Effects of bromodomain and extra-terminal inhibitor JQ1 and interleukin-6 on breast cancer cells.

BACKGROUND: Bromodomain and extra-terminal (BET) proteins are recognized acetylated lysine of histone 4 and act as scaffolds to recruit many other proteins to promoters and enhancers of active genes, especially at the super-enhancers of key genes, driving the transcription process and have been identified as potential therapeutic targets in breast cancer. However, the efficacy of BET inhibitors such as JQ1 in breast cancer therapy is impeded by interleukin-6 (IL-6) through an as-yet-defined mechanism. METHODS AND RESULTS: We investigated the interplay between IL-6 and JQ1 in MCF-7 and MDA-MB-231 human breast cancer cells. The results demonstrate that the efficacy of JQ1 on the inhibition of cell growth and apoptosis was stronger in MDA-MB-231 cells than in MCF-7 cells. Further, MCF-7 cells, but not MDA-MB-231 cells, exhibited increased expression of CXCR4 following IL-6 treatment. JQ1 significantly reduced CXCR4 surface expression in both cell lines and diminished the effects of IL-6 pre-treatment on MCF-7 cells. While IL-6 suppressed the extension of breast cancer stem cells in MCF-7 cells, JQ1 impeded its inhibitory effect. In MCF-7 cells JQ1 increased the number of senescent cells in a time-dependent manner. CONCLUSION: Analysis of gene expression indicated that JQ1 and IL-6 synergistically increase SNAIL expression and decrease c-MYC expression in MCF-7 cells. So, the BET proteins are promising, novel therapeutic targets in late-stage breast cancers. BET inhibitors similar to JQ1 show promise as therapeutic candidates for breast cancers, especially when triple-negative breast cancer cells are increased and/or tumor-promoting factors like IL-6 exist in the tumor microenvironment.

Comparative investigation of different chemicals on the germination of two aquatic microsporidia.

Microsporidia are eukaryotic obligatory intracellular parasites that infect a wide range of vertebrates and invertebrate hosts. Spores infect target cells of the host by transferring their sporoplasm through a distinctive polar tube. This study investigated how selected chemicals influence the germination of two newly discovered microsporidia species from central-western Iran. Spores of Parathelohania iranica were extracted from infected larvae of Anopheles superpictus s.l. and purified by the Percoll discontinuous density gradient method. Because of the small number of spores per copepod, extraction and purification were not performed for spores of the microsporidium infecting Paracyclops chiltoni. Both spores were exposed to KCl, NaCl, KI, NaI, and H2O2 and the effects of concentration (0.5, 1.5, and 2.5 M), pH (7.0, 9.0, and 11.0), temperature (4 °C and 25 °C), and duration of exposure (10 and 30 min) on spore germination were investigated and compared. This study indicated that the type of the ionic nature of the surrounding environment of spores plays an important role in the release of polar tubes of both microsporidia. Additionally, anions played a more significant role than cations. This effect was directly related to concentration, temperature, and time. However, no specific pattern was recognized at different alkaline pH levels. Hydrogen peroxide was not effective in releasing the polar tubes of the spores of these microsporidia. This study demonstrated the comparative role of some chemicals and the associated factors in the release of the polar tube of two aquatic microsporidia. Future research should examine the practical value of these findings in the mass production of candidate microsporidia for the biological control of pest invertebrate hosts.

The effects of a self-management program based on 5 A`s model on the quality of life and self-efficacy in the myocardial infarction patients.

INTRODUCTION AND OBJECTIVES: The myocardial infarction is the most severe manifestation of coronary artery disease. The promotion of self-efficacy in these patients can be effective in the improvement of their quality of life. The aim of this study was to investigate the effects of a self-management program based on 5 A`s model on the quality of life and self-efficacy of the patients with myocardial infarction. METHODS: The current study was a clinical trial that was conducted in Ayatollah Kashani and Hajar hospitals in Shahr-e Kord (Iran) with the participation of 96 patients with myocardial infarction. The research units were blocked randomly into two 48-patient intervention and control groups. The training content was provided to the intervention group in five stages and they were asked to implement in three months. The demographic information questionnaire, the Ferrans and Powers Quality of Life questionnaire, and Sullivan Self-Efficacy questionnaire were the data collection instruments. The mean scores of pre and post-intervention were compared by the use of SPSS, version 16, software, paired t-test, single t-test, chi-square, and Fisher's Exact Test. FINDINGS: The results showed that the mean squares of quality of life and self-efficacy in pre and postintervention had a significant difference and the intervention group had a higher quality of life and self-efficacy levels compared to the control group (P<0.001). CONCLUSION: According to the results of the study, it is suggested to use this model for empowerment and caring of patients besides the medicinal treatments, so that it would not lead to inability, reduction about the medical centers, frequent hospitalization, and ultimately, reduction in medical costs, and promotion of the society's health.

A Comparative Analysis of Patients' Quality of Life, Body Image and Self-confidence Before and After Aesthetic Rhinoplasty Surgery.

OBJECTIVE: Having desired facial features creates a better mental image, results in increased self-confidence and boosts social activities to a more acceptable level. The goal of the current study is to investigate how rhinoplasty surgery affects patients admitted to Shahrekord surgical clinic. METHODS: The study was conducted on 100 patients randomly selected and referring for rhinoplasty surgery. The required information was collected through demographic questionnaires of rhinoplasty outcomes F 36 and Rosenberg's self-esteem scale. The questionnaires were filled out by patients before surgery and 3 months after surgery. The data were analyzed using SPSS and data mining software. FINDINGS: Out of the hundred participants, 63% were female and 37% were male. The number of individuals in the studied groups decreased in older age groups so that most of the participants were in the 20-24-year group followed by 25-30 y/o group. Patients from other age groups were less frequent. In terms of educational attainment, the highest frequency was associated with a BSc and the lowest with a diploma. In terms of employment status, the highest frequency was among students and the unemployed and employees and the self-employed followed. Body image and self-esteem were significantly improved after surgery (p < 0.005). Although not statistically significant, quality of life was improved too after surgery. CONCLUSION: According to the results of this study, physicians and patients should measure the pros and cons of the surgery before making a treatment decision. It also showed that rhinoplasty leads to an increase in quality of life and self-esteem. Prior to surgery, specialist consultation should be performed, and rhinoplasty should be performed if a specialist physician allows it. LEVEL OF EVIDENCE IV: This journal requires that authors assign a level of evidence to each article. For a full description of these Evidence-Based Medicine ratings, please refer to Table of Contents or the Online Instructions to Authors www.springer.com/00266.

The protocol of a population-based prospective cohort study in southwest of Iran to analyze common non-communicable diseases: Shahrekord cohort study.

BACKGROUND: Prospective cohort studies are considered ideal choices to study multiple outcomes and risk factors for Non-communicable diseases (NCDs). Our aim is to set-up the protocol and analyze risk factors, incidence rates, prevalence, trends, and the models of environmental and genetic determinants of NCDs and their outcomes as well as interaction among such determinants. METHODS: Shahrekord cohort study (SCS) that is a population-based prospective, study on a cohort consisting of people aged 35-70 years started in November 2015 in Iran. The sample size of the original cohort is at least 10,000 people. Annual follow-ups (200,000 person-year) of the cohort were designed to be conducted up to 2036. Exposures (a detailed demographic, socioeconomic, general health, quality of life, physical activity, anthropometric indexes, stress, health literacy, social capital, nutrition and eating habits, lifestyle, occupational history, living place, blindness, deafness, electrocardiography, lung capacities, blood pressure, sleep, smoking and alcohol, contact to animals, physical examinations and medical history, dental health, used drugs and supplements, glucose and lipid profiles) were measured by relevant standard methods and questionnaires. Incidence of common NCDs (cardiovascular diseases, cancer, gastrointestinal, respiratory, renal, hepatic, accidents, injury and neurological diseases), trend of risk factors, hospitalization, disability, and death were considered the outcomes of the cohort. The definition of disease was determined based on the International Classification of Diseases 10th version (ICD-10). Routine hematologic and biochemical tests were conducted and an all-inclusive biobank (blood, hair, nail, and urine specimens) of the cohort was stored for future studies. All steps of data collection and examinations are directly monitored by the quality control team. DISCUSSION: The SCS is a unique study conducted in southwest of Iran that is a notable work given the climate conditions and ethnicity population (especially in Bakhtiari) of this region. By providing high quality the protocol and introduce it, the SCS can serve as a solid foundation for management and researchers in southwest of Iran. The SCS provides prerequisites for collaboration and regional, national, and international studies on NCDs. Data are available at the modeling in health research center, Shahrekord University of Medical Sciences, Shahrekord, Iran, for any collaboration.

Association of retinopathy and intima media thickness of common carotid artery in type 2 diabetic patients.

BACKGROUND: This study was carried out in order to evaluate the relationship between retinopathy and carotid intima-media thickness (CIMT). MATERIALS AND METHODS: In a cross-sectional study, 154 diabetic patients who had a history of diabetic disease were evaluated in two equal groups of 77 patients with and without retinopathy, respectively. CIMT was evaluated in all of the patients. RESULTS: Mean age of the patients was 59.65 ± 9.37 years. Mean CIMT of all patients was 0.84 ± 0.18. CIMT of patients with retinopathy was significantly greater than patients without retinopathy (P < 0.001). CIMT also correlated with age, duration of diabetes, systolic blood pressure, blood urea nitrogen, and serum creatinine. CONCLUSION: CIMT may be used as a simple, available and noninvasive method for screening of macro and microvascular complication of diabetic patients.

The effects of an 8-week dynamic neuromuscular stabilization exercise on pain, functional disability, and quality of life in individuals with non-specific chronic low back pain: a randomized clinical trial with a two-month follow-up study.

BACKGROUND: Low back pain (LBP) is a common disorder and is considered one of the leading causes of disability worldwide, resulting in adverse health, social, and economic outcomes. This study aimed to investigate the effects and durability of 8-week Dynamic Neuromuscular Stabilization (DNS) exercises on pain, functional disability, and quality of life in individuals aged 30 to 50 years with non-specific chronic low back pain (NSCLBP). METHODS: This research employed a pre- and post-test design with a follow-up period, in which 29 participants (16 in the control group and 13 in the exercise group) remained until the end of the study. Pain intensity, functional disability, and quality of life were assessed using the visual analog scale (VAS), the Oswestry Disability Index, and the SF-36 questionnaire, respectively, before intervention, immediately after, and two months post-intervention. The control group continued their routine daily activities, while the exercise group performed DNS exercises three times a week for 8 weeks. The data was analyzed using a mixed-design ANOVA (P ≤ 0.05). RESULTS: The results showed improvements in pain (F (2,24) = 5.31, P = 0.01, η2 = 0.31), functional disability (F (2,24) = 4.17, P = 0.03, η2 = 0.26), and quality of life (F (2,24) = 4.70, P = 0.02, η2 = 0.28) in the exercise group at the Post-test compared to the Pre-test. However, the durability of the exercise effects at the follow-up assessment was not sustainable compared to the Post-test and Pre-test (P > 0.05). CONCLUSION: An 8-week period of DNS exercises can improve pain, functional disability, and quality of life in individuals with NSCLBP. However, a 2-month period of detraining can reduce the positive outcomes of these exercises. TRIAL REGISTRATION: The researchers retrospectively registered this trial on 21/04/2024, with the identifier IRCT20240107060646N1 in the Iranian Registry of Clinical Trials (IRCT) at the following address: https://irct.behdasht.gov.ir .

The effect of the supportive care program based on Bandura's self-efficacy on stress and participation of the mothers of the neonates admitted to neonatal intensive care unit.

BACKGROUND: Maternal stress can affect both the neonate and the mother and deter them from participating in the care of preterm neonates. The purpose of the study was to determine the effect of the supportive care program (SCP) based on Bandura's self-efficacy on stress and participation of mothers of neonates admitted to the neonatal intensive care unit. MATERIALS AND METHODS: This quasi-experimental study was performed in 2020 on 90 mothers of premature infants admitted to the NICU of Hajar Hospital in Shahrekord, Iran. First, the control group and then the experimental group were selected and a training package based on Bandura's self-efficacy theory was implemented for the intervention group. The research instruments in this study were the Heidari mothers stress questionnaire and Melnyk mother's participation questionnaire which was completed before and after the intervention. The analysis was performed based on SPSS (version 24) and Chi-square, independent t-test, and paired tests. RESULTS: The results indicated that the demographic variables of mothers and neonatal characteristics of the two groups did not have significant differences except for the history of abortion and infertility in mothers and the weight of preterm neonates (P < 0.05). Mothers in the experimental group had less stress (t (88) = 29.50, P < 0.001) and more participation than the control group (t (88) = -27.18, P < 0.001) after the intervention. CONCLUSIONS: Using self-efficacy-based SCP for maternal education besides routine education could positively affect the reduction of stress and the increase of maternal participation in caring for preterm neonates during hospitalization. Thus, using this supportive program is suggested for mothers with preterm neonates admitted to NICU.

Promoting Health Literacy and Perceived Self-Efficacy in People with Chronic Obstructive Pulmonary Disease.

Background: Chronic Obstructive Pulmonary Disease (COPD) is an irreversible condition and it is of great importance for the patients to practice self-care. Given the impact of inadequate health literacy on people's self-efficacy in a self-care program, the aim of this study was to improve health literacy and self-efficacy in people with COPD. Materials and Methods: The present quasi-experimental study was conducted on 70 patients with COPD admitted to Shahrekord educational hospitals in 2019. Using random allocation software, the samples were randomly divided into intervention and control groups. Data collection tools included three questionnaires including demographic, health literacy, and perceived self-efficacy questionnaires. A training program, with three weekly sessions of theoretical and practical trainings, was conducted for the intervention group in classes in the hospital. The time of each session was 40 min. Data were collected three times i.e., before, immediately after, and three months after the trainings. Data were analyzed by means of SPSS 21 statistical software using descriptive and inferential statistics. Results: Before the intervention, the mean scores of perceived self-efficacy and health literacy did not differ significantly between the two groups, but after the intervention, the scores of the members in the intervention group increased significantly (f = 62.15, p < 0.05). Conclusions: The results of the study indicated an increase in the scores of perceived self-efficacy and health literacy in people with COPD. The use of targeted educational interventions can have a positive effect on the treatment and control of the disease.

Evaluation of Chemical Oxygen Demand and Color Removal from Leachate Using Coagulation/Flocculation Combined with Advanced Oxidation Process.

Background: One of the basic practices in the field of waste management is the collection and treatment of leachate. Leachate from municipal waste due to high chemical oxygen demand (COD) and dark color is a potential pollutant of the environment, which causes a lot of problems in the absence of treatment and direct discharge to the environment. This study aimed to determine the efficiency of ultrasonic process in combination with coagulation and flocculation process using sodium ferrate in COD and color reduction. Materials and Methods: In this experimental study, all experiments were performed in batch conditions and with changing process variables such as pH and sonication time, and the effect of three parameters, including ultrasonic reaction time (15, 30, and 45 min), pH (2, 4, 5/5, and 7), and coagulant dosage (from 1 to 150 g/l) on the COD reduction and color removal, was evaluated. Coagulant concentration and then the removal efficiency of COD and color were analyzed by ANOVA using SPSS 18. Results: The COD reduction and color removal were 87.05% and 88.6% in optimal condition (using 120 g/L of sodium ferrate at pH 5.5), with coagulation/flocculation, after ultrasound (15 min). Ultrasound (15 min) + sodium ferrate (without coagulation/flocculation) achieved 46.25% of COD reduction and 90.35% of color elimination, whereas the ultrasonic process alone allowed removing the COD and color in the leachate by less than 50%. Conclusion: The results indicate that C-F followed by ultrasonic can be used to efficiently reduce the organic matter and color from municipal waste leachate, and it would be an ideal option for leachate treatment.

The effect of situation, background, assessment, recommendation-based safety program on patient safety culture in intensive care unit nurses.

BACKGROUND: Patient safety culture is an integral part of patient care standards and a prerequisite for safe care. SBAR is an acronym for Situation, Background, Assessment, Recommendation; this communication model has gained popularity in health-care settings, especially among professions such as nursing. However, there is little evidence that nursing professional education can enhance patient safety culture. The aim of this study was to investigate the effect of a SBAR-based training program on patient safety culture in intensive care unit (ICU) nurses. MATERIALS AND METHODS: The quasi-experimental study was carried out in 2018-2019 at areas covered by Shahrekord University of Medical Sciences, Iran. This study was performed on 60 nurses working in ICU. The participants were randomly assigned to two experimental and control groups of 30 each. For the experimental group, five workshop sessions of SBAR-based program were held. For the control group, the patient delivery process was performed according to the ward routine. Data were collected using patient safety culture questionnaires before and 1 month after the intervention, and were analyzed using descriptive and analytical tests such as paired t-test, independent t-test, and Chi-square test by SPSS 22. RESULTS: The mean score of safety culture was 31 ± 23.5 and 55.2 ± 28.6 in frequency of reporting events, 32.8 ± 17.8 and 54.3 ± 19 in overall perception of patient safety, 23 ± 20.1 and 52.9 ± 26 in communication channel openness, and 35.2 ± 19.8 and 52.4 ± 18.8 in information exchange and conveyance before and after training intervention, respectively, so that they improved from poor level to neutral-moderate level. There was no strength in any dimensions of safety culture; however, the implementation of the SBAR-based program was significantly associated with patient safety culture (P < 0.001). CONCLUSIONS: Improving patient safety culture requires attention to patient safety models such as SBAR approach that provides an appropriate and reliable structure for quality improvement. SBAR-based program training is effective in promoting patient safety culture; therefore, it is recommended that managers use this technique to promote patient safety culture.

Decolorization mechanism, identification of an FMN-dependent NADH-azoreductase from a moderately halotolerant Staphylococcus sp. MEH038S, and toxicity assessment of biotransformed metabolites.

The application of halotolerant microorganisms capable of decolorizing is attractive. Decolorization mechanism, the effect of different parameters on the decolorization percentage, and toxicity analysis of Reactive Black 5 before and after decolorization were investigated in the present study. The decolorization percentage for live cells of Staphylococcus sp. strain MEH038S was more than dead cells, which demonstrated that Reactive Black 5 was decolorized through the degradation process. The results confirmed that an FMN-dependent NADH-azoreductase gene was responsible for the decolorization and then was identified as Staphylococcus sp. EFS01 azoreductase from a moderately halotolerant Staphylococcus strain for the first time. The maximal decolorization of 98.15% was observed at pH 6.5 and 35 ° C for 50 mg/L of Reactive Black 5. In addition, more than 90% decolorization was achieved with 5-40 g/L of NaCl. The results of Gas chromatography-mass spectrometry and Fourier transform infrared spectroscopy showed that Reactive Black 5 was broken to the lower molecular weight compounds without any chromophoric azo groups. Phytotoxicity and fish toxicity proved that the biotransformed metabolites of Reactive Black 5 degradation were more toxic than the original dye. The moderate halotolerant strain exhibited a remarkable decolorization capability and can be applied for textile wastewater treatment. PRACTITIONER POINTS: An azoreductase gene from a moderately halotolerant Staphylococcus was identified. More than 90% decolorization efficiency was observed under high-salt conditions. Biotransformed metabolites of RB5 degradation were identified. Toxicity analysis of biotransformed metabolites was investigated.

The effect of empowerment program based on the social cognitive theory on the activity of daily living in patients with chronic obstructive pulmonary disease.

OBJECTIVE AND AIM: Chronic obstructive pulmonary disease (COPD) is one of the most common chronic diseases. The patient's fear and anxiety of shortness of breath and coughing during exercise may lead to a decrease in patients' daily activities. Therefore, the present study aimed to determine the effect of empowerment program based on the social cognitive theory (SCT) on the daily activity of patients with COPD. METHODS: This quasi-experimental study was performed on 70 patients with COPD referred to Kashani and Hajar centers in 2019. Samples were randomly divided into two groups of experimental and control. Data collection tools included demographic information questionnaire and activity of daily living questionnaire, specific for COPD, and a researcher-made questionnaire for measuring SCT constructs. For the experimental group, the training program consisted of four theoretical and practical sessions of 40 min/week. The data were collected at three time points, before, immediately and 3 months after the training are 3 time. The data were analyzed by SPSS software using descriptive and inferential statistics. RESULTS: The difference between the mean scores of behavioral ability, self-efficacy, and empowerment in the three stages was significant only in the experimental group (P < 0.001). The mean daily activity score of patients before, immediately, and 3 months after intervention showed a statistically significant difference between the two groups (52.46 ± 21.98, 63.36 ± 21.95, and 71.34 ± 19.02), respectively, in the intervention group, and (51.79 ± 19.29, 53.70 ± 19.28, and 53.82 ± 19.26), respectively, in the control group (P < 0.001). CONCLUSION: The results of this study showed that empowerment of patients through interventions based on SCT can increase the daily activity of patients with COPD. Because nurses play an important role in patient education and improvement, it is hoped that the findings of this study will be used as a strategy to increase the daily activity and ultimately improve the quality of life in these patients.

Association of carotid intima-media thickness with exercise tolerance test in type 2 diabetic patients.

AIMS: Atherosclerosis and ischemic heart disease are more common in diabetic patients. Atherosclerosis process can disturb the normal functioning of the vascular endothelium and increase vessel wall thickness. The aim of this study was the comparison of Carotid intima-media thickness (CIMT) with Exercise tolerance test as an alternative way to evaluate cardiac ischemia in diabetic patients. METHODS: In a cross-sectional study, 30 diabetic patients with positive exercise test and 30 diabetic patients with negative exercise test were enrolled. CIMT of the carotid artery in both groups of patients was measured. RESULT: CIMT in the patients with positive and negative exercise test were 1.04 ±â€¯0.21 mm and 0.61 ±â€¯0.11 mm, respectively (P < 0.001). CIMT in positive exercise test group was positively associated with age and negatively associated with gender, FBS, HDL and LDL cholesterol and in negative exercise group was negatively associated with gender, age, FBS, HDL and LDL cholesterol. CONCLUSION: Considering observed significant positive association between CIMT with result of exercise tolerance test (ETT) in type 2 diabetic patients, it may possible to use CIMT as an inexpensive and non-invasive method for evaluation of ischemic heart disease in diabetic patients.

Artificial Neural Network to Modeling Zero-inflated Count Data: Application to Predicting Number of Return to Blood Donation.

BACKGROUND: Traditional statistical models often are based on certain presuppositions and limitations that may not presence in actual data and lead to turbulence in estimation or prediction. In these situations, artificial neural networks (ANNs) could be suitable alternative rather than classical statistical methods. STUDY DESIGN:  A prospective cohort study. METHODS: The study was conducted in Shahrekord Blood Transfusion Center, Shahrekord, central Iran, on blood donors from 2008-2009. The accuracy of the proposed model to prediction of number of return to blood donations was compared with classical statistical models. A number of 864 donors who had a first-time successful donation were followed for five years. Number of return for blood donation was considered as response variable. Poisson regression (PR), negative binomial regression (NBR), zero-inflated Poisson regression (ZIPR) and zero-inflated negative binomial regression (ZINBR) as well as ANN model were fitted to data. MSE criterion was used to compare models. To fitting the models, STATISTICA 10 and, R 3.2.2 was used RESULTS: The MSE of PR, NBR, ZIPR, ZINBR and ANN models was obtained 2.71, 1.01, 1.54, 0.094 and 0.056 for the training and 4.05, 9.89, 3.99, 2.53 and 0.27 for the test data, respectively. CONCLUSIONS: The ANN model had the least MSE in both training, and test data set and has a better performance than classic models. ANN could be a suitable alternative for modeling such data because of fewer restrictions.

Phytotherapy with Hordeum Vulgare: A Randomized Controlled Trial on Infants with Jaundice.

INTRODUCTION: Jaundice is one of the most common causes of admission to hospital in newborns which is often associated with several complications. AIM: The present study was conducted to evaluate the effect of H. vulgare in reducing jaundice. MATERIALS AND METHODS: In this double-blind, randomized controlled trials 70 term infants hospitalized due to jaundice in 2014 were enrolled. Control group was treated with full-time phototherapy alone using LED except when the infants were breastfed and case group with phototherapy, as per the protocol in the control group, along with and topical H. vulgare seed flour three times a day. Data were analysed using and analysis of covariance (ANCOVA) and paired t-test in SPSS version 16.0. RESULTS: There was a significant difference in mean indirect bilirubin level between the two groups p<0.05, such that the mean indirect bilirubin level was higher in the control group. Furthermore, no significant difference was seen in direct bilirubin level between the two groups at discharge p>0.05. CONCLUSION: H. vulgare flour can cause decrease in indirect bilirubin. Because the rate of decrease in indirect bilirubin can be effective in preventing severe complications due to bilirubinemia, H. vulgare can be used as a complementary therapy to treat jaundice.

Comparison of amoxicillin and metronidazole effect on three-drug regimen for the treatment of Helicobacter pylori infection in children.

Helicobacter pylori is an important risk factor for chronic gastritis, peptic ulcer, and gastric cancer. Three-drug regimen is the first-line treatment for this infection, but the response rate to treatment varies in different geographical regions. This study was conducted to comparatively determine the effect of amoxicillin and metronidazole on three-drug regimen to treat H. pylori infection in 1-15-year-old children. This clinical trial was conducted on 82 patients aged 1-15 years with convenience sampling referring to the Endoscopy Unit of Hajar Hospital, Shahrekord. Group 1 was administered with clarithromycin, amoxicillin, and omeprazole (CAO), and Group 2 with, clarithromycin, metronidazole, and omeprazole (CMO). One month after completion of the treatment, stool antigen test was used to study the eradication of H. pylori. Data were analyzed using SPSS software by Chi-square test. Three of the 82 patients were excluded from the study because of side effects caused by drugs. Nearly 87.2% of the patients in CAO-treated group and 92.5% in CMO-treated group had response to treatment. There was no significant difference in eradication rate between the two regimens (P = 0.43). The two regimens displayed no superiority over each other for eradicating H. pylori infection and response rate to treatment in children aged 1-15 years.

Analysis of Blood Transfusion Data Using Bivariate Zero-Inflated Poisson Model: A Bayesian Approach.

Recognizing the factors affecting the number of blood donation and blood deferral has a major impact on blood transfusion. There is a positive correlation between the variables "number of blood donation" and "number of blood deferral": as the number of return for donation increases, so does the number of blood deferral. On the other hand, due to the fact that many donors never return to donate, there is an extra zero frequency for both of the above-mentioned variables. In this study, in order to apply the correlation and to explain the frequency of the excessive zero, the bivariate zero-inflated Poisson regression model was used for joint modeling of the number of blood donation and number of blood deferral. The data was analyzed using the Bayesian approach applying noninformative priors at the presence and absence of covariates. Estimating the parameters of the model, that is, correlation, zero-inflation parameter, and regression coefficients, was done through MCMC simulation. Eventually double-Poisson model, bivariate Poisson model, and bivariate zero-inflated Poisson model were fitted on the data and were compared using the deviance information criteria (DIC). The results showed that the bivariate zero-inflated Poisson regression model fitted the data better than the other models.

Analysis of the Factors Affecting the Interval between Blood Donations Using Log-Normal Hazard Model with Gamma Correlated Frailties.

BACKGROUND: Time to donating blood plays a major role in a regular donor to becoming continues one. The aim of this study was to determine the effective factors on the interval between the blood donations. METHODS: In a longitudinal study in 2008, 864 samples of first-time donors in Shahrekord Blood Transfusion Center,  capital city of Chaharmahal and Bakhtiari Province, Iran were selected by a systematic sampling and were followed up for five years. Among these samples, a subset of 424 donors who had at least two successful blood donations were chosen for this study and the time intervals between their donations were measured as response variable. Sex, body weight, age, marital status, education, stay and job were recorded as independent variables. Data analysis was performed based on log-normal hazard model with gamma correlated frailty. In this model, the frailties are sum of two independent components assumed a gamma distribution. The analysis was done via Bayesian approach using Markov Chain Monte Carlo algorithm by OpenBUGS. Convergence was checked via Gelman-Rubin criteria using BOA program in R. RESULTS: Age, job and education were significant on chance to donate blood (P<0.05). The chances of blood donation for the higher-aged donors, clericals, workers, free job, students and educated donors were higher and in return, time intervals between their blood donations were shorter. CONCLUSIONS: Due to the significance effect of some variables in the log-normal correlated frailty model, it is necessary to plan educational and cultural program to encourage the people with longer inter-donation intervals to donate more frequently.

A Hybrid ANN-GA Model to Prediction of Bivariate Binary Responses: Application to Joint Prediction of Occurrence of Heart Block and Death in Patients with Myocardial Infarction.

BACKGROUND: In medical studies, when the joint prediction about occurrence of two events should be anticipated, a statistical bivariate model is used. Due to the limitations of usual statistical models, other methods such as Artificial Neural Network (ANN) and hybrid models could be used. In this paper, we propose a hybrid Artificial Neural Network-Genetic Algorithm (ANN-GA) model to prediction the occurrence of heart block and death in myocardial infarction (MI) patients simultaneously. METHODS: For fitting and comparing the models, 263 new patients with definite diagnosis of MI hospitalized in Cardiology Ward of Hajar Hospital, Shahrekord, Iran, from March, 2014 to March, 2016 were enrolled. Occurrence of heart block and death were employed as bivariate binary outcomes. Bivariate Logistic Regression (BLR), ANN and hybrid ANN-GA models were fitted to data. Prediction accuracy was used to compare the models. The codes were written in Matlab 2013a and Zelig package in R3.2.2. RESULTS: The prediction accuracy of BLR, ANN and hybrid ANN-GA models was obtained 77.7%, 83.69% and 93.85% for the training and 78.48%, 84.81% and 96.2% for the test data, respectively. In both training and test data set, hybrid ANN-GA model had better accuracy. CONCLUSIONS: ANN model could be a suitable alternative for modeling and predicting bivariate binary responses when the presuppositions of statistical models are not met in actual data. In addition, using optimization methods, such as hybrid ANN-GA model, could improve precision of ANN model.