Prevalence of Anemia in Patients with Diabetes Mellitus:A Systematic Review and Meta-Analysis

Objective Anemia is a common public health concern in patients with type 2 diabetes worldwide.This study aimed to identify the prevalence of anemia among patients with diabetes.Methods Electronic databases,including PubMed,Scopus,Web of Sciences,and Google Scholar,were searched systematically for studies published between 2010 and 2021.After removing duplicates and inappropriate reports,the remaining manuscripts were reviewed and appraised using theNewcastleOttawa Scale(NOS)tool.A random-effects model was used to calculate the pooled estimates of the extracted data using Stata version 17.Heterogeneity of the studies was assessed using the Q statistic.Results A total of 51 articles containing information on 26,485 patients with diabetes were included in this study.The articles were mainly from Asia(58.82%)and Africa(35.29%).The overall prevalence of anemia was 35.45%(95%CI:30.30–40.76),with no evidence of heterogeneity by sex.Among the two continents with the highest number of studies,the prevalence of anemia in patients with diabetes was significantly higher in Asia[40.02;95%CI:32.72–47.54]compared to Africa[28.46;95%CI:21.90–35.50](P for heterogeneity=0.029).Moreover,there has been an increasing trend in the prevalence of anemia in patients with diabetes over time,from[15.28;95%CI:9.83–22.21]in 2012 to[40.70;95%CI:10.21–75.93]in 2022.Conclusion Globally,approximately 4 in 10 patients with diabetes suffer from anemia.Therefore,routine anemia screening and control programs every 3 months might be useful in improving the quality of life of these patients.

Reasons for informal payments from the perspective of health care providers and recipients:a qualitative study in Iran

Background:Informal payments are one of the major obstacles to health system reform in many developing countries,and its elimination is on the agenda of health system policymakers in many countries,including Iran.This study was conducted to identify the causes of informal payments in the Iranian health system.Methods:This was a qualitative and exploratory study.The study environment included the Ministry of Health,physicians’offices,medical universities,and hospitals and health centers.The study population included health care providers(physicians and hospital staff,managers,supervisors,and nurses)and health care recipients(patients or patients who had a history of dealing with informal payments).Data were collected using open-ended questions and semi-structured interviews.Snowball sampling method was used to select managers,chief executive officers(CEOs)and nurses.Convenience sampling was used to select physicians due to their lack of participation and cooperation.Content analysis method was used to analyze the data.Results:Reasons for informal payments were divided into 4 themes including:Economic factors(improper tariff valuation of services;failure to increase tariffs proportionate to inflation;lack of comprehensive participation of stakeholders in determining tariffs;tariff inconsistency in the public,private and charity sectors;etc.);socio-cultural factors(decreased social capital of the medical community among the people;improving the quality of life;incorrect comparison of providers’income levels with the income of doctors in other countries;existence of a culture of gratitude and appreciation;health as a priority for society;pride of service recipients;pride of service providers;etc.);service delivery challenges(high professional skills of the doctor;use of modern medical equipment;the monopoly of some doctors,etc.)and legal-political factors(inadequate monitoring by upstream organizations;lack of strict rules;difficulty of proving informal payments;presence of stakeholders in management and policy making processes).Conclusions:Knowing the causes of informal payments can help reduce or eliminate it.The results of this study identified the causes of informal payments in the Iranian health system.Accurate knowledge of the needs and motivations of both health care providers and recipients can be effective in accurately identifying and eliminating this phenomenon.

Analysis of dynamic wave model for flood routing in natural rivers

Flooding is a common natural disaster that causes enormous economic, social, and human losses. Of various flood routing methods, the dynamic wave model is one of the best approaches for the prediction of the characteristics of floods during their propagations in natural rivers because all of the terms of the momentum equation are considered in the model. However, no significant research has been conducted on how the model sensitivity affects the accuracy of the downstream hydrograph. In this study, a comprehensive analysis of the input parameters 9f the dynamic wave model was performed through field applications in natural rivers and routing experiments in artificial channels using the graphical multi-parametric sensitivity analysis （GMPSA）. The results indicate that the effects of input parameter errors on the output results are more significant in special situations, such as lower values of Manning＇s roughness coefficient and/or a steeper bed slope on the characteristics of a design hydrograph, larger values of the skewness factor and/or time to peak on the channel characteristics, larger values of Manning＇s roughness coefficient and/or the bed slope on the space step, and lower values of Manning＇s roughness coefficient and/or a steeper bed slope on the time step and weighting factor.

Evaluation of clinical competence and its related factors among ICU nurses in Kermanshah-Iran: A cross-sectional study

Objectives:The present study was conducted to evaluate the clinical competence and its related demographic factors among critical care nurses in Kermanshah,Iran.Methods:In this cross-sectional study,155 Iranian nurses were selected by stratified random sampling.The data collection tools included a personal information form and the"Nurse Competence Scale".Data were analyzed using descriptive and analytical statistics.Results:The mean score of nurses'clinical competence was equal to 76.14±1.59 out of 100,which was at a"very good level".The mean score of using clinical competence in practice was equal to 70.38±15.25 out of 100,which was at a"good level".Among the subscales of clinical competence,the highest mean score was related to"managing situation".The mean score of"using clinical competence in practice"was related to the subscale of"therapeutic interventions".There was no statistically significant difference among the score of clinical competence of nurses varying with different gender,age,academic degree,and work experience.Conclusions:The clinical competence of critical care nurses in Kermanshah was at a"very good"level,and the use of clinical competence in practice was at a"good level."Given the importance of clinical competencies in practice,nurses'clinical competence should be evaluated objectively and positive measures should be taken to promote the application of their clinical competence.

Improving the Sound Absorption Properties of Flexible Polyurethane (PU) Foam using Nanofibers and Nanoparticles

Polyurethane foam as the most well-known absorbent materials has a suitable absorption coefficient only within a limited frequency range.The aim of this study was to improve the sound absorption coefficient of flexible polyurethane(PU)foam within the range of various frequencies using clay nanoparticles,polyacrylonitrile nanofibers,and polyvinylidene fluoride nanofibers.The response surface method was used to determine the effect of addition of nanofibers of PAN and PVDF,addition of clay nanoparticles,absorbent thickness,and air gap on the sound absorption coefficient of flexible polyurethane foam(PU)across different frequency ranges.The absorption coefficient of the samples was measured using Impedance Tubes device.Nano clay at low thicknesses as well as polyacrylonitrile nanofibers and polyvinyl fluoride nanofibers at higher thicknesses had a greater positive effect on absorption coefficient.The mean sound absorption coefficient in the composite with the highest absorption coefficient at middle and high frequencies was 0.798 and 0.75,respectively.In comparison with pure polyurethane foam with the same thickness and air gap,these values were 2.22 times at the middle frequencies and 1.47 times at high frequencies,respectively.Surface porosity rose with increasing nano clay,but decreased with increasing polyacrylonitrile nanofibers and polyvinyl fluoride nanofibers.The results indicated that the absorption coefficient was elevated with increasing the thickness and air gap.This study suggests that the use of a combination of nanoparticles and nanofibers can enhance the acoustic properties of flexible polyurethane foam.

Effects of shallomin and podophyllin solution 25% for genital HPV warts in women: a randomized controlled trial

Objective: To compare the effect of shallomin (pure fraction of Allium hirtifolium) with podophyllin 25% solution on external genital human papillomavirus warts in women. Methods: This study was a randomized controlled trial which was performed on two groups of 25 Iranian women with external genital warts at Imam Khomeini Hospital in Ahvaz, Iran. In the first group, shallomin was used once a day for six weeks at home. In the second group, 25% podophyllin solution, was applied on the lesion once weekly for six weeks. Results: Shallomin and podophyllin resulted in wart clearance in 13/23 (56.5%), and 12/24 (50%) of patients, respectively. The clearance rate for shallomin was not significantly different from that of podophyllin (P=0.082). Six weeks after the treatment, the sizes of the lesions in the shallomin group and the podophyllin group decreased by (1.43±0.53) mm and (1.64±0.70) mm, respectively. Conclusion: Shallomin is an effective treatment for genital warts, with similar efficacy to that of podophyllin.

Duffy blood group genotypes among malaria Plasmodium vivax patients of Baoulch population in southeastern Iran

Objective:To determine the distribution of Duffy blood group genotypes in Balouch population as a major ethnic group that living in a sub-tropical area in south East of Iran.Methods:In this study,the Duffy blood group FY phenolypes were determined using indireet anti-globulin technique and also genotype by PCR-RFLP in 160 vivax malaria patients and 160 control individuals.Results:The results showed that the most common Duffy geitolype was FYA/FYB(46.6%)followed by FYA/FYA(15.3%),FYA/FYO(14.4%),FYB/FYO(11.9%,),FYB/FYB(10%)and FYO/FYO(1.9%).In case individuals,frequency of FY A.FYB and FYO alleles were 0.471,0.431and 0.097,respectively compaired to 0.444,0.353 and 0.203,respectively in control(non-infected)group.Conclusions:This data provide evidence that individuals with the FYA/FYB genotype have higher susceptibility to malaria and there are significant associations between Duffy blood group variants and susceptibility or resistance to vivax malaria.

Prevalence of refractive errors among primary school children in a tropical area,Southeastern Iran

Objective: To determine the prevalence of refractive errors among primary school children in Zahedan District, Southeastern Iran, as a tropical area.Methods: In this cross sectional study, a total of 400 students were selected randomly using multi-stage sampling technique. Myopia was defined as spherical equivalent(SE)of-0.5 diopter(D) or more, hyperopia was defined as SE of +2.00 D or more and a cylinder refraction greater than 0.75 D was considered astigmatism. Anisometropia was defined as a difference of 1 D or more between two eyes. Cycloplegic refractive status was measured using auto-refractometer(Topcon 8800). Data were analyzed using SPSS,version 22 software program.Results: Mean ± SD of SE was(1.71 ± 1.16) D. A total of 20 students [6.3%, 95%confidence interval(CI): 3.96%–9.64%] were myopic(-0.5 D), 186 students(58.1%,95% CI: 52.50%–63.56%) were hyperopic( +2.00 D) and 114 students(35.6%, 95%CI: 30.43%–41.18%) were emmetropic. The prevalence of astigmatism( 0.75 D)among students was 3.4%(95% CI: 1.82%–6.25%). Anisometropia of 1 D or more was found in 21.3%(95% CI: 16.98%–26.23%) of the studied population. The prevalence of refractive errors was higher among girls than boys(73.1% vs. 55.6%, P = 0.001), but it was not significantly different among different age groups(P = 0.790).Conclusions: Refractive errors affect a sizable portion of students in Zahedan. Although myopia is not very prevalent, the high rate of hyperopia in the studied population emphasizes its need for attention.

Comparison between Quanti-FERON-TB Gold In-Tube test and tuberculin skin test for diagnosis of latent tuberculosis in children: A cross-section study

Objective: To compare Quanti-FERON-TB Gold In-Tube (QFT-GIT) test and tuberculin skin test (TST) for the diagnosis of latent tuberculosis infection in children. Methods: In this cross-sectional study, 64 participants who were between 3 months and 14 years old and had close contact with smear-positive pulmonary tuberculosis were included. Both QFT-GIT test and TST were done and the results were analyzed by SPSS software and Kappa test. Results: The distribution of gender and age according to QFT-GIT and TST results were matched (P>0.05). Overall agreement between QFT-GIT and TST for diagnosis of latent tuberculosis infection in children was 75%. In addition, the contingency coefficient was 0.257, and the Kappa measure of agreement was 0.246 (P=0.034). Conclusions: Compared to TST, QFT-GIT shows no apparent advantage for diagnosis of latent tuberculosis infection in children.

Computational Stimulation and Experimental Study on Corrosion Inhibition Qualities of <i>Emilia sonchifolia</i>Leaf Extract for Copper (CU131729) in Hydrochloric Acid

Copper corrosion inhibition by Emilia sonchifolia (ES) leaf extract has been studied in 2 M hydrochloric acid solution using electrochemical measurement, energy dispersive X-ray emission spectroscopy and surface examination techniques. Computational simulations were adopted to describe probable reactiveness of individual ES leaf constituents and mechanism of interaction with copper crystal. Results obtained from potentiodynamic polarization revealed a shift in corrosion potentials of copper (CU131729) to more positive potentials in the presence of ES leaf extract with increased effect as inhibitor concentration increased and also a decrease in both current densities suggesting a mixed type inhibitor characteristics with pronounced anodic protection. Surface elemental characterization revealed presence of the inhibitor species in the corrosion products formed on corroded CU131729 surface confirming the formation of complex chelating ligands through interactions with the metal surface. Quantum chemical calculations and molecular dynamics simulations were employed to theoretically analyse the interactions of individual ES leaf constituent with copper surface at the molecular level and obtained results revealed strong and spontaneous adsorption with high binding energies which affirms observed quality inhibition action. Quantum chemical descriptors such as energy of HOMO and LUMO, energy gap, number of transferred electrons, global hardness and softness, electrophilicity, and interaction energy were computed and discussed.

Migraine History and Breast Cancer Risk: A Systematic Review and Meta-Analysis

Objective: The relationship between migraine and breast cancer risk has been reported inconsistently across different epidemiological studies. This meta-analysis was performed to explore the overall effect of migraine on breast cancer risk. Method: An electronic search of different major databases was conducted, including PubMed, Scopus, ScienceDirect, and the Cochrane library until February 1st, 2015. Of 652 retrieved studies, six population-based studies including two cohort studies with 130,812 and four case-control studies with 14,396 people were included in the analysis. Results: There was an inverse relationship between migraine and breast cancer risk (OR = 0.77;95% CI: 0.64, 0.92). Conclusion: The results of this meta-analysis showed that women with migraine history have a decreased risk of breast cancer. Further biological studies are needed to address the association.

National Breast Cancer Mortality and Incidence Rates According to the Human Development Index: An Ecological Study

Background: This study aimed to identify the role of human development index (HDI) in the incidence and mortality rates of breast cancer (BC) worldwide. Methods: Data on the age-standardized incidence and mortality rates of BC for 184 countries were obtained from the GLOBOCAN. Data about the HDI and other indices were obtained from the World Bank Report 2013. Linear regression model was used for assessment the effect of HDI on BC occurrence rates. Results: In 2012, BCs were estimated to have affected a total of 1,671,149 individuals (crude rate: 47.8 per 100,000 individuals), and caused 521,907 deaths worldwide (crude rate: 14.7 per 100,000 individuals). Nearly half of total female BC cases (46.3%) with the highest risk of incidence (age-standardized Rate (ASR): 128 per 100,000) had occurred in very high HDI regions. The most proportion of the mortality burden was in low HDI and medium HDI areas. Linear regression analyses showed a direct significant correlation between the incidence of BC and HDI at the global level (B = 104.5, P < 0.001). The mortality rate of BC was not significantly associated with HDI (B = 3.26, P = 0.160). Conclusion: Our study showed that the burden of female BC is enormous in very high HDI and low HID regions. Targeted interventions have the ability to reduce this number significantly through resource-dependent interventions. Moreover, further reductions in mortality could be brought about by increasing access to curative treatment for patients with BC.

Factor Structure and Measurement Invariance of the Japanese Version of the Mother-to-Infant Bonding Scale

Background: Bonding disorders affect the growth and development of infants. In Japan, the Japanese version of the Mother-to-Infant Bonding Scale (MIBS-J) is widely used for early detection of bonding disorders. Repeated use of a questionnaire has problems of reduced validity. In order to correctly detect bonding disorders at multiple time points, it is necessary to confirm the measurement invariance of the scale. Baba et al. reported that invariance of the MIBS-J factor structure could only be obtained by abridging the scale into three items. Purpose: The aim of this study was to 1) confirm the factor structure and measurement invariance of the MIBS-J between two measurement times and 2) to examine factors that can be used without being affected by measurement time in order to identify item that contribute to measure met invariance. Methods: We analysed the data of 1049 and 878 mothers with a neonate collected in two waves: 5 days (Wave 1) and 1 month postpartum (Wave 2). Exploratory and confirmatory factor analyses were conducted on the data randomly divided into two groups in each wave. Results: The three-item model (MIBS-J items 1, 6, and 8) was most accepted. Measurement invariance and structural invariance were confirmed in the model. This was consistent with Baba et al.’s model. Conclusion: The three MIBS-J items showed measurement invariance and structural invariance in Japanese mothers during 1 month postpartum.

Inequality in mammography uptake:results from recruitment phase of first cohort study among Iranian Kurdish population

Background:Breast cancer is the most common malignant disease in women and is the leading cause of cancer deaths among women.Mammography is the best and the most available diagnostic method for breast cancer early detection.The aim of this study was to investigate the prevalence and inequality in the mammography uptake among Kurdish women in the west of Iran.Methods:This cohort study was conducted using data extracted from the Ravansar Non-communicable Cohort Study among Kurdish women in the west of Iran from 2014 to 2018.The sample included 5289 women aged 35-65 years.The relative and generalized(absolute)concentration index(RC and GC,respectively)was used to quantify and decompose socioeconomic inequalities in mammography uptake.Results:Overall concentration index for mammography was 0.2107,indicating that the mammography uptake concentration was greater in women with a higher socioeconomic status(SES).The predictor variables accounted for 44.6%of the inequality in the mammography uptake.Higher SES,living in urban areas,and age group of 51-55 years old increased the chance of having a mammogram.Available evidence supports the inequality of mammography uptake in favor of women with higher SES.Conclusions:Cost-free screening services for low SES women,and the development of breast cancer prevention campaigns focusing on disadvantaged women could have an important role in mammography uptake and in the reduction of inequalities.

The common road safety approaches:A scoping review and thematic analysis

Purpose:Comparison of effective road safety approaches with those of relatively similar countries can be used to identify possibilities for safety improvement.Since there is no clear and comprehensive study of countries'current and successful approaches to road safety in the world,the aim of this study was to identifying common road safety approaches in the world.Methods:This study was performed using scoping review and thematic analysis.The study followed the approach proposed by Arksey and O'Malley.In this study all articles were selected without time limit by searching in the following databases:Web of Science,PubMed,Scopus,ProQuest,and Embase.An initial search of 5612 papers was found and finally,20 papers met the inclusion criteria and were analyzed.Results:There were different road safety approaches in different countries around the world,which were classified in three themes:traditional approach,systemic approach,and vision zero.The traditional approach includes the sub-theme of the road-user approach,and the causal approach.The systemic approach also includes sub-themes of sustainable safety,safety system,and the United Nations plan for decade of action,Conclusion:A systemic approach to road safety seems to be welcomed by most developed and developing countries,and a paradigm shift towards a safe system has taken place.Also,given the successful results of implementing vision zero in leading countries,most countries are trying to design and implement this approach.Finally,the choice and implementation of road safety approaches varies according to the principles,priorities and infrastructure of each country.

Clinical Observation on Treatment of Infantile Brachia Plexus Injuries with ＂Three Therapies of Clearing the Meridians＂

Objective： To observe the clinical efficacy of treatment of infantile brachia plexus injuries with three cooperative therapies of Tuina, Acupuncture and Acupoint injection, which have the function of clearing the meridians. Methods： The affected neck and arm were relaxed with Tuina techniques of one-thumb meditation, grasping and kneading. The points of Jiaji （Ex-B 2） on the neck, Jianjing （GB 21）, Futu （LI 18）, Jiquan （HT 1）, Jianyu （LI 15）, Quchi （LI 11）, ect were pressed with one thumb. The points of Jiaji （Ex-B 2） on the neck, Tianchuang （SI 16）, Futu （LI 18）, Jiquan （HT 1）, Quchi （LI 11）, Waiguan （TE 5）, Yangchi （TE 4）, Hegu （LI 4） and the corresponding points were inserted with filiform needles and reinforcing-reducing method. The points of Jianyu （LI 15）, Jianliao （TE 14）, Quchi （LI 11）, Shousanli （LI 10）, Waiguan （TE 5）, Yangchi （TE 4）, Hegu （LI 4） were injected with Methylcobalamin injection. The treatment was given once every other day. Results： Of 35 cases, 22 cases were cured, 9 cases greatly improved and 4 cases improved. Conclusion： ＂Three Therapies of Clearing Meridians＂ have a good clinical efficacy for treating infantile brachia plexus injuries.

Injury surveillance information system: A review of the system requirements

Purpose: An injury surveillance information system (ISIS) collects, analyzes, and distributes data on injuries to promote health care delivery. The present study aimed to review the data elements and functional requirements of this system.Method: This study was conducted in 2019. Studies related to injury surveillance system were searched from January 2000 to September 2019 via the databases of PubMed, Web of Knowledge, ScienceDirect, and Scopus. Articles related to the epidemiology of injury, population survey, and letters to the editor were excluded, while the review and research articles related to ISISs were included in the study. Initially 324 articles were identified, and finally 22 studies were selected for review. Having reviewed the articles, the data needed were extracted and the results were synthesized narratively.Results: The results showed that most of the systems reviewed in this study used the minimum data set suggested by the World Health Organization injury surveillance guidelines along with supplementary data. The main functions considered for the system were injury track, data analysis, report, data linkage, electronic monitoring and data dissemination.Conclusion: ISISs can help to improve healthcare planning and injury prevention. Since different countries have various technical and organizational infrastructures, it is essential to identify system requirements in different settings.

Relationship between using cell phone and the risk of accident with motor vehicles:An analytical cross-sectional study

Purpose Traffic accidents are one of the major health problems in the world,being the first cause of burden of illness and the second leading cause of death in Iran.The Sistan-Baluchestan province is one of the most accidental provinces of Iran with the highest rate of accidents-caused deaths.This study was conducted to determine the risk factors associated with traffic accidents in Zahedan through 2013 to 2016.Methods This analytical cross-sectional study was carried out on 223 drivers from Zahedan who were traumatized by traffic accident and sent to Zahedan hospitals.The data were obtained through interviews taken by the trained interviewers via refereeing to the medical records and collected in the researcher-made checklist.Census was obtained from the study subjects.For data analysis,independent t-test,one-way ANOVA,Chi-square and logistic regression were used with the Stata software version 11.0.Results In this study,223 male subjects with the mean age of(32.54±12.95)years,39.8%single and 60.2%married,entered for investigation.Most accidents(38.8%)occurred between 12:00 to 17:59.While driving,47.1%of the study subjects were using cell phones,89.1%had manual use of mobile phones,21.9%had a habit of sending short message service(SMS)and 23.4%had sent SMS within 10 min before the accident.The one way analysis of variance showed that the mean age of individuals with marital status,driving experience,education and accident with motorcycle were significantly different(p<0.05).Also,the multivariate logistic regression test indicated a significant relationship of smoking,ethnicity,insurance and SMS typing while driving with motorcycle accident(p<0.05).Conclusion In this study,SMS and smoking while driving had the highest risk among the variables studied in the motorcycle accidents.Therefore,effective education attempting to enhance people's awareness about the consequences of using cell phone and smoking during driving to reduce traffic accidents seems necessary.

Road safety data collection systems in Iran: A comparison based on relevant organizations

Purpose:Various organizations and institutions are involved in road traffic injury(RTI)and crash registration such as police,forensic medicine organization,hospitals and emergency medical services.But there is a substantial uncertainty in interpreting the data,duplicated data collection and missing data in relation to RTI in most systems.This study aims to identify data sources for RTI surveillance in Iran and to explore traffic safety data source domains,data elements and detailed information by each data source.Methods:This is a qualitative study which was conducted in 2017 in Iran.Data were collected employing semi-structured interviews with informants in road safety organizations in relation to traffic safety including Police,Ministry of Health and Medical Education as well as Forensic Medicine Organization and other authorities-in-charge.For completing the preliminary extraction information,the minimum data set was used and compared in each system.Results:Eight different organizations relevant to road traffic safety were identified.The main domain of data provided by each one consists of Emergency Medical System form,Police KAM114 form,Ministry of Transport and Road Administration,Red Crescent Organization/Disaster Management Information System,Ministry of Health and Medical Education,Forensic Medicine Organization,Insurance Company and Ministry of Justice.Each system has its own database,based upon its scope and mainly at crash and postcrash status and little on pre-crash circumstance.Conclusion:All current registry systems are not surveillance systems for RTI prevention.Huge data have been collected in various registry systems in Iran,but most of the collected variables are duplicated in each system.On the other hand,some variables like alcohol and substance abuse,child seat belt,helmet use in relation to RTI prevention are missed in all systems.Accordingly,it is a critical need to integrate and establish a comprehensive surveillance system,with focus on the goal of each system and collection of minimum data in each organization,which currently is underway.