Vol 45 No 9 (2016)

Review Article(s)

  • XML | PDF | downloads: 120 | views: 346 | pages: 1103-1117

    Background: Glutathione S-transferases (GSTs) have been investigated as potential carcinoma susceptible genes. However, the relationship between GSTs (GSTM1, GSTT1) variants and gastric carcinoma (GC) risk has been controversial in Chinese population.

    Methods: A comprehensive literature search strategy (PubMed, Chinese Biomedical Database, Chinese National Knowledge Infrastructure, Wan fang Database, etc.) was launched. Crude odds ratios (ORs) and confidence intervals (95% CI) were applied to estimate the strength of the association.

    Results: Significant associations between GSTs genetic polymorphisms and GC were evidenced under random-effects model (ORGSTM1=1.56, 95% CI: 1.39 to 1.76, I2=50.7%, P<0.0001; ORGSTT1=1.24, 95% CI: 1.10 to 1.39, I2=43.6%, P=0.014; ORGSTM1-GSTT1=1.51, 95% CI: 1.26 to 1.81, I2=59.7%, P=0.004). The pooled ORs were not qualitatively changed when any single study was omitted by sensitivity analysis.

    Conclusion: Our results indicated an increased GC risk in Chinese population with GSTM1 and GSTT1 null genotype and GSTM1-GSTT1 dual null genotype. Further multi-center studies are needed to investigate the gene-gene and gene-environment interactions on the susceptibility of GC.


  • XML | PDF | downloads: 130 | views: 566 | pages: 1118-1125

    Background: Citation metrics and total publications in a field has become the gold standard for rating researchers and viability of a field. Hence, stimulating demand for citation has led to a search for useful strategies to improve performance metric index. Meanwhile, title, abstract and morphologic qualities of the articles attract researchers to scientific publications. Yet, there is relatively little understanding of the citation trend in disability related fields. We aimed to provide an insight into the factors associated with citation increase in this field. Additionally, we tried to know at what page number an article might appear attractive to disability researchers needs. Thus, our focus is placed on the article page count and the number of authors contributing to the fields per article.

    Methods: To this end, we evaluated the quantitative characteristics of top cited articles in the fields with a total citation (³50) in the Web of Science (WoS) database. Using one-way independent ANOVA, data extracted spanning a period of 1980-2015 were analyzed, while the non-parametric data analysis uses Kruskal-Walis test.

    Results: Articles with 11 to 20 pages attract more citations followed by those within the range of zero to 10. Articles with upward 21 pages are the least cited. Surprisingly, articles with more than two authors are significantly (P<0.05) less cited and the citation decreases as the number of authors increased.

    Conclusion: Collaborative studies enjoy wider utilization and more citation, yet discounted merit of additional pages and limited collaborative research in disability field is revealed in this study.


  • XML | PDF | downloads: 117 | views: 378 | pages: 1126-1135

    Background: Coffee is implicated in the susceptibility to several cancers. However, the association between coffee and lymphoma remains unclear. This meta-analysis aimed to assess quantitatively the association between coffee and the incidence of lymphoma.

    Methods: A literature search was performed for cohort and case-control studies published using PubMed, Cochrane, and EMBASE databases. Studies were included if they reported relative ratios (RR) and corresponding 95% confidence intervals (CIs) of lymphoma with respect to coffee consumption. Pooled relative risk (RR) and its 95% confidence interval (CI) were calculated. All P values are two tailed

    Results: Seven studies met the inclusion criteria, which included three cohort and four case-control studies. Compared with did not or seldom drink coffee per day, being no significantly association between coffee and risk of lymphoma (pooled RR: 1.05, 95%CI: 0.89-1.23). In the subgroup analysis, no significant association between coffee and lymphoma risk was detected not only in different study types (cohort studies RR: 1.29; 95% CI, 0.92-1.80; case control studies RR: 0.99; 95% CI, 0.82-1.99) but also in different regions (Europe RR: 1.21; 95% CI: 0.99-1.47; USA RR: 0.85; 95% CI, 0.62-1.15; Asia RR: 1.08, 95% CI: 0.84-1.40) and coffee consumption status (≥4cups/d 1.03, 95% CI: 0.69–1.56; <4cups/d RR: 1.06, 95% CI: 0.89- 1.26 ). The funnel plot revealed no evidence for publication bias.

    Conclusion: There was no sufficient evidence to support coffee consumption association with the risk of lymphoma. Further well-designed large-scaled cohort studies are needed to provide conclusions that are more definitive.



  • XML | PDF | downloads: 151 | views: 409 | pages: 1136-1145

    Background: In recent years, the concept of health security has received an international dimension. However, despite evident links between health and security the concept of health security is not used in either academic or political discourse in Serbia. It comes as no surprise then that even though the issue of security challenges is present in Serbian legislation, it has not been incorporated into the National Security Strategy, by which health threats would be recognized as one of contemporary security priorities.

    Methods: The method applied is descriptive and analytical, in keeping with social studies research methodology and the aims of this study.

    Results: The 20th and the 21st century in Serbia have both been marked by events indicating a clear link between health and security. The most telling example of this connection is the events of the 1990s, namely civil wars, sanctions and the NATO bombing. The results of our research show that poor health conditions, an increasing number of reemerging diseases and pandemics of new diseases can have serious implications for the functioning of the state and devastating consequences for its population. What is most at risk are people’s lives, capability for work, the entire economy and the capacities of the army and overall national security.

    Conclusion: The results of this study indicate an inextricable link between health and security and the necessity of viewing health through the lens of health security and incorporating it as such into the National Security Strategy.



  • XML | PDF | downloads: 120 | views: 303 | pages: 1146-1148

    Background: The existing models of information technology in health sciences have full scope of betterment and extension. The high demand pressures, public expectations, advanced platforms all collectively contribute towards hospital environment, which has to be kept in kind while designing of advanced technological ecosystem for information technology. Moreover, for the smooth conduct and operation of information system advanced management avenues are also essential in hospitals. It is the top priority of every hospital to deal with the essential needs of care for patients within the available resources of human and financial outputs. In these situations of high demand, the technological ecosystems in health informatics come in to play and prove its importance and role. The present review article would enlighten all these aspects of these ecosystems in hospital management and health care informatics.

    Methods: We searched the electronic database of MEDLINE, EMBASE, and PubMed for clinical controlled trials, pre-clinical studies reporting utilizaiono of ecosysyem advances in health information technology.

    Results: The primary outcome of eligible studies included confirmation of importance and role of advances ecosystems in health informatics. It was observed that technological ecosystems are the backbone of health informatics.

    Conclusion: Advancements in technological ecosystems are essential for proper functioning of health information system in clinical setting.


  • XML | PDF | downloads: 230 | views: 370 | pages: 1149-1158

    Background: HIV and AIDS have many different epidemiological, social and political aspects. The aim of this study was to determine the research priorities according to the necessary aspects of HIV and AIDS in Iran.

    Methods: The national and international databases were searched to obtain the published articles regarding HIV and AIDS in Iran. All Epidemiologic studies were included in this review for assess research priorities.

    Results: Of 3059 retrieved references, 362 studies were included. The most studies were conducted in Tehran, Kermanshah, Fars and Kerman provinces. The cross-sectional studies with 71.55% have higher proportion. Studies related to adherence to treatment (0.55%), drug resistance (0.83%) and experience, perception and behavior of HIV/AIDS patients (0.83%) had the lowest proportion of conducted studies. Proportion of studies regarding prevention of HIV was 2.76%. The authors of studies on female sex workers (FSWs) (63.64%) and prisoners (58.82%) suggested further studies on these groups.

    Conclusion: According to our results, the high-risk groups such as female sex workers, injecting drug users and prisoners are in priority for research. Moreover, topics related to the prevention of HIV and AIDS, adherence to treatment and antiretroviral drug resistance are other research priorities in Iran.



Original Article(s)

  • XML | PDF | downloads: 153 | views: 325 | pages: 1159-1169

    Background: This study explored the relationship between socio-economic characteristics at the individual and neighbourhood levels, and wellbeing and lifestyle behaviours of young Iranian women.

    Methods: Cluster convenience sampling was used to select 391 Iranian women participated in this cross-sectional survey in Shiraz, Iran in 2013. A scale adapted from the British General Household Social Capital questionnaire was used to assess neighbourhood socio-economic characteristics. The satisfaction with life scale, WHO quality of life scale, and the International Health and Behaviours Survey were used to measure wellbeing outcomes and lifestyle behaviours.

    Results: Findings showed participants were dissatisfied with their neighbourhood socio-economic conditions (M: 36.3±9.8, score range: 11-60) as well as the availability of leisure facilities (M: 1.8, score range: 1-5) in their local areas. Correlations and regression analysis revealed that better neighbourhood socio-economic characteristics were positively associated with better wellbeing outcomes as well as healthier lifestyle behaviours.

    Conclusion: These findings suggest the need for transitioning economies to be cognisant of the importance of social policy and strategies for enhancing neighbourhood socioeconomic status in order to enhance wellbeing outcomes for sub-populations, including young women.


  • XML | PDF | downloads: 122 | views: 318 | pages: 1170-1178

    Background: The aim of this study was to propose a new stochastic model to study the time course of ethanol elimination in human bodies.

    Methods: The times and amount of alcohol ingested are assumed to be random in controllable intervals. Constant elimination rate follows zero order kinetics and is replaced by first order kinetics when the effects of alcohol increase due to alcohol ingestion. Simulation studies of three different models were made to compare the statistical characteristics of the ethanol effects obtained using analytical expressions. For each model, three cases were considered depending on the drinking pattern and by classifying the drinker as heavy, normal or sparse.

    Results: From the model formulation, we noted that as the rate of drinking increases for a given elimination rate, the expected time between overflows goes towards zero. Furthermore, as the average amount of alcohol in each drink increases, the corresponding time between overflows decreases.

    Conclusion: Variations in times of alcohol intakes as well as the amount of alcohol consumption can be accounted through the final created formula. The model proves that overflows occur when alcohol is ingested before the adverse effects of alcohol from the previous drink are completely eliminated. Being the first stochastic model of such a kind, we do hope that it will throw more light on interpreting experimental data of alcohol abuse.



  • XML | PDF | downloads: 158 | views: 393 | pages: 1179-1187

    Background: We aimed to assess the high-risk group for suicide using different classification methods includinglogistic regression (LR), decision tree (DT), artificial neural network (ANN), and support vector machine (SVM).

    Methods: We used the dataset of a study conducted to predict risk factors of completed suicide in Hamadan Province, the west of Iran, in 2010. To evaluate the high-risk groups for suicide, LR, SVM, DT and ANNwere performed. The applied methods were compared using sensitivity, specificity, positive predicted value, negative predicted value, accuracy and the area under curve. Cochran-Q test was implied to check differences in proportion among methods. To assess the association between the observed and predicted values, Ø coefficient, contingency coefficient, and Kendall tau-b were calculated.

    Results: Gender, age, and job were the most important risk factors for fatal suicide attempts in common for four methods. SVM method showed the highest accuracy 0.68 and 0.67 for training and testing sample, respectively. However, this method resulted in the highest specificity (0.67 for training and 0.68 for testing sample) and the highest sensitivity for training sample (0.85), but the lowest sensitivity for the testing sample (0.53). Cochran-Q test resulted in differences between proportions in different methods (P<0.001). The association of SVM predictions and observed values, Ø coefficient, contingency coefficient, and Kendall tau-b were 0.239, 0.232 and 0.239, respectively.

    Conclusion: SVM had the best performance to classify fatal suicide attempts comparing to DT, LR and ANN.


  • XML | PDF | downloads: 148 | views: 386 | pages: 1188-1198

    Background: Reliable methods are crucial to cope with uncertainties in the risk analysis process. The aim of this study is to develop an integrated approach to assessing risks of benzene in the petrochemical plant that produces benzene. We offer an integrated system to contribute imprecise variables into the health risk calculation.

    Methods: The project was conducted in Asaluyeh, southern Iran during the years from 2013 to 2014. Integrated method includes fuzzy logic and artificial neural networks. Each technique had specific computational properties. Fuzzy logic was used for estimation of absorption rate. Artificial neural networks can decrease the noise of the data so applied for prediction of benzene concentration. First, the actual exposure was calculated then it combined with Integrated Risk Information System (IRIS) toxicity factors to assess real health risks.

    Results: High correlation between the measured and predicted benzene concentration was achieved (R2= 0.941). As for variable distribution, the best estimation of risk in a population implied 33% of workers exposed less than 1×10-5 and 67% inserted between 1.0×10-5 to 9.8×10-5 risk levels. The average estimated risk of exposure to benzene for entire work zones is equal to 2.4×10-5, ranging from 1.5×10-6 to 6.9×10-5.

    Conclusion: The integrated model is highly flexible as well as the rules possibly will be changed according to the necessities of the user in a different circumstance. The measured exposures can be duplicated well through proposed model and realistic risk assessment data will be produced.


  • XML | PDF | downloads: 143 | views: 367 | pages: 1199-1207

    Background: Low back pain caused by work, ranked the second after cardiovascular diseases, are among the most common reasons of patients’ referral to the physicians in Iran. This study aimed to determine the changes in back compressive force when measuring maximum acceptable weight of lift in Iranian male students.

    Methods: This experimental study was conducted in 2015 on 15 young male students were recruited from Tehran University of Medical Science. Each participant performed 18 different lifting tasks involving three lifting frequencies, with three lifting heights, and two box sizes. Each set of experiments was conducted during the 20 min work period using free-style lifting technique. The back compressive force evaluated with hand-calculation back compressive force method. Finally, Pearson correlation test, analysis of variance (ANOVA) and t-test were used for data analysis.

    Results: The mean of back compressive force (BCF) for the small and large boxes at a frequency of 1lift/min at heights of F - K height, were 1001.02 (±86.74), 1210.57 (±93.77) Ib, respectively. There was a significant difference between mean BCF in terms of frequencies of lifts (P=0.02). The result revealed significant difference between frequencies of 1 lift/min and 6.67 lift/min (P=0.01). There was a significant difference between mean BCF in terms of the sizes of the two boxes (P=0.001). There was a significant relationship between the BCF and maximum acceptable weight of lift in all test conditions (P=0.001).

    Conclusion: BCF is affected by box size, lifting frequency and weight of load.


  • XML | PDF | downloads: 171 | views: 447 | pages: 1208-1216

    Background: To determine the hospital required beds using stochastic simulation approach in cardiac surgery departments.

    Methods: This study was performed from Mar 2011 to Jul 2012 in three phases: First, collection data from 649 patients in cardiac surgery departments of two large teaching hospitals (in Tehran, Iran). Second, statistical analysis and formulate a multivariate linier regression model to determine factors that affect patient's length of stay. Third, develop a stochastic simulation system (from admission to discharge) based on key parameters to estimate required bed capacity.

    Results: Current cardiac surgery department with 33 beds can only admit patients in 90.7% of days. (4535 d) and will be required to over the 33 beds only in 9.3% of days (efficient cut off point). According to simulation method, studied cardiac surgery department will requires 41-52 beds for admission of all patients in the 12 next years. Finally, one-day reduction of length of stay lead to decrease need for two hospital beds annually.

    Conclusion: Variation of length of stay and its affecting factors can affect required beds. Statistic and stochastic simulation model are applied and useful methods to estimate and manage hospital beds based on key hospital parameters.



Case Report(s)

Letter to the Editor