Geographic risk of general and abdominal obesity and related determinants in Iranian children and adolescents: CASPIAN-IV Study

Background: Obesity, as a risk factor for many noncommunicable diseases, is a common public health problem in developed and developing countries. Among Iranian children and adolescents, the prevalence of being overweight has increased by almost 50% in the past two decades. Aims: To visualize the geographic differences in general and abdominal obesity risks and related determinants among Iranian children and adolescents. Methods: Participants consisted of 14 880 students, aged 7-19 years, living in urban and rural areas of the Islamic Republic of Iran. Spatial patterns of obesity and its association with related risk factors were identified using Bayesian spatial modeling. Results: The highest spatial risks of general obesity (odds ratio 1.21-1.66 for males and 1.81-2.02 for females) and abdominal obesity (odds ratio 1.20-1.82 for males and 1.25-1.78 for females) were observed in the north, northwest and southwest of the country. Risk of obesity was significantly higher in areas with a higher rate of urban residence, active current smokers and prolonged screen time. Conclusion: Identification of high-risk regions for obesity and spatially related risk factors can be used as informative tools for decision-making and planning in health systems at national and subnational levels

Povezanost između radiografskih nalaza, magnetske rezonancije i histopatoloških nalaza kod pokusne rupture prednje križne sveze u kunića.

Experimental osteoarthritis (OA) was induced in the knee joints of rabbits and the trend of changes were compared by radiography, Magnetic Resonance Imaging (MRI) and histopathology. Twenty rabbits were randomly divided into two equal groups based on short (30 days) and long-term (180 days) follow ups. In half of the animals in each group (n = 5) OA was induced by sectioning the cranial cruciate ligament and in the other half, only arthrotomy was performed as a sham operation. Radiography and MRI were carried out on days 0 and 30 in the group of short term studies, and on days 0, 90 and 180 in the other group. Histopathological examinations were performed on day 30 in the short-term group after the animals had been sacrificed and in the other group on day 180. The slope of changes over the course of the study between all 3 methods and the grade of changes, were both highest in histopathology, and then in MRI and radiology respectively. The slope of changes was 0.01 for histopathology, 0.009 for MRI and 0.004 for radiology. The ratios of slopes, when compare to each other, were as follows: His./MRI = 1.1, His./Rad. = 2.5, MRI/Rad. = 2.2. Comparison of MRI with radiology revealed that radiology would not show signs of OA when the MRI grade is less than a grade of 0.27. Comparing both imaging techniques with histopathology showed that whenever the histopathological grade was below 0.22, radiology would not show signs of OA involvement, while MRI was capable of showing signs of OA involvement whenever it was more than 0.018 on histopathological grade.Nakon što je u kunića pokusno izazvan osteoartritis koljenog zgloba, trend promjena promatran je pomoću radiografije, magnetske rezonancije (MRI) i patohistoloških nalaza. Dvadeset kunića bilo je metodom slučajnog odabira podijeljeno u dvije jednake skupine od kojih je jedna promatrana tijekom kratkotrajnog (30 dana), a druga tijekom dugotrajnog (180 dana) razdoblja. U polovice životinja iz svake skupine (n = 5) osteoartroza je bila uzrokovana sekcijom prednje križne sveze, a kod druge polovice primijenjena je samo artrotomija kao lažna operacija. Radiografija i magnetska rezonancija obavljene su 0-ti i 30. dan tijekom kratkotrajnog promatranja te 0-ti, 90. i 180. dan kod dugotrajnog promatranja. Histopatološke pretrage obavljene su 30. dan kod kratkotrajnog praćenja nakon što su životinje bile usmrćene, a kod dugotrajnog 180. dan. Slabljenje promjena tijekom promatranja svima trima metodama kao i stupanj promjena pokazali su se najvećima kod histopatoloških nalaza, zatim kod magnetske rezonancije te nakon toga kod radioloških snimki. Slabljenje promjena bilo je 0,01 za histopatološke nalaze, 0,009 za magnetsku rezonanciju i 0,004 za radiološke snimke. Kad se uzmu u obzir međusobni odnosi slabljenja su bila sljedeća: His./MRI = 1,1, His./Rad. = 2,5, MRI/Rad. = 2,2. Usporedba magnetske rezonancije i radiologije potvrdila je da radiologija neće pokazati znakove osteoartritisa kada je stupanj magnetske rezonance niži od 0,27. Usporedbom obje tehnike snimanja s histopatološkim nalazima utvrđeno je da radiologija neće pokazati znakove osteoartritisa kad je stupanj histopatoloških nalaza ispod 0,22. Primjenom magnentske rezonancije moguće je utvrditi znakove osteoartritisa svaki put kada je njezin stupanj veći od 0,018 u odnosu na stupanj histopatoloških nalaza

Global, regional, and national cancer incidence, mortality, years of life lost, years lived with disability, and disability-Adjusted life-years for 29 cancer groups, 1990 to 2017 : A systematic analysis for the global burden of disease study

Importance: Cancer and other noncommunicable diseases (NCDs) are now widely recognized as a threat to global development. The latest United Nations high-level meeting on NCDs reaffirmed this observation and also highlighted the slow progress in meeting the 2011 Political Declaration on the Prevention and Control of Noncommunicable Diseases and the third Sustainable Development Goal. Lack of situational analyses, priority setting, and budgeting have been identified as major obstacles in achieving these goals. All of these have in common that they require information on the local cancer epidemiology. The Global Burden of Disease (GBD) study is uniquely poised to provide these crucial data. Objective: To describe cancer burden for 29 cancer groups in 195 countries from 1990 through 2017 to provide data needed for cancer control planning. Evidence Review: We used the GBD study estimation methods to describe cancer incidence, mortality, years lived with disability, years of life lost, and disability-Adjusted life-years (DALYs). Results are presented at the national level as well as by Socio-demographic Index (SDI), a composite indicator of income, educational attainment, and total fertility rate. We also analyzed the influence of the epidemiological vs the demographic transition on cancer incidence. Findings: In 2017, there were 24.5 million incident cancer cases worldwide (16.8 million without nonmelanoma skin cancer [NMSC]) and 9.6 million cancer deaths. The majority of cancer DALYs came from years of life lost (97%), and only 3% came from years lived with disability. The odds of developing cancer were the lowest in the low SDI quintile (1 in 7) and the highest in the high SDI quintile (1 in 2) for both sexes. In 2017, the most common incident cancers in men were NMSC (4.3 million incident cases); tracheal, bronchus, and lung (TBL) cancer (1.5 million incident cases); and prostate cancer (1.3 million incident cases). The most common causes of cancer deaths and DALYs for men were TBL cancer (1.3 million deaths and 28.4 million DALYs), liver cancer (572000 deaths and 15.2 million DALYs), and stomach cancer (542000 deaths and 12.2 million DALYs). For women in 2017, the most common incident cancers were NMSC (3.3 million incident cases), breast cancer (1.9 million incident cases), and colorectal cancer (819000 incident cases). The leading causes of cancer deaths and DALYs for women were breast cancer (601000 deaths and 17.4 million DALYs), TBL cancer (596000 deaths and 12.6 million DALYs), and colorectal cancer (414000 deaths and 8.3 million DALYs). Conclusions and Relevance: The national epidemiological profiles of cancer burden in the GBD study show large heterogeneities, which are a reflection of different exposures to risk factors, economic settings, lifestyles, and access to care and screening. The GBD study can be used by policy makers and other stakeholders to develop and improve national and local cancer control in order to achieve the global targets and improve equity in cancer care. © 2019 American Medical Association. All rights reserved.Peer reviewe

Mapping 123 million neonatal, infant and child deaths between 2000 and 2017

Since 2000, many countries have achieved considerable success in improving child survival, but localized progress remains unclear. To inform efforts towards United Nations Sustainable Development Goal 3.2—to end preventable child deaths by 2030—we need consistently estimated data at the subnational level regarding child mortality rates and trends. Here we quantified, for the period 2000–2017, the subnational variation in mortality rates and number of deaths of neonates, infants and children under 5 years of age within 99 low- and middle-income countries using a geostatistical survival model. We estimated that 32% of children under 5 in these countries lived in districts that had attained rates of 25 or fewer child deaths per 1,000 live births by 2017, and that 58% of child deaths between 2000 and 2017 in these countries could have been averted in the absence of geographical inequality. This study enables the identification of high-mortality clusters, patterns of progress and geographical inequalities to inform appropriate investments and implementations that will help to improve the health of all populations

Optimal Use of Ganciclovir and Valganciclovir in Transplanted Patients: How Does It Relate to the Outcome?

Objective. Organ transplant recipients receive immunosuppressive regimens to prevent transplant rejection, which put them at increased risk for opportunistic infections like cytomegalovirus (CMV). Ganciclovir and Valganciclovir are mostly used to prevent or treat CMV. Any incorrect use of the drug may have serious consequences for patients. In this study, the outcome of transplant recipients was assessed in relation to the optimal or suboptimal use of Ganciclovir or Valganciclovir. Methods. This study was performed on 148 hospitalized patients who received Ganciclovir or Valganciclovir in the nephrology and kidney transplantation departments of our university hospitals, from March 2012 to December 2016. Patients’ demographic and clinical data including dose and duration of treatment were collected and then analyzed in comparison with the standard CMV treatment protocols. Findings. About 94.6% of patients received Ganciclovir or Valganciclovir therapy consistent with the standard defined indications. The mean ratio of prescribed daily dose to the optimal dose was 2.9 in the first dose, 2.0 in the second dose, 1.3 in the third dose, and 1.5 in the fourth dose. From 148 included patients, 26.5% experienced CMV infection once, 7.2% experienced CMV infection twice, and 1.2% had CMV infection for 3 times, within six-month follow-up after first episode of antiviral therapy during hospitalization. Conclusion. In this study, empiric anti-CMV therapy was initially given. The doses used were generally higher than recommended but we could not find more adverse events in the patients receiving high initial doses. In any case, it seems necessary to advocate use of standard treatment guidelines to avoid adverse outcomes

Coronary Artery Disease Diagnosis Using Supervised Fuzzy C-Means with Differential Search Algorithm-based Generalized Minkowski Metrics

Introduction: Coronary Artery Disease (CAD), one of the leading causes of death, is narrowing the walls of the coronary arteries. Angiography is the most accurate but invasive and costly CAD diagnosis method associated with mortality. The aim of this study was to design a computer-based non-invasive CAD diagnosis system.Methods: In this work, a dataset from Cleveland clinic foundation, containing 303 patients and 20 features, was used. Supervised Fuzzy C-means (SFCM) classification was used to design a classifier for CAD diagnosis. The Generalized Minkowski Metrics (GMM) was used to handle objects containing different measurement scale features. The performance of the SFCM was assessed with/without Statistical Feature Selection (SFS). The weights of the GMM, i.e. the significance of different features,beside other classifier parameters were tuned using Differential Search Algorithm (DSA), and the validity of the proposed classifier was further investigated. The hold-out and 10-fold cross validation were used for the performance assessment.Result: The average accuracy of the base classifier (SFCM + GMM) was 79% (hold-out validation). It increased to 82% when using SFS. The average accuracy, sensitivity and specificity of the DSA-based classifier were 88%, 86% and 88%, respectively (cross-validation).Conclusion: The most important features were the number of major vessels colored by fluoroscopy, the family history of CAD, peak exercise systolic blood pressure, maximum exercise heart rate achieved, chest pain type, resting heart rate, Fasting Blood Sugar and gender.This classifier showed substantial agreement with the angiographic results. The hybrid diagnosis system is thus promising. However, it is necessary to improve its reliability.</p

Measuring the relationship between equity and intellectual capital

Human resources play essential role on the success of many organizations and it is essential to learn more about the effects of human capital on the success of business units. This paper presents an empirical investigation to study the relationship between equity and intellectual capital among stocks listed on Tehran Stock Exchange over the period 2001-2007. Using Pearson correlation test, the study selects a sample of 77 firms and investigates the relationship between equity and three components of intellectual capital, namely; human capital, structural capital and customer capital. The study has detected a positive and meaningful relationship between equity and all components of the survey (α = 5%)