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Aim: This study aimed to introduce a biomarker panel to detect pancreatic ductal adenocarcinoma (PDAC) in the early stage, and also differentiate of stages from each other. Background: PDAC is a lethal cancer with poor prognosis and overall survival. Methods: Gene expression profiles of PDAC patients were extracted from the Gene Expression Omnibus (GEO) database. The genes that were significantly differentially expressed (DEGs) for Stages I, II, and III in comparison to the healthy controls were identified. The determined DEGs were assessed via protein-protein interaction (PPI) network analysis, and the hub-bottleneck nodes of analyzed networks were introduced. Results: A number of 140, 874, and 1519 significant DEGs were evaluated via PPI network analysis. A biomarker panel including ALB, CTNNB1, COL1A1, POSTN, LUM, and ANXA2 is presented as a biomarker panel to detect PDAC in the early stage. Two biomarker panels are suggested to recognize other stages of illness. Conclusion: It can be concluded that ALB, CTNNB1, COL1A1, POSTN, LUM, and ANXA2 and also FN1, HSP90AA1, LOX, ANXA5, SERPINE1, and WWP2 beside GAPDH, AKT1, EGF, CASP3 are suitable sets of gene to separate stages of PDAC. [ABSTRACT FROM AUTHOR]

Background: The rate of childhood cancer death has dropped steadily over the past 50 years. The pediatric cancer risk has remained under investigation. Objectives: This study aims at investigating the associated factors with the survival of pediatric patients with retinoblastoma, sarcoma, brain tumor, and leukemia cancer. Methods: The cohort study of 1879 children with retinoblastoma, sarcoma, brain tumor, and leukemia aged < 1, 1 - 5, 6 - 10, 11 - 15, and > 15 years in Mahak Hospital and Rehabilitation Complex from 2007 to 2016 were enrolled in the study. Median survival time was reported for each cancer. Parametric survival models including Gompertz, Weibull, lognormal, and log-logistic models were fitted. Then, the model with almost minimum Akaike information criterion (AIC) was chosen. The hazard ratio (HR) and the analysis were performed by R3.5.1. Results: Totally, 270 (14.37%) patients with Retinoblastoma, 667 (35.5%) with leukemia, 625 (33.26%) with a Brain tumor, and317 (16.87%) with Sarcoma were included in this study; 815 (43.37%) patients were female. Gompertz's model was chosen to fit the data due to the minimum AIC. The associated factors with the survival of childhood cancers were as follows: age < 1 year, parental relation, locoregional relapse and chemotherapy alone (HR: 7.63, 1.56, 4.61, 1.12) in leukemia, other nationalities, metastasis or metastasis and loco-regional relapse and chemotherapy alone (HR = 3.74, 5.75, 2.12) in retinoblastoma, loco-regional relapse and metastasis (HR = 2.40, 3.71) in brain tumor, other ages except for 5 - 10 years, parental relation, chemotherapy alone, and metastasis (HR = 33.3, 1.80, 3.57, 3.8) in sarcoma. Conclusions: Age, parental familial relationships, combination therapy, and metastasis of primary cancer were the risk factors for survival of children with 4 common cancers of leukemia, retinoblastoma, brain tumors, and sarcoma, using the Gompertz model. [ABSTRACT FROM AUTHOR]

The factors affecting the dynamics of lengthening of symptoms and serologic responses are not well known. In order to see how the serologic responses change in relation to the clinical features, we selected a group of 472 adults with a positive IgM/IgG antibody test result from a baseline study of the anti-SARS-CoV-2 seropositivity, assessed their COVID-19 and past medical histories, and followed them up in about 3 months. Nearly one-fourth of the subjects were asymptomatic at the baseline; 12.8% subjects became symptomatic at the follow-up (FU) when 39.8% of the subjects had some persisting symptoms. At the baseline, 6.1% showed anti-SARS-CoV-2 IgM positive, 59.3% only for IgG, and 34.5% for both. At the FU, these figures declined to 0.6, 54.0, and 4.4%, respectively, with the mean IgM and IgG levels declining about 6.3 and 2.5 folds. Blood group A was consistently linked to both sustaining and flipping of the gastrointestinal (GI) and respiratory symptoms. The baseline IgM level was associated with GI symptoms and pre-existing cirrhosis in multivariate models. Both of the baseline and FU IgG levels were strongly associated with age, male, and lung involvement seen in chest computed tomography (CT)-scan. Finally, as compared with antibody decayers, IgM sustainers were found to be more anosmic [mean difference (MD): 11.5%; P = 0.047] with lower body mass index (BMI) (MD: 1.30 kg/m2; P = 0.002), while IgG sustainers were more commonly females (MD: 19.2%; P = 0.042) with shorter diarrhea duration in the FU (MD: 2.8 days; P = 0.027). Our findings indicate how the anti-SARS-CoV-2 serologic response and COVID-19 clinical presentations change in relation to each other and basic characteristics. [ABSTRACT FROM AUTHOR]

The β-thalassemias are a group of genetic disorders defined by decreased levels of functional hemoglobin (Hb). In light of pivotal improvements in patient survival, the load of consistent treatment harms patients' quality of life (QOL). This study aimed to determine the QOL in patients with β-thalassemia (β-thal) in Iran and identify associated factors. This cross-sectional study was conducted among 1240 patients with β-thal. Data for this study were obtained from the General, the TranQol (Transfusion-dependent QoL) Standard, and the Multidimensional Scale of Perceived Social Support (MSPSS) questionnaires. The univariate and multivariable linear regression was used in STATA version 14 to identify factors related to QOL. Overall, the QOL score was 103 ± 21.96, and adults had a higher score than children under 15 years old. Emotional health had the highest score (39.96 ± 11.54), and sexual activity in adults (1.87 ± 2.08) and activities related to education in children (10.43 ± 7.46) had the lowest. The multivariable linear regression analysis showed that the age, gender, age of blood transfusion initiation, Hb level, number of underlying diseases, and social support level by family and community significantly impact QOL. In exchange for an increase in comorbidities, patients' QOL decreased by 86.0% [odds ratio (OR) = 0.14, 95% confidence interval (95% CI): 0.04–0.45]. Many factors affecting the QOL can be controlled, so social support, increased Hb levels, regular and timely blood transfusions, and treatment can improve the thalassemia patients' QOL. [ABSTRACT FROM AUTHOR]

Aim: The aim of this study is to explore the expression of genes associated to celiac disease (CD) in the target tissue and peripheral blood monocytes (PBMC) or serum to introduce possible potential biomarkers. Background: Celiac disease (CD) is an autoimmune disease induced by gluten ingestion in genetically predisposed individuals. Despite technological progress, small intestine biopsy is still the gold standard for diagnosis of CD. Methods: CD data were collected from public databases (proteomics and microarray-based techniques documents). Differentially expressed genes (DEGs) in PBMC or serum as well as small intestinal biopsies from celiac patients compared to normal were collected and analyzed to introduce common individuals. Gene ontology was done to identify the involved biological terms. Results: Among 598 CD genes in biopsies and 260 genes in PBMC or serum, 32 common genes with a similar expression pattern in both sources were identified. A total of 48 biological terms were introduced which were involved in the CD via the determined DEGs. "Cytokine activity" was the most expanded one of the biological terms. Conclusion: In this analysis, it was concluded that 32 potential biomarkers of CD can be assessed by complementary research to introduce effective and available biomarkers in biopsy and blood. [ABSTRACT FROM AUTHOR]

Aim: Assessment of related genes to colon cancer to introduce crucial ones, was the aim of this research. Background: Colon cancer is one of the invasive colorectal diseases. This disease is preventable and manageable if it be diagnosed in early stage. The aggressive tools for its detection imply more investigation for new molecular diagnostic methods. Methods: Numbers of 300 genes from String database (SD) are analyzed via constructed Protein-protein interaction (PPI) network by Cytoscape software 3.4.0. Based on centrality parameters the main connected component of network was analyzed and the crucial genes were introduced. Cluster analysis of the network and gene ontology for the nodes of the main cluster revealed more details about the role of the key proteins related to colon cancer disease. Results: The constructed network was consisted of 300 genes which among them 68 genes were isolated and the 232 other genes formed the main connected component. Ten crucial genes related to colon adenocarcinoma were introduced that presented in cluster 1. Gene ontology analysis showed that cluster 1 is involved in 226 biological processes which are classified in 25 groups. Conclusion: In conclusion, results indicate that the identified key proteins play significant roles in colon adenocarcinoma. It may be possible to introduce a few diagnostic biomarker candidates for colon cancer disease. [ABSTRACT FROM AUTHOR]

Background and Aim: A significant social and economic burden inflicts by road traffic injuries (RTIs). We aimed to use Bayesian model, to present the precise method, and to estimate the cost of RTIs in Iran in 2013. Materials and Methods: In a cross-sectional study on costs resulting from traffic injuries, 846 people per road user were randomly selected and investigated during 3 months (1st September-1st December) in 2013. The research questionnaire was prepared based on the standard for willingness to pay (WTP) method considering perceived risks, especially in Iran. Data were collected along with four scenarios for occupants, pedestrians, vehicle drivers, and motorcyclists. Inclusion criterion was having at least high school education and being in the age range of 18-65 years old; risk perception was an important factor to the study and measured by visual tool. Samples who did not have risk perception were excluded from the study. Main outcome measure was cost estimation of traffic injuries using WTP method. Results: Mean WTP was 2,612,050 internal rate of return (IRR) among these road users. Statistical value of life was estimated according to 20,408 death cases 402,314,106,073,648 IRR, equivalent to 13,410,470,202$ based on the dollar free market rate of 30,000 IRR (purchase power parity). In sum, injury and death cases came to 1,171,450,232,238,648 IRR equivalents to 39,048,341,074$. Moreover, in 2013, costs of traffic accident constituted 6.46% of gross national income, which was 604,300,000,000$. WTP had a significant relationship with age, middle and high income, daily payment to injury reduction, more payment to time reduction, trip mileage, private cars drivers, bus, minibus vehicles, and occupants (P < 0.01). Conclusion: Costs of traffic injuries included noticeable portion of gross national income. If policy-making and resource allocation are made based on the scientific pieces of evidence, an enormous amount of capital can be saved through reducing death and injury rates. [ABSTRACT FROM AUTHOR]

Road traffic injuries (RTIs) leading to death need the most essential concern for low, middle and high income societies. Mortality rate due to traffic injuries is considerable in Iran particularly during the last decade along with the industrialization process. The present study considered the trend of traffic injuries leading to death in Iran for a period of seven-years which started from March 2004 to March 2011. The formal merged Iranian database provided by the Ministry of Roads, the Legal Medicine Organization, the Traffic Police (NAJA), and the Ministry of Health covering 146, 269 deaths due to traffic injuries between 2004 and 2011 was analyzed. The time series method was carried out to determine the death trends of RTIs in the whole country. The Poisson regression model was used to estimate the changes in the frequency of events over time adjusting for associated known risk factors. The SARIMA (0, 1, 1)×(0, 1, 1)12 model was used for fitting to the time series of death rate. The death rate due to RTIs in Iran has statistically declined from 38 in 2004 to 31 per 100,000 populations in 2011. Based on the number of vehicles, the mortality rate has also declined from 38 to 12 cases per 10,000 vehicles from 2004 to 2011 respectively. However, the mortality rate was increased from 51 to 65 cases per 1000 accidents from 2004 to March 2011 respectively. Despite minor variations in mortality trends of RTIs in Iran according to different criteria, an annual average of 21,000 deaths is considerable and needs serious attentions. Modification of traffic laws, enhancement of police controls, improving transport infrastructure, holding education courses for drivers and providing optimal healthcare services are recommended. [ABSTRACT FROM AUTHOR]

Background: Clinical manifestations of COVID-19 are different. There are some risk factors for COVID-19. This study aimed to describe the epidemiological features, symptoms and mortality of the patients with COVID-19 in Iran. Methods: This were a cohort study performed on 103,179 patients with COVID-19. The demographic and clinical data were collected in selected provinces. The required data of all patients was extracted from the COVID registry system and analyzed using STATA version 14 and Excel 2016. Results: The mean age was 52.40 years for men and 52.41 years for women. About 55.2% of the study population were male and 44.8% were female. Totally, 60.9% (5085) of deaths happened in men and 39.1% (3263) in women. The mean time from onset of symptoms to hospitalization in men and women were 3.47 and 3.48 days, respectively. The mean time from onset of symptoms to isolation was 2.81 days in men and was 2.87 days in women, from onset of symptoms to death was 9.29 and 9.54 days, respectively, from onset of symptoms to discharge was 7.47 and 7.39 days, and from hospitalization to death was 6.76 and 7.05 days. Cough and shortness of breath were the most common symptoms in the patients. Conclusion: According to the results, the overall mortality rate was higher in men than women. Women with cardiovascular disease and diabetes were more likely to die. The mean time from onset of symptoms to hospitalization, isolation, and discharge was similar in men and women. [ABSTRACT FROM AUTHOR]

Background: Despite the advances in the control of infectious diseases like cholera, they can potentially cause epidemics, especially in mass gathering events. One of the most important countries on the walking way of the Arbaeen religious event is Iran, which requires health system preparedness. The aim of this study was to predict the cholera epidemic in Iran by using the syndromic surveillance system of Iranian pilgrims in Iraq., Methods: The data of the Iranian pilgrims with acute watery diarrhea in Iraq during the Arbaeen religious event and the confirmed cholera cases of pilgrims after returning to Iran were analyzed. We used the Poisson regression model of the relationship between the numbers of cases to evaluate acute watery diarrhea and cholera. Spatial statistics and hot spot analysis were used to identify the provinces with the highest incidence. SPSS software Version 24 was used for statistical analysis., Results: The frequency of acute watery diarrhea cases was 2232 and the frequency of cholera in pilgrims after returning to Iran was 641. The results of spatial analysis for acute watery diarrhea cases showed a high number of acute watery diarrhea cases in the Khuzestan and Isfahan provinces, located in hot spots. Using Poisson regression, the relationship between the number of acute watery diarrhea reported in the syndromic surveillance system and the number of cholera cases was confirmed., Conclusion: The syndromic surveillance system is useful to predict the outbreak of infectious diseases in large religious mass gatherings., Competing Interests: The authors declare that they have no competing interests., (© 2023 Iran University of Medical Sciences.)

Introduction: Health and efforts to maintain and promote it have always been an essential priority in various countries. This study aims to evaluate the implementation of the health system reform plan in emergency departments in Iran., Methods: This qualitative study evaluated five dimensions (finance, social responsibility, growth and learning, service recipients, and internal processes) through examining 70 indicators in 400 healthcare service providers and 300 healthcare recipients after the implementation of reform plan in ten emergency departments affiliated to Shahid Beheshti University of Medical Sciences using the balanced scorecard based on comprehensive evaluation model for the health system reform plan in Iran (CEHSRP-IR), from 2018 to 2019., Results: From the perspective of 51% of service providers and 55% of service recipients, the health system reform plan has achieved its goals in hospital emergencies. Significant gap between the ideal effectiveness and the current situation in health services in hospital emergencies was observed, especially in the educational and financial dimension., Conclusion: According to the findings of this study, adaptation of activities and programs to the model proposed for emergency departments in Health Reform Plan is essential for improving its effectiveness.

Background: Due to their specific nature, such as high incidence, high intensity and direct involvement of all members of society, traffic injuries are of particular importance. Through a mega data, this study investigated the epidemiological aspects and depict current situation of road traffic injuries in Iran., Methods: Using legal medicine and traffic police data, deaths from road traffic injuries in men were predicted through determining the most appropriate model for death using time series statistical models; and then most important human factors associated with it in a period of 6 yr in Iran was analyzed using multi-nominal regression model., Results: The frequency of deaths from traffic injuries in the last seven years was 172,834 cases and the number of deaths at the accident scene was 42798 cases, of which 24.24% (41,971 cases) were recorded by the Traffic Police experts. Death rate from traffic injuries has been declined from 38 cases per 100,000 people in 2004 to 31 cases per 100,000 people between 2009 and 2010. Fatigue and sleepiness (AOR=10.36, 95% CI: 8.41-13.3) was the most significant human risk factors for death outcome in the urban and suburban traffic injuries. According to the predictions, the death rate is about 16488 (CI 95%, 8531-24364) for the year 2012., Conclusion: Despite all measures to prevent such injuries, even fatal injuries have still a high incidence. Intervention in the human risk factors field would be more effective due to their important roles in traffic injuries in Iran.