136 research outputs found

    The predictive value of HLA-DR matching and cytokine gene polymorphisms in renal allograft acute rejection: A living-unrelated donor (LURD) study

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    Background: In addition to Human Leukocyte Antigens (HLA) compatibility, gene polymorphisms in cytokines might also be important in the quality of allogeneic immune response. Objective: To evaluate the influence of HLA-DR matching and a number of cytokine gene polymorphisms on acute rejection after living-unrelated donor (LURD) kidney transplantation. Methods: A total of 42 renal transplants performed at Hashemi Nejad Kidney Hospital (Tehran/Iran) and followed up for 3 months post-transplantation were included. Using PCR-SSP, HLA-DR alleles (DR1-18) of recipients and donors and gene polymorphisms in TNF-a, TGF-b1, IL-10, IL-6, and IFN-γ of recipients were determined. Results: Acute rejection was observed in 11(26.2) of renal recipients. The frequency of one and two HLA-DR mismatches in rejector group was 2(18.2) and 9(81.8) and in non-rejector group was 13(41.9) and 17(54.8), respectively. HLA-DR incompatibility was not significantly higher in rejector (1.82±0.40) compared with non-rejector (1.52±0.57) recipients (P=0.069) and more than half of non-rejectors had completely mismatched HLA-DR antigens with donors. Polymorphisms associated with the mentioned cytokines had no correlation with acute rejection. Conclusion: The predictive value of HLA-DR mismatching for acute rejection is not as prominent in LURD kidney transplantation as in the cadaveric one. In addition, we failed to demonstrate an association between combined cytokine genotypes and HLA-DR matching with acute rejection. Further and more detailed immunogenetic investigations are required in order to have a better prediction of the transplant outcome

    A graph automorphic approach for placement and sizing of charging stations in EV network considering traffic

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    This paper proposes a novel graph-based approach with automorphic grouping for the modelling, synthesis, and analysis of electric vehicle (EV) networks with charging stations (CSs) that considers the impacts of traffic. The EV charge demands are modeled by a graph where nodes are positioned at potential locations for CSs, and edges represent traffic flow between the nodes. A synchronization protocol is assumed for the network where the system states correspond to the waiting time at each node. These models are then utilized for the placement and sizing of CSs in order to limit vehicle waiting times at all stations below a desirable threshold level. The main idea is to reformulate the CS placement and sizing problems in a control framework. Moreover, a strategy for the deployment of portable charging stations (PCSs) in selected areas is introduced to further improve the quality of solutions by reducing the overshooting of waiting times during peak traffic hours. Further, the inherent symmetry of the graph, described by graph automorphisms, are leveraged to investigate the number and positions of CSs. Detailed simulations are performed for the EV network of Perth Metropolitan in Western Australia to verify the effectiveness of the proposed approach

    Genetic polymorphisms of cytochrome P450 enzymes 2C9 and 2C19 in a healthy Iranian population

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    1. The genetically polymorphic cytochrome P450 enzymes 2C9 (CYP2C9) and 2C19 (CYP2C19) are involved in the metabolism and elimination of a number of widely used drugs. The polymorphisms give rise to substantial interindividual and interethnic variability in drug excretion rates and final serum concentrations. For this reason, therapeutic responses and adverse drug reactions may vary from one person to another. In the present study we determined CYP2C9 and CYP2C19 genotypes in a random Iranian population to compare allele frequencies with previous findings in other ethnic groups. 2. Allelic variants of CYP2C9 (*1/*2/*3) and CYP2C19 (*1/*2/*3) were determined in 200 unrelated healthy Iranian volunteers by polymerase chain reaction-restriction fragment length polymorphism (PCR-RFLP) assays. 3. Fifteen subjects (7.5) were homozygous for the CYP2C9*2 allele, whereas 21 individuals (10.5) were heterozygous for this allele and 164 subjects (82) had the wild-type allele (CYP2C9*1). No CYP2C9*3 was detected in the population sampled. Six subjects (3) were homozygous for CYP2C19*2, whereas 44 individuals (22) were heterozygous for this allele. In the remaining subjects (75), no CYP2C19*2 was found. In addition, no CYP2C19*3 was detected in the population sampled. 4. Based on our data, the frequency of the CYP2C9*2 allelic variant in Iranians is similar to that in other Caucasian populations; however, the frequency of the CYP2C9*3 allele differed significantly (P 0.05). © 2007 Blackwell Publishing Asia Pty Ltd

    Exploring spatial patterns of colorectal cancer in Tehran City, Iran

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    Objectives: Colorectal cancer (CRC) may now be the second most common cancer in the world. The aim of this study was to determine whether clusters of high and low risk of CRC might exist at the neighborhood level in Tehran city. Methods: In this study, new cases of CRC provided from Cancer Registry Data of the Management Center of Ministry of Health and Medical Education of Iran in the period from March 2008 to March 2011 were analyzed. Raw standardized incidence rates (SIRs) were calculated for CRC in each neighborhood, along with ratios of observed to expected cases. The York and Mollie (BYM) spatial model was used for smoothing of the estimated raw SIRs. To discover clusters of high and low CRC incidence a purely spatial scan statistic was applied. Results: A total of 2,815 new cases of CRC were identified and after removal of duplicate cases, 2,491 were geocoded to neighborhoods. The locations with higher than expected incidence of CRC were northern and central districts of Tehran city. An observed to expected ratio of 2.57 (p < 0.001) was found for districts of 2, 6 and 11, whereas, the lowest ratio of 0.23 (p < 0.001) was apparent for northeast and south areas of the city, including district 4. Conclusions: This study showed that there is a significant spatial variation in patterns of incidence of CRC at the neighborhood level in Tehran city. Identification of such spatial patterns and assessment of underlying risk factors can provide valuable information for policymakers responsible for equitable distribution of healthcare resources. © 2017, Asian Pacific Organization for Cancer Prevention

    Exploring spatial patterns of colorectal cancer in Tehran City, Iran

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    Objectives: Colorectal cancer (CRC) may now be the second most common cancer in the world. The aim of this study was to determine whether clusters of high and low risk of CRC might exist at the neighborhood level in Tehran city. Methods: In this study, new cases of CRC provided from Cancer Registry Data of the Management Center of Ministry of Health and Medical Education of Iran in the period from March 2008 to March 2011 were analyzed. Raw standardized incidence rates (SIRs) were calculated for CRC in each neighborhood, along with ratios of observed to expected cases. The York and Mollie (BYM) spatial model was used for smoothing of the estimated raw SIRs. To discover clusters of high and low CRC incidence a purely spatial scan statistic was applied. Results: A total of 2,815 new cases of CRC were identified and after removal of duplicate cases, 2,491 were geocoded to neighborhoods. The locations with higher than expected incidence of CRC were northern and central districts of Tehran city. An observed to expected ratio of 2.57 (p < 0.001) was found for districts of 2, 6 and 11, whereas, the lowest ratio of 0.23 (p < 0.001) was apparent for northeast and south areas of the city, including district 4. Conclusions: This study showed that there is a significant spatial variation in patterns of incidence of CRC at the neighborhood level in Tehran city. Identification of such spatial patterns and assessment of underlying risk factors can provide valuable information for policymakers responsible for equitable distribution of healthcare resources. © 2017, Asian Pacific Organization for Cancer Prevention

    Spatial, temporal, and demographic patterns in prevalence of chewing tobacco use in 204 countries and territories, 1990-2019: A systematic analysis from the Global Burden of Disease Study 2019

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    Background: Chewing tobacco and other types of smokeless tobacco use have had less attention from the global health community than smoked tobacco use. However, the practice is popular in many parts of the world and has been linked to several adverse health outcomes. Understanding trends in prevalence with age, over time, and by location and sex is important for policy setting and in relation to monitoring and assessing commitment to the WHO Framework Convention on Tobacco Control. Methods: We estimated prevalence of chewing tobacco use as part of the Global Burden of Diseases, Injuries, and Risk Factors Study 2019 using a modelling strategy that used information on multiple types of smokeless tobacco products. We generated a time series of prevalence of chewing tobacco use among individuals aged 15 years and older from 1990 to 2019 in 204 countries and territories, including age-sex specific estimates. We also compared these trends to those of smoked tobacco over the same time period. Findings: In 2019, 273·9 million (95% uncertainty interval 258·5 to 290·9) people aged 15 years and older used chewing tobacco, and the global age-standardised prevalence of chewing tobacco use was 4·72% (4·46 to 5·01). 228·2 million (213·6 to 244·7; 83·29% [82·15 to 84·42]) chewing tobacco users lived in the south Asia region. Prevalence among young people aged 15–19 years was over 10% in seven locations in 2019. Although global age-standardised prevalence of smoking tobacco use decreased significantly between 1990 and 2019 (annualised rate of change: –1·21% [–1·26 to –1·16]), similar progress was not observed for chewing tobacco (0·46% [0·13 to 0·79]). Among the 12 highest prevalence countries (Bangladesh, Bhutan, Cambodia, India, Madagascar, Marshall Islands, Myanmar, Nepal, Pakistan, Palau, Sri Lanka, and Yemen), only Yemen had a significant decrease in the prevalence of chewing tobacco use, which was among males between 1990 and 2019 (−0·94% [–1·72 to –0·14]), compared with nine of 12 countries that had significant decreases in the prevalence of smoking tobacco. Among females, none of these 12 countries had significant decreases in prevalence of chewing tobacco use, whereas seven of 12 countries had a significant decrease in the prevalence of tobacco smoking use for the period. Interpretation: Chewing tobacco remains a substantial public health problem in several regions of the world, and predominantly in south Asia. We found little change in the prevalence of chewing tobacco use between 1990 and 2019, and that control efforts have had much larger effects on the prevalence of smoking tobacco use than on chewing tobacco use in some countries. Mitigating the health effects of chewing tobacco requires stronger regulations and policies that specifically target use of chewing tobacco, especially in countries with high prevalence. Funding: Bloomberg Philanthropies and the Bill & Melinda Gates Foundation

    Spatial, temporal, and demographic patterns in prevalence of smoking tobacco use and attributable disease burden in 204 countries and territories, 1990-2019: a systematic analysis from the Global Burden of Disease Study 2019

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    Background: Ending the global tobacco epidemic is a defining challenge in global health. Timely and comprehensive estimates of the prevalence of smoking tobacco use and attributable disease burden are needed to guide tobacco control efforts nationally and globally. Methods: We estimated the prevalence of smoking tobacco use and attributable disease burden for 204 countries and territories, by age and sex, from 1990 to 2019 as part of the Global Burden of Diseases, Injuries, and Risk Factors Study. We modelled multiple smoking-related indicators from 3625 nationally representative surveys. We completed systematic reviews and did Bayesian meta-regressions for 36 causally linked health outcomes to estimate non-linear dose-response risk curves for current and former smokers. We used a direct estimation approach to estimate attributable burden, providing more comprehensive estimates of the health effects of smoking than previously available. Findings: Globally in 2019, 1·14 billion (95% uncertainty interval 1·13–1·16) individuals were current smokers, who consumed 7·41 trillion (7·11–7·74) cigarette-equivalents of tobacco in 2019. Although prevalence of smoking had decreased significantly since 1990 among both males (27·5% [26·5–28·5] reduction) and females (37·7% [35·4–39·9] reduction) aged 15 years and older, population growth has led to a significant increase in the total number of smokers from 0·99 billion (0·98–1·00) in 1990. Globally in 2019, smoking tobacco use accounted for 7·69 million (7·16–8·20) deaths and 200 million (185–214) disability-adjusted life-years, and was the leading risk factor for death among males (20·2% [19·3–21·1] of male deaths). 6·68 million [86·9%] of 7·69 million deaths attributable to smoking tobacco use were among current smokers. Interpretation: In the absence of intervention, the annual toll of 7·69 million deaths and 200 million disability-adjusted life-years attributable to smoking will increase over the coming decades. Substantial progress in reducing the prevalence of smoking tobacco use has been observed in countries from all regions and at all stages of development, but a large implementation gap remains for tobacco control. Countries have a clear and urgent opportunity to pass strong, evidence-based policies to accelerate reductions in the prevalence of smoking and reap massive health benefits for their citizens. Funding: Bloomberg Philanthropies and the Bill & Melinda Gates Foundation

    Anemia prevalence in women of reproductive age in low- and middle-income countries between 2000 and 2018

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    Anemia is a globally widespread condition in women and is associated with reduced economic productivity and increased mortality worldwide. Here we map annual 2000–2018 geospatial estimates of anemia prevalence in women of reproductive age (15–49 years) across 82 low- and middle-income countries (LMICs), stratify anemia by severity and aggregate results to policy-relevant administrative and national levels. Additionally, we provide subnational disparity analyses to provide a comprehensive overview of anemia prevalence inequalities within these countries and predict progress toward the World Health Organization’s Global Nutrition Target (WHO GNT) to reduce anemia by half by 2030. Our results demonstrate widespread moderate improvements in overall anemia prevalence but identify only three LMICs with a high probability of achieving the WHO GNT by 2030 at a national scale, and no LMIC is expected to achieve the target in all their subnational administrative units. Our maps show where large within-country disparities occur, as well as areas likely to fall short of the WHO GNT, offering precision public health tools so that adequate resource allocation and subsequent interventions can be targeted to the most vulnerable populations.Peer reviewe

    Spatial, temporal, and demographic patterns in prevalence of smoking tobacco use and attributable disease burden in 204 countries and territories, 1990-2019 : a systematic analysis from the Global Burden of Disease Study 2019

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    Background Ending the global tobacco epidemic is a defining challenge in global health. Timely and comprehensive estimates of the prevalence of smoking tobacco use and attributable disease burden are needed to guide tobacco control efforts nationally and globally. Methods We estimated the prevalence of smoking tobacco use and attributable disease burden for 204 countries and territories, by age and sex, from 1990 to 2019 as part of the Global Burden of Diseases, Injuries, and Risk Factors Study. We modelled multiple smoking-related indicators from 3625 nationally representative surveys. We completed systematic reviews and did Bayesian meta-regressions for 36 causally linked health outcomes to estimate non-linear dose-response risk curves for current and former smokers. We used a direct estimation approach to estimate attributable burden, providing more comprehensive estimates of the health effects of smoking than previously available. Findings Globally in 2019, 1.14 billion (95% uncertainty interval 1.13-1.16) individuals were current smokers, who consumed 7.41 trillion (7.11-7.74) cigarette-equivalents of tobacco in 2019. Although prevalence of smoking had decreased significantly since 1990 among both males (27.5% [26. 5-28.5] reduction) and females (37.7% [35.4-39.9] reduction) aged 15 years and older, population growth has led to a significant increase in the total number of smokers from 0.99 billion (0.98-1.00) in 1990. Globally in 2019, smoking tobacco use accounted for 7.69 million (7.16-8.20) deaths and 200 million (185-214) disability-adjusted life-years, and was the leading risk factor for death among males (20.2% [19.3-21.1] of male deaths). 6.68 million [86.9%] of 7.69 million deaths attributable to smoking tobacco use were among current smokers. Interpretation In the absence of intervention, the annual toll of 7.69 million deaths and 200 million disability-adjusted life-years attributable to smoking will increase over the coming decades. Substantial progress in reducing the prevalence of smoking tobacco use has been observed in countries from all regions and at all stages of development, but a large implementation gap remains for tobacco control. Countries have a dear and urgent opportunity to pass strong, evidence-based policies to accelerate reductions in the prevalence of smoking and reap massive health benefits for their citizens. Copyright (C) 2021 The Author(s). Published by Elsevier Ltd.Peer reviewe
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