Decomposing difference in the kidney cancer burden measures between 1990 and 2019 based on the global burden of disease study.

The kidney cancer (KC) burden measures have changed dramatically in recent years due to changes in exposure to the determinants over time. We aimed to decompose the difference in the KC burden measures between 1990 and 2019. This ecological study included data on the KC burden measures as well as socio-demographic index (SDI), behavioral, dietary, and metabolic risk factors from the global burden of disease study. Non-linear multivariate decomposition analysis was applied to decompose the difference in the burden of KC. Globally, ASIR, ASMR, and ASDR of KC increased from 2.88 to 4.37, from 1.70 to 2.16, and from 46.13 to 54.96 per 100,000 people between 1990 and 2019, respectively. The global burden of KC was more concentrated in developed countries. From 1990 to 2019, the burden of KC has increased the most in Eastern European countries. More than 70% of the difference in the KC burden measures between 1990 and 2019 was due to changes in exposure to the risk factors over time. The SDI, high body mass index (BMI), and alcohol use had the greatest contribution to the difference in the KC burden measures. Changes in characteristics over time, including SDI, high BMI, and alcohol consumption, appear to be important in the evolving landscape of KC worldwide. This finding may help policymakers design policies and implement prevention programs to control and manage KC.

Intensive care unit admission and associated factors in patients hospitalised for COVID-19: A national retrospective cohort study in Iran.

OBJECTIVES: This study aimed to determine factors associated with intensive care unit (ICU) admission in patients hospitalised due to COVID-19. DESIGN: Retrospective cohort. SETTING: Confirmed hospitalised patients from all over Iran were considered for the study. PARTICIPANTS: All patients with COVID-19 admitted to the hospital from March 2020 to May 2021 were included by census. ICU admission was defined by the following criteria: (1) admission to the ICU ward; (2) level of consciousness (loss of consciousness); and (3) use of invasive ventilation. METHODS: This is a secondary data analysis from the Medical Care Monitoring Center. The association between different variables and ICU admission was assessed by forward Logistic regression and restricted cubic spline method. RESULTS: The mean age of the 1 469 620 patients with COVID-19 was 54.49±20.58 years old, and 51.32% of the patients were male. The prevalence of ICU admission was 19.19%. The mean age of patients admitted to the ICU was higher than that of other hospitalised patients (62.49±19.73 vs 52.59±20.31 years). The prevalence of ICU admission was 17.17% in the first, 21.52% in the second, 19.72% in the third, 21.43 in the fourth and 17.4% in the fifth wave. In the multivariable model, age groups, sex, waves of the epidemic, comorbidities and saturation of peripheral oxygen (SpO2) <93% and acute respiratory distress syndrome (ARDS) were associated with an increased odds of ICU admission. The OR for ICU admission indicates a significant protective effect at a young age and then a significant risk factor for admission to the ICU ward at an old age. CONCLUSIONS: Men, older adults, people who suffer from ARDS, patients with SpO2 levels of less than 93% and cases with comorbidities had the highest odds of ICU admission. Therefore, these groups should take all necessary precautions to avoid contracting COVID-19.

Pharmaceutical Therapies for the Treatment of Obesity: A Network Meta-analysis.

PURPOSE: Despite the introduction of various pharmaceutical therapies for treating obesity, selecting the optimal treatment remains challenging for both patients and physicians. Therefore, in this network meta-analysis (NMA), we aim to simultaneously compare the available drugs for treating obesity to determine the most effective treatment options. METHODS: International databases, including PubMed, Web of Science, Scopus, Cochrane Library, and Embase, were searched for studies published from database inception to April 2023. The consistency assumption was evaluated using by the loop-specific and design × treatment interaction approaches. The effects of treatment in the NMA were summarized using mean differences based on a change score analysis. The random-effects model was used to report the results. Results were reported with 95% CIs. FINDINGS: Of 9519 retrieved references, 96 randomized controlled trials, including 68 with both men and women, 23 with women only, and 5 with men only, met the eligibility criteria for this study. There were 4 treatment networks in the trials of both men and women, 4 in the trials of women only, and 1 in the trials of men only. The best-ranked treatments in the network in the trials of both men and women were (1) semaglutide, 2.4 mg (P-score = 0.99); (2) hydroxycitric acid, 4667 mg 3 times daily, supervised walking, and 2000-kcal/d diet (P-score = 0.92); (3) phentermine hydrochloride and behavioral therapy (P-score = 0.92); and (4) liraglutide plus advice to diet and exercise (P-score = 1.00). In women, the best-ranked treatments were beloranib (P-score = 0.98) and sibutramine, metformin, and hypocaloric diet (P-score = 0.90). In men, there was no significant difference among treatments. IMPLICATIONS: According to the results of this NMA, semaglutide seems to be an effective treatment option for both men and women, whereas beloranib appears to be particularly effective for women with obesity and overweight, but its production has been stopped since 2016 and is not available.

Can a rigid antipronation foot orthosis change the effects of prolonged standing on postural control in men with patellofemoral pain?

BACKGROUND: Pronated foot posture is known as a contributing factor for patellofemoral pain (PFP) development. Patients with patellofemoral pain often experience poor postural control. Implementation of optimal management strategies for enhancing their postural performance is important. OBJECTIVES: The aim of this study was to determine whether a rigid antipronation foot orthosis changes prolonged standing effects on postural control in men with PFP. STUDY DESIGN: Case-control study. METHODS: Twenty-eight men with PFP and pronated foot and 28 healthy men were enrolled in this study. Center-of-pressure parameters were measured during short trials (60 seconds) of single-leg standing before and immediately after prolonged standing (20 minutes) using force platform. In patients with PFP, postural control was examined on 2 separate days with and without rigid antipronation foot orthosis. RESULTS: Findings showed that the pre-post differences of sway area (t(48) = -2.22, p = 0.03), mediolateral (ML) displacement (t (48) = -2.51, p = 0.01), and mean velocity (t(48) = -2.01, p = 0.04) were significantly greater in patients with PFP without foot orthosis compared with those in the healthy group. Significant intervention main effect ( p = 0.04) and time-by-intervention interaction ( p = 0.006) for sway area were shown. Significant intervention main effects were noted for ML displacement ( p = 0.007) and mean velocity ( p = 0.003). For these variables, significant time-by-intervention interactions were found. Further analysis showed greater values of ML displacement and mean velocity parameters before the prolonged standing in patients with PFP without foot orthosis compared with patients with PFP with orthosis. CONCLUSIONS: Rigid antipronation foot orthosis can improve the postural performance after prolonged standing in young adult men with PFP.

Risk Factors Associated with Severity and Death from COVID-19 in Iran: A Systematic Review and Meta-Analysis Study.

Objectives: This study aims to investigate the risk factors associated with severity and death from COVID-19 through a systematic review and meta-analysis of the published documents in Iran. Methods: A systematic search was performed based on all articles indexed in Scopus, Embase, Web of Science (WOS), PubMed, and Google Scholar in English and Scientific Information Database (SID) and Iranian Research Institute for Information Science and Technology (IRA)NDOC indexes in Persian. To assess quality, we used the Newcastle Ottawa Scale. Publication bias was assessed using Egger's tests. Forest plots were used for a graphical description of the results. We used HRs, and ORs reported for the association between risk factors and COVID-19 severity and death. Results: Sixty-nine studies were included in the meta-analysis, of which 62 and 13 had assessed risk factors for death and severity, respectively. The results showed a significant association between death from COVID-19 and age, male gender, diabetes, hypertension, cardiovascular disease (CVD), cerebrovascular disease, chronic kidney disease (CKD), Headache, and Dyspnea. We observed a significant association between increased white blood cell (WBC), decreased Lymphocyte, increased blood urea nitrogen (BUN), increased creatinine, vitamin D deficiency, and death from COVID-19. There was only a significant relationship between CVD and disease severity. Conclusion: It is recommended that the predictive risk factors of COVID-19 severity and death mentioned in this study to be used for therapeutic and health interventions, to update clinical guidelines and determine patients' prognoses.

National trends and projection of chronic kidney disease incidence according to etiology from 1990 to 2030 in Iran: a Bayesian age-period-cohort modeling study.

OBJECTIVES: Chronic kidney disease (CKD) is a major public health problem worldwide. Predicting CKD incidence rates and case numbers at the national and global levels is vital for planning CKD prevention programs. METHODS: Data on CKD incidence rates and case numbers in Iran from 1990 to 2019 were extracted from the Global Burden of Disease online database. The average annual percentage change was computed to determine the temporal trends in CKD age-standardized incidence rates from 1990 to 2019. A Bayesian age-period-cohort model was used to predict the CKD incidence rate and case numbers through 2030. RESULTS: Nationally, CKD cases increased from 97,300 in 1990 to 315,500 in 2019. The age-specific CKD incidence rate increased from 168.52 per 100,000 to 382.98 per 100,000 during the same period. Between 2020 and 2030, the number of CKD cases is projected to rise to 423,300. The age-specific CKD incidence rate is projected to increase to 469.04 in 2030 (95% credible interval, 399.20 to 538.87). In all age groups and etiological categories, the CKD incidence rate is forecasted to increase by 2030. CONCLUSIONS: CKD case numbers and incidence rates are anticipated to increase in Iran through 2030. The high level of CKD incidence in people with diabetes mellitus, hypertension, and glomerulonephritis, as well as in older people, suggests a deficiency of attention to these populations in current prevention plans and highlights their importance in future programs for the national control of CKD.

Reflection on near-peer shadowing program: impact on operating room student's perception of their future profession.

BACKGROUND: Reflection is a key element in learning from observation and experience of future profession's roles and responsibilities in clinical encounters. Moreover, reflection helps students cope with the challenges, complexities, and uncertainties of professional development. Students' written reflections on clinical exposure offer valuable information, and their analysis provides instructors with invaluable insight into students' experiences. This study evaluated Operating Room students' written reflections on their first clinical exposure experiences towards their future profession through the shadowing program. METHODS: This study was a qualitative analysis on Operating Room freshmen's reflections in the undergraduate program of Zahedan and Zabol University of Medical Sciences in Iran. After the shadowing program, all participants were asked to write an unstructured written reflection, and these fifty written reflections were de-identified and independently analyzed using the thematic analysis approach. RESULTS: Qualitative analysis extracted 10 subthemes and four main themes including (i) Moving towards the guiding realities of future profession, (ii) Discovering milestones of realizing professional identity, (iii) Managing the emotions affecting the perception of future profession's desirability, and (iv) Excellence in professional growth and development. CONCLUSION: Reflecting on the experience of the shadowing program, the participants described being in the OR environment as a stimulating and valuable learning opportunity. Moreover, this experience helped improve their perception of future profession's realities, as well as initiate realization of professional identity and planning for professional developments.

A Molecular Dynamics Model for Biomedical Sensor Evaluation: Nanoscale Numerical Simulation of an Aluminum-Based Biosensor.

Metallic nanostructured-based biosensors provide label-free, multiplexed, and real-time detections of chemical and biological targets. Aluminum-based biosensors are favored in this category, due to their enhanced stability and profitability. Despite the recent advances in nanotechnology and the significant improvement in development of these biosensors, some deficiencies restrict their utilization. Hence a detailed insight into their behavior in different conditions would be crucial, which can be achieved with nanoscale numerical simulation. With this aim, an Aluminum-based biosensor is chosen to be analyzed with the help of all-atom molecular dynamics model (AA-MD), using large-scale atomic/molecular massively parallel simulator (LAMMPS). The surface properties and adsorption process through different flow conditions and various concentration of the target, are investigated in this study. In the future work, the results of this study will be used for developing a predictive model for surface properties of the biosensor. Clinical Relevance- The role of biosensors in clinical applications and early diagnosis is evident. This work provides a model for predicting the binding behavior of the target molecules on the biosensor surface in different conditions. Results demonstrate an increase in the adsorption of ethanol on the biosensor surface of 7% up to 80% with changing the velocity from 0.001 m/s to 1 m/s Although for cases with higher concentration this trend becomes complicated necessitating the implementation of machine learning models in the future works.

Effect of Massage Therapy for the Treatment of Neonatal Jaundice: A Systematic Review and Dose-Response Meta-analysis.

Background: The effectiveness of massage therapy in the treatment of neonatal jaundice has been established in previous literature, but how much the level of massage can reduce the mean of bilirubin in neonates with jaundice is a question that has been addressed in this review. Methods: Four electronic databases, including Cochrane, PubMed, Scopus, and Web of Science, were searched for relevant literature. For the dose-response association between massage therapy and treatment of neonatal icterus, we conducted a meta-analysis using the random-effects model. For any level of intervention, we calculated the overall mean difference (MD) with 95% confidence intervals (CI). Results: Twenty studies were included in our meta-analysis. There was a positive and significant increasing dose-response trend between massage therapy and the mean reduction of bilirubin in neonates with hyperbilirubinemia as follows: <50 minutes massage during the experiment -0.36 (95% CI: -0.67, -0.06; I 2 = 66%), 50-60 minutes massage during the experiment -0.41 (95% CI: -0.95, 0.13; I 2 = 84%), and ≥101 minutes massage during the experiment -1.20 (95% CI: -1.63, -0.78; I 2 = 83%). The heterogeneity across studies was mild to moderate. Conclusions: The presence of a dose-response relationship favors the causal relationship between massage therapy and reduction of neonatal jaundice.

Insights on my future job: implementing near-peer shadowing program for operating room freshmen.

BACKGROUND: As a main challenge in paramedical faculties of medical sciences, freshmen lose interest in their academic field of study and then job motivation. Lack of developed knowledge about their academic field and unfamiliarity with their future job's tasks and roles contribute to freshmen's job motivation loss. Various interventional programs have been implemented to improve students' job motivation by familiarizing them with their future job's duties and responsibilities. METHODS: This was one-group pretest-posttest design study in 2019-2020. Students grouped into pairs of a freshman (shadowee) with a senior (shadower) in a clinical setting during shadowing program. This program helps freshmen to comprehend and discover realities of their academic field and can help them change their perspectives regarding their future job's duties and responsibilities. The shadowees' main task was reflective observation on operating room events and interactions and to be active in the program, several tasks e.g., how to wear gloves, guns, and disinfect equipment were assigned to them exclusively under the supervision of senior students. The Hackman and Oldham's Job Diagnostic Survey (JDS) questionnaire and a novel Job Motivation Survey (JMS) questionnaire were distributed among participants. RESULTS: Fifty freshmen majoring in operating room participated in the shadowing program from November 2019 to January 2020. Before and after the program, they completed Hackman and Oldham's job diagnostic survey and researcher-made job motivation survey questionnaires. Results were indicative of a significant difference in job diagnostic survey questionnaire score, where overall pre-test and post-test scores before and after the intervention were 57.78 (±9.78) and 68.58 (±5.02), respectively; the score difference was statistically significant (P < 0.001). Moreover, the overall pre-test and post-test scores of the job motivation survey questionnaire were 25.16 (± 9.75) and 39.80 (±5.18), respectively; this score difference was statistically significant (P < 0.001). CONCLUSION: Shadowing program improved freshmen's realistic perception of their future job's duties and responsibility, and hence enhancing their job motivation and job recognition. As future work, in various disciplines, further studies need to evaluate the impact of such interventional programs in providing early insights for freshmen as well as in providing guidance on their plans for education, and future job.

Evaluation of maternal risk factors for preterm delivery in Fatemieh Hospital of Hamadan, Iran, 2019: A case-control study.

BACKGROUND: The present study aimed to evaluate maternal risk factors of preterm delivery in Fatemieh Hospital in Hamadan, Iran, 2019. METHODS: In this case-control study, 7,478 hospital files of live-born neonates and their mothers in Hamadan Fatemieh Hospital in 2019 were examined. According to statistical estimates, 261 preterm deliveries and 736 term deliveries were studied. Information files of neonates and mothers were used to complete the study questionnaire. The data were compared in two separate groups and logistic regression was performed to estimate the crude relationship between demographic and clinical characteristics of term and preterm delivery. RESULTS: The mean age of women was 27.89 ± 6.48 years. Analysis of data revealed that academic education (OR: 2.02, P = 0.014), age group 25-34 years (OR: 1.5, P = 0.016), age of 35 years and above (OR: 1.66, P = 0.018), previous history of preterm delivery (OR: 5.3, P < 0.001), history of abortion (OR: 1.67, P = 0.004), history of surgery (OR: 1.54, P = 0.007), history of infertility (P = 0.016), and a history of cesarean (OR: 2.11, P < 0.001) were potentially associated with a higher odds of preterm delivery (P < 0.2). CONCLUSION: Based on the results, it is important to identify potential risk factors of preterm delivery in mothers and corrective interventions in strengthening consultation and education of pregnant women during pregnancy. Such a measure helps select the type of delivery and strengthen prenatal care in identifying mothers in high-risk groups and performing timely interventions.

Predictors of death in patients with COVID-19: A cross-sectional study in West of Iran.

Background: Coronavirus disease 2019 (COVID-19) is a contagious disease caused by a newly identified coronavirus. Our knowledge about the survival rate and prognostic factors of the disease is not established well. The purpose of this study was to evaluate the predictors of COVID-19 mortality in Hamadan province in western Iran. Methods: In this study, we included all laboratory-confirmed COVID-19 cases with known treatment outcomes in Hamadan province, Iran, between 20, 2020, to May 10, 2020. Demographic, clinical, laboratory data, and treatment outcomes were obtained from computerized medical records and compared between survived cases and patients with death outcomes. Univariable and multivariable logistic regression models were used to determine the predictors of death. Results: From 749 investigated patients, 77 patients (10.28%) died during the treatment. The Mean age of patients was 53.97±19.04 years. Multivariable logistic regression showed that males had 2.07 (95% CI: 1.73, 2.54) fold higher odds of death. Those with 60 years old and more had 6.49 (95% CI: 4.53, 7.93) fold higher odds of death. Patients with an underlying disease had 7.14 (95% CI: 6.94, 7.38) fold higher odds of death, and patients who were hospitalized in the ICU ward had 2.24 (95% CI: 1.75, 2.90) times higher odds of COVID-19 related mortality. Conclusion: The potential predictors of death in COVID-19 cases, including the male gender, older age, and having an underlying disease could help physicians to identify patients with poor prognoses at an early stage and better management of them.

Diet Therapeutics Interventions for Obesity: A Systematic Review and Network Meta-Analysis.

BACKGROUND: Up to now, different diet therapeutics interventions have been introduced for the treatment of obesity. The present study aimed to compare the diet therapeutics interventions for obesity simultaneously. STUDY DESIGN: Systematic review and network meta-analysis METHODS: The major international databases, including Medline (via PubMed), Web of Science, Scopus, Cochrane Library, and Embase, were searched using a predesigned search strategy. Randomized controlled trials (RCTs) that had compared the diet therapy interventions were included. The mean difference with a 95% confidence interval was used to summarize the effect size in the network meta-analysis. The frequentist approach was used for data analysis. RESULTS: In total, 36 RCTs out of 9335 retrieved references met the inclusion criteria in this review. The included RCTs formed nine independent networks. Based on the results, Hypocaloricdiet+Monoselect Camellia (MonCam, P=0.99), energy restriction, behavior modification+exercise (LED) (P=0.99), sweetener at 20% of total calories (HFCS20)+Ex (P=0.67), catechin-richgreentea(650)+inulin (P=0.68), very low calorie diet (VLCD) (P=1.00), normal protein diet+resistance exercise (NPD+RT) (P=0.80), low-calorie diets+exercise (Hyc+Ex) (P=0.85), high-soy-protein low-fat diet (SD) (P=0.75), calorie restriction+behavioral weight loss (Hyc+BWL) (P=0.99) were the better treatments for weight loss in the networks one to nine, respectively. CONCLUSION: Based on the results of network meta-analysis, it seems that Hypocaloricdiet+MonCam, LED, HFCS20+Ex, catechin-rich green tea +inulin, VLCD, NPD+RT, Hyc+Ex, SD, Hyc+BWL, are the better treatments for weight loss in patients with overweight and obesity.

Factors for the Primary Prevention of Breast Cancer: A Meta-Analysis of Prospective Cohort Studies.

BACKGROUND: This report provided the effect of 15 preventable factors on the risk of breast cancer incidence. STUDY DESIGN: A systematic review and meta-analysis. METHODS: A detailed research was conducted on PubMed, Web of Science, and Scopus databases in January 2020. Reference lists were also screened. Prospective cohort studies addressing the associations between breast cancer and 15 factors were analyzed. Between-study heterogeneity was investigated using the χ2, τ2, and I2 statistics. The probability of publication bias was explored using the Begg and Egger tests and trim-and-fill analysis. Effect sizes were expressed as risk ratios (RRs) with 95% confidence intervals (CIs) using a random-effects model. RESULTS: Based on the results, out of 147,083 identified studies, 197 were eligible, including 19,413,702 participants. The RRs (95% CI) of factors associated with breast cancer were as follows: cigarette smoking 1.07 (1.05, 1.09); alcohol drinking 1.10 (1.07, 1.12); sufficient physical activity 0.90 (0.86, 0.95); overweight/obesity in premenopausal 0.92 (0.82, 1.03) and postmenopausal 1.18 (1.13, 1.24); nulliparity 1.16 (1.03, 1.31); late pregnancy 1.37 (1.25, 1.50); breastfeeding 0.87 (0.81, 0.93); ever using oral contraceptive 1.00 (0.96, 1.05); ever using estrogen 1.13 (1.04, 1.23); ever using progesterone 1.02 (0.84, 1.24); ever using estrogen/progesterone 1.60 (1.42, 1.80); ever taking hormone replacement therapy 1.26 (1.20, 1.32); red meat consumption 1.05 (1.00, 1.11); fruit/vegetable consumption 0.87 (0.83, 0.90); and history of radiation therapy, based on single study 1.31 (0.87, 1.98). CONCLUSION: This meta-analysis provided a clear picture of several factors associated with the development of breast cancer. Moreover, the useful information in this study may be utilized for ranking and prioritizing preventable risk factors to implement effective prevention programs.

Pregnancy outcomes among SARS-CoV-2-infected pregnant women with and without underlying diseases: a case-control study.

This study aimed to examine the pregnancy outcomes in women infected with the severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) with and without underlying diseases in western Iran. This case-control study compared 49 pregnant women with Coronavirus disease (COVID-19) with underlying diseases (the case group) and 49 women with COVID-19 without underlying diseases (the control group). The groups were pregnant women with COVID-19 admitted to Hamadan hospitals for delivery. COVID-19 was diagnosed by using the reverse transcriptase-polymerase chain reaction (real-time RT-PCR). Data were evaluated using a checklist. Further, the Statistical Package for the Social Sciences (SPSS) version 16 was used for data analysis. A value of p<0.05 was considered statistically significant. The odds of preterm labor were five times higher in women with underlying diseases (OR=5.95, 95% CI (3.01, 7.15), p=0.034). Moreover, the odds of preeclampsia and eclampsia in women with underlying diseases was (OR=3.35, 95% CI (1.18, 4.93), p=0.048) and (OR=2.65, 95% CI (1.43, 3.54), p=0.035), respectively. The results revealed that preterm labor, preeclampsia, and eclampsia were significantly higher in women with COVID-19 and underlying diseases compared to those without underlying diseases. Thus, the need to identify and educate pregnant mothers on underlying diseases and attention to prenatal care, particularly in high-risk groups, is necessary for the COVID-19 pandemic.

The effect of silica exposure on the risk of lung cancer: A dose-response meta-analysis.

BACKGROUND: The relationship between silica and the risk of developing lung cancer has been established in previous literature, but how much the level of exposure to silica can increase the risk of lung cancer is a question that has been addressed in this review. METHODS: Three electronic databases, including MEDLINE, Scopus, and Web of Science were searched for relevant literature. For the dose-response relationship between exposure to silica and developing lung cancer, we performed a meta-analysis using the random-effects model. For each level of exposure, we calculated the overall risk ratio (RR) with 95% confidence intervals (CI). RESULTS: Nineteen studies were included in the meta-analysis. There was a positive and significant increasing dose-response trend between silica exposure and the risk of developing lung cancer as follows: < 0.50 mg/m3 1.14 (95% CI: 1.05, 1.23; I2 = 79%), 0.50-0.99 mg/m3 1.34 (95% CI: 1.05, 171; I2 = 45%), 1.00-1.99 mg/m3 1.14 (95% CI: 1.00, 1.30; I2 = 70%), 2.00-2.99 mg/m3 1.47 (95% CI: 1.05, 2.06; I2 = 57%), 3.00-3.99 mg/m3 1.44 (95% CI: 0.99, 2.11; I2 = 58%), and ≥ 4.00 mg/m3 1.64 (95% CI: 1.20, 2.24; I2 = 88%). The heterogeneity across studies was mild to moderate. CONCLUSIONS: The presence of a dose-response relationship favors the causal relationship between exposure to silica and developing lung cancer.

Survival Rates and Prognostic Factors in Patients with Coronavirus Disease 2019: A Registry-Based Retrospective Cohort Study.

BACKGROUND: Coronavirus disease 2019 (COVID-19) is a contagious disease caused by a newly identified coronavirus. Our knowledge about the survival rate and prognostic factors of the disease is not established well. Therefore, this study aimed to identify the risk factors associated with the survival of COVID-19 cases in Hamadan province, West of Iran. STUDY DESIGN: A retrospective cohort study METHODS: This retrospective cohort study was performed in Hamadan province, West of Iran. The study included patients that referred to the provincial hospitals from February 20 to September 20, 2020. The follow-up of each subject was calculated from the date of onset of respiratory symptoms to the date of death. Demographic and clinical characteristics were extracted from patients' medical records. Kaplan-Meier method, Flemington-Harrington test, and Cox regression were used for data analysis. RESULTS: The overall 1, 5, 10, 20, 30 and 49-day survival rates were estimated at 99.57%, 95.61%, 91.15%, 87.34%, 86.91%, and 86.74%, respectively. Furthermore, survival time showed a significant association with age, gender, history of traveling to contaminated areas, co-morbidity, neoplasms, chronic diseases, and hospital units. CONCLUSION: In conclusion, elderly people, male gender, and comorbidities presented a greater risk of death. Therefore, it is important to pay more attention to this group of people to reduce the incidence and consequences after infection.

Diagnostic accuracy of apparent diffusion coefficient (ADC) value in differentiating malignant from benign solid liver lesions: a systematic review and meta-analysis.

OBJECTIVES: We undertook a systematic review and meta-analysis of the diagnostic performance of mean apparent diffusion coefficient (ADC) values derived by diffusion-weighted (DW)-MRI in the characterization of solid benign and malignant liver lesions, and to assess their value in discriminating these lesions in daily routine practice. METHODS: A systematic review of PubMed, Embase, Scopus, and Web of Science was conducted to retrieve studies that used ADC values for differentiating solid benign/dysplastic nodules and malignant liver lesions. A bivariate random-effects model with pooled sensitivity and specificity values with 95% CI (confidence interval) was used. This meta-analysis was performed on the per-lesion basis. Summary receiver operating characteristic (SROC) plot and area under curve (AUC) were created. RESULTS: A total of 14 original articles were retrieved. The combined (95% CI) sensitivity and specificity of mean ADC values for differentiating solid benign from malignant lesions were 78% (67-86%) and 74% (64-81%), respectively. The pooled (95% CI) positive and negative LRs were respectively 3 (2.3-3.8) and 0.3 (0.21-0.43). The DOR (95% CI) was 10 (7-15). The AUC (95% CI) of the SROC plot was 82% (78-85%). Reporting bias was negligible (p value of regression test = 0.36). Mean size of malignant lesions and breathing pattern of MRI were found to be sources of heterogeneity of pooled sensitivity. CONCLUSION: ADC measurement independently may not be an optimal diagnostic imaging method for differentiating solid malignant from solid benign hepatic lesions. The meta-analysis showed that ADC measurement had moderate diagnostic accuracy for characterizing solid liver lesions. Further prospective and comparative studies with pre-specified ADC thresholds could be performed to investigate the best MRI protocol and ADC threshold for characterizing solid liver lesions. ADVANCES IN KNOWLEDGE: ADC measurement by DW-MRI does not have a good diagnostic performance to differentiate solid malignant from solid benign lesions. Therefore, we suggest not using ADC values in clinical practice to evaluate solid liver lesions.

Predictors of completed suicide: Results from the suicide registry program in the west of Iran.

Suicide is a crucial public health problem with a serious harmful impact on individuals, families, and societies. Therefore, the current study aimed to evaluate the predictors of death or serious injury related outcome regarding this lethal phenomenon in Hamadan Province. In this registry-based study we used all of suicide attempt entered in Hamadan Suicide Registry Program from January 2016 to the end of 2017. Serious injury and death were considered as suicide worse outcome and its prognostic factors were examined using logistic regression model. From 2493 patients with suicide attempts in 5.61 % and 4.09 % of them, suicide behaviour led to serious injury and death, respectively. Males had 2.83 times higher odds of the worse suicide outcomes ([OR = 2.83, 95 % CI: 1.71, 4.68)], P < 0.001). Moreover, the odds of worse outcomes of suicide in individuals with low level of education, advanced age and with the history of suicidal ideation was significantly higher (P < 0.05). Among different suicide methods, the highest odds of suicide worse outcomes were related to self-immolation, falls, hanging, self-harm, poisoning, and drugs (P < 0.001). We found that the increase odds of suicide worse outcomes were associated with individuals advance age, low level of education, time of suicide attempt, previous history of suicidal ideation and choosing self-immolation, falls, hanging, self-harm, poisoning, and drugs as a suicide method.