Reliability of Ultrasonography in Measuring Deep Abdominal and Lumbar Multifidus Muscle Dimensions in Patients with Unilateral Lumbar Disc Herniation

Introduction: The purpose of this study was to assess the within-day and between-day reliability of abdominal and lumbar multifidus muscle size in patients with unilateral lumbar disc herniation (LDH) using ultrasonography (US). Materials and methods: In this study, 15 patients with unilateral LDH (20-60 years old) were recruited. To assess within-day and between-day reliability, three images were taken with one hour and one week intervals respectively. The images were taken at rest and during contraction. Results: The within-day and between-day reliability of abdominal muscle thickness measurements using US in patients with unilateral lumbar disc herniation (LDH) in both rest and contraction state was found to be high with ICC=0.87 for within and ICC=0.75 for between-day rates of transverse abdominis (TrA) muscles at rest and ICC=0.78 and 0.75, respectively, in contraction state. For internal oblique muscles, ICC=0.70 at rest and 0.79 in contraction state and ICC=0.73 at rest and 0.77 in contraction state were found for within-day and between-day, respectively. Within-day and between-day reliability at rest with ICC=0.76 and 0.76 and in contraction state with ICC=0.75 and 0.74 were demonstrated for the external oblique muscle. Within-day and between-day reliability rates at rest with ICC=0.88 and 0.84, respectively, and in contraction state with ICC=0.84 and 0.80, respectively were demonstrated for the lumbar multifidus muscle. Conclusion: The results of the present study suggest that US is a reliable method for evaluating the thickness of the abdominal and lumbar multifidus muscles. However, further research is recommended to support the findings of the present study.Keywords: Ultrasonography, disc herniation, abdominal muscles, lumbar multifidus muscle, reliabilit

The association between current smoking and binge drinking among adults: A systematic review and meta-analysis of cross-sectional studies

BackgroundThe substantial increasing trend of binge drinking is a global alarm. Our aim was to undertake a systematic review and meta-analysis of cross-sectional studies to explore the association of current smoking with binge drinking among adults.MethodsWe systematically searched Web of Knowledge; PubMed; Scopus; Embase and Ovid (MEDLINE, EMBASE, PsycARTICLES, PsycINFO, PsycEXTRA, and PsycTests) (from inception to 27 May 2020) databases to identify cross-sectional studies of the association between current smoking and binge drinking. Study screening, data extraction, and methodological quality assessment were all carried out by two independent authors. Adjusted odds ratio (AOR) was pooled with 95% confidence intervals (CI) using random effects model in the meta-analysis, followed by the investigation of the heterogeneity via Q-test and I2 statistic. We assessed publication bias using a funnel plot, the Egger’s, and Begg’s tests.ResultsWe identified 3,171 studies and included nine cross-sectional studies with 64,516 participants. A significant association was found between current smoking and binge drinking among both genders (AOR = 2.97; 95% CI = 1.98 to 4.45; I2 = 90.5%). Subgroup analysis showed that this association among women, men, Caucasians, and Asians/Africans were (AOR = 3.68; 95% CI = 1.03 to 13.18; I2 = 98.9%), (AOR = 2.53; 95% CI = 1.87 to 3.42; I2 = 73.1%), (AOR = 1.36; 95% CI: 1.01–1.83, I2 = 47.4%), and (AOR = 3.93; 95% CI: 2.99–5.17, I2 = 61.3%), respectively. There was no evidence of publication bias.ConclusionCurrent smoking is associated with binge drinking and can be used for identifying and screening binge drinkers. Moreover, this association is stronger among men, and Asians/Africans. This meta-analysis estimation was limited to English-language studies, and the full text of about 3.5% of reports for retrieval was not found, then generalization of the results should be done with caution

Non-Pharmacologic Interventions in COVID-19 Pandemic Management; a Systematic Review

Introduction: Different countries throughout the world have adopted non-pharmacologic interventions to reduce and control SARS - CoV-2. In this systematic approach, the impact of non-pharmacologic interventions in management of COVID-19 pandemic was assessed. Methods: Following Preferred Reporting Items for Systematic reviews and Meta-Analyses (PRISMA) guidelines, systematic search was carried out on the basis of a search strategy on PubMed, Web of Science, Scopus, and WHO databases on COVID-19. The impact of travel ban, personal protective equipment, distancing, contact tracing, school closure, and social distancing and the combined effect of interventions on COVID-19 were assessed. Results: Of the 14,857 articles found, 44 were relevant. Studies in different countries have shown that various non-pharmacological interventions have been used during the COVID-19 pandemic. The travel ban, either locally or internationally in most of the countries, movement restriction, social distancing, lockdown, Personal Protective Equipment (PPE), quarantine, school closure, work place closure, and contact tracing had a significant impact on the reduction of mortality or morbidity of COVID-19. Conclusion: Evidence shows that the implementation of non-pharmacologic interventions (NPIs), for example, social distancing, quarantine, and personal protective equipment’s are generally effective and the best way to prevent or reduce transmission. However, this study suggests that the effectiveness of any NPI alone is probably limited, thus, a combination of various actions, for example, social distancing, isolation, and quarantine, distancing in the workplace and use of personal protective equipment, is more effective in reducing COVID-19

Global burden of 369 diseases and injuries in 204 countries and territories, 1990–2019: a systematic analysis for the Global Burden of Disease Study 2019

Background: In an era of shifting global agendas and expanded emphasis on non-communicable diseases and injuries along with communicable diseases, sound evidence on trends by cause at the national level is essential. The Global Burden of Diseases, Injuries, and Risk Factors Study (GBD) provides a systematic scientific assessment of published, publicly available, and contributed data on incidence, prevalence, and mortality for a mutually exclusive and collectively exhaustive list of diseases and injuries. Methods: GBD estimates incidence, prevalence, mortality, years of life lost (YLLs), years lived with disability (YLDs), and disability-adjusted life-years (DALYs) due to 369 diseases and injuries, for two sexes, and for 204 countries and territories. Input data were extracted from censuses, household surveys, civil registration and vital statistics, disease registries, health service use, air pollution monitors, satellite imaging, disease notifications, and other sources. Cause-specific death rates and cause fractions were calculated using the Cause of Death Ensemble model and spatiotemporal Gaussian process regression. Cause-specific deaths were adjusted to match the total all-cause deaths calculated as part of the GBD population, fertility, and mortality estimates. Deaths were multiplied by standard life expectancy at each age to calculate YLLs. A Bayesian meta-regression modelling tool, DisMod-MR 2.1, was used to ensure consistency between incidence, prevalence, remission, excess mortality, and cause-specific mortality for most causes. Prevalence estimates were multiplied by disability weights for mutually exclusive sequelae of diseases and injuries to calculate YLDs. We considered results in the context of the Socio-demographic Index (SDI), a composite indicator of income per capita, years of schooling, and fertility rate in females younger than 25 years. Uncertainty intervals (UIs) were generated for every metric using the 25th and 975th ordered 1000 draw values of the posterior distribution. Findings: Global health has steadily improved over the past 30 years as measured by age-standardised DALY rates. After taking into account population growth and ageing, the absolute number of DALYs has remained stable. Since 2010, the pace of decline in global age-standardised DALY rates has accelerated in age groups younger than 50 years compared with the 1990–2010 time period, with the greatest annualised rate of decline occurring in the 0–9-year age group. Six infectious diseases were among the top ten causes of DALYs in children younger than 10 years in 2019: lower respiratory infections (ranked second), diarrhoeal diseases (third), malaria (fifth), meningitis (sixth), whooping cough (ninth), and sexually transmitted infections (which, in this age group, is fully accounted for by congenital syphilis; ranked tenth). In adolescents aged 10–24 years, three injury causes were among the top causes of DALYs: road injuries (ranked first), self-harm (third), and interpersonal violence (fifth). Five of the causes that were in the top ten for ages 10–24 years were also in the top ten in the 25–49-year age group: road injuries (ranked first), HIV/AIDS (second), low back pain (fourth), headache disorders (fifth), and depressive disorders (sixth). In 2019, ischaemic heart disease and stroke were the top-ranked causes of DALYs in both the 50–74-year and 75-years-and-older age groups. Since 1990, there has been a marked shift towards a greater proportion of burden due to YLDs from non-communicable diseases and injuries. In 2019, there were 11 countries where non-communicable disease and injury YLDs constituted more than half of all disease burden. Decreases in age-standardised DALY rates have accelerated over the past decade in countries at the lower end of the SDI range, while improvements have started to stagnate or even reverse in countries with higher SDI. Interpretation: As disability becomes an increasingly large component of disease burden and a larger component of health expenditure, greater research and developm nt investment is needed to identify new, more effective intervention strategies. With a rapidly ageing global population, the demands on health services to deal with disabling outcomes, which increase with age, will require policy makers to anticipate these changes. The mix of universal and more geographically specific influences on health reinforces the need for regular reporting on population health in detail and by underlying cause to help decision makers to identify success stories of disease control to emulate, as well as opportunities to improve. Funding: Bill & Melinda Gates Foundation. © 2020 The Author(s). Published by Elsevier Ltd. This is an Open Access article under the CC BY 4.0 licens

Global age-sex-specific fertility, mortality, healthy life expectancy (HALE), and population estimates in 204 countries and territories, 1950-2019 : a comprehensive demographic analysis for the Global Burden of Disease Study 2019

Background: Accurate and up-to-date assessment of demographic metrics is crucial for understanding a wide range of social, economic, and public health issues that affect populations worldwide. The Global Burden of Diseases, Injuries, and Risk Factors Study (GBD) 2019 produced updated and comprehensive demographic assessments of the key indicators of fertility, mortality, migration, and population for 204 countries and territories and selected subnational locations from 1950 to 2019. Methods: 8078 country-years of vital registration and sample registration data, 938 surveys, 349 censuses, and 238 other sources were identified and used to estimate age-specific fertility. Spatiotemporal Gaussian process regression (ST-GPR) was used to generate age-specific fertility rates for 5-year age groups between ages 15 and 49 years. With extensions to age groups 10–14 and 50–54 years, the total fertility rate (TFR) was then aggregated using the estimated age-specific fertility between ages 10 and 54 years. 7417 sources were used for under-5 mortality estimation and 7355 for adult mortality. ST-GPR was used to synthesise data sources after correction for known biases. Adult mortality was measured as the probability of death between ages 15 and 60 years based on vital registration, sample registration, and sibling histories, and was also estimated using ST-GPR. HIV-free life tables were then estimated using estimates of under-5 and adult mortality rates using a relational model life table system created for GBD, which closely tracks observed age-specific mortality rates from complete vital registration when available. Independent estimates of HIV-specific mortality generated by an epidemiological analysis of HIV prevalence surveys and antenatal clinic serosurveillance and other sources were incorporated into the estimates in countries with large epidemics. Annual and single-year age estimates of net migration and population for each country and territory were generated using a Bayesian hierarchical cohort component model that analysed estimated age-specific fertility and mortality rates along with 1250 censuses and 747 population registry years. We classified location-years into seven categories on the basis of the natural rate of increase in population (calculated by subtracting the crude death rate from the crude birth rate) and the net migration rate. We computed healthy life expectancy (HALE) using years lived with disability (YLDs) per capita, life tables, and standard demographic methods. Uncertainty was propagated throughout the demographic estimation process, including fertility, mortality, and population, with 1000 draw-level estimates produced for each metric. Findings: The global TFR decreased from 2·72 (95% uncertainty interval [UI] 2·66–2·79) in 2000 to 2·31 (2·17–2·46) in 2019. Global annual livebirths increased from 134·5 million (131·5–137·8) in 2000 to a peak of 139·6 million (133·0–146·9) in 2016. Global livebirths then declined to 135·3 million (127·2–144·1) in 2019. Of the 204 countries and territories included in this study, in 2019, 102 had a TFR lower than 2·1, which is considered a good approximation of replacement-level fertility. All countries in sub-Saharan Africa had TFRs above replacement level in 2019 and accounted for 27·1% (95% UI 26·4–27·8) of global livebirths. Global life expectancy at birth increased from 67·2 years (95% UI 66·8–67·6) in 2000 to 73·5 years (72·8–74·3) in 2019. The total number of deaths increased from 50·7 million (49·5–51·9) in 2000 to 56·5 million (53·7–59·2) in 2019. Under-5 deaths declined from 9·6 million (9·1–10·3) in 2000 to 5·0 million (4·3–6·0) in 2019. Global population increased by 25·7%, from 6·2 billion (6·0–6·3) in 2000 to 7·7 billion (7·5–8·0) in 2019. In 2019, 34 countries had negative natural rates of increase; in 17 of these, the population declined because immigration was not sufficient to counteract the negative rate of decline. Globally, HALE increased from 58·6 years (56·1–60·8) in 2000 to 63·5 years (60·8–66·1) in 2019. HALE increased in 202 of 204 countries and territories between 2000 and 2019

Variation in the rate of land subsidence induced by groundwater extraction and its effect on the response pattern of soil microbial communities

Excessive extraction of groundwater leads to (irreversible) changes in the physical soil properties, causing land subsidence associated with soil compaction to occur. Using a combined image processing and field approach, we examined: (1) how variation in the land subsidence rate induces different soil compaction degrees; and (2) the response patterns of microbial communities to such variations. By using Sentinel Synthetic Aperture Radar image processing, we selected three locations that exhibited different land subsidence rates, including high (HSR), moderate (MSR), and low (LSR). Then, soil sampling was undertaken within these representative locations. Indicators of soil compaction, including total porosity, air-filled porosity, water-filled porosity, and bulk density, were measured. The soil microbial community was determined using qPCR and sequencing. The highest and lowest values for bulk density were observed in the HSR–MSR and LSR zones, respectively. The greatest values of total porosity and macropore volume were displayed in the LSR zone compared to other zones. Bacterial abundance in the LSR zone was significantly greater than that in the HSR and MSR zones. The relative abundances of bacterial taxa indirectly demonstrated that the anaerobic phyla were significantly increased (by 10–13%), and the aerobic phyla decreased (by 30–40%) in the HSR zone compared to the LSR zone. This result demonstrates that the aerobes declined as larger volumes of the soil became more anaerobic. Indeed, the increased abundance of anaerobes was not able to compensate for the larger decrease in the abundance of aerobes. Our work showed that at the increased rates of land subsidence, the abundance distribution of the microbial community critically declined. These findings highlight the critical impacts of increasing the land subsidence rate on the emergence of high soil compaction degrees, which can significantly affect the resilience thresholds of the microbial communities in dryland soils

Interactions of soil quality, ages of alluvial fans, and mechanisms controlling total soil organic carbon dynamics

So far, no studies have tested how alluvial fan aging and associated geomorphological differences can affect the mechanisms that control soil organic carbon (SOC) dynamics. In order to understand the SOC dynamics, we quantified the relationship between soil quality (SQ) indicators and alluvial fans aging over area of about 10,000 km2 in north-eastern Iran, using a minimum data set (MDS) and regression analyses. Twenty seven soil attributes and weathering indices were measured at 90 old and young fans. Total SOC and its fractions were found as the key indicators of the MDS. Despite the higher content of SOC in younger fans (6.25 – 7.11 g kg−1), they exhibited a lower value of SQ (0.35 – 0.42). Younger fans had a low content of fine-sized pedogenic oxides, and, thus, a lower sorption potential, giving rise to a lower ability for stabilising SOC. The higher content of SOC in younger fans was due to an accumulation of coarse particulate organic carbon. Long-term exposure of the older surfaces to weathering caused a statistically significant increase in the chemical index of alteration (57.94 – 72.32 %), chemical index of weathering (64.3 – 77.2 %), the carbon size fraction 53 – 250 µm (2.66 – 5.56 g kg−1), the dithionite-extractable Al (48.4 – 59.2 g kg−1) and Fe (21.5 – 25.7 g kg−1) oxalate-extractable Al (25.6 – 32.7 g kg−1) and Fe (9.5 – 13.0 g kg−1). These characteristics promote physical protection of SOC against microbial decomposition. Alluvial fan aging leads to geomorphological differences in terms of the weathering degree, processes of flooding, inundation, and erosion, contributing to high variability of the SOC dynamics. A proper understanding of the relationships between the age evolution of landforms and associated variations in mechanism regulating the preservation and stability of soil C can help to develop new perspectives for geo-conservation and restoration efforts

Examining the presentation of the model of promoting the interaction between school and family in the prevention of social misbehavior of adolescents (from the point of view of teachers and principals of schools in Tehran)

Background and purpose: School factors such as its staff, which include teachers, administrators, supervisors, educational coaches, office managers and even servants, etc. in the school, can leave an impact on children and teenagers; Therefore, the purpose of this research is to investigate and present the model of improving the interaction between school and family in preventing the misbehavior of social teenagers (from the point of view of teachers and administrators of schools in Tehran). Research method: the current research is applied in terms of purpose and descriptive-survey in terms of the nature and method of collecting information; And it is specifically based on structural equation modeling. The research data has been used using a questionnaire made by the researcher. The statistical population of the research is all principals and teachers of secondary schools in Panj city of Tehran. Cochran's formula was used to determine the sample size. According to the statistical population and according to Cochran's formula, 346 people were selected as a sample. The sampling method was a one-stage cluster random method and simple random. Findings: The results showed that in order to explain the data and check the fit of the model, the value of R2 for endogenous latent variables, as well as the variability value of the indicators of an endogenous structure, was used from the red criterion, and the obtained value was equal to 0.450. To fit the overall model, the GoF criterion method was used, the value obtained was equal to 0.57, which shows the strong fit of the model. Conclusion: The results showed that when parents participate in their child's education, the students' attitudes, behaviors and academic status are strengthened and it makes teenagers stay away from abnormal social behaviors. According to these results, it is suggested to the education organization to allocate enough funds and resources for the activities of teenagers in the school and try to help in the interaction of families and teenagers with the school by creating additional classes and a good educational environment.

The synergistic effect of obesity and dyslipidemia on hypertension: results from the STEPS survey

Abstract Background Obesity and dyslipidemia are important risk factors for hypertension (HTN). When these two conditions coexist, they may interact in a synergistic manner and increase the risk of developing HTN and its associated complications. The aim of this study was to investigate the synergistic effect of general and central obesity with dyslipidemia on the risk of HTN. Method Data from 40,387 individuals aged 25 to 64 years were obtained from a repeated cross-sectional study examining risk factors for non-communicable diseases (STEPS) in 2007, 2011 and 2016. Body mass index (BMI) was calculated as a measure of general obesity and waist circumference (WC) as a measure of central obesity. Dyslipidemia was defined as the presence of at least one of the lipid abnormalities. Hypertension was defined as systolic blood pressure ≥ 140 mmHg or diastolic blood pressure ≥ 90 mmHg or current use of antihypertensive medication. To analyze the synergistic effect between obesity and dyslipidemia and HTN, the relative excess risk due to interaction (RERI), attributable proportion due to interaction (AP), and synergy index (SI) were calculated. A weighted logistic regression model was performed to estimate the odds ratios (ORs) for the risk of HTN. Results The results showed an association between obesity, dyslipidemia and hypertension. The interaction between obesity and dyslipidemia significantly influences the risk of hypertension. In hypertensive patients, the presence of general obesity increased from 14.55% without dyslipidemia to 64.36% with dyslipidemia, while central obesity increased from 13.27 to 58.88%. This interaction is quantified by RERI and AP values of 0.15 and 0.06 for general obesity and 0.24 and 0.09 for central obesity, respectively. The corresponding SI of 1.11 and 1.16 indicate a synergistic effect. The OR also show that the risk of hypertension is increased in the presence of obesity and dyslipidemia. Conclusion Obesity and dyslipidemia are risk factors for HTN. In addition, dyslipidemia with central obesity increases the risk of HTN and has a synergistic interaction effect on HTN. Therefore, the coexistence of obesity and lipid abnormalities has many clinical implications and should be appropriately monitored and evaluated in the management of HTN

Evaluation of the therapeutic effects of Aloe vera gel on minor recurrent aphthous stomatitis

Background: Aphthous ulcer is one of the most common diseases of the oral cavity with no known effective treatment so far, which could cause severe discomfort in patients. Aloe vera (A.V.) is a tropical plant with anti-inflammatory and immunostimulant effects, which could be of benefit in a diversity of wound healing conditions. The aim of this study is to evaluate topically administered A.V. gel on oral cavity minor aphthous healing. Materials and Methods: As a double-blind (case control) clinical trial, 40 patients with oral minor aphthous lesions were randomly allocated in either the case group (A.V. gel) or the control (placebo) group. The healing time (days after gel application), patient′s pain score; the lesion and its surrounding inflammation diameters were recorded for 2 weeks. The obtained results were analyzed by either "Fishers exact" or t-student test using SPSS software. Results : The mean (±SD) of patients′ age was 29.25 ± 8.48 and 27.95 ± 7.96 years in the control and A.V.-treated groups, respectively, which were not significantly different (P > 0.05). The duration of complete wound healing, pain score, wound size and inflammation zone diameter in the A.V.-treated group were significantly lower than the control group (P ≤ 0.05) on specific time points after treatment. Conclusion: It seems likely that A.V. 2% oral gel is not only effective in decreasing the recurrent aphthous stomatitis patients′ pain score and wound size but also decreases the aphthous wound healing period