Prevalence, trend, and associated risk factors for cleft lip with/without cleft palate: a national study on live births from 2016 to 2021.

BACKGROUNDS: Cleft lip with or without cleft palate (CL/P) is the most common congenital craniofacial anomaly, including non-syndromic cleft lip with or without cleft palate and cleft palate only. Failure in the fusion of median and lateral nasal processes, the maxillary prominence, and soft tissues around the oral cavity can cause CL/P. Previously, the prevalence has been estimated to be 1 among every 1000 births in 2014 among American neonates and no other reports have been available since. Thus, this study aimed to calculate the prevalence and trend of isolated CL/P among American live births from 2016 to 2021 with its associated risk factors. METHODS AND MATERIALS: In this cross-sectional population-based retrospective study, we used live birth data provided by the National Center for Health Statistics (NCHS) from the Center for Disease Control and Prevention (CDC). We calculated the prevalence per 10,000 live births of isolated (non-syndromic) CL/P from 2016 to 2021. To examine risk factors for developing isolated CL/P, we used logistic regression modelling. RESULTS: The total prevalence per 10,000 births from 2016 to 2021 was 4.88 (4.79-4.97), for both sexes, and 5.96 (5.82-6.10) for males, and 3.75 (3.64-3.87) for females. The prevalence did not show any consistent linear decreasing or increasing pattern. We found significant association between increased odds of developing isolated CL/P among cases with 20 to 24 year-old mothers (OR = 1.07, 1.01-1.13, p = 0.013), mothers who smoked 11 to 20 cigarettes per day (OR = 1.46, 1.33-1.60, p <  0.001), mothers with extreme obesity (OR = 1.32, 1.21-1.43, p <  0.001), mothers with grade II obesity (OR = 1.32, 1.23-1.42, p <  0.001), mothers with pre-pregnancy hypertension (OR = 1.17, 1.04-1.31, p = 0.009), mothers with pre-pregnancy diabetes mellitus (OR = 1.96, 1.71-2.25, p <  0.001), and mothers who used assisted reproductive technology (OR = 1.40, 1.18-1.66, p <  0.001). CONCLUSIONS: Our findings suggest a minuscule increase, albeit insignificant, in the trend of CL/P prevalence from 2016 to 2021. Developing CL/P had greater odds among mothers with pre-pregnancy diabetes, smoking, obesity, and pre-pregnancy hypertension mothers along with mothers who used assisted reproductive technology. Isolated CL/P had the highest prevalence in non-Hispanic Whites, American Indian or Alaskan Native and Native Hawaiian and Other Pacific Islanders.

Global, regional, and national burden and quality of care index (QCI) of oral disorders: a systematic analysis of the global burden of disease study 1990-2017.

BACKGROUND: Oral disorders are still a major global public health challenge, considering their perpetuating and chronic nature. Currently, there is no direct index to measure the quality of care on a population scale. Hence, we aim to propose a new index to measure the quality of care for oral disorders worldwide. METHODS: We generated our database using the data from the Global Burden of Disease (GBD) study 2017. Among different variables such as prevalence, incidence, years lived with disability, and disability-adjusted life years, we utilised principal component analysis (PCA) to determine the component that bears the greatest proportion of information to generate the novel quality of care index (QCI) for oral disorders. RESULTS: Global QCI for oral disorders gradually increased from 1990 to 2017 (from 70.5 to 74.6). No significant gender disparity was observed during this period, and the gender disparity ratio (GDR) was considered optimal in 1990 and 2017. Between 1990 and 2017, the age-standardised QCI for all oral disorders increased in all the SDI regions. The highest QCI for all oral disorders in 2017 belonged to high-middle SDI countries (=80.24), and the lowest YLDs rate was seen in the low SDI quintile. In 1990, the quality of care in European, Central Asian, and Central and South American countries was in the lowest quintiles, whereas the North American, East Asian, Middle Eastern, and some African countries had the highest quality of dental care. Maynmar (=100), Uganda (=92.5), Taiwan (=92.0), China (=92.5), and the United States (=89.2) were the five countries with the highest age-standardised QCI. Nicaragua (=41.3), Belgium (=40.2), Venezuela (=38.4), Sierra Leone (=30.5), and the Gambia (=30.3) were the five countries with the least age-standardised QCI values. CONCLUSION: The quality of care for all oral disorders showed an increasing trend on a global scale from 1990 to 2017. However, the QCI distribution was not homogenous among various regions. To prevent the exacerbation of imminent disparities in this regard, better attention to total tooth loss in high-income countries and prioritising primary healthcare provision in low-income countries are recommended for oral disorders.

Dental Caries among the Elderly in Iran: A Meta-analysis.

Background: The prevalence of dental caries among the elderly is high worldwide, and dental caries cause the major burden of oral diseases. This meta-analysis aimed to determine the dental caries experience among the elderly in Iran. Methods: A systematic review of the published and grey literature on Iranians aged 65 years or older was performed. Six international and local databases provided the most comprehensive population-based studies. National oral health surveys and national disease and health surveys were considered other primary data sources. The quality of remained studies was assessed by a modified tool designed based on the STROBE statement checklist to evaluate the cross-sectional studies. R Version 3.6.0 was used for statistical analysis. Heterogeneity was assessed using Cochran's Q and F statistics. Subgroup analysis was performed to detect the source of heterogeneity. Funnel plots and Egger's regression intercept test were used to assess publication bias and selective reporting. Results: Overall, 3099 sources were found. After excluding ineligible studies, 46 data points with 10411 people ≥65 years were included in the meta-analysis. The mean pooled decayed, missing, and filled teeth (DMFT) among older people was 26.84 (range, 26.41-27.28). The DMFT was 26.78 (range, 26.12-27.43) in women and 26.91 (range, 26.32-27.50) in men. The mean number of decayed teeth was 1.48 (range, 1.32-1.65). The mean pooled missing teeth was 24.83 (range, 24.20-25.46), and the mean pooled filled teeth was 0.14 (range, 0.12-0.17). The majority (92%) of the DMFT was related to missing teeth. Conclusion: Iranian elderly have almost 5 sound teeth in their mouth on average. The Iranian oral health policymakers should address this considerable burden of dental caries in designing and implementing better oral health policies for the population, especially older Iranian adults.

Design, development and evaluation of a mobile-based self-care application for patients with COVID-19 not requiring hospitalization; a study of Northwest of Iran.

BACKGROUND: Given the effective role of a mobile applications in disease management, disease monitoring, and self-care in patients with COVID-19 disease, we aimed to design, development and evaluation of a self-care Mobile app for COVID-19 patients not requiring hospitalization. METHODS: The design, development and evaluation the usability of the self-care and education mobile app for patients with COVID-19 disease were conducted in two main phases at 2021 in Northwest of IRAN; (1) Determine the features and capabilities and (2) Design, development and evaluation of self-care mobile App. JAVA programming languages and Android Operating System were used and selected to design and development of a mobile app. There were 25 participants who conducted evaluations of the mobile app's usability and impact using the mobile health app usability a Questionnaire of User Interface Satisfaction was administered to assess the usability of the developed application. The results were analyzed via Excel 2013. RESULTS: The model of developing a mobile app as an Information System was the Waterfall model. The smartphone application based on a set of capabilities and features was designed and consists of two main parts: the login screen for user registration, and the main home menu. The user interface includes three main pages or activities; (a) Main Menu for quick access to all of the pages, (b) Symptom management and monitoring to monitor the signs and symptoms during the illness, and (c) Set Reminders and Alarms to notify patients. The users' mean score of the application usability was calculated as 7.91 out of 9 indicating a good level of satisfaction. CONCLUSION: This app can be a guideline and a useful tools for managing and monitoring symptoms, reminding medications, and implementing self-care instructions in outpatients. The authors suggest evaluating the efficacy and functionality test of mobile-based applications for COVID-19 in clinical trial studies.

Assessment of virtual education during the covid-19 pandemic from the perspective of faculty members and students: a cross-sectional descriptive study in northwest Iran.

BACKGROUND: Since the coronavirus outbreak, many countries have replaced traditional education with virtual education in order to prevent the disease spread, and also avoid stopping education. The aim of the present study was to assess the virtual education status at Khalkhal University of Medical Sciences during the covid-19 pandemic from the perspective of students and faculty members. METHODS: This is a descriptive-cross-sectional study that was conducted between December 2021and February 2022. The study population included faculty members and students who were selected by consensus. Data collection instruments included demographic information form and a virtual education assessment questionnaire. Data analysis was carried out using independent T-test, one sample T-test, Pearson Correlation, and ANOVA test in SPSS software. RESULTS: A total of 231 students and 22 faculty members of Khalkhal University of Medical Sciences participated in the present study. The response rate was 66.57%. The mean and standard deviation of assessment scores of students (3.3 ± 0.72) were lower than those of faculty members (3.94 ± 0.64), which showed a statistically significant difference (p < 0.01). User access to the virtual education system (3.8 ± 0.85) and lesson presentation (4.28 ± 0.71) obtained the highest scores from the perspective of students and faculty members, respectively. There was a statistically significant association between employment status and the assessment score of faculty members (p = 0.01), and the field of study (p < 0.01), the year of university entrance (p = 0.01), and the assessment score of students. CONCLUSION: The results showed a higher than mean assessment score in both groups of faculty members and students. There was a difference between faculty members and students in terms of virtual education scores in the parts that require the creation of better processes and more complete capabilities in the systems, which seems that more detailed planning and reforms will improve the process of virtual education.

Trends in dental caries of deciduous teeth in Iran: a systematic analysis of the national and sub-national data from 1990 to 2017.

BACKGROUND: Dental caries is the most prevalent child affliction in the world and can be reduced through effective preventive interventions. To plan cost-effective interventions, clear and integrated data are needed. This study has been designed to overcome the lack of national trend in deciduous dental caries in Iran. OBJECTIVE: To estimate the dental caries trend in deciduous teeth in the Iranian population at different ages from 1990 to 2017. METHODS: From 1990 to 2017 a literature search about dmf and its components (decayed, missed, and filled tooth, abbreviated as dt, mt, and ft) as well as dental caries was done in the Iranian population in three English (PubMed, Web of Science, and Scopus) and three national databases (in Persian). All eligible national oral health surveys in these 28 years were included. National dmft data were categorised based on age (1-4, 5-9, and 10-14), sex, province and year. The final trends were estimated using an age-spatio-temporal hierarchical model. We used the bootstrap method in multilevel models to predict the uncertainty interval (UI) of the modelled results. Finally, the estimations of dmft, dt, mt, and ft with a 95% UI were reported from 1990 to 2017. RESULTS: Almost 22% of the Iranian deciduous teeth were involved with dental caries in 1990 [dmft = 4.37; (95% UI 2.23, 6.62)] which more than 83% of it was dt [3.64 (1.53, 5.88)] and less than 7% was ft [0.30 (0.06, 0.65)]. During 1990-2017, dmft increased by more than 15% [in 2017, dmft = 5.03 (2.82, 7.29)]. The highest increase was seen in dt which was more than 17% [in 2017, dt = 4.27 (1.96, 6.57)]. CONCLUSION: Increasing dental caries among Iranian children over 28 years shows that oral health policies in Iran need critical evaluation. We need cost-effective nationwide interventions (e.g., supervised tooth brushing and improving dietary habits) and training well-experienced intermediate manpower (e.g., dental hygienists) to reduce dental caries.

In vitro study of the mesenchymal stem cells-conditional media role in skin wound healing process: A systematic review.

Mesenchymal stromal cell (MSC)-conditioned medium (CM) offers a potential opportunity in the skin wound healing treatment. In this systematic review, an overview of the knowledge on this topic has been provided. A multistep search of the PubMed, Scopus and Science Direct database has been performed to identify papers on MSCs-conditional media used in skin wound healing. Eligibility checks were performed based upon predefined selection criteria. Of the 485 articles initially identified, consequently, only 96 articles apparently related to MSC-conditional media were initially assessed for eligibility. Finally, the 32 articles, strictly regarding the in vitro use of MSCs-conditional media in skin wounds, were analysed. The information analysed highlights the efficacy of MSCs-conditional media on skin wound healing in vitro models. The outcome of this review may be used to guide pre-clinical and clinical studies on the role of MSCs-conditional media in skin wound healing.

Global, regional, and national burden and quality of care index (QCI) of lip and oral cavity cancer: a systematic analysis of the Global Burden of Disease Study 1990-2017.

BACKGROUND: To measure the quality of care for lip and oral cavity cancer worldwide using the data from the Global Burden of Disease (GBD) Study 2017. METHODS: After devising four main indices of quality of care for lip and oral cavity cancer using GBD 2017 study's measures, including prevalence, incidence, years of life lost, years lived with disability, and disability-adjusted life years, we utilised principal component analysis (PCA) to determine a component that bears the most proportion of info among the others. This component of the PCA was considered as the Quality-of-Care Index (QCI) for lip and oral cavity cancer. The QCI score was then reported in both men and women worldwide and different countries based on the socio-demographic index (SDI) and World Bank classifications. RESULTS: Between 1990 and 2017, care quality continuously increased globally (from 53.7 to 59.6). In 1990, QCI was higher for men (53.5 for men compared with 50.8 for women), and in 2017 QCI increased for both men and women, albeit a slightly higher rise for women (57.2 for men compared with 59.9 for women). During the same period, age-standardised QCI for lip and oral cavity cancer increased in all regions (classified by SDI and World Bank). Globally, the highest QCI scores were observed in the elderly age group, whereas the least were in the adult age group. Five countries with the least amount of QCIs were all African. In contrast, North American countries, West European countries and Australia had the highest indices. CONCLUSION: The quality of care for lip and oral cavity cancer showed a rise from 1990 to 2017, a promising outcome that supports patient-oriented and preventive treatment policies previously advised in the literature. However, not all countries enjoyed such an increase in the QCI to the same extent. This alarming finding could imply a necessary need for better access to high-quality treatments for lip and oral cavity cancer, especially in central African countries and Afghanistan. More policies with a preventive approach and paying more heed to the early diagnosis, broad insurance coverage, and effective screening programs are recommended worldwide. More focus should also be given to the adulthood age group as they had the least QCI scores globally.

Modeling and forecasting the spread and death rate of coronavirus (COVID-19) in the world using time series models.

Coronaviruses are a huge family of viruses that affect neurological, gastrointestinal, hepatic and respiratory systems. The numbers of confirmed cases are increased daily in different countries, especially in Unites State America, Spain, Italy, Germany, China, Iran, South Korea and others. The spread of the COVID-19 has many dangers and needs strict special plans and policies. Therefore, to consider the plans and policies, the predicting and forecasting the future confirmed cases are critical. The time series models are useful to model data that are gathered and indexed by time. Symmetry of error's distribution is an essential condition in classical time series. But there exist cases in the real practical world that assumption of symmetric distribution of the error terms is not satisfactory. In our methodology, the distribution of the error has been considered to be two-piece scale mixtures of normal (TP-SMN). The proposed time series models works well than ordinary Gaussian and symmetry models (especially for COVID-19 datasets), and were fitted initially to the historical COVID-19 datasets. Then, the time series that has the best fit to each of the dataset is selected. Finally, the selected models are applied to predict the number of confirmed cases and the death rate of COVID-19 in the world.

The Effect of Genetically Modified Food on Infertility Indices: A Systematic Review Study.

Background and Objectives. With the increase in the growth of genetically modified (GM) crops, concerns as to the adverse effects of GM crops have risen in the community. The present systematic review seeks to assess the GM plants' potential impacts on the sperm parameters, including sperm head, sperm motility, sperm abnormality, and fertility index. Materials and Methods. A structured literature search was independently performed by three authors on Scopus, Web of Science, PubMed, and Embase in January 2019. A total of 1467 publications were obtained by the search strategy after eliminating the duplicates. Moreover, the review only included articles written in English language. Other pertinent peer-reviewed publications were chosen ("snowballing") from the reference lists in the selected publications. To assess the GM crop effects on infertility, experimental studies designed with the control group were selected. On the basis of abstract screening and full-text reviewing, 39 relevant publications were selected, seven of which were used in our review. To access the quality of articles, we used the Cochrane checklist. The collected articles were scored independently by three authors, and the publications with the eligibility criteria were included in our review. No article was excluded due to quality assessment. Results and Conclusion. Our findings indicated that GM products had no adverse effects on infertility indices such as the sperm head, sperm motility, sperm abnormality, and fertility indices. Long-term research still seems to be strongly necessary to ensure that the use of GM plants does not cause any harm to consumers, especially in infertility area.

Effect of urea, compost, manure and bio-fertilizers on yield, percentage and composition of fatty acids of sesame seed oil (Sesamum indicum L.).

This study was carried out in Iran during two growing seasons 2016-2017. Sesame is one of the earliest oilseed plants, high oil percentage and high content of unsaturated fatty acids, especially oleic acid and linoleic acid, have led to an increase in the nutritional quality of sesame oil. Accordingly, a two-year experiment was conducted as factorial based on randomized complete block design with three replications. The evaluated factors included four levels of urea as nitrogen fertilizer (0, 33, 66 and 100% of plant requirement), three kinds of organic fertilizer (manure, vermicompost and control) and four kinds of biofertilizers (Azosperillum, Azotobacter, Azosperillum +Azotobacter and control). At the end of the growing season, seed yield, percentage and yield of seed oil and fatty acids composition (oleic acid, linolenic acid, linoleic acid, stearic acid and palmitic acid) were measured. The results showed that the effect of different levels of nitrogen, organic and biological fertilizers on all studied traits was significant in two years of experiment and in all three environments (control, manure and compost). Vermicompost fertilizer and Azosperillum + Azotobacter have a more favorable effect on traits than other levels of each of these fertilizers, but nitrogen fertilizer levels have different effects on different traits.  The highest seed yield (1298 kg ha-1) was obtained for control environment in 100% nitrogen application, for manure environment in 33% nitrogen application (1565 kg ha-1) and for compost environment in 66% nitrogen application (1799 kg ha-1).

Ergonomic intervention, workplace exercises and musculoskeletal complaints: a comparative study.

BACKGROUND: Musculoskeletal disorders are among the most prevalent occupational disorders in different jobs such as office work. Some interventions such as ergonomic modifications and workplace exercises are introduced as the methods for alleviating these disorders. In this study we compared the effect of ergonomic modifications and workplace exercises on musculoskeletal pain and discomfort in a group of office workers. METHODS: In an interventional study on office workers, the effect of two interventions was compared. Ergonomic modification consisted of correcting the arrangement of workstation and changing some equipment; workplace exercises included stretching exercises focusing on neck, shoulders, low back, and hand and wrist. Musculoskeletal complaints were assessed and compared before and after 1 month interventions. RESULTS: The frequency of musculoskeletal complaints was high before the study. Both interventions significantly reduced complaints in a similar manner except for low back pain which was reduced in exercise group more than the other group. CONCLUSION: In this study we found a beneficial short-term effect for both ergonomic modifications and stretching work-place exercises on reducing musculoskeletal pain in office workers.

Determinants of unmet needs for mental health services amongst adolescents in Shiraz, Iran: a cross-sectional study.

Background: Mental disorders are increasingly prevalent among adolescents without appropriate response. There are a variety of reasons for unmet mental health needs, including attitudinal and structural barriers. Accordingly, we investigated perceived mental health needs, using mental health services, and their barriers in adolescents. Method: This cross-sectional study was conducted in 2022 in Shiraz, Iran. Demographic characteristics, the Adolescent Unmet Needs Checklist, and the Young Schema Questionnaire were administered to 348 adolescents aged 13-19 years. Adolescents were classified as having no needs, fully met needs, partially met needs, or wholly unmet needs. Logistic regression analysis was used to determine factors associated with perceived unmet need and refer participants to healthcare centers. Results: 193 (55.5%) adolescents reported perceived need for mental healthcare out of whom, 21.6% reported fully and 21.6% partially unmet needs. Noticeably, only 12.4% of needy participants reported met need. "Reluctance to seek mental healthcare" and "asked but not receiving help" were common barriers to using the services. Conclusion: The present study reveals unmet mental healthcare needs as a significant public health concern among the adolescents. To address this significant concern, reorientation of primary care, removing economic barriers from mental healthcare services, and improving health literacy in the community are recommended.

Contribution of obesity to racial and ethnic disparities in the risk of fetal myelomeningocele: a population-based study.

BACKGROUND: Prepregnancy obesity and racial-ethnic disparities has been shown to be associated with meningomyelocele. OBJECTIVE: This study aimed to investigate the association of maternal periconceptional factors, including race-ethnicity and prepregnancy body mass index, with the prevalence of isolated fetal myelomeningocele. METHODS: This was a population-based cross-sectional study using Centers for Disease Control and Prevention birth data from 2016 to 2021. Major structural anomalies or chromosomal abnormalities were excluded. Race-ethnicity was classified as non-Hispanic White (reference population), non-Hispanic Black, non-Hispanic Asian, Hispanic, and others. Maternal prepregnancy body mass index was classified as underweight (<18.5 kg/m2), normal (reference group; 18.5-24.9 kg/m2), overweight (25-29.9 kg/m2), and class I (30-34.9 kg/m2), class II (35-39.9 kg/m2), and class III obesity (≥40 kg/m2). A chi-square test of independence was performed to identify factors significantly associated with myelomeningocele. These factors were then stratified into 3 adjusted clusters/levels. The prevalence was calculated per 10,000 live births. The Cochran-Armitage test for trend was used to detect any significant increasing or decreasing trends. RESULTS: A total of 22,625,308 pregnancies with live birth, including 2866 pregnancies with isolated fetal myelomeningocele, were included in the analysis. The prevalence of isolated fetal myelomeningocele per 10,000 live births varied among different racial/ethnic groups, with the highest prevalence found among the non-Hispanic White (1.60 [1.52-1.67]) and lowest among the non-Hispanic Asian (0.50 [0.40-0.64]) population. The prevalence significantly increased with body mass index, with the highest prevalence found in the population with class III obesity (1.88 per 10,000 live births). Subgroup analysis of the associations between the significant variables (obesity, diabetes, hypertension, and education) and each ethnicity in cases with myelomeningocele showed significant variations in prevalence of these variables among different racial/ethnic groups. Following the model with the 3 levels of adjustment described in the Methods section, prepregnancy overweight and class I, II, and III obesity remained significantly associated with the odds of isolated fetal myelomeningocele. The adjusted odds ratios were 1.32 (95% confidence interval, 1.19-1.46; P<.001) for overweight, 1.55 (95% confidence interval, 1.38-1.75; P<.001) for class I obesity, 1.68 (95% confidence interval, 1.45-1.94; P<.001) for class II obesity, and 1.73 (95% confidence interval, 1.47-2.04; P<.001) for class III obesity. Similarly, following the 3-level adjustment model, the obesity-mediated effect of maternal race-ethnicity on the odds of myelomeningocele remained significant (non-Hispanic Black: adjusted odds ratio, 1.03; 95% confidence interval, 1.02-1.05; P<.001; non-Hispanic Asian: adjusted odds ratio, 1.02; 95% confidence interval, 1.01-1.03; P<.001; Hispanic: adjusted odds ratio, 1.5; 95% confidence interval, 1.03-1.6; P<.001). The test for trend among different racial/ethnic groups did not show significant results across the past 6 years. However, the test for trend showed a significant increase in the prevalence of isolated myelomeningocele associated with class II and III obesity over the past 6 years. CONCLUSION: There has been a rising trend of fetal isolated myelomeningocele in pregnancies with maternal class II and III obesity over the past 6 years after adjusting for other covariates. Prepregnancy obesity, a modifiable risk factor, is a significant driver of racial/ethnic disparities in the overall risk for isolated fetal myelomeningocele.

National and Subnational Trend of Dental Caries of Permanent Teeth in Iran, 1990-2017.

OBJECTIVE: There are currently no integrated data on the trend of dental caries amongst distinct age groups in Iran. We aimed to assess the national and subnational trend of dental caries of permanent teeth in Iran from 1990 to 2017. METHODS: A literature search about dental caries and the decayed-missing-filled teeth index (DMFT) was performed in PubMed, Web of Science, Scopus, and 3 national databases (in Persian). All eligible national oral health surveys in these 28 years were included. We categorised and aggregated the DMFT values and their components based on age (5-year-based groups from 5 to 9 to 60+ years), sex, year, and province. The data for missing spots were estimated using the spatiotemporal Bayesian hierarchical model. We used the bootstrap method in multilevel models to predict the uncertainty interval (UI) of the modelled results. RESULTS: Nationally, the all-ages mean DMFT increased by nearly 58.0% (6.8 [95% UI, 4.1-10.5] in 1990 to 10.8 [95% UI, 7.5-14.5] in 2017). Decayed teeth (DT) and missing teeth (MT) rose by 84.5% and 31.6% during this period, respectively. Filled teeth (FT) showed almost a 2.6-fold increase in the same period from 0.6 (95% UI, 0.01-1.6) in 1990 to 1.7 (95% UI, 0.6-2.8) in 2017. The proportion of DT and FT continuously increased in both sexes. In 2017, the highest DT, MT, and FT were estimated in the 25-29 (4.9 [95% UI, 2.5-7.2]), 60+ (21.5 [95% UI, 17.5-25.4]), and 35-39 (2.6 [95% UI, 1.3-4.0]) year age groups. CONCLUSIONS: Caries of permanent dentition levies a growing burden on the Iranian population. Considering the continuous increase in caries during the 1990-2017 period, Iranian policymakers should pay heed to these findings and react more proactively to mitigate this perpetuating issue. Implementing nationwide interventions such as sugar consumption management should be encouraged to achieve sustainable outcomes in this regards.

The association between dental caries, periodontal diseases, and tooth loss with diabetes mellitus among the elderly population.

Purpose: Our study investigated the association between dental caries, periodontal diseases, and tooth loss with diabetes mellitus (DM) among the elderly population, representing the first study of its kind in Iran. Methods: This was a cross-sectional community-based study as a part of the second wave of the Birjand longitudinal aging study (BLAS, 2021-2022) for people older than 60. We used the Comprehensive Geriatric Oral Health Assessment Tool (CGOHAT) for the oral health evaluation. Participants were initially categorized into diabetic and non-diabetic groups. Those patients with DM were further categorised into uncontrolled and controlled diabetes based on their HbA1c level. The association between periodontitis, gingivitis, and edentulism with type II diabetes mellitus and uncontrolled diabetes was assessed using logistic regression. Results: Among the 1,011 participants, 324 (32.04%) had DM. The mean ± SD DMFT was 27.06 ± 7.71 and 27.07 ± 7.72 among those with and without DM, respectively (p = 0.976). The M index comprised 85.46% of the total DMFT among those without DM and 84.51% among those with DM. The prevalence of periodontitis was higher among those without DM (110, 32.84%, p = 0.390). The prevalence of gingivitis was higher among those with DM (73, 45.06%, p = 0.617). Among the diabetic group, 137 (42.28%) had controlled DM. Based on the adjusted matched multivariate logistic model, decayed teeth (1.24, 95%CI: 1.06 - 1.46, p-value = 0.006), periodontitis (2.78, 95%CI: 1.02 - 7.56, p-value = 0.044), and moderate tooth loss (5.73, 95%CI: 1.13 - 28.88, p-value = 0.034) were significantly associated with increased odds of uncontrolled DM. Conclusions: Based on the findings of this study, tooth loss was highly prevalent among the elderly Iranians regardless of their diabetes status. Also, periodontitis, tooth loss, and decayed teeth were significantly associated with increased odds of poor glycemic control among those with DM. Thus, it can be concluded that improving the oral health of the geriatric population may be a crucial part of improving the glycemic control among those with diabetes which has been frequently neglected. Supplementary Information: The online version contains supplementary material available at 10.1007/s40200-024-01434-2.

Broadband high-efficiency 3-bit coding metasurface in transmission mode based on the polarization conversion technique.

The main drawback of the transmissive focusing metasurface (TFM) is its low operational bandwidth and aperture efficiency. Increasing both of these radiation characteristics simultaneously is a major challenge for these structures. This paper introduces a novel multi-state coding metasurface that utilizes system-level and element-level synthesis approaches to enhance frequency bandwidth and aperture efficiency. Unlike most of the TFMs proposed in this field, the proposed novel element consists of only two dielectric layers. The multi-frequency phase synthesis (MFPS) approach, a well-established broadband technique, is utilized for the system-level synthesis approach. An optimization algorithm is utilized to balance the phase error in the whole band in terms of gain variations and aperture efficiency. At the element design level, a PCT-based wideband technology is utilized and implemented by a subwavelength non-resonant element. The element is composed of three C-shaped metallic patterns, and the metal layers are printed on both sides of two identical dielectric layers without using any metalized via in the configuration. By simply changing the angle of arc curves in all layers, eight states of phase quantization are achieved. The amplitude of the transmitted wave with rotated polarization is larger than 0.9 from 12.3 to 16.5 GHz, except for state 4, which has an amplitude greater than 0.5 at the beginning of the band. A 25 [Formula: see text] 25-element TFM was designed, fabricated, and tested using the aforementioned broadband technique (MFPS along with PCT-based wideband technology). The measurement results show that the 1-dB gain bandwidth of the antenna is 12.3-16.5 GHz, which is equivalent to 29%. The maximum measured aperture efficiency is 53.6%, occurring at 12.8 GHz. The proposed metasurface is classified in the group of broadband high-efficiency TFMs.

Orthonormal piecewise Vieta-Lucas functions for the numerical solution of the one- and two-dimensional piecewise fractional Galilei invariant advection-diffusion equations.

INTRODUCTION: Recently, a new family of fractional derivatives called the piecewise fractional derivatives has been introduced, arguing that for some problems, each of the classical fractional derivatives may not be able to provide an accurate statement of the consideration problem alone. In defining this kind of derivatives, several types of fractional derivatives can be used simultaneously. OBJECTIVES: This study introduces a new kind of piecewise fractional derivative by employing the Caputo type distributed-order fractional derivative and ABC fractional derivative. The one- and two-dimensional piecewise fractional Galilei invariant advection-diffusion equations are defined using this piecewise fractional derivative. METHODS: A new class of basis functions called the orthonormal piecewise Vieta-Lucas (VL) functions are defined. Fractional derivatives of these functions in the Caputo and ABC senses are computed. These functions are utilized to construct two numerical methods for solving the introduced problems under non-local boundary conditions. The proposed methods convert solving the original problems into solving systems of algebraic equations. RESULTS: The accuracy and convergence order of the proposed methods are examined by solving several examples. The obtained results are investigated, numerically. CONCLUSION: This study introduces a kind of piecewise fractional derivative. This derivative is employed to define the one- and two-dimensional piecewise fractional Galilei invariant advection-diffusion equations. Two numerical methods based on the orthonormal VL polynomials and orthonormal piecewise VL functions are established for these problems. The numerical results obtained from solving several examples confirm the high accuracy of the proposed methods.

Public Health Risk Evaluation through Mathematical Optimization in the Process of PPPs.

The public sector is becoming increasingly appealing. In the context of declining public money to support health studies and public health interventions, public-private partnerships with entities (including government agencies and scientific research institutes) are becoming increasingly important. When forming this type of cooperation, the participants highlight synergies between the private partners and the public's missions or goals. The tasks of private and public sector actors, on the other hand, frequently diverge significantly. The integrity and honesty of public officials, institutions, trust, and faith in those individuals and institutions may all be jeopardized by these collaborations. In this study, we use the institutional corruption framework to highlight systemic concerns raised by PPPs affiliated with the governments of one of South Asia's countries. Overall analytical frameworks for such collaborations tend to downplay or disregard these systemic impacts and their ethical implications, as we argue. We offer some guidelines for public sector stakeholders that want to think about PPPs in a more systemic and analytical way. Partnership as a default paradigm for engagement with the private sector needs to be reconsidered by public sector participants. They also need to be more vocal about which goals they can and cannot fulfill, given the limitations of public financing resources.