Isolated tricuspid stenosis in a patient with history of scleroderma

Isolated tricuspid stenosis (TS) is a very uncommon finding. There are some reports of isolated TS in the setting of systemic lupus erythematous, but its presence in scleroderma has never been reported before. We report a 48-year- old female with isolated TS with a background of scleroderma, diagnosed by echocardiography

The global burden of cancer attributable to risk factors, 2010–19: a systematic analysis for the Global Burden of Disease Study 2019

BACKGROUND: Understanding the magnitude of cancer burden attributable to potentially modifiable risk factors is crucial for development of effective prevention and mitigation strategies. We analysed results from the Global Burden of Diseases, Injuries, and Risk Factors Study (GBD) 2019 to inform cancer control planning efforts globally. METHODS: The GBD 2019 comparative risk assessment framework was used to estimate cancer burden attributable to behavioural, environmental and occupational, and metabolic risk factors. A total of 82 risk–outcome pairs were included on the basis of the World Cancer Research Fund criteria. Estimated cancer deaths and disability-adjusted life-years (DALYs) in 2019 and change in these measures between 2010 and 2019 are presented. FINDINGS: Globally, in 2019, the risk factors included in this analysis accounted for 4·45 million (95% uncertainty interval 4·01–4·94) deaths and 105 million (95·0–116) DALYs for both sexes combined, representing 44·4% (41·3–48·4) of all cancer deaths and 42·0% (39·1–45·6) of all DALYs. There were 2·88 million (2·60–3·18) risk-attributable cancer deaths in males (50·6% [47·8–54·1] of all male cancer deaths) and 1·58 million (1·36–1·84) risk-attributable cancer deaths in females (36·3% [32·5–41·3] of all female cancer deaths). The leading risk factors at the most detailed level globally for risk-attributable cancer deaths and DALYs in 2019 for both sexes combined were smoking, followed by alcohol use and high BMI. Risk-attributable cancer burden varied by world region and Socio-demographic Index (SDI), with smoking, unsafe sex, and alcohol use being the three leading risk factors for risk-attributable cancer DALYs in low SDI locations in 2019, whereas DALYs in high SDI locations mirrored the top three global risk factor rankings. From 2010 to 2019, global risk-attributable cancer deaths increased by 20·4% (12·6–28·4) and DALYs by 16·8% (8·8–25·0), with the greatest percentage increase in metabolic risks (34·7% [27·9–42·8] and 33·3% [25·8–42·0]). INTERPRETATION: The leading risk factors contributing to global cancer burden in 2019 were behavioural, whereas metabolic risk factors saw the largest increases between 2010 and 2019. Reducing exposure to these modifiable risk factors would decrease cancer mortality and DALY rates worldwide, and policies should be tailored appropriately to local cancer risk factor burden

Assessment of prioritizing the effective factors on human resources effectiveness (Case study: Tehran Industrial Parks Organization)

Identifying the effective factors on human resources effectiveness can help management and leadership to obtain success, organization goals and fulfillment of high effectiveness and efficiency. Thus, they always have to survey the effective factors on effectiveness of these valuable and transformational resources. Effective factors on employee effectiveness have different aspects and varieties. For instance, Hay Group® model which is in order to compare organizations based on employee effectiveness. The model includes different factors located in two groups of ENGAGEMENT and ENABLEMENT. The main purpose of this study is to assess and prioritize effective factors on employee effectiveness in Tehran Industrial Parks. Furthermore, it is required to be surveyed and determined according to organizational properties and content dimensions of under study organization, and use of latent knowledge amongst organization experts (senior managers). This cross-sectional and descriptive- analytical research was performed in 2017. So, it is trying to achieve the purposes of study through interview, Delphi method, Multiple Criteria Decision-Making (MCDM) and Analytical Hierarchy Process (AHP). Keywords: Human Resources Management, Hay Group®, Effectiveness, Engagement, Enablemen

Colorectal cancer nutritional risk factors: A population based case-control study

Background: Colorectal cancer (CRC) is the third common malignancy all over the world. Modern life styles affecting nutritional habits have been providing a potential impact on CRC. This study aims to assess the nutritional characteristics in CRC patients of Golestan province, Northeast of Iran. Methods: All incident CRC cases (N=47) in northeast of Iran (2004-2005) and a matched number of healthy persons were selected as cases and controls respectively. The subjects filled the Questionnaires containing socio-demographic and nutritional characteristics (FFQ). Results: Data analysis showed that Total Energy Expenditure (TEE) higher than 1837.5 Kcal/ day (first quartile of TEE) was significantly related to CRC risk (OR= 3.8; 95% Cl:l.2-ll.3); no other relationship was reported. Conclusions: Findings suggested that higher levels of total energy expenditure may increase the risk of CRC about 4-fold. We also found that there are relationships between CRC and high fat diets or cooking methods. Nutritional interventions should be considered as an important part in colorectal cancer prevention programs

The global burden of adolescent and young adult cancer in 2019: a systematic analysis for the Global Burden of Disease Study 2019

Background In estimating the global burden of cancer, adolescents and young adults with cancer are often overlooked, despite being a distinct subgroup with unique epidemiology, clinical care needs, and societal impact. Comprehensive estimates of the global cancer burden in adolescents and young adults (aged 15–39 years) are lacking. To address this gap, we analysed results from the Global Burden of Diseases, Injuries, and Risk Factors Study (GBD) 2019, with a focus on the outcome of disability-adjusted life-years (DALYs), to inform global cancer control measures in adolescents and young adults. Methods Using the GBD 2019 methodology, international mortality data were collected from vital registration systems, verbal autopsies, and population-based cancer registry inputs modelled with mortality-to-incidence ratios (MIRs). Incidence was computed with mortality estimates and corresponding MIRs. Prevalence estimates were calculated using modelled survival and multiplied by disability weights to obtain years lived with disability (YLDs). Years of life lost (YLLs) were calculated as age-specific cancer deaths multiplied by the standard life expectancy at the age of death. The main outcome was DALYs (the sum of YLLs and YLDs). Estimates were presented globally and by Socio-demographic Index (SDI) quintiles (countries ranked and divided into five equal SDI groups), and all estimates were presented with corresponding 95% uncertainty intervals (UIs). For this analysis, we used the age range of 15–39 years to define adolescents and young adults. Findings There were 1·19 million (95% UI 1·11–1·28) incident cancer cases and 396 000 (370 000–425 000) deaths due to cancer among people aged 15–39 years worldwide in 2019. The highest age-standardised incidence rates occurred in high SDI (59·6 [54·5–65·7] per 100 000 person-years) and high-middle SDI countries (53·2 [48·8–57·9] per 100 000 person-years), while the highest age-standardised mortality rates were in low-middle SDI (14·2 [12·9–15·6] per 100 000 person-years) and middle SDI (13·6 [12·6–14·8] per 100 000 person-years) countries. In 2019, adolescent and young adult cancers contributed 23·5 million (21·9–25·2) DALYs to the global burden of disease, of which 2·7% (1·9–3·6) came from YLDs and 97·3% (96·4–98·1) from YLLs. Cancer was the fourth leading cause of death and tenth leading cause of DALYs in adolescents and young adults globally. Interpretation Adolescent and young adult cancers contributed substantially to the overall adolescent and young adult disease burden globally in 2019. These results provide new insights into the distribution and magnitude of the adolescent and young adult cancer burden around the world. With notable differences observed across SDI settings, these estimates can inform global and country-level cancer control efforts