Short view of leukemia diagnosis and treatment in Iran

Background: Early diagnosis and treatment of leukemia patients remains a fundamental aim in clinical oncology, especially in developing country. Present study highlights the basic requirements of these patients in Iran. Better understanding of these issues may lead to improve the healthcare standards toward leukemia diagnosis and treatment. Methods: This descriptive study included 101 specialists in hematology-oncology and pathology serving in oncology centers. The participants were then asked to fill out a standard questionnaire on the issues around diagnosis and treatment of blood malignancies. Results: According to specialists, unfair distribution of facilities across the country, delayed diagnosis of disease, absence of psychological support for patients, and insufficient financial support were the main reasons of inappropriate diagnosis and treatment in leukemia patients. Conclusions: Our results show that making an amendment to health policies by preparing well-equipped medical centers in all provinces, improving the morale of patients through consultation during the process of treatment, and above all, subsiding leukemia patients' financial problems will promote the health standard regarding the leukemia diagnosis and treatment in Iran. © 2015, Tehran University of Medical Sciences (TUMS). All rights reserved

Quantitative evaluation and identification of fungi in Shahid Rajaeii Dam Lake, Mazandaran Province (Sari)

The present study is carried out to investigate the fungal species present in water of Shahid Rajaeii damlake in Sari, (Mazandaran province). Samples were taken from five stations including, Station 1: Input of Shirinrud river, station 2: Input of Sefidrud river, Station 3: The confluence of the two branches, Station 4: dam crest and stations 5: Output dam from June to February 2012. Every sample was diluted by sterile saline (10-1 and 10-2) and 0.5 mL from each dilution was cultured on SD and incubated at 27-30°C for 3-5 days. Finally, the number of colonies wasrecorded as (colony forming unit = CFU) per 100 mL. Identification of fungal agents were conducted by slide culture preparation and stained in lacto-phenol blue. The results showed that in August and February were significantly highest and lowest rates of fungal colonies were isolated from water in different stations respectively. Moreover, the number of fungal colonies in the crown and the output was significantly higher than other stations. The frequency of identified fungi were: Aspergillus species (31.4%), various types of yeast (mainly Candida) (24.2%), Penicillium sp. (19.3%), Cladosporium sp.(10.3%), Mucor sp. (5.4%), Fusarium sp. (2.9%), sterile hype (2.8%), Alternaria sp. (2.3%) and Paecilomyces sp. (1.4%)

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. Funding: Bill & Melinda Gates Foundation

Global age-sex-specific mortality, life expectancy, and population estimates in 204 countries and territories and 811 subnational locations, 1950–2021, and the impact of the COVID-19 pandemic: a comprehensive demographic analysis for the Global Burden of Disease Study 2021

Background: Estimates of demographic metrics are crucial to assess levels and trends of population health outcomes. The profound impact of the COVID-19 pandemic on populations worldwide has underscored the need for timely estimates to understand this unprecedented event within the context of long-term population health trends. The Global Burden of Diseases, Injuries, and Risk Factors Study (GBD) 2021 provides new demographic estimates for 204 countries and territories and 811 additional subnational locations from 1950 to 2021, with a particular emphasis on changes in mortality and life expectancy that occurred during the 2020–21 COVID-19 pandemic period. Methods: 22 223 data sources from vital registration, sample registration, surveys, censuses, and other sources were used to estimate mortality, with a subset of these sources used exclusively to estimate excess mortality due to the COVID-19 pandemic. 2026 data sources were used for population estimation. Additional sources were used to estimate migration; the effects of the HIV epidemic; and demographic discontinuities due to conflicts, famines, natural disasters, and pandemics, which are used as inputs for estimating mortality and population. Spatiotemporal Gaussian process regression (ST-GPR) was used to generate under-5 mortality rates, which synthesised 30 763 location-years of vital registration and sample registration data, 1365 surveys and censuses, and 80 other sources. ST-GPR was also used to estimate adult mortality (between ages 15 and 59 years) based on information from 31 642 location-years of vital registration and sample registration data, 355 surveys and censuses, and 24 other sources. Estimates of child and adult mortality rates were then used to generate life tables with a relational model life table system. For countries with large HIV epidemics, life tables were adjusted using independent estimates of HIV-specific mortality generated via an epidemiological analysis of HIV prevalence surveys, antenatal clinic serosurveillance, and other data sources. Excess mortality due to the COVID-19 pandemic in 2020 and 2021 was determined by subtracting observed all-cause mortality (adjusted for late registration and mortality anomalies) from the mortality expected in the absence of the pandemic. Expected mortality was calculated based on historical trends using an ensemble of models. In location-years where all-cause mortality data were unavailable, we estimated excess mortality rates using a regression model with covariates pertaining to the pandemic. Population size was computed using a Bayesian hierarchical cohort component model. Life expectancy was calculated using age-specific mortality rates and standard demographic methods. Uncertainty intervals (UIs) were calculated for every metric using the 25th and 975th ordered values from a 1000-draw posterior distribution. Findings: Global all-cause mortality followed two distinct patterns over the study period: age-standardised mortality rates declined between 1950 and 2019 (a 62·8% [95% UI 60·5–65·1] decline), and increased during the COVID-19 pandemic period (2020–21; 5·1% [0·9–9·6] increase). In contrast with the overall reverse in mortality trends during the pandemic period, child mortality continued to decline, with 4·66 million (3·98–5·50) global deaths in children younger than 5 years in 2021 compared with 5·21 million (4·50–6·01) in 2019. An estimated 131 million (126–137) people died globally from all causes in 2020 and 2021 combined, of which 15·9 million (14·7–17·2) were due to the COVID-19 pandemic (measured by excess mortality, which includes deaths directly due to SARS-CoV-2 infection and those indirectly due to other social, economic, or behavioural changes associated with the pandemic). Excess mortality rates exceeded 150 deaths per 100 000 population during at least one year of the pandemic in 80 countries and territories, whereas 20 nations had a negative excess mortality rate in 2020 or 2021, indicating that all-cause mortality in these countries was lower during the pandemic than expected based on historical trends. Between 1950 and 2021, global life expectancy at birth increased by 22·7 years (20·8–24·8), from 49·0 years (46·7–51·3) to 71·7 years (70·9–72·5). Global life expectancy at birth declined by 1·6 years (1·0–2·2) between 2019 and 2021, reversing historical trends. An increase in life expectancy was only observed in 32 (15·7%) of 204 countries and territories between 2019 and 2021. The global population reached 7·89 billion (7·67–8·13) people in 2021, by which time 56 of 204 countries and territories had peaked and subsequently populations have declined. The largest proportion of population growth between 2020 and 2021 was in sub-Saharan Africa (39·5% [28·4–52·7]) and south Asia (26·3% [9·0–44·7]). From 2000 to 2021, the ratio of the population aged 65 years and older to the population aged younger than 15 years increased in 188 (92·2%) of 204 nations. Interpretation: Global adult mortality rates markedly increased during the COVID-19 pandemic in 2020 and 2021, reversing past decreasing trends, while child mortality rates continued to decline, albeit more slowly than in earlier years. Although COVID-19 had a substantial impact on many demographic indicators during the first 2 years of the pandemic, overall global health progress over the 72 years evaluated has been profound, with considerable improvements in mortality and life expectancy. Additionally, we observed a deceleration of global population growth since 2017, despite steady or increasing growth in lower-income countries, combined with a continued global shift of population age structures towards older ages. These demographic changes will likely present future challenges to health systems, economies, and societies. The comprehensive demographic estimates reported here will enable researchers, policy makers, health practitioners, and other key stakeholders to better understand and address the profound changes that have occurred in the global health landscape following the first 2 years of the COVID-19 pandemic, and longer-term trends beyond the pandemic. Funding: Bill & Melinda Gates Foundation

Removal of phenol from steel plant wastewater in three dimensional electrochemical (TDE) process using CoFe2O4@AC/H2O2

This study investigated the removal of phenol from steel industry wastewater by three dimensional electrochemical (TDE) process using CoFe2O4nanobiocomposite based activated carbon in the presence of H2O2(EC-CoFe2O4@AC-H2O2). In this study, CoFe2O4nanobiocomposite-foundation activated carbon (CoFe2O4@AC)was used as microelectrode, adsorbent, and activator for peroxide hydrogen. The removal efficiency of phenol and COD was investigated through the parameters of pH, contact time, CoFe2O4@AC dosage, current density, and H2O2concentration. The highest removal rates of phenol and COD were >99 and 98, respectively. Also, steel plantwastewater under the optimal conditions of pH = 6.5, current density = 15 mA cm-2, contact time = 25 min, H2O2concentration of 1.0 mM, and CoFe2O4@AC dose = 0.3 g L-1. Kinetic analysis revealed that the adsorption experimental data was best fitted by the pseudofirst- order model. © 2020 De Gruyter. All rights reserved

CoFe2O4@Methylcelloluse as a New Magnetic Nano Biocomposite for Sonocatalytic Degradation of Reactive Blue 19

Reactive Blue 19 (RB19) removal from synthetic textile wastewater was investigated by using a CoFe2O4@methylcellulose (MC) activated with peroxymonosulfate (PMS) and the ultrasound process. CoFe2O4@MC as a new magnetic nano-biocomposite was prepared using a convenient and rapid microwave-assisted technique in presence of MC as a green biopolymer, and characterized by FESEM, EDS, Mapping, TEM, FTIR, XRD, TGA, VSM, and BET techniques. Then, the effective parameters including pH (4�10), reaction time (0�30 min), CoFe2O4@MC (0.2�1 g/L), and PMS concentration (0.5�10 mM) in the sonocatalytic degradation of RB19 were investigated. The maximum removal efficiency of RB19 was achieved as 97 for synthetic wastewater under the optimal conditions of pH 4, CoFe2O4@MC dosage (0.6 g/L), reaction time = 30 min, and PMS (5 mM) in the presence of ultrasonic waves (60 kHz) at the ambient room temperature of 22 °C. The CoFe2O4@MC catalyst was simply isolated using a magnet and recycled with no remarkable loss of catalytic activity following usage in four runs. The results showed that the CoFe2O4@MC sonocatalysis process is practical, and effective for degrading complex and resistant dyes such as RB19. © 2021, The Author(s), under exclusive licence to Springer Science+Business Media, LLC part of Springer Nature

The Correlation between Managers’ Delegation of Authority with the Manner of Employee Direction in Hospitals of Qom Province

Background and Objectives: The destructive effect of centralized management can be found throughout each organization, which is a barrier for delegation of authority and productivity leading to administrative violence increase and compression and frigidity of affairs. With attention to the importance of delegation of authority this research aimed at determining the correlation between the manager's delegation of authority with the manner of employee direction in Qom hospitals, designed for contributing to improvement of managers’ performance in hospitals.Methods: This correlational and cross-sectional research, was carried out on all the employees under the control of managers and chiefs of Qom province hospitals (N=2167). Sampling was done by cluster sampling method through the use of Cokran sampling based on Morgan and kerjsi chart. 998 samples with the confidence level of %95 and permitted errors of 0.05 were randomly selected. Data were collected via questionnaires which were answered by self-report method. The data were then analyzed by the Pearson correlation coefficient, variance's test F analyses, multiple variant regression and T-test.Results: The mean score of the manager's non-delegation of authority was (32.4). Among the indicators of the direction, there was a significant relationship between the motivation (mean= 61.44) and organizational communication (49.39), also there was a significant relationship between the managers’ delegation of authority and the manner of their employees direction (non-delegation of authority R=-0.13). Conclusion: Due to the meaningful and direct relationship between most of direction variables with the managers’ delegation of authority, increasing the delegation of authority and deconcentration can lead to an increase in employee motivation and (vertical and formal) communication and improved performance of affairs

The Comparison of Rumen Fungi Quantification in the Medium Containing Sunflower Meal Treated with Formaldehyde and or Sodium Hydroxide by Using Quantitative Competitive PCR

The method of quantitative competitive polymerase chain reaction (QC-PCR) was conducted to compare the number of rumen anaerobic fungi in pure culture of fungi containing high fat sunflower meal (165 g fat/kg DM) processed with formaldehyde and NaOH. Twenty one multiparous early lactating Holstein cows (30±5 days of lactation) selected and fed experimental diets for 7 weaks. The diets were including untreated sunflower meal (control, n=3) and treated 4 % sodium hydroxide (n=3) and treated with 0.3 and 0.6 % formaldehyde (n=3). Competitive PCR technique was used to evaluate quantitative difference of anaerobic fungal population in the rumen under the dietary treatments. Standard control DNA was constructed from lambda phage for use in the competitive PCR and was shown to amplify under the same reaction condition and with the same amplification efficiency as the target DNA. The relative intensities of PCR products were used to evaluate variety of fungal population under fed treatments. The analysis of data of present study showed that NaOH treated sunflower meal increased and formaldehyde treated sunflower meal decreased number of fungi in medium compared to control. Therefore it seems that QC-PCR method has appropriate efficacy for enumerating rumen fungal population under the effect of dietary treatments

Production and characterization of egg yolk antibody (IgY) against recombinant VP8 - S2 antigen

Bovine Rotavirus and Bovine Coronavirus are the most important causes of diarrhea in newborn calves and in some other species such as pigs and sheep. VP8 subunit of rotavirus is the major determinant of the viral infectivity and neutralization. Spike glycoprotein of coronavirus is responsible for induction of neutralizing antibody response. Studies showed that immunoglobulin of egg yolk (IgY) from immunized hens has been identified to be a convenient source for specific antibodies for using in immunotherapy and immunodiagnostic to limit the infections. In this study, chimeric VP8-S2 gene was designed using by computational techniques. The chimeric VP8-S2 gene was cloned and sub-cloned into pGH and pET32a (+) vectors. Then, recombinant pET32a-VP8-S2 vector was transferred into E. coli BL21 CodonPlus (DE3). The expressed protein was purified by Ni-NTA chromatography column. Hens were immunized with the purified VP8-S2 protein three times. IgY was purified from egg yolks using polyethylene glycol precipitation method. Activity and specificity of anti-VP8-S2 IgY were detected by dot-blotting, Western-blotting and indirect ELISA. We obtained anti-VP8-S2 IgY by immunizing hens with the recombinant VP8-S2 protein. The anti-VP8-S2 IgY was showed to bind specifically to the chimeric VP8-S2 protein by dot-blotting, Western-blotting analyses and indirect ELISA. The result of this study indicated that such construction can be useful to investigate as candidates for development of detection methods for simultaneous diagnosis of both infections. Specific IgY against the recombinant VP8-S2 could be recommended as a candidate for passive immunization against bovine rotavirus and bovine coronavirus