Background: Several studies have investigated the prevalence of Alzheimer’s disease (AD) among the general population in several parts of China. However, the results have been inconsistent. This meta-analysis was conducted to estimate the overall prevalence of AD between 2007 and 2017 in China.

Methods: English and Chinese electronic databases were searched with a date range from Nov 2007 to Nov 2017 and the reference lists of the included studies were screened as well. Cross-sectional studies addressing the prevalence of AD among the general Chinese population were retrieved irrespective of the age, location or sex of the participants. Study quality was assessed using the recommended checklist of STROBE.

Results: Overall, 184058 subjects and 7445 patients with AD were included from 17 studies in this meta-analysis. The overall prevalence of AD in China was calculated to be 0.04(95% CI:0.04-0.05). The prevalence was higher in older age groups, among females, and in the rural areas of the country, with an increasing trend in recent years.

Conclusion: AD is a common problem among those in the Chinese population older than 65 yr. Furthermore, an increasing trend of the disease over the past 10 years is indicative of a critical public health problem in China in the near future. Further evidence based on a national survey is needed to estimate the exact prevalence of the disease in the country.

Background: Evidence of increased type 2 diabetes (T2D) risk associated with potatoes consumption is equivocal. We aimed to perform a meta-analyses on the association between potatoes consumption and T2D risk in prospective cohort studies.

Methods: Studies published prior to 31 Aug 2016 were identified in PubMed, EMBASE, and Web of Science. Pooled relative risks (RR) and 95% confidence intervals (95%CI) based upon the highest vs. lowest category of potatoes consumption in each study were calculated in meta-analysis using random-effects models. Dose-response meta-analysis was fitted using generalized least squares regression in order to quantify the association between potatoes consumption and T2D risk.

Results: The pooled RR comparing the highest vs. lowest category of potato consumption was 1.077 (95%CI: 1.005, 1.155). Dose-response meta-analysis revealed T2D risk increased 3.5% (RR=1.035, 95% CI: 1.004-1.067) for additional three serving per week serving of potato. The pooled RR comparing the highest vs. lowest category of French fries consumption was 1.362 (95%CI: 1.004, 1.850). Dose-response meta-analysis indicated T2D risk increased 18.7% (RR = 1.187, 95% CI: 1.067-1.321) for additional three serving per week of French fries.

Conclusion: This meta-analysis support a significant positive association between high potatoes consumption and risk of T2D, especially the consumption of French fries.

Background: We evaluated the prevalence and risk factors of workplace violence against Brazilian nurses in 2014.

Methods: The study’s population comprised of 112 nurses working in teams of Family Primary Care Units and Primary Care Health Centers. Those nurses were asked to answer a questionnaire that addressed the socio-demographic information, the professional routine and the occupational violence faced (types, frequency and characteristics of perpetrators). Data were analyzed using the SPSS software.

Results: Most of nurses were female (94.6%), aged between 34-43 yr (38.4%), living with a partner (60.7%) and having a weekly workload of 40 h (90.1 %). The prevalence of violence was 73.2%. Predominantly, occupational violence comprised of verbal violence (67.0%) and psychological harassment (bullying -27.1%). Patients (81.1%) and caregivers (83.1%) were responsible for verbal violence, whilst the heads of teams (78.3%) and other health professionals (41.7 %) practiced bullying. The risk factors more frequently reported were the lack of safety in the workplace (73.2%) and the aggressive behavior of patients (67%). The occupational violence was not statistically associated with the gender, professional experience, experience at primary health care, weekly working hours, or working shift. The type of violence faced was not either statistically associated with gender, marital status, professional experience, weekly working hours, or working shift.

Conclusion: Occupational violence has high prevalence among Brazilian nurses working at primary health care system. Verbal violence is more prevalent and frequently practiced by patients. The lack of safety in the workplace is the main risk factor associated with occupational violence faced by nurses.

Background: The world is experiencing the biggest wave of urban growth in history. The association between urbanization and health at the global level, as well as the role of air pollution, has not been studied. We aimed to examine the effect of urbanization on global health and the role of air pollution.

Methods: Unbalanced panel data comprising 3, 093 observations of 163 countries for 1990–2012 from the World Bank database was used. An infinite distributed lag model was applied to estimate the contemporary and long-term effects of urbanization on health outcomes measured by mortality, under-five mortality, infant mortality, life expectancy at birth(all; female; and male).

Results: Urbanization was positively related to global health in the short term and long term. In the short run, 1% increase in urbanization was associated with reduced mortality, under-five mortality, and infant mortality of 0.05%, 0.04%, and 0.04%, respectively, as well as increased life expectancy of 0.01 year. The effects of urbanization were stronger for high-income countries. However, air pollution undermined the positive impacts of urbanization on health.

Conclusion: Although urbanization leads to improved global health, air pollution undermines the positive effects of urbanization on health. Developing sustainable urbanization practices is crucial for addressing the challenges of pollution caused by urbanization.

Background: Korean traditional nuruk, consisting of a variety of microorganisms, is widely used in traditional liquor materials. The present study evaluated the antimicrobial activity of strains isolated from Korean traditional nuruk in 2016.

Methods: The strain was isolated from Korea traditional nuruk and performed antimicrobial activities using the paper disc test and phylogenetic analysis using 16S rRNA sequencing. The bacteriocin was identified by matrix-assisted laser desorption/ionization time-of-flight mass spectrometry.

Results: The isolate, S-2, demonstrated highest antibacterial activity against various gram-positive and gram-negative pathogens, including Klebsiella pneumoniae, Salmonella enterica subsp. enterica, Bacillus subtilis, B. cereus, Escherichia coli and Shigella flexneri. The isolated was identified as P. acidilactici, by 16S rRNA sequence analysis. Antibacterial activity of P. acidilactici was retained over a wide temperature range. And the P. acidilactici strains remained active over a wide pH range. However, reduced activities were obtained at alkaline pH. When the bacteriocins from this strain were treated with proteolytic enzymes, loss of antibacterial activity was observed. No effect in the activity, however, was observed upon treatment with α-amylase, β-amylase, lipases, proteases, and proteinase K. The molecular weight of bacteriocins was estimated to be approximately 51 kDa. Using MALDI-TOF/MS, the bacteriocins were identified as a putative penicillin binding protein.

Conclusion: This study is the first report of isolation of bacteriocin with the above mode of actions from Korean traditional nuruk. The bacteriocins produced by the strain have potential applications in food preservation.

Background: Dyslipidemia is a common and serious health problem, especially in middle-aged women. We aimed to reveal quantile-specific associations of serum lipids [triglycerides (TG), total cholesterol (TC), low density lipoprotein cholesterol (LDL-c) and high density lipoprotein cholesterol (HDL-c)] with influencing factors in middle-aged women.

Methods: A sample of 5635 participants were enrolled from Jilin, China, in 2012. Quantile regression (QR) model was performed to identify factors which influenced serum lipids in different quantiles.

Results: The influencing factors of TG, TC, LDL-c and HDL-c were different. Waist circumference (WC), menopause, smoking, diabetes and hypertension were positively associated with TG in almost all quantiles; Menopause and age were positively associated with TC in almost all quantiles. WC, living in urban areas and alcohol consumption were positively associated with TC in low and middle quantiles, diabetes was positively associated with TC from P50 to P95. The result of LDL-c was similar to TC; BMI was negatively associated with HDL-c from P50 to P90. WC and diabetes were negatively associated with HDL-c from P5 to P90.

Conclusion: Among middle-aged women, menopause, diabetes and WC were the main factors affecting the serum lipids. Postmenopausal women would get more risk in increasing the level of serum lipids.

Background: We aimed to define the epidemiological characteristics of poisoning cases in children that have occurred in Antalya, a major city in the Mediterranean.

Methods: The hospital records of children between the ages of 0 to 17 yr admitted to the Pediatric Emergency Department of Antalya Training and Research Hospital, Antalya, Turkey due to poisoning in a 6-year period from 2012-2017 were evaluated.

Results: Overall, 1507 poisoning cases were included in the study, of which 56% were female and 44% were male. Of them, 55% were between the ages of 0 and 5 yr, 10% were between 6 and 12, and 35% were between 13 and 17 year. In the 0-5 yr group, the poisonings were mostly in boys (55.1%) and were all accidental, while in children above 13, the poisonings were mostly in girls (77.8%) and suicide-related (97.1%). The poisonings were due to medication (64.5%) and chemical substances (35.5%). Among medication poisonings, the most common agents were paracetamol (18.0%), NSAID (15.2%) and antibiotics (8.0%). The most frequent chemical substances leading to poisoning were caustic/corrosive chemicals (22.8%) pesticides (8.0%). Interventions most commonly administered were activated charcoal (60.9%), gastric lavage (38.6%) and naso-gastric catheter (36.6%). Mortality was observed in 2 cases during six years.

Conclusion: Knowledge on epidemiological and clinical features of poisoning in children according to age groups, establishing drug and chemical substance safety for children, and widespread parent education shall help decreasing childhood poisoning.

Background: Dialysis costs was a heavy burden in End Stage Renal Disease (ESRD) patients. In China, the two major medical insurance systems are the New Cooperative Medical Scheme (NCMS) for rural residents and the Urban Employees’ Medical Insurance (UEMI) for urban patients. This study compared the economic bur-den of ESRD patients under different dialysis methods and the impact of the medical insurance system on it.

Methods: Overall, 156 ESRD patients were enrolled at the Department of Nephrology in the First Affiliated Hospital of Zhengzhou University, Zhengzhou, China between Jan 2013 and Jan 2014. They were divided into hemodialysis group (HD group, n=84) and peritoneal dialysis group (PD group, n=72). The data, such as the patient's basic information, total expenses and self-paid expenses in the early stage of dialysis and 1-year treatment, and medical insurance type, were separately collected.

Results: The early-stage average total expenses and self-paid expenses in the PD group were higher than those in the HD group (P<0.01). The average total expenses and self-paid expenses in the PD group were lower than those in the HD group (P<0.01). Whichever dialysis method was used, the self-paid expense percentage for the NCMS patients and was higher than UEMI patients.
Conclusion: In terms of the long-term dialysis treatment for ESRD patients, the better choice was PD judging by the treatment expenses. Meanwhile, different medical insurance types had significant economic burden im-pacts on dialysis patients.

Background: There are many assessment instruments used for cancer worry. Many women worry about breast cancer, but In Turkey, there is no scale that assesses the worry about developing breast cancer. The aim of this study was to investigate the validity and reliability of the Turkish Breast Cancer Worry Scale (BCWS). This scale was created as a modified version of the Cancer Worry Scale.

Methods: The study was conducted in a Family Health Center (FHC) located in eastern Turkey using a methodological design. The study sample consisted of 610 healthy women who referred to a FHC for any reason. The data were collected using the Participant Information Form and BCWS with a face-to-face interview conducted between Jun 2015 and Jan 2016. Construct validity of the scales was tested via factor analysis, Cronbach’s alpha coefficient, item-total score correlation coefficient, and test-retest correlations were calculated to check for reliability.

Results: The factor load values of BCWS were found to be between 0.45 and 0.79. The total Cronbach’s alpha coefficient of the scale was 0.78, and the total score correlations of items ranged between 0.32 and 0.64. The test-retest reliability coefficient of the scale was 0.81 (P=0.001).

Conclusion: The Turkish version of the BCWS is a valid and reliable tool for assessing the effect of breast cancer worry on daily activities and mental condition.

Background: To predict the optimal functions of key aberrant genes in early-onset preeclampsia (EOPE) by using a modified network-based gene function inference method.

Methods: First, differentially expressed genes (DEGs) were extracted using linear models for microarray data (LIMMA) package. Then the Spearman's rank correlation coefficient was calculated to assess co-expressed strength of each interaction between DEGs, based on which the co-expressed genes network was constructed to vividly exhibit their interlinking relationship. Subsequently, Gene ontology (GO) annotations for EOPE were collected according to known confirmed database and DEGs. Ultimately, the multifunctionality algorithm was used to extend the “guilt by association” method based on the co-expressed network, and a 3-fold cross validation was operated to evaluate the accuracy of the algorithm.

Results: During the process, the GO terms, of which the area under the curve (AUC) over 0.7 were screened as the optimal gene functions for EOPE. Six functions including the ion binding and cellular response to stimulus were determined as the optimal gene functions.

Conclusion: Such findings should help to better understand the pathogenesis of EOPE, so as to provide some references for clinical diagnosis and treatment in the future.

Background: This cross-sectional was aimed to assess the prevalence of pre-pregnancy care services usage and its determinant factors among women of reproductive age in Kedah, Malaysia.

Methods: Overall, 1347 respondents who attended 24 government health clinics, were chosen using systematic multistage random sampling. A validated self-administered questionnaire which consisted of sections including socio-demographic characteristics, social support, knowledge on pre-pregnancy care, perception on risk of pregnancy, health status, as well as intention and awareness on pre-pregnancy care services were distributed.

Results: The prevalence of utilization of pre-pregnancy care services was still low i.e. 44.0%. Bivariate and multivariate analysis showed consistent significant level between all factors and pre-pregnancy care usage except for family planning practice. The factors that showed significant difference with the usage of pre-pregnancy care services were age of more than 35 (P<0.001), high education level (P<0.001), non-working mothers (P<0.001), multipara (P=0.001), awareness on the existence of pre-pregnancy care services in government health facilities (P<0.001), intention to use the services (P=0.0030), having medical illness (P=0.005), having social support (P=0.001), high knowledge (P<0.001), and positive perception (P<0.001).

Conclusion: Low usage of pre-pregnancy care services can be improved through health screening on reproductive-aged women with positive determinant factors at the triage level in integrated clinics. Information and knowledge on pre-pregnancy services should be disseminated among community members through various means including roadshows and pre-wedding workshops.

Background: This study aimed to observe the effect of fine nursing on pain and postpartum recovery during natural delivery of pregnant women.

Methods: The clinical data of 192 primiparas who were expecting labor in Nanfang Hospital, Southern Medical University, Guangzhou, China from 2015-2016 were retrospectively analyzed. Among them, 100 cases were treated with fine nursing before and after delivery, and 92 cases were treated with routine nursing. The pain rate, the second stage of labor, the amount of bleeding 2 hours postpartum, and postpartum recovery were compared between the two groups.

Results: The number of cases of grade 0 and 1 pain and the good rate of pain were significantly higher in the observation group than in the control group, the number of cases with grade 2 pain in the observation group was significantly lower than that of the control group (P<0.01). The second stage of labor and the 2h postpartum hemorrhage in the observation group were significantly lower than those in the control group (P<0.001). The number of maternal cases with good postpartum sleep, good lactation and good mental health in the observation group was significantly higher than that in the control group (P<0.05).

Conclusion: Fine nursing before and after delivery can reduce maternal pain rate, shorten the second stage of labor, reduce the amount of bleeding after 2 hours postpartum, promote good sleep, lactation, psychological conditions, reduce postpartum infection rate, which is conducive to maternal body recovery, worthy of clinical promotion.

Background: The rate of caesarean section (C-section) in Iran is too high, so having a plan to control it is crucial. Since one of the most important reasons for inclination of providers to do C-section is financial issues, the purpose of this study was offering financial solutions for increasing normal vaginal delivery (NVD) and decreasing non-indicated C-section.

Methods: This analytical-descriptive research, used game theory for offering financial mechanisms. The game was a dynamic one in which the backward induction was used to obtain a Nash equilibrium. Financial structure and the mean number of NVD and C-section in a certain period of time in comparison with standards were as the main influential factors on financial dimensions and were included in the model.

Results: The effect of financial structure was shown through a specified insurance for childbirth, existence of a monitoring department and tariffs.

Conclusion: The main solution for controlling C-section in designed game was taxes and fines for physician or hospital in non- indicated cases and giving reward otherwise.

Background: Acute kidney injury (AKI) is the most common cause of organ dysfunction in intensive care unit (ICU) patients. There is no consensus definition of AKI in ICU patients. Therefore, we aimed to evaluate the incidence rate, risk factors and clinical outcome of AKI using the RIFLE (Risk, Injury, Failure, Loss of kidney function, and End-stage kidney disease) classification in ICU patients.

Methods: We performed a retrospective cohort study, on 900 patients admitted to the ICU during a one year period at Imam Khomeini Hospital in Ardebil, Iran from 2014 to 2015. AKI was defined by the consensus RIFLE criteria.

Results: The overall incidence rate of AKI was 37%. The patients with AKI were also classified according to RIFLE as follows: Risk (8.2%), Injury (13.4%), Failure (13.2%), Loss of kidney function (1.3%), and End-stage kidney disease (0.8%). The mortality rate was 58.3% for AKI patients, and 13.4% for non-AKI patients (P<0.001). Patients in RIFLE-R (Risk) had a mortality rate of 37.8% compared with 48.8% for those in RIFLE-I (Injury) and 76.5% for RIFLE-F (Failure) patients (P<0.0001). Significant risk factors to the development of AKI were included: age more than 60 yr, increased length of hospital stay, systolic blood pressure less than 100 mm Hg, requirement of mechanical ventilation, relevant comorbidities, anemia, thrombocytopenia, increased serum bilirubin and liver enzymes, and serum sodium abnormalities.

Conclusion: The RIFLE classification is a useful and suitable clinical tool to evaluate the incidence and mortality rate of AKI. In ICU patients, AKI is associated with increased mortality rate.

Background: The aim of this study was assessment of the chronic effects of sulfur mustard (SM) among victims.

Methods: In this cohort study, 355 SM-exposed subjects from Sardasht, and 123 controls from Rabat, both from West Azerbaijan Province, Iran were included. The spirometric evaluation and the global initiative for chronic obstructive lung disease (GOLD) classification were applied for all. Serum levels of urea, creatinine (Cr), and uric acid (UA) and glomerular filtration rate (GFR) were assessed. Data analysis was conducted using IBM SPSS.

Results: All were male, with a mean age of 43.7±10.7 and 41.6±9.9 years in case and control groups, respectively. The case group had significantly higher values of Cr (P<0.001) and UA (P=0.018) than the control group. This was also the case in the Cr level (P<0.001) in subjects without pulmonary dysfunction, between both groups. There was significant difference in the GFR (P=0.047) between both groups and between sub-groups with pulmonary dysfunction in the case and control groups (P=0.045), as well as between SM-exposed subjects with and without pulmonary dysfunction (P=0.009). Serum Cr, UA, sUA/Cr ratio, and BUN as well as the GFR did not have any significant correlation with forced expiratory volume in one second (FEV1), forced vital capacity (FVC), and FEV1/FVC ratio.

Conclusion: Despite significantly high levels of Cr and UA in the case group, no significant correlation was found between serum Cr, UA, sUA/Cr ratio, BUN, and GFR with spirometric values. Further studies are required to reveal the underlying molecular and clinical significance of these findings.

Background: Nitric oxide (NO) has been associated with insulin resistance and type 2 diabetes (T2D). NO is synthesized enzymatically from l-arginine (l-Arg) by three NO synthase (NOS) isoforms, Neuronal NOS (nNOS or NOS1), Inducible NOS (iNOS or NOS2), and Endothelial NOS (eNOS or NOS3). The impact of NOS2 gene polymorphism was investigated on the susceptibility of T2D in a sample of Iranian population (Southeastern of Iran).

Methods: In 2015, the present case-control study was conducted on 152 T2D patients and 157 healthy control subjects (HCs) referring to Bu-ali Hospital of Zahedan, eastern Iran. Genotyping of NOS2 rs2779248T/C and rs1137933C/T variants were done using the Tetra-Amplification Refractory Mutation System Polymerase Chain Reaction (Tetra-ARMS PCR) method.

Results: CT genotype of rs1137933C/T was significantly associated with increased risk of T2D (P<0.0001). The T allele of this single nucleotide polymorphism (SNP) was also strongly associated with T2D risk (P<0.0001). For rs2779248 T/C, TC genotype of this SNP decreased the risk of T2D (OR=0.25 95%CI= 0.15-0.42, P<0.0001); however, CC genotype of this SNP increased the risk of T2D (P<0.005). There was no significant association between clinical-demographic characteristics of T2D group with respect to both SNPS in dominant.

Conclusion: CT genotype and C allele of NOS2 rs1137933 C/T polymorphism were associated with a higher risk of T2D, and no association was observed between T allele of NOS2 rs2779248 T/C polymorphism and T2D while TC genotype of this SNP decreased the risk of T2D in the study participants.

Background: Visceral leishmaniasis (VL), so-called Kala-azar is a life threating parasitic infectious disease caused by Leishmania spp. L. infantum is the main causative agent for Mediterranean form of Kala-azar which is endemic in northeastern Iran. This study attempted to investigate existence of canine visceral leishmaniasis (CVL) in Khorasan Razavi.

Methods: Between 2014 and 2016, tissue samples collected from spleen and liver of 192 stray dogs were examined to investigate existence of L. infantum. Kinetoplast DNA (k-DNA) PCR was performed to identify the species of parasites. The positive PCR products were sequenced in both directions to confirm the kDNA PCR results

Results: Among samples obtained from 192 dogs, kinetoplast DNA of L. infantum was detected in two female dogs. L. infantum was confirmed by sequence analysis of PCR products.

Conclusion: Our data confirm stray dogs play as potential reservoirs for VL in this province. Further investigation will be necessary to clear role of stray dogs in the transmission of L. infantum to human and domestic dogs.

Background: The Rapid Office Strain Assessment (ROSA) is a tool employed online to screen office workstations, which may require modification to decrease musculoskeletal discomfort of workers. This study aimed to examine if the ROSA is able to evaluate pain severity in the lower back, shoulder and neck of office workers accurately.

Methods: Overall, 142 participants (height: 1.80 ± 0.15 m, BMI: 26.08± 6.70, age: 35±15 yr) with at least a year of working experience completed both questionnaires, the online ROSA and the Cornell musculoskeletal discomfort, in 2016 in Malaysia. 

Results: Relationship between the total scores of both questionnaires for lower back, shoulder and neck pain were significant but exhibited a weak to moderate relationship (range of r values from 0.012 (CI 95%, -0.153-0.176) to 0.503 (CI 95%, 0.369-0.616).

Conclusion: The online ROSA does not appear to be a reasonable tool for evaluating the severity of lower back, shoulder and neck pain among office workers as the correlations were low. We suggest continued use of the musculoskeletal discomfort questionnaire. Additional studies are required to further examine the ROSA for other anatomical regions.

Background: Alteration of environmental factors and air pollution affects the trend of allergic diseases especially in cities such as Tehran. This study aimed to determine the prevalence of allergic rhinitis, conjunctivitis, atopic dermatitis and asthma among adults in the capital city of Iran.

Methods: This cross-sectional study was performed between 2013 and 2016 in Tehran, Iran. The participants were adults between 18 and 45 yr of age. A specific questionnaire including demographic data and clinical symptoms was filled out by a trained interviewer. The diagnosis of allergic diseases was performed based on standard questionnaires and criteria.

Results: The prevalence of allergic rhinitis, conjunctivitis, asthma and atopic dermatitis were 28.3%, 15.9%, 7.6% and 3.9%, respectively. Allergic rhinitis and conjunctivitis together were reported in 12.3% of the participants. Among patients with asthma, 47.4% had AR. Additionally, 25.7% of atopic dermatitis subjects were reported to have asthma. The subjects with at least one of these allergic diseases were 36.3%. Women showed a higher prevalence of allergic symptoms than men. There was a significant relationship between allergic symptoms and family history of atopic diseases.

Conclusion: The most common allergic disease was allergic rhinitis. Regarding the comorbidity of asthma and allergic rhinitis, paying more attention to controlling these allergic diseases is deemed necessary.

Wegener's granulomatosis is a rare vasculitis affecting the upper and lower respiratory tracts and kidneys. The cornerstone of treatment in these patients is immunosuppressive therapy, which may predispose the patient to super-infections such as fungal diseases per se. However, the fungal infection mimics the clinical manifestations of Wegener's diseases would lead to neglected course of the infection and subsequent morbidity and mortality especially if unusual organs are involved. Here we report a 21-yr-old female patient referred to a hospital, Tehran, Iran in 2013 with a neglected skin mucormycosis and the course of the disease and outcome with Wegener's granulomatosis.

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