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1. Maternal obesity management: a narrative literature review of health policies

Author: Elnaz Kalantari, Maryam Tajvar, Shohreh Naderimagham, and Amirhossein Takian
Subjects: Maternal obesity management, Prevention, Health Policy, Narrative literature review, Gynecology and obstetrics, RG1-991, Public aspects of medicine, RA1-1270
Abstract: Abstract Maternal obesity rates are increasing significantly, posing substantial risks to both mothers and their children. This study aims to introduce health policies addressing maternal obesity, identify preventive interventions, and highlight scientific gaps necessitating further research. We identified documents through electronic searches in PubMed, CINAHL Plus, EMBASE, and grey literature sources (ministry of health websites, national gynecology and obstetrics associations) from January 2013 to August 2023, updated in June 2024. The inclusion criteria focused on English-language documents discussing interventions or health policies that promote weight loss through lifestyle changes during pregnancy. A total of 22 documents (10 studies and 12 guidelines) were included. 12 studies (N=1244) identified via databases; included two Clinical Practice Guidelines (CPGs) from Canada and Singapore. Other 10 CPGs sourced from governmental websites and national associations: England (1), Australia (1), New Zealand (1), combined Australia and New Zealand (1), Canada (3), USA (1), Ireland (1), Germany (1). 10 guidelines focused on obesity in pregnancy, two on weight management during pregnancy. Covered interventions across pre-pregnancy, pregnancy, and postpartum periods (9 guidelines); pre-pregnancy and pregnancy (2); exclusively postpartum (1). Seven guidelines offered evidence-based recommendations on maintaining healthy weight in mothers, largely based on expert opinions. Maternal obesity poses significant risks to both mothers and children, underscoring the need for effective health policies and systems. However, few countries have integrated adequate responses into their healthcare policies and guidelines for professionals. Limited evidence exists on optimal practices to improve reproductive health outcomes in obese women. Hence, the crucial need to developing comprehensive guidelines and proactive strategies to manage maternal obesity. These measures can improve outcomes and reduce healthcare costs. Increased focus on research and policymaking is essential to protect the health of mothers and their children.
Published: 2024
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2. A Report on Statistics of an Online Self-screening Platform for COVID-19 and Its Effectiveness in Iran

Author: Sina Azadnajafabad, Sahar Saeedi Moghaddam, Negar Rezaei, Erfan Ghasemi, Shohreh Naderimagham, Mehrdad Azmin, Esmaeil Mohammadi, Kosar Jamshidi, Nima Fattahi, Hossein Zokaei, Ashkan Mehregan, Bahman Damerchilu, Pouya Fathi, Hossein Erfani, Abbas Norouzinejad, Mohammad Mehdi Gooya, Hamidreza Jamshidi, Reza Malekzadeh, Bagher Larijani, and Farshad Farzadfar
Subjects: covid-19, self-screening, epidemics, iran, public health, Public aspects of medicine, RA1-1270
Abstract: BackgroundThe most recent emerging infectious disease, coronavirus disease 2019 (COVID-19), is pandemic now. Iran is a country with community transmission of the disease. Telehealth tools have been proved to be useful in controlling public health disasters. We developed an online self-screening platform to offer a population-wide strategy to control the massive influx to medical centers. MethodsWe developed a platform operating based on given history by participants, including sex, age, weight, height, location, primary symptoms and signs, and high risk past medical histories. Based on a decision-making algorithm, participants were categorized into four levels of suspected cases, requiring diagnostic tests, supportive care, not suspected cases. We made comparisons with Iran STEPs (STEPwise approach to Surveillance) 2016 study and data from the Statistical Centre of Iran to assess population representativeness of data. Also, we made a comparison with officially confirmed cases to investigate the effectiveness of the platform. A multilevel mixed-effects Poisson regression was used to check the association of visiting platform and deaths caused by COVID-19. ResultsAbout 310 000 individuals participated in the online self-screening platform in 33 days. The majority of participants were in younger age groups, and males involved more. A significant number of participants were screened not to be suspected or needing supportive care, and only 10.4% of males and 12.0% of females had suspected results of COVID-19. The penetration of the platform was assessed to be acceptable. A correlation coefficient of 0.51 was calculated between suspected results and confirmed cases of the disease, expressing the platform’s effectiveness. ConclusionImplementation of a proper online self-screening tool can mitigate population panic during wide-spread epidemics and relieve massive influx to medical centers. Also, an evidence-based education platform can help fighting infodemic. Noticeable utilization and verified effectiveness of such platform validate the potency of telehealth tools in controlling epidemics and pandemics.
Published: 2022
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3. A national and sub-national metaregression of the trend of insufficient physical activity among Iranian adults between 2001 and 2016

Author: Aida Kamalian, Fatemeh Khosravi Shadmani, Moein Yoosefi, Bahram Mohajer, Farnam Mohebi, Shohreh Naderimagham, Negar Rezaei, Erfan Ghasemi, Mahtab Rouhifard Khalilabad, Bahar Hassanmirzaei, Maryam Selk Ghaffari, Afifeh Khosravi, Ramin Kordi, and Farshad Farzadfar
Subjects: Medicine, Science
Abstract: Abstract Insufficient physical activity (IPA) caused approximately 5% of mortalities in 2017 in Iran, almost double its global average. Despite the relatively considerable burden, a knowledge gap exists regarding the trend of IPA in recent years. We described the trend of IPA prevalence utilizing the data from six rounds of STEPwise approach to risk factor Surveillance (STEPS) in Iran. We estimated the physical activity status of Iranian adults from 2006 to 2016 after adjusting for years of schooling, urbanization percentage, and wealth index. We used the spatiotemporal model to interpolate and extrapolate the IPA prevalence for the years in-between the series and from 2001 to 2006, respectively. We used the data of 177,910 participants from six STEPS surveys and found that the national prevalence of IPA had steadily increased over the course of 16 years and had almost doubled in this time period (23.1% in 2001 to 55.4% in 2016). The increase was persistent across all age and gender strata and in every province. Moreover, IPA was more prevalent among women than their male peers regardless of their age category or province of residence. The prevalence of IPA in Khuzestan (highest prevalence) was almost double compared to that in Lorestan (lowest prevalence) in 2016. The IPA prevalence increased considerably and almost doubled in 16 years among Iranian adults, particularly women. Policies need to target IPA as a high priority contributing to the burden of Non-communicable diseases.
Published: 2021
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4. Global, regional, and national burden and quality of care index (QCI) of thyroid cancer: A systematic analysis of the Global Burden of Disease Study 1990–2017

Author: Sina Azadnajafabad, Sahar Saeedi Moghaddam, Esmaeil Mohammadi, Negar Rezaei, Erfan Ghasemi, Nima Fattahi, Arya Aminorroaya, Reza Azadnajafabad, Armin Aryannejad, Nazila Rezaei, Shohreh Naderimagham, Vahid Haghpanah, Ali H. Mokdad, Hossein Gharib, Farshad Farzadfar, and Bagher Larijani
Subjects: gender disparity, global burden of disease, healthcare quality, quality of care index, socioeconomic factors, thyroid cancer, Neoplasms. Tumors. Oncology. Including cancer and carcinogens, RC254-282
Abstract: Abstract Background Thyroid cancer (TC) is the most prevalent malignancy of the endocrine system. Over the past decades, TC incidence rates have been increasing. TC quality of care (QOC) has yet to be well understood. We aimed to assess the quality of TC care and its disparities. Methods We retrieved primary epidemiologic indices from the Global Burden of Disease (GBD) 1990–2017 database. We calculated four secondary indices of mortality to incidence ratio, disability‐adjusted life years (DALYs) to prevalence ratio, prevalence to incidence ratio, and years of life lost (YLLs) to years lived with disability (YLD) ratio and summarized them by the principal component analysis (PCA) to produce one unique index presented as the quality of care index (QCI) ranged between 0 and 100, to compare different scales. The gender disparity ratio (GDR), defined as the QCI for females divided by QCI for males, was applied to show gender inequity. Results In 2017, there were 255,489 new TC incident cases (95% uncertainty interval [UI]: 245,709–272,470) globally, which resulted in 41,235 deaths (39,911–44,139). The estimated global QCI was 84.39. The highest QCI was observed in the European region (93.84), with Italy having the highest score (99.77). Conversely, the lowest QCI was seen in the African region (55.09), where the Central African Republic scored the lowest (13.64). The highest and lowest socio‐demographic index (SDI) regions scored 97.27 and 53.85, respectively. Globally, gender disparity was higher after the age of 40 years and in favor of better care in women. Conclusion TC QOC is better among those countries of higher socioeconomic status, possibly due to better healthcare access and early detection in these regions. Overall, the quality of TC care was higher in women and younger adults. Countries could adopt the introduced index of QOC to investigate the quality of provided care for different diseases and conditions.
Published: 2021
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5. Twenty-Six-Year Trend of Mortality Rate due to Ischemic Heart Diseases (IHDs) in Iran: 1990-2015

Author: Shohreh Naderimagham, Kimiya Gohari, Ali Sheidaei, Hamidreza Jamshidi, Alireza Namazi Shabestari, Mitra Modirian, Nazila Rezaei, Farzad Kompani, Bahman Damerchilu, Hamidreza Bahrami-Taghanaki, Bagher Larijani, and Farshad Farzadfar
Subjects: Ischemic heart disease, Myocardial ischemia, Burden, Iran, Public aspects of medicine, RA1-1270
Abstract: Background: Ischemic Heart Diseases (IHDs) are the main causes of deaths all over the world. Since there is no comprehensive study on IHDs mortality rate in Iran, the present study aimed to estimate age-standardized IHDs mortality rate by sex, age, geography, and time trends at both national and sub-national levels in Iran. Methods: We used the Death Registration System (DRS) data from 1990 to 2015 collected by the Iranian Ministry of Health and Medical Education across the country, Tehran, and Isfahan main cemetery, not included in the DRS. Utilized death distribution methods to overcome the incompleteness of data. Statistical models including Spatio-temporal and Gaussian-Process Regression models were used to extrapolate all-cause and cause-specific mortality rates. Results: Age-standardized IHDs mortality rate in Iran almost doubled from 1990 to 2015. Forty-nine deaths per 100.000 population in 1990, which increased to 91.6 deaths per 100.000 in 2015). Male to female age-standardized mortality rate increased from 1.07 to 1.32 during the studied period. Aging was associated with an increase in age-standardized IHDs mortality rate in both sexes, all provinces, and all of the years. The range of age-standardized IHDs mortality rate for both sexes was from 58 to 136.2 deaths per 100,000 across provinces in 2015. Conclusion: Due to the increase in age-standardized IHDs mortality rate in Iran, it seems necessary to design and implement appropriate public health interventions by health authorities to prevent and control this group of diseases.
Published: 2022

6. Quality of care of peptic ulcer disease worldwide: A systematic analysis for the global burden of disease study 1990–2019

Author: Mohsen Abbasi-Kangevari, Naser Ahmadi, Nima Fattahi, Negar Rezaei, Mohammad-Reza Malekpour, Seyyed-Hadi Ghamari, Sahar Saeedi Moghaddam, Sina Azadnajafabad, Zahra Esfahani, Ali-Asghar Kolahi, Shahin Roshani, Sahba Rezazadeh-Khadem, Fateme Gorgani, Seyyed Nima Naleini, Shohreh Naderimagham, Bagher Larijani, and Farshad Farzadfar
Subjects: Medicine, Science
Abstract: Background Peptic ulcer disease (PUD) affects four million people worldwide annually and has an estimated lifetime prevalence of 5−10% in the general population. Worldwide, there are significant heterogeneities in coping approaches of healthcare systems with PUD in prevention, diagnosis, treatment, and follow-up. Quantifying and benchmarking health systems’ performance is crucial yet challenging to provide a clearer picture of the potential global inequities in the quality of care. Objective The objective of this study was to compare the health-system quality-of-care and inequities for PUD among age groups and sexes worldwide. Methods Data were derived from the Global Burden of Disease Study 1990–2019. Principal-Component-Analysis was used to combine age-standardized mortality-to-incidence-ratio, disability-adjusted-life-years-to-prevalence-ratio, prevalence-to-incidence-ratio, and years-of-life-lost-to-years-lived-with-disability-into a single proxy named Quality-of-Care-Index (QCI). QCI was used to compare the quality of care among countries. QCI’s validity was investigated via correlation with the cause-specific Healthcare-Access-and-Quality-index, which was acceptable. Inequities were presented among age groups and sexes. Gender Disparity Ratio was obtained by dividing the score of women by that of men. Results Global QCI was 72.6 in 1990, which increased by 14.6% to 83.2 in 2019. High-income-Asia-pacific had the highest QCI, while Central Latin America had the lowest. QCI of high-SDI countries was 82.9 in 1990, which increased to 92.9 in 2019. The QCI of low-SDI countries was 65.0 in 1990, which increased to 76.9 in 2019. There was heterogeneity among the QCI-level of countries with the same SDI level. QCI typically decreased as people aged; however, this gap was more significant among low-SDI countries. The global Gender Disparity Ratio was close to one and ranged from 0.97 to 1.03 in 100 of 204 countries. Conclusion QCI of PUD improved dramatically during 1990–2019 worldwide. There are still significant heterogeneities among countries on different and similar SDI levels.
Published: 2022

7. National and Subnational Incidence, Mortality, and Years of Life Lost Due to Breast Cancer in Iran: Trends and Age-Period-Cohort Analysis Since 1990

Author: Bahar Ataeinia, Sahar Saeedi Moghaddam, Mahsima Shabani, Kimiya Gohari, Ali Sheidaei, Nazila Rezaei, Shohreh Naderimagham, Erfan Ghasemi, Mahtab Rouhifard Khalilabad, Shahin Roshani, Yosef Farzi, and Farshad Farzadfar
Subjects: age-period-cohort model, breast cancer, incidence, mortality, time trend, Neoplasms. Tumors. Oncology. Including cancer and carcinogens, RC254-282
Abstract: Breast cancer is the most common cancer among women, causing considerable burden and mortality. Demographic and lifestyle transitions in low and low-middle income countries have given rise to its increased incidence. The successful management of cancer relies on evidence-based policies taking into account national epidemiologic settings. We aimed to report the national and subnational trends of breast cancer incidence, mortality, years of life lost (YLL) and mortality to incidence ratio (MIR) since 1990. As part of the National and Subnational Burden of Diseases project, we estimated incidence, mortality and YLL of breast cancer by sex, age, province, and year using a two-stage spatio-temporal model, based on the primary dataset of national cancer and death registry. MIR was calculated as a quality of care indicator. Age-period-cohort analysis was used to distinguish the effects of these three collinear factors. A significant threefold increase in age-specific incidence at national and subnational levels along with a twofold extension of provincial disparity was observed. Although mortality has slightly decreased since 2000, a positive mortality annual percent change was detected in patients aged 25–34 years, leading to raised YLLs. A significant declining pattern of MIR and lower provincial MIR disparity was observed. We observed a secular increase of breast cancer incidence. Further evaluation of risk factors and developing national screening policies is recommended. A descending pattern of mortality, YLL and MIR at national and subnational levels reflects improved quality of care, even though mortality among younger age groups should be specifically addressed.
Published: 2021
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8. How the scientific community responded to the COVID-19 pandemic: A subject-level time-trend bibliometric analysis.

Author: Mohammad-Reza Malekpour, Mohsen Abbasi-Kangevari, Sina Azadnajafabad, Seyyed-Hadi Ghamari, Negar Rezaei, Sahba Rezazadeh-Khadem, Nazila Rezaei, Arya Aminorroaya, Elham Abdolhamidi, Sahar Mohammadi Fateh, Rosa Haghshenas, Shahin Roshani, Naser Ahmadi, Kosar Jamshidi, Shohreh Naderimagham, and Farshad Farzadfar
Subjects: Medicine, Science
Abstract: BackgroundCOVID-19 has triggered an avalanche of research publications, the various aspects of which need to be assessed. The objective of this study is to determine the scientific community's response patterns to COVID-19 through a bibliometric analysis of the time-trends, global contribution, international collaboration, open-access provision, science domains of focus, and the behavior of journals.MethodsThe bibliographic records on COVID-19 literature were retrieved from both PubMed and Scopus. The period for searching was set from November 1, 2019, to April 15, 2021. The bibliographic data were coupled with COVID-19 incidence to explore possible association, as well as World Bank indicators and classification of economies.ResultsA total of 159132 records were included in the study. Following the escalation of incidences of COVID-19 in late 2020 and early 2021, the monthly publication count made a new peak in March 2021 at 20505. Overall, 125155 (78.6%) were national, 22548 (14.2%) were bi-national, and 11429 (7.2%) were multi-national. Low-income countries with 928 (66.8%) international publications had the highest percentage of international. The open-access provision decreased from 85.5% in February 2020 to 62.0% in April 2021. As many as 82841 (70.8%) publications were related to health sciences, followed by life sciences 27031 (23.1%), social sciences 20291 (17.3%), and physical sciences 15141 (12.9%). The top three medical subjects in publications were general internal medicine, public health, and infectious diseases with 28.9%, 18.3%, and 12.6% of medical publications, respectively.ConclusionsThe association between the incidence and publication count indicated the scientific community's interest in the ongoing situation and timely response to it. Only one-fifth of publications resulted from international collaboration, which might lead to redundancy without adding significant value. Our study underscores the necessity of policies for attraction of international collaboration and direction of vital funds toward domains of higher priority.
Published: 2021
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9. Patterns of Obesity and Overweight in the Iranian Population: Findings of STEPs 2016

Author: Shirin Djalalinia, Sahar Saeedi Moghaddam, Ali Sheidaei, Nazila Rezaei, Seyed Sina Naghibi Iravani, Mitra Modirian, Hossein Zokaei, Moein Yoosefi, Kimiya Gohari, Ahmad Kousha, Zhaleh Abdi, Shohreh Naderimagham, Ahmad Reza Soroush, Bagher Larijani, and Farshad Farzadfar
Subjects: obesity, overweight, BMI, STEPs, Iran, Diseases of the endocrine glands. Clinical endocrinology, RC648-665
Abstract: Background: Obesity has become a common health problem all over the world. Benefiting from a national representative sample, the present study aimed to estimate the prevalence of overweight/obesity and the distribution of Body Mass Index (BMI) levels in the Iranian adult population, by sex, age, and geographical distribution.Methods: This was a large-scale national cross-sectional study of Non-communicable Diseases risk factor surveillance in Iran. Through a systematic random sampling cluster, 31,050 Iranian adult participants aged 18 years and over were enrolled in the study. The main research tools were used to assess three different levels of data, namely: (1) demographic, epidemiologic, and risk-related behavioral data, (2) physical measurements, and (3) lab measurements. Anthropometric measurements were taken using standard protocols and calibrated instruments.Results: In 2016, the national prevalence rates of normal weight, obesity, and overweight/obesity among Iranian adults were, 36.7% (95% CI: 36.1–37.3), 22.7% (22.2–23.2), and 59.3% (58.7–59.9), respectively. There was a significant difference between the prevalence of obesity among males [15.3% (14.7–15.9)] and females [29.8% (29.0–30.5)] (p < 0.001). The 55–64 [31.5% (30.1–33.0)] and the 18–24 [8.3% (7.3–9.4)] year-old age groups had the highest and lowest prevalence of obesity, respectively. The results show a geographical pattern at provincial level, where the level of BMI increases among populations ranging from the southeastern to the northwestern regions of the country. The highest provincial prevalence of obesity was almost 2.5-fold higher than the lowest provincial prevalence.Conclusion: We found a significant difference between the prevalence of obesity in males and females. Moreover, there was a considerable difference in the geographical pattern of the prevalence of obesity and overweight. Further evidence is warranted to promote strategies and interventions related to prevention and control of factors that are associated with weight gain.
Published: 2020
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10. Prevalence of Non-Engineered Buildings and Population at Risk for a Probable Earthquake: A Cross-Sectional Study from an Informal Settlement in Tehran, Iran

Author: Soraya FATHOLLAHI, Sahar SAEEDI MOGHADDAM, Mohammad Ali MANSOURNIA, Mahmoud RAHIMI, Mehdi ZARE, Ali ARDALAN, Ali SHEIDAEI, Niloofar PEYKARI, Shohreh NADERIMAGHAM, and Farshad FARZADFAR
Subjects: Earthquake, Non-engineered buildings, Population, Informal settlements, Disasters, Public aspects of medicine, RA1-1270
Abstract: Background: Constructions in informal settlements not respected any applying rules, regulations of urban planning, and building codes with high population density, are the municipality challenge. We aimed to identify level of buildings seismic vulnerability and population at risk in Tehran’s Farahzad informal settlement in 2017. Methods: In this observational cross-sectional study, residential buildings were assessed for seismic performance of constructions. We screened 160 buildings according to Iranian national guidelines by Rapid Seismic Visual Screening Method as a tool to calculate and determine Level of Retrofitting (LR) scores of buildings. We also interviewed residents of the buildings to collect data regarding socio-demographic data, individual disability status, Disaster Assessment of Readiness and Training (DART) regarding household disaster preparedness, and time occupancy in the buildings. Results: Overall, 160 buildings with 209 households and 957 individuals were surveyed. 97.5% of buildings were formed of heavy construction materials. None of them were categorized as engineered buildings and LR of residential buildings ranged from 82.4% to 163.8% with a mean 117.9%. LR scores of more than 100% were capped as 100%. Vulnerable groups of the sample population include under-five years old (8.7%), 60 yr old and above (6.7%), and 9.1% of households had at least one disabled member. 16.7% of households were living in homes with dense area. The DART score for 94.3% of surveyed households was zero. Conclusion: Disaster managers in Tehran municipality must design and implement a comprehensive risk reduction plan in poor urban areas as vulnerable regions for earthquake hazard.
Published: 2020
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11. Impact of rural family physician program on child mortality rates in Iran: a time-series study

Author: Shohreh Naderimagham, Hamidreza Jamshidi, Alireza Khajavi, Farhad Pishgar, Ali Ardam, Bagher Larijani, Zohreh Mahmoudi, Alireza Jeddian, Hamid Reza Bahrami-Taghanaki, and Farshad Farzadfar
Subjects: Child Mortality, Family Physician, Health Care Reform, Mortality, Infant Mortality, Iran, Computer applications to medicine. Medical informatics, R858-859.7, Public aspects of medicine, RA1-1270
Abstract: Abstract Background The rural family physician program and social protection scheme were started in Iran about 10 years ago, and no comprehensive study has been carried out to investigate the effects of this program on mortality-related health indicators yet. The present study aims to examine the impacts of implementation of the family physician program and rural insurance program, which was launched in June 2005, on neonatal (NMR), infant (IMR), and under-5-year (U5MR) mortality rates in rural areas of Iran between 1995 and 2011, using a time-series analysis. Methods Three segmented regression models were built to evaluate the effects of the program on NMR, IMR, and U5MR, and several independent variables were entered into the models, including annual incremental effect of the program (variable of interest), time effect, behvarz density, effect of the family physician and rural insurance programs, as well as socioeconomic variables including years of schooling, wealth index, sex ratio, and logarithmic scales of rural population size in each area. Data were gathered from secondary sources and other studies. Data pertaining to the year 2007 were excluded from the final analysis due to their inaccuracy. Results Our results show that the incremental effect of implementing the rural family physician program is associated with significant reductions in NMR (β = − 0.341. p − value = 0.003) and IMR (β = − 0.016. p − value = 0.009). Although the association between this effect and reductions in U5MR were evident, they were not statistically significant (β = − 0.003. p − value = 0.542). Moreover, wealth status of inhabitants was associated with reductions in NMR (β = − 0.889. p − value = 0.001), IMR (β = − 0.052. p − value
Published: 2017
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12. Socioeconomic inequalities in neonatal and postneonatal mortality: Evidence from rural Iran, 1998–2013

Author: Alireza Khajavi, Farhad Pishgar, Mina Dehghani, and Shohreh Naderimagham
Subjects: Healthcare disparities, Inequality, Infant mortality, Iran, Socioeconomic factors, Public aspects of medicine, RA1-1270
Abstract: Abstract Background Over the past three decades, interventions have been implemented to reduce childhood mortality in Iran. Despite declines in overall mortality rates, inequalities in mortality across socioeconomic groups have remained unchanged. In this study, we assessed inequalities in infant mortality in rural regions of Iran. Methods We obtained data from the Iranian vital registration system, which includes data on 5,626,158 live births, 79,457 neonatal deaths, and 36,397 postneonatal deaths in rural areas of Iran over the course of a 16-year period, which was then divided into 4 four-year intervals. In addition to building multivariate regression models to identify factors associated with mortality, we calculated a concentration index for each province to measure inequalities in neonatal and postneonatal mortality, using wealth index as the socioeconomic variable of interest. We further assessed these inequalities as a component of their contributors by using the decomposition method. Results Although both neonatal (17.62 to 10.92) and postneonatal (8.11 to 5.14) mortality rates exhibited decreasing trends from 1998-2001 to 2010–2013, the inequalities observed in these indices remained nearly unchanged (concentration indices of −0.062 to −0.047 and −0.098 to −0.083, respectively). Furthermore, fraction of births occurred in hospitals and literate women contributed positively to the inequalities observed in both neonatal and postneonatal mortality rates, whereas the proportion of infants classified as low birth weight contributed negatively over all study periods. We also identified decreasing trends in inequalities of the proportion of infants classified as having low birth weight, being born in hospitals, being covered by health insurance, mothers’ age, and literacy of women within the time intervals under study. Conclusions Although infant mortality rates in Iran decreased over the studied time period, we observed notable inequalities in these measures. Several steps are needed to overcome these inequalities, including improving access to professional health services for lower income households, fairly distributing facilities and human resources, and improving insurance coverage to protect families from financial hardships. Moreover, social factors, such as literacy of women, were found to be important in decreasing inequalities in infant mortality. These steps require improving societal awareness of infant mortality and implementing improved and problem-oriented health policies.
Published: 2017
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13. Insulin pen use and diabetes treatment goals: A study from Iran STEPS 2016 survey.

Author: Hedyeh Ebrahimi, Farhad Pishgar, Moein Yoosefi, Sedighe Moradi, Nazila Rezaei, Shirin Djalalinia, Mitra Modirian, Niloofar Peykari, Shohreh Naderimagham, Rosa Haghshenas, Saral Rahimi, Hamidreza Jamshidi, Alireza Esteghamati, Bagher Larijani, and Farshad Farzadfar
Subjects: Medicine, Science
Abstract: BackgroundFrequency of insulin pen use, despite its higher costs, is increasing to substitute the traditional use of insulin vials. This study aims to report insulin pen use frequency and its associated factors among participants of the STEPS survey 2016 in Iran, which was conducted based on the World Health Organization (WHO) STEPS methodology.MethodsIn this cross-sectional study, 19,503 (mean age of 46.03±0.13) out of 30,541 participants of the Iran STEPS survey were included (Inclusion criteria: aged >25 years old and availability of their demographic, clinical, and laboratory results for serum glucose, HbA1c, and lipid profile). Clinical and demographic characteristics, a frequency of use of each diabetes mellitus treatment type, and the association of insulin pen use with health outcomes are reported using descriptive analysis and propensity score modeling.ResultsThere were 1,999(10.85%) individuals diagnosed with diabetes in the population, while 1,160(56.87%) cases were taking antihyperglycemic treatments. In this subset, 240(21.14%) individuals administered insulin with or without using oral agents at the same time. 52.28% of participants who were under insulin therapy used insulin pens. None of the socioeconomic determinants, including gender (p-value = 0.11), type of residential areas (p-value = 0.52), years of schooling (p-value = 0.27), wealth index (p-value = 0.19), marital status (p-value = 0.37), and insurance types (p-value = 0.72) were significantly different among groups using insulin pens and insulin vials. Moreover, in the propensity score modeling, pen usage was not associated with a lower heart attack and ischemic stroke histories, systolic blood pressure, serum lipid profile, blood glucose, or HbA1c levels.ConclusionResults showed that the use of the higher-costing insulin pens compared to traditional vials and syringes is not associated with improved glycemic control and better lipid profile in our sample. Future studies are needed to confirm these findings and to compare other aspects of insulin pen use, including adherence to treatment and cost-effectiveness.
Published: 2019
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14. Diabetes research in Middle East countries; a scientometrics study from 1990 to 2012

Author: Niloofar Peykari, Shirin Djalalinia, Amir Kasaeian, Shohreh Naderimagham, Tahereh Hasannia, Bagher Larijani, and Farshad Farzadfar
Subjects: Diabetes, Middle East, scientometrics, Medicine
Abstract: Background: Diabetes burden is a serious warning for urgent action plan across the world. Knowledge production in this context could provide evidences for more efficient interventions. Aimed to that, we quantify the trend of diabetes research outputs of Middle East countries focusing on the scientific publication numbers, citations, and international collaboration. Materials and Methods: This scientometrics study was performed based on the systematic analysis through three international databases; ISI, PubMed, and Scopus from 1990 to 2012. International collaboration of Middle East countries and citations was analyzed based on Scopus. Diabetes′ publications in Iran specifically were assessed, and frequent used terms were mapped by VOSviewer software. Results: Over 23-year period, the number of diabetes publications and related citations in Middle East countries had increasing trend. The number of articles on diabetes in ISI, PubMed, and Scopus were respectively; 13,994, 11,336, and 20,707. Turkey, Israel, Iran, Saudi Arabia, and Egypt have devoted the five top competition positions. In addition, Israel, Turkey, and Iran were leading countries in citation analysis. The most collaborative country with Middle East countries was USA and within the region, the most collaborative country was Saudi Arabia. Iran in all databases stands on third position and produced 12.7% of diabetes publications within region. Regarding diabetes researches, the frequent used terms in Iranian articles were "effect," "woman," and "metabolic syndrome." Conclusion: Ascending trend of diabetes research outputs in Middle East countries is appreciated but encouraging to strategic planning for maintaining this trend, and more collaboration between researchers is needed to regional health promotion.
Published: 2015

15. Prevalence of dyslipidemia in Iranian children and adolescents: A systematic review

Author: Silva Hovsepian, Roya Kelishadi, Shirin Djalalinia, Farshad Farzadfar, Shohreh Naderimagham, and Mostafa Qorbani
Subjects: Dyslipidemia, Iran, lipid profile, pediatrics, prevalence, systematic review, Medicine
Abstract: Background: Dyslipidemia is considered as an important modifiable risk factor for cardiovascular disease (CVD). The link between childhood dyslipidemia and occurrence of atherosclerosis and its sequels in adulthood are well-documented. This study aimed to systematically review the prevalence of dyslipidemia among Iranian children and adolescents. Materials and Methods: An electronic search was conducted on studies published from January 1990 to January 2014. The main international electronic data sources were PubMed and the NLM Gateway (for MEDLINE), Institute of Scientific Information (ISI), and SCOPUS. For Persian databases, we used domestic databases with systematic search capability including IranMedex, Irandoc, and Scientific Information Database (SID). We included all available population-based studies and national surveys conducted in the pediatric age group (aged
Published: 2015
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16. Health Literacy for Iranian Adults (HELIA): development and psychometric properties

Author: Ali Montazeri, Mahmoud Tavousi, Fateme Rakhshani, Seyed Ali Azin, Katayoun Jahangiri, Mahdi Ebadi, Shohreh Naderimagham, Atoosa Solimanian, Fateme Sarbandi, Amir Motamedi, and Mohammad Mahdi Naghibi Sistani
Subjects: health literacy, adults, iran, Medicine, Medicine (General), R5-920
Abstract: Objective (s): Health literacy has been defined as ‘the degree to which individuals have the capacity to obtain, process and understand basic health information and services needed to make basic health decisions’. This study aimed to develop and psychometrically evaluate a measure for health literacy in Iranian adults. Methods: A review of literature on all measures of health literacy was conducted in order to generate an item pool. Then, based on a definition of health literacy and the most important public health issues in Iran, a framework was identified in order to develop the initial questionnaire. The initial questionnaire contained 66 items. Accordingly 15 specialists from different disciplines were approached to carry out content validity. Consequently 19 items were removed and a provisional version of the questionnaire with 47 items was provided. Finally, a random sample of adults living in Tehran completed the questionnaire. Psychometric properties of the instrument were assessed performing exploratory factor analysis and internal consistency. Results: In all 336 adults aged 18 to 65 years old completed the questionnaire. When performed the exploratory factor analysis, 33 items were loaded indicating a 5-factor solution for the questionnaire namely: access (6 items), reading (4 items), understanding (7 items), appraisal (4 items), and decision (12 items) that jointly explained %53.2 of variance observed. Additional analysis for internal consistency showed satisfactory results with Cronbach’s alpha coefficients ranging from 0.72 to 0.89. Conclusion: The findings suggest that the Health Literacy for Iranian Adults (HELIA) is a reliable and valid instrument for measuring health literacy in Iran.
Published: 2014

17. Development and psychometric properties of perceived self-efficacy scale (SES) for self-care in middle-aged patients with diabetes mellitus type 2

Author: Shohreh Naderimagham, Shamsoddin Niknami, Farid Abolhassani, and Ebrahim Hajizadeh
Subjects: diabetes mellitus type 2, self-care, perceived self-efficacy, middle-aged, Medicine, Medicine (General), R5-920
Abstract: Methods: This was a two-phase study that was conducted during 2009 to 2011 in Tehran, Iran. First, an item pool was prepared according to the literature, focus group discussions, and expert panel. In the quantitative part of the study; content, face and construct validity using factor analysis (both exploratory and confirmatory) were performed and reliability (internal consistency and test-retest) was determined for assessing the psychometric properties of the scale.Results: A 21-item questionnaire was developed through the qualitative phase. In face and content validity process 3 items were dropped. Exploratory factor analysis loaded 17 items with a five-factor solution (nutrition, physical activity, self monitoring of blood glucose, foot care and smoking) that jointly accounted for 67.4% of observed variance. The confirmatory factor analysis showed a good fit to the data. Cronbach’s alpha coefficient indicated a good consistency (α=0.85), and test-retest of the scale with 2-weeks interval confirmed appropriate stability for the scale (ICC=0.81).Conclusion: The findings showed the designed questionnaire can assess the self-efficacy for self-care in middle-aged (30-60 years old) patients with type II diabetes. It is a short and easy to use questionnaire and contains the 5 most important diabetes related behaviors which need self-efficacy for self-care.
Published: 2013

18. A burden assessment of occupational exposures in Iran, 1990–2010: Findings from the global burden of disease study 2010

Author: Sharareh R NiakanKalhori, Ali Behzadi, Hamidreza Maharlou, Shadi Rahimzadeh, Alireza Khajavi, Gholamreza Pouryaghoub, Ramin Mehrdad, Omid Aminian, Alireza Jeddian, and Shohreh Naderimagham
Subjects: Global burden of diseases, Iran, occupational diseases, Medicine
Abstract: Background: The present study describes the burden of occupational diseases in Iran based on the results of the Global Burden of Disease study conducted in 2010 (GBD 2010). This study aimed to determine the burden of occupational diseases in Iran based on the results of GBD 2010. It is a cross-sectional study. Methods: Disability-adjusted life years (DALYs) of occupational diseases were calculated based on the prevalence rates obtained through model estimation, as well as GBD 2010 disability weights and mortality rates obtained from different data registry systems of Iran. Causal association criteria application to select risk outcome pairs, estimation of exposure to each risk factor in the population, estimation of etiological effect size, selection of a counterfactual exposure distribution, risk assessment, and identification of burden attributable to each risk factor were the main conducted statistical steps. Results: There was an increasing trend of DALYs (710.08/100,000 people in 1990 and 833.00/100,000 people in 2005) followed by a slight decrease (833.00/100,000 in 2005–784.55/100,000 people in 2010). A total of 50.4% and 36% of total DALYs per 100,000 people were due to the adverse effects of musculoskeletal disorders and work-related injuries, respectively. Conclusions: Musculoskeletal disorders and work-related injuries are the most important adverse consequences of work-related risks that require urgent interventions to be controlled. Male workers (15–25 years and over 60) with the highest DALYs and mortality rates need more training programs, safety regulations, and higher level of protection support. In spite the decreasing trend of occupational disease related DALYs and death rates in Iran in recent years, a long-term effort is required to maintain the currently decreasing trend.
Published: 2018
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19. The first nationally and sub-nationally representative non-communicable diseases cohort study in Iran: Iran Cohort Study (ICS) protocol

Author: Shirin Djalalinia, Sina Azadnajafabad, Nazila Rezaei, Mohammad-Reza Malekpour, Erfan Ghasemi, Moein Yoosefi, Shohreh Naderimagham, Azin Ghamari, Rosa Haghshenas, Yosef Farzi, Sahar Saeedi Moghaddam, Negar Rezaei, and Farshad Farzadfar
Subjects: Endocrinology, Diabetes and Metabolism, Internal Medicine
Published: 2022
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20. Global, regional, and national survey on the burden and quality of care of pancreatic cancer: a systematic analysis for the Global Burden of Disease study 1990–2017

Author: Narges Ebrahimi, Armin Aryannejad, Sina Azadnajafabad, Shahin Roshani, Mana Moghimi, Negar Rezaei, Nima Fattahi, Masoud Masinaei, Sahar Mohammadi Fateh, Farzad Kompani, Shohreh Naderimagham, Esmaeil Mohammadi, Mohammadreza Tabary, Kosar Jamshidi, and Farshad Farzadfar
Subjects: Male, Burden of disease, medicine.medical_specialty, Inequality, Endocrinology, Diabetes and Metabolism, media_common.quotation_subject, Global Health, Global Burden of Disease, Japan, Pancreatic cancer, Environmental health, medicine, Humans, Quality of care, Aged, Quality of Health Care, media_common, Hepatology, business.industry, Public health, Australia, Gastroenterology, medicine.disease, Pancreatic Neoplasms, Female, business
Abstract: Background Pancreatic cancer (PC) is among the most lethal cancers worldwide, and the quality of care provided to PC patients is a vital public health concern. We aimed to investigate the quality of care of PC globally and to report its current burden. Methods The Quality of Care Index (QCI) was achieved by performing a Principal Component Analysis utilizing the results of the GBD study 2017. The QCI was defined as a range between 0 and 100, in which higher QCIs show higher quality of care. Possible gender- and age-related inequalities in terms of QCI were explored based on WHO world regions and the sociodemographic index (SDI). Results In 2017, Japan had the highest QCI among all countries (QCI = 99/100), followed by Australia (QCI = 83/100) and the United States (QCI = 76/100). In Japan and Australia, males and females had almost the same QCIs in 2017, while in the United States, females had lower QCIs than males. In contrast to these high-QCI nations, African countries had the lowest QCIs in 2017. Besides, QCI increased by SDI, and high-SDI regions had the highest QCIs. Regarding patients’ age, elderly cases had higher QCIs than younger patients globally and in high-SDI regions. Conclusion This study provides clinicians and health authorities with a wider vision around the quality of care of PC worldwide and highlights the existing disparities. This could help them investigate possible effective strategies to improve the quality of care in regions with lower QCIs and higher gender- and age-related inequities.
Published: 2021
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21. A national and sub-national metaregression of the trend of insufficient physical activity among Iranian adults between 2001 and 2016

Author: Shohreh Naderimagham, Bahar Hassanmirzaei, Afifeh Khosravi, Aida Kamalian, Maryam Selk Ghaffari, Negar Rezaei, Farshad Farzadfar, Moein Yoosefi, Erfan Ghasemi, Ramin Kordi, Mahtab Rouhifard Khalilabad, Farnam Mohebi, Bahram Mohajer, and Fatemeh Khosravi Shadmani
Subjects: Adult, Male, Time Factors, Adolescent, Epidemiology, Physical activity.status, Science, Health Behavior, Physical activity, Iran, Article, Age and gender, Young Adult, Risk Factors, Surveys and Questionnaires, Urbanization, Prevalence, Humans, Medicine, Obesity, Risk factor, Noncommunicable Diseases, skin and connective tissue diseases, Exercise, Aged, Public health, Multidisciplinary, business.industry, Middle Aged, Wealth index, bacterial infections and mycoses, respiratory tract diseases, Socioeconomic Factors, Female, Residence, Sedentary Behavior, business, Stepwise approach, Demography
Abstract: Insufficient physical activity (IPA) caused approximately 5% of mortalities in 2017 in Iran, almost double its global average. Despite the relatively considerable burden, a knowledge gap exists regarding the trend of IPA in recent years. We described the trend of IPA prevalence utilizing the data from six rounds of STEPwise approach to risk factor Surveillance (STEPS) in Iran. We estimated the physical activity status of Iranian adults from 2006 to 2016 after adjusting for years of schooling, urbanization percentage, and wealth index. We used the spatiotemporal model to interpolate and extrapolate the IPA prevalence for the years in-between the series and from 2001 to 2006, respectively. We used the data of 177,910 participants from six STEPS surveys and found that the national prevalence of IPA had steadily increased over the course of 16 years and had almost doubled in this time period (23.1% in 2001 to 55.4% in 2016). The increase was persistent across all age and gender strata and in every province. Moreover, IPA was more prevalent among women than their male peers regardless of their age category or province of residence. The prevalence of IPA in Khuzestan (highest prevalence) was almost double compared to that in Lorestan (lowest prevalence) in 2016. The IPA prevalence increased considerably and almost doubled in 16 years among Iranian adults, particularly women. Policies need to target IPA as a high priority contributing to the burden of Non-communicable diseases.
Published: 2021

22. COVID-19 in patients with diabetes: factors associated with worse outcomes

Author: Sina Azadnajafabad, Erfan Ghasemi, Farzad Kaveh, Mohammad-Reza Malekpour, Maryam Nasserinejad, Negar Rezaei, Fateme Montazeri, Mohsen Abbasi-Kangevari, Bagher Larijani, Abbas Norouzinejad, Alireza Raeisi, Shohreh Naderimagham, Esmaeil Mohammadi, Farshad Farzadfar, Nazila Rezaei, Seyyed-Hadi Ghamari, Ali Ghanbari, and Mohammad Mehdi Gouya
Subjects: medicine.medical_specialty, COPD, business.industry, Endocrinology, Diabetes and Metabolism, Mortality rate, Diabetes, COVID-19, Guideline, medicine.disease, Comorbidity, Comorbidities, Antibiotics, Internal medicine, Diabetes mellitus, Internal Medicine, medicine, Risk of mortality, Medical prescription, Antiviral, business, Kidney disease, Research Article
Abstract: Purpose Diabetes is one of the major comorbidities associated with COVID-19. We aimed to determine the clinical and epidemiological factors associated with the mortality of COVID-19 in diabetic patients in Iran, and also the impact of prescribed antiviral and antibiotics on patients' status. Methods In this study, we used the national registry of hospitalized patients with Severe Acute Respiratory Syndrome (SARS) Symptoms with diabetes from February 18, 2020, to December 22, 2020. Demographic, clinical features, treatments, concurrent comorbidities, and their associations with mortality and severity outcomes were assessed using logistic regression. Results 78,554 diabetic in-patients with SARS symptoms were included from 31 provinces of whom 37,338 were PCR positive for COVID-19. Older age and male gender are associated with COVID-19 mortality in diabetic patients. CVD is the most frequent comorbidity (42%). CVD, kidney disease, liver disease, and COPD are associated comorbidities which increased the risk of mortality. The mortality rate is higher in diabetic patients comparing to patients with no comorbidities, particularly in younger age groups. The frequency of antiviral, and antibiotics in COVID-19 positive patients was 34%, and 31%, respectively. Antibiotic treatment has no association with mortality in COVID-19 patients. Conclusions Diabetic patients indicate higher mortality comparing to patients without any underlying comorbidities. Restrict strategies on increasing effective health care utilization must be considered in diabetic patients, especially in those with parallel underlying comorbidities. Regarding the antibiotic resistance issue and the noticeable use of antibiotics in diabetic patients, it is recommended to prioritize an antibiotic guideline prescription in COVID-19 patients for better stewardship by countries.
Published: 2021

23. Trends of Diabetes Mortality in Iran at National and Sub-National Levels from 1990 to 2015 and Its Association with Socioeconomic Factors

Author: Niloofar Peykari, Sahar Saeedi Moghaddam, Shirin Djalalini, Nazila Rezaei, Anita Mansouri, Shohreh Naderimagham, Parinaz Mehdipour, Forough Pazhuheian, Alireza Khajavi, Rosa Haghshenas, Negar Mahmoudi, Zohreh Mahmoudi, Arezou Dilmaghani-Marand, Kamyar Rezaee, Bagher Larijani, Ardeshir Khosravi, and Farshad Farzadfar
Subjects: General Medicine
Published: 2022
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24. Global, regional, and national burden and quality of care index (QCI) of thyroid cancer: A systematic analysis of the Global Burden of Disease Study 1990–2017

Author: Ali H. Mokdad, Esmaeil Mohammadi, Reza Azadnajafabad, Shohreh Naderimagham, Vahid Haghpanah, Sahar Saeedi Moghaddam, Sina Azadnajafabad, Nima Fattahi, Nazila Rezaei, Arya Aminorroaya, Hossein Gharib, Bagher Larijani, Negar Rezaei, Erfan Ghasemi, Armin Aryannejad, and Farshad Farzadfar
Subjects: Adult, Male, 0301 basic medicine, Burden of disease, quality of care index, Cancer Research, Time Factors, Index (economics), socioeconomic factors, Global Health, healthcare quality, lcsh:RC254-282, Young Adult, 03 medical and health sciences, Sex Factors, 0302 clinical medicine, Health care, Prevalence, thyroid cancer, Humans, Medicine, Radiology, Nuclear Medicine and imaging, Thyroid Neoplasms, Quality of care, Socioeconomic status, Thyroid cancer, Gender disparity, Original Research, Aged, Quality of Health Care, Aged, 80 and over, global burden of disease, business.industry, Age Factors, Middle Aged, lcsh:Neoplasms. Tumors. Oncology. Including cancer and carcinogens, medicine.disease, 030104 developmental biology, Years of potential life lost, Oncology, 030220 oncology & carcinogenesis, Female, gender disparity, business, Cancer Prevention, Demography
Abstract: Background Thyroid cancer (TC) is the most prevalent malignancy of the endocrine system. Over the past decades, TC incidence rates have been increasing. TC quality of care (QOC) has yet to be well understood. We aimed to assess the quality of TC care and its disparities. Methods We retrieved primary epidemiologic indices from the Global Burden of Disease (GBD) 1990–2017 database. We calculated four secondary indices of mortality to incidence ratio, disability‐adjusted life years (DALYs) to prevalence ratio, prevalence to incidence ratio, and years of life lost (YLLs) to years lived with disability (YLD) ratio and summarized them by the principal component analysis (PCA) to produce one unique index presented as the quality of care index (QCI) ranged between 0 and 100, to compare different scales. The gender disparity ratio (GDR), defined as the QCI for females divided by QCI for males, was applied to show gender inequity. Results In 2017, there were 255,489 new TC incident cases (95% uncertainty interval [UI]: 245,709–272,470) globally, which resulted in 41,235 deaths (39,911–44,139). The estimated global QCI was 84.39. The highest QCI was observed in the European region (93.84), with Italy having the highest score (99.77). Conversely, the lowest QCI was seen in the African region (55.09), where the Central African Republic scored the lowest (13.64). The highest and lowest socio‐demographic index (SDI) regions scored 97.27 and 53.85, respectively. Globally, gender disparity was higher after the age of 40 years and in favor of better care in women. Conclusion TC QOC is better among those countries of higher socioeconomic status, possibly due to better healthcare access and early detection in these regions. Overall, the quality of TC care was higher in women and younger adults. Countries could adopt the introduced index of QOC to investigate the quality of provided care for different diseases and conditions., In this study, we retrieved primary epidemiologic data from the Global Burden of Disease (GBD) 1990–2017 database. We produced one unique index, presented as the quality of care index (QCI), to compare different geographical, socio‐developmental, and age scales. The main finding of this survey was the better quality of care among those of higher socioeconomic status, revealing the effect of better healthcare access and early detection in these regions. Also, quality of thyroid cancer care was better in women and younger adults. Evaluation and comparison of thyroid cancer care among various regions and populations, provides data for policy‐makers and healthcare authorities to improve quality of care for patients with thyroid cancer in different settings.
Published: 2021
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25. Global and regional burden and quality of care of non-rheumatic valvular heart diseases: a systematic analysis of Global Burden of Disease 1990–2017

Author: Mehrabi Nejad, Naser Ahmadi, Esmaeil Mohammadi, Mahya Shabani, Alborz Sherafati, Armin Aryannejad, Negar Rezaei, Ali Ghanbari, Moein Yoosefi, Arya Aminorroaya, Mahsima Shabani, Nazila Rezaei, Tina Salavati, Bagher Larijani, Shohreh Naderimagham, and Farshad Farzadfar
Subjects: Male, Incidence, Health Policy, Heart Valve Diseases, Public Health, Environmental and Occupational Health, Humans, Female, Quality-Adjusted Life Years, General Medicine, Global Health, Health Services Accessibility, Global Burden of Disease, Quality of Health Care
Abstract: Background With an increase in the incidence and prevalence of non-rheumatic valvular heart diseases (NRVHDs), having a proper understanding of the disease current status in terms of quality of care and healthcare access can considerably affect further planning for the healthcare system. Objective In this study, we aimed to evaluate and compare the quality and equity of care concerning NRVHDs in terms of gender and sociodemographic index (SDI) using a newly proposed index. Methods We obtained the primary measures (e.g. incidence) from the Global Burden of Disease (GBD) data about NRVHD from 1990 to 2017 to calculate the subsequent secondary indices (e.g. mortality-to-incidence ratio) with close association to quality of care. Then, using principal component analysis (PCA), quality of care index (QCI) was calculated as a novel index from the secondary indices, rescaled to 0–100. QCI was calculated for all age groups and both genders, globally, regionally and nationally between 1990 and 2017. Results Globally, the QCI for NRVHDs in 2017 was 87.3, and it appears that gender inequity was unremarkable (gender disparity ratio = 1.00, female QCI: 90.2, male QCI: 89.7) in 2017 similar to the past three decades. Among WHO world regions, the Western Pacific Region and Eastern Mediterranean Region showed the highest (90.1) and lowest (74.0) QCI scores. Regarding SDI, the high-middle-SDI quintile with a QCI of 89.4 and the low-SDI quintile with a QCI of 77.8 were the two extremes of healthcare quality in 2017. Conclusion Although global status regarding the NRVHD’s quality of care is acceptable, higher attention is required for lower SDI countries.
Published: 2022
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26. Epidemiologic pattern of cancers in Iran; current knowledge and future perspective

Author: Bagher Larijani, Yosef Farzi, Arya Aminorroaya, Esmaeil Mohammadi, Negar Rezaei, Shohreh Naderimagham, Farshad Farzadfar, Nazila Rezaei, Nima Fattahi, and Sina Azadnajafabad
Subjects: Future perspective, business.industry, Endocrinology, Diabetes and Metabolism, Demographic transition, Developing country, Treatment method, Review Article, Iranian population, 03 medical and health sciences, Epidemiological transition, 0302 clinical medicine, 030220 oncology & carcinogenesis, Environmental health, Epidemiology of cancer, Internal Medicine, Life expectancy, Medicine, 030212 general & internal medicine, business
Abstract: Iran is a developing country facing demographic transition. Cancers are among the major non-communicable disorders with remarkable budern on the health-care governing systems. Extended life expectancy of Iranian population, change in living style, as well as promoted diagnostic and treatment methods have resulted into significant malignancies emergence and detection. Understanding the trend of this epidemiologic transition is required for proper allotment of resources. In this manuscript, overall epidemiologic pattern of cancers and their burden transition is reviewed. In addition, more concerning neoplasia (gastrointestinal, breast, thyroid, urologic, and respiratory system cancers) are reviewed in more details.
Published: 2020
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27. Household Food Insecurity and Health-related Quality of Life in an Urban Adult Population in Iran

Author: Bahareh Amirkalali, Ali Gholami, Mehran Shams-Beyranvand, Shohreh Naderimagham, Maryam Khazaee-Pool, Leila Moosavi Jahromi, Ali Asghar Heari Mehrizi, and Mohsen Asadi-Lari
Subjects: Food insecurity, Health related quality of life, 03 medical and health sciences, 0302 clinical medicine, Nutrition and Dietetics, 030503 health policy & services, Environmental health, Public Health, Environmental and Occupational Health, Adult population, 030212 general & internal medicine, 0305 other medical science, Psychology, Food Science
Abstract: Background: The relationship between food insecurity and mental and physical components of health-related quality of life (HRQOL) has been less addressed by healthcare professionals. Objective: We aimed to investigate the relationship between household food insecurity and mental and physical components of HRQOL in a large sample of urban people and to determine whether household food insecurity has a negative effect on mental and physical components of HRQOL. Methods: This cross-sectional study was conducted across twenty-two districts of Tehran (capital of Iran) during 2011. The participants were selected through multistage cluster random sampling. Two questionnaires were used to measure household food insecurity and HRQOL in the study population, while descriptive and inferential statistics were applied to test the relationships between these two parameters. Results: The mean age of the study population was 44.5 ± 15.5 years and most were female (64.8%). The results of this study indicated an independent relationship between household food insecurity and different subscales of HRQOL (P Conclusion: Food insecurity was associated with mental and physical components of HRQOL among urban participants and can be considered as a part of comprehensive interventions that target to improve general health.
Published: 2020
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28. Heterogeneous contributions of change in population distribution of body mass index to change in obesity and underweight

Author: Maryam Sharafkhah, Emanuel Zitt, Majid Ezzati, Luxia Zhang, Young-Ho Khang, Ellina Rakhimova, Kairit Mikkel, Tiina Vlasoff, Eruke E. Egbagbe, Sidsel Graff-Iversen, Ilona Nenko, Magdalena Klimek, Mathilde Savy, Sanjib Kumar Sharma, Alfonso Siani, Luís Lopes, Vanina Bongard, Gregor Jurak, Jacqueline F. Price, Christina-Paulina Lambrinou, Maria Lc Iurilli, Rainford J. Wilks, Bontha V. Babu, Fereidoun Azizi, Harunobu Nakamura, Marialaura Bonaccio, Angela Döring, Zhenyu Zhang, Naser Ahmadi, Jolanta Słowikowska-Hilczer, Ana Paula Carlos Cândido, Clive Osmond, Thirunavukkarasu Sathish, Robert J. Adams, Themistoklis Tzotzas, Reina Engle-Stone, Atul Trivedi, Shoichiro Tsugane, Niels Møller, Jorge Bezerra, Dénes Molnár, Muhammad Fadhli Mohd Yusoff, Badreya Al-Lahou, J. Jaime Miranda, Bahram Mohajer, Sigmund A. Anderssen, Lital Keinan Boker, Eero Kajantie, Martin Gulliford, Maties Torrent, Sumit Bharadwaj, Toshiharu Ninomiya, Zbigniew Gaciong, Nayu Ikeda, Li Juan Wu, Adrian Richter, Licia Iacoviello, Marc J. Gunter, Wenbin Wei, Norsyamlina Che Abdul Rahim, Eman Aly, Ambady Ramachandran, Nils Lehmann, Soile E. Puhakka, Giovanni Veronesi, Hongsheng Bi, Eiji Oda, Jia Li Duan, Per Tynelius, José María Huerta, Janne Schurmann Tolstrup, Rodrigo M. Carrillo-Larco, Rosangela Fernandes Lucena Batista, Victoria E Soto-Rojas, Hanno Ulmer, Shukri F. Mohamed, Anthony Kafatos, Suyeon Park, Mohsen Ibrahim, Hamed Pouraram, Bin Zhou, May Soe Aung, Lars Bo Andersen, Erfan Ghasemi, René Charles Sylva, Himanshu K. Chaturvedi, Luc Dauchet, Ahmad Ali Zainuddin, Angela Chetrit, Dan Zhu, Valérie Deschamps, Ko Ko Zaw, Peter Vollenweider, Tomas Vega, Yves Martin-Prével, Mahfuzar Rahman, Dorja Vočanec, Roman Topor-Madry, Vinay Nangia, Herculina S. Kruger, Asher Fawwad, Emily Sonestedt, Elena Pahomova, Aleksander Giwercman, Elżbieta Dziankowska-Zaborszczyk, Cecilia Björkelund, Tatjana Hejgaard, Maria Puiu, Maria Benedetta Donati, Andrew Wong, Carlos P. Boissonnet, Santosh K. Bhargava, Patrick Kolsteren, Dermot O'Reilly, Bahareh Kheiri, Wolfgang Kratzer, Susanne R. de Rooij, H. Bas Bueno-de-Mesquita, Günther Fink, José R. Banegas, Michele Monroy-Valle, Drude Molbo, Mahmudur Rahman, Hynek Pikhart, Rafael N. Pichardo, Massimo Salvetti, Hui Cai, Sarah Filippi, Georg Posch, Hung-Kwan So, Yonghua Hu, Katsuyasu Kouda, Joana Carvalho, Gailute Bernotiene, Hannu Uusitalo, Thein Thein Htay, Felix Kaducu, Maigeng Zhou, Lars Ängquist, Thi Tuyet-Hanh Tran, Charles Lunogelo, Michel Joffres, Sabina Zambon, Ronald D. Gregor, Vayia Rarra, Seyed Mohammad Hashemi-Shahri, Loreto Santa Marina, Galina Obreja, Rudolf Kaaks, Aya Mostafa, Maria do Carmo Franco, Beata Gurzkowska, Chien-Jen Chen, Marie Moitry, Nizal Sarrafzadegan, Xiangjun Wang, Diego Giulliano Destro Christofaro, Imperia Brajkovich, Fangfang Chen, Francesco Panza, Ling Yang, Holly E. Syddall, Cecily Kelleher, Michael Tornaritis, Ningli Wang, Lutgarde Thijs, Marjolein Visser, Angelika Schaffrath Rosario, María José Tormo, Jostein Steene-Johannessen, Norbert Amougou, Emmanuella Magriplis, Mar Alvarez-Pedrerol, Jingli Gao, Stig E. Bojesen, Giuseppe Grosso, Seongjun Ha, Lauren Lissner, Mikhail Benet, Anastasia Markaki, Sanjay Rampal, Antônio Augusto Moura da Silva, Maria Lorenza Muiesan, Angelique Chan, Yvonne T. van der Schouw, Annamari Lundqvist, Philippe Amouyel, Kristyna Zejglicova, Charalambos Hadjigeorgiou, João Breda, Jørgen Meisfjord, Fatima Zahra Laamiri, Carl Lachat, Kai-Uwe Saum, Vilma Irazola, Leng Huat Foo, Óscar Lopes, Dickman Gareta, Flavio Nervi, Imre Janszky, Ruzena Kubinova, Terho Lehtimäki, Mario V. Capanzana, Moyses Szklo, Ramfis Nieto-Martínez, Viswanathan Mohan, Shuohua Chen, Arvind Pandey, Luigi Palmieri, Roya Kelishadi, Srinivasan Kannan, Jie Mi, Robert Beaglehole, Liliana Dacica, Jyrki K. Virtanen, Mohan Deepa, Peter Ueda, Isti Ilmiati Fujiati, Hermann Pohlabeln, Morten Sodemann, Jytte Halkjær, Zbigniew Kułaga, Sophie Visvikis-Siest, Farshad Farzadfar, Mohsen Azimi-Nezhad, Henry Völzke, Karolina Milkowska, Zahra Mohammadi, Belgin Ünal, Magda Gasull, George S. Stergiou, Marshall K. Tulloch-Reid, Seppo Koskinen, James E. Bennett, Marcela González-Gross, Virginija Dulskiene, Idris Guessous, Assembekov Batyrbek, Kamarul Imran Musa, Jeannette Lee, Josep Redon, Bihungum Bista, Luisa M Macieira, Johan Sundström, Andres Metspalu, Lariane M Ono, Flora A. Ukoli, Salar Rahimikazerooni, Andrea Gualtieri, Trevor S. Ferguson, Félicité Tchibindat, Eliza Cinteza, Ha Tp Do, Tajana Zeljkovic Vrkic, Tuyen D Le, Alison J. Hayes, Abdul Basit, Chandini Nekkantti, Teresa Norat, Eunice Ugel, Gulmira Aitmurzaeva, Mariachiara Di Cesare, Abdul Hamid Zargar, Vincenzo Solfrizzi, Garry L. Jennings, Aline Meirhaeghe, Kaare Christensen, Päivi Mäki, Xu Lin, Ali Esmaeili, Joanna Baran, Aneta Grajda, Renata Cifkova, Alexandre C. Pereira, Martin Bobak, Iuliia A Rusakova, Keiu Nelis, Damian K Francis, Guansheng Ma, Axel C. Carlsson, Alejandro Diaz, Alireza Ansari-Moghaddam, N Capkova, Zumin Shi, Maria Turley, Imelda A. Agdeppa, Helena I. S. Nogueira, Marcia Scazufca, Katharina Maruszczak, Natascia Rinaldo, Paulo A. Lotufo, Nuno Lunet, Thor Aspelund, Caroline H.D. Fall, Antonio Cabrera de León, Ahmad Faudzi Yusoff, Holger Theobald, Beatriz D'Agord Schaan, Pedro Marques-Vidal, William A. Neal, Mihai Gafencu, Tandi E. Matsha, Ana B. Crujeiras, Ahmad Reza Dorosty, Alain Morejon, Weili Yan, Dominique Hange, Bekbolat Zholdin, Frédéric Gottrand, Jorge Mota, Jana Námešná, Stevo Popovic, Louise Eriksen, Line Lund Kårhus, Cihangir Erem, Juergen Breckenkamp, Mathilde Kersting, Yi Song, Martin McKee, Aleksandra Gomula, Rafaela Rosário, Enzo Manzato, S. Goya Wannamethee, Sounnia Mediene Benchekor, Azim Nejatizadeh, Krishna Kumar Aryal, Juan P. González-Rivas, Vedrana Sember, Stephen T. McGarvey, Jukka T. Salonen, Patrick Pasquet, Patricia Varona-Pérez, Amelia C. Crampin, Ramin Heshmat, Violeta Iotova, Juvenal Soares Dias-da-Costa, Oye Gureje, Aletta E. Schutte, João Luiz Bastos, Anelise Reis Gaya, Konrad Jamrozik, Dalia Luksiene, Amina Barkat, Maria Paula Santos, José Camolas, Azli Baharudin, Diego Vanuzzo, Doris Stöckl, Rosalynn Siantar, Jouko Saramies, Albertino Damasceno, Davood Khalili, Simona Bo, Martina Müller-Nurasyid, Dominique Cottel, Markku Peltonen, Fikru Tullu, Ana Isabel Rito, Angélica Ochoa-Avilés, Annette J. Dobson, Christopher T. Cowell, Charumathi Sabanayagam, Rildo de Souza Wanderley Júnior, Oanh T. H. Trinh, Farahnaz Joukar, Mostafa K. Mohamed, Mostafa Qorbani, Jeongseon Kim, Helmut Schröder, Machi Suka, Natasja M. van Schoor, Jussi Kauhanen, Teresa Haugsgjerd, Goodarz Danaei, M. Fernanda Lima-Costa, Yong Tao, Elisabetta L. Romeo, Grazyna Jasienska, Victor Guillermo Sequera, Kazem Mohammad, Yanina Zócalo, Fernanda Cunha Soares, Jianfeng Wu, Mohammad Esmaeel Motlagh, María Elena Díaz-Sánchez, Monika Zuziak, Eldridge Ferrer, Anette Varbo, Leila Beltrami Moreira, Jeremy M. Jacobs, Kenneth James, Elena Sacchini, Pascal Bovet, Mahboubeh Parsaeian, Tania Lopez, Ya Xing Wang, Wojciech Drygas, Jody C Miller, Svetlana A. Shalnova, Maria Elisa Zapata, Chung T Nguyen, Nimmathota Arlappa, Edwige Landais, Thorkild I. A. Sørensen, Jeannette Klimont, Amirabbas Momenan, Erik J. Timmermans, Mari-Liis Tammesoo, Jost B. Jonas, Stefania Toselli, Maria Teresa Anselmo Olinto, Bahman Cheraghian, Kouamelan Doua, Esteban Carmuega, Marjeta Mišigoj-Duraković, Bo Werner, M. Arfan Ikram, Breige A. McNulty, Christa Meisinger, Clara Homs, Namuna Shrestha, Alina Kerimkulova, Youcef Laid, Claes Ohlsson, Alicia Matijasevich, Alison J Price, Ala'a Alkerwi, Kristine H. Allin, Lorenza Pilotto, Mohannad Al Nsour, Ingunn Holden Bergh, Marianna Noale, Heba Fouad, Vilnis Dzerve, Novie O. Younger-Coleman, Peter Willeit, Andrea R. V. R. Horimoto, Freda Pitakaka, Habiba Ben Romdhane, Savvas C. Savva, Rajeev Gupta, Jennifer Servais, Cristina Padez, Sarah P. Garnett, Maria del Cristo Rodriguez-Perez, Michala Lustigová, Tien Yin Wong, Rosa Haghshenas, Jonathan Giovannelli, Christina Howitt, Marleen E. Hendriks, Fadia AlBuhairan, Huashuai Chen, Gretchen A Stevens, Luís B. Sardinha, David Goltzman, Jenny M. Kindblom, Karina Mary de Paiva, Yousef Khader, Eric Monterrubio-Flores, Rajendra Pradeepa, Yi-Ting Lin, Martin Neovius, Juan Francisco Miquel, Ellis Owusu-Dabo, Anil Poudyal, Marzieh Katibeh, Tanja Stocks, Veronica Mocanu, Ulla Roggenbuck, Robespierre Ribeiro, Gabriele Eiben, Mary Simon, Christine Cameron, Hamid Hakimi, Kamel Ajlouni, Jakub Stokwiszewski, Iulia Jurca Simina, Pietro Amedeo Modesti, Frederick C. W. Wu, Peter Kristensen, Charles Mondo, Felix Gutzwiller, Mariana Sbaraini, Martijn Huisman, Betina H. Thuesen, Queenie Chan, Antonisamy Belavendra, Artur Mazur, Ulf Ekelund, Laura A. Rodríguez-Villamizar, Marcos André Moura-dos-Santos, Jean Ferrières, Farhad Zamani, Shina Avi, Yves Kameli, Luis Paulo Gomes Mascarenhas, Aluísio J D Barros, Thomas Meinertz Dantoft, Hossein Poustchi, Farid Najafi, Giovanni de Gaetano, Azaliia M Tuliakova, Vera Lanska, Tint Swe Latt, Matthias Bopp, Abbas Rezaianzadeh, Rod Jackson, Johan Van der Heyden, Reecha Sofat, Koen Van Herck, Allan G. Hill, Con Burns, Emanuela Pettenuzzo, Ming-Dong Wang, Stela McLachlan, Ulrike Gehring, Ranko Stevanovic, Nagalla Balakrishna, Lekhraj Rampal, Marjolijn C. E. Bragt, Saeid Eslami, Napoleón Pérez-Farinós, G. K. Mini, Viktoria Anna Kovacs, Rosemarie Martin, Nahla Hwalla, Wei Zheng, Hoang Van Minh, Edward D Janus, Laetitia Huiart, Farhad Pourfarzi, Sudha Ramachandra Rao, Fred Paccaud, Marcia Makdisse, Aye Aye Sein, Enrique Gutiérrez-González, Yang Yang, Anneke Blokstra, Henrike Galenkamp, Jaume Marrugat, Nazan Yardim, Wan Nazaimoon Wan Mohamud, Jesús Ibarluzea, Julio Zuñiga Cisneros, Laura Lauria, Argyro Karakosta, Dragana P Jovic, Jun Hata, Elio Riboli, Piotr Bandosz, Xun Tang, Parvina Mukhtorova, Jean Dallongeville, Jean-Bernard Ruidavets, Anne Tjønneland, Guillermo Frontera, Rahul Malhotra, Thomas Ferrao, Aleksandra Piwońska, Dusan Grafnetter, Mette Rasmussen, Daniel Weghuber, Sherali Rakhmatulloev, Martine Vrijheid, Johann Willeit, Motahareh Kheradmand, Małgorzata Mossakowska, Lechaba Tshepo, Dongfeng Gu, Hyeon Chang Kim, Vilmundur Gudnason, Maria Forsner, Peter Bjerregaard, Leon A. Simons, Rachael McLean, Japhet Killewo, Ramón Suárez-Medina, Y Nikitin, Eng Joo Tan, Jean Claude Mbanya, Aroor Bhagyalaxmi, Renata Kuciene, Kairat Davletov, Jose Eugenio Lozano, Afshin Ostovar, Niloofar Peykari, Guy De Backer, Soheir H Ahmed, Nicholas J. Wareham, Sai Yin Ho, Constanta Huidumac Petrescu, Maria Hassapidou, Iris Pigeot, Myriam Galfo, Susana Cararo Confortin, Blanca Sandra Ruiz-Betancourt, W. M. Monique Verschuren, Catterina Ferreccio, Fabio Galvano, Leila Houti, Daniel Bia, Annika Rosengren, Marcin Rutkowski, Biruta Velika, Joana Araújo, Fernando Rigo, Angela Spinelli, Scott B. McLean, Shirin Djalalinia, Marie Kunešová, Boban Mugoša, Sania Nishtar, Mangesh S. Pednekar, Shahla AlDhukair, Helle-Mai Loit, Antonis Zampelas, Altan Onat, Maciej Banach, Shohreh Naderimagham, Hajer Aounallah-Skhiri, Maja Bæksgaard Jørgensen, Yin Guo, Ewelina Czenczek-Lewandowska, Parasmani Dasgupta, Elvis Oa Wambiya, Inge Huybrechts, Raimund Erbel, Jari Jokelainen, Ana P. Ortiz, Stefan Kiechl, Emmanuel Cohen, Caleb Ochimana, Shynar Abdrakhmanova, Laura Censi, Iqbal Bata, Geetha R Menon, Snehalatha Chamukuttan, Pedro Plans-Rubio, Domenico Palli, Ana Azevedo, Slawomir Koziel, Benoît Salanave, Parinaz Mehdipour, Shu Ti Chiou, Lela Sturua, Lubica Ticha, Felipe Vogt Cureau, Jin Soo Moon, Ming-Hui Zhao, Urho M. Kujala, Nathalie Michels, Ertugrul Celikcan, Jaakko Tuomilehto, Judith Benedics, Tobias F. Rinke de Wit, Agnès Le Port, Reza Homayounfar, Andrea Rodriguez-Martinez, Tai Hing Lam, Yn-Tz Sung, Jürgen König, Kodavanti Mallikharjuna Rao, Hazzaa M. Al-Hazzaa, Karen Morgan, Bogdan Wojtyniak, Cynthia M. Pérez, Ilse Khouw, Manoli Garcia-de-la-Hera, Dong Wook Shin, Genc Burazeri, Ausra Petrauskiene, Charles Sossa Jérome, Kenisha Russell Jonsson, José Boggia, Daniela Galeone, Alice Bonilla-Vargas, Han Cg Kemper, Rahman Shiri, Stefaan Demarest, Else Karin Grøholt, San-Lin You, Adelheid Weber, Juha Auvinen, Aida Pilav, Sibel Gogen, Suzanne N Morin, Wan Mohamad Wan Bebakar, Viviane Cunha Cardoso, Kavumpurathu Raman Thankappan, Hana Zamrazilová, Frank Claessens, Karien Stronks, Helen Gonçalves, Tahir Aris, Luis Revilla, Sérgio Viana Peixoto, Zhamilya Battakova, Jing Liu, Eliza Markidou Ioannidou, Leticia Hernandez Cadena, Priscilla Duboz, Sandjaja, Tiina Laatikainen, Rafel Ramos, Sareh Eghtesad, Judith Simons, Orn Olafsson, E. Shyong Tai, Louise A. Baur, Nihal Thomas, Aung Soe Htet, Bente Sparboe-Nilsen, Paul Elliott, Soon-Woo Park, Angel R. Gonzalez, Ying-Wei Wang, Rob M. van Dam, Ryutaro Ohtsuka, Ludmila Sevcikova, Suhaila Abdul Ghaffar, Lynell V Maniego, Fariborz Mansour-Ghanaei, Maria Dorobantu, Giovanni Viegi, Xiaoguang Yang, Honor Bixby, Prakash C. Gupta, Ofra Kalter-Leibovici, Eugene Sobngwi, Ričardas Radišauskas, Jurate Medzioniene, Roy A Wong-McClure, Kim F. Michaelsen, Antonia Trichopoulou, Tania Tello, Francesco Branca, Johanna Gunnlaugsdottir, Els Clays, Wei-Yen Lim, Suzanne C. Ho, Toomas Veidebaum, Rebecca Goldsmith, Margot González-León, Matthias Nauck, Alibek Mereke, Marta Buoncristiano, Jakob Tarp, Rosalba Rojas-Martínez, Maya Tanrygulyyeva, Reza Malekzadeh, Abdonas Tamosiunas, Dimitrios Poulimeneas, Pedro Ordunez, Isabelle Herter-Aeberli, Khanh Le Nguyen Bao, Anne Juolevi, Vassilis Zafiropulos, Emanuela Gualdi-Russo, Jordi Sunyer, Manu Raj, Chaoqiang Jiang, Sofia Malyutina, Efthymios Kapantais, Maria Lazo-Porras, Maung Maung Than Htike, Michael Hobbs, Ranjit Mohan Anjana, Merike Liivak, Johan G. Eriksson, Margarita Samoutian, Andreia N. Pizarro, Mohammed Rasoul Tarawneh, Jean Woo, Kaspar Staub, Maria Teresa Menzano, Mojtaba Farjam, Adroaldo Cesar Araujo Gaya, Mohammad El-khateeb, Zulfiqar A Bhutta, Mukharram M. Bikbov, Hsien-Ho Lin, Oscar Noboa, Thomas Waldhör, Garry Brian, Simona Costanzo, Frank Tanser, Nor Azwany Yaacob, Michelle Cilia, Ivo Rakovac, Bill Stavreski, Ioannis Pagkalos, Ivan Pećin, Carlo M. Barbagallo, Abla M. Sibai, Yuna He, Matsuda Fumihiko, Bharathi Viswanathan, Ali Reza Safarpour, Wei Cheng Lo, Abdullatif Husseini, Jiang He, Liv Elin Torheim, Nipa Rojroongwasinkul, Aicha Soumare, Astrid Petersmann, Tomasz Grodzicki, Davide Noto, Panayiotis K. Yiallouros, Kelias P. Msyamboza, William R. Tebar, Yingfeng Zheng, Eha Nurk, Bhawesh Koirala, Ana Jelakovic, Suhad Bahijri, Freja B Kampmann, Qi Sheng You, Marika Ferrari, María-Elena González-Villalpando, Aline Wagner, Olfa Saidi, Anwar Batieha, Eduardo Capuano, Coimbatore Subramaniam Shanthirani, Dong Wook Kim, Albina A Fakhretdinova, Tom Wilsgaard, Maria Avdicova, Moesijanti Soekatri, Chiara Donfrancesco, Salim Mohanna, Paola Russo, Uruwan Yamborisut, Rafael dos Santos Henrique, Martin Nankap, Allan Linneberg, Khairil Si-Ramlee, Kirsten Mehlig, Christina Mavrogianni, Raluca Pop, Lèlita Santos, Graziella Bruno, Valentina Peterkova, Iná S. Santos, Georg Lappas, Alberto Palloni, Malay K. Mridha, Andrzej Pajak, Marta García-Solano, Stefaan De Henauw, Daniel Ferrante, Rute Santos, Anders Grøntved, Lucjan Szponar, Mihaela Vladulescu, Chien-An Sun, Jan A. Staessen, Paula Duarte de Oliveira, Norazizah Ibrahim Wong, Maria Nordendahl, Elaine M. Dennison, Jeonghee Lee, Diego Salmerón, Ida Maria Schmidt, Gao Pei, Noushin Mohammadifard, Igor Spiroski, Fernando Rodríguez-Artalejo, Xu Ma, Elin Pettersen Sørgjerd, Valéria Regecová, Cláudia S. Minderico, Johanna A. Otero, Jamila Abubakar Garba, Vesselka Duleva, Rui Ornelas, Ilpo Huhtaniemi, Cesar G. Victora, Lijuan Liu, Rody G. Sy, Mahmood Moosazadeh, Ali Ahmadi, Antonio Pedro Graça, Natalia Nowak-Szczepanska, Miao Li Chee, Michael Sjöström, Charles Agyemang, Shiqi Zhen, Xiu-Hua Guo, Pawel Kurjata, Jardena J. Puder, Mehrdad Azmin, Neil Murphy, Kaosar Afsana, Alireza Sadjadi, Johanna M. Geleijnse, Prashant Mathur, Elysée Claude Bika Lele, Raphael Mendes Ritti-Dias, Yannis Manios, Majid Shirani, Rosemary B. Duda, Liis Nelis, Jurate Klumbiene, Zhengming Chen, Wichai Aekplakorn, Alun Evans, Andrzej Wiecek, Lars Lind, Denise Eldemire-Shearer, Bernardo L. Horta, Macia Enguerran, Seyed Rasoul Zakavi, Daniel Fernández-Bergés, Kumiko Ohara, Ursula Kiechl-Kohlendorfer, Hermann Brenner, Przemyslaw Slusarczyk, Espen Bjertness, Jutta Stieber, Augusto Di Castelnuovo, Joel G. R. Roy, Aryeh D. Stein, Ruth Frikke-Schmidt, Vera Musil, Amaneh Shayanrad, Marcel Goldberg, Ramon O. Jimenez, Mohammad Reza Fattahi, Jolanda Hyska, Amir Houshang Mehrparvar, Elin Kolle, Mohamed Bamoshmoosh, Michelle Holdsworth, Felipe F. Casanueva, Børge G. Nordestgaard, Niels Wedderkopp, Eva Corpeleijn, Elias F. Gudmundsson, Antonio Mistretta, Daniel Lemogoum, Larissa Pruner Marques, Slavica Sović, Olli T. Raitakari, Marco Aurélio Peres, Alexandra Cucu, Gregorio Varela-Moreiras, Janine Clarke, Andrea Gazzinelli, Mieczysław Litwin, Sara Schramm, Xenophon Theodoridis, Harshpal Singh Sachdev, Mohammad Reza Mirjalili, Dimitrios Papandreou, Peter T. Katzmarzyk, Benjamin Acosta-Cazares, Ben Schöttker, Prabhdeep Kaur, Norlaila Mustafa, Shariq Rashid Masoodi, Sadaf G. Sepanlou, Adolfo Rubinstein, Francis Delpeuch, Julianne Williams, Abbas Dehghan, Leanne M. Riley, Heloisa Bettiol, Gabriele Nagel, Ellisiv B. Mathiesen, Ekaterina Stoyanova, Alisha N. Wade, Zhamyila Usupova, Arnaud Chiolero, Oonagh Markey, Jacqueline Ramke, Elena Bogova, Niveen M E Abu-Rmeileh, Nguyen D Nguyen, Tomasz Zdrojewski, Marjo-Riitta Järvelin, Jose Sanchez-Abanto, Rômulo Araújo Fernandes, Lourdes Ribas-Barba, Nalan Uysal, Mohamad Hasnan Ahmad, Krista Fischer, Maria Wany Louzada Strufaldi, Ramiro Guerrero, Farnam Mohebi, Tran Quoc Bao, Flávio Danni Fuchs, Salim Berkinbayev, Enisa Kujundzic, Sari Voutilainen, Farzad Hadaegh, Robert Lundqvist, Saeid Safiri, Iraj Mohebbi, George Luiz Lins Machado-Coelho, Annette Peters, Gonzalo Valdivia, Magdalena Korzycka, Rajiv T Erasmus, Masanori Iwasaki, Charmaine A. Duante, Sheikh Mohammed Shariful Islam, Quang Ngoc La, Ricky Eddie, Petra Rust, Daniela Rodrigues, Dirk De Bacquer, Karen Sparrenberger, Agneta Sjöberg, Thet Thet Mu, Katarzyna Dereń, Cora L. Craig, Jorge Motta, Janina Petkeviciene, Boyd Swinburn, Paibul Suriyawongpaisal, Visnja Djordjic, Ramón Alberto Rascón-Pacheco, Pradeep Joshi, Daan Kromhout, Marius B. Bjertness, Stefano Marventano, Juel Jarani, Alireza Khosravi, Eva Martos, David De Ridder, Lizzy M. Brewster, Nico Dragano, Liam Smeeth, Kenji Shibuya, Emma Ruiz Moreno, Hashem Jaddou, Grzegorz Sobek, Dimitrios Trichopoulos, Marvin Cervantes-Loaiza, Abu Am Hanif, Elaine M. Murtagh, Carlos A. Aguilar-Salinas, Graziella D'Arrigo, Kyungwon Oh, Heiner Boeing, Regina Heidinger-Felso, André Luiz Sena Guimarães, Balkish M. Naidu, Avula Laxmaiah, Ana M. B. Menezes, Marie Eliasen, Francesco Pistelli, Yuan He, Dusko Bjelica, José A. Casajús, Guang Ning, Lutgart Braeckman, Dirk Vanderschueren, Jochanan Stessman, Ivana Radic, Yi Zeng, Hans Concin, Damaskini Valvi, Sari Hantunen, Catherine Kyobutungi, Diego Augusto Santos Silva, Wenhua Zhao, Sok King Ong, Anne W. Taylor, Iraj Nabipour, Justyna Godos, Cyrus Cooper, Mattias Johansson, Samuel C. Dumith, Magdalena Muc, Sabine Schipf, Idowu O Senbanjo, Jim Mann, Rajaa Al-Raddadi, Yih Chung Tham, Kay-Tee Khaw, Joseph Cacciottolo, Ana Henriques, Sahar Saeedi Moghaddam, Reza Mohammadpourhodki, Bernhard O. Boehm, Songhomitra Panda-Jonas, Iveta Pudule, Elisabete Ramos, Lacramioara Aurelia Brinduse, Paul H. Lee, Terence W O'Neill, Javad Aghazadeh-Attari, Margus Punab, Bojan Jelaković, Camilla T. Damsgaard, Takafumi Ishida, Ekaterina Chikova-Iscener, Mirjam M. Heinen, Tazeen H. Jafar, Semánová Csilla, Constance Schultsz, Santiago F. Gomez, Raija Korpelainen, Edward W. Gregg, Laura Gutierrez, Pierre Traissac, Victor M. Herrera, Aristides M. Machado-Rodrigues, Fatemeh Malekzadeh, Shouling Wu, Jennifer L. Baker, Clicerio González-Villalpando, Eleonora d'Orsi, Irene G. M. van Valkengoed, Anna Fijałkowska, Wen-Harn Pan, Gregor Starc, Meghnath Dhimal, Murat Topbaş, George Moschonis, Robert Eggertsen, Abdullah Alkandari, Quang Ngoc Nguyen, Janette Walton, Elnaz Faramarzi, Saeed Dastgiri, Lien Braeckevelt, Nasheeta Peer, Radka Taxová Braunerová, Mohamed M. Ali, Steiner Krokstad, Harald Geiger, Morteza Shamshirgaran, Lela Shengelia, María Ángeles Dal Re Saavedra, Silvana Donoso, Khem Bahadur Karki, Timothy J. Key, Maria G. Grammatikopoulou, Susana Vale, Felix K. Assah, Juan A Rivera, Peter H. Whincup, Oana-Florentina Gheorghe-Fronea, Cassiano Ricardo Rech, Paul Ferdinand M. Reganit, Rachakulla Hari Kumar, Jaakko Mursu, Luis A. Moreno, Glen Gironella, Jelena Kos, Tilema Cama, Haakon E. Meyer, Jun Ma, Raphael E. Arku, Ziad Abdeen, Dianna J. Magliano, Jitendra Jonnagaddala, Konstantinos Gkiouras, Paola Nardone, Alberto Barceló, Tomi-Pekka Tuomainen, Francesco Gianfagna, Stefania Maggi, Mohammad Hossein Somi, Behrooz Hamzeh, Miquel Porta, Vesna Jureša, Alexander D. Deev, David Faeh, Antonio Bernabe-Ortiz, Sirkka Keinänen-Kiukaanniemi, Ian Hambleton, Stefan Savin, Andre Pascal Kengne, R. Krishna Kumar, Kurt Widhalm, Marco M Ferrario, Parisa Amiri, Anjani Kumar Jha, Thamara Hubler Figueiró, Jana Kratenova, Claudia M. Hormiga, Maria Tsigga, Zivka Dika, Indrapal I. Meshram, Ei Ei K. Nang, Ian Rouse, Rusidah Selamat, Paul Korrovits, Grethe S. Tell, Julie Taylor, Anabela Mota-Pinto, Paolo Vineis, Kotsedi D Monyeki, Khuong Quynh Long, Frank J Rühli, Shelly R. McFarlane, Sara Santos Sanz, Edyta Łuszczki, Maria G. Stathopoulou, Tara Coppinger, Karin De Ridder, Lucie Viet, Anna Bugge, Mehdi Yaseri, Safiah Md Yusof, Sandra C. Fuchs, Muhammad Islam, Irfan Nuhoglu, Rui Providência, Bernard Maire, Leandra Abarca-Gómez, Sinead Brophy, Maria Ruiz-Castell, Daniela Pierannunzio, Cristina Taddei, Gowri Mahasampath, Gustavo Velasquez-Melendez, Hanna Tolonen, Sudhir Kowlessur, Bagher Larijani, Laura Torres-Collado, Susi Kriemler, Ali Akbar Shayesteh, Cynthia Robitaille, Jorge Escobedo-de la Peña, Yufang Bi, Chinh Nguyen Huu, Line Tang Møllehave, Vincent Jr DeGennaro, Noor Ani Ahmad, Anar Dushpanova, Agustinus Soemantri, Susana Sans, Ionela Pascanu, Gwenaëlle Le Coroller, Inger Ariansen, Kodanda R Kanala, Gert B. M. Mensink, Abhijit Sen, Sergej M. Ostojic, Hanan F. Abdul Rahim, Hélène Delisle, Francisco J. Félix-Redondo, Yadlapalli S. Kusuma, Michael Knoflach, Moein Yoosefi, Tanja G. M. Vrijkotte, Wolfgang Ahrens, Osvaldo Santos, Bethlehem D. Solomon, Erik Lykke Mortensen, Nikhil D. Patel, Reynaldo Martorell, Ching-Yu Cheng, Stine Schramm, Hana Shimizu-Furusawa, Jacek Jóźwiak, Radwan Qasrawi, Herman Borghs, Zhanna Kalmatayeva, Heidi Klakk, Akram Pourshams, Naomi S. Levitt, Son Thai Pham, Simona Giampaoli, Dong Zhao, Indah Suci Widyahening, Merete Osler, Paula Margozzini, Silvia Bel-Serrat, Dora Romaguera, Monira Alarouj, Winsome R. Parnell, Marloes Cardol, Giota Touloumi, Janice Luisa Lukrafka, Adela Chirita-Emandi, Maryam Kavousi, Sanja Musić Milanović, Jean-Michel Gaspoz, Jalila El Ati, Sauli Herrala, Liang Xu, Pilar Guallar-Castillón, Bee Koon Poh, Luis Serra-Majem, Jonathan E. Shaw, Belong Cho, Daphne Mirkopoulou, Salvador Villalpando, Yuki Fujita, Tiffany K. Gill, Nish Chaturvedi, Erkin M. Mirrakhimov, Günay Can, Mark Woodward, Esther Lopez-Garcia, Mauro Virgílio Gomes de Barros, Ahmed A. Madar, Shoaib Afzal, Melanie J. Cowan, Gareth Stratton, Eduardo Salazar Martinez, Sameer Narake, Norie Sawada, Deepak Amarapurkar, Deepa Weerasekera, Diana A. Santos, Marjeta Majer, Herman Schargrodsky, Bruna Gonçalves Cordeiro da Silva, Ebrahim Eftekhar, Jesús Vioque, Marisa K. Sophiea, Teresa Shamah-Levy, María Dolores Chirlaque, Mohd Azahadi Omar, Stefan Söderberg, Isabel O. Oliveira, Joanne Katz, Xingwang Ye, Christophe Tzourio, Marie Zins, Aneta Weres, Ulrich Keil, Haiquan Xu, Akihiro Yoshihara, Rachel Dankner, Gabriella Gruden, Maroje Sorić, Hanspeter Stamm, Kim Overvad, Yanping Li, Carsten Oliver Schmidt, Christa L. Lilly, Veikko Salomaa, Gilad Twig, Senthil K Vasan, Qian Wang, Liufu Cui, Andrzej Galbarczyk, Sylvain Sebert, Wilma M. Hopman, Karl-Heinz Jöckel, Ari Voutilainen, Peter Schnohr, Jerzy Chudek, Katia Vergetti Bloch, Vincenzo Capuano, Jyh Eiin Wong, Torben Jørgensen, Anja Schienkiewitz, Nader Saki, Carolina Tarqui-Mamani, Maria Cecília Formoso Assunção, Kazi M. Jamil, Juraci Almeida Cesar, Pedro J Ortiz, Delphine De Smedt, Luciana Zaccagni, Lynne M. Boddy, Jie Hao, David Alejandro González-Chica, Romana Roccaldo, Sara Magnacca, Peter Stehle, Victoria Farrugia Sant'Angelo, Gry Skodje, Maryam Keramati, Tabara Yasuharu, Ali Ghanbari, Gyulli M. Kazakbaeva, Takuro Furusawa, Felicia Cañete, Kari Kuulasmaa, Justina Vaitkeviciute, (NCD-RisC), NCD Risk Factor Collaboration, Imperial College London, Harvard T.H. Chan School of Public Health, Middlesex University [London], Organisation Mondiale de la Santé / World Health Organization Office (OMS / WHO), Montpellier Interdisciplinary center on Sustainable Agri-food systems (Social and nutritional sciences) (UMR MoISA), Centre de Coopération Internationale en Recherche Agronomique pour le Développement (Cirad)-Institut de Recherche pour le Développement (IRD)-Centre International de Hautes Etudes Agronomiques Méditerranéennes - Institut Agronomique Méditerranéen de Montpellier (CIHEAM-IAMM), Centre International de Hautes Études Agronomiques Méditerranéennes (CIHEAM)-Centre International de Hautes Études Agronomiques Méditerranéennes (CIHEAM)-Institut national d’études supérieures agronomiques de Montpellier (Montpellier SupAgro), Institut national d'enseignement supérieur pour l'agriculture, l'alimentation et l'environnement (Institut Agro)-Institut national d'enseignement supérieur pour l'agriculture, l'alimentation et l'environnement (Institut 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Chiara Donfrancesco , Silvana P Donoso , Angela Döring , Maria Dorobantu , Ahmad Reza Dorosty , Kouamelan Doua , Nico Dragano , Wojciech Drygas , Jia Li Duan , Charmaine A Duante , Priscilla Duboz , Rosemary B Duda , Vesselka Duleva , Virginija Dulskiene , Samuel C Dumith , Anar Dushpanova , Vilnis Dzerve , Elzbieta Dziankowska-Zaborszczyk , Ricky Eddie , Ebrahim Eftekhar , Eruke E Egbagbe , Robert Eggertsen , Sareh Eghtesad , Gabriele Eiben , Ulf Ekelund , Mohammad El-Khateeb , Jalila El Ati , Denise Eldemire-Shearer , Marie Eliasen , Paul Elliott , Reina Engle-Stone , Macia Enguerran , Rajiv T Erasmus , Raimund Erbel , Cihangir Erem , Louise Eriksen , Johan G Eriksson , Jorge Escobedo-de la Peña , Saeid Eslami , Ali Esmaeili , Alun Evans , David Faeh , Albina A Fakhretdinova , Caroline H Fall , Elnaz Faramarzi , Mojtaba Farjam , Victoria Farrugia Sant'Angelo , Farshad Farzadfar , Mohammad Reza Fattahi , Asher Fawwad , Francisco J Felix-Redondo , Trevor S Ferguson , Romulo A Fernandes , Daniel Fernández-Bergés , Daniel Ferrante , Thomas Ferrao , Marika Ferrari , Marco M Ferrario , Catterina Ferreccio , Eldridge Ferrer , Jean Ferrieres , Thamara Hubler Figueiró , Anna Fijalkowska , Günther Fink , Krista Fischer , Leng Huat Foo , Maria Forsner , Heba M Fouad , Damian K Francis , Maria do Carmo Franco , Ruth Frikke-Schmidt , Guillermo Frontera , Flavio D Fuchs , Sandra C Fuchs , Isti I Fujiati , Yuki Fujita , Matsuda Fumihiko , Takuro Furusawa , Zbigniew Gaciong , Mihai Gafencu , Andrzej Galbarczyk , Henrike Galenkamp , Daniela Galeone , Myriam Galfo , Fabio Galvano , Jingli Gao , Manoli Garcia-de-la-Hera , Marta García-Solano , Dickman Gareta , Sarah P Garnett , Jean-Michel Gaspoz , Magda Gasull , Adroaldo Cesar Araujo Gaya , Anelise Reis Gaya , Andrea Gazzinelli , Ulrike Gehring , Harald Geiger , Johanna M Geleijnse , Ali Ghanbari , Erfan Ghasemi , Oana-Florentina Gheorghe-Fronea , Simona Giampaoli , Francesco Gianfagna , Tiffany K Gill , Jonathan Giovannelli , Glen 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, Zhanna Kalmatayeva , Ofra Kalter-Leibovici , Yves Kameli , Freja B Kampmann , Kodanda R Kanala , Srinivasan Kannan , Efthymios Kapantais , Argyro Karakosta , Line L Kårhus , Khem B Karki , Marzieh Katibeh , Joanne Katz , Peter T Katzmarzyk , Jussi Kauhanen , Prabhdeep Kaur , Maryam Kavousi , Gyulli M Kazakbaeva , Ulrich Keil , Lital Keinan Boker , Sirkka Keinänen-Kiukaanniemi , Roya Kelishadi , Cecily Kelleher , Han Cg Kemper , Andre P Kengne , Maryam Keramati , Alina Kerimkulova , Mathilde Kersting , Timothy Key , Yousef Saleh Khader , Davood Khalili , Kay-Tee Khaw , Bahareh Kheiri , Motahareh Kheradmand , Alireza Khosravi , Ilse Msl Khouw , Ursula Kiechl-Kohlendorfer , Stefan Kiechl , Japhet Killewo , Dong Wook Kim , Hyeon Chang Kim , Jeongseon Kim , Jenny M Kindblom , Heidi Klakk , Magdalena Klimek , Jeannette Klimont , Jurate Klumbiene , Michael Knoflach , Bhawesh Koirala , Elin Kolle , Patrick Kolsteren , Jürgen König , Raija Korpelainen , Paul Korrovits , Magdalena Korzycka , 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, Luxia Zhang , Zhen-Yu Zhang , Dong Zhao , Ming-Hui Zhao , Wenhua Zhao , Shiqi Zhen , Wei Zheng , Yingfeng Zheng , Bekbolat Zholdin , Maigeng Zhou , Dan Zhu , Marie Zins , Emanuel Zitt , Yanina Zocalo , Julio Zuñiga Cisneros , Monika Zuziak , Majid Ezzati , Sarah Filippi, Epidemiology, Iurilli, Maria LC, Zhou, Bin, Bennett, James E, Carrillo-Larco, Rodrigo M, Sophiea, Marisa K, Rodriguez-Martinez, Andrea, Bixby, Honor, Solomon, Bethlehem D, Taddei, Cristina, Danaei, Goodarz, Di Cesare, Mariachiara, Stevens, Gretchen A, Riley, Leanne M, Savin, Stefan, Cowan, Melanie J, Bovet, Pascal, Damasceno, Albertino, Chirita-Emandi, Adela, Hayes, Alison J, Ikeda, Nayu, Jackson, Rod T, Khang, Young-Ho, Laxmaiah, Avula, Liu, Jing, Miranda, J Jaime, Saidi, Olfa, Sebert, Sylvain, Sorić, Maroje, Starc, Gregor, Gregg, Edward W, Abarca-Gómez, Leandra, Abdeen, Ziad A, Abdrakhmanova, Shynar, Ghaffar, Suhaila Abdul, Rahim, Hanan F Abdul, Abu-Rmeileh, Niveen M, Garba, Jamila Abubakar, Acosta-Cazares, 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Cynthia, Roccaldo, Romana, Rodrigues, Daniela, Rodríguez-Artalejo, Fernando, del Cristo Rodriguez-Perez, María, Rodríguez-Villamizar, Laura A, Roggenbuck, Ulla, Rojas-Martinez, Rosalba, Rojroongwasinkul, Nipa, Romaguera, Dora, Romeo, Elisabetta L, Rosario, Rafaela V, Rosengren, Annika, Rouse, Ian, Roy, Joel GR, Rubinstein, Adolfo, Rühli, Frank J, Ruidavets, Jean-Bernard, Ruiz-Betancourt, Blanca Sandra, Ruiz-Castell, Maria, Moreno, Emma Ruiz, Rusakova, Iuliia A, Jonsson, Kenisha Russell, Russo, Paola, Rust, Petra, Rutkowski, Marcin, Sabanayagam, Charumathi, Sacchini, Elena, Sachdev, Harshpal S, Sadjadi, Alireza, Safarpour, Ali Reza, Safiri, Saeid, Saki, Nader, Salanave, Benoit, Martinez, Eduardo Salazar, Salmerón, Diego, Salomaa, Veikko, Salonen, Jukka T, Salvetti, Massimo, Samoutian, Margarita, Sánchez-Abanto, Jose, Sandjaja, null, Sans, Susana, Marina, Loreto Santa, Santos, Diana A, Santos, Ina S, Santos, Lèlita C, Santos, Maria Paula, Santos, Osvaldo, Santos, Rute, Sanz, Sara Santo, Saramies, Jouko L, Sardinha, Luis B, Sarrafzadegan, Nizal, Sathish, Thirunavukkarasu, Saum, Kai-Uwe, Savva, Savva, Savy, Mathilde, Sawada, Norie, Sbaraini, Mariana, Scazufca, Marcia, Schaan, Beatriz D, Rosario, Angelika Schaffrath, Schargrodsky, Herman, Schienkiewitz, Anja, Schipf, Sabine, Schmidt, Carsten O, Schmidt, Ida Maria, Schnohr, Peter, Schöttker, Ben, Schramm, Sara, Schramm, Stine, Schröder, Helmut, Schultsz, Constance, Schutte, Aletta E, Sein, Aye Aye, Selamat, Rusidah, Sember, Vedrana, Sen, Abhijit, Senbanjo, Idowu O, Sepanlou, Sadaf G, Sequera, Victor, Serra-Majem, Lui, Servais, Jennifer, Ševcíková, Ludmila, Shalnova, Svetlana A, Shamah-Levy, Teresa, Shamshirgaran, Morteza, Shanthirani, Coimbatore Subramaniam, Sharafkhah, Maryam, Sharma, Sanjib K, Shaw, Jonathan E, Shayanrad, Amaneh, Shayesteh, Ali Akbar, Shengelia, Lela, Shi, Zumin, Shibuya, Kenji, Shimizu-Furusawa, Hana, Shin, Dong Wook, Shirani, Majid, Shiri, Rahman, Shrestha, Namuna, Si-Ramlee, Khairil, Siani, Alfonso, Siantar, Rosalynn, Sibai, Abla M, Silva, Antonio M, Silva, Diego Augusto Santo, Simon, Mary, Simons, Judith, Simons, Leon A, Sjöberg, Agneta, Sjöström, Michael, Skodje, Gry, Slowikowska-Hilczer, Jolanta, Slusarczyk, Przemyslaw, Smeeth, Liam, So, Hung-Kwan, Soares, Fernanda Cunha, Sobek, Grzegorz, Sobngwi, Eugène, Sodemann, Morten, Söderberg, Stefan, Soekatri, Moesijanti YE, Soemantri, Agustinu, Sofat, Reecha, Solfrizzi, Vincenzo, Somi, Mohammad Hossein, Sonestedt, Emily, Song, Yi, Sørensen, Thorkild IA, Sørgjerd, Elin P, Jérome, Charles Sossa, Soto-Rojas, Victoria E, Soumaré, Aïcha, Sovic, Slavica, Sparboe-Nilsen, Bente, Sparrenberger, Karen, Spinelli, Angela, Spiroski, Igor, Staessen, Jan A, Stamm, Hanspeter, Stathopoulou, Maria G, Staub, Kaspar, Stavreski, Bill, Steene-Johannessen, Jostein, Stehle, Peter, Stein, Aryeh D, Stergiou, George S, Stessman, Jochanan, Stevanovic, Ranko, Stieber, Jutta, Stöckl, Dori, Stocks, Tanja, Stokwiszewski, Jakub, Stoyanova, Ekaterina, Stratton, Gareth, Stronks, Karien, Strufaldi, Maria Wany, Sturua, Lela, Suárez-Medina, Ramón, Suka, Machi, Sun, Chien-An, Sundström, Johan, Sung, Yn-Tz, Sunyer, Jordi, Suriyawongpaisal, Paibul, Swinburn, Boyd A, Sy, Rody G, Syddall, Holly E, Sylva, René Charle, Szklo, Moyse, Szponar, Lucjan, Tai, E Shyong, Tammesoo, Mari-Lii, Tamosiunas, Abdona, Tan, Eng Joo, Tang, Xun, Tanrygulyyeva, Maya, Tanser, Frank, Tao, Yong, Tarawneh, Mohammed Rasoul, Tarp, Jakob, Tarqui-Mamani, Carolina B, Braunerová, Radka Taxová, Taylor, Anne, Taylor, Julie, Tchibindat, Félicité, Tebar, William R, Tell, Grethe S, Tello, Tania, Tham, Yih Chung, Thankappan, KR, Theobald, Holger, Theodoridis, Xenophon, Thijs, Lutgarde, Thomas, Nihal, Thuesen, Betina H, Tichá, Lubica, Timmermans, Erik J, Tjonneland, Anne, Tolonen, Hanna K, Tolstrup, Janne S, Topbas, Murat, Topór-Madry, Roman, Torheim, Liv Elin, Tormo, María José, Tornaritis, Michael J, Torrent, Matie, Torres-Collado, Laura, Toselli, Stefania, Touloumi, Giota, Traissac, Pierre, Tran, Thi Tuyet-Hanh, Trichopoulos, Dimitrio, Trichopoulou, Antonia, Trinh, Oanh TH, Trivedi, Atul, Tshepo, Lechaba, Tsigga, Maria, Tsugane, Shoichiro, Tuliakova, Azaliia M, Tulloch-Reid, Marshall K, Tullu, Fikru, Tuomainen, Tomi-Pekka, Tuomilehto, Jaakko, Turley, Maria L, Twig, Gilad, Tynelius, Per, Tzotzas, Themistokli, Tzourio, Christophe, Ueda, Peter, Ugel, Eunice, Ukoli, Flora AM, Ulmer, Hanno, Unal, Belgin, Usupova, Zhamyila, Uusitalo, Hannu MT, Uysal, Nalan, Vaitkeviciute, Justina, Valdivia, Gonzalo, Vale, Susana, Valvi, Damaskini, van Dam, Rob M, Van der Heyden, Johan, van der Schouw, Yvonne T, Van Herck, Koen, Van Minh, Hoang, Van Schoor, Natasja M, van Valkengoed, Irene GM, Vanderschueren, Dirk, Vanuzzo, Diego, Varbo, Anette, Varela-Moreiras, Gregorio, Varona-Pérez, Patricia, Vasan, Senthil K, Vega, Toma, Veidebaum, Tooma, Velasquez-Melendez, Gustavo, Velika, Biruta, Veronesi, Giovanni, Verschuren, WM Monique, Victora, Cesar G, Viegi, Giovanni, Viet, Lucie, Villalpando, Salvador, Vineis, Paolo, Vioque, Jesu, Virtanen, Jyrki K, Visser, Marjolein, Visvikis-Siest, Sophie, Viswanathan, Bharathi, Vladulescu, Mihaela, Vlasoff, Tiina, Vocanec, Dorja, Vollenweider, Peter, Völzke, Henry, Voutilainen, Ari, Voutilainen, Sari, Vrijheid, Martine, Vrijkotte, Tanja GM, Wade, Alisha N, Wagner, Aline, Waldhör, Thoma, Walton, Janette, Wambiya, Elvis OA, Bebakar, Wan Mohamad Wan, Mohamud, Wan Nazaimoon Wan, de Souza Wanderley Júnior, Rildo, Wang, Ming-Dong, Wang, Ningli, Wang, Qian, Wang, Xiangjun, Wang, Ya Xing, Wang, Ying-Wei, Wannamethee, S Goya, Wareham, Nichola, Weber, Adelheid, Wedderkopp, Niel, Weerasekera, Deepa, Weghuber, Daniel, Wei, Wenbin, Weres, Aneta, Werner, Bo, Whincup, Peter H, Widhalm, Kurt, Widyahening, Indah S, Wiecek, Andrzej, Wilks, Rainford J, Willeit, Johann, Willeit, Peter, Williams, Julianne, Wilsgaard, Tom, Wojtyniak, Bogdan, Wong-McClure, Roy A, Wong, Andrew, Wong, Jyh Eiin, Wong, Tien Yin, Woo, Jean, Woodward, Mark, Wu, Frederick C, Wu, Jianfeng, Wu, Li Juan, Wu, Shouling, Xu, Haiquan, Xu, Liang, Yaacob, Nor Azwany, Yamborisut, Uruwan, Yan, Weili, Yang, Ling, Yang, Xiaoguang, Yang, Yang, Yardim, Nazan, Yaseri, Mehdi, Yasuharu, Tabara, Ye, Xingwang, Yiallouros, Panayiotis K, Yoosefi, Moein, Yoshihara, Akihiro, You, Qi Sheng, You, San-Lin, Younger-Coleman, Novie O, Md Yusof, Safiah, Yusoff, Ahmad Faudzi, Zaccagni, Luciana, Zafiropulos, Vassili, Zainuddin, Ahmad A, Zakavi, Seyed Rasoul, Zamani, Farhad, Zambon, Sabina, Zampelas, Antoni, Zamrazilová, Hana, Zapata, Maria Elisa, Zargar, Abdul Hamid, Ko Zaw, Ko, Zdrojewski, Tomasz, Zejglicova, Kristyna, Vrkic, Tajana Zeljkovic, Zeng, Yi, Zhang, Luxia, Zhang, Zhen-Yu, Zhao, Dong, Zhao, Ming-Hui, Zhao, Wenhua, Zhen, Shiqi, Zheng, Wei, Zheng, Yingfeng, Zholdin, Bekbolat, Zhou, Maigeng, Zhu, Dan, Zins, Marie, Zitt, Emanuel, Zocalo, Yanina, Cisneros, Julio Zuñiga, Zuziak, Monika, Ezzati, Majid, Filippi, Sarah, Cohortes épidémiologiques en population (CONSTANCES), Université de Versailles Saint-Quentin-en-Yvelines (UVSQ)-Institut National de la Santé et de la Recherche Médicale (INSERM)-Université Paris-Saclay-Université Paris Cité (UPCité), Université Paris Cité (UPCité), Centre International de Hautes Études Agronomiques Méditerranéennes (CIHEAM)-Centre International de Hautes Études Agronomiques Méditerranéennes (CIHEAM)-Institut National de Recherche pour l’Agriculture, l’Alimentation et l’Environnement (INRAE)-Institut Agro - Montpellier SupAgro, and Institut national d'enseignement supérieur pour l'agriculture, l'alimentation et l'environnement (Institut Agro)-Institut national d'enseignement supérieur pour l'agriculture, l'alimentation et l'environnement (Institut Agro)
Subjects: Population -- Health aspects, Leanness, Baixo peso/Underweight, none, Double burden, alipainoisuus, tulotaso, global health, systematic analysis, Sedentary behaviors, RC1200, Prospective associations, 0302 clinical medicine, underweight, nälänhätä, Biology (General), skin and connective tissue diseases, Children, ComputingMilieux_MISCELLANEOUS, Body mass index, Human Nutrition & Health, education.field_of_study, Humane Voeding & Gezondheid, ylipaino, General Medicine, kansainvälinen vertailu, 3. Good health, World health, Medicine, A100 Pre-clinical Medicine, Population distribution, medicine.medical_specialty, QH301-705.5, Science, Socio-culturale, Nursing, Social sciences, General Biochemistry, Genetics and Molecular Biology, 03 medical and health sciences, Thinness, SDG 3 - Good Health and Well-being, BMI, epidemiology, obesity, None, Humans, Obesidade/Obesity, SDG 2 - Zero Hunger, education, VLAG, US adults, Omvårdnad, body mass index, malnutrition, obesity, underweight, nutritional and metabolic diseases, medicine.disease, terveellisyys, Obesity, Faculdade de Ciências Sociais, Body Mass Index, Prevalence, Risk Factors, General Biochemistry, WIAS, lihavuus, RA, Demography, N.A, double burden, Settore MED/09 - Medicina Interna, alueelliset erot, Nutrition and Disease, Animal Nutrition, [SDV]Life Sciences [q-bio], Medizin, 030204 cardiovascular system & hematology, 0601 Biochemistry and Cell Biology, Change distribution of body mass index, RA0421, Voeding en Ziekte, Epidemiology, Medicine and Health Sciences, Global health, Índice de massa corporal/Body Mass Index, 030212 general & internal medicine, Underweight, painoindeksi, 2. Zero hunger, General Neuroscience, aliravitsemus, elintarvikkeet, health, Public Health, Global Health, Social Medicine and Epidemiology, Diervoeding, 3142 Public health care science, environmental and occupational health, purl.org/pe-repo/ocde/ford#3.01.03 [https], Chinese adults, pooled analysis, medicine.symptom, Diet quality, B120 Physiology, Research Article, trends, purl.org/pe-repo/ocde/ford#1.06.03 [https], prevalence, Population, Mothers, Genetics and Molecular Biology, 3121 Internal medicine, medicine, Life Science, ddc:610, 3125 Otorhinolaryngology, ophthalmology, kehonkoostumus, Nutrition, Australian adults, General Immunology and Microbiology, purl.org/pe-repo/ocde/ford#3.01.04 [https], Ciências sociais, Folkhälsovetenskap, global hälsa, socialmedicin och epidemiologi, Malnutrition, Epidemiology and Global Health, sense organs, Estilos de Vida e Impacto na Saúde
Abstract: From 1985 to 2016, the prevalence of underweight decreased, and that of obesity and severe obesity increased, in most regions, with significant variation in the magnitude of these changes across regions. We investigated how much change in mean body mass index (BMI) explains changes in the prevalence of underweight, obesity, and severe obesity in different regions using data from 2896 population-based studies with 187 million participants. Changes in the prevalence of underweight and total obesity, and to a lesser extent severe obesity, are largely driven by shifts in the distribution of BMI, with smaller contributions from changes in the shape of the distribution. In East and Southeast Asia and sub-Saharan Africa, the underweight tail of the BMI distribution was left behind as the distribution shifted. There is a need for policies that address all forms of malnutrition by making healthy foods accessible and affordable, while restricting unhealthy foods through fiscal and regulatory restrictions., Wellcome Trust, Medical Research Council, peer-reviewed
Published: 2021
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29. Assessing the effect of socioeconomic factors on prevalence of dyslipidemia among iranian adult population; district level analysis from 2016 STEPS national study using small area estimation

Author: Hamidreza Soleimani, Erfan Ghasemi, Sahar Saeedi Moghaddam, Sina Azadnajafabad, Negar Rezaei, Masoud Masinaei, Shohreh Naderimagham, Nazila Rezaei, Mohammad-Reza Malekpour, Mohammad Keykhaei, Fateme Gorgani, Ameneh Kazemi, Saba Tahmasebi, Rashed Makhdoom, and Farshad Farzadfar
Subjects: Endocrinology, Diabetes and Metabolism, Internal Medicine, Research Article
Abstract: BACKGROUND: Atherosclerotic Cardiovascular Disease (CVD) is the leading cause of death globally and dyslipidemia plays a critical role in the development of this condition. This study aimed to analyze the potential impact of socioeconomic factors on the prevalence of dyslipidemia at district level in Iran. Understanding these factors is important for development of future risk factor control programs. METHODS: We used the nationwide Iran STEPwise approach to risk factor Surveillance (STEPS) 2016 survey as a representative dataset on the Non-Communicable Diseases (NCDs) risk factors in Iran. To obtain a district level dyslipidemia estimates, we utilized the small area estimation method with a Bayesian spatial hierarchical multilevel regression and multilevel mixed models. The principal component analysis was applied to derive household wealth index. For evaluation of education, successful years of schooling was calculated at district level. Urbanization ratio was defined as the proportion of residents in the urban area to the urban and rural areas for each district. RESULTS: The highest difference was found for hypercholesterolemia coverage with 9.11 times difference among the lowest and highest prevalence across the country’s district for males. Men with lower income, lower urbanization, and lower education levels had lower values of high-density lipoprotein (HDL) cholesterol, and higher level of hypercholesterolemia, and hypertriglyceridemia (P-value
Published: 2021

30. Is salt intake reduction a universal intervention for both normotensive and hypertensive people: a case from Iran STEPS survey 2016

Author: Negar Mahmoudi, Ali Gholami, Ahmad Kousha, Hamid Reza Baradaran, Mitra Modirian, Shohreh Naderimagham, Zohreh Mahmoudi, Leila Moosavi Jahromi, Ali Ghanbari, Mohammad Javad Hajipour, Nazila Rezaei, Farshad Farzadfar, Shirin Djalalinia, Shahabeddin Rezaei, and Siamak Mirab Samiee
Subjects: 0301 basic medicine, education.field_of_study, 030109 nutrition & dietetics, Nutrition and Dietetics, business.industry, Population, Medicine (miscellaneous), Physiology, 030209 endocrinology & metabolism, Multiple linear regression model, Spot urine sample, 03 medical and health sciences, 0302 clinical medicine, Blood pressure, Quartile, Medicine, Salt intake, business, Urine sample, education
Abstract: There is a direct association between salt intake and blood pressure (BP), one of the main risk factors for CVDs. However, yet there has been a debate that how strong is this association in people with and without hypertension. This study was conducted to evaluate the magnitude of the association between salt intake and BP in hypertensive and normotensive population among a nationally representative population. The study was conducted on a nationally representative sample of 18,635 Iranian adults aged 25 years and older who participated in the STEPS survey 2016 and provided urine sample. Salt intake was estimated through spot urine sample and Tanaka equation. Multiple linear regression model in survey data analysis was used to assess the independent effect of salt intake on BP. After adjusting for covariates, there was a significant association between salt intake and SBP in hypertensive (p
Published: 2019
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31. Patterns of tobacco use in low and middle income countries by tobacco product and sociodemographic characteristics: nationally representative survey data from 82 countries

Author: Michaela Theilmann, Julia M Lemp, Volker Winkler, Jennifer Manne-Goehler, Maja E Marcus, Charlotte Probst, William A Lopez-Arboleda, Cara Ebert, Christian Bommer, Maya Mathur, Glennis Andall-Brereton, Silver K Bahendeka, Pascal Bovet, Farshad Farzadfar, Erfan Ghasemi, Mary T Mayige, Sahar Saeedi Moghaddam, Kibachio J Mwangi, Shohreh Naderimagham, Lela Sturua, Rifat Atun, Justine I Davies, Till Bärnighausen, Sebastian Vollmer, and Pascal Geldsetzer
Subjects: Male, Cross-Sectional Studies, Tobacco, Smokeless, Tobacco, Prevalence, Humans, Tobacco Products, General Medicine, Developing Countries
Abstract: ObjectivesTo determine the prevalence and frequency of using any tobacco product and each of a detailed set of tobacco products, how tobacco use and frequency of use vary across countries, world regions, and World Bank country income groups, and the socioeconomic and demographic gradients of tobacco use and frequency of use within countries.DesignSecondary analysis of nationally representative, cross-sectional, household survey data from 82 low and middle income countries collected between 1 January 2015 and 31 December 2020.SettingPopulation based survey data.Participants1 231 068 individuals aged 15 years and older.Main outcome measuresSelf-reported current smoking, current daily smoking, current smokeless tobacco use, current daily smokeless tobacco use, pack years, and current use and use frequencies of each tobacco product. Products were any type of cigarette, manufactured cigarette, hand rolled cigarette, water pipe, cigar, oral snuff, nasal snuff, chewing tobacco, and betel nut (with and without tobacco).ResultsThe smoking prevalence in the study sample was 16.5% (95% confidence interval 16.1% to 16.9%) and ranged from 1.1% (0.9% to 1.3%) in Ghana to 50.6% (45.2% to 56.1%) in Kiribati. The user prevalence of smokeless tobacco was 7.7% (7.5% to 8.0%) and prevalence was highest in Papua New Guinea (daily user prevalence of 65.4% (63.3% to 67.5%)). Although variation was wide between countries and by tobacco product, for many low and middle income countries, the highest prevalence and cigarette smoking frequency was reported in men, those with lower education, less household wealth, living in rural areas, and higher age.ConclusionsBoth smoked and smokeless tobacco use and frequency of use vary widely across tobacco products in low and middle income countries. This study can inform the design and targeting of efforts to reduce tobacco use in low and middle income countries and serve as a benchmark for monitoring progress towards national and international goals.
Published: 2022
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32. Geographical, gender and age inequalities in non-communicable diseases both at national and provincial levels in Iran

Author: Erfan Ghasemi, Shahabeddin Rezaei, Bagher Larijani, Esmaeil Mohammadi, Farshad Farzadfar, Negar Rezaei, Nima Fattahi, Arya Aminorroaya, Shohreh Naderimagham, and Sina Azadnajafabad
Subjects: Inequality, business.industry, Endocrinology, Diabetes and Metabolism, media_common.quotation_subject, Mortality rate, Social class, Municipal level, Age and gender, 03 medical and health sciences, 0302 clinical medicine, 030220 oncology & carcinogenesis, Environmental health, Health care, Internal Medicine, Medicine, 030212 general & internal medicine, business, Developed country, Health policy, media_common
Abstract: Over 80% of deaths due to non-communicable diseases (NCDs) occur in low and middle-income countries, indicating an inequality in the health care system around the world. Conducted studies at provincial level in developed countries have shown that mortality rates due to this group of diseases are higher in the populations with lower education, income, and social class. NCDs account for 71.3% of total world deaths in 2016 and 79.2% of total deaths in Iran in the same year. Improving the health of Iranian population and reducing the number of communicable diseases over the past decades have made NCDs as a major health problem in Iran. In this study, we describe the status of most lethal NCDs in the country at national and provincial level. In addition, study on the inequality of deaths due to NCDs at provincial level in Iran showed that there is a considerable difference between different provinces. Furthermore, there is an age inequality so that mortality of main NCDs increased dramatically after the age of 70. Therefore, health policy makers and decision makers should adopt appropriate policies to reduce gender, geographic and age disparities to reduce gender and inter-provincial inequalities in Iran.
Published: 2021
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33. Global, regional, and national quality of care of ischaemic heart disease from 1990 to 2017: a systematic analysis for the Global Burden of Disease Study 2017

Author: Sina Azadnajafabad, Naser Ahmadi, Bagher Larijani, Nima Fattahi, Mohammadhassan Mirbolouk, Hooman Ebrahimi, Maryam Nasserinejad, Nazila Rezaei, Shohreh Naderimagham, Negar Rezaei, Moein Yoosefi, Arya Aminorroaya, Esmaeil Mohammadi, Mahsima Shabani, Farshad Farzadfar, and Michael J. Blaha
Subjects: Burden of disease, Male, South asia, Epidemiology, Myocardial Ischemia, 030204 cardiovascular system & hematology, Global Health, Global Burden of Disease, Coronary artery disease, 03 medical and health sciences, 0302 clinical medicine, Age groups, medicine, Humans, 030212 general & internal medicine, Quality of care, Noncommunicable Diseases, Gender disparity, Aged, Quality of Health Care, business.industry, medicine.disease, Years of potential life lost, Ischaemic heart disease, Female, Quality-Adjusted Life Years, Cardiology and Cardiovascular Medicine, business, Demography
Abstract: Aims By 2030, we seek to reduce premature deaths from non-communicable diseases, including ischaemic heart disease (IHD), by one-third to reach the sustainable development goal (SDG) target 3.4. We aimed to investigate the quality of care of IHD across countries, genders, age groups, and time using the Global Burden of Diseases Study (GBD) 2017 estimates. Methods and results We did a principal component analysis on IHD mortality to incidence ratio, disability-adjusted life-years (DALYs) to prevalence ratio, and years of life lost to years lived with disability ratio using the results of the GBD 2017. The first principal component was scaled from 0 to 100 and designated as the quality of care index (QCI). We evaluated gender inequity by the gender disparity ratio (GDR), defined as female to male QCI. From 1990 to 2017, the QCI and GDR increased from 71.2 to 76.4 and from 1.04 to 1.08, respectively, worldwide. In the study period, countries of Western Europe, Scandinavia, and Australasia had the highest QCIs and a GDR of 1 to 1.2; however, African and South Asian countries had the lowest QCIs and a GDR of 0.8 to 1. Moreover, the young population experienced more significant improvements in the QCI compared to the elderly in 2017. Conclusion From 1990 to 2017, the QCI of IHD has improved; nonetheless, there are remarkable disparities between countries, genders, and age groups that should be addressed. These findings may guide policymakers in monitoring and modifying our path to achieve SDGs.
Published: 2021

34. Non-communicable diseases’ risk factors in Iran; a review of the present status and action plans

Author: Shohreh Naderimagham, Shahabeddin Rezaei, Sina Azadnajafabad, Farshad Farzadfar, Nima Fattahi, Rosa Haghshenas, Bagher Larijani, Negar Rezaei, Arya Aminorroaya, and Esmaeil Mohammadi
Subjects: medicine.medical_specialty, Population ageing, Epidemiology, business.industry, Risk Factor, Endocrinology, Diabetes and Metabolism, Review Article, Review, Iran, 030204 cardiovascular system & hematology, Risk factor (computing), Prevention and control, 03 medical and health sciences, Intervention (law), 0302 clinical medicine, Action (philosophy), Environmental health, Internal Medicine, medicine, Disease risk, Non-communicable diseases, 030212 general & internal medicine, business, Healthcare system
Abstract: Non-communicable Diseases (NCDs) are the leading causes of death globally, imposing a heavy burden on the healthcare systems, especially in low- and middle-income countries. Iran is a country in the Middle-East region with an aging population and changing disease risk factors, and now is facing NCDs as the major health problem of the country. Investigating NCDs’ risk factors and tackling preventable ones is the main intervention to control their heavy burden. In this review, we discussed the most critical risk factors in Iran and the implemented programs and action plans to control them. A better knowledge on current status of risk factors and plans to tackle them, could help policymakers effectively rule policies and allocate resources to curb heavy burden of NCDs in Iran.
Published: 2021
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35. A Report on Statistics of an Online Self-screening Platform for COVID-19 and Its Effectiveness in Iran

Author: Erfan Ghasemi, Bahman Damerchilu, Kosar Jamshidi, Farshad Farzadfar, Sina Azadnajafabad, Hossein Zokaei, Abbas Norouzinejad, Hossein Erfani, Pouya Fathi, Bagher Larijani, Shohreh Naderimagham, Ashkan Mehregan, Mohammad Mehdi Gouya, Negar Rezaei, Reza Malekzadeh, Nima Fattahi, Sahar Saeedi Moghaddam, Hamidreza Jamshidi, Mehrdad Azmin, and Esmaeil Mohammadi
Subjects: 0301 basic medicine, medicine.medical_specialty, Health (social science), Leadership and Management, Population, Disease, Telehealth, Management, Monitoring, Policy and Law, Representativeness heuristic, 03 medical and health sciences, symbols.namesake, 0302 clinical medicine, Health Information Management, Pandemic, medicine, 030212 general & internal medicine, Poisson regression, education, education.field_of_study, business.industry, Health Policy, Public health, 030104 developmental biology, Family medicine, symbols, Emerging infectious disease, business
Abstract: Background: The most recent emerging infectious disease, coronavirus disease 2019 (COVID-19), is pandemic now. Iran is a country with community transmission of the disease. Telehealth tools have been proved to be useful in controlling public health disasters. We developed an online self-screening platform to offer a population-wide strategy to control the massive influx to medical centers. Methods: We developed a platform operating based on given history by participants, including sex, age, weight, height, location, primary symptoms and signs, and high risk past medical histories. Based on a decision-making algorithm, participants were categorized into four levels of suspected cases, requiring diagnostic tests, supportive care, not suspected cases. We made comparisons with Iran STEPs (STEPwise approach to Surveillance) 2016 study and data from the Statistical Centre of Iran to assess population representativeness of data. Also, we made a comparison with officially confirmed cases to investigate the effectiveness of the platform. A multilevel mixed-effects Poisson regression was used to check the association of visiting platform and deaths caused by COVID-19. Results: About 310 000 individuals participated in the online self-screening platform in 33 days. The majority of participants were in younger age groups, and males involved more. A significant number of participants were screened not to be suspected or needing supportive care, and only 10.4% of males and 12.0% of females had suspected results of COVID-19. The penetration of the platform was assessed to be acceptable. A correlation coefficient of 0.51 was calculated between suspected results and confirmed cases of the disease, expressing the platform’s effectiveness. Conclusion: Implementation of a proper online self-screening tool can mitigate population panic during wide-spread epidemics and relieve massive influx to medical centers. Also, an evidence-based education platform can help fighting infodemic. Noticeable utilization and verified effectiveness of such platform validate the potency of telehealth tools in controlling epidemics and pandemics.
Published: 2021
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36. Author response: Heterogeneous contributions of change in population distribution of body mass index to change in obesity and underweight

Author: Zahra Mohammadi, Abdul Basit, Helena I. S. Nogueira, Soile E. Puhakka, Hongsheng Bi, Ari Voutilainen, Davood Khalili, Bin Zhou, Dermot O'Reilly, Natascia Rinaldo, Paulo A. Lotufo, Bahareh Kheiri, Thein Thein Htay, Simona Giampaoli, Goodarz Danaei, M. Fernanda Lima-Costa, Simona Bo, Peter Schnohr, Jerzy Chudek, Francesco Panza, Ling Yang, Katia Vergetti Bloch, Vincenzo Capuano, Holly E. Syddall, Dong Zhao, Indah Suci Widyahening, Maria Lorenza Muiesan, Leng Huat Foo, Mohsen Azimi-Nezhad, Merete Osler, Laura Torres-Collado, Manu Raj, Adroaldo Cesar Araujo Gaya, Susi Kriemler, Ali Akbar Shayesteh, Aneta Grajda, Anette Varbo, Kazem Mohammad, Leila Beltrami Moreira, Shu Ti Chiou, Iuliia A Rusakova, Jyh Eiin Wong, Torben Jørgensen, Lela Sturua, Lubica Ticha, Hamid Hakimi, Hazzaa M. Al-Hazzaa, Yanina Zócalo, Freda Pitakaka, Savvas C. Savva, Rajeev Gupta, Jennifer Servais, Marie Kunešová, Johanna M. Geleijnse, Elysée Claude Bika Lele, Yannis Manios, Jorge Escobedo-de la Peña, Yufang Bi, Chinh Nguyen Huu, Sibel Gogen, Viviane Cunha Cardoso, Kristine H. Allin, Ana Azevedo, Line Tang Møllehave, Vincent Jr DeGennaro, Novie O. Younger-Coleman, Gretchen A Stevens, Dickman Gareta, Holger Theobald, Anja Schienkiewitz, Bekbolat Zholdin, Janice Luisa Lukrafka, Adela Chirita-Emandi, Ulla Roggenbuck, Kenisha Russell Jonsson, Robespierre Ribeiro, Gabriele Eiben, Eero Kajantie, Sounnia Mediene Benchekor, Fariborz Mansour-Ghanaei, Mary Simon, Prakash C. Gupta, Mohammad Esmaeel Motlagh, Emanuela Gualdi-Russo, María Elena Díaz-Sánchez, Pilar Guallar-Castillón, Bee Koon Poh, Cristina Padez, Azaliia M Tuliakova, Sarah P. Garnett, William R. Tebar, Yingfeng Zheng, Suhad Bahijri, Christina Mavrogianni, Mihaela Vladulescu, Jan A. Staessen, Paula Duarte de Oliveira, Rui Ornelas, Michael Sjöström, Charles Agyemang, Slawomir Koziel, Shohreh Naderimagham, Jari Jokelainen, Stephen T. McGarvey, Patrick Pasquet, Farnam Mohebi, Nader Saki, Aida Pilav, Azim Nejatizadeh, Marianna Noale, Habiba Ben Romdhane, Luís B. Sardinha, Laura Lauria, Jun Hata, Kodanda R Kanala, Gert B. M. Mensink, Nils Lehmann, Elio Riboli, Carolina Tarqui-Mamani, Rodrigo M. Carrillo-Larco, Rosangela Fernandes Lucena Batista, Victoria E Soto-Rojas, Luis Serra-Majem, Martina Müller-Nurasyid, Felipe Vogt Cureau, Lekhraj Rampal, Zhamilya Battakova, Ludmila Sevcikova, Suhaila Abdul Ghaffar, Fikru Tullu, Aung Soe Htet, Angel R. Gonzalez, Annette J. Dobson, Kavumpurathu Raman Thankappan, Hélène Delisle, Francisco J. Félix-Redondo, Ramón Suárez-Medina, Annika Rosengren, Sania Nishtar, Tanja G. M. Vrijkotte, Wolfgang Ahrens, Osvaldo Santos, Maria Cecília Formoso Assunção, Kazi M. Jamil, Stefano Marventano, Wenbin Wei, Norsyamlina Che Abdul Rahim, Shukri F. Mohamed, Bente Sparboe-Nilsen, Soon-Woo Park, Ana Isabel Rito, David Goltzman, W. M. Monique Verschuren, Catterina Ferreccio, Marta Buoncristiano, Ramón Alberto Rascón-Pacheco, Pradeep Joshi, Edward D Janus, Laetitia Huiart, Ala'a Alkerwi, Lorenza Pilotto, Mohannad Al Nsour, Daan Kromhout, Marius B. Bjertness, Oanh T. H. Trinh, Nico Dragano, Angélica Ochoa-Avilés, Ingunn Holden Bergh, Yuki Fujita, Juraci Almeida Cesar, Hajer Aounallah-Skhiri, Maria Dorobantu, Jordi Sunyer, Wolfgang Kratzer, Susanne R. de Rooij, Drude Molbo, Rebecca Goldsmith, Jean Woo, Mohammad El-khateeb, Tiffany K. Gill, Nish Chaturvedi, Benjamin Acosta-Cazares, Erik Lykke Mortensen, Nikhil D. Patel, Francesco Pistelli, Yuan He, Ivana Radic, Yi Zeng, Ilse Khouw, Reynaldo Martorell, Ching-Yu Cheng, Stine Schramm, Hana Shimizu-Furusawa, Jacek Jóźwiak, Radwan Qasrawi, Isti Ilmiati Fujiati, Charles Sossa Jérome, Ben Schöttker, Mikhail Benet, Anastasia Markaki, Christopher T. Cowell, Bharathi Viswanathan, Renata Kuciene, Jose Eugenio Lozano, Pedro J Ortiz, Delphine De Smedt, Elaine M. 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Casanueva, Khairil Si-Ramlee, Soheir H Ahmed, Maria Nordendahl, Luciana Zaccagni, Mahboubeh Parsaeian, Rod Jackson, Jorge Motta, Keiu Nelis, Fernando Rigo, Andrzej Pajak, Christa Meisinger, Clara Homs, Namuna Shrestha, Mar Alvarez-Pedrerol, Xun Tang, Johann Willeit, Motahareh Kheradmand, Jean Dallongeville, Jean-Bernard Ruidavets, Anne Tjønneland, Diana A. Santos, Lynne M. Boddy, Jie Hao, David Alejandro González-Chica, Elin Kolle, Jingli Gao, Małgorzata Mossakowska, Isabel O. Oliveira, Giuseppe Grosso, Seongjun Ha, Olfa Saidi, Albina A Fakhretdinova, Oye Gureje, Raluca Pop, Iulia Jurca Simina, Nuno Lunet, Maria Forsner, Peter Bjerregaard, Rachael McLean, Antonio Cabrera de León, Guy De Backer, José A. Casajús, Guang Ning, Emmanuella Magriplis, Laura Censi, Graziella Bruno, Valentina Peterkova, Angelique Chan, Yvonne T. van der Schouw, Charalambos Hadjigeorgiou, Anjani Kumar Jha, Toomas Veidebaum, Thamara Hubler Figueiró, Jana Kratenova, Michelle Cilia, Ivo Rakovac, Bill Stavreski, Ya Xing Wang, Oscar Noboa, Romana Roccaldo, Sara Magnacca, Johan Sundström, Peter Stehle, Tania Lopez, Francis Delpeuch, Julianne Williams, Ellisiv B. Mathiesen, Leanne M. Riley, Claudia M. Hormiga, Joanne Katz, Ekaterina Stoyanova, Heloisa Bettiol, Gabriele Nagel, Alireza Khosravi, Lars Bo Andersen, João Breda, Jørgen Meisfjord, Ahmad Faudzi Yusoff, Marjeta Majer, Robert Beaglehole, Caleb Ochimana, Shynar Abdrakhmanova, George S. Stergiou, Blanca Sandra Ruiz-Betancourt, Leon A. Simons, Eng Joo Tan, Victoria Farrugia Sant'Angelo, Gry Skodje, Maryam Keramati, Liv Elin Torheim, Seppo Koskinen, Assembekov Batyrbek, Jaakko Tuomilehto, Marjo-Riitta Järvelin, Ming-Hui Zhao, Krista Fischer, Tobias F. Rinke de Wit, Agnès Le Port, Reza Homayounfar, James E. Bennett, Yuna He, Matsuda Fumihiko, Qi Sheng You, Angela Spinelli, Scott B. McLean, Shirin Djalalinia, Thet Thet Mu, Yves Martin-Prével, Rafael N. Pichardo, Gailute Bernotiene, Pietro Amedeo Modesti, Frederick C. W. Wu, Chandini Nekkantti, Daniela Rodrigues, Tandi E. Matsha, Mihai Gafencu, Xingwang Ye, Salar Rahimikazerooni, Trevor S. Ferguson, Christophe Tzourio, Marie Zins, Fernando Rodríguez-Artalejo, Xu Ma, Elin Pettersen Sørgjerd, Lourdes Ribas-Barba, Nalan Uysal, Salim Berkinbayev, Enisa Kujundzic, Sari Voutilainen, Iraj Mohebbi, Heiner Boeing, Jorge Mota, Jana Námešná, Maria Tsigga, Zivka Dika, Gulmira Aitmurzaeva, Xu Lin, Valéria Regecová, Herman Schargrodsky, Stevo Popovic, Amelia C. Crampin, Hannu Uusitalo, André Luiz Sena Guimarães, Ali Esmaeili, Catherine Kyobutungi, Virginija Dulskiene, Diego Augusto Santos Silva, David De Ridder, Lizzy M. Brewster, Hashem Jaddou, Eunice Ugel, José Camolas, Azli Baharudin, Idris Guessous, Sok King Ong, Tabara Yasuharu, Ali Ghanbari, Anne W. Taylor, Iraj Nabipour, Justyna Godos, Cyrus Cooper, Bruna Gonçalves Cordeiro da Silva, Gonzalo Valdivia, Gyulli M. Kazakbaeva, Takuro Furusawa, Pawel Kurjata, Diego Vanuzzo, Marvin Cervantes-Loaiza, Karen Morgan, Mostafa Qorbani, Rute Santos, Marika Ferrari, Diego Salmerón, Ida Maria Schmidt, Gao Pei, Abu Am Hanif, Balkish M. Naidu, Maria Wany Louzada Strufaldi, Moesijanti Soekatri, Marcia Scazufca, Katharina Maruszczak, Jacqueline Ramke, Elvis Oa Wambiya, Kairit Mikkel, Napoleón Pérez-Farinós, Natalia Nowak-Szczepanska, Miao Li Chee, Jose Sanchez-Abanto, Rajaa Al-Raddadi, Michel Joffres, Vayia Rarra, Ningli Wang, Charmaine A. Duante, Sheikh Mohammed Shariful Islam, Manoli Garcia-de-la-Hera, Weili Yan, Dong Wook Shin, Rômulo Araújo Fernandes, Ilona Nenko, Sanjib Kumar Sharma, Alfonso Siani, Indrapal I. Meshram, Imelda A. Agdeppa, Ei Ei K. Nang, Ian Rouse, Avula Laxmaiah, Ana M. B. Menezes, Yih Chung Tham, Ebrahim Eftekhar, María José Tormo, Felicia Cañete, Marie Eliasen, Lutgart Braeckman, Dirk Vanderschueren, Genc Burazeri, Kari Kuulasmaa, Jesús Vioque, Marisa K. Sophiea, Agneta Sjöberg, Katarzyna Dereń, Albertino Damasceno, Jochanan Stessman, Stig E. Bojesen, Aline Meirhaeghe, Else Karin Grøholt, Flávio Danni Fuchs, Robert Lundqvist, Frédéric Gottrand, Jeongseon Kim, Helmut Schröder, Joanna Baran, Karina Mary de Paiva, Yousef Khader, Eric Monterrubio-Flores, Aneta Weres, Hans Concin, Damaskini Valvi, Sari Hantunen, Machi Suka, Elena Sacchini, Norbert Amougou, Ursula Kiechl-Kohlendorfer, Edwige Landais, Viktoria Anna Kovacs, Rosemarie Martin, Kenneth James, Amaneh Shayanrad, Grethe S. Tell, Norazizah Ibrahim Wong, Vedrana Sember, Anelise Reis Gaya, Konrad Jamrozik, Thorkild I. A. Sørensen, Martin Neovius, Urho M. Kujala, Nathalie Michels, Marcel Goldberg, Alexandra Cucu, Liliana Dacica, Adelheid Weber, Hermann Pohlabeln, Sandjaja, Jukka T. Salonen, Patricia Varona-Pérez, Tiina Laatikainen, Jolanta Słowikowska-Hilczer, Ana Paula Carlos Cândido, Julie Taylor, Anabela Mota-Pinto, Cora L. Craig, Teresa Shamah-Levy, María Dolores Chirlaque, Mohd Azahadi Omar, Dominique Cottel, Charumathi Sabanayagam, Andrea Gazzinelli, Mieczysław Litwin, Sadaf G. Sepanlou, Adolfo Rubinstein, Abbas Dehghan, Rildo de Souza Wanderley Júnior, Wenhua Zhao, Aleksandra Piwońska, Yong Tao, Bontha V. Babu, Marc J. Gunter, Harunobu Nakamura, Wojciech Drygas, Eiji Oda, Jia Li Duan, Stefan Söderberg, Anthony Kafatos, Lynell V Maniego, Els Clays, Wei-Yen Lim, Marshall K. Tulloch-Reid, Mariachiara Di Cesare, Mattias Johansson, Simona Costanzo, Margot González-León, Matthias Nauck, Henry Völzke, George Luiz Lins Machado-Coelho, Annette Peters, Rajiv T Erasmus, Juan Francisco Miquel, Andrea Gualtieri, Abdul Hamid Zargar, Kaare Christensen, Peter Willeit, Tanja Stocks, Christine Cameron, Samuel C. Dumith, Janina Petkeviciene, Boyd Swinburn, Magdalena Muc, Sabine Schipf, Tajana Zeljkovic Vrkic, Martin Bobak, Damian K Francis, Veronica Mocanu, Karien Stronks, Antonisamy Belavendra, Artur Mazur, Nagalla Balakrishna, Jardena J. Puder, Mehrdad Azmin, Shelly R. McFarlane, Sara Santos Sanz, Yang Yang, Anneke Blokstra, Rafel Ramos, Ertugrul Celikcan, Jody C Miller, Jesús Ibarluzea, Svetlana A. Shalnova, Maria Elisa Zapata, Guansheng Ma, Fereidoun Azizi, Beatriz D'Agord Schaan, Pedro Marques-Vidal, William A. Neal, Ana B. Crujeiras, Zhenyu Zhang, Naser Ahmadi, Abdullatif Husseini, Alun Evans, Jiang He, Edyta Łuszczki, Maria G. 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Bikbov, Hsien-Ho Lin, Eva Corpeleijn, Harshpal Singh Sachdev, Mohammad Reza Mirjalili, Maria del Cristo Rodriguez-Perez, Michala Lustigová, Tuyen D Le, Teresa Norat, Hana Zamrazilová, Garry Brian, Tien Yin Wong, Rosa Haghshenas, Clive Osmond, Diego Giulliano Destro Christofaro, Mahmood Moosazadeh, Vilma Irazola, Olli T. Raitakari, Marco Aurélio Peres, Terho Lehtimäki, Shuohua Chen, Dimitrios Papandreou, Robert J. Adams, Sigmund A. Anderssen, Peter T. Katzmarzyk, Luisa M Macieira, Félicité Tchibindat, Lital Keinan Boker, Toshiharu Ninomiya, Morten Sodemann, Jytte Halkjær, Zbigniew Kułaga, Sophie Visvikis-Siest, Farshad Farzadfar, N Capkova, Zumin Shi, Maria Turley, Zbigniew Gaciong, Giovanni Veronesi, Martin McKee, Veikko Salomaa, Gilad Twig, Elisabetta L. Romeo, Peter Kristensen, Grazyna Jasienska, Victor Guillermo Sequera, Mario V. Capanzana, Con Burns, Emanuela Pettenuzzo, Ming-Dong Wang, Jonathan Giovannelli, Stela McLachlan, Ellis Owusu-Dabo, Stefania Toselli, Maria Teresa Anselmo Olinto, Senthil K Vasan, Sara Schramm, Xenophon Theodoridis, Moyses Szklo, Ramfis Nieto-Martínez, Viswanathan Mohan, Guillermo Frontera, Rahul Malhotra, Thomas Ferrao, Dongfeng Gu, Tomas Vega, Hynek Pikhart, Päivi Mäki, Heba Fouad, Vilnis Dzerve, Christina Howitt, Seyed Mohammad Hashemi-Shahri, Jenny M. Kindblom, Marjolijn C. E. Bragt, G. K. Mini, Qian Wang, Liufu Cui, Andrzej Galbarczyk, Sylvain Sebert, Vilmundur Gudnason, Loreto Santa Marina, Kairat Davletov, Afshin Ostovar, Niloofar Peykari, Nicholas J. Wareham, Wilma M. Hopman, Karl-Heinz Jöckel, Jussi Kauhanen, Breige A. McNulty, Alina Kerimkulova, Youcef Laid, Claes Ohlsson, Stefan Kiechl, Alicia Matijasevich, Boban Mugoša, Srinivasan Kannan, Jyrki K. Virtanen, Mohan Deepa, Mangesh S. Pednekar, Shahla AlDhukair, Cynthia M. Pérez, Vera Lanska, Tint Swe Latt, Dominique Hange, João Luiz Bastos, Eliza Markidou Ioannidou, Leticia Hernandez Cadena, Maya Tanrygulyyeva, Reza Malekzadeh, Dimitrios Poulimeneas, Pedro Ordunez, Thomas Waldhör, Ioannis Pagkalos, Carlo M. Barbagallo, Abla M. Sibai, Peter Vollenweider, Asher Fawwad, Emily Sonestedt, Elena Pahomova, Santosh K. Bhargava, Patrick Kolsteren, Aya Mostafa, Fangfang Chen, Flavio Nervi, Imre Janszky, Arvind Pandey, Renata Cifkova, Alexandre C. Pereira, Alejandro Diaz, Alireza Ansari-Moghaddam, Rachakulla Hari Kumar, Jaakko Mursu, Luis A. Moreno, Glen Gironella, Jelena Kos, Tilema Cama, Haakon E. Meyer, Jun Ma, Raphael E. Arku, Ziad Abdeen, Rusidah Selamat, Dianna J. Magliano, Jitendra Jonnagaddala, Konstantinos Gkiouras, Paul Korrovits, Paola Nardone, Paolo Vineis, Kotsedi D Monyeki, Khuong Quynh Long, Alberto Barceló, Camilla T. Damsgaard, Constance Schultsz, Frank J Rühli, Santiago F. Gomez, Tara Coppinger, Muhammad Islam, Pierre Traissac, Eleonora d'Orsi, Irfan Nuhoglu, Rui Providência, Bernard Maire, Leandra Abarca-Gómez, Sinead Brophy, Daniela Pierannunzio, Cristina Taddei, Wen-Harn Pan, Gregor Starc, Abdullah Alkandari, Saeed Dastgiri, Lien Braeckevelt, Gustavo Velasquez-Melendez, Sudhir Kowlessur, Bagher Larijani, Cynthia Robitaille, Mohamed M. Ali, Steiner Krokstad, Noor Ani Ahmad, Anar Dushpanova, Agustinus Soemantri, Susana Sans, Ionela Pascanu, Gwenaëlle Le Coroller, Inger Ariansen, Abhijit Sen, Sergej M. Ostojic, Silvana Donoso, Felix K. Assah, Juan A Rivera, Peter H. Whincup, Oana-Florentina Gheorghe-Fronea, Hanan F. Abdul Rahim, Yadlapalli S. Kusuma, Michael Knoflach, Moein Yoosefi, Cassiano Ricardo Rech, Paul Ferdinand M. Reganit, Tomi-Pekka Tuomainen, Francesco Gianfagna, Stefania Maggi, Mohammad Hossein Somi, Behrooz Hamzeh, Bethlehem D. Solomon, Herman Borghs, Zhanna Kalmatayeva, Heidi Klakk, Akram Pourshams, Naomi S. Levitt, Miquel Porta, Vesna Jureša, Alexander D. Deev, Son Thai Pham, Paula Margozzini, Silvia Bel-Serrat, Dora Romaguera, Monira Alarouj, Winsome R. Parnell, Marloes Cardol, David Faeh, Antonio Bernabe-Ortiz, Giota Touloumi, Maryam Kavousi, Sanja Musić Milanović, Jalila El Ati, Sauli Herrala, Liang Xu, Sirkka Keinänen-Kiukaanniemi, Ian Hambleton, Stefan Savin, Andre Pascal Kengne, R. Krishna Kumar, Kurt Widhalm, Marco M Ferrario, Parisa Amiri, Yi Song, Jianfeng Wu, Jeannette Klimont, Jean Ferrières, Farhad Zamani, Shina Avi, Luis Paulo Gomes Mascarenhas, Aluísio J D Barros, Reecha Sofat, Koen Van Herck, Hoang Van Minh, Enrique Gutiérrez-González, Martine Vrijheid, Susana Cararo Confortin, Antonis Zampelas, Bogdan Wojtyniak, Ausra Petrauskiene, Juha Auvinen, Maryam Sharafkhah, Emanuel Zitt, Majid Ezzati, Young-Ho Khang, Ellina Rakhimova, Magdalena Klimek, Luís Lopes, Erkin M. Mirrakhimov, Maria Lc Iurilli, Günay Can, Mark Woodward, Esther Lopez-Garcia, Mauro Virgílio Gomes de Barros, Ahmed A. Madar, Rainford J. Wilks, Shoaib Afzal, Melanie J. Cowan, Gareth Stratton, Eduardo Salazar Martinez, Sameer Narake, Norie Sawada, Li Juan Wu, Adrian Richter, Licia Iacoviello, Hanno Ulmer, Deepak Amarapurkar, Mohsen Ibrahim, Hamed Pouraram, Massimo Salvetti, Hung-Kwan So, Yonghua Hu, Lars Ängquist, Thi Tuyet-Hanh Tran, Charles Lunogelo, Sabina Zambon, Angelika Schaffrath Rosario, Lauren Lissner, Kamarul Imran Musa, Deepa Weerasekera, Bihungum Bista, Takafumi Ishida, Ekaterina Chikova-Iscener, Mirjam M. Heinen, Tazeen H. Jafar, Semánová Csilla, Raija Korpelainen, Edward W. Gregg, Laura Gutierrez, Victor M. Herrera, Aristides M. Machado-Rodrigues, Fatemeh Malekzadeh, Shouling Wu, Jennifer L. Baker, Clicerio González-Villalpando, Irene G. M. van Valkengoed, Anna Fijałkowska, Meghnath Dhimal, Murat Topbaş, George Moschonis, Robert Eggertsen, Quang Ngoc Nguyen, Janette Walton, Elnaz Faramarzi, Nasheeta Peer, Radka Taxová Braunerová, Harald Geiger, Morteza Shamshirgaran, Lela Shengelia, María Ángeles Dal Re Saavedra, Khem Bahadur Karki, Timothy J. Key, Maria G. Grammatikopoulou, Susana Vale, Bernhard O. Boehm, Songhomitra Panda-Jonas, Iveta Pudule, Elisabete Ramos, Lacramioara Aurelia Brinduse, Paul H. Lee, Terence W O'Neill, Javad Aghazadeh-Attari, Margus Punab, Bojan Jelaković, Eliza Cinteza, Ha Tp Do, and Alison J. Hayes
Subjects: education.field_of_study, business.industry, Population, Distribution (economics), medicine.disease, Obesity, Geography, medicine, Underweight, medicine.symptom, education, business, Body mass index, Demography
Published: 2020
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37. Estimating the attributable risk of vascular disorders in different ranges of fasting plasma glucose and assessing the effectiveness of anti-diabetes agents on risk reduction; questioning the current diagnostic criteria

Author: Mahtab Rouhifard Khalilabad, Shahin Roshani, Narges Ebrahimi, Maryam Karimian, Kosar Jamshidi, Farshad Farzadfar, Nima Fattahi, Negar Rezaei, Sina Azadnajafabad, Fatemeh Sadeghi Morasa, Sahar Saeedi Moghaddam, Bagher Larijani, Shohreh Naderimagham, Mehrdad Azmin, and Esmaeil Mohammadi
Subjects: medicine.medical_specialty, Plasma glucose, education.field_of_study, Minimal risk, business.industry, Endocrinology, Diabetes and Metabolism, Population, 030204 cardiovascular system & hematology, medicine.disease, 03 medical and health sciences, 0302 clinical medicine, Internal medicine, Diabetes mellitus, Attributable risk, Internal Medicine, medicine, Disease risk, 030212 general & internal medicine, Young adult, business, education, Kidney disease, Research Article
Abstract: INTRODUCTION: Attributable risk of cardiovascular disorders (CVDs) and chronic kidney disease (CKD) in association with diabetes and pre-diabetes is under debate. Moreover, the role of anti-diabetes agents in risk reduction of such conditions is obscure. The purpose of this work is to define the population attributable fraction (PAF) of CVDs and CKD in different rages of plasma glucose. METHOD: Iranian stepwise approach for surveillance of non-communicable disease risk factors (STEPs) was used to calculate PAF in four subsequent phases. Phase 0: whole population regardless of diagnosis; Phase I: in three CVD risk groups: minimal risk (FPG
Published: 2020

38. Burden of non-communicable diseases in Iran: past, present, and future

Author: Arya Aminorroaya, Shohreh Naderimagham, Bagher Larijani, Negar Rezaei, Esmaeil Mohammadi, Nima Fattahi, Sahar Mohammadi Fateh, Sina Azadnajafabad, Mahtab Rouhifard Khalilabad, Kosar Jamshidi, and Farshad Farzadfar
Subjects: Burden of disease, medicine.medical_specialty, Rehabilitation, business.industry, Endocrinology, Diabetes and Metabolism, medicine.medical_treatment, Public health, Disease, 030204 cardiovascular system & hematology, 03 medical and health sciences, 0302 clinical medicine, Years of potential life lost, Environmental health, Internal Medicine, Health for all, Medicine, 030212 general & internal medicine, business, Ischemic heart
Abstract: Iran, as an in-transition country, tackled communicable diseases and now is confronting emerging challenges of non-communicable diseases (NCDs) in the path to reach health for everyone at all ages by 2030. Across Iran, death-averting treatments of NCDs have been expanded recently which might cause a shift toward a greater share of years lived with disability (YLDs) compared to years of life lost (YLLs) in the disability-adjusted life years of NCDs. Since the management of disability differs from the reduction of mortality in terms of public health policies, depicting the current picture of the burden of NCDs is principal for policymakers in achieving health for all. In this communication, we briefly reviewed our current knowledge about the burden of NCDs in Iran and found that burdens of cardiovascular diseases and asthma are shifting toward greater YLDs than YLLs. In addition to expanding preventive measures and maintenance of the current system, this profile calls policymakers for the development of more rehabilitation centers for patients with ischemic heart disease, stroke, and respiratory diseases to mitigate their disabilities. The consistent increase in the age-standardized YLD rate of neoplasms necessitates providing rehabilitation centers as well. Morbidity and mortality of diabetes have increased robustly which warrant extensive preventive and control measures. It should be noted that the estimates of the Global Burden of Disease study offer us invaluable insights on the burden of diseases in Iran; nonetheless, efforts for gathering nationally-representative data, e.g., National and Subnational Burden of Diseases, Injuries, and Risk Factors study, are strongly encouraged in the future.
Published: 2020
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39. National and provincial population‐based incidence and mortality of skin cancer in Iran; 1990–2016

Author: Farzad Kompani, Sahar Saeedi Moghaddam, Negar Rezaei, Mahtab Rouhifard Khalilabad, Shahin Roshani, Soheila Sobhani, Zahra Madadi, Farshad Farzadfar, Shohreh Naderimagham, Naser Ahmadi, Sahar Mohammadi Fateh, Nima Fattahi, and Masoud Masinaei
Subjects: Male, Skin Neoplasms, Population based, Iran, Proxy (climate), 03 medical and health sciences, 0302 clinical medicine, Cost of Illness, medicine, Humans, 030212 general & internal medicine, Mortality, Quality of Health Care, business.industry, Incidence, Mortality rate, Incidence (epidemiology), General Medicine, medicine.disease, Standardized mortality ratio, Years of potential life lost, Oncology, 030220 oncology & carcinogenesis, Female, Standardized rate, Skin cancer, business, Demography
Abstract: Purpose To estimate the national and provincial estimates of incidence, mortality and burden of skin cancer in Iran from 1990 to 2016. Methods The data for incidence and mortality rates were collected from the National and Subnational Burden of Diseases (NASBOD) project. We employed a two-stage spatiotemporal model to estimate cancer incidence based on sex, age, province and year. The national and subnational age and gender specific trends were calculated from 1990 to 2016. Mortality-to-incidence ratio (MIR) was considered as an indicator of cancer care quality. Results At the national level, the age standardized incidence rate (ASIR) of skin cancer decreased 1.29 times, from 23.6 (95% uncertainty interval [UI], 17.1-31.1) per 100 000 persons in 1990 to 18.2 (95% UI, 15.8-20.6) in 2016; a similar trend was seen in both males and females. The highest ASIR was seen in 2000. National estimates of the age standardized mortality rate (ASMR) steadily decreased from 2.8 per 100 000 persons (95% UI, 1.9-4.1) in 1990 to 0.2 (95% UI, 0.1-0.3) per 100 000 persons in 2015. The MIR decreased continuously from 1990 to 2015 in all provinces and among both genders. The age standardized rate of years of life lost also decreased 8.7 times, from 30.1 (95% UI, 20.2-45.1) in 1990 to 3.5 (95% UI, 2.3-5.3) in 2015. Conclusions During the study period, skin cancer ASIR, ASMR and burden steadily decreased among the Iranian population. The declining MIR for all provinces from 1990 to 2015 was a proxy of early detection and high-quality medical care for skin cancer in Iran. These results can be beneficial to policymakers and health planners to make correct decisions and determine proper resource allocation.
Published: 2020
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40. Trends of Diabetes Mortality in Iran at National and Sub-national levels from 1990 to 2015 and its association with socioeconomic factors

Author: Forough Pazhuheian, Zohreh Mahmoudi, Parinaz Mehdipour, Sahar Saeedi Moghaddam, Nazila Rezaei, Negar Mahmoudi, Shohreh Naderimagham, Arezou Dilmaghani-Marand, Farshad Farzadfar, Rosa Haghshenas, Alireza Khajavi, Anita Mansouri, Niloofar Peykari, Kamyar Rezaee, and Bagher Larijani
Subjects: business.industry, Association (object-oriented programming), Diabetes mellitus, Environmental health, medicine, medicine.disease, business, Socioeconomic status
Abstract: Background Following global commitments to prevent and control non-communicable diseases, we sought to estimate national and sub-national trends in diabetes mortality in Iran and to assess its association with socioeconomic factors.Methods To assess the correlation between diabetes mortality and socioeconomic factors we used data obtained from the Death Registration System (DRS), the spatio-temporal model and Gaussian Process Regression (GPR) levels and the diabetes mortality trends, which were estimated by sex, age and year at national and sub-national levels from 1990 to 2015.Results Between the years 1990 and 2015, the age-standardized diabetes mortality rate (per 100,000) increased from 3.40 (95% UI: 2.33 to 4.99) to 7.72 (95% UI: 5.51 to 10.78) in males and from 4.66 (95% UI: 3.23 to 6.76) to 10.38 (95% UI: 7.54 to 14.23) in females. In 1990, the difference between the highest age-standardized diabetes mortality rate among males was 3.88 times greater than the lowest (5.97 vs. 1.54) and in 2015 this difference was 3.96 times greater (14.65 vs. 3.70). This provincial difference was higher among females and was 5.13 times greater in 1990 (8.41 vs. 1.64) and 5.04 times greater in 2015 (19.87 vs. 3.94). The rate of diabetes mortality rose with urbanization, yet declined with an increase in wealth and years of schooling as the main socio-economic factors.Conclusion The rising trend of diabetes mortality rate at national level and the sub-national disparities associated with socioeconomic status in Iran warrant the implementation of specific interventions recommended by the ‘25 by 25’ goal.
Published: 2020
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41. How the scientific community responded to the COVID-19 pandemic: A subject-level time-trend bibliometric analysis

Author: Sahar Mohammadi Fateh, Seyyed-Hadi Ghamari, Rosa Haghshenas, Shohreh Naderimagham, Elham Abdolhamidi, Shahin Roshani, Nazila Rezaei, Negar Rezaei, Mohsen Abbasi-Kangevari, Kosar Jamshidi, Farshad Farzadfar, Mohammad-Reza Malekpour, Sina Azadnajafabad, Sahba Rezazadeh-Khadem, Arya Aminorroaya, and Naser Ahmadi
Subjects: Viral Diseases, PubMed, medicine.medical_specialty, Biomedical Research, Medical Journals, Epidemiology, Science Policy, Science, Scopus, MEDLINE, Bibliometrics, Research and Analysis Methods, Open Access Medical Journals, Medical Conditions, Open Science, Pandemic, Medicine and Health Sciences, medicine, Humans, Public and Occupational Health, Pandemics, Scientific Publishing, Publishing, Multidisciplinary, SARS-CoV-2, business.industry, Incidence, Incidence (epidemiology), Public health, COVID-19, Covid 19, Research Assessment, Infectious Diseases, Geography, Open Access Publishing, Citation Analysis, Medicine, Public Health, business, Medical Humanities, Publication Practices, Research Article, Demography, Biomedical sciences
Abstract: BackgroundCOVID-19 has triggered an avalanche of research publications, the various aspects of which need to be assessed. The objective of this study is to determine the scientific community’s response patterns to COVID-19 through a bibliometric analysis of the time-trends, global contribution, international collaboration, open-access provision, science domains of focus, and the behavior of journals.MethodsThe bibliographic records on COVID-19 literature were retrieved from both PubMed and Scopus. The period for searching was set from November 1, 2019, to April 15, 2021. The bibliographic data were coupled with COVID-19 incidence to explore possible association, as well as World Bank indicators and classification of economies.ResultsA total of 159132 records were included in the study. Following the escalation of incidences of COVID-19 in late 2020 and early 2021, the monthly publication count made a new peak in March 2021 at 20505. Overall, 125155 (78.6%) were national, 22548 (14.2%) were bi-national, and 11429 (7.2%) were multi-national. Low-income countries with 928 (66.8%) international publications had the highest percentage of international. The open-access provision decreased from 85.5% in February 2020 to 62.0% in April 2021. As many as 82841 (70.8%) publications were related to health sciences, followed by life sciences 27031 (23.1%), social sciences 20291 (17.3%), and physical sciences 15141 (12.9%). The top three medical subjects in publications were general internal medicine, public health, and infectious diseases with 28.9%, 18.3%, and 12.6% of medical publications, respectively.ConclusionsThe association between the incidence and publication count indicated the scientific community’s interest in the ongoing situation and timely response to it. Only one-fifth of publications resulted from international collaboration, which might lead to redundancy without adding significant value. Our study underscores the necessity of policies for attraction of international collaboration and direction of vital funds toward domains of higher priority.
Published: 2021
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42. The levels and trends of raised total cholesterol at national and sub-national scale in Iran from 1990 to 2016: systematic review and pooled analysis

Author: Shirin Djalalinia, Rosa Haghshenas, Ehsan Rezaei-Darzi, Parinaz Mehdipour, Shohreh Naderimagham, Yousef Moradi, Alireza Ahmadvand, Farnam Mohebi, Hamidreza Jamshidi, Farshad Farzadfar, Niloofar Peykari, and Sadaf G. Sepanlou
Subjects: Pooled analysis, Scale (ratio), business.industry, Total cholesterol, Environmental health, Medicine, business
Abstract: Raised serum cholesterol is a main risk factor for all-cause and cardiovascular-attributable mortality and morbidity in all nations, particularly in developing countries. Effective policy making in this regard requires detailed data to distinguish disparities and specific patterns. Thus, we aimed to estimate the level and trends of serum cholesterol level and raised total cholesterol prevalence at subnational level from 1990 to 2016 in Iran.We conducted a comprehensive systematic review, through which we detected nine national surveillances, seven large-scale population-based studies, and 88 studies published in databases. We conducted a two-stage model: an Age-Spatio-Temporal model and a Gaussian Process Regression to estimate mean total cholesterol (TC). We used crosswalk to estimate prevalence of raised total cholesterol based on estimated mean, defined as TC higher than 200 mg/dL. All estimations were done in subgroups with sex, age, year, and province combinations.At national level, the number of adults with raised total cholesterol decreased from 10·5 (9·8 – 11·5) million (5·2 million in women) in 1990 to 9·9 (9·0 – 10·6) million (5·4 million in women) in 2016. Age standardized prevalence of raised total cholesterol at national level has decreased from 57·2% (95% CI: 53·3 – 61·1) to 22·4% (20·5 – 24·3) in women and from 53·2% (49·1 – 57·3) to 18·0% (16·4 – 19·6) in men between 1990 and 2016. From 1990 to 2016, age standardized mean TC in both men and women has decreased from 197·3 mg/dL (186·1 – 209·4) to 168·5 (160·7 – 176·7) and from 202·5 mg/dL (191·2 – 214·6) to 174·5 mg/dL (166·6 – 182·8), respectively. In both sexes, population growth had the highest contribution to increase in number of adults with high TC.Decrease in raised TC is likely the result of statin widespread use, food industry improvements, and the expanded primary health care of the country. Provided data at subnational level would help with further evidence-based and population-specific policy making to ensure the continuation of this successful experience, particularly targeting inter-gender and inter-provincial differences. Finally, the increased number of adults with TC slightly below the 200 mg/dL cutoff is threat for the healthcare that should be systematically managed.
Published: 2019
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43. Is salt intake reduction a universal intervention for both normotensive and hypertensive people: a case from Iran STEPS survey 2016

Author: Ali, Gholami, Shahabeddin, Rezaei, Leila Moosavi, Jahromi, Hamid Reza, Baradaran, Ali, Ghanbari, Shirin, Djalalinia, Nazila, Rezaei, Shohreh, Naderimagham, Mitra, Modirian, Negar, Mahmoudi, Zohreh, Mahmoudi, Mohammad Javad, Hajipour, Ahmad, Kousha, Siamak Mirab, Samiee, and Farshad, Farzadfar
Subjects: Adult, Male, Hypertension, Humans, Blood Pressure, Female, Feeding Behavior, Iran, Middle Aged, Sodium Chloride, Dietary, Health Surveys
Abstract: There is a direct association between salt intake and blood pressure (BP), one of the main risk factors for CVDs. However, yet there has been a debate that how strong is this association in people with and without hypertension. This study was conducted to evaluate the magnitude of the association between salt intake and BP in hypertensive and normotensive population among a nationally representative population.The study was conducted on a nationally representative sample of 18,635 Iranian adults aged 25 years and older who participated in the STEPS survey 2016 and provided urine sample. Salt intake was estimated through spot urine sample and Tanaka equation. Multiple linear regression model in survey data analysis was used to assess the independent effect of salt intake on BP.After adjusting for covariates, there was a significant association between salt intake and SBP in hypertensive (p 0.001) and normotensive people (p 0.001). In hypertensive people, with 1 g of increase in salt intake, the SBP and DBP increased 0.37 mmHg and 0.07 mmHg, respectively. Whereas in normotensive people, with 1 g of increase in salt intake, the SBP and DBP increased 0.26 mmHg and 0.05 mmHg, respectively. Moreover, there was a significant trend toward an increase of SBP across salt intake quartiles in both hypertensive (p 0.001) and normotensive people (p = 0.002), though the slope was steeper in hypertensive than in normotensive people.The present study demonstrated that salt intake significantly increased SBP in both hypertensive and normotensive people, though the magnitude of this increase was greater in hypertensive people as compared with normotensive people.
Published: 2019

44. National and Sub-National Pediatric Cancer Mortality in Iran, 2000-2015

Author: Nazila, Rezaei, Farhad, Pishgar, Moein, Yoosefi, Ali, Sheidaei, Sahar, Saeedi Moghaddam, Anita, Mansouri, Leila, Tahernia, Shohreh, Naderimagham, Mitra, Modirian, Forough, Pazhuheian, Negar, Rezaei, Alireza, Namazi Shabestari, Farzad, Kompani, and Farshad, Farzadfar
Subjects: Male, Adolescent, Socioeconomic Factors, Child, Preschool, Incidence, Neoplasms, Infant, Newborn, Humans, Infant, Female, Registries, Iran, Child
Abstract: Cancer, a common disease in adulthood, is a rare albeit slowly increasing condition among children. Currently, limited data are available on the incidence, prevalence, and mortality of these diseases in many regions, including developing countries. Herein, we are reporting national and sub-national estimates on deaths due to childhood cancers between 2000 and 2015 in Iran.Cancer mortality rates were estimated using the national death registration system's data after addressing its incompleteness and misclassification, using demographic (complete birth history and summary birth history) and statistical analysis (spatiotemporal, Gaussian process regression, and generalized linear mixed models). We included data from cemeteries of two cities (Tehran and Isfahan) that were not included in the death registration system. We used census data and household expenditure and income surveys for data on population and other covariates used in the modeling.The overall age-standardized death rate (ASDR) of childhood cancers have decreased by 69.52% (80.67-49.71) in Iran (equal to an annual percent change of -3.63 [-4.53- -2.24]), declining from 12.24 (95% UI: 10.52-14.49) in 2000 to 3.73 (2.8-5.29) deaths per 100000 in 2015. This decrement was equal to an annual percent change of 4.35% over these years. Leukemia, brain, and nervous system malignancies accounted for about 66% of all cancer-related mortalities among children and adolescents in 2015, which had a 10% increase compared to 2000. Moreover, trends at the sub-national level showed that the highest and lowest ASDR of childhood cancers ranged from 2.12 to 4.99 across provinces of Iran in 2015.Although the overall mortalities have decreased, there is still inequality in the distribution of the recorded deaths. This inequality should be addressed with the improvement of the quality of care and better access to pediatric hospitals and oncologists in these areas.
Published: 2018

45. Mortality Attributable to Nutritional Deficiencies among Iranian Children under the Age of Five at National and Subnational Level: 1995-2015

Author: Mojdeh, Soleimanzadehkhayat, Moein, Yoosefi, Negar, Zamaninour, Nazila, Shahbal, Kimiya, Gohari, Ali, Sheidaei, Shohreh, Naderimagham, Alireza, Khajavi, Mitra, Modirian, Negar, Mahmoudi, Zohreh, Mahmoudi, Arezou, Dilmaghani-Marand, Kamyar, Rezaee, Maryam, Chegini, and Ardeshir, Khosravi
Subjects: Male, Spatio-Temporal Analysis, Child, Preschool, Child Mortality, Malnutrition, Humans, Infant, Female, Iran, Sex Distribution
Abstract: Under-five mortality is considered an indicator of population well-being and health equality in societies. Under-five mortality caused by nutritional deficiencies is a public health concern in developing countries. In this study, we aimed to report the trend and mortality rate of nutritional deficiencies from 1995 to 2015 in children aged under five years.In this study, we used the death registration system (DRS) data to estimate age- and sex-specific nutritional deficiency mortality rates at national and sub-national levels in Iran from 1995 to 2015. The Iranian DRS used the 10th revision of International Classification of Diseases (ICD-10) but we report our results based on Global Burden of Diseases (GBD) study codes. We used the average annual percent change (AAPC) to quantify trend in under-five mortality rate attributable to nutritional deficiencies from 1995 to 2015.At national level, mortality rates in both sexes were 8.53 (95% uncertainty interval [UI]: 7.69-9.47), 1.04 (0.86-1.36), and 0.37 (95% UI: 0.28-0.57) per 100,000 in 1995, 2005, and 2015, respectively. AAPC was estimated between 1995 and 2015. At sub-national level, the highest and lowest mortality rates across provinces ranged from 17.7 per 100000 in 1995 to 1.1 per 100000 in 2015. In the latest years, protein-energy malnutrition (PEM) was the most frequent cause of mortality among other nutritional deficiencies.The results show a substantial reduction in terms of mortality caused by nutritional deficiencies at national, as well as provincial, level among children under-five years of age.
Published: 2018

46. National and sub-national patterns of mortality from stroke in the Iranian population (1990-2015): Complementary results from the NASBOD study

Author: Shohreh Naderimagham, Mitra Modirian, Sara Khademiureh, Kamyar Rezaee, Anita Mansouri, Farshad Farzadfar, Mona Marzban, Nazila Rezaei, Negar Rezaei, Shirin Djalalinia, Alireza Namazi Shabestari, Sahar Saeedi Moghaddam, Milad Hasan, and Elham Abdolhamidi
Subjects: Adult, Male, medicine.medical_specialty, Population level, Adolescent, 030204 cardiovascular system & hematology, Iran, Iranian population, 03 medical and health sciences, Young Adult, 0302 clinical medicine, Epidemiology, Medicine, Humans, Registries, Child, Stroke, Aged, Aged, 80 and over, business.industry, Infant, Newborn, Infant, Middle Aged, medicine.disease, Survival Rate, Neurology, Child, Preschool, Female, business, 030217 neurology & neurosurgery, Demography
Abstract: Background Iran lacks a population level comprehensive assessment of stroke epidemiology. Using data from the NASBOD Study, we estimated the mortality of stroke among the Iranian population from 1990 to 2015. Methods Data were collected from all the available sources including the national death registration system and two major cemeteries. After addressing incompleteness of child and adult death data and by using mixed effect model, spatio-temporal model and Gaussian Process Regression, levels and trends of child and adult mortality were estimated. By considering cause fraction to these estimates; cause specific mortality was estimated. In these process wealth index, urbanization, and years of schooling were used as covariates. Results In 2015, the age-standardized stroke mortality rate due was 47.76 (95% UI: 34.68–65.03) for males and 40.16 (30.38–5 2.72) for females, per 100,000 population. Stroke occurrence for both ischemic and non-ischemic strokes showed decreasing trends in both sexes after 2001–2002, at national and sub-national levels. The highest and lowest mortality rates between provinces ranged from 52.11 (40.3–66.66) to 24.47 (18.71–31.79) in men and from 65.51 (47.13–89.41) to 30.43 (21.95–41.82) in women per 100,000 population. Conclusion Although age-standardized rates of stroke mortality are falling, in the past three decades, the absolute number of people who have had a stroke has increased. Stroke mortality remains high in Iran.
Published: 2018

47. National and subnational mortality of urological cancers in Iran, 1990-2015

Author: Kimiya Gohari, Farzad Kompani, Ali Sheidaei, Nazila Rezaei, Erfan Amini, Farhad Pishgar, Farshad Farzadfar, Mitra Modirian, Alireza Namazi Shabestari, Shohreh Naderimagham, Arya Aminorroaya, Hooman Ebrahimi, Moein Yoosefi, and Yasna Rostam-Abadi
Subjects: Adult, Male, Urologic Neoplasms, Urinary system, Iran, History, 21st Century, 03 medical and health sciences, 0302 clinical medicine, Risk Factors, Medicine, Humans, 030212 general & internal medicine, Mortality, Aged, business.industry, Mortality rate, General Medicine, History, 20th Century, Middle Aged, Survival Analysis, Urological Neoplasms, Urological cancers, Oncology, 030220 oncology & carcinogenesis, Death registration, Mixed effects, Female, business, Demography
Abstract: Purpose To study trends of urological cancers mortalities in Iran between 1990 and 2015 as a part of a larger project named national and subnational burden of diseases, injuries, and risk factors. Methods The primary dataset of this project comprises data of national death registration system. Cause-specific mortality fraction for each age, sex, province, and year group was calculated using a two-stage mixed effects and spatiotemporal models, and then these fractions were applied to all-cause mortality rates, obtained from a parallel study to estimate mortality rates attributable to each cause. Results In 2015, urological cancers constituted 8% of cancer-related deaths in Iran, and number of deaths due to prostate, bladder, testicular, and kidney and other urinary organs cancers were estimated as 2,128 (1,565-2,891), 297 (230-385), 301 (144-639), and 195 (143-267), respectively. Our estimates show that age-standardized death rates (ASDRs) of these cancers reached 6.8 (5-9.23), 0.47 (0.37-0.61), 0.96 (0.46-2.04), and 0.24 (0.18-0.33) deaths per 100,000 individuals in 2015, a reduction in the three latter cancers, from 4.09 (2.92-5.76), 13.04 (10.04-16.95), 1.23 (0.46-3.34), and 1.76 (1.28-2.42) deaths per 100,000 individuals in 1990, respectively. Conclusions In conclusion, despite disparities among different provinces, overall mortality rate of urological cancers decreased significantly since 1990s in Iran.
Published: 2018

48. Prevalence of dyslipidemia in Iranian children and adolescents: A systematic review

Author: Shirin Djalalinia, Mostafa Qorbani, Farshad Farzadfar, Roya Kelishadi, Silva Hovsepian, and Shohreh Naderimagham
Subjects: Pediatrics, medicine.medical_specialty, pediatrics, Population, prevalence, MEDLINE, Scopus, Psychological intervention, lcsh:Medicine, Review Article, Iran, systematic review, Environmental health, medicine, Risk factor, education, education.field_of_study, business.industry, lcsh:R, Hypertriglyceridemia, nutritional and metabolic diseases, General Medicine, medicine.disease, lipid profile, Dyslipidemia, Electronic data, business
Abstract: Background: Dyslipidemia is considered as an important modifiable risk factor for cardiovascular disease (CVD). The link between childhood dyslipidemia and occurrence of atherosclerosis and its sequels in adulthood are well-documented. This study aimed to systematically review the prevalence of dyslipidemia among Iranian children and adolescents. Materials and Methods: An electronic search was conducted on studies published from January 1990 to January 2014. The main international electronic data sources were PubMed and the NLM Gateway (for MEDLINE), Institute of Scientific Information (ISI), and SCOPUS. For Persian databases, we used domestic databases with systematic search capability including IranMedex, Irandoc, and Scientific Information Database (SID). We included all available population-based studies and national surveys conducted in the pediatric age group(aged
Published: 2015

49. Protocol Design for Large-Scale Cross-Sectional Studies of Surveillance of Risk Factors of Non-Communicable Diseases in Iran: STEPs 2016

Author: Shirin, Djalalinia, Mitra, Modirian, Ali, Sheidaei, Moein, Yoosefi, Hossein, Zokaiee, Bahman, Damirchilu, Zohreh, Mahmoudi, Negar, Mahmoudi, Mohammad Javad, Hajipour, Niloofar, Peykari, Nazila, Rezaei, Rosa, Haghshenas, Mohammad Hossein, Mohammadi, Alireza, Delavari, Mohammad Mehdi, Gouya, Shohreh, Naderimagham, Ahmad, Kousha, Alireza, Moghisi, Alireza, Mahdavihezaveh, Kambiz, Abachizadeh, Reza, Majdzadeh, Ali Akbar, Sayyari, Reza, Malekzadeh, Bagher, Larijani, and Farshad, Farzadfar
Subjects: Adult, Male, Adolescent, Iran, Middle Aged, Health Surveys, Young Adult, Age Distribution, Cross-Sectional Studies, Research Design, Risk Factors, Humans, Female, Sex Distribution, Noncommunicable Diseases, Aged
Abstract: The rise in non-communicable diseases (NCDs) has gained increasing attention. There is a great need for reliable data to address such problems. Here, we describe the development of a comprehensive set of executive and scientific protocols and instructions of STEPs 2016.This is a large-scale cross-sectional study of Surveillance of Risk Factors of NCDs in Iran. Through systematic proportional to size cluster random sampling, 31,050 participants enrolled in three sequential processes, of completing questionnaires; physical measurements, and lab assessment.Out of 429 districts, samples were taken from urban and rural areas of 389 districts. After applying sampling weight to the samples, comparing the distribution of population and samples, compared classification was determined in accordance with the age and sex groups. Out of 31,050 expected participants, 30,541 participant completed questionnaires (52.31% female). For physical measurements and lab assessment, the cases included 30,042 (52.38% female) and 19,778 (54.04% female), respectively.There is an urgent need to focus on reviewing trend analyses of NCDs.To the best of our knowledge, the present study is the first comprehensive experience on systematic electronic national survey. The results could be also used for future complementary studies.
Published: 2017

50. Burden of disease attributable to vitamin A deficiency in Iranian population aged less than five years: findings from the global burden of disease study 2010

Author: Morteza Mansourian, Sara Nejatinamini, Omid Safari, Shohreh Naderimagham, Ali Asghar Ahmadishokouh, Mostafa Qorbani, Asal Ataie-Jafari, Maryam Bahreynian, Alireza Khajavi, Fahad Saqib, Hamid Asayesh, Farshad Sharifi, and Roya Kelishadi
Subjects: 0301 basic medicine, Vitamin a deficiency, medicine.medical_specialty, Pediatrics, Endocrinology, Diabetes and Metabolism, Iran, Disability-adjusted life years, Measles, 03 medical and health sciences, 0302 clinical medicine, parasitic diseases, Internal Medicine, Medicine, 030212 general & internal medicine, 030109 nutrition & dietetics, business.industry, Public health, Years lived with disability, medicine.disease, Vitamin A deficiency, Diarrhea, Low birth weight, Years of potential life lost, medicine.symptom, business, Risk assessment, Global burden of disease (GBD), Malaria, Research Article, Demography
Abstract: Background Vitamin A deficiency (VAD) is considered as one of the most serious public health concerns in developing countriesand the leading cause of mortality in under-five-year-old children.A large number of young children and pregnant women especially in low-income, non-industrialized communities are more susceptible to VAD. This study aims to report the burden of disease (BOD) attributable to VAD in Iranian population aged less than 5 years by using data of the Global Burden of Disease (GBD) study 2010. Methods The GBD 2010 study calculated the proportion of deaths, years of life lost (YLLs), and years lived with disability (YLDs) and disability-adjusted life years (DALYs) attributable to VAD by using the comparative risk assessment (CRA). VAD defined as low serum retinol concentrations (plasma retinol concentration
Published: 2017
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