Normalization and reliability evaluation of persian version of two-pair dichotic digits in 8 to 12-year-old children

Objectives: All subjects suspected of Central Auditory Processing Disorder (CAPD) were previously tested by free recall dichotic digits test (DDT). The study objective was normalization and reliability evaluation of two-pair DDT in 750 native Persian subjects aged 8 to 12 years. Materials: A total of 750 subjects were divided into five age groups varying between 8 years and 12 years and 11 months old. Each age group had 150 subjects. DDT was tested in free recall condition. For evaluating DDT test-retest reliability, 300 participants (60 subjects in each age group) were tested again after one month. Results: Right and left ear mean score increased from 71.68(±2.19) and 58.51(±1.71) in the 8-year-old group to 90.26(±1.96) and 88.38(±1.36) in 12-year-old group, respectively. The mean Right Ear Advantage (REA) decreased from 13.16(±2.58) in the 8-year-old group to 1.88(±2.49) in the 12-year-old group. A high stability was observed between test-retest results (P < 0.0001). Discussion: Persian version of two-pair dichotic digits exhibited proper reliability for evaluating 8 to 12-year-old subjects, and the study results can be used for evaluating the dichotic hearing function in subjects of the same age group

Multiple air pollutants exposure and leukaemia incidence in Tehran, Iran from 2010 to 2016: a retrospective cohort study

OBJECTIVE: Leukaemia is one of the most common cancers and may be associated with exposure to environmental carcinogens, especially outdoor air pollutants. The objective of this study was to investigate the association of ambient air pollution and leukaemia in Tehran, Iran. DESIGN: In this retrospective cohort study, data about the residential district of leukaemia cases diagnosed from 2010 to 2016 were inquired from the Ministry of Health cancer database. Data from a previous study were used to determine long-term average exposure to different air pollutants in 22 districts of Tehran. Latent profile analysis (LPA) was used to classify pollutants in two exposure profiles. The association between air pollutants and leukaemia incidence was analysed by negative binomial regression. SETTING: Twenty-two districts of Tehran megacity. PARTICIPANTS: Patients with leukaemia. OUTCOME MEASURES: The outcome variables were incidence rate ratios (IRR) of acute myeloid and lymphoid leukaemia across the districts of Tehran. RESULTS: The districts with higher concentrations for all pollutants were near the city centre. The IRR was positive but non-significant for most of the air pollutants. However, annual mean NOx was directly and significantly associated with total leukaemia incidence in the fully adjusted model (IRR (95% CI): 1.03 (1.003 to 1.06) per 10 ppb increase). Based on LPA, districts with a higher multiple air-pollutants profile were also associated with higher leukaemia incidence (IRR (95% CI): 1.003 (0.99 to 1.007) per 1 ppb increase). CONCLUSIONS: Our study shows that districts with higher air pollution (nitrogen oxides and multipollutants) have higher incidence rates of leukaemia in Tehran, Iran. This study warrants conducting further research with individual human data and better control of confounding

Prevalence of depression and anxiety among participants with glaucoma in a population-based cohort study : the Gutenberg Health Study

Background To investigate the prevalence of depression and anxiety among subjects with self-reported glaucoma and the association between self-reported glaucoma and depression respectively anxiety in a European cohort. Methods A study sample of 14,657 participants aged 35 to 74 years was investigated in a population-based cohort study. All participants reported presence or absence of glaucoma. Ophthalmological examinations were carried out in all participants and demographic and disease related information were obtained by interview. Depression was assessed with the Patient Health Questionnaire (PHQ-9), and generalized anxiety with the two screening items (GAD-2) of the short form of the GAD-7 (Generalized Anxiety Disorder-7 Scale). Prevalence of depression and generalized anxiety were investigated for subjects with and without self-reported glaucoma. Logistic regression analyses with depression, respectively anxiety as dependent variable and self-reported glaucoma as independent variable were conducted and adjusted for socio-demographic factors, systemic comorbidities (arterial hypertension, myocardial infarction, stroke, diabetes mellitus, chronic obstructive pulmonary disease, cancer), ocular diseases (cataract, macular degeneration, corneal diseases, diabetic retinopathy), visual acuity, intraocular pressure, antiglaucoma eye drops (sympathomimetics, parasympathomimetics, carbonic anhydrase inhibitors, beta-blockers, prostaglandins) and general health status. Results 293 participants (49.5% female) reported having glaucoma. Prevalence of depression among participants with and without self-reported glaucoma was 6.6% (95%-CI 4.1–10.3) respectively 7.7% (95%-CI 7.3–8.2), and for anxiety 5.3% (95%-CI 3.1–8.7) respectively 6.6% (95%-CI 6.2–7.1). Glaucoma was not associated with depression (Odds ratio 1.10, 95%-CI 0.50–2.38, p = 0.80) or anxiety (1.48, 95%-CI 0.63–3.30, p = 0.35) after adjustment for socio-demographic factors, ocular/systemic diseases, ocular parameters, antiglaucoma drugs and general health status. A restriction to self-reported glaucoma cases either taking topical antiglaucoma medications or having a history of glaucoma surgery did not alter the result. Conclusions This is the first study analyzing both depression and anxiety among glaucoma patients in a European cohort. Subjects with and without self-reported glaucoma had a similar prevalence of depression and anxiety in our population-based sample. Self-reported glaucoma was not associated with depression or anxiety. A lack of a burden of depressive symptoms may result from recruitment from a population-based sample as compared to previous study groups predominantly recruited from tertiary care hospitals

Frequency of celiac disease in children with type 1 diabetes

Background and aims: Occurrence of celiac and diabetes is accompanied by numerous complications in children and if diagnoses do not occur promptly, celiac disease complications including gastrointestinal disorders, loss of appetite and damage caused by hypoproteinemia, and most importantly, growth disorder occurs in diabetic children. This study was aimed to compare the frequency of celiac disease in children with diabetes aged under 15 years and the controls of the same age referring to the clinics affiliated with Shahrekord University of Medical Sciences. Methods: In this case-control study, using convenience sampling, 42 patients with diabetes and 43 patients without diabetes admitted for gastrointestinal diseases were assigned as cases and controls, respectively. The description of all patients was provided, and physical examinations and serologic tests were conducted on them. If the serologic tests tTGA-IgA and tTGA-IgG were positive, the intestinal biopsy was taken. The data were analyzed by descriptive statistics and t-test, chi-square, and Mann–Whitney test in SPSS. Results: The mean serum levels of tTGA-IgA and tTGA-IgG were significantly higher in the case group than the control group (P<0.05). There were significant differences in weight gain between the cases and the controls (P=0.017). The frequency of celiac disease was 15% (n: 6) in children with diabetes with a significant difference from the controls (P=0.02). Conclusion: In this study, the frequency of celiac disease was higher in children with diabetes than children without. Therefore, in the study area, routine screening for celiac disease is helpful in reducing possible disorders and complications in diabetic children

Developing lean and responsive supply chains : a robust model for alternative risk mitigation strategies in supply chain designs

This paper investigates how organization should design their supply chains (SCs) and use risk mitigation strategies to meet different performance objectives. To do this, we develop two mixed integer nonlinear (MINL) lean and responsive models for a four-tier SC to understand these four strategies: i) holding back-up emergency stocks at the DCs, ii) holding back-up emergency stock for transshipment to all DCs at a strategic DC (for risk pooling in the SC), iii) reserving excess capacity in the facilities, and iv) using other facilities in the SC’s network to back-up the primary facilities. A new method for designing the network is developed which works based on the definition of path to cover all possible disturbances. To solve the two proposed MINL models, a linear regression approximation is suggested to linearize the models; this technique works based on a piecewise linear transformation. The efficiency of the solution technique is tested for two prevalent distribution functions. We then explore how these models operate using empirical data from an automotive SC. This enables us to develop a more comprehensive risk mitigation framework than previous studies and show how it can be used to determine the optimal SC design and risk mitigation strategies given the uncertainties faced by practitioners and the performance objectives they wish to meet

Spatial planning for water sustainability projects under climate uncertainty: balancing human and environmental water needs

Societies worldwide make large investments in the sustainability of integrated human-freshwater systems, but uncertainty about water supplies under climate change poses a major challenge. Investments in infrastructure, water regulation, or payments for ecosystem services may boost water availability, but may also yield poor returns on investment if directed to locations where water supply unexpectedly fluctuates due to shifting climate. How should investments in water sustainability be allocated across space and among different types of projects? Given the high costs of investments in water sustainability, decision-makers are typically risk-intolerant, and considerable uncertainty about future climate conditions can lead to decision paralysis. Here, we use mathematical optimization models to find Pareto-optimal satisfaction of human and environmental water needs across a large drought-prone river basin for a range of downscaled climate projections. We show how water scarcity and future uncertainty vary independently by location, and that joint consideration of both factors can provide guidance on how to allocate water sustainability investments. Locations with high water scarcity and low uncertainty are good candidates for high-cost, high-reward investments; locations with high scarcity but also high uncertainty may benefit most from low regret investments that minimize the potential for stranded assets if water supply increases. Given uncertainty in climate projections in many regions worldwide, our analysis illustrates how explicit consideration of uncertainty may help to identify the most effective strategies for investments in the long-term sustainability of integrated human-freshwater systems.The project described in this publication was supported by the Science Applications division of the Southwest Region of the US Fish and Wildlife Service, and by Grant No. G17AP00120, Balancing Water Usage and Ecosystem Outcomes Under Drought and Climate Change: Enhancing an Optimization Model for the Red River, from the United States Geological Survey. Open Access fees paid for in whole or in part by the University of Oklahoma Libraries.Ye