Iranian medical English journals: reference analysis based on journal selection criteria in WOS, PubMed and Scopus

Objective: The references are an important component of citation analysis. In this study, it is aimed to determine the reference analysis of Iranian Medical English Journals (IMEJ) based on WOS, Scopus and PubMed journal selection criteria. Methods: This study is a descriptive quantitative analysis which deals with the last issues of 52 numbers of IMEJ which haven\u27t been indexed in WOS, Scopus, and PubMed. The data were collected observing the journals data provider websites and then entered into a checklist tool. MS Excel software was used for data analysis. Results: About 88.5% of journals had their own reference style. In 60.9% of journals, the amount of failure in the reference style was less than 10%. The average of self-citations to authors and journal articles, were 3.6% and 1.2%, respectively. The average percentage of foreign references was 83.6%. Most of the references were old and only 2.9% of references were done in the study year. Journals with 87.2%, had received most of the references. Conclusion: References old date, imbalance the format of cited resources, and high distances between the rate of Iranian and foreign references, were the shortcomings of cited references in IMEJ

Diagnostic triad of pulmonary anthracofibrosis in spiral CT scan : a retrospective study

Purpose: Anthracosis, a form of pneumoconiosis commonly caused by air pollution and other environmental factors, is a new entity in respiratory disorders. Bronchoscopy and transbronchial lung biopsy (TBLB) are the gold standard of diagnosis. Herein, we evaluated the results of bronchoscopy and chest computed tomography (CT) scans of 187 anthracotic patients. Material and methods: Between April 2016 and April 2017, 187 cases (99 males, mean age 65 ± 10.2 years) who underwent flexible bronchoscopy and TBLB for various indications were considered for this study. CT examinations of these patients were reported as "blind to bronchoscopy results" by two experienced board-certified radiologists. Results: According to the results of bronchoscopy and TBLB, 100 patients were diagnosed as anthracotic. CT scans confirmed 71 of these cases as anthracosis. Sensitivity, specificity, PPV, NPV, and accuracy of hyperdense non-calcified mediastinal and hilar lymph nodes, known as "brilliant lymph nodes", compared to bronchoscopy were 55%, 92%, 89%, 64%, and 72%, respectively (CI: 95%). Also, there was a positive correlation between anthracosis and brilliant lymph nodes (p-value = 0). Analysis of hyper-attenuated lung with bronchoscopy estimated sensitivity, specificity, PPV, NPV, and accuracy gave 41%, 94%, 89%, 58%, and 65%, respectively (CI: 95%). The specificity of brilliant lymph nodes, hyper-attenuated lung, and multi-segmental atelectasis as a diagnostic "triad of anthracosis" was 100%. Conclusions: Based on our analyses, the triad of brilliant lymph nodes, hyper-attenuated lung, and multi-segmental atelectasis was identified as a reliable set of imaging findings for the diagnosis of anthracosis

Recent Iranian Health System Reform: An Operational Perspective to Improve Health Services Quality

Abstract The operational management of healthcare services is expected to directly touch patient experiences. Iranian Ministry of Health and Medical Education (MoHME) for the first time, as such, has sought to improve the operational management of healthcare delivery within a reform agenda by setting benchmarks for ‘number of visit per hour’ and waiting time in outpatient clinics of about 700 affiliated hospitals. As a new initiative, it has faced with mixed reactions and various doubts have been cast on its successful implementation. This manuscript aims to shed some light on the operational challenges of the initiative and the requirements of its successful implementation

Mapping catquest scores onto EQ-5D utility values in patients with cataract disease

Background: Mapping from non-performance-based measures onto generic performance-based measures provides an appropriate solution to derive utilities to be used in economic evaluations. Objectives: This study aimed to create a model through which EQ-5D utilities for cataracts can be obtained from scores on the disease-specific Catquest measure. Patients and Methods: One hundred ninety-nine observations from 103 patients who self-administered the EQ-5D, the Catquest and questions on demographic and clinical characteristics were included in the analysis. Data was divided into estimation and validation datasets. To predict EQ-5D utilities, multiple regression analysis, using the Ordinary Least Square (OLS) and the censored least absolute deviation (CLAD), was performed. Catquest scores, age, gender, and performing surgery were included as explanatory variables. An estimation dataset was used to derive the coefficients, and these coefficients were then validated using a validation dataset. Based on the explanatory power, the consistency, the simplicity, the mean absolute error (MAE) and the correlations between observed and fitted utilities, the most appropriate model was selected. Results: The mean EQ-5D and Catquest scores of the total sample were 0.631 and 15.8, respectively. Age and surgery showed no significant effect for either method. Removing age and surgery, model II was built and given an R2of 0.697, an MAE of 0.1176 for the OLS and an R2of 0.614, and an MAE of 0.1153 for the CLAD method. In the validation stage, the CLAD revealed better prediction ability, with an MAE of 0.198 versus an MAE of 0.209 for the OLS. ICC and Bland-Altman analysis put the CLAD as a preferred method with the following equation: Utilities (EQ-5D) = 0.988 - 0.0281 × Catquest (PD) + 0.102 × gender (male = 1). Conclusions: Based on these results, a mapping function was obtained which appears to be valuable in predicting EQ-5D utilities from Catquest scores. This function gives an appropriate solution to estimate utilities when primary EQ-5D data is not available. Although the model represents good consistency and predictive ability, further examination of obtained function is required with large samples. © 2016, Iranian Red Crescent Medical Journal

Tropisetron suppresses colitis-associated cancer in a mouse model in the remission stage

Patients with inflammatory bowel disease (IBD) have a high risk for development of colitis-associated cancer (CAC). Serotonin is a neurotransmitter produced by enterochromaffin cells of the intestine. Serotonin and its receptors, mainly 5-HT3 receptor, are overexpressed in IBD and promote development of CAC through production of inflammatory cytokines. In the present study, we demonstrated the in vivo activity of tropisetron, a 5-HT3 receptor antagonist, against experimental CAC. CAC was induced by azoxymethane (AOM)/dextran sodium sulfate (DDS) in BALB/c mice. The histopathology of colon tissue was performed. Beta-catenin and Cox-2 expression was evaluated by immunohistochemistry as well as quantitative reverse transcription-PCR (qRT-PCR). Alterations in the expression of 5-HT3 receptor and inflammatory-associated genes such as Il-1β, Tnf-α, Tlr4 and Myd88 were determined by qRT-PCR. Our results showed that tumor development in tropisetron-treated CAC group was significantly lower than the controls. The qRT-PCR analysis demonstrated that the expression of 5-HT3 receptor was significantly increased following CAC induction. In addition, tropisetron reduced expression of β-catenin and Cox-2 in the CAC experimental group. The levels of Il-1β, Tnf-α, Tlr4 and Myd88 were significantly decreased upon tropisetron treatment in the AOM/DSS group. Taken together, our data show that tropisetron inhibits development of CAC probably by attenuation of inflammatory reactions in the colitis

Developing Framework and Strategies for Capacity Building to Apply Evidence-Informed Health Policy-Making in Iran: Mixed Methods Study of SAHSHA Project

BACKGROUND: SASHA, which stands for "evidence-informed health policy-making (EIHP)" in Persian, is a national project to draw a roadmap for strengthening EIHP in Iran. As a part of SASHA, this research aimed to develop evidence-based and context-aware policy options for increasing the capacity of decision-makers to apply EIHP in Iran. METHODS: This was a qualitative study, which was informed by a literature review of pull efforts' capacity building programs. Based on the review, we developed policy options and validated them through an expert panel that involved twelve experts. Data were analyzed using a content analysis method. RESULTS: We extracted data from 11 articles. The objectives of capacity building programs were: single-skill development, personal/professional development, and organizational development. According to these objectives, the contents and training methods of the programs vary. Capacity building programs have shown positive impacts on individual knowledge/attitudes to use EIHP. However, the impacts of programs at the organizational or the health system level remain under-researched. We followed several threads from the literature review through to the expert panel that included training the management team, instead of training managers, training for problem-solving skills, and designing tailored programs. Barriers of capacity building for EIHP regard the context of the health system (weak accountability and the widespread conflict of interest) and healthcare organizational structures (decision support systems, knowledge management infrastructures, and lack of management team). Experts suggested interventions on the barriers, particularly on resolving the conflict of interests before launching new programs. A proposed framework to increase the capacity of health policy-makers incorporates strategies at three levels: capacity building program, organizational structure, and health system context. CONCLUSION: To prepare the context of Iranian healthcare organizations for capacity building programs, the conflict of interests needs to be resolved, decision-makers should be made more accountable, and healthcare organizations need to provide more knowledge management infrastructures and decision support systems

The global burden of cancer attributable to risk factors, 2010-19 : a systematic analysis for the Global Burden of Disease Study 2019

Background Understanding the magnitude of cancer burden attributable to potentially modifiable risk factors is crucial for development of effective prevention and mitigation strategies. We analysed results from the Global Burden of Diseases, Injuries, and Risk Factors Study (GBD) 2019 to inform cancer control planning efforts globally. Methods The GBD 2019 comparative risk assessment framework was used to estimate cancer burden attributable to behavioural, environmental and occupational, and metabolic risk factors. A total of 82 risk-outcome pairs were included on the basis of the World Cancer Research Fund criteria. Estimated cancer deaths and disability-adjusted life-years (DALYs) in 2019 and change in these measures between 2010 and 2019 are presented. Findings Globally, in 2019, the risk factors included in this analysis accounted for 4.45 million (95% uncertainty interval 4.01-4.94) deaths and 105 million (95.0-116) DALYs for both sexes combined, representing 44.4% (41.3-48.4) of all cancer deaths and 42.0% (39.1-45.6) of all DALYs. There were 2.88 million (2.60-3.18) risk-attributable cancer deaths in males (50.6% [47.8-54.1] of all male cancer deaths) and 1.58 million (1.36-1.84) risk-attributable cancer deaths in females (36.3% [32.5-41.3] of all female cancer deaths). The leading risk factors at the most detailed level globally for risk-attributable cancer deaths and DALYs in 2019 for both sexes combined were smoking, followed by alcohol use and high BMI. Risk-attributable cancer burden varied by world region and Socio-demographic Index (SDI), with smoking, unsafe sex, and alcohol use being the three leading risk factors for risk-attributable cancer DALYs in low SDI locations in 2019, whereas DALYs in high SDI locations mirrored the top three global risk factor rankings. From 2010 to 2019, global risk-attributable cancer deaths increased by 20.4% (12.6-28.4) and DALYs by 16.8% (8.8-25.0), with the greatest percentage increase in metabolic risks (34.7% [27.9-42.8] and 33.3% [25.8-42.0]). Interpretation The leading risk factors contributing to global cancer burden in 2019 were behavioural, whereas metabolic risk factors saw the largest increases between 2010 and 2019. Reducing exposure to these modifiable risk factors would decrease cancer mortality and DALY rates worldwide, and policies should be tailored appropriately to local cancer risk factor burden. Copyright (C) 2022 The Author(s). Published by Elsevier Ltd. This is an Open Access article under the CC BY 4.0 license.Peer reviewe

Assessing of Iranian medical English journals based on journal selection criteria in Scopus

Journals which have been indexed in universal citation databases can introduce their countries’ scientific productions to the world’ scientific communications. In this study, it is aimed to evaluate Iranian Medical English Journals (IMEJ) based on Scopus’ journal selection criteria. This is a descriptive quantitative study which deals with the last issues of 52 numbers of IMEJ which have not been indexed in Web of Science, Scopus, and PubMed. Data is collected using a researcher-developed checklist whose validity was confirmed by faculty members. Microsoft Office Excel was used to analyze data. According to our findings, the studied journals were in compliance with Scopus’ journal selection criteria in the cases regularity in publishing, providing informative abstracts for articles, limiting the amount of self-citation, providing XML format for articles, providing the online system for sending and receiving the articles, and providing author\u27s guidelines. The low amount of structured abstracts, the low number of foreign authors and editors, and the low amount of Endnote output were the most important weakness in IMEJ. Suggested solutions were promoting the cooperation with foreign editors and authors, and providing structured abstracts, and EndNote outputs by journals and authors

Funding Hospital Services: A Critical Analysis and Feasibility Study of the Casemix Funding Model in Iran

Background Hospitals in Iran have mainly been managed in a centralised system and funded historically through annual budgeting with little autonomy at hospital level. The current annual budgeting system is inequitable and is not reflective of hospital activity. Hospital resources are not distributed with regard to efficiency indicators and lobbying and political power of the managers are common issues influencing budget. Evidence suggests that hospitals in Iran will be even further challenged due to the growing and aging population. Reform of funding policy, particularly in hospitals, is now being considered as a critical step to improvement of Irans health system. Objectives This is a study of the theoretical and practical aspects of the implementation of casemix funding of hospitals in Iran. It aims to identify the knowledge and attitude of hospital managers and staff about the feasibility of casemix; to investigate availability, reliability and completeness of hospital discharge and financial data; to measure the appropriateness of the Australian Refined Diagnosis Related Groups (AR-DRGs); to build up a basis for further studies on casemix funding of hospitals; and, to assist the efficient use of scarce resources among and between hospital systems. Methods First, a descriptive survey, using an eleven-item questionnaire, was conducted to assess the level of knowledge and attitudes of hospital managers and key staff about casemix funding and its appropriateness. Second, patients clinical and demographic information were collected from the discharge system of a single study hospital, to evaluate the accuracy and completeness of these data for adopting casemix in Irans hospitals. This information was used to classify patient episodes into DRG classes using the LAETA Grouper and AR-DRGs. Third, DRG cost weights were calculated based on the internationally accepted principles of 'activity-based' cost accounting and cost-modelling, taking into account current realities of hospital accounting structures, availability of data, as well as time and budget constraints. To identify whether there is any association between modelled cost weights and length of stay at the DRG level, two statistical measures, the Pearson correlation coefficient and regression coefficient were calculated using the STATA statistical package. Finally, a total of 465,531 acute inpatient separations, from 35 hospitals, was used to examine the performance of AR-DRGs in the study environment. L3H3; IQR; and 10th- 95th percentile methods were used for excluding extreme cases. The coefficient of variation (CV) and reduction in variance (R2) were used to measure the degree of homogeneity achieved by the classification system and the extent to which the dispersion of lengths of stay could be explained by grouping the cases into the discrete DRG classes. Results The staff survey results showed that 75% and 58% of the participants had not ever heard of the terms casemix and DRGs, respectively. The majority of the participants described casemix and DRGs as a cost allocation and/or funding tool rather than a classification system useful for management and performance measurement. The most common barriers to casemix implementation outlined by the participants included: the lack of good foundation knowledge; difficulty in data access; and lack of or incomplete knowledge of the chief managers and staff about the casemix. The data quality study findings suggest that the accuracy and completeness of the available data in the study hospital is variable and not highly reliable. The grouper identified invalid records of principal diagnosis, age, sex, and length of stay for 4% of total separations. No complication and comorbidity effects were recorded for 93% of cases. Although general practitioners are employed as gate keepers to control coding accuracy, there is no standard quality control to secure the accuracy and consistency of coding either at the physician or coder level. Coders, except in a few cases, have not been formally trained. According to the data study, the estimation of DRG cost weights using a clinical costing approach is almost impossible due to inadequate financial and utilisation information at the patient level, poorly computerised 'feeder systems', and low quality data. In contrast, the cost modelling approach, using Australian service weights resulted in the average DRG cost weight of 2.723 million Iranian Rials (equal to US $295). A regression coefficient of 0.14 (CI = 0.12 − 0.16) suggests that the average cost weight increases by 14% for every one day increase in average length of stay. Classifying a total of 465,531 acute inpatient separations using AR-DRG resulted in 579 DRG classes. Although reduction in variance (R2) for untrimmed data was low (R2 = 0.17) for LOS, trimming by L3H3, IQR, and 10th-95th percentile method improved the value of R2 to 0.53, 0.48, and 0.51, respectively. Low values of R2 for DRGs within several MDCs such as MDC 02, 05, 10, 15, and MDC 20 were identified. Conclusion This study concludes that the implementation of the casemix funding of hospitals in the Iranian health system and in Iranian Social Security Organisation in particular, is quite feasible and that AR-DRGs would provide a useful basis for introducing casemix in the system. However, the effective implementation of casemix in Iran would depend on a number of factors including: active cooperation and contribution of hospital staff at all levels and in all departments in the implementation process and provision of reliable data; updating hospital information systems; improving the quality of costing information; adopting an appropriate classification system, and, finally, adequate scrutiny of health care providers behaviours through the regular assessment of hospital performance and quality of care