Airway obstruction, serum vitamin D and mortality in a 33-year follow-up study

Background and objective: Chronic obstructive pulmonary disease and low vitamin D status predict mortality, but their combined effect on mortality remains inconclusive. We aimed to investigate a joint effect of airway obstruction and vitamin D status on mortality in a nationally representative cohort. Methods: We analysed data of 6676 Finnish adults participating between 1978 and 1980 in a national health examination survey, undergoing spirometry and having all necessary data collected. We followed them up in national registers through record linkage until 31 December 2011. We categorised the subjects with obstruction using the lower limit of normal (LLN) and the measured serum 25-hydroxyvitamin-D (s-25(OH)D) into tertiles. Results: Both obstruction and low s-25(OH) D independently predicted mortality in a multivariate model adjusted also for age, sex, smoking, education, leisure physical activity, body mass index, asthma and serum C-reactive protein. However, a statistically significant (p = 0.007) interaction emerged: the adjusted mortality HRs (95% CI's) for s-25(OH)D in tertiles among the subjects without and with obstruction were 1.00 (lowest), 0.96 (0.87-1.05) and 0.89 (0.81-0.98); and 1.00, 0.96 (0.71-1.31) and 0.57 (0.40-0.80), respectively. Conclusions: In conclusion, obstruction and low s-25(OH)D predict mortality independently of each other. Our findings suggest that low vitamin D status might be particularly detrimental among subjects with obstruction.Peer reviewe

The first inherited retinal disease registry in Iran: Research protocol and results of a pilot study

Background: To describe the protocol for developing a national inherited retinal disease (IRD) registry in Iran and present its initial report. Methods: This community-based participatory research was approved by the Ministry of Health and Medical Education of Iran in 2016. To provide the minimum data set (MDS), several focus group meetings were held. The final MDS was handed over to an engineering team to develop a web-based software. In the pilot phase, the software was set up in two referral centers in Iran. Final IRD diagnosis was made based on clinical manifestations and genetic findings. Ultimately, patient registration was done based on all clinical and non-clinical manifestations. Results: Initially, a total of 151 data elements were approved with Delphi technique. The registry software went live at www.IRDReg.org based on DHIS2 open source license agreement since February 2016. So far, a total of 1001 patients have been registered with a mean age of 32.41±15.60 years (range, 3 months to 74 years). The majority of the registered patients had retinitis pigmentosa (42, 95 CI: 38.9 to 45). Genetic testing was done for approximately 20 of the registered individuals. Conclusion: Our study shows successful web-based software design and data collection as a proof of concept for the first IRD registry in Iran. Multicenter integration of the IRD registry in medical centers throughout the country is well underway as planned. These data will assist researchers to rapidly access information about the distribution and genetic patterns of this disease. © 2020 The Author(s). This is an open-access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons. org/licenses/by/4.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited

Integrative neurobiology of metabolic diseases, neuroinflammation, and neurodegeneration

Alzheimer’s disease (AD) is a complex, multifactorial disease with a number of leading mechanisms, including neuroinflammation, processing of amyloid precursor protein (APP) to amyloid β peptide, tau protein hyperphosphorylation, relocalization and deposition. These mechanisms are propagated by obesity, the metabolic syndrome and type-2 diabetes mellitus. Stress, sedentariness, dietary overconsumption of saturated fat and refined sugars, and circadian derangements/disturbed sleep contribute to obesity and related metabolic diseases, but also accelerate age-related damage and senescence that all feed the risk of developing AD too. The complex and interacting mechanisms are not yet completely understood and will require further analysis. Instead of investigating AD as a mono- or oligocausal disease we should address the disease by understanding the multiple underlying mechanisms and how these interact. Future research therefore might concentrate on integrating these by systems biology approaches, but also to regard them from an evolutionary medicine point of view. The current review addresses several of these interacting mechanisms in animal models and compares them with clinical data giving an overview about our current knowledge and puts them into an integrated framework

The effect of internal marketing on service quality with emphasis on moderator role of organizational citizenship behavior (case study postal services in khorasan razavi province)

The purpose of this study was to identify the effect of internal marketing actions on service quality and considering organizational citizenship behaviors as a moderator. The research method used is descriptive-survey and correlation type and is specifically based on structural equation model. The statistical population of the study consisted of all frontline employees in the post offices of Khorasan Razavi province, as well as all postal service clients of these departments. Among them, 214 individuals from each of the statistical communities (428 people in total) were interviewed with Statistical analysis of SPSS20 and Amos21 software was performed. The results of this study showed that the status of internal marketing actions in the post offices of Khorasan Razavi province is undesirable, and the status of frontline staff's organizational citizenship behaviors and perceived service quality by the customers is desirable. The results of structural equation model showed that internal marketing measures had a significant effect on organizational citizenship behaviors of employees, but internal marketing actions as well as organizational citizenship behaviors had no significant effect on service quality

Effect of diabetes on median and dorsal raphe nuclei efferent fibers to CA3 hippocampal area in rat

Diabetes Mellitus (DM) is one of the most important metabolic disease causes in many side effects. The decrease of mental abilities and even some form of dementia followed prolonged diabetes has been reported. There are evidences that show hippocampus might be the site of neural involvement in patients with dementia followed diabetes. As hippocampus received main serotonergic efferents from brain stem raphe nuclei include dorsal raphe nucleus (DRN) and median raphe nucleus (MRN), it is possible that these efferent affected by diabetes. We used adult male Wistar rat in this study. Diabetes was induced by IP injection of streptozotocin (STZ). After 2,4 and 6 months, HRP tracing were done for the efferent from DRN & MRN to CA3 of hippocampus.HRP Positive neuron of DRN & MRN and also the distribution of these cells were study by light microscopy. Statistical analysis was done by SPSS software. Microscopic study clearly showed significant decrease in HRP positive cells population in DRN & MRN after prolonged diabetes. Based on our finding ,the changes in the neural connection between serotonergic nuclei and hippocampus followed diabetes might be one of the reasons for dementia in these patients. © 2010 Tehran University of Medical Sciences. All rights reserved