145 research outputs found

    Evaluation of Artificial Neural Network for determining distribution pattern of ascid family (Acari: Mesostigmata) in Damghan

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    In this study, the artificial neural network methods were used to estimate the distribution of ascid family (Acari: Mesostigmata). For this aim, latitude, longitude and elevation from the sea level of 137 points were defined as inputs and output of method was number of species of this family on those points and Perceptron with propagation algorithm was evaluated in artificial neural network method. To evaluate the ability of neural networks used to predict dispersion, statistical comparison of parameters such as variance, statistical distribution and mean of spatial predicted values by neural network and their actual values were used. The results showed that there was no significant difference (p> 0.4) in the training and test phases between the values of the statistical characteristics of variance, the statistical distribution and the mean of real and predicted spatial data of this family by the neural network. It can be concluded that the artificial neural network method was able to predict the dispersion of this family with proper precision by integrating three factors of latitude and longitude and elevation from the sea level. ;font-family:"Times New Roman","serif"; mso-bidi-font-family:"B Lotus";mso-bidi-language:FA'>p> 0.4). در مجموع می­توان چنین نتیجه گرفت که روش شبکه عصبی مصنوعی با تلفیق سه عامل طول و عرض جغرافیایی و ارتفاع از سطح دریا، قادر به پیش­بینی پراکندگی این خانواده با دقت مناسب بود

    Financing of physical rehabilitation services in Iran: A stakeholder and social network analysis

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    Background: Inadequate financing is one of the major barriers in securing equitable access to high-quality physical rehabilitation services, without imposing financial hardship. Despite this, no sufficient attention has been paid to physical rehabilitation services and no specific financial resources have been allocated to such services in many countries including Iran. Owing to the fact that effective decision- and policy-making requires identifying possible stakeholders and actors and their characteristics, in the current study a stakeholder analysis and also a social network analysis (SNA) was conducted to identify the potential stakeholders and also their characteristics involved in physical rehabilitation financing (PRF)-related policies in Iran. Methods: The present study was performed in two phases. Firstly, semi-structured interviews and relevant document review were conducted to identify the stakeholders. Then, the position, power, interest, and influence of each stakeholder were determined using a web-based questionnaire. Secondly, SNA approach was utilized to map and visualize the interactions among stakeholders. Results: The findings showed that there are different stakeholders in PRF-related decision- and policy-making processes in Iran. In addition, the position, power, interest, and influence level of the identified stakeholders were varied. Moreover, although some stakeholders, like the Ministry of Health and the parliament have the highest level of power and position, they lack sufficient interest to participate in PRF-policies. Furthermore, SNA demonstrated that social network density was low, which indicates the lack of proper collaboration and interaction among the stakeholders. Conclusion: As many powerful and influential stakeholders had low interest levels to warrant participate in the FPR-related decision- and policy-making processes in Iran, employing careful and effective strategies, that is ongoing negotiations, receiving advocacy, and making senior managers and policy-makers aware can be helpful. © 2020 The Author(s)

    Physical rehabilitation financing in Iran: a policy analysis using Kingdon�s multiple streams

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    Background: Adequate financing is a crucial function, securing that physical rehabilitation services (i.e., physiotherapy, occupational therapy, prosthetics and orthotics) are available with no financial hardship. Like many other countries, despite the adoption of various policies and strategies in recent decades, Iran enjoys no desirable physical rehabilitation financing (PRF). Accordingly, this qualitative study aimed to explore the PRF-related strategies and issues as well as their impacts on relevant policies in Iran. Methods: An analysis of PRF-related policies was conducted in Iran using semi-structured interviews and policy documents review. Purposive and snowball sampling techniques were employed to select key informants, including health-policy makers, civil society, rehabilitation-policy makers, university professors, and practitioners. Thematic analysis was used to analyze the collected data. The analysis was framed within Kingdon�s multiple streams. Results: The hindering factors for desirable financing were weak insurance coverage, lack of sustainable financial resources, fragmented financing, lack of split between provider and financer, high-cost of physical rehabilitation services, low engagement of relevant experts in policy-making processes, and corrupt activities. In the policy stream, the following factors were highlighted: involvement of sustainable financial resources, the use of external revenue sources, allocated resources� earmarking, the integration of the current funds to have better pooling, the use of incentive and timely payment mechanisms, the implementation of strategic purchasing principals, and the employment of effective rationing strategies. Moreover, parliament support, changes in administrations, international effects, pressures from interest campaigns and NGOs, and international sanctions were found as factors affecting the politics stream. Conclusion: The study findings revealed that a variety of national and international factors affect PRF-related issues in Iran. The recently enacted laws indicate that the PRF policies have already been on the national health political agenda. The study reflected the multifaceted nature of barriers to optimal PRF in Iran. © 2021, The Author(s)

    Physical rehabilitation in Iran after international sanctions: Explored findings from a qualitative study

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    Background: Although the main aims of sanctions are the political and economic pressures on governments, literature has demonstrated the harsh effects of sanctions on the general public, especially on the patients, poor and disabled people. Since the international sanctions regime negatively affected almost all dimensions of Iran's health sector, this qualitative study was conducted to investigate the situation of the physical rehabilitation sector after these sanctions. Methods: This qualitative study was conducted from January 2019 to June 2019 in Iran using Skype, telephone, and face-to-face in-depth semi-structured interviews. Purposive and snowball sampling approaches were used to identify the participants. Also, framework analysis approach was applied to analyze the collected data. Results: In total, 38 individuals including health policy-maker, faculty member, rehabilitation expert, Physiotherapist, Occupational therapist, and Orthotist/Prosthetist, were involved in the study. Based on our findings, a number of challenges facing the Iranian physical rehabilitation sector during the international sanctions period included: 1) socioeconomic challenges (inadequate funding, rising inflation rate, high unemployment rate, catastrophic expenditures, and inappropriate employment status of practitioners); 2) education challenges (decreased international collaboration and shortage of training devices and materials); 3) international challenges (rising issues in accessing services for patients from neighborhood countries); and 4) service delivery challenges (shortage of raw materials for producing the orthoses and prostheses, hardening of the importing the needed equipment, inappropriate infrastructures, and impossibility to use external assistance). Conclusion: After international sanctions, the Iranian physical rehabilitation sector has faced considerable multifaceted challenges. Therefore, the international community must be aware of the situation and be concerned about the irreparable consequences. © 2020 The Author(s)

    Therapeutic potentials of curcumin in the treatment of glioblstoma

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    Glioblastoma multiforme (GBM), a greatly aggressive malignancy of the brain, is correlated with a poor prognosis and low rate of survival. Up to now, chemotherapy and radiation therapy after surgical approaches have been the treatments increasing the survival rates. The low efficacy of mentioned therapies as well as their side-effects has forced researchers to explore an appropriate alternative or complementary treatment for glioblastoma. In experimental models, it has been shown that curcumin has therapeutic potentials to fight against GBM. Given that curcumin has pharmacological effects against cancer stem cells, as major causes of resistance to therapy in glioblastoma cells. Moreover, it has been showed that curcumin exerts its therapeutic effects on GBM cells via affecting on apoptosis, oxidant system, and inflammatory pathways. Curcumin would possess a synergistic impact with chemotherapeutic agents. Herein, we summarized the current findings on curcumin as therapeutic agent in the treatment of GBM. © 2020 Elsevier Masson SA

    Quercetin and cancer: New insights into its therapeutic effects on ovarian cancer cells

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    Ovarian cancer is known as a serious malignancy that affects women's reproductive tract and can considerably threat their health. A wide range of molecular mechanisms and genetic modifications have been involved in ovarian cancer pathogenesis making it difficult to develop effective therapeutic platforms. Hence, discovery and developing new therapeutic approaches are required. Medicinal plants, as a new source of drugs, could potentially be used alone or in combination with other medicines in the treatment of various cancers such as ovarian cancer. Among various natural compounds, quercetin has shown great anti-cancer and anti-inflammatory properties. In vitro and in vivo experiments have revealed that quercetin possesses a cytotoxic impact on ovarian cancer cells. Despite obtaining good results both in vitro and in vivo, few clinical studies have assessed the anti-cancer effects of quercetin particularly in the ovarian cancer. Therefore, it seems that further clinical studies may introduce quercetin as therapeutic agent alone or in combination with other chemotherapy drugs to the clinical setting. Here, we not only summarize the anti-cancer effects of quercetin but also highlight the therapeutic effects of quercetin in the ovarian cancer. © 2020 The Author(s)

    Association between PM2.5 and risk of hospitalization for myocardial infarction: A systematic review and a meta-analysis

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    Background: It is generally assumed that there have been mixed results in the literature regarding the association between ambient particulate matter (PM) and myocardial infarction (MI). The aim of this meta-analysis was to explore the rate of short-term exposure PM with aerodynamic diameters �2.5 μm (PM2.5) and examine its potential effect(s) on the risk of MI. Methods: A systematic search was conducted on databases like PubMed, Scopus, Web of Science, and Embase with components: "air pollution" and "myocardial infarction". The summary relative risk (RR) and 95 confidence intervals (95CI) were also calculated to assess the association between the PM2.5 and MI. Results: Twenty-six published studies were ultimately identified as eligible candidates for the meta-analysis of MI until Jun 1, 2018. The results illustrated that a 10-μg/m 3 increase in PM2.5 was associated with the risk of MI (RR = 1.02; 95 CI 1.01-1.03; P � 0.0001). The heterogeneity of the studies was assessed through a random-effects model with p < 0.0001 and the I2 was 69.52, indicating a moderate degree of heterogeneity. We also conducted subgroup analyses including study quality, study design, and study period. Accordingly, it was found that subgroups time series study design and high study period could substantially decrease heterogeneity (I2 = 41.61, 41.78). Conclusions: This meta-analysis indicated that exposure-response between PM2.5 and MI. It is vital decision makers implement effective strategies to help improve air pollution, especially in developing countries or prevent exposure to PM2.5 to protect human health. © 2020 The Author(s)

    Exploring Interventions to Improve the Oral Health and Related Health Behaviours of Adults Experiencing Severe and Multiple Disadvantage: Protocol for a Qualitative Study with Stakeholders

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    The number of individuals in England experiencing homelessness, substance use, and involvement with the criminal justice system is increasing. These issues, referred to as severe and multiple disadvantage (SMD), are often interlinked and co-occur. Health inequalities, particularly poor oral health, persist for those facing these inter-related issues and are closely linked with high levels of substance use, smoking, and poor diet. However, evidence for interventions that can improve these health outcomes for those experiencing these issues is limited. This paper outlines the design of a qualitative study which aims to explore the perspectives of stakeholders to understand what interventions can help to support SMD groups with their oral health and related health behaviours (i.e., substance use, smoking, diet). Interviews and focus groups will be undertaken with stakeholders comprising two groups: (1) individuals with experience of SMD, and (2) service providers (staff and volunteers), policy makers, and commissioners who support such individuals. Public involvement and engagement is central to the project. For example, stakeholders and research partners in policy and practice and people with lived experience of SMD will provide input at all stages of this study. Findings from the study will inform an ‘evidence for practice’ briefing outlining recommendations for policy. Dissemination will occur through presentations to a range of practice, policy and academic beneficiaries, and through peer-reviewed publications

    Primary trabeculectomy versus primary glaucoma eye drops for newly diagnosed advanced glaucoma:TAGS RCT

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    Funding Information: Declared competing interests of authors: Anthony J King declares receiving honoraria payments from Thea Pharmaceutical (Keele, UK) and Allergan Pharmaceutical (Dublin, Ireland) for speaking at educational meetings. Augusto Azuara-Blanco declares membership of the National Institute for Health Research (NIHR) Health Technology Assessment (HTA) Prioritisation Committee B (2020–present). Jennifer Burr declares membership of the NIHR HTA Clinical Evaluations and Trials Committee (2010–14). David Garway-Heath reports grants from NIHR for the HTA programme 12/35/38 during the conduct of the study; personal fees from Aerie Pharmaceuticals (Bedminster, NJ, USA), Allergan Pharmaceuticals, Bausch & Lomb (Rochester, NY, USA), Omikron (Beirut, Lebanon) and OptoVue (Fremont, CA, USA); personal fees and non-financial support from Carl Zeiss Meditec (Jena, Germany) and CenterVue (Padova, Italy); grants from Pfizer Inc. (New York, NY, USA) and Alcon Research Institute (Geneva, Switzerland); grants and personal fees from Santen Pharmaceutical (Osaka, Japan); and research equipment from Heidelberg Engineering (Heidelberg, Germany) and Topcon (Tokyo, Japan) outside the submitted work. David Garway-Heath also declared membership of the NIHR HTA Clinical Evaluations and Trials Committee (2014–17). John Norrie reports grants from University of Aberdeen and University of Edinburgh during the conduct of the study; and reports being a past and present member of the following: HTA Commissioning Sub-Board (EOI), NIHR Clinical Trials Unit Standing Advisory Committee, NIHR HTA and Efficacy and Mechanism Evaluation (EME) Editorial Board, Pre-Exposure Prophylaxis Impact Review Panel, EME Strategy Advisory Committee, EME Funding Committee Members, EME Funding Committee Sub-Group Remit and Comp Check, HTA General Committee, HTA Funding Committee Policy Group (formerly CSG) and the HTA Commissioning Committee. John Norrie also reports the HTA Post-funding Committee Teleconference (2016–19) and Covid Reviewing 2020. Luke Vale reports grants from NIHR HTA programme 12/35/38 during the conduct of the study. Luke Vale was also a member of the NIHR HTA Clinical Trials and Evaluation Panel from 2014 to 2018. John M Sparrow reports grants from NIHR HTA programme 12/35/38 during the conduct of the study, and was the previous chairperson of the National Institute for Health and Care Excellence Glaucoma Guideline Committee guideline published in 2017. Keith Barton reports personal fees from Allergan Pharmaceuticals, Alcon Pharmaceuticals, Laboratoires Thea (Clermont-Ferrand, France), EyeTechCare (Rillieux-la-Pape, France), Glaukos (San Clemente, CA, USA), Kowa Pharmaceuticals (Montgomery, AL, USA), Ivantis Inc. (Irvine, CA, USA), pH Pharma (South San Francisco, CA, USA), iStar Medical (Wavre, Belgium), Radiance Therapeutics (Tucson, AZ, USA) and EyeD Pharma (Liège, Belgium), grants from Allergan and Laboratoires Thea, stock from Vision Medical Events Ltd (London, UK), International Glaucoma Surgery Registry (London, UK) and MedEther Ophthalmology (London, UK), and a patent from Advanced Ophthalmic Implants outside the submitted work. This project was funded by the National Institute for Health Research (NIHR) Health Technology Assessment programme and will be published in full in Health Technology Assessment; Vol. 25, No. 72. See the NIHR Journals Library website for further project information. The research reported in this issue of the journal was funded by the HTA programme as project number 12/35/38. The contractual start date was in January 2014. The draft report began editorial review in February 2020 and was accepted for publication in December 2020. The authors have been wholly responsible for all data collection, analysis and interpretation, and for writing up their work. The HTA editors and publisher have tried to ensure the accuracy of the authors’ report and would like to thank the reviewers for their constructive comments on the draft document. However, they do not accept liability for damages or losses arising from material published in this report.Peer reviewedPublisher PD
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