Reliability analysis of a newly developed questionnaire for quality control of follow-up visits in polyiran study

Background: The PolyIran study is a large-scale pragmatic cluster randomized controlled trial of fixed-dose combination therapy (Polypill) for prevention of cardiovascular diseases (CVD) in Iran. The PolyIran Quality Control Program (PIQCP) including a new questionnaire was developed to assess the quality of data collection during follow-up visits. The aim of this study was to assess the inter-rater reliability of PIQCP questionnaire. Methods: The study was conducted in 26 (11%) randomly selected clusters (from a total of 236 PolyIran clusters). All participants within these 26 clusters were enrolled. The quality scores were measured according to the PIQCP guidelines by two independent raters. The intraclass correlation coefficients (ICC) were measured. In addition, the quality scores were categorized into good (370%) and poor (<70%). The kappa coefficient was used to assess inter-rater agreement for this categorical quality scores. Results: A total number of 945 PolyIran participants were enrolled of which, 501 (53%) were from intervention arm. In 934 participants (98.8%), the quality score could be successfully identified by both raters. The ICC (95%CI) ofthe overall quality scores was 0.985 (0.983-0.987). It was 0.976 (0.972-0.980) and 0.988 (0.986-0.990) in intervention and control arms, respectively. We found excellent agreement between the two raters in identifying participants with good and poor quality scores (kappa = 0.988, P < 0.001). The kappa values were 0.972 (P < 0.001) and 1.000 (P < 0.001) in intervention and control arms, respectively. Discussion: Our results suggested that the PIQCP questionnaire is a reliable tool for assessing quality of data collection in PolyIran follow-up visits. Using this measure will help us in efficient monitoring of the PolyIran follow-ups and may ensure high quality data. © 2016, Academy of Medical Sciences of I.R. Iran. All rights reserved

Analysis of factors influencing the ultrasonic fetal weight estimation

Objective: The aim of our study was the evaluation of sonographic fetal weight estimation taking into consideration 9 of the most important factors of influence on the precision of the estimation. Methods: We analyzed 820 singleton pregnancies from 22 to 42 weeks of gestational age. We evaluated 9 different factors that potentially influence the precision of sonographic weight estimation ( time interval between estimation and delivery, experts vs. less experienced investigator, fetal gender, gestational age, fetal weight, maternal BMI, amniotic fluid index, presentation of the fetus, location of the placenta). Finally, we compared the results of the fetal weight estimation of the fetuses with poor scanning conditions to those presenting good scanning conditions. Results: Of the 9 evaluated factors that may influence accuracy of fetal weight estimation, only a short interval between sonographic weight estimation and delivery (0-7 vs. 8-14 days) had a statistically significant impact. Conclusion: Of all known factors of influence, only a time interval of more than 7 days between estimation and delivery had a negative impact on the estimation

Impact of neuraminidase inhibitors on influenza A(H1N1)pdm09‐related pneumonia: an individual participant data meta‐analysis

BACKGROUND: The impact of neuraminidase inhibitors (NAIs) on influenza‐related pneumonia (IRP) is not established. Our objective was to investigate the association between NAI treatment and IRP incidence and outcomes in patients hospitalised with A(H1N1)pdm09 virus infection. METHODS: A worldwide meta‐analysis of individual participant data from 20 634 hospitalised patients with laboratory‐confirmed A(H1N1)pdm09 (n = 20 021) or clinically diagnosed (n = 613) ‘pandemic influenza’. The primary outcome was radiologically confirmed IRP. Odds ratios (OR) were estimated using generalised linear mixed modelling, adjusting for NAI treatment propensity, antibiotics and corticosteroids. RESULTS: Of 20 634 included participants, 5978 (29·0%) had IRP; conversely, 3349 (16·2%) had confirmed the absence of radiographic pneumonia (the comparator). Early NAI treatment (within 2 days of symptom onset) versus no NAI was not significantly associated with IRP [adj. OR 0·83 (95% CI 0·64–1·06; P = 0·136)]. Among the 5978 patients with IRP, early NAI treatment versus none did not impact on mortality [adj. OR = 0·72 (0·44–1·17; P = 0·180)] or likelihood of requiring ventilatory support [adj. OR = 1·17 (0·71–1·92; P = 0·537)], but early treatment versus later significantly reduced mortality [adj. OR = 0·70 (0·55–0·88; P = 0·003)] and likelihood of requiring ventilatory support [adj. OR = 0·68 (0·54–0·85; P = 0·001)]. CONCLUSIONS: Early NAI treatment of patients hospitalised with A(H1N1)pdm09 virus infection versus no treatment did not reduce the likelihood of IRP. However, in patients who developed IRP, early NAI treatment versus later reduced the likelihood of mortality and needing ventilatory support

Highlights lecture EANM 2015: the search for nuclear medicine’s superheroes

The EANM 2015 Annual Congress, held from October 10th to 14th in Hamburg, Germany, was outstanding in many respects. With 5550 participants, this was by far the largest European congress concerning nuclear medicine. More than 1750 scientific presentations were submitted, with more than 250 abstracts from young scientists, indicating that the future success of our discipline is fuelled by a high number of young individuals becoming involved in a multitude of scientific activities. Significant improvements have been made in molecular imaging of cancer, particularly in prostate cancer. PSMA-directed PET/CT appears to become a new gold standard for staging and restaging purposes. Novel tumour specific compounds have shown their potential for target identification also in other solid neoplasms and further our understanding of tumour biology and heterogeneity. In addition, a variety of nuclear imaging techniques guiding surgical interventions have been introduced. A particular focus of the congress was put on targeted, radionuclide based therapies. Novel theranostic concepts addressing also tumour entities with high incidence rates such as prostate cancer, melanoma, and lymphoma, have shown effective anti-tumour activity. Strategies have been presented to improve further already established therapeutic regimens such as somatostatin receptor based radio receptor therapy for treating advanced neuroendocrine tumours. Significant contributions were presented also in the neurosciences track. An increasing number of target structures of high interest in neurology and psychiatry are now available for PET and SPECT imaging, facilitating specific imaging of different subtypes of dementia and movement disorders as well as neuroinflammation. Major contributions in the cardiovascular track focused on further optimization of cardiac perfusion imaging by reducing radiation exposure, reducing scanning time, and improving motion correction. Besides coronary artery disease, many contributions focused on cardiac inflammation, cardiac sarcoidosis, and specific imaging of large vessel vasculitis. The physics and instrumentation track included many highlights such as novel, high resolution scanners. The most noteworthy news and developments of this meeting were summarized in the highlights lecture. Only 55 scientific contributions were mentioned, and hence they represent only a brief summary, which is outlined in this article. For a more detailed view, all presentations can be accessed by the online version of the European Journal of Nuclear Medicine and Molecular Imaging (Volume 42, Supplement 1)

Genotoxicity of methyl acrylate and ethyl acrylate and its relationship with glutathione

Methyl acrylate (MA) and ethyl acrylate (EA) had previously tested positive for mutagenicity in vitro, but in vivo studies were negative. One of the metabolism pathways of alkyl acrylates is conjugation with glutathione. The glutathione availability is restricted in standard in vitro test systems so that they do not reflect the in vivo metabolism in this respect. We investigated whether the addition of glutathione to the in vitro L5178Y/TK+/− mouse lymphoma mutagenicity test prevents alkyl acrylate’s mutagenicity in vitro. We also investigated whether the quantitative relationships support the notion that the GSH supplemented in vitro systems reflect the true in vivo activity. Indeed, glutathione concentrations as low as 1 mM completely negate the mutagenicity of MA and EA in the L5178Y/TK+/− mouse lymphoma mutagenicity test up to the highest concentrations of the two acrylates tested, 35 µg/ml, a higher concentration than that previously found to be mutagenic in this test (14 µg MA/ml and 20 µg EA/ml). 1 mM Glutathione reduced the residual MA and EA at the end of the exposure period in the mutagenicity tests by 96–97%, but in vivo up to 100 mg/kg body weight MA and EA left the glutathione levels in the mouse liver and forestomach completely intact. It is concluded that the in-situ levels of glutathione, 7.55 ± 0.57 and 2.84 ± 0.22 µmol/g mouse liver and forestomach, respectively, can efficiently protect against MA and EA-induced mutagenicity up to the high concentration of 100 mg MA and EA/kg body weight and that the negative in vivo mutagenicity tests on MA and EA reflect the true in vivo situation

A Novel High-Isolation Resistor-Less Millimeter-Wave Power Divider Based on Metamaterial Structures for 5G Applications

In this article, a simple and effective method based on the metamaterial concept is proposed to achieve very high isolation between the output ports of a millimeter-wave power divider (MWPD). The proposed MWPD is designed for use in 5G applications (28-32 GHz). In order to increase the isolation, three metamaterial rows are used, each row containing eight proposed unit cells. These metamaterial unit cells are loaded between two dielectric layers. By using this method and without isolating resistors, isolation is improved by more than 36 dB, as compared with a prototype power divider in which no metamaterial element was used. The maximum measured isolation is 43 dB at 30 GHz. The final dimensions of the proposed MWPD are 8 x 8 x 0.582 mm(3) or 0.9 lambda(g) x 0.9 lambda(g) x 0.08 lambda(g) where lambda(g) is the guided wavelength at 30 GHz. The simplicity of design, its compactness, and most importantly, high isolation between output ports without any lumped resistor are the key advantages of the proposed MWPD

Comparison of Sensitivity and Specificity of Papanicolaou Test, Visual Inspection of Cervix with Acetic Acid (VIA) and Colposcopy in Cervical Cancer Screening in Patients with Secondary Immunodeficiency

Purpose: Cervical cancer is one of the most common problems in public health, especially in developing countries, which is identifiable by screening programs. This study aimed to compare the sensitivity and specificity of Papanicolaou test, visual inspection of cervix with acetic acid and colposcopy in immunodeficient patients. Methods: This examination on the test study was conducted on 135 immunodeficient patients who were referred to Afzalipour Hospital, Kerman, for cervical cancer screening from 2017 to 2018. In the first visit of all the patients, 3 separate tests of Papanicolaou test, VIA and colposcopy were simultaneously performed, and the results were recorded. To analyze the data, descriptive and analytical methods and SPSS software version 20 were used. Results: Most of the cases were between 20 and 40 years old. The most frequency of immunodeficiency was noted among patients with AIDS (19.3). According to the results of the colposcopy, VIA, Papanicolaou test and biopsy, 77, 77.8, 73.3 and 77 of the results were normal, respectively. Most patients were ASCUS in Papanicolaou test, and twenty-one of them were cervical intraepithelial neoplasia 1 (15.6). Sensitivity, specificity, positive and negative predictive values of colposcopy were more than those of VIA and Papanicolaou test (74.1, 92.3, 74.1 and 92.3, respectively). Conclusion: The results of the study showed that colposcopy is an appropriate method for cervical cancer screening in immunodeficient patients. Accordingly, at times when it is not possible to screen with other methods such as Papanicolaou test, this method may be used in preliminary evaluation. © 2021, Association of Gynecologic Oncologists of India

Cultural and livelihood impacts on the physical and biolospatial formation of traditional houses in Paveh

Native design of buildings is a branch of architecture based on local needs and available materials that reflect regional traditions. The city of Paveh in the northwestern Iranian province of Kermanshah has many valuable buildings, with some dating back to more than three thousand years which are stepped-type based the topography of the land. The purpose of this research is to investigate the impact of culture and livelihood on the physical and biological space formation of traditional houses in Paveh. Data were collected through measuring livelihood standard, geographical location, and type of materials, culture and environmental factors through observation method in spring 2023 and based on questionnaire as a tool. The data analysis was done through factor analysis and regression tests with Lisrel and SPSS software. Validation of the questionnaire was confirmed through content validity and its reliability was checked through Cronbach alpha (r=0.701). By confirmatory analysis, research components with a factor load above 0.4 were identified and confirmed. The ADJR2 index in the regression test showed that the research indicators predict 61% of the physical and biospatial variance of the traditional houses in Paveh. The component of culture and climate has the highest influence (beta=0.779) on the physical and spatial formation of traditional houses there. The results obtained from the observation method also showed that the cultural, social, religious, livelihood features include the use of natural materials, spatial hierarchy, proper separation of spaces, building houses on top or next to each other and paying attention to the environment, including the correct orientation, the use of brick laying, the appropriate dimensions of the openings, etc. which have been the most important factors in bodily and spatial formation of houses in Paveh