Construction data mining methods in the prediction of death in hemodialysis patients using support vector machine, neural network, logistic regression and decision tree

Objectives: Chronic kidney disease (CKD) is one of the main causes of morbidity and mortality worldwide. Detecting survival modifiable factors could help in prioritizing the clinical care and offers a treatment decision-making for hemodialysis patients. The aim of this study was to develop the best predictive model to explain the predictors of death in Hemodialysis patients by using data mining techniques. Methods: In this study, we used a dataset included records of 857 dialysis patients. Thirty-one potential risk factors, that might be associated with death in dialysis patients, were selected. The performances of four classifiers of support vector machine, neural network, logistic regression and decision tree were compared in terms of sensitivity, specificity, total accuracy, positive likelihood ratio and negative likelihood ratio. Results: The average total accuracy of all methods was over 61%; the greatest total accuracy belonged to logistic regression (0.71). Also, logistic regression produced the greatest specificity (0.72), sensitivity (0.69), positive likelihood ratio (2.48) and the lowest negative likelihood ratio (0.43). Conclusions: Logistic regression had the best performance in comparison to other methods for predicting death among hemodialysis patients. According to this model female gender, increasing age, addiction, low Iron level, C-reactive protein positive and low urea reduction ratio were the main predictors of death in hemodialysis patients

Angiogenic factors and the risk of preeclampsia: A systematic review and meta-analysis

Background: The etiological nature of preeclampsia is heterogeneous. The use of biomarkers indices in early pregnancy helps to have appropriate stratification of pregnancies into high- and low risk for the purpose of choosing timely interventions. Objective: The aim of this systematic review was to determine the pathogenic role of soluble soluble fms-like tyrosine kinase-1 (sFlt-1) and placental growth factor (PlGF) inthe prediction of preeclampsia in women. Materials and Methods: We performed a systematic search of the international databases including PubMed, Scopus, and Web of Science until August 2017. The quality of included studies was assessed using the Newcastle-Ottawa Scale. The primary outcome in this review was preeclampsia. The statistical heterogeneity was assessed using the X2 test and quantified by I2. Pooled effects size was obtained by random effects model. Subgroup  analyses were also carried out. Results: Totally, 284 records were identified in the initial search and 15 records were finally included in the meta-analysis. The pooled odds ratios (ORs) for the association between the high level of sFlt-1 and low level of PlGF and subsequent development of preeclampsia among women were 5.20 (95% CI: 1.24–9.16) and 2.53 (95% CI: 1.33–3.75), respectively. The mean difference for sFlt-1 and PlGF in women with preeclampsia compared to controls was 1.15 (95% CI: 0.43–1.86) and –0.94 (95% CI: –1.37–0.52),respectively. Conclusion: According to the results from this meta-analysis, increased levels of sFlt-1 and reduced levels of PlGF predict the subsequent development of preeclampsia. Key words: Angiogenic factors, Preeclampsia, sFLT-1, PlGF

The Incidence and Geographical Distribution of Brucellosis in Iran Using Geographic Information System and Prediction of its Incidence in 2021

Background: Brucellosis is one of the most challenging health issues in many developing countries including Iran. The purpose of this study is to investigate the incidence and geographical distribution of brucellosis using Geographic Information System (GIS) and to predict its incidence in Iran in 2021. Method: This is a descriptive-analytical cross-sectional study, which contains spatial and climatic information along with the prevalence rate of brucellosis in Iran. Disease information was obtained from the National Center for Infectious Diseases Management during 2011-2015. Then, Arc GIS version 9.3 was used to plot the geographical maps for the incidence and frequency of the disease. Using the Raster calculator tool, the disease prediction map for the future was plotted. For proper spatial distribution of hot and cold spots, Getis-Ord-Gi statistic was employed. Results: The highest incidence of brucellosis during 2009-2015 was observed in the western provinces of Iran (North Khorasan, South Khorasan and Razavi Khorasan provinces). The incidence of brucellosis in Iran decreased from 2009 to 2011 but it exhibited an increasing trend from 2011 to 2014. The provinces of Kurdistan, Lorestan, Ilam, Zanjan and Kermanshah may be among the hot spots in terms of brucellosis incidence in 2021. Conclusion: We predicted significant variations in brucellosis risk distribution in Iran in the coming years. In the western and northwestern provinces, which are among the high risk areas for the incidence of this disease in the future, this disease can pose a serious health threat to the residents of these areas

Health effects of air pollution in worldwide countries: an ecological study

Background and aims: Air pollution is one of the health problems worldwide. Previous epidemiological studies have investigated the impacts of air pollution on respiratory and cardiovascular diseases. The aim of this study was to determine the associations between air pollution levels and different health indicators among world countries. Methods: This ecological study was performed in 2013 by using dataset of World Health Organization (WHO). The main variable in our study was air pollution index. The data including Maternal Mortality Rate (MMR) (per 100000 live births), Life Expectancy at birth (LE), preterm birth rate (per 1000 live births) and Non-Communicable Diseases (NCD) death rate (per 100000 populations) from 91 countries were extracted. Pearson correlation coefficient was used to assess the linear correlation between air pollution and investigated indexes using Stata 11. Results: MMR (r=0.36, P=0.001) and NCD death rate (r=0.31, P=0.002) were positively associated with air pollution level. The rate of air pollution was also negatively associated with LE among world countries (r=-0.57, P=0.001). Our findings have not shown any significant liner association between air pollution and preterm birth rate (r=0.14, P=0.41). Conclusion: Our results are in agreement with other recent findings that there is an association between air pollution and health indexes, especially mortality rate. Accordingly, from a public health perspective, reducing pollutant emissions to outdoor air should be a high priority for all countries

5-year survival rates based on the type of leukemia in Iran, a Meta-analysis

Background: According to epidemiological studies, leukemia is among the five most common cancers in Iran. Keeping efforts to estimate survival is critical to monitoring and improving patients’ quality of life with leukemia. The purpose of this study was to evaluate the 5-year survival rate of leukemia patients in Iran using meta-analysis method. Methods: This meta-analysis was carried out according to studies that adhere to inclusion and exclusion criteria during enrolment. The valid Iranian databases included: Medex, Magiran, SID, and Medlib, along with international data bases, namely, Scopus, Pubmed, and ISI were searched to find relevant articles. After determining the heterogeneity between studies, the random effects models were used to estimate pooled survival in leukemia patients. Results: In total, 18 studies involving 2517 participants were included in this meta-analysis. The pooled 5-year survival rate was 0.56 % (95% CI, 0.54 to 0.58). According to types AML and ALL, the 5-year survival rates in Iran were 35.0 % (95% CI: 32.0-38.0) and 57.0 % (95% CI: 54.0-60.0), respectively. Conclusion: Based on our findings, slightly less than 50% of leukemia deaths happened in the first 5 years after diagnosis, which is lower than the global average

Epidemiological features of brucellosis and factors affecting its treatment failure and relapse in Qom Province, Iran

Background: Brucellosis is one of the major health problems in many areas of the world, especially in the Mediterranean and the Middle East regions.Objective: To determine the epidemiological characteristics, clinical signs, and risk factors of relapse rate in patients with brucellosis, Qom Province, Iran.Methods: A descriptive-analytic study was conducted on 410 confirmed brucellosis cases in Qom Province, central Iran, from 2015 to 2019, based on epidemiological checklists and according to the Iran Ministry of Health and Medical Education (MOHME). Univariate and multiple logistic regression analyses were conducted using Stata software version 14.Results: The relapse rate of brucellosis was 6.6% until nine months after s arting the treatment, and all recurrent cases were infected by Brucella melitensis. Based on univariate logistic regression analysis, the delayed treatment and type species of Brucella were significant factors affecting the relapse of brucellosis. The relapse rates were 5.4%, 6.2%, and 20.0% in patients whose delayed treatments were <50, 51-150, and >151days, respectively. Based on the multiple logistic regression, it was observed that delayed treatment >50 days increased the rate of relapse more than four times.Conclusion: The delayed initiation of treatment was a significant factor influencing the relapse of brucellosis; therefore, it is necessary to provide enough diagnostic and laboratory facilities, and people need to be educated about the signs and symptoms of the disease

Epidemiologic characteristics of injuries among 1-5 year-old children in Hamadan Province: Analysis of 4523 hospitalized children over a 6-year period

Background: Unintentional injuries are one of the major causes of death in Iranian children. Information on epidemiological pattern of injury among one-to 5-year-old children is limited in Hamadan. The aim of this study was to clarify the person, space and time pattern of injury among 1-5 year-old children in Hamadan Province. Methods: All registered incidence cases of injury among 1-5 year-old children in Hamadan Province from March 2009 to March 2015 were included in this cross-sectional study. We analyzed the data on county, gender, age category, type of injury, season and outcome of injury. Temporal trend was explored using time series regression with accounting autocorrelation, seasonality, and short-term variation. Results: This study included 4523 injury cases. During the studied period, urban residents and boys had a higher number of injuries. Motor vehicle-related injuries were the most common type of injury. A seasonality pattern was found so that most of the cases were occurred in summer months. The lowest and highest incidence rate ratios (IRRs) were occurred in January 2011 (IRR = 0.61 with 95 confidence interval CI: 0.31, 1.18) and May 2014 and August 2013 (IRR = 6.78 with 95% CI: 4.38, 10.51), respectively. Conclusion: In Hamadan Province, childhood injury has a variation in person, place, and time pattern, as some groups such as boys and urban residents among 1-5 year-old children are at a higher risk for the incidence of injury. Therefore, it is recommended that health service managers and health policymakers devote more healthcare and resources to the high-risk groups