Modeling the risk of esophageal squamous cell carcinoma and squamous dysplasia in a high risk area in Iran

Background: Identifying people at higher risk of having squamous dysplasia, the precursor lesion for esophageal squamous cell carcinoma (ESCC), would allow targeted endoscopic screening. Methods: We used multivariate logistic regression models to predict ESCC and dysplasia as outcomes. The ESCC model was based on data from the Golestan Case-Control Study (total n = 871; cases = 300), and the dysplasia model was based on data from a cohort of subjects from a gastroenterology clinic in Northeast Iran (total n = 724; cases = 26). In each of these analyses, we fit a model including all risk factors known in this region to be associated with ESCC. Individual risks were calculated using the linear combination of estimated regression coefficients and individual-specific values for covariates. We used cross-validation to determine the area under the curve (AUC) and to find the optimal cut points for each of the models. Results: The model had an area under the curve of 0.77 (95 CI: 0.74-0.80) to predict ESCC with 74 sensitivity and 70.4 specificity for the optimum cut point. The area under the curve was 0.71 (95 CI: 0.64-0.79) for dysplasia diagnosis, and the classification table optimized at 61.5 sensitivity and 69.5 specificity. In this population, the positive and negative predictive values for diagnosis of dysplasia were 6.8 and 97.8, respectively. Conclusion: Our models were able to discriminate between ESCC cases and controls in about 77, and between individuals with and without squamous dysplasia in about 70 of the cases. Using risk factors to predict individual risk of ESCC or squamous dysplasia still has limited application in clinical practice, but such models may be suitable for selecting high risk individuals in research studies, or increasing the pretest probability for other screening strategies

Cancer registry in Iran: A brief overview

Cancer registry is an important tool for any successful cancer control program. The first formal cancer related data from Iran were published in 1956. In 1969, observations documenting a high incidence of esophageal cancer in the Caspian Littoral, urged researchers to set up the first population-based cancer registry in this region. This cancer registry was established jointly by University of Tehran and the International Agency for Research on Cancer (IARC). In 1976, another cancer registry started its activities in Fars Province. In 1984, the Parliament passed a bill mandating the report of all tissues "diagnosed or suspected as cancer tissue" to the Ministry of Health. While only 18% of all estimated cancer cases were reported in first reports, this rate increased to 81% in 2005 In 1998, Tehran Population-Based Cancer Registry started to collect data from cases of cancer referred to the treatment and diagnostic facilities throughout the Tehran metropolis. Digestive Disease Research Center, Tehran University of Medical Sciences, established four new population-based cancer registries in Northern Iran and another in Kerman Province in the south. These five provinces have a total population of about 9.5 million, and constitute about 16% of the total population of Iran. While the pathology-based cancer registration is in place, we hope that the addition of the population-based cancer registries, and establishment of new registries in poorly-covered areas, will improve cancer reporting in the country

Corrigendum to �Cauda equine syndrome due to Brucella spondylodiscitis and epidural abscess formation: A case report� (Interdisciplinary Neurosurgery: Advanced Techniques and Case Management (2019) 17 (42�44), (S2214751918302676), (10.1016/j.inat.2019.01.011))

The authors' regret: Acknowledgements must be deleted because it is not related to our manuscript. The authors apologise for any inconvenience caused. © 201

Assessment of Composite Restorations and Their Unique Features in Forensic Identification of Unidentified Human Beings

Background: Dental identification mainly involves the comparison of antemortem and postmortem records. Keiser-Nielson (1980) recommended restored tooth surfaces as the smallest unit to consider in the comparison of dental restorations for identification purposes. Unique appearance of radiographic images of amalgam has led to their application in dental forensic. The present study aimed to investigate the value of composite restorations and their features in forensic identification.Methods: The antemortem sample included 40 periapical radiographs of anterior teeth with class III composite restorations which had been taken at least one year before the study. Ten randomly selected recent radiographs of the same subjects along with two radiographs from other patients were regarded as postmortem samples. Afterward, 12 dentally trained examiners were asked to match the 12 radiographs of group 2 with those of group 1 and to determine which features of the teeth (e.g. shape, contour, and surface) had helped them.Results: Ten examiners were able to correctly match all of the 12 images. According to kappa coefficient, the inter-rater agreement was high (0.8-1.0). The shape of the restoration was the most useful feature in identification.Conclusion: A composite restoration has a unique radiographic morphology that can be used for human identification. Therefore, if the antemortem radiograph of a single composite restoration is available, its comparison with a postmortem radiograph can help identify unidentified human beings

The relationship between nurses' clinical competency and job stress in Ahvaz university hospital, 2013

زمینه و هدف: صلاحیت بالینی پرستاری، شایستگی کاربرد همزمان دانش، مهارت، نگرش ها و ارزش ها در مراقبت از بیمار است که به دلیل اهمیت آن اخیراً مورد توجه بیشتری قرار گرفته است. با توجه به اهمیت روز افزون موضوع صلاحیت پرستاری، شناخت عوامل مرتبط با آن و از جمله استرس شغلی ضروری به نظر می رسد؛ لذا مطالعه حاضر با هدف تعیین رابطه صلاحیت بالینی و استرس شغلی پرستاران شاغل در بیمارستان های دانشگاهی شهر اهواز در سال1392 انجام شد. روش بررسی: در این پژوهش توصیفی- تحلیلی که به صورت مقطعی در طی سال 1392 انجام شد، 80 نفر پرستار شاغل در بیمارستان های آموزشی شهر اهواز از طریق نمونه گیری تصادفی انتخاب و وارد مظالعه شدند. ابزار گردآوری داده ها شامل پرسشنامه های استرس شغلی Osipow و پرسشنامه صلاحیت بالینی Benner بود که به صورت خود ایفاء تکمیل گردیدند. میزان صلاحیت بالینی پرستاران ارزیابی و ارتباط آن با استرس شغلی تعیین شد. یافته ها: بیشتر پرستاران (3/81 درصد) دارای استرس شغلی متوسط بودند. میانگین نمره کل صلاحیت بالینی پرستاران 48/18± 15/61 بود. آزمون همبستگی پیرسون نشان داد که بین استرس شغلی و صلاحیت بالینی پرستاران در تمام حیطه های آن همبستگی منفی و معنی داری وجود دارد (01/0>P). همچنین بین میزان استرس شغلی و بکارگیری صلاحیت بالینی کل ارتباط معنی داری وجود داشت (001/0>P). نتیجه گیری: بر اساس نتایج مطالعه حاضر، افزایش استرس شغلی پرستاران با کاهش صلاحیت های بالینی آنها رابطه دارد که بایستی مورد توجه مدیران پرستاری قرار گیرد

Wave functions in the neighborhood of a toroidal surface; hard vs. soft constraint

The curvature potential arising from confining a particle initially in three-dimensional space onto a curved surface is normally derived in the hard constraint $q \to 0$ limit, with $q$ the degree of freedom normal to the surface. In this work the hard constraint is relaxed, and eigenvalues and wave functions are numerically determined for a particle confined to a thin layer in the neighborhood of a toroidal surface. The hard constraint and finite layer (or soft constraint) quantities are comparable, but both differ markedly from those of the corresponding two dimensional system, indicating that the curvature potential continues to influence the dynamics when the particle is confined to a finite layer. This effect is potentially of consequence to the modelling of curved nanostructures.Comment: 4 pages, no fig

Endoscopic screening for precancerous lesions of the esophagus in a high risk area in northern Iran

Background: Esophageal squamous cell carcinoma (ESCC) is a major health problem in many developing countries, including Iran. ESCC has a very poor prognosis, largely due to late diagnosis. As a first step in developing an early detection and treatment program, we conducted a population-based endoscopic screening for ESCC and its precursor lesion, esophageal squamous dysplasia (ESD), in asymptomatic adults from Golestan Province, northern Iran (a high-risk area for ESCC) to evaluate the feasibility of such a program and to document the prevalence and risk factor correlates of ESD. Methods: This cross-sectional study was conducted among participants of the Golestan Cohort Study (GCS), a population-based cohort of 50,000 adults in eastern Golestan Province. Randomly selected GCS participants were invited by telephone. Those who accepted were referred to a central endoscopy clinic. Eligible subjects who consented were asked to complete a brief questionnaire. Detailed information about selected risk factors was obtained from the GCS main database. Endoscopic examination with was performed with Lugol's iodine staining; biopsies were taken from unstained lesions as well as the normally stained mucosa of the esophagus, and the biopsies were diagnosed by expert pathologists according to previously described criteria. Results: In total, 1906 GCS subjects were invited, of whom only 302 (15.8%) were successfully enrolled. Esophagitis (29.5%) and ESD (6.0%) were the most common pathological diagnoses. Turkmen ethnicity (adjusted OR = 8.61; 95%CI: 2.48-29.83), being older than the median age (OR = 7.7; 95% CI: 1.99-29.87), and using deep frying cooking methods (OR = 4.65; 95%CI: 1.19-18.22) were the strongest predictors for ESD. There were significant relationships between esophagitis and smoking (p-value<0.001), drinking hot tea (P value = 0.02) and lack of education (P value = 0.004). Conclusion: We observed a low rate of participation in endoscopic screening. The overall prevalence of ESD was 6.0%. Developing non-endoscopic primary screening methods and screening individuals with one or more risk factors may improve these rates

Geochemistry, petrogenesis, zircon U-Pb geochronology and Sr-Nd isotopic composition of Kuh-e-Shah volcanic rocks: Implications for an active continental margin along with eastern Iran during the Paleogene

The Kuh-e-Shah complex includes the Paleogene volcano-plutonic belt of the Lut Block, eastern Iran. The volcanic rocks which outcropped in this complex mainly consist of trachy-andesites, andesites, and basaltic-andesites that mineralogically contain plagioclase, pyroxene, hornblende, and minor biotite and olivine. Geochemically, they have features typical of high-K calc-alkaline to shoshsonitic magmas with enrichment in large ion lithophile elements (LILE), and depletion in high field strength elements (HFSE) and heavy rare earth elements (HREE). Chondrite-normalized REE plots show enrichment in light REE (4.9 < LaN/YbN < 11.6), Nb depletion and the slight negative Eu anomalies (Eu/Eu* = 0.80–0.99). Tectonic discrimination diagrams are used to infer a volcanic arc setting related to a continental subduction zone. It is concluded that the studied volcanic rocks have resulted from FC of a parental magma which formed by partial melting of the subducted oceanic crust and the overlying mantle wedge with spinel-lherzolite composition. Zircon Usingle bondPb dating indicates an age of 38.6 to 38.9 Ma for volcanic rocks (Middle Eocene, Bartonian). Initial 87Sr/86Sr and 143Nd/144Nd ratios (0.704350–0.704820 and 0.512619–0.512779, resp.), are compatible with parental melts formation in a subduction mantle wedge. The ɛNdi values (+0.60 to +3.73) are in the range of mantle-derived melts. We suggest that volcanic rocks of the Lut Block are part of the Paleogene volcanism resulted from the Sistan oceanic crust subduction under the Lut Block during the Cretaceous.publishe

Cauda equnia syndrome due to Brucella spondylodiscitis and epidural abscess formation: A case report

Brucellosis is an infection with a widening clinical disease spectrum, has been reported as the causative agent of lumbar spine complications but rarely accompanying CES Injury. We report a female patient with Brucella spondylodiscitis affecting the lumbosacral region resulting in CES due to epidural abscess formation. Brucella spondylodiscitis should be suspected in patients with unexplained neurological features and low back pain in endemic regions. © 201

U-Pb zircon geochronology, geochemistry, and petrogenesis of the Hamech intrusions in the Kuh-e-Shah volcano-plutonic complex, Eastern Iran

The Hamech area is located in the west of Kuh-e-Shah volcano-plutonic complex, close to the boundary between the Lut Block and Sistan Suture Zone (SSZ), and is composed of monzonite to diorite porphyries and rare gabbro that intruded into older volcanic rocks. U-Pb zircon dating indicates an age of 36.9 ± 1 Ma for gabbro (Late Eocene, Priabonian) and 38.6 ± 0.5 Ma for dacite (Late Eocene, Bartonian). Geochemically, the studied intrusions are dominantly I-type, high-K calc-alkaline, and metaluminous features. Primitive mantle-normalized trace-element spider diagrams of these rocks present enrichment in ion lithophile elements such as Cs, Rb, Ba, K, and Sr and depletion in high field strength elements such as Nb, Ti, Zr, and heavy rare earth elements. Besides, chondrite-normalized rare earth elements plots of the rocks show enrichment in light rare earth elements (6.85 < LaN/YbN < 9.72) and a lack or weak negative Eu anomaly (Eu/Eu* = 0.81–1.02). The initial 87Sr/86Sr and 143Nd/144Nd ratios for the rocks from 0.704541 to 0.704880 and from 0.512633 to 0.512691, respectively, when recalculated to an age of 39 Ma. The εNd(i) values vary from +0.87 to +1.99, which fits into a suprasubduction mantle wedge source for the parental melts. All data suggest that the Hamech intrusions developed in a low maturity continental margin arc setting related to the convergence of the Afghan and Lut Blocks and subduction of Sistan oceanic crust during the Eocene.publishe