Evaluation of simple calculated osteoporosis risk estimation (SCORE) in Iranian postmenopausal women

زمینه و هدف: پوکی استخوان به یک مشکل عمومی سلامت در تمام جهان تبدیل شده است. روش جذب دوگانه پرتو ایکس، به عنوان مطمئن ترین روش برای تشخیص به دلیل هزینه بالا و عدم سهولت دسترسی، جهت غربالگری پوکی استخوان توصیه نمی گردد. بر اساس عوامل خطر، ابزارهایی برای غربالگری و سنجش میزان خطر ابتلا به استئوپروز ابداع، که مشهورترین آنها ابزار محاسبه ساده تخمین خطر پوکی استخوان (SCORE) می باشد، این مطالعه با هدف بررسی کارآیی این ابزار در غربالگری زنان یائسه ایرانی برای ابتلا به استئوپروز انجام گردیده است. روش بررسی: در این مطالعه توصیفی-تحلیلی 341 زن یائسه که جهت سنجش تراکم استخوان به مرکز تشخیصی سنجش تراکم استخوان اصفهان مراجعه نموده بودند، مورد پرسش قرار گرفته و فرم پایش پوکی استخوان (SCORE) بر اساس خصوصیات افراد برای آنان تکمیل گردید. نتایج فرم ها و امتیاز بدست آمده با نتایج تراکم استخوان بدست آمده در هر فرد، با هم مقایسه و حساسیت، اختصاصی بودن و ارزش اخباری این روش غربالگری مشخص گردید. یافته ها: از 341 زن یائسه مورد مطالعه، 71 نفر دچار استئوپروز (8/20)، 135 نفر (6/39) دارای تراکم استخوان پایین (استئوپنی) در یک یا هر دو ناحیه مورد بررسی و 135 نفر (6/39) نیز دارای سنجش تراکم استخوان نرمال بودند. ابزار SCORE دارای حساسیت 2/87 و اختصاصی بودن 9/37 برای مشخص کردن زنان دارای تراکم استخوان پایین بود. نتیجه گیری: ابزار SCORE برای غربالگری زنان یائسه ایرانی نیز با حساسیت قابل قبول می تواند مورد استفاده قرار گرفته و برای پایش زنان یائسه ایرانی و ارجاع آنها برای سنجش تراکم استخوان مناسب و قابل اطمینان می باشد

Diversity techniques for a free-space optical communication system in correlated log-normal channels

International audiencePerformance analysis of free-space optical (FSO) communication systems in different channel conditions has gained significant attention in literature. Nevertheless, most existing studies consider uncorrelated channel conditions. An uncorrelated channel requires sufficient spacing between transmitters and limits the receiver field of view and link distance. However, this might not be feasible in all applications. Thereby, this paper studies repetition code (RC) and orthogonal space time block code (OSTBC) performance in correlated log-normal FSO channels using intensity modulation and direct detection. An approximate analytical expressions using moment generating function for the average bit error probability are derived. Our simulation results show that RCs are superior to OSTBCs in correlated channel conditions

A framework for the design of a medical tutoring system for the instruction of undergraduates in general practice.

One of the difficulties in teaching clinical medicine is the lack of opportunity a student has to acquire techniques for solving clinical problems. By using a computer to simulate a General Practice environment where patients with sets of symptoms are presented, a student can gain experience of diagnostic techniques and treatment management for any medical condition. Such an approach should enhance a student's development of properly structured clinical algorithms for interrogating a patient and arriving at an appropriate management plan. The intelligent tutoring system developed at the Department of Computer Science with the collaboration of the Department of General Practice aims not only to simulate this environment but also to formulate the basis for a general interactive learning environment for all subject domains with similar problem-solving model. In this system, a student may question, examine and provide treatment plans for a patient whilst constantly being monitored by the system:. Using Artificial Intelligence techniques, the tutor is able to assess the progress of a student throughout the tutorial session and produce tutoring interventions at appropriate stages, according to the student's ability. The system's knowledge base consists of disease profiles and population parameters which are created and updated by a separate system - the Medical Editor. The manipulation of this database allows tailoring of the system to simulate any clinical situation in Primary Care. This research considers in detail the current teaching/tutoring strategies adopted by all medical computer-assisted learning systems. It identifies the main areas of difficulty for using such systems in the Primary Care undergraduate course and discusses the consultation model used in this system with full comparison of the models used in Secondary Care. The research also discusses the main design issues which forms the framework for building learning environments based on intelligent tutoring systems

The prevalence of potential drug interactions in Intensive Care Units

Aims: Drug interaction occurs when a drug affects the action of another. In this line, the present study has been conducted to determine the prevalence of potential drug interactions in critical care units. Methods: In the present retrospective study, the first twenty-four hour prescriptions of 371 patients admitted to intensive care unit of Shahid Bahonar hospital of Kerman were investigated in terms of the number and type of drug interaction in addition to other factors such as number of drugs, age, gender, length of ICU stay and number of prescribing doctors. In order to determine the number and type of drug interactions, a reference textbook of "Drug Interaction Facts" was used, and data analysis was performed by SPSS18 statistical software with respect to the study objectives using descriptive statistics, Pierson correlation test, independent t-test, and variance analysis. Results: In terms of the drugs received, 77 different drugs and, in total, 2091 cases of drug prescription were found with the average of 5.6 (±1.5) for each patient. Overall, 726 cases of drug interactions were observed among critical care unit patients in the first 24 hour of prescription. Delayed, moderate, and possible interactions were accounted for the most interactions found. The results are indicative of a significant correlation between the number of drug interactions and prescribed medications, age, gender, duration of hospitalizations and number of prescribing doctors. Conclusion: Due to possessing more risk factors of drug interactions, critical care unit patients are at higher risk of developing drug interaction which behooves the medical team to pay more attention to this issue

Why do farmers over-extract groundwater resources? Assessing (un)sustainable behaviors using an Integrated Agent-Centered framework

This study uses an Integrated Agent-Centered (IAC) framework to investigate the socio-psychological drivers of Iranian farmers’ unsustainable groundwater management practices. Empirical land use change analysis of US Geological Survey Landsat satellite images of the Jaz-Murian wetland region for 1990, 2010, and 2022, is combined with community surveys conducted with randomly selected farmers in five townships within the region (n=356). Visual analysis reveals dramatic increases in agricultural land coverage, diminished water bodies and increased salt lands over the 32-year sampled period. We use survey data to explain the socio-psychological drivers of unsustainable groundwater use that lead to these adverse environmental changes. In the IAC survey analysis, we find that variables for “expectation” and “subjective culture” have a negative influence on pro-environmental “intention”. “Intention” and “habit” have a positive influence, and “contextual factors” have a negative influence on the drivers of “unsustainable water use behavior”. We conclude that situational influences, habitual process, intentional process, and normative processes must be considered together to alleviate pressure on wetland ecosystems. Policy makers must provide effective agricultural extension training, deliberative dialogue amongst farmer networks, well governed local water markets and financial support to shift farmer short-termist economic gain-thinking towards socially-supported pro-environmental habits over the longer term

Genome-Wide Association Study (GWAS) and genome prediction of seedling salt tolerance in bread wheat (Triticum aestivum L.)

Background: Salinity tolerance in wheat is imperative for improving crop genetic capacity in response to the expanding phenomenon of soil salinization. However, little is known about the genetic foundation underlying salinity tolerance at the seedling growth stage of wheat. Herein, a GWAS analysis was carried out by the random-SNP-effect mixed linear model (mrMLM) multi-locus model to uncover candidate genes responsible for salt tolerance at the seedling stage in 298 Iranian bread wheat accessions, including 208 landraces and 90 cultivars.Results: A total of 29 functional marker-trait associations (MTAs) were detected under salinity, 100 mM NaCl (sodium chloride). Of these, seven single nucleotide polymorphisms (SNPs) including rs54146, rs257, rs37983, rs18682, rs55629, rs15183, and rs63185 with R-2 >= 10% were found to be linked with relative water content, root fresh weight, root dry weight, root volume, shoot high, proline, and shoot potassium (K+), respectively. Further, a total of 27 candidate genes were functionally annotated to be involved in response to the saline environment. Most of these genes have key roles in photosynthesis, response to abscisic acid, cell redox homeostasis, sucrose and carbohydrate metabolism, ubiquitination, transmembrane transport, chromatin silencing, and some genes harbored unknown functions that all together may respond to salinity as a complex network. For genomic prediction (GP), the genomic best linear unbiased prediction (GBLUP) model reflected genetic effects better than both bayesian ridge regression (BRR) and ridge regression-best linear unbiased prediction (RRBLUP), suggesting GBLUP as a favorable tool for wheat genomic selection.Conclusion: The SNPs and candidate genes identified in the current work can be used potentially for developing salt-tolerant varieties at the seedling growth stage by marker-assisted selection