Occupational Stressors Among Firefighters: Application of Multi-Criteria Decision Making (MCDM)Techniques

Background: Firefighters are exposed to a wide range of occupational stressors due to the nature of their job. Multicriteria decision-making technique (MCDM) is a method for identifying, evaluating, and preventing occupational stressors among firefighters. The purpose of this study was to identify and prioritize the occupational stressors among firefighters using the fuzzy delphi method (FDM) and fuzzy analytical hierarchy process (FAHP). Methods: This qualitative-descriptive study was carried out in two stages. First, the most important occupational stressors of firefighters were identified and screened using a systematic review of scientific references and expert opinions based on the FDM. Then, all of the screened stressors were weighted and prioritized by the FAHP using the opinions of experts. All results were analyzed using Excel software. Results: Among, the 52 occupational stressors of firefighters identified in the first stage, 27 stressors were selected to enter into the FAHP. The FAHP results showed that among the four main dimensions, the weight of managerial factors (0.358) was more than other dimensions. The overall result of the study, regardless of the stressors’ main dimensions showed that the most important stressors among firefighters were financial strain due to inadequate pay, fear of explosion at incident scenes, toxic smoke, and gases produced at fires and lack of attention given to job safety by management, respectively. Conclusion: According to the results of the study, most occupational stressors of the firefighters are caused by organizational factors. Therefore, the implementation of management strategies to reduce the occupational stress of firefighters is recommended

Association of the p53 Codon 72 Polymorphism with Colorectal Cancer in South West of Iran

Abstract—The p53 tumor suppressor gene plays two important roles in genomic stability: blocking cell proliferation after DNA damage until it has been repaired, and starting apoptosis if the damage is too critical. Codon 72 exon4 polymorphism (Arg72Pro) of the P53 gene has been implicated in cancer risk. Various studies have been done to investigate the status of p53 at codon 72 for arginine (Arg) and proline (Pro) alleles in different populations and also the association of this codon 72 polymorphism with various tumors. Our objective was to investigate the possible association between P53 Arg72Pro polymorphism and susceptibility to colorectal cancer among Isfahan and Chaharmahal Va Bakhtiari (a part of south west of Iran) population. We investigated the status of p53 at codon 72 for Arg/Arg, Arg/Pro and Pro/Pro allele polymorphisms in blood samples from 145 colorectal cancer patients and 140 controls by Nested-PCR of p53 exon 4 and digestion with BstUI restriction enzyme and the DNA fragments were then resolved by electrophoresis in 2% agarose gel. The Pro allele was 279 bp, while the Arg allele was restricted into two fragments of 160 and 119 bp. Among the 145 colorectal cancer cases 49 cases (33.79%) were homozygous for the Arg72 allele (Arg/Arg), 18 cases (12.41%) were homozygous for the Pro72 allele (Pro/Pro) and 78 cases (53.8%) found in heterozygous (Arg/Pro). In conclusion, it can be said that p53Arg/Arg genotype may be correlated with possible increased risk of this kind of cancers in south west of Ira

Defining microRNA signatures of hair follicular stem and progenitor cells in healthy and androgenic alopecia patients

[Background]: The exact pathogenic mechanism causes hair miniaturization during androgenic alopecia (AGA) has not been delineated. Recent evidence has shown a role for non-coding regulatory RNAs, such as microRNAs (miRNAs), in skin and hair disease. There is no reported information about the role of miRNAs in hair epithelial cells of AGA.[Objectives]: To investigate the roles of miRNAs affecting AGA in normal and patient’s epithelial hair cells.[Methods]: Normal follicular stem and progenitor cells, as well as follicular patient’s stem cells, were sorted from hair follicles, and a miRNA q-PCR profiling to compare the expression of 748 miRNA (miRs) in sorted cells were performed. Further, we examined the putative functional implication of the most differentially regulated miRNA (miR-324-3p) in differentiation, proliferation and migration of cultured keratinocytes by qRT-PCR, immunofluorescence, and scratch assay. To explore the mechanisms underlying the effects of miR-324-3p, we used specific chemical inhibitors targeting pathways influenced by miR-324-3p.[Result]: We provide a comprehensive assessment of the "miRNome" of normal and AGA follicular stem and progenitor cells. Differentially regulated miRNA signatures highlight several miRNA candidates including miRNA-324-3p as mis regulated in patient’s stem cells. We find that miR-324-3p promotes differentiation and migration of cultured keratinocytes likely through the regulation of mitogen-activated protein kinase (MAPK) and transforming growth factor (TGF)-β signaling. Importantly, pharmacological inhibition of the TGF-β signaling pathway using Alk5i promotes hair shaft elongation in an organ-culture system.[Conclusion]: Together, we offer a platform for understanding miRNA dynamic regulation in follicular stem and progenitor cells in baldness and highlight miR-324-3p as a promising target for its treatment.This study was funded by a grant provided from Royan Institute and Disease Models & Mechanisms Travelling Fellowship by Biologists Company.Peer reviewe

Global burden of 288 causes of death and life expectancy decomposition in 204 countries and territories and 811 subnational locations, 1990–2021: a systematic analysis for the Global Burden of Disease Study 2021

BACKGROUND Regular, detailed reporting on population health by underlying cause of death is fundamental for public health decision making. Cause-specific estimates of mortality and the subsequent effects on life expectancy worldwide are valuable metrics to gauge progress in reducing mortality rates. These estimates are particularly important following large-scale mortality spikes, such as the COVID-19 pandemic. When systematically analysed, mortality rates and life expectancy allow comparisons of the consequences of causes of death globally and over time, providing a nuanced understanding of the effect of these causes on global populations. METHODS The Global Burden of Diseases, Injuries, and Risk Factors Study (GBD) 2021 cause-of-death analysis estimated mortality and years of life lost (YLLs) from 288 causes of death by age-sex-location-year in 204 countries and territories and 811 subnational locations for each year from 1990 until 2021. The analysis used 56 604 data sources, including data from vital registration and verbal autopsy as well as surveys, censuses, surveillance systems, and cancer registries, among others. As with previous GBD rounds, cause-specific death rates for most causes were estimated using the Cause of Death Ensemble model-a modelling tool developed for GBD to assess the out-of-sample predictive validity of different statistical models and covariate permutations and combine those results to produce cause-specific mortality estimates-with alternative strategies adapted to model causes with insufficient data, substantial changes in reporting over the study period, or unusual epidemiology. YLLs were computed as the product of the number of deaths for each cause-age-sex-location-year and the standard life expectancy at each age. As part of the modelling process, uncertainty intervals (UIs) were generated using the 2·5th and 97·5th percentiles from a 1000-draw distribution for each metric. We decomposed life expectancy by cause of death, location, and year to show cause-specific effects on life expectancy from 1990 to 2021. We also used the coefficient of variation and the fraction of population affected by 90% of deaths to highlight concentrations of mortality. Findings are reported in counts and age-standardised rates. Methodological improvements for cause-of-death estimates in GBD 2021 include the expansion of under-5-years age group to include four new age groups, enhanced methods to account for stochastic variation of sparse data, and the inclusion of COVID-19 and other pandemic-related mortality-which includes excess mortality associated with the pandemic, excluding COVID-19, lower respiratory infections, measles, malaria, and pertussis. For this analysis, 199 new country-years of vital registration cause-of-death data, 5 country-years of surveillance data, 21 country-years of verbal autopsy data, and 94 country-years of other data types were added to those used in previous GBD rounds. FINDINGS The leading causes of age-standardised deaths globally were the same in 2019 as they were in 1990; in descending order, these were, ischaemic heart disease, stroke, chronic obstructive pulmonary disease, and lower respiratory infections. In 2021, however, COVID-19 replaced stroke as the second-leading age-standardised cause of death, with 94·0 deaths (95% UI 89·2-100·0) per 100 000 population. The COVID-19 pandemic shifted the rankings of the leading five causes, lowering stroke to the third-leading and chronic obstructive pulmonary disease to the fourth-leading position. In 2021, the highest age-standardised death rates from COVID-19 occurred in sub-Saharan Africa (271·0 deaths [250·1-290·7] per 100 000 population) and Latin America and the Caribbean (195·4 deaths [182·1-211·4] per 100 000 population). The lowest age-standardised death rates from COVID-19 were in the high-income super-region (48·1 deaths [47·4-48·8] per 100 000 population) and southeast Asia, east Asia, and Oceania (23·2 deaths [16·3-37·2] per 100 000 population). Globally, life expectancy steadily improved between 1990 and 2019 for 18 of the 22 investigated causes. Decomposition of global and regional life expectancy showed the positive effect that reductions in deaths from enteric infections, lower respiratory infections, stroke, and neonatal deaths, among others have contributed to improved survival over the study period. However, a net reduction of 1·6 years occurred in global life expectancy between 2019 and 2021, primarily due to increased death rates from COVID-19 and other pandemic-related mortality. Life expectancy was highly variable between super-regions over the study period, with southeast Asia, east Asia, and Oceania gaining 8·3 years (6·7-9·9) overall, while having the smallest reduction in life expectancy due to COVID-19 (0·4 years). The largest reduction in life expectancy due to COVID-19 occurred in Latin America and the Caribbean (3·6 years). Additionally, 53 of the 288 causes of death were highly concentrated in locations with less than 50% of the global population as of 2021, and these causes of death became progressively more concentrated since 1990, when only 44 causes showed this pattern. The concentration phenomenon is discussed heuristically with respect to enteric and lower respiratory infections, malaria, HIV/AIDS, neonatal disorders, tuberculosis, and measles. INTERPRETATION Long-standing gains in life expectancy and reductions in many of the leading causes of death have been disrupted by the COVID-19 pandemic, the adverse effects of which were spread unevenly among populations. Despite the pandemic, there has been continued progress in combatting several notable causes of death, leading to improved global life expectancy over the study period. Each of the seven GBD super-regions showed an overall improvement from 1990 and 2021, obscuring the negative effect in the years of the pandemic. Additionally, our findings regarding regional variation in causes of death driving increases in life expectancy hold clear policy utility. Analyses of shifting mortality trends reveal that several causes, once widespread globally, are now increasingly concentrated geographically. These changes in mortality concentration, alongside further investigation of changing risks, interventions, and relevant policy, present an important opportunity to deepen our understanding of mortality-reduction strategies. Examining patterns in mortality concentration might reveal areas where successful public health interventions have been implemented. Translating these successes to locations where certain causes of death remain entrenched can inform policies that work to improve life expectancy for people everywhere. FUNDING Bill & Melinda Gates Foundation

A global review of energy consumption, CO2 emissions and policy in the residential sector (with an overview of the top ten CO2 emitting countries)

Climate change and global warming as the main human societies' threats are fundamentally associated with energy consumption and GHG emissions. The residential sector, representing 27% and 17% of global energy consumption and CO2 emissions, respectively, has a considerable role to mitigate global climate change. Ten countries, including China, the US, India, Russia, Japan, Germany, South Korea, Canada, Iran, and the UK, account for two-thirds of global CO2 emissions. Thus, these countries' residential energy consumption and GHG emissions have direct, significant effects on the world environment. The aim of this paper is to review the status and current trends of energy consumption, CO2 emissions and energy policies in the residential sector, both globally and in those ten countries. It was found that global residential energy consumption grew by 14% from 2000 to 2011. Most of this increase has occurred in developing countries, where population, urbanization and economic growth have been the main driving factors. Among the ten studied countries, all of the developed ones have shown a promising trend of reduction in CO2 emissions, apart from the US and Japan, which showed a 4% rise. Globally, the residential energy market is dominated by traditional biomass (40% of the total) followed by electricity (21%) and natural gas (20%), but the total proportion of fossil fuels has decreased over the past decade. Energy policy plays a significant role in controlling energy consumption. Different energy policies, such as building energy codes, incentives, energy labels have been employed by countries. Those policies can be successful if they are enhanced by making them mandatory, targeting net-zero energy building, and increasing public awareness about new technologies. However, developing countries, such as China, India and Iran, still encounter with considerable growth in GHG emissions and energy consumption, which are mostly related to the absence of strong, efficient policy

An Open Study of Botulinum-A Toxin Treatment of Idiopathic Trigeminal Neuralgia

Introduction: Trigeminal Neuralgia (TN) is a unilateral, recurrent, sharp facial pain disorder that is limited to the distribution of divisions of the trigeminal nerve. The aim of this study was to evaluate the efficacy of Botulinum neurotoxin type A (BTX-A) for alleviating the frequency and severity of TN pain. Materials and Methods: This trial was performed as a before and after study. We treated 31 patients (15 male and 16 female) with mean age of 52 year old that their diagnosis was made at least 4.5 years before. We injected BTX-A in various parts of face and particularly in the origin of mandibular and maxillary branches of trigeminal nerve. Injection volume was determined by the necessity and pain intensity measured with visual analog scale up to 100U. Patients were evaluated before and after the injection and were followed after week, and each month, for a three months period. Other related variables were recorded such as: toxin complications, pain status variations by brushing, chewing, cold weather and patient’s satisfaction with their therapy. Results: showed that after injection, pain intensity and frequency decreased after tooth brushing, chewing and cold weather (

Automatic fetal biometry prediction using a novel deep convolutional network architecture

Fetal biometric measurements face a number of challenges, including the presence of speckle, limited soft-tissue contrast and difficulties in the presence of low amniotic fluid. This work proposes a convolutional neural network for automatic segmentation and measurement of fetal biometric parameters, including biparietal diameter (BPD), head circumference (HC), abdominal circumference (AC), and femur length (FL) from ultrasound images that relies on the attention gates incorporated into the multi-feature pyramid Unet (MFP-Unet) network

Extreme βHCG levels in first trimester screening are risk factors for adverse maternal and fetal outcomes

Abstract Multiples of the normal median (MoM) of free βHCG is a valuable parameter in evaluation of risk of adverse pregnancy outcomes. In the current retrospective study, we assessed the maternal and fetal outcomes in pregnant women having free βHCG MoM levels  5 in their first trimester screening (FTS). Relative risk of trisomy 21 was significantly higher in patients having free βHCG MoM > 5. On the other hand, relative risk of trisomies 13 and 18 and Turner syndrome were higher in those having free βHCG MoM  5. Relative risk of hydrocephaly and hydrops fetalis was higher when free βHCG MoM was below 0.2. On the other hand, relative risk of low birth weight was higher when free βHCG MoM was above 5. Moreover, frequency of gestational diabetes mellitus, preeclampsia, preterm delivery and vaginal bleeding increased with levels of free βHCG MoM. However, polyhydramnios had the opposite trend. Frequencies of premature rupture of membranes and pregnancy induced hypertension were highest among pregnant women having levels of free βHCG MoM  5 can be regarded as risk factors for adverse maternal or fetal outcomes irrespective of the presence of other abnormalities in the FTS results

Nanoscale Heterogeneities in Monolayer MoSe₂ Revealed by Correlated Scanning Probe Microscopy and Tip-Enhanced Raman Spectroscopy

Understanding growth, grain boundaries (GBs), and defects of emerging two-dimensional (2D) materials is key to enabling their future applications. For quick, nondestructive metrology, many studies rely on confocal Raman spectroscopy, the spatial resolution of which is constrained by the diffraction limit (∼0.5 μm). Here we use tip-enhanced Raman spectroscopy (TERS) for the first time on synthetic MoSe₂ monolayers, combining it with other scanning probe microscopy (SPM) techniques, all with sub-20 nm spatial resolution. We uncover strong nanoscale heterogeneities in the Raman spectra of MoSe₂ transferred to gold substrates [one near 240 cm^–1 (A₁′), and others near 287 cm^–1 (E′), 340 cm^–1, and 995 cm^–1], which are not observable with common confocal techniques and appear to imply the presence of nanoscale domains of MoO₃. We also observe strong tip-enhanced photoluminescence (TEPL), with a signal nearly an order of magnitude greater than the far-field PL. Combining TERS with other SPM techniques, we find that GBs can cut into larger domains of MoSe₂, and that carrier densities are higher at GBs than away from them