Decomposing socioeconomic inequality in dental caries in Iran: cross-sectional results from the PERSIAN cohort study.

BACKGROUND: The current study aimed to measure and decompose socioeconomic-related inequalities in DMFT (decayed, missing, and filled teeth) index among adults in Iran. METHODS: The study data were extracted from the adult component of Prospective Epidemiological Research Studies in IrAN (PERSIAN) from 17 centers in 14 different provinces of Iran. DMFT score was used as a measure of dental caries among adults in Iran. The concentration curve and relative concentration index (RC) was used to quantify and decompose socioeconomic-related inequalities in DMFT. RESULTS: A total of 128,813 adults aged 35 and older were included in the study. The mean (Standard Deviation [SD]) score of D, M, F and DMFT of the adults was 3.3 (4.6), 12.6 (10.5), 2.1 (3.4) and 18.0 (9.5), respectively. The findings suggested that DMFT was mainly concentrated among the socioeconomically disadvantaged adults (RC = - 0.064; 95% confidence interval [CI), - 0.066 to - 0.063). Socioeconomic status, being male, older age and being a widow or divorced were identified as the main factors contributing to the concentration of DMFT among the worse-off adults. CONCLUSIONS: It is recommended to focus on the dental caries status of socioeconomically disadvantaged groups in order to reduce socioeconomic-related inequality in oral health among Iranian adults. Reducing socioeconomic-related inequalities in dental caries should be accompanied by appropriate health promotion policies that focus actions on the fundamental socioeconomic causes of dental disease.

GLOBAL Leukemia in Children 0-14 Statistics 2018, Incidence and Mortality and Human Development Index (HDI): GLOBOCAN Sources and Methods.

OBJECTIVE: Cancer is the second leading cause of death in children under 15 and leukemia is the most common type of cancer in this age group.  The aim of the present study is to investigate the incidence and mortality of leukemia in children aged 0-14 years and its relationship with Human Development Index (HDI in different countries of the world.  Methods: Incidence and mortality rates were obtained from GLOBOCAN and Country's income from World Bank. The data analysis was conducted using correlation analysis. The association of incidence and mortality rates with HDI was investigated using linear regression models. RESULTS: The results revealed a significant positive correlation between the incidence rate and Gross National Income per capita (r = 0.464, P <0.0001), mean years of schooling (r = 0.566, P <0.0001), life expectancy at birth (r = 0.712, P <0.0001) and expected years of schooling (r = 0.604, P <0.0001). The results also demonstrated a positive and significant correlation between mortality rate and life expectancy at birth (r = 0.199, P <0.0001). An improvement in HDI [Beta = 7.7, CI95% (0.1, 15.3)] and life Expectancy at birth [Beta = 0.1, CI95% (0.03, 0.1)] caused a significantly rise in the incidence of leukemia. Moreover, the improved HDI [Beta = 6.2, CI95% (1.9, 10.5)] was associated with increased mean years of schooling [Beta = -0.1, CI95% (-0.2, -0.01)] and expected years of schooling [Beta = -0.1, CI95% (-0.3, -0.08). CONCLUSION: As the HDI increases, incidence and mortality from of leukemia increases indicating a change in factors that affects leukemia incidences.

Socioeconomic-related inequalities in oral hygiene behaviors: a cross-sectional analysis of the PERSIAN cohort study.

BACKGROUND: Socioeconomic-related inequality in oral hygiene behaviors in Iran is poorly understood. This study aims to measure and decompose socioeconomic-related inequalities in oral hygiene behaviors among middle-aged and elderly adults in Iran. METHODS: A cross-sectional analysis was performed using data from the Prospective Epidemiological Research Studies in IrAN (PERSIAN), a large national cohort study. A total of 130,016 individuals aged 35 years and above from 17 cohort centers in Iran were included in the study. The normalized concentration index (Cn) was used to measure the magnitude of inequality in oral hygiene behaviors, i.e. brushing at least twice and flossing once daily, among middle-aged and elderly Iranian adults included in the cohort centers. Decomposition analysis was performed to quantify the contribution of each determinant to the observed inequality in oral hygiene behaviors. RESULTS: Totally, 65.5% of middle-aged and elderly adults brushed their teeth twice a day or more, 7.6% flossed at least once a day and 3.48% had both habits. The estimated Cn of the two habits combined, i.e. tooth brushing and dental flossing, for all provinces taken part in the PERSIAN cohort study was 0.399 (95% confidence interval [CI]: 0.383 to 0.417), indicating that the prevalence of the two habits combined is more concentrated among individuals with higher socioeconomic status. Inequality in oral hygiene behaviors was pro-rich in all cohort centers. The decomposition results suggested socioeconomic status as the main factor contributing to the overall inequality, followed by the level of education, and the province of residence. CONCLUSION: A low prevalence of oral hygiene behaviors among middle-aged and elderly Iranian adults was observed. There was also a pro-rich inequality in oral hygiene behaviors among middle-aged and elderly adults in all cohort centers. These results suggest an urgent need for targeted policy interventions to increase the prevalence of preventive oral hygiene behaviors among the poor and less-educated middle-aged and elderly adults in Iran.

Ecological and health risk assessment of exposure to atmospheric heavy metals.

In the present study, we assessed the concentration of airborne HMs (Zn, Cu, Pb, and Cd) and their probable sources using the bark of Pinus eldarica as a bio-indicator. Hence, 47 tree bark samples were harvested according to the land uses and biomonitoring techniques in the city of Yazd, Iran. The potential health risks in 13 age groups, ecological risk, as well as the possible relationship between HM concentrations and traffic indicators, were evaluated. The order of average HM concentrations in the P. eldarica bark samples was as Zn > Pb > Cu > Cd. The mean values of non-carcinogenic risks of all HMs in entire age groups were within secure range (HQ < 1); however, the carcinogenic risk of Cd was higher than the allowed level (TCR > 1 × 10-6). About Pb, it was in the safe level. The main element causing potential ecological risks was Cd, indicating moderate to very high ecological risk in most of the study areas. There was an inverse significant association between distance from major roads and Pb concentration (ß = -0.011 95% confidence interval (CI): 0.022, -0.0001). All HMs in bark samples render the negative Moran's index, representing a random spatial distribution pattern. Besides, according to principal component analysis (PCA), the first component accounted for 36.55% of the total variance, dominated by Cd, Pb, Cu, and Zn, respectively, and characterized by vehicle and industrial emissions. Our results infer that industrial activities and traffic are the main sources of HMs pollution in urban environments that should be considered by decision-makers.

An assessment of the risk factors for vitamin D deficiency using a decision tree model.

BACKGROUND AND OBJECTIVES: Vitamin D (25-hydroxyvitamin D or 25OHD) has a key role in the pathogenesis of several chronic disorders. Vitamin D deficiency is a common global public health problem. We aimed to evaluate the risk factors associated with vitamin D deficiency using a decision tree algorithm. METHODS: A total of 988 adolescent girls, aged 12-18 years old, were recruited to the study. Demographic characteristics, serum biochemical factors, all blood count parameters and trace elements such as Zinc, Copper, Calcium and SOD were measured. Serum levels of vitamin D below 20 ng/ml were considered to be deficiency. 70% of these girls (618 cases) were randomly allocated to a training dataset for the constructing of the decision-tree. The remaining 30% (285 cases) were used as the testing dataset to evaluate the performance of decision-tree. In this model, 14 input variables were included: age, academic attainment of their father, waist circumference, waist to hip ratio, zinc, copper, calcium, SOD, FBG, HDL-C, RBC, MCV, MCHC, HCT. The validation of the model was assessed by constructing a receiver operating characteristic (ROC) curve. RESULTS: The results showed that serum Zn concentration was the most important associated risk factor for vitamin D deficiency. The sensitivity, specificity, accuracy and the area under the ROC curve (AUC) values were 79.3%, 64%, 77.8% and 0.72 respectively using the testing dataset. CONCLUSIONS: The results suggest that the serum levels of Zn is an important associated risk factor for identifying subjects with vitamin D deficiency among Iranian adolescent girls.