Co-infection of Malaria and Crimean-Congo Hemorrhagic Fever

Southeast of Iran is an endemic area for Malaria and Crimean-Congo hemorrhagic fever (CCHF). In 1999, we faced with an outbreak of CCHF in Sistan and Baluchistan Province, in the border of Pakistan and Afghanistan. The most cases of Malaria in Iran are also reported from this area. This article presents a 17-year- old woman who admitted to our hospital because of acute fever, headache, epistaxis, hemorrhagic lesions on the skin and vaginal bleeding. Finally, she was recognized as a case that was co –infected with CCHF and malaria

Sequence Analysis of Pvama-1 among Plasmodium Vivax Isolates in Sistan-Baluchistan

BACKGROUND: Apical Membrane antigen 1 (AMA-1) is an important membrane protein that presents in all Plasmodium species and participates in critical phases in the attraction of cells. In human, it is one of the most immunodominant antigens with a protective immune response simulation role Apical Membrane antigen 1 (AMA-1) is an important membrane protein which presents in all Plasmodium species and is located on the surface of merozoite and sporozoites that participates in critical phases in attraction of human red blood cells by merozoites and hepatocytes by sporozoites, so in human, it is one of the most immunodominant antigens with a protective immune response simulation role. Since extra information is necessary to lighten of AMA-1 scope, we equaled genetic variation in P.vivax AMA-1 from 40 Iranian isolates with those reported from the other malarious countries.METHODS: Blood samples were collected from 40 patients’ positive of P.vivax, and genomic DNA was extracted from the blood. The nucleotide sequence for 446 amino acid (AA) residues (42–488 of PvAMA-1) of AMA-1 gene was amplified via PCR and then sequenced.RESULTS: A total of 24 different haplotypes were recognized between samples. No new haplotype was determined in this research that was reported previously in other regions of Iran and the world. We detected 37-point mutations at the nucleotide level in their sequences and showed 43 amino acid variations, at 37 positions in which 6 sites demonstrate trimorphic polymorphism, and the others were dimorphic.CONCLUSION: Sequence analysis of the major haplotype showed 95% similarity with P.vivax Sal-1 AMA-1 gene and high level of allelic diversity at the domain I of PvAMA-1 among P. vivaxisolates of Iran. Because PvAMA-1 is noticeable as vaccinecandidate antigen, these documents provide valuable informationfor the development of malaria vaccine

INVESTIGATING THE RELATIONSHIP BETWEEN CORPORATE SOCIAL RESPONSIBILITY AND FINANCIAL PERFORMANCE OF CONSTRUCTION, ARCHITECTS AND INDUSTRIAL COMPANIES IN THE MUNICIPALITIES OF MAZANDARAN PROVINCE

Abstract. The purpose of this research was to investigate the relationship between corporate social responsibility and financial performance of construction, architecture and industrial companies in the municipalities of Mazandaran province. This research is descriptive-correlative method and is of applied research type. The statistical population of the study consisted of all construction, architectural and industrial companies in the municipalities of Mazandaran province during 2013 to 2017, in which 50 companies were studied. The data of the research were extracted from the financial statements of the companies and analyzed using regression models using combination data. The research findings showedthat there is a positive and significant relationship between corporate social capital and asset returns and earnings per share of companies, and there is not a significant relationship between corporate social capitals with equity returns.Keywords: Social Responsibility, Financial Performance, Returns on Assets, Return on Equity, Earnings perShare

Global fertility in 204 countries and territories, 1950–2021, with forecasts to 2100: a comprehensive demographic analysis for the Global Burden of Disease Study 2021

Background Accurate assessments of current and future fertility—including overall trends and changing population age structures across countries and regions—are essential to help plan for the profound social, economic, environmental, and geopolitical challenges that these changes will bring. Estimates and projections of fertility are necessary to inform policies involving resource and health-care needs, labour supply, education, gender equality, and family planning and support. The Global Burden of Diseases, Injuries, and Risk Factors Study (GBD) 2021 produced up-to-date and comprehensive demographic assessments of key fertility indicators at global, regional, and national levels from 1950 to 2021 and forecast fertility metrics to 2100 based on a reference scenario and key policy-dependent alternative scenarios. Methods To estimate fertility indicators from 1950 to 2021, mixed-effects regression models and spatiotemporal Gaussian process regression were used to synthesise data from 8709 country-years of vital and sample registrations, 1455 surveys and censuses, and 150 other sources, and to generate age-specific fertility rates (ASFRs) for 5-year age groups from age 10 years to 54 years. ASFRs were summed across age groups to produce estimates of total fertility rate (TFR). Livebirths were calculated by multiplying ASFR and age-specific female population, then summing across ages 10–54 years. To forecast future fertility up to 2100, our Institute for Health Metrics and Evaluation (IHME) forecasting model was based on projections of completed cohort fertility at age 50 years (CCF50; the average number of children born over time to females from a specified birth cohort), which yields more stable and accurate measures of fertility than directly modelling TFR. CCF50 was modelled using an ensemble approach in which three sub-models (with two, three, and four covariates variously consisting of female educational attainment, contraceptive met need, population density in habitable areas, and under-5 mortality) were given equal weights, and analyses were conducted utilising the MR-BRT (meta-regression—Bayesian, regularised, trimmed) tool. To capture time-series trends in CCF50 not explained by these covariates, we used a first-order autoregressive model on the residual term. CCF50 as a proportion of each 5-year ASFR was predicted using a linear mixed-effects model with fixed-effects covariates (female educational attainment and contraceptive met need) and random intercepts for geographical regions. Projected TFRs were then computed for each calendar year as the sum of single-year ASFRs across age groups. The reference forecast is our estimate of the most likely fertility future given the model, past fertility, forecasts of covariates, and historical relationships between covariates and fertility. We additionally produced forecasts for multiple alternative scenarios in each location: the UN Sustainable Development Goal (SDG) for education is achieved by 2030; the contraceptive met need SDG is achieved by 2030; pro-natal policies are enacted to create supportive environments for those who give birth; and the previous three scenarios combined. Uncertainty from past data inputs and model estimation was propagated throughout analyses by taking 1000 draws for past and present fertility estimates and 500 draws for future forecasts from the estimated distribution for each metric, with 95% uncertainty intervals (UIs) given as the 2·5 and 97·5 percentiles of the draws. To evaluate the forecasting performance of our model and others, we computed skill values—a metric assessing gain in forecasting accuracy—by comparing predicted versus observed ASFRs from the past 15 years (2007–21). A positive skill metric indicates that the model being evaluated performs better than the baseline model (here, a simplified model holding 2007 values constant in the future), and a negative metric indicates that the evaluated model performs worse than baseline. Findings During the period from 1950 to 2021, global TFR more than halved, from 4·84 (95% UI 4·63–5·06) to 2·23 (2·09–2·38). Global annual livebirths peaked in 2016 at 142 million (95% UI 137–147), declining to 129 million (121–138) in 2021. Fertility rates declined in all countries and territories since 1950, with TFR remaining above 2·1—canonically considered replacement-level fertility—in 94 (46·1%) countries and territories in 2021. This included 44 of 46 countries in sub-Saharan Africa, which was the super-region with the largest share of livebirths in 2021 (29·2% [28·7–29·6]). 47 countries and territories in which lowest estimated fertility between 1950 and 2021 was below replacement experienced one or more subsequent years with higher fertility; only three of these locations rebounded above replacement levels. Future fertility rates were projected to continue to decline worldwide, reaching a global TFR of 1·83 (1·59–2·08) in 2050 and 1·59 (1·25–1·96) in 2100 under the reference scenario. The number of countries and territories with fertility rates remaining above replacement was forecast to be 49 (24·0%) in 2050 and only six (2·9%) in 2100, with three of these six countries included in the 2021 World Bank-defined low-income group, all located in the GBD super-region of sub-Saharan Africa. The proportion of livebirths occurring in sub-Saharan Africa was forecast to increase to more than half of the world's livebirths in 2100, to 41·3% (39·6–43·1) in 2050 and 54·3% (47·1–59·5) in 2100. The share of livebirths was projected to decline between 2021 and 2100 in most of the six other super-regions—decreasing, for example, in south Asia from 24·8% (23·7–25·8) in 2021 to 16·7% (14·3–19·1) in 2050 and 7·1% (4·4–10·1) in 2100—but was forecast to increase modestly in the north Africa and Middle East and high-income super-regions. Forecast estimates for the alternative combined scenario suggest that meeting SDG targets for education and contraceptive met need, as well as implementing pro-natal policies, would result in global TFRs of 1·65 (1·40–1·92) in 2050 and 1·62 (1·35–1·95) in 2100. The forecasting skill metric values for the IHME model were positive across all age groups, indicating that the model is better than the constant prediction. Interpretation Fertility is declining globally, with rates in more than half of all countries and territories in 2021 below replacement level. Trends since 2000 show considerable heterogeneity in the steepness of declines, and only a small number of countries experienced even a slight fertility rebound after their lowest observed rate, with none reaching replacement level. Additionally, the distribution of livebirths across the globe is shifting, with a greater proportion occurring in the lowest-income countries. Future fertility rates will continue to decline worldwide and will remain low even under successful implementation of pro-natal policies. These changes will have far-reaching economic and societal consequences due to ageing populations and declining workforces in higher-income countries, combined with an increasing share of livebirths among the already poorest regions of the world

Pre-Exposure and Post-Exposure Prophylaxis of Crimean-Congo Hemorrhagic Fever

Context: Crimean-Congo hemorrhagic fever (CCHF) is a tick-borne viral disease with a mortality rate of 30% to 80% and reported from more than 30 countries in Asia, Africa, South-Eastern Europe, and the Middle East. It is a zoonotic viral disease and an important health problem. In endemic areas, livestock handlers, livestock market workers, skin processors, veterinary staff, farmers, and healthcare personnel are at risk. Clinical manifestations are non-specific. Diagnosis is based on clinical manifestations, epidemiologic factors, and laboratory tests. Here, we reviewed the routes of transmission, pre-exposure, and post-exposure prophylaxis to help the public health authorities for decreasing rate of the disease in the community. Evidence Acquisition: Medical databases (PubMed, Scopus, and Embase) were searched from June 1985 to June 2014. Keywords, including CCHF, epidemiology, transmission, control, prophylaxis, and prevention routes were searched. Results: CCHF is widely distributed in many countries of the world, including our country, Iran which is an endemic region. Infection has a wide distribution that correlates with a global distribution of Hyalomma tick (the vector responsible for viral transmission). Preventive measures are very important in lowering the incidence rate. Post-exposure prophylaxis should be considered for people exposed to CCHF virus, such as those who have mucous membrane contact or a percutaneous injury in contact with the secretions or blood of infected animal or patients. Conclusions: CCHF is a fatal viral disease. Therefore, pre-exposure and post-exposure prophylaxis should be considered to decrease the infection rate. All strategies should be centralized on raising surveillance using standardized case finding and proper case management, reduction of infection in animals, and increasing laboratory capacity in at risk regions for CCHF