Startup’s critical failure factors dynamic modeling using FCM

The emergence of startups and their influence on a country's economic growth has become a significant concern for governments. The failure of these ventures leads to substantial depletion of financial resources and workforce, resulting in detrimental effects on a country's economic climate. At various stages of a startup's lifecycle, numerous factors can affect the growth of a startup and lead to failure. Numerous scholars and authors have primarily directed their attention toward studying the successes of these ventures. Previous research review of critical failure factors (CFFs) reveals a dearth of research that comprehensively investigates the introduction of all failure factors and their interdependent influences. This study investigates and categorizes the failure factors across various stages of a startup's life cycle to provide a deeper insight into how they might interact and reinforce one another. Employing expert perspectives, the authors construct fuzzy cognitive maps (FCMs) to visualize the CFFs within entrepreneurial ventures and examine these factors' influence across the four growth stages of a venture. Our primary aim is to construct a model that captures the complexities and uncertainties surrounding startup failure, unveiling the concealed interconnections among CFFs. The FCMs model empowers entrepreneurs to anticipate potential failures under diverse scenarios based on the dynamic behavior of these factors. The proposed model equips entrepreneurs and decision-makers with a comprehensive understanding of the collective influence exerted by various factors on the failure of entrepreneurial ventures

Efficacy of radiosynovectomy in the treatment of chronic knee synovitis: Systematic review and meta-analysis

ABSTRACT Introduction: Knee joints are commonly involved with various inflammatory and non-inflammatory rheumatic diseases. Radiosynovectomy is being used as a local therapeutic option to alleviate pain and swelling in involved joints. The present study evaluated the effectiveness of radiosynovectomy for treatment of chronic knee synovitis. Methods: Through a search of Medline and SCOPUS with (Radiosynovectomy OR radio-synovectomy OR "radio synovectomy" OR "radiation synovectomy" OR radiosynoviorthesis OR radio-synoviorthesis OR synoviorthesis OR "radiochemical synovectomy" OR "radioisotope synovectomy") AND (Re-188 OR Y-90 OR Sm-153 OR P-32) as key words, 9 RCTs were enrolled in the analysis. Results: The outcomes of interest were odds ratio and risk difference of improvement in the radiosynovectomy group compared to the control group. Odds ratio and risk difference for Sm-153 plus corticosteroid subgroup was 1. 959[0.571-6.72

Association Between Metabolic Syndrome and Stroke: A Population Based Cohort Study

Both metabolic syndrome (MetS) and stroke are associated with increased risk of mortality. Here, we aimed to assess the prevalence of MetS among adults using three definitions (Adult Treatment Panel III (ATP-III), International Diabetes Federation (IDF) and IDF ethnic specific cut-off for Iranian criteria) and its association with stroke. We performed a cross-sectional study of a total of 9991 adult participants of Rafsanjan Cohort Study (RCS), as part of the Prospective epidemiological research studies in Iran (PERSIAN cohort study). The MetS prevalence was evaluated in participants according to the different criteria. Multivariate logistic regression analyses were conducted to assess the association between three definitions of MetS with stroke. We found that MetS was significantly associated with higher odds of stroke according to NCEP-ATP III (odds ratio (OR): 1.89, 95% confidence interval (CI) 1.30-2.74), international IDF (OR:1.66, 95% CI: 1.15-2.40) and Iranian IDF (OR:1.48, 95% CI: 1.04-2.09) after adjusted for variables confounders. Furthermore, after adjustment, in receiver operating characteristic (ROC) curve, the AUROC was 0.79 (95% CI = 0.75-0.82), 0.78(95% CI = 0.74-0.82) and 0.78(95% CI = 0.74-0.81) for presence of MetS according to NCEP-ATP III, international IDF and Iranian IDF, respectively. ROC analyses revealed that all of these three criteria for MetS are moderately accurate for the identification of increased stroke risk.In conclusion, our results showed that MetS was associated with increased odds of stroke. Our findings implicate the importance of early identification, treatment, and ultimately prevention of the metabolic syndrome

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 comparison of the efficacy of textured insoles on balance performance in older people with versus without plantar callosities

Background: Textured insoles have been suggested to enhance foot sensation, which contributes to controlling upright balance. However, the interaction between plantar callosity and the textured surface has not been studied. Research question: Firstly, to compare the efficacy of textured insoles on balance performance and foot position sense between two groups of older people: one group had plantar callosity, and the other did not. Secondly, to investigate the efficacy of textured insoles within each study group. Methods: Thirty older people with a history of falls (15 with plantar callosity and 15 without callosity) participated in this study. All participants underwent assessments of postural sway on a force plate, joint position sensation of the ankle with a slope box, and mobility using the "Timed Up and Go" test under three insole surface conditions: 1) smooth (control), 2) placebo and 3) textured surface. Two-way analyses of variance were used to compare the outcomes of the two groups and three conditions. Results: Older people with plantar callosity had worse ankle joint position sense and slower antero-posterior and mediolateral postural sway velocity than their peers who did not have plantar callosity. The textured insoles improved ankle joint position sense and mobility regardless of callus status in the plantar surface of older peoples’ feet. The insole-callosity interaction was not significant for any study outcome. Significance: Textured insoles could be beneficial to older people with and without callosity as they have shown immediate improvements in ankle joint position sense and mobility

The Effect of Benson Relaxation Technique on Depression in Patients Undergoing Hemodialysis

BACKGROUND AND OBJECTIVE: Depression is the most common mental disorder in patients undergoing hemodialysis. This disorder has adverse effects on the course of disease and treatment process and is recognized as an independent risk factor for death in hemodialysis patients. The purpose of this study was to determine the relaxing effects of Benson relaxation technique on depression in patients undergoing hemodialysis. METHODS: This clinical trial was performed on 65 hemodialysis patients. Subjects were randomly divided into two groups: control group (n=32) and intervention group using Benson relaxation technique (n=33). The intervention group performed Benson relaxation exercises twice a day for 20 minutes over one month. Beck Depression Inventory was completed one month before and one month after the intervention. The control group received usual treatments (IRCT: 2014011115393N2( FINDINGS: Overall, 51 patients were male in the present study. The mean age of participants was 48.57±9.18 years in the intervention group and 49.93±8.17 years in the control group. Before the intervention, there was no significant difference between the groups in terms of the studied variables. The mean score of depression in the intervention group decreased from 32.46±9.86 before the intervention to 23.30±9.23 after the intervention the difference was statistically significant (p<0.001). Also, the mean score of depression in the control group changed from 30.58±9.24 before the intervention to 30.83±9.63 after the intervention. CONCLUSION: The results of this study showed that Benson relaxation technique is effective in reducing depression in hemodialysis patients. Therefore, by applying this technique, we can take a major step towards improving and preventing patients’ psychological problems

Diagnostic Performance of Positron Emission Tomography/Computed Tomography Using Fluorine-18 Fluorodeoxyglucose in Detecting Locoregional Nodal Involvement in Patients with Anal Canal Cancer: A Systematic Review and Meta-Analysis

Purpose. The diagnostic performance of positron emission tomography using 18F-fluorodeoxyglucose (FDG-PET) in detecting nodal involvement in patients with anal canal cancer (ACC) has been investigated by several studies with conflicting results. The aim of our study is to systematically review and meta-analyze published data about this topic. Methods. A comprehensive computer literature search of PubMed/MEDLINE, Scopus, and Embase databases was carried out on July 10 to find relevant articles concerning the diagnostic performance of FDG-PET in detecting locoregional nodal involvement in patients with ACC. No language restriction was used. Pooled diagnostic performance on a lesion-based analysis was calculated. Results. Seven retrospective and five prospective studies have been reviewed. Six studies allowed assessing pooled sensitivity; five studies allowed assessing pooled specificity. Sensitivity and specificity values of FDG-PET/CT on a lesion-based analysis ranged from 31 to 100% and from 53 to 98%, with pooled estimates of 56% (95% CI: 45–67%) and 90% (95% CI: 86–93%), respectively. Conclusions. Our meta-analysis demonstrates that FDG-PET is a specific diagnostic tool in detecting locoregional lymph node involvement in patients with ACC. Low sensitivity is a major concern; however, higher sensitivity could be reached combining FDG-PET with MR scan

Caregiving Appraisal in Family Caregivers of Older Adults

Objectives: With increasing the older adults&rsquo; population, the old age diseases increase, as well as older&nbsp;people&rsquo;s dependency and need for care. This issue further highlights the importance of attention to&nbsp;family caregiving and experiences. Among the concepts related to family caregiving, the concept of selfappraisal&nbsp;of caregiver has a special role in acceptance, continuance, and outcomes of caregiving. This&nbsp;study aimed to review all aspects of caregiving appraisal concept in family caregivers. Methods & Materials: The current study is a review study. To examine the concept of family caregiver&nbsp;appraisal, all articles without time limitation were searched in databases of Google Scholar, ProQuest,&nbsp;Scopus, and PubMed with keywords of &ldquo;appraisal,&rdquo; &ldquo;caregiving,&rdquo; &ldquo;family caregiving,&rdquo; &ldquo;burden,&rdquo; &ldquo;satisfaction,&rdquo;&nbsp;&ldquo;positive aspect,&rdquo; &ldquo;negative aspect,&rdquo; &ldquo;older adults,&rdquo; and &ldquo;elderly.&rdquo; The Iranian databases of IranMedex,&nbsp;IranDoc, and SID were also searched with equivalent Persian Keywords. Results: Many factors such as social, cultural, and personal characteristics can influence the caregivers&rsquo;&nbsp;perception. This subjective appraisal makes caregivers not to perceive their conditions the same, in spite&nbsp;of stressful situation of caregiving. Some caregivers have positive experiences in this condition and some&nbsp;perceive stress more than what actually exist. This will create negative outcomes for the health and&nbsp;welfare of the caregivers. Conclusion: Caregiving appraisal is a multidimensional concept, which has positive and negative aspects.&nbsp;By taking into account all aspects of this concept, one can better understand and ultimately has a more&nbsp;comprehensive assessment of the status of caregivers, and implement effective interventions towards&nbsp;improving the health of this group

Analysis of the Psychometric Properties of the Perceived Social Support Scales in Older Adults

Objectives: An important part of health status assessment of older adults is measurement of their perceived&nbsp;social support. Choosing a sound scale with good psychometrics properties is a prerequisite for&nbsp;proper assessment. The aim of this review article was to analyze the psychometric properties of perceived&nbsp;social support scales to help researchers become more familiar with positive and negative aspects&nbsp;of these instruments and select a more valid and appropriate one. Methods & Materials: A comprehensive search of databases of Medline, Google scholar, and Scopus was&nbsp;conducted, using the keywords related to design and process of psychometrics scales of perceived social&nbsp;support. In this regard, the articles published from 1970 until 2014 were collected. Then, the psychometric&nbsp;properties of the selected scales, including validity, reliability, responsiveness, and interpretability&nbsp;were assessed using the COSMIN comprehensive checklist. Results: Most of the scales had not reported a complete and desirable psychometrics properties. Some&nbsp;of them, despite of being developed for adult populations, lacked the capability for using in older adults&nbsp;(length of scale, length of questions, special questions). Conclusion: The results revealed that despite the lack of an appropriate scale for measurement of old&nbsp;adults perceived social support, the MOS is the only scale which can be recommended to gerontologists&nbsp;until now. However, a vital need is felt for developing an instrument based on cultural and social characteristics&nbsp;of different societies with acceptable psychometrics properties for measuring perceived social&nbsp;support in older adults

Association between metabolic syndrome and stroke: a population based cohort study

Abstract Both metabolic syndrome (MetS) and stroke are associated with increased risk of mortality. Here, we aimed to assess the prevalence of MetS among adults using three definitions (Adult Treatment Panel III (ATP-III), International Diabetes Federation (IDF) and IDF ethnic specific cut-off for Iranian criteria) and its association with stroke. We performed a cross-sectional study of a total of 9991 adult participants of Rafsanjan Cohort Study (RCS), as part of the Prospective epidemiological research studies in Iran (PERSIAN cohort study). The MetS prevalence was evaluated in participants according to the different criteria. Multivariate logistic regression analyses were conducted to assess the association between three definitions of MetS with stroke. We found that MetS was significantly associated with higher odds of stroke according to NCEP-ATP III (odds ratio (OR): 1.89, 95% confidence interval (CI) 1.30–2.74), international IDF (OR:1.66, 95% CI: 1.15–2.40) and Iranian IDF (OR:1.48, 95% CI: 1.04–2.09) after adjusted for variables confounders. Furthermore, after adjustment, in receiver operating characteristic (ROC) curve, the AUROC was 0.79 (95% CI = 0.75–0.82), 0.78(95% CI = 0.74–0.82) and 0.78(95% CI = 0.74–0.81) for presence of MetS according to NCEP-ATP III, international IDF and Iranian IDF, respectively. ROC analyses revealed that all of these three criteria for MetS are “moderately accurate” for the identification of increased stroke risk. In conclusion, our results showed that MetS was associated with increased odds of stroke. Our findings implicate the importance of early identification, treatment, and ultimately prevention of the metabolic syndrome