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The use of telehealth technology is a way to promote the health status of the community. The purpose of this study was to investigate staff and students' perceptions about using telehealth technology in a medical university. This was a qualitative study completed in 2020. The research participants were 26 university staff and students who took part in semi-structured interviews. To analyze the data, the thematic analysis method was used. The findings of the present study included five themes, 20 subthemes and 58 categories. The main themes were the current status of providing healthcare services at the university, and the strengths, weaknesses, opportunities and threats of using telehealth technology for the university staff and students. According to the results, there are many opportunities for using telehealth technology in the medical university. The experiences of other institutes can be used to implement the technology successfully. [ABSTRACT FROM AUTHOR]

Background: Policymakers require a systematic approach when planning for information technology needs in healthcare. Objective: The aim of this study was to obtain experts' predictions of future health information technology (HIT) needs until 2025 for Iran in relation to the relative importance of key technologies, expected timeframe of realisation, areas that may be impacted upon and obstacles to achieving these goals. Method: This article presents results from the third phase (a Delphi study) of a larger mixed-method study. Policymakers from the Iranian Ministry of Health and faculty members from different medical universities across the country who were expert in the field of HIT were invited to participate (n = 61). Results: Participants (39) completed the first-round questionnaire and 24 completed the second. The development of personal health records (n = 32, 82.0%), the development of clinical decision-making systems (n = 30, 76.9%) and the use of business intelligence for collecting and analysing clinical and financial data (n = 32, 82.0%) were predicted to occur after 2025. The healthcare areas predicted to experience the greatest impact from most HITs were facilitating patient–provider communication and improving healthcare quality. Key barriers to achieving HITs were related to weaknesses in planning and limited financial resources for most technologies. Conclusion: By identifying the areas of impact and the barriers to achieving the HIT goals, more accurate planning is possible and resources can be allocated according to priorities. [ABSTRACT FROM AUTHOR]

This research was aimed at examining the challenges of the publishing industry in order to identify scientific solutions to these problems with a qualitative study. The analysis of interviews resulted in four main themes, 12 classes, and 36 subclasses. The main themes were the economy in the publishing industry, technology in the publishing industry, politics in the publishing industry, social issues in the publishing industry. Totally, it resulted in 11 major challenges. In general, Iran's publishing industry needs to consider its challenges in order to plan for the future. [ABSTRACT FROM AUTHOR]

Background: Homozygous mutations and deletions of the microcephalin gene ( MCPH1; OMIM *607117) have been identified as a cause of autosomal recessive primary microcephaly and intellectual disability (MIM #251200). Previous studies in families of Asian descent suggest that the severity of the phenotype may vary based on the extent of the genomic alteration. We report chromosome microarray (CMA) findings and the first described family study of a patient with primary microcephaly in a consanguineous Hispanic family. Case presentation: The proband, a boy born at full-term to consanguineous parents from Mexico, presented at 35 months of age with microcephaly, abnormal brain MRI findings, underdeveloped right lung, almond-shaped eyes, epicanthal folds, bilateral esotropia, low hairline, large ears, smooth philtrum, thin upper lip, and developmental delay. MRI of the brain showed a small dermoid or lipoma (without mass effect) within the interpeduncular cistern and prominent arachnoid granulation. The underdeveloped right lung was managed with long-acting inhaled corticosteroids. Otherwise the proband did not have any other significant medical history. The proband had 2 older brothers, ages 14 and 16, from the same consanguineous parents. The 14-year-old brother had a phenotype similar to that of the proband, while both parents and the oldest brother did not have the same phenotypic findings as the proband. The SNP-based CMA analysis of the proband detected a homozygous 250-kb microdeletion at 8p23.2p23.1, extending from 6,061,169 to 6,310,738 bp [hg19]. This genomic alteration encompasses the first 8 exons of MCPH1. Follow-up studies detected the same homozygous deletion in the affected brother, segregating with microcephaly and intellectual disability. Regions of homozygosity (ROHs) were also observed in the affected brother. Since ROHs are associated with an increased risk for recessive disorders, presence of ROH may also contribute to the phenotype of the affected brothers. The parents were both hemizygous for the deletion. Conclusion: Here we report a homozygous deletion of multiple exons of the MCPH1 gene that was associated with primary microcephaly and intellectual disability in a Hispanic family. In the context of previous studies, our results support the idea that deletions involving multiple exons cause a more severe phenotype than point mutations. [ABSTRACT FROM AUTHOR]

Advances in genome-wide molecular cytogenetics allow identification of novel submicroscopic DNA copy number alterations (aCNAs) and copy-neutral loss of heterozygosity (cnLOH) resulting in homozygosity for known gene mutations in myeloid neoplasms. We describe the use of an oligo-SNP array for genomic profiling of aCNA and cnLOH, together with sequence analysis of recurrently mutated genes, in a patient with myelodysplastic syndrome (MDS) presenting with normal karyotype and FISH results. Oligo-SNP array analysis revealed a hemizygous deletion of 896 kb at chromosome 5q31.2, representing the smallest 5q deletion reported to date. The deletion involved multiple genes, including two tumor suppressor candidate genes (CTNNA1 and HSPA9) that are associated with MDS/AML. The SNP-array study also detected 3 segments of somatic cnLOH: one involved the entire long arm of chromosome 4; the second involved the distal half of the long arm of chromosome 7, and the third encompassed the entire chromosome 22 (UPD 22). Sequence analysis revealed mutations in TET2 (4q), EZH2 (7q), ASXL1 (20q11.21), and RUNX1 (21q22.3). Coincidently, TET2 and EZH2 were located at segments of cnLOH resulting in their homozygosity. Loss of heterozygosity affecting these two chromosomes and mutations in TET2 and EZH2 are indicative of a myelodysplastic syndrome with a poor prognosis. Deletion of the tumor suppressor genes CTNNA1 and HSPA9 is also likely to contribute to a poor prognosis. Furthermore, the original cnLOHs in multiple chromosomes and additional cnLOH 14q in the follow-up study suggest genetic evolution of the disease and poor prognosis. This study attests to the fact that some patients with a myelodysplastic syndrome who exhibit a normal karyotype may have underlying genetic abnormalities detectable by chromosomal microarray and/or targeted mutation analyses. [ABSTRACT FROM AUTHOR]

MicroRNAs (miRNAs) are key regulators of gene expression, playing important roles in development, homeostasis, and disease. Recent experimental evidence indicates that mutation or deregulation of the MIR17HG gene (miR-17 ~ 92 cluster) contributes to the pathogenesis of a variety of human diseases, including cancer and congenital developmental defects. We report on a 9-year-old boy who presented with developmental delay, autism spectrum disorder, short stature, mild macrocephaly, lower facial weakness, hypertelorism, downward slanting palpebral fissures, brachydactyly, and clinodactyly. SNP-microarray analysis revealed 516 kb microduplication at 13q31.3 involving the entire MIR17HG gene encoding the miR-17 ~ 92 polycistronic miRNA cluster, and the first five exons of the GPC5 gene. Family study confirmed that the microduplication was maternally inherited by the proband and one of his five half-brothers; digit and other skeletal anomalies were exclusive to the family members harboring the microduplication. This case represents the smallest reported microduplication to date at 13q31.3 and provides evidence supporting the important role of miR-17 ~ 92 gene dosage in normal growth and skeletal development. We postulate that any dosage abnormality of MIR17HG, either deletion or duplication, is sufficient to interrupt skeletal developmental pathway, with variable outcome from growth retardation to overgrowth. [ABSTRACT FROM AUTHOR]

Background: Jumping translocations are a rare type of mosaicism in which the same portion of one donor chromosome is translocated to several recipient chromosomes. Constitutional forms of jumping translocations are rare, and the 48 cases reported to date have been associated with both normal and abnormal phenotypes. Concurrence of isochromosome (i) of one arm and translocation of the other is also rare, with seven reported cases. We describe a unique case involving concurrence of i(Yp) and a jumping translocation of Yq to the telomere of chromosomes 12q and 17q, which resulted in five cell lines. Case presentation: The patient, an otherwise healthy 35-year-old man, was referred for cytogenetic studies because of absolute azoospermia. He had elevated levels of follicle stimulating hormone and luteinizing hormone, consistent with abnormal spermatogenesis, and decreased levels of free testosterone and inhibin B. G-banded chromosome analysis revealed a mosaic male karyotype involving five abnormal cell lines. One of the cell lines showed loss of chromosome Y and presence of i(Yp) as the sole abnormality. Three cell lines exhibited jumping translocation: two involved 17qter, and the other involved 12qter as the recipient and Yq as the common donor chromosome. One of the cell lines with der(17) additionally showed i(Yp). The other der(17) and der(12) cell lines had a missing Y chromosome. All five cell lines were confirmed by FISH. Subtelomric FISH study demonstrated no loss of chromosome material from the recipient chromosomes at the translocation junctions. Conclusions: We postulate that a postzygotic pericentromeric break of the Y chromosome led to formation of isochromosome Yp, whereas Yq formed a jumping translocation through recombination between its internal telomere repeats and telomeric repeats of recipient chromosomes. This in turn led to either pairing or an exchange at the complimentary sequences. Such translocation junctions appear to be unstable and to result in a jumping translocation. Cryptic deletion or disruption of AZF (azoospermic factor) genes at Yq11 during translocation or defective pairing of X and Y chromosomes during meiosis, with abnormal sex vesicle formation and consequent spermatogenetic arrest, might be the main cause of the azoospermia in our patient. [ABSTRACT FROM AUTHOR]

Background: Recombinant chromosome 4, a rare constitutional rearrangement arising from pericentric inversion, comprises a duplicated segment of 4p13~p15→4pter and a deleted segment of 4q35→4qter. To date, 10 cases of recombinant chromosome 4 have been reported. Result: We describe the second case in which array-CGH was used to characterize recombinant chromosome 4 syndrome. The patient was a one-year old boy with consistent clinical features. Conventional cytogenetics and FISH documented a recombinant chromosome 4, derived from a paternal pericentric inversion, leading to partial trisomy 4p and partial monosomy of 4q. Array-CGH, performed to further characterize the rearranged chromosome 4 and delineate the breakpoints, documented a small (4.36 Mb) 4q35.1 terminal deletion and a large (23.81 Mb) 4p15.1 terminal duplication. Genotype-phenotype analysis of 10 previously reported cases and the present case indicated relatively consistent clinical features and breakpoints. This consistency was more evident in our case and another characterized by array-CGH, where both showed the common breakpoints of p15.1 and q35.1. A genotypephenotype correlation study between rec(4), dup(4p), and del(4q) syndromes revealed that urogenital and cardiac defects are probably due to the deletion of 4q whereas the other clinical features are likely due to 4p duplication. Conclusion: Our findings support that the clinical features of patients with rec(4) are relatively consistent and specific to the regions of duplication or deletion. Recombinant chromosome 4 syndrome thus appears to be a discrete entity that can be suspected on the basis of clinical features or specific deleted and duplicated chromosomal regions. [ABSTRACT FROM AUTHOR]

Background: Currently, share of the scientific output, citation per paper, and coauthorship for articles indexed in databases such as ISI Web of Science, are very important criteria for the evaluation and ranking of countries, researchers, institutes, articles, disciplines and journals in the world. Therefore, the main objectives of the study were to determine co-authorship, the average citation per paper and the most prolific Iranian university or institution in the field of immunology. Methods: For performing this scientometric study, we employed survey methods and citation analysis of the indexed papers in the ISI Web of Science from 1974 to 2010. Results: A total of 1775 articles by Iranian authors in the field of immunology had been indexed in the database for the aforesaid period. Most collaborations and co-authorship of Iranian authors was with their counterparts from the USA. The average citation per paper in the field was 6.26 per paper. Tehran University of Medical Sciences had the highest number of articles in the database. Conclusion: According to the results, Iranians collaborated with American peers more than any other nationality and the average citation per paper in the field of immunology is higher than that of other fields in Iran but lower than the global average. Tehran University of Medical Sciences is the most prolific university in the field. [ABSTRACT FROM AUTHOR]

Background: Neocentromeres are rare human chromosomal aberrations in which a new centromere has formed in a previously non-centromeric location. We report the finding of a structurally abnormal X chromosome with a neocentromere in a 15-year-old girl with clinical features suggestive of Turner syndrome, including short stature and primary amenorrhea. Result: G-banded chromosome analysis revealed a mosaic female karyotype involving two abnormal cell lines. One cell line (84% of analyzed metaphases) had a structurally abnormal X chromosome (duplication of the long arm and deletion of the short arm) and a normal X chromosome. The other cell line (16% of cells) exhibited monosomy X. C-banding studies were negative for the abnormal X chromosome. FISH analysis revealed lack of hybridization of the abnormal X chromosome with both the X centromere-specific probe and the "all human centromeres" probe, a pattern consistent with lack of the X chromosome endogenous centromere. A FISH study using an XIST gene probe revealed the presence of two XIST genes, one on each long arm of the iso(Xq), required for inactivation of the abnormal X chromosome. R-banding also demonstrated inactivation of the abnormal X chromosome. An assay for centromeric protein C (CENP-C) was positive on both the normal and the abnormal X chromosomes. The position of CENP-C in the abnormal X chromosome defined a neocentromere, which explains its mitotic stability. The karyotype is thus designated as 46,X,neo(X)(qter->q12::q12->q21.2->neo->q21.2->qter)[42]/45,X[8], which is consistent with stigmata of Turner syndrome. The mother of this patient has a normal karyotype; however, the father was not available for study. Conclusion: To our knowledge, this is the first case of mosaic Turner syndrome involving an analphoid iso(Xq) chromosome with a proven neocentromere among 90 previously described cases with a proven neocentromere. [ABSTRACT FROM AUTHOR]

The article presents a case study of two sisters with unbalanced karyotypes that are attributable to their father's mosaic inv(20). The patients' father was identified with a balanced pericentric inversion of chromosome 20 which caused their identical recombinant chromosome 20. It says that common developmental manifestations of their condition include poor motor coordination and mental retardation. It states that further evaluations may clarify the phenotypic features found in them.

Background: Telehealth services can utilize various information technologies and improve quality and efficiency of healthcare delivery by facilitating education, treatment, follow-up, and decision-making. However, these services are not always commercialized, and in case of commercialization, there is no guarantee for their long-term sustainability in market. Therefore, business models and frameworks are used as part of commercialization processes to identify a set of factors affecting the sustainability, effectiveness, and key business activities. The current study aimed to develop a telehealth business framework for Iran.Methods: This research was conducted in 2021, and a mixed-methods approach was used for data collection. Initially, a telehealth business framework was developed based on the findings derived from a systematic review and a qualitative research. The proposed framework was then reviewed by an expert panel (n = 9) in which the participants had at least three years of work experience in telehealth. Finally, the framework was validated using the Delphi method (three rounds).Results: The expert panel believed that some components such as partners' expertise, required capital and financial resources, research and analysis, marketing and branding, tax, product registration, and marketing at scientific congresses and science and technology exhibitions needed to be added to the framework. In the Delphi study, 68 out of 74 components proposed in the initial framework were approved across four major dimensions; namely, prerequisites, production, payments and costs, and post-production services.Conclusions: It seems that the developed framework can facilitate commercializing telehealth technologies and developing business plans. In addition, telehealth start-ups can use this framework and its various components in a competitive market to be more successful in their businesses. However, it is still critical to evaluate the effectiveness of the framework in practice and in relation to the commercialization of telehealth technologies. [ABSTRACT FROM AUTHOR]

Background: Injury is one of the leading causes of death worldwide, and the abdomen is the most common area of trauma after the head and extremities. Abdominal injury is often divided into two categories: blunt and penetrating injuries. This study aims to determine the epidemiological and clinical characteristics of these two types of abdominal injuries in patients registered with the National Trauma Registry of Iran (NTRI). Methods: This multicenter cross-sectional study was conducted with data from the NTRI from July 24, 2016, to May 21, 2023. All abdominal trauma patients defined by the International Classification of Diseases; 10th Revision (ICD-10) codes were enrolled in this study. The inclusion criteria were one of the following: hospital length of stay (LOS) of more than 24 h, fatal injuries, and trauma patients transferred from the ICU of other hospitals. Results: Among 532 patients with abdominal injuries, 420 (78.9%) had a blunt injury, and 435 (81.7%) of the victims were men. The most injured organs in blunt trauma were the spleen, with 200 (47.6%) and the liver, with 171 (40.7%) cases, respectively. Also, the colon and small intestine, with 42 (37.5%) cases, had the highest number of injuries in penetrating injuries. Blood was transfused in 103 (23.5%) of blunt injured victims and 17 (15.2%) of penetrating traumas (p = 0.03). ICU admission was significantly varied between the two groups, with 266 (63.6%) patients in the blunt group and 47 (42%) in penetrating (p < 0.001). Negative laparotomies were 21 (28%) in penetrating trauma and only 11 (7.7%) in blunt group (p < 0.001). In the multiple logistic regression model after adjusting, ISS ≥ 16 increased the chance of ICU admission 3.13 times relative to the ISS 1–8 [OR: 3.13, 95% CI (1.56 to 6.28), P = 0.001]. Another predictor was NOM, which increased ICU chance 1.75 times more than OM [OR: 1.75, 95% CI (1.17 to 2.61), p = 0.006]. Additionally, GCS 3–8 had 5.43 times more ICU admission odds than the GCS 13–15 [OR:5.43, 95%CI (1.81 to 16.25), P = 0.002] respectively. Conclusion: This study found that the liver and spleen are mostly damaged in blunt injuries. Also, in most cases of penetrating injuries, the colon and small intestine had the highest frequency of injuries compared to other organs. Blunt abdominal injuries caused more blood transfusions and ICU admissions. Higher ISS, lower GCS, and NOM were predictors of ICU admission in abdominal injury victims. [ABSTRACT FROM AUTHOR]

Background: Telehealth technology and related products can help to solve the problems associated with providing health care services and equal distribution of resources. However, in order to run a telehealth business successfully, key components and critical factors need to be taken into account. A telehealth business framework can provide a rich understanding of these components and factors. Therefore, the present study aimed to identify the key components and critical factors for developing a telehealth business framework from the experts' perspectives.Methods: The present qualitative study was conducted in 2020. The participants were 22 experts in the fields of medical informatics, health information management, telemedicine, telehealth, health entrepreneurship, health insurance, and digital health start-ups. In depth semi-structured interviews were conducted to collect data, and the data were analyzed using framework analysis.Results: Four main themes derived from data analysis. The themes included key components for developing a telehealth business framework, success factors, challenges, and barriers of a telehealth business. Overall, the results indicated that the key components in a telehealth business framework included created value, key resources, key activities, key partners, licenses and permissions, product pricing, revenue, marketing, supporting services, and getting feedback from customers. Although receiving support from different individuals and organizations as well as economic benefits of telehealth services may consider as success factors, there are a number of challenges and barriers which should be taken into account. Otherwise, these factors may hinder the success of a telehealth business.Conclusions: The development of a telehealth business framework might be an important step towards developing a more complete business plan, facilitating the commercialization of telehealth products, and providing a solution for product sustainability in a competitive market. In the current study, the key components and critical factors for developing a telehealth business framework were identified; however, further research is needed to explore how these components and factors can be helpful in developing business plans and running a successful telehealth business. [ABSTRACT FROM AUTHOR]

The impact of HIV-related stigma on people living with HIV has been well documented, but there have been few studies examining how drug-related stigma impacts risk-taking in the lives of people who inject drugs (PWID). This meta-analysis aimed to determine HIV and drug-related stigma and the association it has with risk-taking behaviors among PWID. We searched PubMed, Science Direct, Web of Science, and Cochrane electronic databases independently in March 2019. After reviewing for any study duplicates the full-text of selected articles were assessed for eligibility using Population, Intervention, Comparator, Outcomes (PICO) criteria. We used fixed and random-effects meta-analysis models to estimate the pooled prevalence, pooled odds ratio (OR) and 95% confidence intervals. After a detailed assessment, a total of 14 studies containing 13,689 participants met the eligibility criteria. Among the potential risk factors: employment status, depression and sharing injecting paraphernalia had a significant relationship with HIV and drug stigma among PWIDs respectively (OR = 0.78, 95%CI = 0.62–0.98), (OR = 1.84, 95%CI = 1.45–2.33) and (OR = 2.20, 95%CI = 1.84–1.63). Illicit drug use related stigma was found to be associated with several concurrent effects. The impact of stigma should be considered in the development of drug use prevention strategies. Perceived stigma is correlated with numerous negative consequences in other populations including people living with HIV/AIDS. These data suggest this could also be generalized to people who inject drugs because it seems that individuals with internalized stigma experience drug dependence, reduced comfort in seeking help from services and higher rates of depression. [ABSTRACT FROM AUTHOR]

Background: New learning methods can create enormous changes in knowledge and help students learn more. The purpose of this study was to determine the effect of Comparison of the Effect of Competence Stimulus in Two Methods of Spaced Learning and Flexible Fridays on the Nursing Students' Critical Thinking which was done in 2017. Materials and Method: This was a semi-experimental study between two before and after groups of nursing students of Saveh Medical faculty in 2017. The research population consisted of 60 nursing students selected by stratified sampling method. Data collection was done by Ritex Critical Thinking Questionnaire with a reliability of 0.86. In order to analyze the data, Kruskal-Wallis, Kendall, Chi-square, ans Fischer's exact tests were used. Result: The mean (SD) of student's critical thinking score had a statistically significant difference before and after the Intervention in each of the spaced learning (respectively 54.96 (31.64) vs 138.76 (24.98), df = - 4.795, P = 0.001) and flexible Friday (respectively 46.20 (26.85) vs 149.26 (20.09), df = -4.787, P = 0.001) groups; The mean (SD) of critical thinking score, had a significant difference after the Intervention, between the two groups of spaced learning and flexible Fridays (Respectively, mean (SD), 138.76 (24.98) vs 149.26 (20.09), p<0.035). Conclusions: Using new methods of spaced learning and flexible Friday's one can create a suitable context for more accurate and effective communication between teacher and learner, and, on the other hand, enhance the students' motivation for analyzing and solving problems. [ABSTRACT FROM AUTHOR]

The aim of this meta-analysis is to summarize the available evidence on the social and demographic determinants of health-related quality of life (QoL) for HIV-infected populations in order to provide a direction to policy makers, planners, and program developers on how best to use their resources to improve the QoL of HIV-infected people. PubMed, Science Direct, Web of Science, and Cochrane electronic databases were searched (up to February 2017) to identify the relevant studies. A meta-analysis was conducted with procreate polled odds ratios (ORs and β) and the confidence intervals of 95% on determining factors of QoL in social and demographic terms. Random effect model was applied to calculate pooled estimation, due to varied sampling methods of researches. In total, 5607 papers were identified from 4 databases and additional search in reference lists. Of these, 2107 articles were selected for full-text review. We included 19 studies that met the eligibility criteria. The pooled effect size shows a relative positive impact of social support for QoL among HIV/AIDS patients and its lower boundary is about 0.61 and the higher about 1.49. The pooled effect size has a considerable negative impact stigma on people who live with HIV/AIDS (PWLHs') QoL ranges from −0.34 to −0.32. Low socioeconomic status (poverty situation) was found to have a degenerative impact with PWLHs' QoL. Our finding indicates an association between younger 35 and QoL is negative with a relatively wide range, the minimum level of education has a weak association with PWLHs' QoL (ES: 0.14–0.2). There are several sociodemographic determinants of QoL among PWLHs and in this study, we found that stigma, low level of socioeconomic status, and being younger than 35 years old have a negative association with QoL, while the social support showed a positive association and a minimum level of education did not show a rigorous negative or positive association. [ABSTRACT FROM AUTHOR]

The field of education has experienced a profound change following the introduction of mobile technology over the last decades, and nursing education is not an exception. This study explored the experiences of nursing students about the ethical concerns regarding the use of mobile devices for learning purposes, that is, mobile learning, in educational and clinical contexts. A qualitative phenomenological study was carried out on nursing students (n = 19) in Saveh University of Medical Sciences of Iran between December 2017 and April 2018. Data were collected through semi-structured interviews with openended questions. Data analysis was done using Colaizzi's 7-step method, revealing four themes and nine sub-themes including: 1) preserving professional dignity (in front of the patient, and the teacher, and preserving academic virtual identity); 2) securing informed consent and respecting personal (the patient's and teachers) autonomy; 3) proper and efficient use (observing the regulations and codes, and making educational use); and 4) avoiding harm (responsible use of class and patient data). It was revealed that using mobile technology in education could raise ethical concerns for nursing students, and this should be emphasized in nursing educational programs. [ABSTRACT FROM AUTHOR]

The present meta-analysis aimed to investigate the effect of injection duration on injection and sexual high-risk behaviors among people who inject drugs (PWID), in order to inform development of intensive HIV prevention services for selected PWID sub-populations. We searched PubMed, Science Direct, Web of Science, and Cochrane electronic databases independently in December 2018. After reviewing for duplication, full-texts of selected articles were assessed for eligibility using certain Population, Intervention, Comparator, Outcomes (PICO) criteria. We used fixed and random-effects meta-analysis models to estimate the pooled prevalence, pooled odds ratio (OR) and 95% confidence intervals (CI). Our result indicated significant association between age of injection initiation > 17 years, frequency of drug injection > 5 times/day, injection by others, having sex partner, history of imprisonment with new injectors (OR = 0.93, 95%CI = 0.87–0.98), (OR = 0.51, 95%CI = 0.29–0.73), (OR = 1.11, 95%CI = 1.05–1.17), (OR = 2.08, 95%CI = 1.02–3.14) and (OR = 1.20, 95%CI = 1.03–1.37). Our research found that new injectors were more likely to report frequency of injections injected by others, has sex partner and prison detention. Our findings are significant for policy makers and public health practitioners to implement and design HIV prevention programs among PWID with shorter periods of injection. The findings of the present study extend our knowledge about new injection drug users, the significance of assured behaviors at IDUs' initial injection, and the educational importance of syringe exchange programs. [ABSTRACT FROM AUTHOR]

Background: Traffic accidents are one of the more important national and international issues, and their consequences are important for the political, economical, and social level in a country. Management of traffic accident information requires information systems with analytical and accessibility capabilities to spatial and descriptive data. Objective: The aim of this study was to determine the capabilities of a Geographic Information System (GIS) in management of traffic accident information. Methods: This qualitative cross-sectional study was performed in 2016. In the first step, GIS capabilities were identified via literature retrieved from the Internet and based on the included criteria. Review of the literature was performed until data saturation was reached; a form was used to extract the capabilities. In the second step, study population were hospital managers, police, emergency, statisticians, and IT experts in trauma, emergency and police centers. Sampling was purposive. Data was collected using a questionnaire based on the first step data; validity and reliability were determined by content validity and Cronbach's alpha of 75%. Data was analyzed using the decision Delphi technique. Results: GIS capabilities were identified in ten categories and 64 sub-categories. Import and process of spatial and descriptive data and so, analysis of this data were the most important capabilities of GIS in traffic accident information management. Conclusion: Storing and retrieving of descriptive and spatial data, providing statistical analysis in table, chart and zoning format, management of bad structure issues, determining the cost effectiveness of the decisions and prioritizing their implementation were the most important capabilities of GIS which can be efficient in the management of traffic accident information. [ABSTRACT FROM AUTHOR]

Copy neutral segments with allelic homozygosity, also known as regions of homozygosity (ROHs), are frequently identified in cases interrogated by oligonucleotide single-nucleotide polymorphism (oligo-SNP) microarrays. Presence of ROHs may be because of parental relatedness, chromosomal recombination or rearrangements and provides important clues regarding ancestral homozygosity, consanguinity or uniparental disomy. In this study of 14 574 consecutive cases, 832 (6%) were found to harbor one or more ROHs over 10 Mb, of which 651 cases (78%) had multiple ROHs, likely because of identity by descent (IBD), and 181 cases (22%) with ROHs involving a single chromosome. Parental relatedness was predicted to be first degree or closer in 5%, second in 9% and third in 19%. Of the 181 cases, 19 had ROHs for a whole chromosome revealing uniparental isodisomy (isoUPD). In all, 25 cases had significant ROHs involving a single chromosome; 5 cases were molecularly confirmed to have a mixed iso- and heteroUPD15 and 1 case each with segmental UPD9pat and segmental UPD22mat; 17 cases were suspected to have a mixed iso- and heteroUPD including 2 cases with small supernumerary marker and 2 cases with mosaic trisomy. For chromosome 15, 12 (92%) of 13 molecularly studied cases had either Prader-Willi or Angelman syndrome. Autosomal recessive disorders were confirmed in seven of nine cases from eight families because of the finding of suspected gene within a ROH. This study demonstrates that ROHs are much more frequent than previously recognized and often reflect parental relatedness, ascertain autosomal recessive diseases or unravel UPD in many cases. [ABSTRACT FROM AUTHOR]

Background Cytogenetic evaluation of products of conception (POC) for chromosomal abnormalities is central to determining the cause of pregnancy loss. We compared the test success rates in various specimen types and the frequencies of chromosomal abnormalities detected by Gbanding analysis with those found by Oligo-SNP chromosomal microarray analysis (CMA). We evaluated the benefit of CMA testing in cases of failed culture growth. Methods Conventional cytogenetic results of 5457 consecutive POC specimens were reviewed and categorized as placental villi, fetal parts, and unspecified POC tissue. The CMA was performed on 268 cases. Of those, 32 cases had concurrent G-banding results. The remaining 236 cases included 107 cases with culture failure and 129 cases evaluated by CMA alone. Results The overall POC culture success rate was 75%, with the lowest for fetal parts (37.4%) and the highest for placental villi (81%). The abnormality rate was 58% for placental villi, but only 25% for fetal parts. Of the abnormalities detected, the most common were aneuploidies, including trisomy 16, triploidy, monosomy X, trisomy 22, trisomy 21 and trisomy 15, while the least encountered aneuploidies were trisomy 1, trisomy 19 and monosomies (except monosomy 21). Overall, POC specimens studied by CMA were successful in 89.6% of cases and yielded a 44.6% abnormality rate. Conclusions Placental villi yielded higher rates of culture success and a higher percentage of abnormal karyotypes than did other specimen types. The Oligo-SNP CMA method has demonstrated a viable alternative to the G-banding method in view of its advantages in detection of submicroscopic genomic aberrations, shorter turnaround time due to elimination of time required for culture and a higher test success rate. [ABSTRACT FROM AUTHOR]

Background: Hepatitis C diagnosis could be a gateway to behavioral change and subsequent decline in transmission among people who inject drugs (PWIDs). We assessed the association between the social determinants of PWID, their risk behaviors and hepatitis C testing.Methods: We searched for studies in English published before May 1, 2020, on PubMed, Scopus, Cochrane, and Web of Science to identify primary studies on the factors associated with hepatitis C virus (HCV) testing among PWID. After reviewing for study duplicates, the full-text of selected articles were assessed for eligibility using Population, Intervention, Comparator, Outcomes (PICO) criteria. i) population: individuals who report injecting drugs; ii) intervention: HCV testing in the past year; iii) comparator: PWIDs who did not have an HCV test; iv) outcome: HCV testing among PWIDs and v) study type: cross-sectional, cohort, and case-control studies. Two independent reviewers (author BA and AB) chose the references in a two-phased monitoring process. The authors gathered data from selected papers, including the surname of the first author, publication date, participant demographic data (age, sex, and level of education) and other characteristics like previous HCV testing, past treatment attempts, duration of injecting drug use and condomless sex. We used fixed and random-effects meta-analysis models to estimate the pooled prevalence, pooled odds ratio (OR), and 95% confidence intervals. The data were analyzed using Stata 12.0 software.Results: After a detailed assessment of over 12,000 articles, a total of 16 studies containing 38,952 participants met the eligibility criteria. Our findings showed a pooled prevalence rate of 61.01% (95% CI, 34.65-84.32%) for recent HCV testing among PWIDs. Being female (OR = 1.69, 95%CI = 1.13, 2.26), aged > 30 years, (OR = 2.61, 95%CI = 1.66-3.56) having past treatment attempt (OR = 2.24, 95%CI = 1.80-2.68), and reporting a previous test (OR = 2.03, 95%CI = 1.23-2.82). were significantly associated with having a recent HCV test.,,. Finding of present study was that unprotected sex had a negative association with HCV testing. Those PWIDs who had unprotected sex were 0.56 times less likely to have completed HCV testing during last year (OR = 0.56, 95%CI = 0.33-0.78).Conclusion: Prevention programs that address age > 30 years, being female, past treatment attempt, previous testing of safe sexual practices, are strongly recommended to prioritize HCV risk reduction strategies. [ABSTRACT FROM AUTHOR]