Modeling of influential predictors of gastric cancer incidence rates in Golestan Province, North Iran

Golestan province has a reputation for relatively high incidence rates of gastric cancer in Iran. Along with dietary, lifestyle and environmental influential factors, soil selenium and high levels of pesticide used may exert influence in this region. The present study was designed for modeling the influential predictors on incidence of gastric cancer in Golestan. All registered cases of gastric cancer from March 2009 to March 2010 (49 females and 107 males) were investigated. Data were gathered by both check list and researcher made questionnaire (demographic, clinical and lifestyle characteristics) and analysed using logistic regression. Mean (±SD) age at diagnosis was 62.9±13.8 years. CIR and ASR of gastric cancer showed 9.16 and 13.9 per 100,000 people, respectively. Based on univariate logistic regression, a history of smoking (OR= 2.076), unwashed hands after defecation (OR= 2.612), history of cancer in relatives (OR= 2.473), history of gastric cancer in first-degree relatives (OR= 2.278), numbers of gastric cancers in first-degree relatives (OR= 2.078), history of X-ray and dye exposure (OR= 2.395), history of CT scan encounter (OR= 2.915), improper food habits (OR= 3.320), specific eating behavior (OR= 0.740), consumption of probable high risk foods (OR= 2.942), charred flesh (OR= 1.945), and animal fat (OR= 2.716) were confirmed as a risk factors. Changes in lifestyle may be expected to increase gastric cancer incidence dramatically in the near future. Therefore, appropriate educational interventions should be designed and implemented by competent authorities

Clinical course and effective factors of primary vesicoureteral reflux

Vesicoureteral reflux (VUR) is one of the most important causes of urinary tract infection and renal failure in children. It is a potentially self-limited disease. The aim of this study was to evaluate the clinical course and significant factors in children with primary VUR. The medical charts of 125 infants and children (27.2 males, 72.8 females) with all grades of primary VUR were retrospectively reviewed. Mean age at diagnosis was 22.3±22.9 months. 52 of patients had bilateral VUR. Mild reflux (Grade I, II) was the most common initial grade. 53.6 of patients achieved spontaneous resolution. 30.1 of patients had decreased renal function on initial DMSA renal scan, significantly in males and severe VUR. Reflux nephropathy occurred in 17.6 of patients, especially in renal damage and male sex. No significant association was observed between recurrent urinary tract infection with the severity of VUR, and the presence of renal damage at admission. Age at diagnosis, gender, grade, laterality, the absence of recurrent urinary tract infection and renal damage had a significant correlation between spontaneous VUR resolution. Spontaneous resolution of primary VUR occurred significantly in female patients, age � 30months at diagnosis, mild-to-moderate VUR, unilateral reflux, the absence of recurrent urinary tract infection, and renal damage. © 2015 Tehran University of Medical Sciences. All rights reserved

What happens to patients with COPD with long-term oxygen treatment who receive mechanical ventilation for COPD exacerbation? A 1-year retrospective follow-up study

We performed a retrospective cohort study of patients with chronic obstructive lung disease (COPD) on long-term oxygen treatment (LTOT) who received invasive mechanical ventilation for COPD exacerbation. Of the 4791 patients, 23% died in the hospital, and 45% died in the subsequent 12 months. 67% of patients were readmitted at least once in the subsequent 12 months, and 26.8% were discharged to a nursing home or skilled nursing facility within 30 days. We conclude that these patients have high mortality rates, both in-hospital and in the 12 months postdischarge. If patients survive, many will be readmitted to the hospital and discharged to nursing home. These potential outcomes may support informed critical care decision making and more preference congruent care

A Machine Learning Method for Modeling Wind Farm Fatigue Load

Wake steering control can significantly improve the overall power production of wind farms. However, it also increases fatigue damage on downstream wind turbines. Therefore, optimizing fatigue loads in wake steering control has become a hot research topic. Accurately predicting farm fatigue loads has always been challenging. The current interpolation method for farm-level fatigue loads estimation is also known as the look-up table (LUT) method. However, the LUT method is less accurate because it is challenging to map the highly nonlinear characteristics of fatigue load. This paper proposes a machine-learning algorithm based on the Gaussian process (GP) to predict the farm-level fatigue load under yaw misalignment. Firstly, a series of simulations with yaw misalignment were designed to obtain the original load data, which considered the wake interaction between turbines. Secondly, the rainflow counting and Palmgren miner rules were introduced to transfer the original load to damage equivalent load. Finally, the GP model trained by inputs and outputs predicts the fatigue load. GP has more accurate predictions because it is suitable for mapping the nonlinear between fatigue load and yaw misalignment. The case study shows that compared to LUT, the accuracy of GP improves by 17% (RMSE) and 0.6% (MAE) at the blade root edgewise moment and 51.87% (RMSE) and 1.78% (MAE) at the blade root flapwise moment

Barriers to Summer Food Service Program (SFSP) Implementation Before and After COVID-19: A Qualitative, Collective Case Study

Objectives: SFSP, as a federal food assistance program, could ensure that children have sufficient nutritious food during summer. According to a 2016 USDA report, only 0.4–0.6% of eligible children participated in this program in Nebraska, which makes for one of the lowest SFSP participation rates in the U.S. This study aims to better understand how the COVID-19 pandemic has impacted SFSP implementation in urban and rural settings across the state. Conclusions: Insights from this study may inform the development of policies that expand food access to vulnerable families. On the organizational level, this includes providing participating kids and their parents with both meal distribution options - meal sites and delivery options - during summer. On the policy level, this calls for revising the eligibility of SFSP by decreasing the threshold level from 50% to 30% to allow more schools in low-income neighborhoods to participate