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In this study, we aimed to examine the relationship between energy-adjusted dietary inflammatory index (E-DII) and a comprehensive profile of malnutrition in Iranian haemodialysis (HD) patients. In this cross-sectional study, 291 participants on HD for at least 6 months before enrollment were included. The current dietary intakes of participants were assessed using a 4-d diet diary-assisted recall, including 2 non-dialysis days and 2 dialysis days to calculate E-DII. To determine the malnutrition status of HD patients, BMI, subjective global assessment (SGA), dialysis malnutrition score (DMS) and malnutrition inflammation score (MIS) were used. Overall, 291 HD patients comprised our study population. After controlling for potential confounders, E-DII was associated with a higher risk of malnutrition, as evidenced by SGA (OR = 2·23; 95 % CI: 1·11, 4·49), DMS (OR = 2·31; 95 % CI: 1·16, 4·60) and MIS (OR = 2·50; 95 % CI: 1·28, 4·88). No significant association was detected between E-DII and BMI either before (OR = 1·78; 95 % CI: 0·83, 3·81) or after adjustment for possible confounders (OR = 1·43; 95 % CI: 0·58, 3·54). This study showed that E-DII was significantly associated with reliable malnutrition markers including SGA, DMS and MIS in HD patients. However, further longitudinal studies are warranted to infer a cause-and-effect relationship between DII and malnutrition. [ABSTRACT FROM AUTHOR]

The star-shaped ordering between probability distributions is a common way to express aging properties. A well-known criterion was proposed by Saunders and Moran [(1978). On the quantiles of the gamma and F distributions. Journal of Applied Probability 15(2): 426–432], to order families of distributions depending on one real parameter. However, the lifetime of complex systems usually depends on several parameters, especially when considering heterogeneous components. We extend the Saunders and Moran criterion characterizing the star-shaped order when the multidimensional parameter moves along a given direction. A few applications to the lifetime of complex models, namely parallel and series models assuming different individual components behavior, are discussed. [ABSTRACT FROM AUTHOR]

The relationship between the Dietary Approaches to Stop Hypertension (DASH) diet and clinical, quality of life and mental health outcomes in migraine is unknown. To address this knowledge gap, we conducted a parallel-group, randomised controlled trial to evaluate the effect of the DASH diet on these health outcomes in women with migraine. Of 102 eligible women (20–50 years), fifty one randomised to the DASH and fifty one to the usual dietary advice (control) groups completed a 12-week intervention. The DASH diet was designed using a 7-d menu cycle to provide 15–20 % of total daily energy requirements from proteins, 25–30 % from fats and 55–60 % from carbohydrates. Dietary records and serum vitamin C levels were used to assess women's compliance with the DASH diet. The clinical symptoms of migraine (i.e., frequency, duration and severity) and quality of life and mental health (i.e., depression, anxiety and stress) outcomes were assessed in groups pre-and post-intervention. We observed greater decreases in the frequency (–3·00 v. −1·40, P = 0·025) and severity (–1·76 v. −0·59, P < 0·001) of migraine in the DASH v. control group post-intervention. Similarly, the DASH group exhibited a tendency towards greater decreases in migraine duration (–0·58 v. −0·33 d, P = 0·053) and had lower scores of depression (–4·50 v. −2·73, P = 0·019) and stress (–5·84 v. −2·98, P = 0·011) v. controls. However, the quality of life and anxiety outcomes remained comparable in groups post-intervention. Together, evidence supports the benefits of the DASH diet on improving migraine health outcomes in reproductive-aged women. Further research is needed to confirm our findings. [ABSTRACT FROM AUTHOR]

Objective: The outbreak of coronavirus disease 2019 (COVID-19) has exerted unprecedented pressure on healthcare systems throughout the world. This study was designed to develop a national health emergency management program based on risk assessment for COVID-19. Methods: Mixed-methods research was used. Based on recommendations of the national epidemiology committee, 2 risk scenarios were used as basic scenarios for risk assessment. Two rounds of Focus Group Discussions (FGDs) were conducted between January and May 2020 with 30 representatives of the health system. The data were collected, analyzed, and integrated by the research team. Results: In the risk matrix, "contamination of environment and individuals" and "burnout of medical staff" occupied the red zone (intolerable risk). "Defects in screening and admissions," "process disruption in medical care and rehabilitation," "increased mental disorders," "social dissatisfaction," "the decline in healthcare services," and "loss of medical staff" were identified as the orange zone (significant risk) of the matrix. Conclusions: The avoidance of environmental and individual contamination and healthcare worker burnout are the priorities in Iran. Attention to intersectoral cooperation, the involvement of non-governmental organizations and private center capacities, integration of information health systems, and developing evidence-based protocols are other measures that can improve the health system's capacity in the response COVID-19. [ABSTRACT FROM AUTHOR]

As defined by the World Health Organization, the Eastern Mediterranean Region (EMR), given its special geopolitical situation and internal/external conflicts, faces an increase in illegal activities such as drug production and trafficking, highlighting the need for a comprehensive understanding of the substance use situation. On the basis of a review of published papers between 2015 and 2021 we briefly review substance use in the EMR with special focus on the emerging drugs pertinent to this region, namely tramadol, captagon and khat. [ABSTRACT FROM AUTHOR]

Few studies have assessed the association between sodium (Na) and potassium (K) and migraine headaches. In this study, we aimed to examine the relationship between 24-hour urine Na and K intakes and clinical findings of migraine in an Iranian sample. In this cross-sectional study, 262 participants, aged 20–50 years, were included with a body mass index (BMI) of 18·5–30 kg/m2 and a diagnosis of migraine. One 24-hour urine sample was collected from each subject to estimate the Na and K intakes. The clinical features of migraine, including frequency, duration, severity, Migraine Headache Index Score (MHIS), and Headache Impact Test (HIT) score, were assessed. Besides, a multiple linear regression analysis was performed, and beta estimates and the corresponding 95% confidence intervals (CIs) were reported. Overall, 224 women and 38 men, with a mean age of 36·10 years and BMI of 25·55 kg/m2 comprised our study population. After controlling for potential confounders, the 24-hour urine Na was positively associated with a longer headache duration (β = 0·29; 95% CI: 0·06, 0·53) in the group with the highest urine Na levels as compared to the group with the lowest levels. After adjustments for potential confounders, an increase of 13·05 in the MHIS was observed when the 24-hour urine Na level increased from the first to the third tertile (β = 13·05; 95% CI: 1·70, 24·41). Our findings suggested that a higher 24-hour urine Na level was positively associated with a longer duration of migraine headaches and a higher MHIS. [ABSTRACT FROM AUTHOR]

Shahab Ahmed's What Is Islam? The Importance of Being Islamic (2016) challenges Islamic Studies scholars, (art) historians, and anthropologists to reconsider theoretical frameworks underpinning historical and ethnographic research. This article addresses Ahmed's concerns that studies of Islam often conceptually privilege orthodoxy, by including drinking and intoxication as worthy of close attention in examining the history and the anthropology of Islam. The case of Wine Shop the Philosopher, run by a former Afghan refugee in The Hague and Amsterdam, is presented after establishing the comparative and interdisciplinary relevance of alcohol consumption in studies of Islam and Muslims. Ahmed's conceptual framework is used and assessed in comparison with the wine shops' contemporary pluralist reality by exploring the idealized boundaries of Persianate culture and Islam in dialogues between Persian-speaking interlocutors. It is argued that alcoholic drinks lend themselves to competing gastro-nationalisms and prompt ethnolinguistic tensions between and within groups with Turkish, Moroccan, Iranian, and Afghan backgrounds in the Netherlands. The focus on diverse, coexisting and clashing drink regimes, in conclusion, allows us to deconstruct dichotomies between sober Muslims and European drinkers, African and Asian believers and European unbelievers, and refugees and citizens. [ABSTRACT FROM AUTHOR]

In the literature of stochastic orders, one rarely finds results characterizing non-comparability of random variables. We prove simple tools implying the non-comparability with respect to the convex transform order. The criteria are used, among other applications, to provide a negative answer for a conjecture about comparability in a much broader scope than its initial statement. [ABSTRACT FROM AUTHOR]

Objective: The present study examined the extent to which social support (SS) availability and satisfaction could predict the extent of caregiver burden (CB) among mothers of children with Acute Lymphocytic Leukemia (ALL).Method: The study was a cross-sectional, descriptive-correlative study. It was conducted on a sample of 117 mothers whose children were undergoing treatment in a public hospital in Bam, Iran. The Norbeck Social Support Scale and the Caregiver Burden Scale were used to measuring study variables. The data were analyzed using Pearson's correlations, t-tests, ANOVAs, and linear regressions.Results: Significant correlations were observed between CB and SS availability (r = -0.499, p < 0.001), SS satisfaction (r = -0.543, p < 0.001), the age of the child with cancer (r = -0.22, p = 0.01), and duration of treatment (r = 0.336, p < 0.001). Married mothers experienced less CB than those that were widowed or divorced. Within the regression equation, SS satisfaction, SS availability, marital status, and duration of treatment were the predictors of CB.Significance Of Results: Based on the results of the current study, mothers who have less SS, especially those who are single mothers, with younger children, and who have taken care of their child for an extended duration should be given special attention. Furthermore, it appears that there are distinct cultural variations amongst Iranian mothers which suggest that culture may impact upon SS availability. Results also suggest a need for interventions that enhance nurses' ability to provide support to caregivers and the broader family unit as a whole. Nurses in cancer care need to have psychological competencies to help family members of cancer patients especially mothers and more so those that are single mothers. As integral members of the patient care experience, nurses may be uniquely positioned to provide this needed psychosocial support. [ABSTRACT FROM AUTHOR]

We study failure rate monotonicity and generalised convex transform stochastic ordering properties of random variables, with an emphasis on applications. We are especially interested in the effect of a tail-weight iteration procedure to define distributions, which is equivalent to the characterisation of moments of the residual lifetime at a given instant. For the monotonicity properties, we are mainly concerned with hereditary properties with respect to the iteration procedure providing counterexamples showing either that the hereditary property does not hold or that inverse implications are not true. For the stochastic ordering, we introduce a new criterion, based on the analysis of the sign variation of a suitable function. This criterion is then applied to prove ageing properties of parallel systems formed with components that have exponentially distributed lifetimes. [ABSTRACT FROM AUTHOR]

This article describes the characteristics of the health system and reviews the history of health technology assessment (HTA) in Iran, including its inception, processes, challenges, and lessons learned. This study was conducted by analyzing existing documents, reports, and guidelines related to HTA and published articles in the field. HTA in Iran has been established since the late 2000s and was first introduced as a secretariat by the Deputy of Health at the Ministry of Health and Medical Education. The mission of the HTA office is to systematically assess technologies to improve evidence-informed decision making. Despite its 10 years of existence, HTA in Iran still faces some challenges. The most pressing problems currently facing HTA in Iran include conflicts of interest among researchers performing the HTAs, the absence of a systematic structure for identifying and introducing new technologies, the lack of interest in HTA results among high-level policy makers, and the lack of external oversight for HTA projects. [ABSTRACT FROM AUTHOR]

A number of clinical trials have examined the effect of l -arginine on lipid profile in recent years; however, the results remain equivocal. Therefore, the present study aims to summarise and quantitatively examine the available evidence on the effectiveness l -arginine supplementation on lipid parameters using a systematic review and meta-analytic approach. Online databases including PubMed, Scopus, ISI Web of Science, Cochrane Library and Google Scholar were searched up to April 2019 for randomised controlled trials that examined the effect of l -arginine supplementation on lipid profile in adults. Treatment effects were expressed as weighted mean difference (WMD) and the corresponding standard error in concentrations of serum lipids. To estimate the overall effect of l -arginine supplementation, we used the random-effects model. In total, twelve studies were included in the systematic review. The meta-analysis revealed that l -arginine supplementation did not significantly change the concentrations of total cholesterol (WMD: –5·03 mg/dl; 95 % CI –10·78, 0·73; P = 0·08; inconsistency index (I 2) = 39·0 %), LDL (WMD: –0·47 mg/dl; 95 % CI –3·61, 2·66; P = 0·76; I 2 = 0·0 %), or HDL (WMD: 0·57 mg/dl; 95 % CI –1·28, 2·43; P = 0·54; I 2 = 68·4 %). A significant reduction was observed only in serum TAG levels (WMD: –7·04 mg/dl; 95 % CI –11·42, –2·67; P < 0·001; I 2 = 0·0 %). This meta-analysis concludes that l -arginine supplementation can significantly reduce blood TAG levels; however, there is insufficient evidence to support its hypocholesterolaemic effects. To draw straightforward conclusions regarding generalised recommendations for l -arginine supplementation for improving lipid profile, there is a need for more well-controlled trials targeting exclusively patients with dyslipidaemia. [ABSTRACT FROM AUTHOR]

The emergence of coronavirus disease 2019 (COVID-19), a novel unknown virus that is challenging whole countries all over the world, has prompted different strategies from various governments. Iran, as one of the first countries to experience the onset of the virus outbreak, made and implemented some policies that should be assessed, so that lessons may be learned for the future. Although some negative actions and policies, such as delays in cancellation of international flights especially from China, not taking the disease seriously and comparing it with seasonal influenza, and the like, are hard to ignore, some impressive actions are also vividly clear. Policies, such as social distancing, dramatically increasing social awareness about preventive actions in terms of public health, and using masks and hand washing, were cost-effective policies that resulted in successful control of the virus in the first onset. While some quite clearly ineffective decisions were made by Iranian authorities, the huge catastrophic effect of sanctions cannot be forgotten. Possibly in level situations with similar countries, Iran will have far better results regarding preparedness for future pandemics like COVID-19. [ABSTRACT FROM AUTHOR]

Stochastic ordering of random variables may be defined by the relative convexity of the tail functions. This has been extended to higher order stochastic orderings, by iteratively reassigning tail-weights. The actual verification of stochastic orderings is not simple, as this depends on inverting distribution functions for which there may be no explicit expression. The iterative definition of distributions, of course, contributes to make that verification even harder. We have a look at the stochastic ordering, introducing a method that allows for explicit usage, applying it to the Gamma and Weibull distributions, giving a complete description of the order of relations within each of these families. [ABSTRACT FROM AUTHOR]

Objective: In resource-constrained facilities or during resuscitation, immediate paediatric weight estimation remains a fundamental challenge. We aimed to develop and validate weight estimation models based on ulna length and forearm width and circumference measured by simple and portable tools; and to compare them against previous methods (advanced paediatric life support (APLS), Theron and Traub-Johnson formulas).Design: Cross-sectional analysis of anthropometric measurements. Four ulna- and forearm-based weight estimation models were developed in the training set (n 1016). Assessment of bias, precision and accuracy was examined in the validation set (n 457).Setting: National Children's Study-Formative Research in Anthropometry (2011-2012).Subjects: Multi-racial/ethnic infants and children aged <6 years (n 1473).Results: Developed Models 1-4 had high predictive precision (R 2=0·91-0·97). Mean percentage errors between predicted and measured weight were significantly smaller across the developed models (0·1-0·7 %) v. the APLS, Theron and Traub-Johnson formulas (-1·7, 9·2 and -4·9 %, respectively). Root-mean-squared percentage error was overall smaller among Models 1-4 v. the three existing methods (range=7·5-8·7 v. 9·8-13·3 %). Further, Models 1-4 were within 10 and 20 % of actual weight in 72-87 and 95-99 % of the weight estimations, respectively, which outperformed any of the three existing methods.Conclusions: Ulna length, forearm width and forearm circumference by simple and portable tools could serve as valid and reliable surrogate measures of weight among infants and children aged <6 years with improved precision over the existing age- or length-based methods. Further validation of these models in physically impaired or non-ambulatory children is warranted. [ABSTRACT FROM AUTHOR]

The aim of this paper is to introduce a new measure of noncompactness on the Sobolev space $W^{n,p}[0,T]$. As an application, we investigate the existence of solutions for some classes of functional integro-differential equations in this space using Darbo’s fixed point theorem. [ABSTRACT FROM PUBLISHER]

Prostate cancer is the most common non-cutaneous cancer and the second leading cause of cancer-related mortality among men in the USA. Growing evidence suggests that oxidative stress is involved in the development and progression of prostate cancer. In this study, the association between antioxidants from diet and supplements and biomarkers of oxidative stress in blood (n 278), urine (n 298) and prostate tissue (n 55) were determined among men from the North Carolina-Louisiana Prostate Cancer Project. The association between antioxidant intake and oxidative stress biomarkers in blood and urine was determined using linear regression, adjusting for age, race, prostate cancer aggressiveness and smoking status. Greater antioxidant intake was found to be associated with lower urinary 8-isoprostane concentrations, with a 10 % increase in antioxidant intake corresponding to an unadjusted 1·1 % decrease in urinary 8-isoprostane levels (95 % CI −1·7, −0·3 %; P value<0·01) and an adjusted 0·6 % decrease (95 % CI −1·4, 0·2 %; P value=0·16). In benign prostate tissue, thioredoxin 1 was inversely associated with antioxidant intake (P=0·02). No significant associations were found for other blood or urinary biomarkers or for malignant prostate tissue. These results indicate that antioxidant intake may be associated with less oxidative stress among men diagnosed with prostate cancer. [ABSTRACT FROM AUTHOR]

The current study investigated basic biological features for two co-occurring shore crabs Pachygrapsus marmoratus and P. transversus in the eastern Mediterranean Sea. Differences in population structure, reproductive periods and settlement patterns were studied along the coast of Lebanon. Sizes of sampled individuals ranged from 4 to 37 mm carapace width (CW) for P. marmoratus and from 3.5 to 24 mm CW for P. transversus. Males were larger than females in both species, each of them exhibiting different size frequency distributions. Both male and female proportions were similar for P. marmoratus while males dominated the population of P. transversus. Fecundity and egg sizes were higher in P. marmoratus and fecundity was directly related to body size for the two crabs. Size structures differed between studied locations showing size restrictions for specific size-classes. Females from both species remained ovigerous for about 5 months, with P. transversus (May–August) started 1 month after P. marmoratus. Larger sized females displayed higher fecundities. The recruitment of juveniles lasted 5 months for both P. marmoratus (December–May) and P. transversus (November–April). Our results showed that niche partitioning occurred between the two species, where P. marmoratus starts incubating earlier than P. transversus while young of the year of the latter settle earlier on the reefs, taking advantage of convenient seawater temperatures and thus minimizing competition. This study shed some light on the populations of grapsid crabs living in the eastern Mediterranean and provided baseline information on the biology and ecology of the two congeneric shore crabs and their interactions. [ABSTRACT FROM PUBLISHER]