ninth leading cause of childhood disease burden globally. 82.2% (82.1-82.2) of global childhood cancer DALYs occurred in low, low-middle, or middle Socio-demographic Index locations, whereas 50.3% (50.3-50.3) of adult cancer DALYs occurred in these same locations. Cancers that are uncategorised in the current GBD framework comprised 26.5% (26.5-26.5) of global childhood cancer DALYs. Interpretation The GBD 2017 results call attention to the substantial burden of childhood cancer globally, which disproportionately affects populations in resource-limited settings. The use of DALY-based estimates is crucial in demonstrating that childhood cancer burden represents an important global cancer and child health concern. (C) 2019 The Author(s). Published by Elsevier Ltd

The global, regional, and national burden of colorectal cancer and its attributable risk factors in 195 countries and territories, 1990-2017: a systematic analysis for the Global Burden of Disease Study 2017

Safiri S, Sepanlou SG, Ikuta KS, et al. The global, regional, and national burden of colorectal cancer and its attributable risk factors in 195 countries and territories, 1990-2017: a systematic analysis for the Global Burden of Disease Study 2017. LANCET GASTROENTEROLOGY & HEPATOLOGY. 2019;4(12):913-933.Background Data about the global, regional, and country-specific variations in the levels and trends of colorectal cancer are required to understand the impact of this disease and the trends in its burden to help policy makers allocate resources. Here we provide a status report on the incidence, mortality, and disability caused by colorectal cancer in 195 countries and territories between 1990 and 2017. Methods Vital registration, sample vital registration, verbal autopsy, and cancer registry data were used to generate incidence, death, and disability-adjusted life-year (DALY) estimates of colorectal cancer at the global, regional, and national levels. We also determined the association between development levels and colorectal cancer age-standardised DALY rates, and calculated DALYs attributable to risk factors that had evidence of causation with colorectal cancer. All of the estimates are reported as counts and age-standardised rates per 100 000 person-years, with some estimates also presented by sex and 5-year age groups. Findings In 2017, there were 1.8 million (95% UI 1.8-1.9) incident cases of colorectal cancer globally, with an age-standardised incidence rate of 23.2 (22.7-23.7) per 100 000 person-years that increased by 9.5% (4.5-13.5) between 1990 and 2017. Globally, colorectal cancer accounted for 896 000 (876 300-915 700) deaths in 2017, with an age-standardised death rate of 11.5 (11.3-11.8) per 100 000 person-years, which decreased between 1990 and 2017 (-13.5% [-18.4 to -10.0]). Colorectal cancer was also responsible for 19.0 million (18.5-19.5) DALYs globally in 2017, with an age-standardised rate of 235.7 (229.7-242.0) DALYs per 100 000 person-years, which decreased between 1990 and 2017 (-14.5% [-20.4 to -10.3]). Slovakia, the Netherlands, and New Zealand had the highest age-standardised incidence rates in 2017. Greenland, Hungary, and Slovakia had the highest age-standardised death rates in 2017. Numbers of incident cases and deaths were higher among males than females up to the ages of 80-84 years, with the highest rates observed in the oldest age group (>= 95 years) for both sexes in 2017. There was a non-linear association between the Socio-demographic Index and the Healthcare Access and Quality Index and age-standardised DALY rates. In 2017, the three largest contributors to DALYs at the global level, for both sexes, were diet low in calcium (20.5% [12.9-28.9]), alcohol use (15.2% [12.1-18.3]), and diet low in milk (14.3% [5.1-24.8]). Interpretation There is substantial global variation in the burden of colorectal cancer. Although the overall colorectal cancer age-standardised death rate has been decreasing at the global level, the increasing age-standardised incidence rate in most countries poses a major public health challenge across the world. The results of this study could be useful for policy makers to carry out cost-effective interventions and to reduce exposure to modifiable risk factors, particularly in countries with high incidence or increasing burden. Copyright (C) 2019 The Author(s). Published by Elsevier Ltd