Frequency of celiac disease in children with type 1 diabetes

Background and aims: Occurrence of celiac and diabetes is accompanied by numerous complications in children and if diagnoses do not occur promptly, celiac disease complications including gastrointestinal disorders, loss of appetite and damage caused by hypoproteinemia, and most importantly, growth disorder occurs in diabetic children. This study was aimed to compare the frequency of celiac disease in children with diabetes aged under 15 years and the controls of the same age referring to the clinics affiliated with Shahrekord University of Medical Sciences. Methods: In this case-control study, using convenience sampling, 42 patients with diabetes and 43 patients without diabetes admitted for gastrointestinal diseases were assigned as cases and controls, respectively. The description of all patients was provided, and physical examinations and serologic tests were conducted on them. If the serologic tests tTGA-IgA and tTGA-IgG were positive, the intestinal biopsy was taken. The data were analyzed by descriptive statistics and t-test, chi-square, and Mann–Whitney test in SPSS. Results: The mean serum levels of tTGA-IgA and tTGA-IgG were significantly higher in the case group than the control group (P<0.05). There were significant differences in weight gain between the cases and the controls (P=0.017). The frequency of celiac disease was 15% (n: 6) in children with diabetes with a significant difference from the controls (P=0.02). Conclusion: In this study, the frequency of celiac disease was higher in children with diabetes than children without. Therefore, in the study area, routine screening for celiac disease is helpful in reducing possible disorders and complications in diabetic children

Global age-sex-specific mortality, life expectancy, and population estimates in 204 countries and territories and 811 subnational locations, 1950–2021, and the impact of the COVID-19 pandemic: a comprehensive demographic analysis for the Global Burden of Disease Study 2021

Background Estimates of demographic metrics are crucial to assess levels and trends of population health outcomes. The profound impact of the COVID-19 pandemic on populations worldwide has underscored the need for timely estimates to understand this unprecedented event within the context of long-term population health trends. The Global Burden of Diseases, Injuries, and Risk Factors Study (GBD) 2021 provides new demographic estimates for 204 countries and territories and 811 additional subnational locations from 1950 to 2021, with a particular emphasis on changes in mortality and life expectancy that occurred during the 2020–21 COVID-19 pandemic period. Methods 22 223 data sources from vital registration, sample registration, surveys, censuses, and other sources were used to estimate mortality, with a subset of these sources used exclusively to estimate excess mortality due to the COVID-19 pandemic. 2026 data sources were used for population estimation. Additional sources were used to estimate migration; the effects of the HIV epidemic; and demographic discontinuities due to conflicts, famines, natural disasters, and pandemics, which are used as inputs for estimating mortality and population. Spatiotemporal Gaussian process regression (ST-GPR) was used to generate under-5 mortality rates, which synthesised 30 763 location-years of vital registration and sample registration data, 1365 surveys and censuses, and 80 other sources. ST-GPR was also used to estimate adult mortality (between ages 15 and 59 years) based on information from 31 642 location-years of vital registration and sample registration data, 355 surveys and censuses, and 24 other sources. Estimates of child and adult mortality rates were then used to generate life tables with a relational model life table system. For countries with large HIV epidemics, life tables were adjusted using independent estimates of HIV-specific mortality generated via an epidemiological analysis of HIV prevalence surveys, antenatal clinic serosurveillance, and other data sources. Excess mortality due to the COVID-19 pandemic in 2020 and 2021 was determined by subtracting observed all-cause mortality (adjusted for late registration and mortality anomalies) from the mortality expected in the absence of the pandemic. Expected mortality was calculated based on historical trends using an ensemble of models. In location-years where all-cause mortality data were unavailable, we estimated excess mortality rates using a regression model with covariates pertaining to the pandemic. Population size was computed using a Bayesian hierarchical cohort component model. Life expectancy was calculated using age-specific mortality rates and standard demographic methods. Uncertainty intervals (UIs) were calculated for every metric using the 25th and 975th ordered values from a 1000-draw posterior distribution. Findings Global all-cause mortality followed two distinct patterns over the study period: age-standardised mortality rates declined between 1950 and 2019 (a 62·8% [95% UI 60·5–65·1] decline), and increased during the COVID-19 pandemic period (2020–21; 5·1% [0·9–9·6] increase). In contrast with the overall reverse in mortality trends during the pandemic period, child mortality continued to decline, with 4·66 million (3·98–5·50) global deaths in children younger than 5 years in 2021 compared with 5·21 million (4·50–6·01) in 2019. An estimated 131 million (126–137) people died globally from all causes in 2020 and 2021 combined, of which 15·9 million (14·7–17·2) were due to the COVID-19 pandemic (measured by excess mortality, which includes deaths directly due to SARS-CoV-2 infection and those indirectly due to other social, economic, or behavioural changes associated with the pandemic). Excess mortality rates exceeded 150 deaths per 100 000 population during at least one year of the pandemic in 80 countries and territories, whereas 20 nations had a negative excess mortality rate in 2020 or 2021, indicating that all-cause mortality in these countries was lower during the pandemic than expected based on historical trends. Between 1950 and 2021, global life expectancy at birth increased by 22·7 years (20·8–24·8), from 49·0 years (46·7–51·3) to 71·7 years (70·9–72·5). Global life expectancy at birth declined by 1·6 years (1·0–2·2) between 2019 and 2021, reversing historical trends. An increase in life expectancy was only observed in 32 (15·7%) of 204 countries and territories between 2019 and 2021. The global population reached 7·89 billion (7·67–8·13) people in 2021, by which time 56 of 204 countries and territories had peaked and subsequently populations have declined. The largest proportion of population growth between 2020 and 2021 was in sub-Saharan Africa (39·5% [28·4–52·7]) and south Asia (26·3% [9·0–44·7]). From 2000 to 2021, the ratio of the population aged 65 years and older to the population aged younger than 15 years increased in 188 (92·2%) of 204 nations. Interpretation Global adult mortality rates markedly increased during the COVID-19 pandemic in 2020 and 2021, reversing past decreasing trends, while child mortality rates continued to decline, albeit more slowly than in earlier years. Although COVID-19 had a substantial impact on many demographic indicators during the first 2 years of the pandemic, overall global health progress over the 72 years evaluated has been profound, with considerable improvements in mortality and life expectancy. Additionally, we observed a deceleration of global population growth since 2017, despite steady or increasing growth in lower-income countries, combined with a continued global shift of population age structures towards older ages. These demographic changes will likely present future challenges to health systems, economies, and societies. The comprehensive demographic estimates reported here will enable researchers, policy makers, health practitioners, and other key stakeholders to better understand and address the profound changes that have occurred in the global health landscape following the first 2 years of the COVID-19 pandemic, and longer-term trends beyond the pandemic

Novel ensemble method for the prediction of response to fluvoxamine treatment of obsessive&ndash;compulsive disorder

Hesam Hasanpour,1 Ramak Ghavamizadeh Meibodi,1 Keivan Navi,1 Sareh Asadi2 1Department of Computer Science and Engineering, Shahid Beheshti University, Tehran, Iran; 2Neuroscience Research Center, Shahid Beheshti University of Medical Sciences, Tehran, Iran Objective: About 30% of obsessive&ndash;compulsive disorder (OCD) patients exhibit an inadequate response to pharmacotherapy. The detection of clinical variables associated with treatment response may result in achievement of remission in shorter period, preventing illness development and reducing socioeconomic costs.Methods: In total, 330 subjects with OCD diagnosis underwent 12-week pharmacotherapy with fluvoxamine (150&ndash;300 mg). Treatment response was &ge;25% reduction in Yale-Brown Obsessive&ndash;Compulsive Scale (Y-BOCS) score. In total, 36 clinical attributes of 151 subjects who had completed their treatment course were analyzed. Data mining algorithms included missing value handling, feature selection, and new analytical method based on ensemble classification. The results were compared with those of other traditional classification algorithms such as decision tree, support vector machines, k-nearest neighbor, and random forest.Results: Sexual and contamination obsessions are high-ranked predictors of resistance to fluvoxamine pharmacotherapy as well as high Y-BOCS obsessive score. Our results showed that the proposed analysis strategy has good ability to distinguish responder and nonresponder patients according to their clinical features with 86% accuracy, 79% sensitivity, and 89% specificity.Conclusion: This study proposed an analytical approach which is an accurate and a sensitive method for the analysis of high-dimensional medical data sets containing more number of missing values. The treatment of OCD could be improved by better understanding of the predictors of pharmacotherapy, which may lead to more effective treatment of patients with OCD. Keywords: obsessive&ndash;compulsive disorder, ensemble classification, treatment predictors, attribute bagging, fluvoxamine, contamination, sexual obsessio

Effect of progressive muscle relaxation with analgesic on anxiety status and pain in surgical patients

INTRODUCTION:: surgery is a stressful experience for patients and most surgical patients have some degree of anxiety. The purpose of this study was to investigate the effect of a relaxation technique in addition to narcotic analgesic on health promotion in surgical patients. METHODS:: in this clinical trial, 70 patients who were candidates for elective upper and lower gastrointestinal system surgery were selected. They were randomly divided into two groups: case (morphine 0.15 mg/kg daily in divided doses and progressive muscle relaxation (PMR)) and control (morphine 0.15 mg/kg daily in divided doses). The intervention group (case group) performed PMR from 6 hours before surgery until 24 hours after surgery. Vital signs and anxiety were evaluated in the two groups after surgery. Data were analysed by t-test, analysis of variance, and chi-square test. RESULTS:: a statistically significant difference was seen in vital signs, pain and anxiety between the two groups. However, there was also a significant difference between them in terms of economic status and insurance coverage, which could have had an effect on stress and anxiety. CONCLUSION:: PMR could increase the pain threshold, stress and anxiety tolerance and adaptation level in surgical patients. Therefore, using this technique could be an appropriate way to reduce analgesic drug consumption

Intensive longitudinal characterization of multidimensional biobehavioral dynamics in laboratory rats

Rats have been used as animal models for human diseases for more than a century, yet a systematic understanding of basal biobehavioral phenotypes of laboratory rats is still missing. In this study, we utilize wireless tracking technology and videography, collect and analyze more than 130 billion data points to fill this gap, and characterize the evolution of behavior and physiology of group-housed male and female rats (n = 114) of the most commonly used strains (Lister Hooded, Long-Evans, Sprague-Dawley, and Wistar) throughout their development. The resulting intensive longitudinal data suggest the existence of strain and sex differences and bi-stable developmental states. Under standard laboratory 12-h light/12-h dark conditions, our study found the presence of multiple oscillations such as circatidal-like rhythms in locomotor activity. The overall findings further suggest that frequent movement along cage walls or thigmotaxic activity may be a physical feature of motion in constrained spaces, critically affecting the interpretation of basal behavior of rats in cages

Prevalence of Depression among Iranian Elderly: Systematic Review and Meta-Analysis

Objective: depression is one of the most serious and prevalent mood disorders. Aging population is an important economic, social, and health challenge of the 21(st) century. The present study aimed at estimating the prevalence of depression among the Iranian elderly through meta-analysis method. Method: Studies were searched in ISI, Scopus, Pub Med, Google Scholar, and in Iranian databases including Iran Medex, Magiran, SID, and Med Lib using the following keywords: "depression", "prevalence", and "elderly". Data were analyzed using meta-analysis (random effects model). Heterogeneity among the results of the studies was examined by "I(2)" index. Beck, DASS-21, GHQ-28, and G DS questionnaires were used in this study, and analyses were performed using STATA Ver.11. Results: A total of 26 studies in Iran with a sample size of 5781 individuals had been found during 2001 and 2015. Prevalence of depression among Iranian elderly was estimated to be 43 (95 confidence interval (CI):30 - 55). The findings showed that the prevalence of depression among Iranians were49 in women, 48 in men, 37 in unmarried, and 45in the married. In addition, the prevalence of very severe, severe, moderate, and mild depression levels were estimated to be 5, 19, 33, and 38 of the participants, respectively. No significant difference was observed between married and unmarried individuals. Most of Iranian elderly suffered from mild depression. Conclusion: There was high level of depression prevalence among Iranian elderly, and women were more depressed than men. So, policy makers must design and run mental health programs to decrease the prevalence of depression among Iranian elderly

Electroplated Ni/Ni-Co multilayer coatings for higher corrosion-erosion resistance

Erosion-corrosion behaviour of hierarchical structured hydrophobic nickel-cobalt coating, obtained by electrodeposition, was assessed. In situ electrochemical measurements were carried out to study the corrosion resistance and stability during erosion tests. The electrochemical behaviour was related to surface hydrophobicity and its hierarchical structure nature as well as its modification. The pure Ni showed the lowest erosion-corrosion resistance. A smoothing of the hierarchical structure and thus a reduction the hydrophobicity was highlighted. On the other hand, Ni-Co coating even if associated to a lower electrochemical stability showed a more stable hierarchical structure also at high erosion times