Genetic Study of Nephrotic Syndrome in Iranian Children- Systematic Review

Idiopathic nephrotic syndrome is a heterogeneous disease with a spectrum of age at presentation, phenotype, renal pathology, and response to treatment. Many mutations are recognized to be implicated in sporadic or hereditary forms. The aim of this review was to summarize the results of the genetic studies which have already been carried out in Iran considering their limitations.A literature search was conducted from March 1970 to September 2015 through MEDLINE, EMBASE, Google Scholar, Google, Iran Medex, Magiran, and SID. Eleven studies were relevant. Three articles were excluded due to insufficient data, duplicated case, and a syndromic nephrotic case without genetic studies. Our results showed that in the southwest of Iran, 80% of the patients had mutations in NPHS1 while in Fars Province, one third showed mutations in NPHS2 when all exons were assessed. In two different studies conducted in one center in Tehran, no mutation was detected in exon 5 but when all exons were studied, more than 65% had hot spot mutation in exon 8 of NPHS2. Interestingly, none of adolescents with FSGS showed mutation in p.R229Q (NPHS2, exon 5). This review revealed that both NPHS1 and NPHS2 were prevalent in Iranian children with SRNS. No mutation of p.R229Q was reported in Iranian adolescent with SRNS.Keywords: Nephrin; NPHS2 protein; Nephrotic Syndrome; Glomerulosclerosis; Focal Segmental

TFUZZY-OF: a new method for routing protocol for low-power and lossy networks load balancing using multi-criteria decision-making

The internet of things (IoT) based on a network layer perspective includes low-power and lossy networks (LLN) that are limited in terms of power consumption, memory, and energy usage. The routing protocol used in these networks is called routing over low-power and lossy networks (RPL). Therefore, the IoT networks include smart objects that need multiple routing for their interconnections which makes traffic load balancing techniques indispensable to RPL routing protocol. In this paper, we propose a method based on fuzzy logic and the technique for the order of prioritization by similarity to the ideal solution (TOPSIS) as a well-known multi-criteria decision-making method to solve the load balancing problem by routing metrics composition. For this purpose, a combination of both link and node routing metrics namely hop count, expected transmission count, and received signal strength indicator is used. The results of simulations show that this method can increase the quality of services in terms of packet delivery ratio and average end-to-end delay

Assessment of safety in drinking water supply system of Birjand city using World Health Organization’s water safety plan

Background: The conventional method for managing drinking water quality is not a suitable preventive strategy for protecting public health. A water safety plan (WSP) presents a systematic approach to ensuring the health and quality of drinking water. This study assessed the drinking water supply system safety of Birjand city using the WHO’s WSP. Methods: This investigation employed the WSP-QA Tool and the WSP manual of the WHO and the AWI. For this purpose, software checklists were prepared and, after confirmation of content and face validity, completed based on Birjand’s water and wastewater company records and interview with company’s experts. Data was analyzed using WSP-QA Tool. Results: From total possible 440 points for full use of the program and 328 points of the studied phases, a score of 190 was acquired, indicating a 43.18% coordinated implementation with WSP. System description and management procedures showed the maximum and minimum percentages of congruency with the WSP of 87.5% and 25%, respectively. Among the components of the water supply system, water resource had the most attention. Conclusion: As regards the percentage of overall WSP-phase implementation and the low attention given to some key parameters of the water supply system, such as risk assessment and management procedures, the system currently enjoys a relatively medium level of safety. However, the high points of some phases such as system description, operational monitoring and verification enhance the system’s flexibility for changing the current approach of qualitative management to the WSP. Keywords: Drinking water, Safety, Water supply, Risk assessment, Softwar

The Effectiveness of Play Therapy in Improving Attention and Working Memory in Students with Specific Learning Disorders

Background: One of the most prominent challenges faced by students with learning disorders is attention and working memory deficits. This study aimed to investigate the effectiveness of play therapy in improving attention and working memory in students with specific learning disorders.Methods: The study employed a quasi-experimental design with pre-test and post-test measurements, including a control group. The statistical population consisted of all fourth-grade students with specific learning disorders in Dezful, Iran, in 2022. Thirty students were purposively selected and allocated to either an experimental or control group, with 15 participants in each group. The experimental group received play therapy sessions (ten 90-minute sessions and one session per week), while the control group received no intervention. The Test of Variables of Attention (TOVA) and the Working Memory Test Battery for Children (WMTB-C) were used for data collection. The analysis of covariance was used to analyze the data via SPSS version 26.Results: The study included 30 students with specific learning disorders, aged 10.24±2.26 years. In the pre-test stage, the experimental group’s mean scores for central executive, visual-spatial sketchpad, and phonological loop were 59.47±2.03, 44.80±3.21, and 64.27±1.62, respectively. In the post-test stage, these means increased to 71.87±3.24, 59.87±2.97, and 78.73±2.93, respectively. Furthermore, the experimental group’s mean attention scores increased from 69.53±16.81 in the pretest stage to 84.93±14.35 in the post-test stage. The findings indicated that play therapy was effective in improving the attention and working memory of students with specific learning disorders (P<0.001).Conclusion: The results suggested that play therapy can be an effective intervention for improving academic achievement by enhancing attention and working memory in students with specific learning disorders

SELF-POISONING SUICIDE ATTEMPTS AMONG STUDENTS IN TEHRAN, IRAN

Background: This study aim was to describe the epidemiology of intentional self-poisoning among students. Subjects and methods: A cross-sectional study was conducted on self-poisoned students admitted to Loghman-Hakim Hospital in Tehran, Iran. Variables studied included age, sex, substance abuse, personal history, familial history and the immediate precipitant for the suicide attempt. Results: A total of 248 students (200 F and 48 M) studied. The mean age was 16.3±1.42 years. Self poisoning with a pharmaceutical agent was the most common attempt modality (87.5%). The most common precipitant for the suicide attempt was family conflict (54.4%), followed by romantic disappointment (29.4%). The most common psychiatric disorders were adjustment disorder (84.3%). and depression (18.1%). Conclusion: The emphasis in student suicide prevention programs must be on early identification of students at risk, and appropriate treatment of episodes of psychopathology

Global, regional, and national burden of neurological disorders, 1990–2016 : a systematic analysis for the Global Burden of Disease Study 2016

Background: Neurological disorders are increasingly recognised as major causes of death and disability worldwide. The aim of this analysis from the Global Burden of Diseases, Injuries, and Risk Factors Study (GBD) 2016 is to provide the most comprehensive and up-to-date estimates of the global, regional, and national burden from neurological disorders. Methods: We estimated prevalence, incidence, deaths, and disability-adjusted life-years (DALYs; the sum of years of life lost [YLLs] and years lived with disability [YLDs]) by age and sex for 15 neurological disorder categories (tetanus, meningitis, encephalitis, stroke, brain and other CNS cancers, traumatic brain injury, spinal cord injury, Alzheimer's disease and other dementias, Parkinson's disease, multiple sclerosis, motor neuron diseases, idiopathic epilepsy, migraine, tension-type headache, and a residual category for other less common neurological disorders) in 195 countries from 1990 to 2016. DisMod-MR 2.1, a Bayesian meta-regression tool, was the main method of estimation of prevalence and incidence, and the Cause of Death Ensemble model (CODEm) was used for mortality estimation. We quantified the contribution of 84 risks and combinations of risk to the disease estimates for the 15 neurological disorder categories using the GBD comparative risk assessment approach. Findings: Globally, in 2016, neurological disorders were the leading cause of DALYs (276 million [95% UI 247–308]) and second leading cause of deaths (9·0 million [8·8–9·4]). The absolute number of deaths and DALYs from all neurological disorders combined increased (deaths by 39% [34–44] and DALYs by 15% [9–21]) whereas their age-standardised rates decreased (deaths by 28% [26–30] and DALYs by 27% [24–31]) between 1990 and 2016. The only neurological disorders that had a decrease in rates and absolute numbers of deaths and DALYs were tetanus, meningitis, and encephalitis. The four largest contributors of neurological DALYs were stroke (42·2% [38·6–46·1]), migraine (16·3% [11·7–20·8]), Alzheimer's and other dementias (10·4% [9·0–12·1]), and meningitis (7·9% [6·6–10·4]). For the combined neurological disorders, age-standardised DALY rates were significantly higher in males than in females (male-to-female ratio 1·12 [1·05–1·20]), but migraine, multiple sclerosis, and tension-type headache were more common and caused more burden in females, with male-to-female ratios of less than 0·7. The 84 risks quantified in GBD explain less than 10% of neurological disorder DALY burdens, except stroke, for which 88·8% (86·5–90·9) of DALYs are attributable to risk factors, and to a lesser extent Alzheimer's disease and other dementias (22·3% [11·8–35·1] of DALYs are risk attributable) and idiopathic epilepsy (14·1% [10·8–17·5] of DALYs are risk attributable). Interpretation: Globally, the burden of neurological disorders, as measured by the absolute number of DALYs, continues to increase. As populations are growing and ageing, and the prevalence of major disabling neurological disorders steeply increases with age, governments will face increasing demand for treatment, rehabilitation, and support services for neurological disorders. The scarcity of established modifiable risks for most of the neurological burden demonstrates that new knowledge is required to develop effective prevention and treatment strategies. Funding: Bill & Melinda Gates Foundation

Mapping geographical inequalities in access to drinking water and sanitation facilities in low-income and middle-income countries, 2000-17

Background: Universal access to safe drinking water and sanitation facilities is an essential human right, recognised in the Sustainable Development Goals as crucial for preventing disease and improving human wellbeing. Comprehensive, high-resolution estimates are important to inform progress towards achieving this goal. We aimed to produce high-resolution geospatial estimates of access to drinking water and sanitation facilities. Methods: We used a Bayesian geostatistical model and data from 600 sources across more than 88 low-income and middle-income countries (LMICs) to estimate access to drinking water and sanitation facilities on continuous continent-wide surfaces from 2000 to 2017, and aggregated results to policy-relevant administrative units. We estimated mutually exclusive and collectively exhaustive subcategories of facilities for drinking water (piped water on or off premises, other improved facilities, unimproved, and surface water) and sanitation facilities (septic or sewer sanitation, other improved, unimproved, and open defecation) with use of ordinal regression. We also estimated the number of diarrhoeal deaths in children younger than 5 years attributed to unsafe facilities and estimated deaths that were averted by increased access to safe facilities in 2017, and analysed geographical inequality in access within LMICs. Findings: Across LMICs, access to both piped water and improved water overall increased between 2000 and 2017, with progress varying spatially. For piped water, the safest water facility type, access increased from 40·0% (95% uncertainty interval [UI] 39·4–40·7) to 50·3% (50·0–50·5), but was lowest in sub-Saharan Africa, where access to piped water was mostly concentrated in urban centres. Access to both sewer or septic sanitation and improved sanitation overall also increased across all LMICs during the study period. For sewer or septic sanitation, access was 46·3% (95% UI 46·1–46·5) in 2017, compared with 28·7% (28·5–29·0) in 2000. Although some units improved access to the safest drinking water or sanitation facilities since 2000, a large absolute number of people continued to not have access in several units with high access to such facilities (>80%) in 2017. More than 253 000 people did not have access to sewer or septic sanitation facilities in the city of Harare, Zimbabwe, despite 88·6% (95% UI 87·2–89·7) access overall. Many units were able to transition from the least safe facilities in 2000 to safe facilities by 2017; for units in which populations primarily practised open defecation in 2000, 686 (95% UI 664–711) of the 1830 (1797–1863) units transitioned to the use of improved sanitation. Geographical disparities in access to improved water across units decreased in 76·1% (95% UI 71·6–80·7) of countries from 2000 to 2017, and in 53·9% (50·6–59·6) of countries for access to improved sanitation, but remained evident subnationally in most countries in 2017. Interpretation: Our estimates, combined with geospatial trends in diarrhoeal burden, identify where efforts to increase access to safe drinking water and sanitation facilities are most needed. By highlighting areas with successful approaches or in need of targeted interventions, our estimates can enable precision public health to effectively progress towards universal access to safe water and sanitation