Comparison of Two Statistical Methods to Determine Normal Range of Androgen Hormones: K-Means Cluster Analysis and Receiver Operating Characteristic Curve

Objective: To assess and compare the normal ranges of androgen hormones level, total testosterone (TT), free testosterone (FT), dehydrotestosterone (DHT), androstenedione (A4), dehydroepiandrosterone (DHEA), and dehydroepiandrosterone sulfate (DHEAS), in Iranian women based on different statistical methods. Materials and methods: This study was conducted on previous data collected in Iranian PCOS Prevalence Study, which details have been published before. A total of 1772 women of 18-45 years were recruited from urban areas of five randomly selected provinces in different geographic regions of Iran. The natural range of androgen hormones was determined and compared by two statistical methods including k-means cluster analysis, and receiver operating characteristic curve. Results: In women younger than 35 years old with any BMI, cut-off points obtained for FAI hormone were in lower percentiles; however, in older women, the results of the two methods were almost the same. Cut-off points of DHEAS in under 35 years old women of normal and obese weight and women older than 35 years old with normal weight calculated by ROC curve method was in higher percentiles than that in the cluster analysis method. In >35 years obese women, obtained cut-off points for DHEAS ROC curve was in lower percentiles in comparison to cluster analysis Conclusion: Although our study depicts the differences among the cutoff values among two statistical methods; however, lacking a gold standard test to define hyperandrogenism, we need further studies to obtain more comprehensive results

A Systematic Review of Psychometric Properties of the Edinburgh Postnatal Depression Scale in Iranian Population

Background: Regarding adverse effects of postpartum depression on maternal mental health and the reduction of mother-infant attachment, there is a need to comprehensively understand Edinburgh Postnatal Depression Scale (EPDS). We aimed to review the validity and reliability of the EPDS in Iranian population to provide comprehensive information for the health providers. Materials and Methods The search procedure was fulfilled on the databases of Medline (via PubMed), Scopus, Cochran Library and Web of Science from inception to April 2018. The quality of studies was assessed by COSMIN checklist. Search keywords include (Edinburgh Postnatal Depression Scale) AND (Psychometric Properties). Results: Three studies identified a two-factor structure and one study found a three-factor structure. Discriminant validity of the EPDS was able to differentiate three groups (minor depression, major depression, and healthy women); but failed to distinguish between women with caesarean section, and women with normal delivery. Internal consistency was reported by four studies. Cronbach’s alpha ranged from 0.7 to 0.79 for total EPDS score. Test-retest reliability was reported only in a study with Intraclass Correlation Coefficient (ICC) > 0.80. In terms of convergent validity, the EPDS was significantly positively correlated with General Health Questionnaire (GHQ) (r=0.76;

Global burden of 288 causes of death and life expectancy decomposition in 204 countries and territories and 811 subnational locations, 1990–2021: a systematic analysis for the Global Burden of Disease Study 2021

BACKGROUND Regular, detailed reporting on population health by underlying cause of death is fundamental for public health decision making. Cause-specific estimates of mortality and the subsequent effects on life expectancy worldwide are valuable metrics to gauge progress in reducing mortality rates. These estimates are particularly important following large-scale mortality spikes, such as the COVID-19 pandemic. When systematically analysed, mortality rates and life expectancy allow comparisons of the consequences of causes of death globally and over time, providing a nuanced understanding of the effect of these causes on global populations. METHODS The Global Burden of Diseases, Injuries, and Risk Factors Study (GBD) 2021 cause-of-death analysis estimated mortality and years of life lost (YLLs) from 288 causes of death by age-sex-location-year in 204 countries and territories and 811 subnational locations for each year from 1990 until 2021. The analysis used 56 604 data sources, including data from vital registration and verbal autopsy as well as surveys, censuses, surveillance systems, and cancer registries, among others. As with previous GBD rounds, cause-specific death rates for most causes were estimated using the Cause of Death Ensemble model-a modelling tool developed for GBD to assess the out-of-sample predictive validity of different statistical models and covariate permutations and combine those results to produce cause-specific mortality estimates-with alternative strategies adapted to model causes with insufficient data, substantial changes in reporting over the study period, or unusual epidemiology. YLLs were computed as the product of the number of deaths for each cause-age-sex-location-year and the standard life expectancy at each age. As part of the modelling process, uncertainty intervals (UIs) were generated using the 2·5th and 97·5th percentiles from a 1000-draw distribution for each metric. We decomposed life expectancy by cause of death, location, and year to show cause-specific effects on life expectancy from 1990 to 2021. We also used the coefficient of variation and the fraction of population affected by 90% of deaths to highlight concentrations of mortality. Findings are reported in counts and age-standardised rates. Methodological improvements for cause-of-death estimates in GBD 2021 include the expansion of under-5-years age group to include four new age groups, enhanced methods to account for stochastic variation of sparse data, and the inclusion of COVID-19 and other pandemic-related mortality-which includes excess mortality associated with the pandemic, excluding COVID-19, lower respiratory infections, measles, malaria, and pertussis. For this analysis, 199 new country-years of vital registration cause-of-death data, 5 country-years of surveillance data, 21 country-years of verbal autopsy data, and 94 country-years of other data types were added to those used in previous GBD rounds. FINDINGS The leading causes of age-standardised deaths globally were the same in 2019 as they were in 1990; in descending order, these were, ischaemic heart disease, stroke, chronic obstructive pulmonary disease, and lower respiratory infections. In 2021, however, COVID-19 replaced stroke as the second-leading age-standardised cause of death, with 94·0 deaths (95% UI 89·2-100·0) per 100 000 population. The COVID-19 pandemic shifted the rankings of the leading five causes, lowering stroke to the third-leading and chronic obstructive pulmonary disease to the fourth-leading position. In 2021, the highest age-standardised death rates from COVID-19 occurred in sub-Saharan Africa (271·0 deaths [250·1-290·7] per 100 000 population) and Latin America and the Caribbean (195·4 deaths [182·1-211·4] per 100 000 population). The lowest age-standardised death rates from COVID-19 were in the high-income super-region (48·1 deaths [47·4-48·8] per 100 000 population) and southeast Asia, east Asia, and Oceania (23·2 deaths [16·3-37·2] per 100 000 population). Globally, life expectancy steadily improved between 1990 and 2019 for 18 of the 22 investigated causes. Decomposition of global and regional life expectancy showed the positive effect that reductions in deaths from enteric infections, lower respiratory infections, stroke, and neonatal deaths, among others have contributed to improved survival over the study period. However, a net reduction of 1·6 years occurred in global life expectancy between 2019 and 2021, primarily due to increased death rates from COVID-19 and other pandemic-related mortality. Life expectancy was highly variable between super-regions over the study period, with southeast Asia, east Asia, and Oceania gaining 8·3 years (6·7-9·9) overall, while having the smallest reduction in life expectancy due to COVID-19 (0·4 years). The largest reduction in life expectancy due to COVID-19 occurred in Latin America and the Caribbean (3·6 years). Additionally, 53 of the 288 causes of death were highly concentrated in locations with less than 50% of the global population as of 2021, and these causes of death became progressively more concentrated since 1990, when only 44 causes showed this pattern. The concentration phenomenon is discussed heuristically with respect to enteric and lower respiratory infections, malaria, HIV/AIDS, neonatal disorders, tuberculosis, and measles. INTERPRETATION Long-standing gains in life expectancy and reductions in many of the leading causes of death have been disrupted by the COVID-19 pandemic, the adverse effects of which were spread unevenly among populations. Despite the pandemic, there has been continued progress in combatting several notable causes of death, leading to improved global life expectancy over the study period. Each of the seven GBD super-regions showed an overall improvement from 1990 and 2021, obscuring the negative effect in the years of the pandemic. Additionally, our findings regarding regional variation in causes of death driving increases in life expectancy hold clear policy utility. Analyses of shifting mortality trends reveal that several causes, once widespread globally, are now increasingly concentrated geographically. These changes in mortality concentration, alongside further investigation of changing risks, interventions, and relevant policy, present an important opportunity to deepen our understanding of mortality-reduction strategies. Examining patterns in mortality concentration might reveal areas where successful public health interventions have been implemented. Translating these successes to locations where certain causes of death remain entrenched can inform policies that work to improve life expectancy for people everywhere. FUNDING Bill & Melinda Gates Foundation

Evaluation of Phytochemical Composition of Mentha pulegium L. Essential Oil and Its Antibacterial Activity against Several Pathogenic Bacteria

Background and Aims: Mentha pulegium L. is one of the medicinal plants used in the food production as a flavoring substance and its antibacterial effect has also been considered. The present study was designed to evaluate the phytochemical composition of Mentha pulegium L. originated from Iran and its antimicrobial activity against several pathogenic bacteria. Materials and Methods: The chemical compounds of this medicinal plant were analyzed by GC-MS and 14 components were identified, representing 86.98% of its total essential mass. The antibacterial activity of the essential oil (EO) of Mentha pulegium L., has been evaluated against Staphylococcus aureus, Escherichia coli, Pseudomonas aeroginosa, and Pseudomonas syringae pv. tomato using disc diffusion method compared to synthetic antibiotic ciprofloxacin. The minimum inhibitory concentration (MIC) was evaluated against the above tested bacteria using macrobroth dilution method. Results: Results showed that the EO of Mentha pulegium L., was formed by the main components of piperitone (32.1%), piperitenone (21.71%) and pulegone (15.85%). In addition, the results obtained using MIC and MBC showed that the minimum inhibitory concentration of the EO of M. pulegium was in the range of 10-40 mg/mL for S. aureus, E. coli, P. aeroginosa and 20 mg/mL for Ps. syringae pv. tomato, respectively. According to the results, the maximum zones of inhibition (29.15 mm) was observed on P. syringae P. tomato in 40 mg/mL of essential oil, and the minimum zone of inhibition (17.08 mm) was related to P. aeroginosa in the same concentration. Conclusions: The results revealed that EO of Mentha pulegium L. had an appropriate inhibitory effect on Staphylococcus aureus and Escherichia coli

Oral White Lesions: An Updated Clinical Diagnostic Decision Tree

Diagnosis of oral white lesions might be quite challenging. This review article aimed to introduce a decision tree for oral white lesions according to their clinical features. General search engines and specialized databases including PubMed, PubMed Central, EBSCO, Science Direct, Scopus, Embase, and authenticated textbooks were used to find relevant topics by means of MeSH keywords such as “mouth disease„, “oral keratosis„, “oral leukokeratosis„, and “oral leukoplakia„. Related English-language articles published since 2000 to 2017, including reviews, meta-analyses, and original papers (randomized or nonrandomized clinical trials; prospective or retrospective cohort studies), case reports, and case series about oral diseases were appraised. Upon compilation of data, oral white lesions were categorized into two major groups according to their nature of development: Congenital or acquired lesions and four subgroups: Lesions which can be scraped off or not and lesions with the special pattern or not. In total, more than 20 entities were organized in the form of a decision tree in order to help clinicians establish a logical diagnosis by a stepwise progression method

Investigation of Phenol Removal from Aqueous Solutions by Electrofenton and Electropersulfate Processes

Phenol, or benzene hydroxyl is a toxic aromatic hydrocarbon discharged into the environment through certian industrial effluents which, thereby, pollute water resources. This study examines phenol removal from aqueous solutions through electro-Fenton and electro/persulfate processes using iron electrodes. For this purpose, a laboratory-scale electrochemical batch reactor was used that was equipped with four electrodes and a direct DC power supply. In the tests carried out, the effects of operational parameters such as initial pH; current density; and initial concentrations of phenol, hydrogen peroxide, and persulfate on the removal of phenol were investigated. The results showed that EPS and EF processes achieved phenol removal efficiencies of 95.18% and 93.99%, respectively, at operating conditions of pH = 3, initial phenol concentration of 100 mg/l, hydrogen peroxide and persulfate concentration of 0. 4 mM, and a current density 0.07A/dm2 over 45 min. Increasing persulfate and hydrogen peroxide concentration from 0.4 to 0.8 mM reduced phenol removal efficiencies from 95.18% and 93.99% to 43% and 85%, respectively. Generally speaking, EPS and EF processes exhibited almost identical phenol removal efficiencies. Finally, the integrated electrochemical and persulphate process was found to be more productive in producing electrical iron and persulphate activation than using each single process in isolation

A Comparative Histological Study of Gingival Depigmentation by 808 and 445 nm Diode Lasers: Histological evaluation after gingival diode laser depigmentation

Introduction: Using lasers in melanin depigmentation is one of the main fields of interest for dental practitioners and patients. However, it is important to know what would happen inside the tissue and how the cells would interact inside the tissue with a laser.Methods: In this study, we used both wavelengths of 445 nm and 808 nm on sheep gingiva to find out the effects and side effects of these diode lasers while using them for gingival depigmentation.Results: After microscopic evaluation, we concluded that 808 nm and 445 nm lasers with a power of 1 W are safe enough to use in the depigmentation of gingiva, and both lasers are highly effective in melanin pigments which are located in the basal membrane.Conclusion: The 445 nm blue laser produced a less thermal effect, which means it is safer to be used in gingival hyperpigmentation than a diode lase

Comparison of the Diode Laser Wavelengths 445 nm and 810 nm in Gingival Depigmentation – A Clinical Evaluation: Laser gingival depigmentation

Introduction: Nowadays, esthetic appearance plays an important role in the field of dentistry. Discolorations and pigmentations of the gingiva reduce the appearance of a healthy-looking smile. On this occasion, the use of lasers shows a promising approach for a fast and non-aggressive treatment in this field. Different laser wavelengths are being used for gingival depigmentation this clinical study aimed to investigate the effect of the novel laser wavelength (445 nm) in this field and compare it with an 810 nm diode laser.Methods: Two diode laser wavelengths (445 nm and 810 nm) were used for depigmentation. The laser output power chosen was 1 W. An optical fiber with a diameter of 400 µm was used. 21 patients with pigmented gingiva were selected. Depigmentation was carried out in a split-mouth design for a direct comparison of the clinical effect. Outcomes were documented by photograph after one month and six months of follow-up.Results: For each wavelength, 21 volunteers evaluated 21 clinical cases of depigmentation, which means that 441 comparisons were carried out in total regarding the color change from brownish to pinkish. A 100% clarification was achieved for 445 nm. In the 810 nm group, the color change in 44 of 441 cases (10%) could not be identified. No statistically significant difference in pain experience was reported for both laser treatments.Conclusion: The clinical evaluation showed that within the limitations of this study, most of the clinical outcome parameters were highly acceptable by the patients due to mild pain and discomfort for both laser systems