Optimal Water Allocation among Agricultural Consumers Using Crop Pattern Change Approach to Improve Farmers' Livelihood

Qazvin plain is one of the areas in the country facing a severe shortage of water. In recent years, after the reduction of water allocation to this plain from Taleghan Dam, farmers have been digging illegal wells or over-harvesting existing wells in order to maintain their livelihoods. This has adverse effects, including severe depletion of wells, drying of aqueducts, salinity and degradation of groundwater quality, reduced yield of agricultural products, loss of soil quality, imposition of high costs on well owners, creating a major supply problem. Drinking water in cities and villages and eventually land subsidence (Qazvin Regional Water Authority, 2014). Studies show that the cultivation pattern in the last ten years has been almost constant and included wheat products, forage corn, canola, tomato, alfalfa, barley, sugar beet, peas, beans, potatoes, corn and lentils (Simiari and Mazandaranizadeh, 2017).Studies have shown that previous studies have either optimized water distribution or optimized cultivation patterns, but this study compared the differences between the two approaches to farmers' livelihoods in order to conserve groundwater resources

The relationship of high-sensitivity C-reactive protein (Hs-CRP) serum level and peritonitis in patients on peritoneal dialysis

Background: C-reactive protein (CRP) is a predictor of cardiovascular diseases in both normal people and patients on hemodialysis. This study aimed to assess the relationship of high-sensitivity C-reactive protein (Hs-CRP) serum level and peritonitis in patients on peritoneal dialysis. Methods: 113 patients on peritoneal dialysis in Isfahan city, Iran, participated in our study in 2015. Serum albumin and Hs-CRP levels were measured in each patient at three times (baseline, and 6 and 12 month after that) and the patients were followed up for 1 year. All the patients were evaluated for peritonitis in every visit. At the end of the study, two groups of patients on peritoneal dialysis with and without peritonitis were compared. Findings: Among 113 patients, 24 were excluded from the study because of death or kidney transplantation and 89 patients were included in final analysis. The mean Hs-CRP levels in patients with peritonitis were 4.83, 5.79, and 7.42 mg/l at baseline, and 6 and 12 month after it, respectively; these levels were 4.47, 3.19, and 2.69 mg/l in patients without peritonitis, respectively. In addition, the mean albumin levels in patient with peritonitis were 3.38, 3.29 and 3.40 mg/l at baseline, and 6 and 12 month after it, respectively; these values were 3.56, 4.05, and 3.51 mg/l in patients without peritonitis, respectively. Conclusion: Results showed that with increase in Hs-CRP level, the risk of peritonitis increased. Besides, the albumin level decreased among patients with peritonitis in comparison with patients without peritonitis; there was no significant correlation between albumin level and peritonitis. © 2017, Isfahan University of Medical Sciences(IUMS). All rights reserved

Effect of vitamin D supplementation on inflammatory markers and total antioxidant capacity in breast cancer women using a machine learning technique

Aim: This study aimed to establish a learning system using an artificial neural network (ANN) to predict the effects of vitamin D supplementation on the serum levels of vitamin D, inflammatory factors, and total antioxidant capacity (TAC) in women with breast cancer. Methods: The data set of the current project was created from women with breast cancer who were referred to the Shafa State Hospital of Patients with Cancers in Ahvaz city, Iran. Modeling was implemented using the data set at the serum levels of vitamin D, tumor necrosis factor-α (TNF-α), transforming growth factor β (TGF-β), and TAC, before and after vitamin D3 supplement therapy. A prediction ANN model was designed to detect the effects of vitamin D3 supplementation on the serum level changes of vitamin D, inflammatory factors and TAC. Results: The results showed that the ANN model could predict the effect of vitamin D3 supplementation on the serum level changes of vitamin D, TNF-α, TGF-β1, and TAC with an accuracy average of 85%, 40%, 89.5%, and 88.1%, respectively. Conclusions: According to the findings of the study, the ANN method could accurately predict the effect of vitamin D3 supplementation on the serum levels of vitamin D, TNF-α, TGF-β1, and TAC. The results showed that the proposed ANN method can help specialists to improve the treatment process more confidently in terms of time and accuracy of predicting the influence of vitamin D supplementation on the factors affecting the progression of breast cancer (https://www.irct.ir/ identifier: IRCT2015090623924N1)

Evaluation of Suitability Groundwater Quality for Agricultural, Drinking and Industrial Purposes (Case Study: South of Chaharmahal and Bakhtiari Province)

The significant reduction of surface water resources and recent recurrent droughts have increased the reliance on groundwater sources, leading to a decline in their quality. In this study, 28 samples of well water from different locations in Khanmirza, Lordegan, Borujen, Ardal and Kiar were collected in 2020-2021 and underwent chemical analysis in the laboratory. To evaluate the quality of the samples for use in agricultural, drinking and industrial sectors, the Wilcox diagram, Schuler diagram and Langlier index were used. Using interpolation methods, the chemical properties of the samples taken within the study area were examined and qualitative zoning maps were prepared using Kriging and inverse distance weighting methods. The results showed that according to the Wilcox diagram, most of the samples are within the range of C2S1 and are suitable for agricultural purposes. According to the Schuler diagram, these samples are within the range of good quality for drinking and based on the Langlier index, they are within the range of precipitating and consumable. This study helps decision-makers to have a clear view and plan comprehensively and effectively for the exploitation and preservation of groundwater resources, taking into account the qualitative maps of groundwater

Comparative Analysis of Patient Satisfaction and Sedation Outcomes in Bronchoscopy: Fentanyl/Chlorpheniramine vs. Ketamine/Chlorpheniramine

This randomized clinical trial aimed to assess and compare patient satisfaction and sedation outcomes in bronchoscopy procedures using two distinct sedation protocols: fentanyl/chlorpheniramine (FC) and ketamine/chlorpheniramine (KC). Ninety patients undergoing simple bronchoscopy and bronchoalveolar lavage were randomly assigned to receive either FC (1 µg/kg fentanyl and 10 mg chlorpheniramine) or KC (0.5 mg/kg ketamine and 10 mg chlorpheniramine). Lidocaine was also administered during bronchoscopy. Primary outcomes included patient satisfaction scores, while secondary outcomes encompassed sedation levels, bronchoscopist satisfaction, cough rates, lidocaine usage, and physiological parameters. Patients in the FC group exhibited significantly higher satisfaction levels compared to the KC group (P=0.002). Bronchoscopist satisfaction was also superior in the FC group (P=0.001). Although cough rates did not differ significantly, severe persistent coughs were more prevalent in the KC group. Physiological parameters such as oxygen saturation were comparable, but the KC group demonstrated higher increases in systolic blood pressure and heart rate. The use of fentanyl/chlorpheniramine resulted in higher patient and bronchoscopist satisfaction during simple bronchoscopy and bronchoalveolar lavage compared to ketamine/chlorpheniramine. This study suggests that the combination of fentanyl and chlorpheniramine may be a preferable sedation choice for bronchoscopy procedures

Association of NFKB1 gene polymorphism (rs28362491) with cardiometabolic risk factor in patients undergoing coronary angiography

Introduction: Genetic and environmental factors are involved in the pathogenesis of cardiovascular diseases (CVDs). The aim of the study was to investigate between the genotype of the NFKB1 gene and the cardiometabolic risk factor in patients undergoing coronary angiography. Methods: This cross-sectional study was conducted on 462 adults (male and women) aged between 35 and 75 years who referred to Afshar Hospital for coronary angiography in 2021- 2022. The polymerase chain reaction restriction fragment length polymorphism method was used to detect the genotype of rs28362491. Biochemical parameters were measured using commercial kits. Gensini and Syntax scores were calculated using the angiography result to assess the extent of coronary artery stenosis. We used multivariate logistic regression analysis to examine the relationship between genotype variants and cardiometabolic risk factors. Results: There was no association between variant genotypes and abnormally levels of serum alanine aminotransferase (ALT) (P value=0.51), aspartate aminotransferase (AST) (P value=0.99), triglyceride (TG) (P value=0.48), total cholesterol (P value=0.79), low density lipoprotein-cholestero (LDL-C) (P value=0.31), high-density lipoprotein-cholesterol (HDL-C) (P value=0.53), fast blood sugar (FBS) (P value=0.39), systolic blood pressure (P value=0.14), diastolic blood pressure (P value=0.64), Gensini score (P value=0.48) and syntax score (P value=0.74) in the crude model even after adjustment for confounding factors. Conclusion: We found no association between the ATTG polymorphism and cardiometabolic risk factors in patients who had coronary angiography. Further investigations are needed to assess the association between variants of 28362491 and cardiometabolic markers

Mapping 123 million neonatal, infant and child deaths between 2000 and 2017

Since 2000, many countries have achieved considerable success in improving child survival, but localized progress remains unclear. To inform efforts towards United Nations Sustainable Development Goal 3.2—to end preventable child deaths by 2030—we need consistently estimated data at the subnational level regarding child mortality rates and trends. Here we quantified, for the period 2000–2017, the subnational variation in mortality rates and number of deaths of neonates, infants and children under 5 years of age within 99 low- and middle-income countries using a geostatistical survival model. We estimated that 32% of children under 5 in these countries lived in districts that had attained rates of 25 or fewer child deaths per 1,000 live births by 2017, and that 58% of child deaths between 2000 and 2017 in these countries could have been averted in the absence of geographical inequality. This study enables the identification of high-mortality clusters, patterns of progress and geographical inequalities to inform appropriate investments and implementations that will help to improve the health of all populations

Global, regional, and national comparative risk assessment of 84 behavioural, environmental and occupational, and metabolic risks or clusters of risks for 195 countries and territories, 1990-2017: a systematic analysis for the Global Burden of Disease Study 2017

Background The Global Burden of Diseases, Injuries, and Risk Factors Study (GBD) 2017 comparative risk assessment (CRA) is a comprehensive approach to risk factor quantification that offers a useful tool for synthesising evidence on risks and risk–outcome associations. With each annual GBD study, we update the GBD CRA to incorporate improved methods, new risks and risk–outcome pairs, and new data on risk exposure levels and risk–outcome associations. Methods We used the CRA framework developed for previous iterations of GBD to estimate levels and trends in exposure, attributable deaths, and attributable disability-adjusted life-years (DALYs), by age group, sex, year, and location for 84 behavioural, environmental and occupational, and metabolic risks or groups of risks from 1990 to 2017. This study included 476 risk–outcome pairs that met the GBD study criteria for convincing or probable evidence of causation. We extracted relative risk and exposure estimates from 46 749 randomised controlled trials, cohort studies, household surveys, census data, satellite data, and other sources. We used statistical models to pool data, adjust for bias, and incorporate covariates. Using the counterfactual scenario of theoretical minimum risk exposure level (TMREL), we estimated the portion of deaths and DALYs that could be attributed to a given risk. We explored the relationship between development and risk exposure by modelling the relationship between the Socio-demographic Index (SDI) and risk-weighted exposure prevalence and estimated expected levels of exposure and risk-attributable burden by SDI. Finally, we explored temporal changes in risk-attributable DALYs by decomposing those changes into six main component drivers of change as follows: (1) population growth; (2) changes in population age structures; (3) changes in exposure to environmental and occupational risks; (4) changes in exposure to behavioural risks; (5) changes in exposure to metabolic risks; and (6) changes due to all other factors, approximated as the risk-deleted death and DALY rates, where the risk-deleted rate is the rate that would be observed had we reduced the exposure levels to the TMREL for all risk factors included in GBD 2017. Findings In 2017, 34·1 million (95% uncertainty interval [UI] 33·3–35·0) deaths and 1·21 billion (1·14–1·28) DALYs were attributable to GBD risk factors. Globally, 61·0% (59·6–62·4) of deaths and 48·3% (46·3–50·2) of DALYs were attributed to the GBD 2017 risk factors. When ranked by risk-attributable DALYs, high systolic blood pressure (SBP) was the leading risk factor, accounting for 10·4 million (9·39–11·5) deaths and 218 million (198–237) DALYs, followed by smoking (7·10 million [6·83–7·37] deaths and 182 million [173–193] DALYs), high fasting plasma glucose (6·53 million [5·23–8·23] deaths and 171 million [144–201] DALYs), high body-mass index (BMI; 4·72 million [2·99–6·70] deaths and 148 million [98·6–202] DALYs), and short gestation for birthweight (1·43 million [1·36–1·51] deaths and 139 million [131–147] DALYs). In total, risk-attributable DALYs declined by 4·9% (3·3–6·5) between 2007 and 2017. In the absence of demographic changes (ie, population growth and ageing), changes in risk exposure and risk-deleted DALYs would have led to a 23·5% decline in DALYs during that period. Conversely, in the absence of changes in risk exposure and risk-deleted DALYs, demographic changes would have led to an 18·6% increase in DALYs during that period. The ratios of observed risk exposure levels to exposure levels expected based on SDI (O/E ratios) increased globally for unsafe drinking water and household air pollution between 1990 and 2017. This result suggests that development is occurring more rapidly than are changes in the underlying risk structure in a population. Conversely, nearly universal declines in O/E ratios for smoking and alcohol use indicate that, for a given SDI, exposure to these risks is declining. In 2017, the leading Level 4 risk factor for age-standardised DALY rates was high SBP in four super-regions: central Europe, eastern Europe, and central Asia; north Africa and Middle East; south Asia; and southeast Asia, east Asia, and Oceania. The leading risk factor in the high-income super-region was smoking, in Latin America and Caribbean was high BMI, and in sub-Saharan Africa was unsafe sex. O/E ratios for unsafe sex in sub-Saharan Africa were notably high, and those for alcohol use in north Africa and the Middle East were notably low. Interpretation By quantifying levels and trends in exposures to risk factors and the resulting disease burden, this assessment offers insight into where past policy and programme efforts might have been successful and highlights current priorities for public health action. Decreases in behavioural, environmental, and occupational risks have largely offset the effects of population growth and ageing, in relation to trends in absolute burden. Conversely, the combination of increasing metabolic risks and population ageing will probably continue to drive the increasing trends in non-communicable diseases at the global level, which presents both a public health challenge and opportunity. We see considerable spatiotemporal heterogeneity in levels of risk exposure and risk-attributable burden. Although levels of development underlie some of this heterogeneity, O/E ratios show risks for which countries are overperforming or underperforming relative to their level of development. As such, these ratios provide a benchmarking tool to help to focus local decision making. Our findings reinforce the importance of both risk exposure monitoring and epidemiological research to assess causal connections between risks and health outcomes, and they highlight the usefulness of the GBD study in synthesising data to draw comprehensive and robust conclusions that help to inform good policy and strategic health planning