The Long-Term Effectiveness of Methadone Maintenance Treatment in Prevention of Hepatitis C Virus Among Illicit Drug Users : A Modeling Study

Article Accepted Date: Oct 7, 2013 Acknowledgments: We would like to thank all MMT centers' staff in Shiraz for their cooperation in this study. Funding Support: This study was funded and supported by the Tehran University of Medical Sciences.Peer reviewedPublisher PD

Projection of Diabetes Population Size and Associated Economic Burden through 2030 in Iran : Evidence from Micro-Simulation Markov Model and Bayesian Meta-Analysis

Acknowledgments The authors would like to thank kindly all advisors and colleagues, for their valuable technical support. We would like to thank you Ms Laura Marie Dysart for editing the paper.Peer reviewedPublisher PD

Health Related Quality of Life in Patients with Type 2 Diabetes Mellitus in Iran : A National Survey

Acknowledgements The authors would like to thank kindly all participants in the study.Peer reviewedPublisher PD

Photodynamic Therapy in Ocular Oncology

Over the past two decades, we have witnessed the increasing use of photodynamic therapy (PDT) in the field of ocular oncology. Based on a review of the literature and our own experience, we herein review the role of PDT for the management of intraocular tumors. The discussion includes two main topics. First, we discuss the application of PDT for benign tumors, including circumscribed choroidal hemangioma, choroidal osteoma, retinal astrocytoma, retinal capillary hemangioma (retinal hemangioblastoma), and retinal vasoproliferative tumor. Second, we assess the role of PDT for malignant tumors, including choroidal melanoma and choroidal metastasis

Pharmacist-Led Medication Review: Supports for New Role of Pharmacists

In recent decades, by increasing complexity of drug therapy, pharmacists considered as health- care members who can help optimizing drug therapy. We know that medicines do not have the anticipated effects all the times and a vast variability may exist in their behaviors in the body. So, it is very crucial to individualize treatment for every single patient. Nowadays, optimizing drug therapy in patients needs a collaborative interdisciplinary approach to patients care and treatment. Specifically when drug therapy is considered for a condition, pharmacists can enroll as a valuable professional to help for modification of therapy along with other clinicians. Abundant number of studies and reports exist in the literatures which address usefulness of pharmacist engagement in patient care. In this review we have presented some valuable evidences supporting pharmacist role in different clinical settings

Cost-Effectiveness Analysis of Intravascular Targeted Temperature Management after Cardiac Arrest in England

Background: Targeted temperature management (TTM) has been shown to improve neurological outcomes and survival in patients resuscitated from cardiac arrest; however, the cost effectiveness of multiple TTM methods is not well studied. Objective: This study aimed to evaluate the cost effectiveness of intravascular temperature management (IVTM) using Thermogard XP compared with surface cooling methods after cardiac arrest in the England from the perspectives of the UK national health service and Personal Social Services. Methods: We developed a multi-state Markov model that evaluated IVTM (Thermogard XP) compared with surface cooling using two different devices (Blanketrol III and Arctic Sun 5000) over a short-term and lifetime time horizon. Model input parameters were obtained from the literature and local databases. We assumed a hypothetical cohort of 1000 patients who required TTM after cardiac arrest per year in the England. The outcomes were costs (in £, year 2019 values) and quality-adjusted life-years (QALYs), discounted at 3.5% annually. Deterministic and probabilistic sensitivity analyses were undertaken to examine the effect of alternative assumptions and uncertainty in model parameters on the results. Results: The cost-effectiveness analysis determined that Thermogard XP resulted in direct cost savings of £2339 and £2925 (per patient) compared with Blanketrol III and Arctic Sun 5000, respectively, and a gain of 0.98 QALYs over the patient lifetime. The probabilistic sensitivity analysis demonstrated that the probability of Thermogard XP being cost saving would be 69.2% and 65.3% versus the Arctic Sun 5000 and Blanketrol III, respectively. Conclusion: Implementation of IVTM using Thermogard XP can lead to cost savings and improved patient quality of life versus surface cooling methods

Estimation and prediction of avoidable health care costs of cardiovascular diseases and type 2 diabetes through adequate dairy food consumption: a systematic review and micro simulation modeling study

Background: Recent evidence from prospective cohort studies show a relationship between consumption of dairy foods and cardiovascular diseases (CVDs) and type 2 diabetes mellitus (T2DM). This association highlights the importance of dairy foods consumption in prevention of these diseases and also reduction of associated healthcare costs. The aim of this study was to estimate avoidable healthcare costs of CVD and T2D through adequate dairy foods consumption in Iran. Methods: This was a multistage modelling study. We conducted a systematic literature review in PubMed and EMBASE to identify any association between incidence of CVD and T2DM and dairy foods intake, and also associated relative risks. We obtained age- and sex-specific dairy foods consumption level and healthcare expenditures from national surveys and studies. Patient level simulation Markov models were constructed to predict the disease incidence, patient population size and associated healthcare costs for current and optimal dairy foods consumption at different time horizons (1, 5, 10 and 20 years). All parameters including costs and transition probabilities were defined as statistical distributions in the models, and all analyses were conducted by accounting for first and second order uncertainty. Results: The systematic review results indicated that dairy foods consumption was inversely associated with incidence of T2DM, coronary heart disease (CHD) and stroke. We estimated that the introduction of a diet containing 3 servings of dairy foods per day may produce a $0.43 saving in annual per capita healthcare costs in Iran in the first year due to saving in cost of CVD and T2DM treatment. The estimated savings in per capita healthcare costs were$8.42, $39.97 and$190.25 in 5, 10 and 20-years’ time, respectively. Corresponding total aggregated avoidable costs for the entire Iranian population within the study time horizons were $33.83,$661.31, $3,138.21 and$14,934.63 million, respectively. Conclusion: Our analysis demonstrated that increasing dairy foods consumption to recommended levels would be associated with reductions in healthcare costs. Further randomized trial studies are required to investigate the effect of dairy foods intake on cost of CVD and T2DM in the population

Towards Fairness in Personalized Ads Using Impression Variance Aware Reinforcement Learning

Variances in ad impression outcomes across demographic groups are increasingly considered to be potentially indicative of algorithmic bias in personalized ads systems. While there are many definitions of fairness that could be applicable in the context of personalized systems, we present a framework which we call the Variance Reduction System (VRS) for achieving more equitable outcomes in Meta's ads systems. VRS seeks to achieve a distribution of impressions with respect to selected protected class (PC) attributes that more closely aligns the demographics of an ad's eligible audience (a function of advertiser targeting criteria) with the audience who sees that ad, in a privacy-preserving manner. We first define metrics to quantify fairness gaps in terms of ad impression variances with respect to PC attributes including gender and estimated race. We then present the VRS for re-ranking ads in an impression variance-aware manner. We evaluate VRS via extensive simulations over different parameter choices and study the effect of the VRS on the chosen fairness metric. We finally present online A/B testing results from applying VRS to Meta's ads systems, concluding with a discussion of future work. We have deployed the VRS to all users in the US for housing ads, resulting in significant improvement in our fairness metric. VRS is the first large-scale deployed framework for pursuing fairness for multiple PC attributes in online advertising.Comment: 11 pages, 7 figure, KDD 202

Pharmacy Students' Self-Identified Interests in a Hospital Pharmacy Internship Course in Iran

Introduction: After revision of pharmacy curriculum by, Iranian Health and Education Ministry reviewed in 2005, it was decided that pharmacy students need extra internship courses such as hospital internship course. Hospital internship course could provide students with the opportunity to acquire the knowledge and master the skills required for current pharmacy practices in community and hospital setting. The aim of this study was to identify and analyze pharmacy students’ experiences during hospital internship. Methods: Each student attended in 3 wards and provided a logbook for each ward. Students were asked to document at least one topic interesting for them on each day. The collected information was divided into sections and analyzed using SPSS ver 14. Results: Seventeen students enrolled in the course. Endocrinology and nephrology wards had the highest and neurology the lowest number of attended students. Seven hundred and one reported learning subjects were divided into 24 areas. The highest numbers of reported topics were the drugs indications, adverse drug reactions and diagnosis of diseases while the lowest number was pretreatment laboratory tests, pharmacoeconomy, counseling medical staffs and off label use of medications. Gastroenterology and endocrinology wards with 210 reports had the highest and neurology ward with 12 had the lowest number of reports. Conclusion: Completing the logbooks was an encouragement for students to seek and document and learn new topics and also a major feature of the clinical assessment scheme of the course. The majority of the reported topics were learning objectives but not the interventional ones. The present study showed us some areas of pharmacy education which need further attention