Evaluation of prevalence and risk factors of hepatitis G virus infection among hemodialysis patients referred to Iranian Army Hospitals in Tehran during 2012-2013

Background: GB virus C (GBV-C) or hepatitis G virus (HGV) is a newly discovered and enveloped RNA positive-stranded flavivirus-like particle, which has not yet been proven to have major negative effects on liver. Objectives: Increasing the risk of blood-borne infections in hemodialysis patients is a main health care concern in different countries. Therefore, it is important to estimate the prevalence and risk factors of hepatitis G virus infection in Iranian hemodialysis patients to design standard prevention and treatment plans. Patients and Methods: In this multicenter observational or epidemiologic study, 138 patients who underwent hemodialysis in Iranian Army hospitals in Tehran were included. Serum HIV antibody (Ab), HCV antibody and HBS antigen (Ag) were assessed. Demographic data such as gender, age, blood group, cause of renal failure, dialysis onset and duration were collected from medical files. GBV-C/HGV was evaluated by nested reverse transcription polymerase chain reaction (RT-PCR) method. Then, all data were analyzed by SPSS ver. 13. Results: In total, 81 males and 57 females were included. The mean age of patients was 62.16 ± 14.86 years. Six (4.3) had positive results for GBV-C/HGV by RT-PCR. Except gender (P = 0.045) and duration of dialysis in a week (P 0.05). All patients had negative results for HIV Ab, HCV Ab and HBS Ag. Conclusions: Overall, 4.3 of patients had positive results for GBV-C/HGV and all negative for HIV, HCV and HBV. Further studies are needed to elucidate real prevalence, risk factors and characteristics of HGV infection in Iranian hemodialysis patients. © 2015, Kowsar Corp

Assessment of ethno-racial and insurance-based disparities in pediatric forearm and tibial fracture care in the United States

INTRODUCTION: Despite growing attention to healthcare disparities and interventions to improve inequalities, additional identification of disparities is needed, particularly in the pediatric population. We used state and nationwide databases to identify factors associated with the surgical treatment of pediatric forearm and tibial fractures. METHODS: The Healthcare Cost and Utilization Project State Inpatient, Emergency Department, and Ambulatory Surgery and Services Databases from four US states and the Nationwide Emergency Department Sample database were quarried using International Classification of Diseases codes to identify patients from 2006 to 2015. Multivariable regression models were used to determine factors associated with surgical treatment. RESULTS: State databases identified 130,006 forearm (1575 open) and 51,979 tibial fractures (1339 open). Surgical treatment was done in 2.6% of closed and 37.5% of open forearm fractures and 7.9% of closed and 60.5% of open tibial fractures. A national estimated total of 3,312,807 closed and 46,569 open forearm fractures were included, 59,024 (1.8%) of which were treated surgically. A total of 719,374 closed and 26,144 open tibial fractures were identified; 52,506 (7.0%) were treated surgically. Multivariable regression revealed that race and/or insurance status were independent predictors for the lower likelihood of surgery in 3 of 4 groups: Black patients were 43% and 35% less likely to have surgery after closed and open forearm fractures, respectively, and patients with Medicaid were less often treated surgically for open tibial fractures in state (17%) and nationwide (20%) databases. CONCLUSIONS: Disparities in pediatric forearm and tibial fracture care persist, especially for Black patients and those with Medicaid; identification of influencing factors and interventions to address them are important in improving equality and value of care

Progress in nutrition related millennium development goals in Uganda before adoption of post-2015 development agenda: review of goals 1, 2 and 4

Promulgation of Millennium Development Goals (MDG) in year 2000 gave hope to the world that common interests and challenges such as poverty and hunger, education, gender equality and women empowerment, child mortality and maternal health, diseases such as, HIV/AIDS, malaria, environmental sustainability, as well as global partnerships that were affecting the world could, respectively, be prioritized and responded to within a timeframe of the year 2001 to 2015. In this case, the developing countries like Uganda were accorded great attention. Nutrition has been at the forefront of the MDG implementation as one of the daunting challenges affecting developing countries. This paper is based on a narrative review of quantitative and qualitative data aimed at establishing the progress Uganda made towards achieving the three nutrition related MDG (1, 2 and 4). A timeframe of 2001 when the goals were officially launched up to the deadline of 31st December 2015 and the adoption of the Post-2015 Development Agenda was considered. The majority of Low and Middle Income Developing Countries (LMIDCS) failed to make substantial progress in achieving most of the goals, including the nutrition related goals. Uganda only achieved MDG one - target 1.A indicator of halving a proportion of people living below less than $ 1.25 a day. To some extent, this helped in alleviating poverty, creating jobs, and generating income and saving and other opportunities which are indeed catalysts to human development and socioeconomic wellbeing. Unfortunately, Uganda missed achieving the rest of the nutrition related MDG. They included: reducing underweight children under five years (MDG 1.8), increasing net enrollment of boys and girls in primary education (MDG 2.1), increasing proportion of pupils starting grade one to last primary grade (MDG 2.2), reducing child mortality rate per 1,000 live births (MDG 4.1) and reducing infant mortality rate per 1,000 live births (MDG 4.2). However, the hope at this particular moment ought to be directed towards tracking and achieving goals in the Post-2015 Development Agenda whose aim is mainly to build on the progress of the MDG.Key words: Nutrition, Millennium Development Goals, Post-Development Agenda, Ugand

SN 2016iet: The Pulsational or Pair Instability Explosion of a Low Metallicity Massive CO Core Embedded in a Dense Hydrogen-Poor Circumstellar Medium

We present optical photometry and spectroscopy of SN 2016iet, an unprecedented Type I supernova (SN) at $z=0.0676$ with no obvious analog in the existing literature. The peculiar light curve has two roughly equal brightness peaks ($\approx -19$ mag) separated by 100 days, and a subsequent slow decline by 5 mag in 650 rest-frame days. The spectra are dominated by emission lines of calcium and oxygen, with a width of only $3400$ km s$^{-1}$, superposed on a strong blue continuum in the first year, and with a large ratio of $L_{\rm [Ca\,II]}/L_{\rm [O\,I]}\approx 4$ at late times. There is no clear evidence for hydrogen or helium associated with the SN at any phase. We model the light curves with several potential energy sources: radioactive decay, central engine, and circumstellar medium (CSM) interaction. Regardless of the model, the inferred progenitor mass near the end of its life (i.e., CO core mass) is $\gtrsim 55$ M$_\odot$ and up to $120$ M$_\odot$, placing the event in the regime of pulsational pair instability supernovae (PPISNe) or pair instability supernovae (PISNe). The models of CSM interaction provide the most consistent explanation for the light curves and spectra, and require a CSM mass of $\approx 35$ M$_\odot$ ejected in the final decade before explosion. We further find that SN 2016iet is located at an unusually large offset ($16.5$ kpc) from its low metallicity dwarf host galaxy ($Z\approx 0.1$ Z$_\odot$, $M\approx 10^{8.5}$ M$_\odot$), supporting the PPISN/PISN interpretation. In the final spectrum, we detect narrow H$\alpha$ emission at the SN location, likely due to a dim underlying galaxy host or an H II region. Despite the overall consistency of the SN and its unusual environment with PPISNe and PISNe, we find that the inferred properties of SN\,2016iet challenge existing models of such events.Comment: 26 Pages, 17 Figures, Submitted to Ap

Luminous Supernovae: Unveiling a Population Between Superluminous and Normal Core-collapse Supernovae

Stripped-envelope core-collapse supernovae can be divided into two broad classes: the common Type Ib/c supernovae (SNe Ib/c), powered by the radioactive decay of $^{56}$Ni, and the rare superluminous supernovae (SLSNe), most likely powered by the spin-down of a magnetar central engine. Up to now, the intermediate regime between these two populations has remained mostly unexplored. Here, we present a comprehensive study of 40 \textit{luminous supernovae} (LSNe), SNe with peak magnitudes of $M_r = -19$ to $-20$ mag, bound by SLSNe on the bright end and by SNe Ib/c on the dim end. Spectroscopically, LSNe appear to form a continuum between Type Ic SNe and SLSNe. Given their intermediate nature, we model the light curves of all LSNe using a combined magnetar plus radioactive decay model and find that they are indeed intermediate, not only in terms of their peak luminosity and spectra, but also in their rise times, power sources, and physical parameters. We sub-classify LSNe into distinct groups that are either as fast-evolving as SNe Ib/c or as slow-evolving as SLSNe, and appear to be either radioactively or magnetar powered, respectively. Our findings indicate that LSNe are powered by either an over-abundant production of $^{56}$Ni or by weak magnetar engines, and may serve as the missing link between the two populations.Comment: 39 pages, 16 figures, submitted to Ap