Predicting COVID-19 fatality rate based on age group using LSTM

Objective: To predict the daily incidence and fatality rates based on long short-term memory (LSTM) in 4 age groups of COVID-19 patients in Mazandaran Province, Iran. Methods: To predict the daily incidence and fatality rates by age groups, this epidemiological study was conducted based on the LSTM model. All data of COVID-19 disease were collected daily for training the LSTM model from February 22, 2020 to April 10, 2021 in the Mazandaran University of Medical Sciences. We defined 4 age groups, i.e., patients under 29, between 30 and 49, between 50 and 59, and over 60 years old. Then, LSTM models were applied to predict the trend of daily incidence and fatality rates from 14 to 40 days in different age groups. The results of different methods were compared with each other. Results: This study evaluated 5 0826 patients and 5 109 deaths with COVID-19 daily in 20 cities of Mazandaran Province. Among the patients, 25 240 were females (49.7%), and 25 586 were males (50.3%). The predicted daily incidence rates on April 11, 2021 were 91.76, 155.84, 150.03, and 325.99 per 100 000 people, respectively; for the fourteenth day April 24, 2021, the predicted daily incidence rates were 35.91, 92.90, 83.74, and 225.68 in each group per 100 000 people. Furthermore, the predicted average daily incidence rates in 40 days for the 4 age groups were 34.25, 95.68, 76.43, and 210.80 per 100 000 people, and the daily fatality rates were 8.38, 4.18, 3.40, 22.53 per 100 000 people according to the established LSTM model. The findings demonstrated the daily incidence and fatality rates of 417.16 and 38.49 per 100 000 people for all age groups over the next 40 days. Conclusions: The results highlighted the proper performance of the LSTM model for predicting the daily incidence and fatality rates. It can clarify the path of spread or decline of the COVID-19 outbreak and the priority of vaccination in age groups.

Predicting COVID-19 fatality rate based on age group using LSTM

Objective: To predict the daily incidence and fatality rates based on long short-term memory (LSTM) in 4 age groups of COVID-19 patients in Mazandaran Province, Iran. Methods: To predict the daily incidence and fatality rates by age groups, this epidemiological study was conducted based on the LSTM model. All data of COVID-19 disease were collected daily for training the LSTM model from February 22, 2020 to April 10, 2021 in the Mazandaran University of Medical Sciences. We defined 4 age groups, i.e., patients under 29, between 30 and 49, between 50 and 59, and over 60 years old. Then, LSTM models were applied to predict the trend of daily incidence and fatality rates from 14 to 40 days in different age groups. The results of different methods were compared with each other. Results: This study evaluated 5 0826 patients and 5 109 deaths with COVID-19 daily in 20 cities of Mazandaran Province. Among the patients, 25 240 were females (49.7%), and 25 586 were males (50.3%). The predicted daily incidence rates on April 11, 2021 were 91.76, 155.84, 150.03, and 325.99 per 100 000 people, respectively; for the fourteenth day April 24, 2021, the predicted daily incidence rates were 35.91, 92.90, 83.74, and 225.68 in each group per 100 000 people. Furthermore, the predicted average daily incidence rates in 40 days for the 4 age groups were 34.25, 95.68, 76.43, and 210.80 per 100 000 people, and the daily fatality rates were 8.38, 4.18, 3.40, 22.53 per 100 000 people according to the established LSTM model. The findings demonstrated the daily incidence and fatality rates of 417.16 and 38.49 per 100 000 people for all age groups over the next 40 days. Conclusions: The results highlighted the proper performance of the LSTM model for predicting the daily incidence and fatality rates. It can clarify the path of spread or decline of the COVID-19 outbreak and the priority of vaccination in age groups.

Explicit priority setting approaches in health care coverage policies

Background: Several explicit approaches are used to make decision on health services coverage and to develop the basic health package. In this study, first the approaches used to prioritize health services were introduced, and then the limitations of each method were reported

Methods: We critically reviewed market literature regarding explicit priority setting approaches. The current literature focusing on explicit priority setting approaches in health care system was reviewed

Results: Eight explicit approaches for prioritizing health care were identified: CEA, CEA / BOD, PBMA, HTA, MCDA, A4R, the Value Assessment Framework, and combinational approaches such as MCDA-A4R and PBMA-A4R. Developing the value framework for making a decision, not just informing a decision was needed to be investigated

Conclusion: This study addressed the explicit health services prioritization methods. The results showed that a value framework approach as one of the innovative approaches that has become increasingly widespread in recent years can help to achieve goals of the health system

Correlation between serum ferritin level and histopathological disease severity in non-alcoholic fatty liver disease

Background: Non-alcoholic fatty liver disease [NAFLD] is one of the most common causes of chronic liver disease worldwide. Recently several parameters, such as serum ferritin, have emerged as possible predictors for the severity of NAFLD and insulin sensitivity. We aimed to investigate the value of serum ferritin level as a useful biomarker for the prediction of histopathological disease severity in non-alcoholic steatohepatitis [NASH], the necro-inflammatory form of NAFLD

Methods: This was a prospective cross sectional study in which demographic, clinical, histological, laboratory, and anthropometric data of 30 adult patients with biopsy-proven NAFLD/NASH were analyzed

Results: In our patients population with mean age of 37.9 years and mean BMI of 26.5, statistical analysis did not show a significant difference between the three grades of steatosis in the mean ferritin levels [p=0.559]. It was also observed that ferritin level did not have a significant correlation with the stage of fibrosis [p =0.228]. The mean transferrin saturation did not show significant difference in different stages and grades of NASH [p =0.260 and 0.944, respectively], either

Conclusion: Serum ferritin level may not be useful as a single marker for the prediction of histopathological severity of disease in young patients with NASH who are not morbidly obese

[Evaluation of antiviral effects of sumac [Rhus coriaria L.] fruit extract on acyclovir resistant Herpes simplex virus type 1]

Background: Herpes simplex virus type 1 [HSV-1] is a common virus in human. The rate of drug resistance is increasing in HSV-1. In this study, anti-viral effects of Rhus coriaria L. fruit extract was evaluated against acyclovir resistant HSV-1 before, during and after the infection of Hela cell line

Materials and methods: In this experimental study, the trypan blue and 3-[4,5-dimethylthiazol-2-yl]-2,5 diphenyltetrazolium bromide [MTT] tests were used to rule out the potential toxic effects extract on the Hela cell line. Antiviral effects of the extract on acyclovir resistant HSV-1 were evaluated before the infection and at different concentrations of the extract. The effective minimal cytotoxic concentration was assessed at different times of virus replication after virus adsorption. Virus titer was determined by tissue culture infectious dose 50 [TCID50] method

Results: The CC50 value and effective minimal cytotoxic concentration were determined at 780 micro g/ml and 390 micro g/ml respectively. Treatment of HSV-1 with extract resulted in 1 log10 TCID50 reduction in virus titers after 3 and 4 hour. The highest reduction in acyclovir resistant HSV-1 infectivity was obtained 2 and 4 hour after the infection of the cells with virus resulting in 1.7 log10 TCID50 reduction as compared with control

Conclusion: The antiviral effects of Rhus coriaria L. fruit extract on acyclovir resistant HSV-1 after virus infection was more remarkable than the treatment of virus with the extract before virus adsorption

Shaping the health and foreign policy framework; lessons learned for global health diplomacy in Iran

Background: Today, peace and stability of health diplomacy in the Eastern Mediterranean region is faced with many challenges. In spite of extensive ignorance on health consequences in other fields and priorities of foreign policy, but foreign policy can be applied to improve health particularly in international health negotiations

Methods: To conduct this non-systematic review, articles relevant with the topic were selected from published texts and credible databases for investigation. Databases included Medline, web of science, Google scholar, Springer, PubMed, and all news websites

Results: Since issues of health are getting more political, having political view and mastering negotiation techniques is necessary. One of these conditions is multilateral negotiations, in which non-governmental organizations, advocacy groups, foundations, research centers, and private sectors get together to affect the present representatives of the member countries' decision making about health topics and also to be part of the negotiation process. On the other hand, the international commitments of the Millennium Development goals, has put the health issue in a special position in international discussions. Further, epidemic growth of emerging diseases [such as AIDS, hepatitis, and influenza], immigration, and the sanctions have their impacts on the health sector, especially medicines and equipment, its serious impact on public health is also considered as an undeniable threat

Conclusion: In order to have effective application, health policy principles should be coordinated with other forms of diplomacy and also be placed at the top of all key stakeholders' affairs including the Ministry of Health and other organizations effective on the health. Thus, to achieve the Millennium Development Goals and to escape from the problems based on the objectives of Vision 2025; this approach will solve many problems

Waiting time to receive healthcare services and factors affecting it: Case study in a university hospital

Background: The clinic in a hospital is usually the first place to which patients are referred. A long queue, which results in dissatisfaction among patients, is economically costly for managers; medical institutions can, therefore, determine the level of required resources for optimum investment through management tools like queue theory and waiting time caused by it. The current study was conducted to evaluate waiting time at various clinics of Amir Alam Hospital in Tehran

Methods: The analytical study was conducted in the period from April to August in 2015 on 150 patients who were referred to five clinics of Amir Alam Hospital. The samples were selected through stratified random proportion to sample size and data was collected in a designed frame through SPSS[21] and descriptive tests of mean, standard deviation and regression analysis

Results: The longest waiting time for patients was related to the surgery clinic at 61.05 minutes. Also, the longest time to provide service was related to the surgery unit at 26.84 minutes. Results obtained from univariate logistic regression test indicated that all evaluated variables-including time to receive service, capacity of providing service, order of queues and number of doctors-exert a significant effect on waiting time of patients in the hospital [P-value < 0.05]

Conclusion: Increasing capacities, keeping adequate number of doctors, reforms, removal of unnecessary works and using scientific tools to manage queues can be effective in reducing waiting time for patients. Owing to its importance for patient satisfaction, it is necessary for managers to think of ways to shorten queues in hospitals

Rapid detection of MDR-Mycobacterium tuberculosis using modified PCR-SSCP from clinical Specimens

Objective: To design a rapid test to detect the rifampin (RIF) and isoniazid (INH) resistant mutant based on polymerase chain reaction-single strand conformation polymorphism (PCR-SSCP) technique that analyzes the katG, rpoB genes.Methods:tuberculosis. To determine the susceptibility of isolates to anti TB drugs, the proportional method was used. Mutations presented within the amplified products of the katG, rpoB genes were evaluated by SSCP.Results:Using proportional method, 12 (11.6%) and 9 (8.7%) isolates were resistant respectively Biochemical test as well as IS6110 targeting PCR revealed 103 clinical samples were to INH and RIF and 9 (8.7%) isolates showed resistance to both drug (multi-drug resistant tuberculosis). Three (2.9%) multi-drug resistant tuberculosis and two INH resistant isolates were detected by the PCR-SSCP and sequencing. The sensitivity and specificity of PCR-SSCP for multi-drug resistant isolates were 33% and 100%, respectively.Conclusions:Complete agreement between SSCP and sequencing can indicate that resistance-associated mutations have occurred in other genes except our considered genes.

Pattern of traumatic injuries and injury severity score in a major trauma center in shiraz, southern iran

Objective: To record and classify mechanisms of injury and injury severity score [ISS] in trauma patients admitted to the largest trauma center in Southern Iran

Methods: This was a prospective cross-sectional study including all the patients who were admitted to Nemazee hospital from 2009 to 2010. We recorded the trauma injury information of 1217 patients who were admitted to of emergency room of the Nemazee hospital during a 13-months period by means of a standard questionnaire. ISS was then obtained for every single patient

Results: The mean age of patients was 26.6 +/-15.1 [range 1-95] years. The commonest type of trauma including 279 cases [22.9%] was car accident and the least resulted from shotgun injuries in 13 [1.1%] patients. The lowest ISS was due to assault multiple blunt traumas and the highest ISS resulted from shotgun injury. The mean ISS was about 6.3 +/- 1.8 [range 1-66]. Overall, 86 patients had scores above 17 [7.1%]. A total of 69 male patients [7.5%] compared to 17 females [5.7%] had severe injury [ISS>17]. Trauma injuries were significantly more severe in males compared to females [p=0.014]. In the sunny and hot seasons total number of patient was higher. The mean ISS was highest in during spring [p<0.001]

Conclusion: In Shiraz, most of the trauma injuries are occurred during summer and hot weather. Men have greater number of injuries and higher ISS compared to women. The lowest ISS was due to assault multiple blunt trauma and the highest ISS was caused by shotgun injury, and car accident was the commonest cause of trauma with head and neck being the most frequent sites in our patients

Apoptosis induction of salvia chorassanica root extract on human cervical cancer cell line

Salvia chorassanica Bunge is one of the Iranian endemic species of Salvia. There is not any reported literature on S. chorassanica. This study was designed to examine the in-vitro anti- proliferative and proapoptotic effects of the methanol extract of S. chorassanica and its fractions on HeLa cell line. Cells were cultured in EX-CELL®, an animal free medium specially designed for HeLa cell line and incubated with different concentrations of plant extracts. Cell viability was quantified by MTS assay. Apoptotic cells were determined using propidium iodide [PI] staining of DNA fragmentation by flow cytometry [sub-G1 peak]. Activity of caspase -3, -8 and -9 was measured by the caspase colorimetric kit assay. S. chorassanica inhibited the growth of malignant cells and the CH[2]Cl[2] fraction was determined as the most cytotoxic fraction in comparison with other fractions. The calculated IC[50] values for methanol extract, n-hexane, and CH[2]Cl[2] and EtOAc fractions were 8.841, 5.45, 2.38, and 58.03 [micro]g/mL, respectively. S. chorassanica induced a sub-G1 peak in the flow cytometry histogram of treated cells compared to control cells indicating that the cytotoxic mechanism is characterized by apoptosis induction. The activity of caspase-3 and 8 proteins in treated HeLa cells was significantly higher than that of the control while caspase-9 activity did not change significantly. Based on the result obtained from our study, the apoptosis pathway involved in S. chorassanica-induced cell death may be through the extrinsic pathway and it can be a novel promising candidate in the treatment of cancer

[Relationship of specialty select and education place with internship students anxiety in 2010]

Background and Objectives: Selection of specialty field to continue education is such a great challenge for general physicians that can create stress in their personal life. The purpose of this study is survey of relationship of specialty select and education place with internship students anxiety in 2010

Methods: This descriptive and cross-sectional study was performed on a total of 370 medical residents selected through stratified sampling from Isfahan, Guilan, Zahedan, Sanandaj and Kashan Universities of Medical Sciences, Iran. Data were collected through demographic features questionnaire and Zung anxiety self-evaluation questionnaire

Results : More than 92% of residents did not have anxiety and were in normal condition. From all, 168 [45.4%] had selected their specialty field based on just their personal interests, 55 [14.9%] based on external factors, and 147 [39.74%] based on both internal and external factors. In regard to the place of study, 220 residents [59.5%] were studying in their first three preferred cities and there was a significant relationship between anxiety and place of education [P < 0.05]

Conclusion: Since academic satisfaction and success of medical residents is highly dependent on studying in their favorite specialty field and place, administrative programming by officials and planners is highly required for omitting barriers in selecting field and place of education

[Effect of insulin on local and tissue ace activity in diabetic rats]

Background: the precise mechanisms of vascular diseases in insulin dependent diabetes mellitus [IDDM] are not clearly understood. There are evidences of alteration in mechanisms involved in regulating vascular tone including increased ACE activity in some tissues. To investigate the effect of insulin treatment on these changes this study was performed

Methods: three groups of 8 male Sprauge Dawely rats including control [C] and two diabetic groups [D, IT] were used in this study. Diabetes was induced by injection of 60 mg/kg STZ ip. After induction of diabetes IT group were treated with insulin [10 units/kg/day s.c.] for four weeks. The control group and the untreated diabetic group were treated with the same amount of Saline and for the same time. ACE activity was determined by HPLC method

Results: 4 weeks after induction of diabetes, SBP and ACE activity in serum, lung, heart and aorta increased in D group compared to control rats. Insulin treatment reversed these changes to normal values in IT group

Conclusion: it is concluded that increased ACE activity could contribute to the development of diabetic vasculopathy and ACE reducing activity of insulin may be partially involved in decrease of cardiovascular complications in diabetes

Comparison of the osteoporosis between male smokers with and without chronic obstructive pulmonary disease

Background: Osteoporosis is the most common metabolic bone disease that represents an increasingly serious problem, particularly as the population ages. It occurs because loss of bone mineral content. Osteoporosis, thus, causes significant morbidity, especially in elderly, due to recurrent pathologic fractures. It has been suggested that Chronic Obstructive Pulmonary Disease [COPD] is a risk factor for osteoporosis. We intended to investigate the relationship between COPD and osteoporosis in our patient population

Materials and Methods: Setting: Pulmonary diseases division of Hazrate Rasool-e-Akram hospital. Design: It is a case- control study

Target: One hundred volunteer men with history of at least 20 pack year cigarette smoking were sequentially assigned into two groups: 50 patients with COPD [according to the result of spirometry] and a control group of 50 individuals of matching age

Interventions: All individuals were underwent Bone Mass Densitometry [BMD] by Dual-Energy X-Ray Absorptiometry [DEXA], and Pulmonary Function Testing [PFT]

Statistical Analysis: The data was processed using descriptive statistical analysis and t-test and chi[2] test

Results: The frequency of osteoporosis in our patient and control groups were 52% [26 patients] and 8% [4 persons], respectively. The mean T-score value of spinal bone density in patient and control groups were -1.15 and +0.62 respectively [p <0.0001]. The mean T-score value of femoral bone density was -2.58 in patient group and -0.49 in controls [p <0.0001]. There was a statistically significant correlation between the presence of osteoporosis with both the severity and duration of COPD [p <0.0001]. However, BMD was not correlated with the body mass index [BMI], age or the amount of cigarette smoking. Patients with COPD are 12.5 times more likely than their controls to develop osteoporosis [OR: 12.46, CI 95% = 3.9 - 39.85]

Conclusion: Our study confirms that COPD is a risk factor for osteoporosis. There may be many contributing factors such as immobility, chronic respiratory acidosis and the use of gluccocorticoids. Therefore, prevention of osteoporosis should be a part of medical care for COPD patients