Spatial and temporal analysis of thyroid cancer incidence in Guilan Province, Northern Iran, 2009-2018.

BACKGROUND: Thyroid cancer is one of the most common malignancies of the endocrine system, the fifth most common malignancy in women worldwide, and the second most common cancer in women over 50 in 2019. It is the sixth most common cancer in both sexes and the third most common cancer in women in Guilan province. This study was conducted to describe the geographic variation and investigate any changes in the trend of the thyroid cancer incidence rate. METHODS: This study was conducted on the data of the Guilan University of Medical Sciences cancer registration system. The crude and age-standardized incidence rate was calculated per 100,000 person-years. Joinpoint regression analysis evaluated the time trends and annual percent changes (APC). The incidence rate was estimated separately for each city and high-risk areas were shown on the province map using GIS software. RESULTS: 1742 cases of thyroid cancer (83.7 % in women and 16.3 % in men) were registered in Guilan province from 2009 to 18. The incidence of thyroid cancer was 5.1-fold higher in women than men. The results of the joinpoint regression analysis showed that the age-standardized incidence rate of thyroid cancer in both sexes has increased significantly over ten years (APC: 26.4; 95 %CI: 22.5-30.4), (P-value < 0.001). In our study, Astaneh-ye Ashrafiyeh, Lahijan, and Langarud cities were identified as high-risk areas of the province for both sexes. CONCLUSION: The trend of incidence of thyroid cancer in Guilan province is increasing. Also, a wide geographical variation was found in the incidence of thyroid cancer.

The Iranian blood pressure measurement campaign, 2019: study protocol and preliminary results.

Purpose: Hypertension is one of the most important risk factors for premature mortality and morbidity in Iran. The objective of the Iranian blood pressure (BP) measurement campaign was to identify individuals with raised blood pressure and providing appropriate care and increase the awareness among the public and policymakers of the importance of tackling hypertension. Methods: The campaign was conducted in two phases. The first (communication) phase started on May 17th (International Hypertension Day). The second phase started on June 8th, 2019, and lasted up to July 7th during which, blood pressures were measured. The target population was Iranians aged ≥ 30 years. Participants voluntarily referred to health houses in rural and health posts and comprehensive health centers in urban areas in the setting of the Primary Health Care network. Additionally, over 13,700 temporary stations were set up in highly visited places in urban areas. Volunteer healthcare staff interviewed the participants, measured their BP, and provided them with lifestyle advice and knowledge of the risks and consequences of high blood pressure. They referred participants to physicians in case their BP was high. Participants immediately received a text message containing the relevant advice based on their measured BP and their past history. Results: Blood pressure was measured for a total of 26,678,394 participants in the campaign. A total of 13,722,148 participants (51.4%) were female. The mean age was 46 ± 14.1 years. Among total participants, 15,012,693 adults (56.3%) with no past history of hypertension had normal BP, 7,959,288 participants had BP in the prehypertension range (29.8%), and finally, 3,706,413 participants (13.9%) had either past medical history of hypertension, used medications, or had high BP measured in the campaign. Conclusion: The campaign was feasible with the objective to increase the awareness among the public and policymakers of the importance of tackling hypertension in Iran.

Long-term inactivation of bacteriophage PRD1 as a function of temperature, pH, sodium and calcium concentration.

The two most significant processes controlling virus mobility in the subsurface environment are virus attachment and inactivation. In particular, models that predict subsurface virus transport are highly sensitive to inactivation. Virus inactivation is known to depend on temperature as well as hydrochemical conditions. The aim of the current work was to study the effects of temperature and hydrochemical conditions on the inactivation of bacteriophage PRD1 as a model virus, and to develop a quantitative relation for these effects. Series of batch experiments under controlled temperature were conducted, for a range of conditions: 9.5 °C and 12 °C, pH4 - pH8, sodium concentrations of 1, 10 and 20 mM, and calcium concentrations of 0.5, 1.5, and 3 mM. By multivariate regression analysis, a joint log-square model was developed that describes the inactivation rate of PRD1 as a function of these hydrochemical conditions. This model approximates two rate and Weibull models and accounts for the observed non-linear inactivation at increased pH and salt concentrations. Model predictions are within ±0.4 log10 (0.4-2.5 times) virus concentration reduction. The nature of the log-square model does not allow extrapolation of virus inactivation beyond the experimental conditions. Inactivation rate of PRD1 was found to increase with increasing temperature and increasing sodium and calcium concentrations, and to be lowest between pH 6.5 and pH 7.5. Within the studied conditions, the developed log-square model may be applied at field scale for predicting inactivation during subsurface transport of viruses.

Bacteriophage PRD1 batch experiments to study attachment, detachment and inactivation processes.

Knowledge of virus removal in subsurface environments is pivotal for assessing the risk of viral contamination of water resources and developing appropriate protection measures. Columns packed with sand are frequently used to quantify attachment, detachment and inactivation rates of viruses. Since column transport experiments are very laborious, a common alternative is to perform batch experiments where usually one or two measurements are done assuming equilibrium is reached. It is also possible to perform kinetic batch experiments. In that case, however, it is necessary to monitor changes in the concentration with time. This means that kinetic batch experiments will be almost as laborious as column experiments. Moreover, attachment and detachment rate coefficients derived from batch experiments may differ from those determined using column experiments. The aim of this study was to determine the utility of kinetic batch experiments and investigate the effects of different designs of the batch experiments on estimated attachment, detachment and inactivation rate coefficients. The experiments involved various combinations of container size, sand-water ratio, and mixing method (i.e., rolling or tumbling by pivoting the tubes around their horizontal or vertical axes, respectively). Batch experiments were conducted with clean quartz sand, water at pH 7 and ionic strength of 20 mM, and using the bacteriophage PRD1 as a model virus. Values of attachment, detachment and inactivation rate coefficients were found by fitting an analytical solution of the kinetic model equations to the data. Attachment rate coefficients were found to be systematically higher under tumbling than under rolling conditions because of better mixing and more efficient contact of phages with the surfaces of the sand grains. In both mixing methods, more sand in the container yielded higher attachment rate coefficients. A linear increase in the detachment rate coefficient was observed with increased solid-water ratio using tumbling method. Given the differences in the attachment rate coefficients, and assuming the same sticking efficiencies since chemical conditions of the batch and column experiments were the same, our results show that collision efficiencies of batch experiments are not the same as those of column experiments. Upscaling of the attachment rate from batch to column experiments hence requires proper understanding of the mixing conditions. Because batch experiments, in which the kinetics are monitored, are as laborious as column experiments, there seems to be no major advantage in performing batch instead of column experiments.

Effect of dissolved calcium on the removal of bacteriophage PRD1 during soil passage: the role of double-layer interactions.

The objective of this work was to investigate and obtain quantitative relations for the effects of Ca(2+) concentration on virus removal in saturated soil and to compare the experimental findings with predictions of the DLVO theory. In order to do so, a systematic study was performed with a range of calcium concentrations corresponding to natural field conditions. Experiments were conducted in a 50-cm column with clean quartz sand under saturated conditions. Inflow solutions were prepared by adding CaCl(2,) NaCl and NaHCO(3) to de-ionized water. Values of pH and ionic strength were fixed at 7 and 10mM, respectively. Bacteriophage PRD1 was used as a conservative model virus for virus removal. The samples were assayed using the plaque forming technique. Attachment, detachment and inactivation rate coefficients were determined from fitting breakthrough curves. Attachment rate coefficients were found to increase with increasing calcium concentration. Results were used to calculate sticking efficiency, for which an empirical formula as a function of Ca(2+) was developed. Numerical solutions of the Poisson-Boltzmann equation were obtained to evaluate the effect of Ca(2+) on the double-layer interactions between quartz and PRD1. Based on these results, the DLVO interaction energies were calculated. It turned out that the experimental findings cannot be explained with the distance profiles of the DLVO interaction. The discrepancy between theory and experiment can be attributed to underestimation of the van der Waals interactions, chemisorption of Ca(2+) onto the surfaces, or by factors affecting the double-layer interactions, which are not included in the Poisson-Boltzmann equation. When abruptly changing from inflow solution containing Ca(2+) to a Ca(2+)-free solution, pronounced mobilization of viruses was observed. This indicates virus removal is not irreversible and that chemical perturbations of the groundwater can cause a burst of released viruses.

Systematic study of effects of pH and ionic strength on attachment of phage PRD1.

Objectives of this work are to investigate effects of pH and ionic strength (IS) on virus transport in saturated soil and to develop a quantitative relationship for these effects. A series of 50-cm column experiments with clean quartz sand under saturated conditions and with pH values of 5, 6, 7, 8, and IS values of 1, 10, and 20 mM were conducted. Bacteriophage PRD1 was used as a model virus. Applying a one-site kinetic model, attachment, detachment, and inactivation rate coefficients were determined from fitting breakthrough curves using the software package Hydrus-1D. Attachment rate coefficients increased with decreasing pH and increasing IS, in agreement with DLVO theory. Sticking efficiencies were calculated from the attachment rate coefficients and used to develop an empirical formula for sticking efficiency as a function of pH and IS. This relationship is applicable under unfavorable conditions for virus attachment. We compared sticking efficiencies predicted by the empirical formula with those from field and column experiments. Within the calibrated range of pH and IS, the predicted and observed sticking efficiencies are in reasonable agreement for bacteriophages PRD1 and MS2. However, the formula significantly overestimates sticking efficiencies for IS higher than 100 mM. In addition, it performs less well for viruses with different surface reactivity than PRD1 and MS2. Effects of pH and IS on detachment and inactivation rate coefficients were also investigated but the experimental results do not allow constraining these parameters with sufficient certainty.