Determinant criteria for designing Health benefit package in selected countries

Health benefit package described as primary health interventions that provided with government using general funds for all regardless their financial ability. This study was aimed at determine appropriate pattern for Iran using comparative survey of Health benefit package in various countries. A review exploration was done, scholars was selected population of both developed and developing countries, required information was also extracted by articles, searches and reports of reliable sources and date were analyzed by SPSS, in brief. The vast majority frequencies was respectively allocated to accessibility (40.7%), cost- effectiveness (29.6%), prioritize, efficacy and cost (22.2%). most countries located in WHO African region were selected cost-effectiveness and accessibility, WHO southeast Asia region were selected, coverage, prioritize, efficacy and quality and finally most WHO Europeans region were elected effectiveness and services costs for including services in Health benefit package. According to most Health benefit package designer emphasis on criteria including accessibility and costeffectiveness, to design Health benefit package for Iran, these criteria must be noticed

A suggested prototype for assessing bone health

Background- Osteoporosis is becoming a health concern worldwide. Considering the fact that prevention plays an important role in reducing the burden of this silent disease and in view of the limited resources available, many countries have adopted certain programs to fight osteoporosis through shifting their attention towards at-risk individuals. The Iranian Multicenter Osteoporosis Study (IMOS) is one of these programs. The program aims to assess bone health and the prevalence of vitamin D deficiency in different parts of Iran with various altitudes, latitudes and lifestyle habits in a way that the results could be generalized to the country. Method- The present article presents the protocol used in the third phase of the study. It was designed based on the experiences gathered in the previous phases to overcome the shortcomings particularly subject loss. The questionnaire applied in this study was developed based on a thorough literature review of the risk factors and secondary causes of osteoporosis and was approved by an expert panel. It should be added that while the majority of the existing studies aim to study a certain aspect of osteoporosis, the present protocol provides the information needed for policy makers and researchers to study different osteoporosis-related issues. Conclusion- The authors believe the protocol, to be implemented with small modifications, can help policymakers in different parts of the world, particularly developing countries, gather accurate information on different aspects of bone health at the national level. © 2015, Academy of Medical Sciences of I.R. Iran. All rights reserved

Multiple air pollutant exposure and lung cancer in Tehran, Iran

Lung cancer is the most rapidly increasing malignancy worldwide with an estimated 2.1 million cancer cases in the latest, 2018 World Health Organization (WHO) report. The objective of this study was to investigate the association of air pollution and lung cancer, in Tehran, Iran. Residential area information of the latest registered lung cancer cases that were diagnosed between 2014 and 2016 (N = 1,850) were inquired from the population-based cancer registry of Tehran. Long-term average exposure to PM10, SO2, NO, NO2, NOX, benzene, toluene, ethylbenzene, m-xylene, p-xylene, o-xylene (BTEX), and BTEX in 22 districts of Tehran were estimated using land use regression models. Latent profile analysis (LPA) was used to generate multi-pollutant exposure profiles. Negative binomial regression analysis was used to examine the association between air pollutants and lung cancer incidence. The districts with higher concentrations for all pollutants were mostly in downtown and around the railway station. Districts with a higher concentration for NOx (IRR = 1.05, for each 10 unit increase in air pollutant), benzene (IRR = 3.86), toluene (IRR = 1.50), ethylbenzene (IRR = 5.16), p-xylene (IRR = 9.41), o-xylene (IRR = 7.93), m-xylene (IRR = 2.63) and TBTEX (IRR = 1.21) were significantly associated with higher lung cancer incidence. Districts with a higher multiple air-pollution profile were also associated with more lung cancer incidence (IRR = 1.01). Our study shows a positive association between air pollution and lung cancer incidence. This association was stronger for, respectively, p-xylene, o-xylene, ethylbenzene, benzene, m-xylene and toluene

Performance Measurements of a Low Specific Speed TurboClaw (R) Compressor

Low specific speed compressors have been historically based on positive displacement machines. Attempts to bring advantages of turbomachinery such as oil free, low parts counts, low cost of manufacture, and reliability to low flow rate applications have not been sparse, but the principle difficulty has always been that the conventional turbomachine design operates at ultra-high speed to deliver low volume flow rates. This is synonymous with low efficiency due to higher losses (windage, surface finish, and tip clearances). The innovative TurboClaw® design is a low specific speed turbomachinery with forward swept impeller geometry. It owes its high efficiency and operational stability to careful design of its nearly tangential forward swept blading and diffuser geometry. The present contribution describes the design and development of a high speed test rig to accurately measure TurboClaw efficiency using shaft torque. The test rig employs a permanent magnet high speed motor designed and developed for this purpose. The motor shaft drives a single stage TurboClaw® compressor via a high speed torque sensor. The results are presented and compared to data obtained through an energy balance method well established for this geometry since its first innovative development at Imperial College in 2003. The accurate performance measurements have been used to design and test a two stage compressor to recover energy from waste steam. This is also briefly described

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

The epidemiology of tuberculosis in the Iranians' population in 2016

Background: Tuberculosis (TB) is the 10thmost common infectious disease in the world, and it is one of the major health problems in Iran despite the implementation of the National Tuberculosis Control Program. Methods: Tuberculosis data in Iran were used in 2016 by the Ministry of Health and Treatment. The data on mortality and incidence of disease were determined by age groups, sex, and the provinces of country. Data were analyzed using Excel (2010) and SPSS software. Findings: The overall incidence rate of tuberculosis in the country was 9.7 per 100000 population (10.7 in men and 8.7 in women). The highest incidence rate of TB and mortality in both sexes were over 80 years. The death rate was 1 person per 100,000 populations, 57.7 of whom were men. Most of the deaths were from pulmonary tuberculosis. The highest incidence and mortality rates were reported in Golestan and Sistan and Baluchestan provinces. Conclusion: The incidence and mortality rate of TB has decreased in recent decades in Iran. Nevertheless, considering the raising trend of human immunodeficiency virus (HIV) among the patients with TB, and the neighborhood with endemic countries, TB should be noticed as one of the most important health priorities in the health system of the country. © 2020 Isfahan University of Medical Sciences(IUMS). All rights reserved

Rate of the incidence of hospital-acquired infections in Iran based on the data of the national nosocomial infections surveillance

Hospital-acquired infections (HAIs) lead to increased length of hospital stay, inappropriate use of broad-spectrum antibiotics and multiple antibiotic resistance. This study aimed to investigate the rate of HAIs in Iran. In this multi-centre study, the rate of HAIs was calculated based on the data collected through Iranian nosocomial infections surveillance for patients with HAIs, as well as through hospital statistics and information systems on hospital-related variables. Data were analysed using STATA software; in addition, ArcGIS was used for plotting the geographical distribution of HAIs by different provinces. The mean age of the 107 669 patients affected by HAIs was 52 ± 26.71 years. Just over half (51.55) of the patients were male. The overall rate of HAIs was 26.57 per 1000 patients and 7.41 per 1000 patient-days. The most common HAIs were urinary tract infections (26.83; 1.99 per 1000 patient-days), ventilator-associated events (20.28; 1.5 per 1000 patient-days), surgical-site infections (19.73; 1.45 per 1000 patient-days) and bloodstream infections (13.51; 1 per 1000 patient-days), respectively. The highest rate of HAIs was observed in intensive care units. Device, catheter and ventilator-associated infections accounted for 38.72, 18.79 and 16 of all HAIs, respectively. Based on the results, HAIs are common in intensive care units, and urinary tract infections and device-related infections are more prevalent in Iran. To reduce HAIs it is recommended to implement appropriate policies and interventions, train staff about the use of devices, and prepare and update protocols and guidelines for improving the quality of care. © 2020 The Author(s

Nonadiabatic approach to dimerization gap and optical absorption coefficient of the Su-Schrieffer-Heeger model

An analytical nonadiabatic approach has been developed to study the dimerization gap and the optical absorption coefficient of the Su-Schrieffer-Heeger model where the electrons interact with dispersive quantum phonons. By investigating quantitatively the effects of quantum phonon fluctuations on the gap order and the optical responses in this system, we show that the dimerization gap is much more reduced by the quantum lattice fluctuations than the optical absorption coefficient is. The calculated optical absorption coefficient and the density of states do not have the inverse-square-root singularity, but have a peak above the gap edge and there exist a significant tail below the peak. The peak of optical absorption spectrum is not directly corresponding to the dimerized gap. Our results of the optical absorption coefficient agree well with those of the experiments in both the shape and the peak position of the optical absorption spectrum.Comment: 14 pages, 7 figures. to be published in PR

The Burden of Statin Therapy based on ACC/AHA and NCEP ATP-III Guidelines: An Iranian Survey of Non-Communicable Diseases Risk Factors

To compare the burden of statin therapy according to the Third Adult Treatment Panel (ATP-III) and the American College of Cardiology/American Heart Association (ACC/AHA) guidelines the Survey of Risk Factors of Non-Communicable Disease (SuRFNCD)-2011of Iran was used. A survey analysis associated with sex and age categorization was run. Of total 3496 persons (1322 men) aged 40-70 years, based on the ACC/AHA guidelines, about 46.5 were eligible to receive moderate- to high-intensity statin therapy. Based on the ATP-III guidelines, 17.0 were considered as needing statin drugs. Among adults aged <60 years, the proportion of those who were eligible for statin therapy was higher (38.3) according to the ACC/AHA guidelines compared to the ATP-III guidelines (15.2), a difference more prominent in adults aged �60 years (85.2 versus 25.0). Agreement between the two guidelines was low (kappa: 0.32). Compared to the ATP-III guidelines, the ACC/AHA guidelines increase the number of adults eligible for statin therapy in an Iraninan population from 2.5 million to 7.0 million people according to the 2011 census, specifically in those aged � 60 years, a finding in agreement with those of studies from different countries. © 2018 The Author(s)

What’s in a Smile? Initial results of multilevel principal components analysis of facial shape and image texture

Multilevel principal components analysis (mPCA) has previously been shown to provide a simple and straightforward method of forming point distribution models that can be used in (active) shape models. Here we extend the mPCA approach to model image texture as well as shape. As a test case, we consider a set of (2D frontal) facial images from a group of 80 Finnish subjects (34 male; 46 female) with two different facial expressions (smiling and neutral) per subject. Shape (in terms of landmark points) and image texture are considered separately in this initial analysis. Three-level models are constructed that contain levels for biological sex, “within-subject” variation (i.e., facial expression), and “between-subject” variation (i.e., all other sources of variation). By considering eigenvalues, we find that the order of importance as sources of variation for facial shape is: facial expression (47.5%), between-subject variations (45.1%), and then biological sex (7.4%). By contrast, the order for image texture is: between-subject variations (55.5%), facial expression (37.1%), and then biological sex (7.4%). The major modes for the facial expression level of the mPCA models clearly reflect changes in increased mouth size and increased prominence of cheeks during smiling for both shape and texture. Even subtle effects such as changes to eyes and nose shape during smile are seen clearly. The major mode for the biological sex level of the mPCA models similarly relates clearly to changes between male and female. Model fits yield “scores” for each principal component that show strong clustering for both shape and texture by biological sex and facial expression at appropriate levels of the model. We conclude that mPCA correctly decomposes sources of variation due to biological sex and facial expression (etc.) and that it provides a reliable method of forming models of both shape and image texture