Ambient air pollutants and breast cancer stage in Tehran, Iran.

This study aimed to examine the impacts of single and multiple air pollutants (AP) on the severity of breast cancer (BC). Data of 1148 diagnosed BC cases (2008-2016) were obtained from the Cancer Research Center and private oncologist offices in Tehran, Iran. Ambient PM10, SO2, NO, NO2, NOX, benzene, toluene, ethylbenzene, m-xylene, p-xylene, o-xylene, and BTEX data were obtained from previously developed land use regression models. Associations between pollutants and stage of BC were assessed by multinomial logistic regression models. An increase of 10 µg/m3 in ethylbenzene, o-xylene, m-xylene, and 10 ppb of NO corresponded to 10.41 (95% CI 1.32-82.41), 4.07 (1.46-11.33), 2.89 (1.08-7.73) and 1.08 (1.00-1.15) increase in the odds of stage I versus non-invasive BC, respectively. Benzene (OR, odds ratio = 1.16, 95% CI 1.01-1.33) and o-xylene (OR = 1.18, 1.02-1.38) were associated with increased odds of incidence of BC stages III & IV versus non-invasive stages. BC stage I and stage III&IV in women living in low SES areas was associated with significantly higher levels of benzene, ethylbenzene, o-xylene, and m-xylene. The highest multiple-air-pollutants quartile was associated with a higher odds of stage I BC (OR = 3.16) in patients under 50 years old. This study provides evidence that exposure to AP is associated with increased BC stage at diagnosis, especially under premenopause age.

Factors Affecting Survival of Patients with Cervical Cancer.

Background: Cervical cancer is the fourth leading cause of cancer-related death among women worldwide. We aimed to identify the factors affecting the survival rate of cervical cancer patients, as these factors are vital for preventing the progression and effective treatment of cancer. Methods: In this retrospective cohort study, 254 patients with cervical cancer who were registered in The Kerman Population-Based Cancer Registry (KPBCR) between 2012 and 2022 and whose status was known to be alive or dead were enrolled. Since the proportional hazard assumption was not established for the type of treatment, the extended Cox model was used to determine the variables influencing the survival of the patients. Results: The mean survival time of the patients was 91.28 ± 3.02 months. The results of fitting the extended Cox model showed that the risk of death increases by 1.02 per year of age at diagnosis (HR=1.02; 95% CI: 1.00, 1.04). Moreover, for a one-unit increase in body mass index (BMI), the risk of death increased by 0.93 (HR=0.93; 95% CI: 0.88, 0.98). The risk of death in patients with disease stages III&IV was 3.08 times that of patients with disease stages I&II (HR=3.08; 95% CI: 1.05, 9.03). The risk of death in patients receiving at least one of the radiotherapy and chemotherapy treatments after 18 months was 7.11 times that of patients undergoing surgery (HR=7.11; 95% CI: 1.69, 29.91). Conclusion: The age of diagnosis, BMI, disease stage, and type of treatment significantly affect the survival of patients. Thus, raising women's awareness of periodical examinations and early diagnosis can reduce the risk of death and prevent cervical cancer progression.

Monitoring of airborne fungi during the second wave of COVID-19 in selected wards of the referral university hospital in southeastern Iran.

Microbiological monitoring of the air hospital is essential for prevention and control, due to the possible airborne route of infection transmission, especially in high-risk wards. This study aimed to monitor the airborne fungi during the second wave of the COVID-19 pandemic in selected wards of the biggest university educational hospital in Kerman, southeastern Iran. This study was conducted in 11 different wards, separated into the patient room and nursing station, of the Afzalipour hospital from May to August 2021. Fungal isolates were characterized to the species level by conventional and sequencing methods. Out of 93 obtained fungal colonies, 70 (75.3%) isolates were filamentous and 23 (24.7%) isolates were yeast. Aspergillus species were the predominant fungal isolates among the filamentous colonies (n=19; 27.1%), and Naganishia albida (formerly Cryptococcus albidus) was identified as the most common yeast isolate (n=13/23; 56.8%). The infectious ward was the most contaminated unit (n=19/93), while the least contaminated units were the neonatal intensive care unit (n=3/93), and oncology (n=3/93). The statistical findings displayed that the number of fungal isolates in patients' rooms is significantly higher than in nurses' stations (p-value=0.013). Our study demonstrated the presence of diverse fungal species in all wards of the hospital. Considering the presence of airborne fungi in hospitals and related public health problems is one of the critical issues for health systems management. In this regard, efficient monitoring of airborne fungi might play an influential role in hospital infection control and surveillance, particularly in high-risk hospitalization patients in critical wards.

Clinical Risk Factors of Need for Intensive Care Unit Admission of COVID-19 Patients; a Cross-sectional Study.

Introduction: It could be beneficial to accelerate the hospitalization of patients with the identified clinical risk factors of intensive care unit (ICU) admission, in order to control and reduce COVID-19-related mortality. This study aimed to determine the clinical risk factors associated with ICU hospitalization of COVID-19 patients. Methods: The current research was a cross-sectional study. The study recruited 7182 patients who had positive PCR tests between February 23, 2020, and September 7, 2021 and were admitted to Afzalipour Hospital in Kerman, Iran, for at least 24 hours. Their demographic characteristics, underlying diseases, and clinical parameters were collected. In order to analyze the relationship between the studied variables and ICU admission, multiple logistic regression model, classification tree, and support vector machine were used. Results: It was found that 14.7 percent (1056 patients) of the study participants were admitted to ICU. The patients' average age was 51.25±21 years, and 52.8% of them were male. In the study, some factors such as decreasing oxygen saturation level (OR=0.954, 95%CI: 0.944-0.964), age (OR=1.007, 95%CI: 1.004-1.011), respiratory distress (OR=1.658, 95%CI: 1.410-1.951), reduced level of consciousness (OR=2.487, 95%CI: 1.721-3.596), hypertension (OR=1.249, 95%CI: 1.042-1.496), chronic pulmonary disease (OR=1.250, 95%CI: 1.006-1.554), heart diseases (OR=1.250, 95%CI: 1.009-1.548), chronic kidney disease (OR=1.515, 95%CI: 1.111-2.066), cancer (OR=1.682, 95%CI: 1.130-2.505), seizures (OR=3.428, 95%CI: 1.615-7.274), and gender (OR=1.179, 95%CI: 1.028-1.352) were found to significantly affect ICU admissions. Conclusions: As evidenced by the obtained results, blood oxygen saturation level, the patient's age, and their level of consciousness are crucial for ICU admission.

Short-term and long-term survival of patients with gastric cancer.

AIM: The aim of this study was to apply the Bayesian mixture cure rate frailty model to determine the factors that influence short-term and long-term survival of patients with gastric cancer. BACKGROUND: Determining the risk factors of gastric cancer is currently considered very important, because the disease has become one of the most dangerous types of mortal cancers. Therefore, it is possible to determine the effective risk factors of short-term and long-term survival in patients through utilizing this model. METHODS: The present retrospective study was conducted on 339 gastric cancer patients whose data was recorded in hospitals of Kerman province, Iran, during 2001-2015. In the study, the Bayesian mixture cure rate frailty model was used to determine the effective factors of short-term and long-term survival in patients. RESULTS: In the present study, the event of interest occurred for 57.5% of patients. Over time, the survival rate of cancer patients reached its lowest point, approximately 0.3 at the end of study. According to the results of the present study, variables of chemotherapy (ß=-0.35 (-0.75, -0.03) and OR=1.59 (1.08, 2.19)), morphology (ß =-0.98(-1.45, -0.48) and OR=2.99 (1.78, 4.17)), and metastasis (ß =0.42(0.10, 0.93) and OR=0.39(0.01, 0.84)) were identified as effective factors in short-term and long-term survival of patients. CONCLUSION: The effective factors of long-term and short-term survival can be identified by utilizing the Bayesian mixture cure rate frailty model, while it is impossible through conventional models of survival analysis. Chemotherapy, morphology, and metastasis are the most important effective factors of short-term and long-term survival in patients with gastric cancer.

Bayesian mixture cure rate frailty models with an application to gastric cancer data.

Mixture cure rate models are commonly used to analyze lifetime data with long-term survivors. On the other hand, frailty models also lead to accurate estimation of coefficients by controlling the heterogeneity in survival data. Gamma frailty models are the most common models of frailty. Usually, the gamma distribution is used in the frailty random variable models. However, for survival data which are suitable for populations with a cure rate, it may be better to use a discrete distribution for the frailty random variable than a continuous distribution. Therefore, we proposed two models in this study. In the first model, continuous gamma as the distribution is used, and in the second model, discrete hyper-Poisson distribution is applied for the frailty random variable. Also, Bayesian inference with Weibull distribution and generalized modified Weibull distribution as the baseline distribution were used in the two proposed models, respectively. In this study, we used data of patients with gastric cancer to show the application of these models in real data analysis. The parameters and regression coefficients were estimated using the Metropolis with Gibbs sampling algorithm, so that this algorithm is one of the crucial techniques in Markov chain Monte Carlo simulation. A simulation study was also used to evaluate the performance of the Bayesian estimates to confirm the proposed models. Based on the results of the Bayesian inference, it was found that the model with generalized modified Weibull and hyper-Poisson distributions is a suitable model in practical study and also this model fits better than the model with Weibull and Gamma distributions.

Linguatula serrata in cattle in southeastern Iran: Epidemiological, histopathological and phylogenetic profile and its zoonotic importance.

This study aimed to determine the prevalence, histopathological observations, and phylogenetic analysis of L. serrata in cattle and its potential zoonotic and public health implications in southeastern Iran.The cross-sectional study was performed in cattle in southeastern Iran. Lymph nodes were collected from each cattle and examined by parasitological and histopathological techniques. A binary logistic regression and chi-square tests were implemented to analyze the data. Genomic DNA was randomly extracted from the nymphal stages of Linguatula isolates. Further characterization and phylogenetic relationships were done using two primers for amplification of partial DNA fragments of 18 s rRNA and cytochrome C oxidase subunit 1 (cox1), respectively.The results showed that 64 cattle of the total 404 were infected with L. serrata. There was no significant difference between linguatulosis infection and gender, while age was significantly different (P < 0.05). The cyst-like spaces containing the longitudinal and transverse sections of the L. serrata nymphs were surrounded by granulomatous reactions. The higher nucleotide variation in the cox1 region was supported by estimating the evolutionary divergence between L. serrata isolates and other Linguatula records of ruminants in Iran. The phylogenetic tree confirmed the close evolutionary relationships among all reported records of L. serrata in Iran.The high prevalence of linguatulosis caused by L. serrata declares the existence of a potential risk of FBPs for humans in southeastern Iran. This condition can advance more serious public health problems and requires a comprehensive control program and treatment strategies to prevent the disease.