International classification of external causes of injury: a study on its content coverage.

BACKGROUND: Injuries are a major health issue worldwide and their prevention requires access to accurate statistics in this regard. This can be achieved by classifying the collected data using the international classification systems. This study aimed at investigating the content coverage rate of the International Classification of External Causes of Injury (ICECI) regarding the external causes of injury in a hospital. METHODS: This cross-sectional descriptive-analytical study was performed on 322 injured individuals visiting the emergency unit of a hospital which is the biggest truma center in the southeast of Iran. The required data were collected via a designed questionnaire by the researcher visiting the Emergency ward. The collected data were encoded based on the ICECI textbook by two encoders. Their agreement rate was calculated using the Kappa estimate of agreement. The content coverage of the classification system and the degree of completeness of the required data for encoding in the patients' records were measured. Data were analyzed by the SPSS software, ver 19. RESULTS: The findings showed that 70% of the external causes of injury were covered by ICECI. Among the 322 cases, 138 (43%) had been referred due to a car crash. The injured were mostly drivers of land transport vehicles who had been unintentionally involved in a car crash. The least mechanism for injury was bite injury with 5 (2%). ICECI was capable of classifying 92% of the data related to the external causes of the injuries. The most un-covered data has belonged to the "activity when injured" axis (n = 18). Lack of precise data recording in the medical records resulted in missing data about at least one of the axis of the external causes in most records. CONCLUSION: The findings of the present study showed that ICECI has good content coverage for encoding the external causes of injuries. Before implementing ICECI for encoding the external causes of injuries, it is required to train clinicians regarding how to document all aspects of an injury incidence.

Assessment of changes in physiological and biochemical traits in four pistachio rootstocks under drought, salinity and drought + salinity stresses.

In this study, 7-month-old UCB-1, Badami, Ghazvini and Kale-Ghouchi pistachio rootstocks were exposed to control, drought, salinity and drought + salinity environments for 60 d. Total chlorophyll and total carotenoid contents decreased in all cultivars under drought, salinity and drought + salinity stresses. Under drought and salinity stresses, alone or in combination, Na+ and Cl- ions increased in all four pistachio rootstocks, while K+ ion decreased only in Ghazvini and Kaleh-Ghouchi cultivars. The enzyme activities of ascorbate peroxidase, polyphenol oxidase, catalase and guaiacol peroxidase increased in all cultivars when subjected to all three stresses with the exception of the ascorbate peroxidase activity in Kale-Ghouchi cultivar during drought stress. Oxidative stress parameters including electrolyte leakage, malondialdehyde, other aldehydes and hydrogen peroxide increased under all three stress conditions in all genotypes. The content of proline, total free amino acids and total soluble carbohydrates were enhanced under drought, salinity and drought + salinity stresses, whereas the protein content decreased in all pistachio rootstocks. In all evaluated traits, except for the K+ ion content and APX activity, the highest impacts was seen for drought + salinity > salinity > drought stresses, respectively. For the first time, we have proven that K+ ion content has a positive correlation with the ascorbate peroxidase, polyphenol oxidase, catalase and guaiacol peroxidase enzymes activities under drought + salinity stress. Finally, based on the bi-plot and cluster analyses, we have selected the UCB-1 > Badami > Ghazvini > Kale-Ghouchi cultivars as the most tolerant pistachio rootstocks under drought + salinity stress, respectively.

Correction to: Reducing chemotherapy use in clinically high-risk, genomically low-risk pN0 and pN1 early breast cancer patients: five-year data from the prospective, randomised phase 3 West German Study Group (WSG) PlanB trial.

The article Reducing chemotherapy use in clinically high-risk, genomically low-risk pN0 and pN1 early breast cancer patients: five-year data from the prospective, randomised phase 3 West German Study Group (WSG) PlanB trial, written by Ulrike Nitz, Oleg Gluz, Matthias Christgen, Ronald E. Kates, Michael Clemens, Wolfram Malter, Benno Nuding, Bahriye Aktas, Sherko Kuemmel, Toralf Reimer, Andrea Stefek, Fatemeh Lorenz-Salehi, Petra Krabisch, Marianne Just, Doris Augustin, Cornelia Liedtke, Calvin Chao, Steven Shak, Rachel Wuerstlein, Hans H. Kreipe, Nadia Harbeck, was originally published electronically on the publisher's internet portal (currently SpringerLink) on June 29, 2017 without open access.With the author(s)' decision to opt for Open Choice the copyright of the article changed on January 6, 2019 to © The Author(s) 2017 and the article is forthwith distributed under the terms of the Creative Commons Attribution-NonCommercial 4.0 International License ( http://creativecommons.org/licenses/by-nc/4.0/ ), which permits any noncommercial use, duplication, adaptation, distribution and reproduction in any medium or format, as long as you give appropriate credit to the original author(s) and the source, a link is provided to the Creative Commons license and any changes made are indicated. The original article has been corrected.

Evaluation of observed and the expected incidence of common cancers: An experience from Southwestern of Iran, 2010-2014.

BACKGROUND: Awareness of observed and expected incidence of cancers is so important in managing cancer as the third mortality cause in Iran. In the present study, we evaluated observed and the expected incidence of common cancers in Chaharmahal and Bakhtiari province. MATERIALS AND METHODS: This study is a Secondary data analysis. All data about pathology-based cancer registration (Cancer diagnosis was based on pathological laboratory, ICD-O2) in Chaharmahal and Bakhtiari in Southwestern Iran in 2010-2014 was used. By dividing the number of registered cases of each cancer in every age group into the total observed cancers in that age group, the observed ratio of each cancer in that age group was calculated. Then, using the proposed coefficients Parkin and age-standardized cancer ratio method, the expected ratios in each age group, were calculated. RESULTS: In 5 years study, 2918 new cases of cancer were recorded. Out of them, 1735 (59.46%) were male. The annual average total occurrence of all cancers in this province was 68.2/100,000 populations. The observed incidence ratios of common cancers, including stomach, breast, colorectal, thyroid, lymph nodes, ovaries, gall bladder, the bladder and the brain, were 0.11, 0.12, 0.09, 0.06, 0.02, 0.03, 0.01, 0.08, and 0.05, respectively. The expected incidence ratios of above-mentioned cancers are 0.11, 0.13, 0.1, 0.06, 0.02, 0.03, 0.01, 0.08, and 0.05, respectively. Based on observed (O) and expected (E) comparison, breast and colorectal cancer had higher incidence than expected ratio. CONCLUSION: Our results showed that in our area, treatment programs and health plans should focus on cancer registration, especially on common cancers and reevaluate breast and colorectal cancer occurrence. Therefore, the plan for the control and prevention of this cancer must be a high priority for health policymakers.

Cancer trends in a province of Southwest of Iran, 2003-2016.

BACKGROUND: Awareness of the trends of cancer incidence in each geographic region is an important. The aim of present study was to determine the incidence trends of cancer in Chaharmahal and Bakhtiari (Ch and B) province in Southwest of Iran. MATERIALS AND METHODS: In this secondary data analysis, retrospective existing data were used from cancer registry reports in Ch and B in Southwest of Iran in 2003-2016. Data on epidemiologic trend were analyzed using Joinpoint software package and annual percentage change (APC) with 95% confidence interval (95% CI) was computed. RESULTS: Age-standardized incidence rate per 100,000 persons in the province in 2003 was 31.74 that increased to 147.14 in 2016. APC during 2003-2016 was 12.58% (CI: 9.3-16) and significant, which was 10.22% (7.4-13.1) and 14.47% (10.2-18.9) in men and women, respectively. Incidence of the stomach, breast, colorectal, thyroid, lymph node, and ovarian cancers is increasing and the highest incidence was observed in two age groups of 25-34 and 55-64 years. CONCLUSION: In general, cancers are of increasing trend. Surveillance and monitoring the incidence of cancer and studying the causes of environmental or genetic in the cancer changes can help for cancer prevention and control.

Reducing chemotherapy use in clinically high-risk, genomically low-risk pN0 and pN1 early breast cancer patients: five-year data from the prospective, randomised phase 3 West German Study Group (WSG) PlanB trial.

BACKGROUND: The prospective phase 3 PlanB trial used the Oncotype DX® Recurrence Score® (RS) to define a genomically low-risk subset of clinically high-risk pN0-1 early breast cancer (EBC) patients for treatment with adjuvant endocrine therapy (ET) alone. Here, we report five-year data evaluating the prognostic value of RS, Ki-67, and other traditional clinicopathological parameters. METHODS: A central tumour bank was prospectively established within PlanB. Following an early amendment, hormone receptor (HR)+ , pN0-1 RS ≤ 11 patients were recommended to omit chemotherapy. Patients with RS ≥ 12, pN2-3, or HR-negative/HER2-negative disease were randomised to anthracycline-containing or anthracycline-free chemotherapy. Primary endpoint: disease-free survival (DFS). PlanB Clinicaltrials.gov identifier: NCT01049425. FINDINGS: From 2009 to 2011, PlanB enrolled 3198 patients (central tumour bank, n = 3073) with the median age of 56 years, 41.1% pN+, and 32.5% grade 3 EBC. Chemotherapy was omitted in 348/404 (86.1%) eligible RS ≤ 11 patients. After 55 months of median follow-up, five-year DFS in ET-treated RS ≤ 11 patients was 94% (in both pN0 and pN1) versus 94% (RS 12-25) and 84% (RS > 25) in chemotherapy-treated patients (p < 0.001); five-year overall survival (OS) was 99 versus 97% and 93%, respectively (p < 0.001). Nodal status, central/local grade, tumour size, continuous Ki-67, progesterone receptor (PR), IHC4, and RS were univariate prognostic factors for DFS. In a multivariate analysis including all univariate prognostic markers, only pN2-3, central and local grade 3, tumour size >2 cm, and RS, but not IHC4 or Ki-67 were independent adverse factors. If RS was excluded, IHC4 or both Ki-67 and PR entered the model. The impact of RS was particularly pronounced in patients with intermediate Ki-67 (>10%, <40%) tumours. INTERPRETATION: The excellent five-year outcomes in clinically high-risk, genomically low-risk (RS ≤ 11) pN0-1 patients without adjuvant chemotherapy support using RS with standardised pathology for treatment decisions in HR+ HER2-negative EBC. Ki-67 has the potential to support patient selection for genomic testing.

The application of geographic information systems (GIS) in identifying the priority areas for maternal care and services.

BACKGROUND: Improving maternal health is globally introduced as an important health priority. The purpose of this study is to identify the high priority areas which require more maternal health services in Kerman, Iran. METHODS: This is a descriptive cross-sectional study, performed in 2015. The literatures were first explored in order to extract geographic indicators and sub indicators relevant to the maternal health. Data were collected by the use of a questionnaire designed on the basis of AHP (Analytic Hierarchy Process) method. The validity and reliability of the questionnaire were confirmed by three medical informatics experts and test-retest method, respectively. Data were analyzed by Expert Choice software in order to specify the weight and importance of each indicator. The information were then added to Geographic Information System (GIS) to analyze and create the related maps. RESULTS: Women's access to hospitals plays an important role in identifying high priority areas which need maternal care and services. More than half of the mothers in Kerman have a moderate level of access to maternal care services. There is an association between facilities that are provided for pregnant women and the existence of healthcare centers. Moreover, there is a negative correlation between maternal death and the number of facilities provided for medical care and services for pregnant women. CONCLUSIONS: The application of GIS provides us with the capability to identify high priority areas which need maternal care. According to current population policies in Iran and the probable increase in the fertility rate, it is wise to plan proper schedules to improve health care services for pregnant women in Kerman.

A role for matrix remodelling proteins in invasive and malignant meningiomas.

AIMS: Meningiomas are one of the most common brain tumours in adults. Invasive and malignant meningiomas present a significant therapeutic challenge due to high recurrence rates and invasion into surrounding bone, brain, neural and soft tissues. Understanding the molecular mechanism of invasion could help in designing novel therapeutic approaches in order to prevent the need for repeat surgery, decrease morbidity and improve patient survival. The aim of this study was to identify the key factors and underlying mechanisms which govern invasive properties of meningiomas. METHODS: Formalin-fixed paraffin-embedded (FFPE) as well as frozen tumour tissues from bone-invasive, non-invasive and malignant meningiomas were used for RNA microarray, quantitative real-time PCR or Western blot analyses. Malignant meningioma cell lines (F5) were subject to MMP16 downregulation or overexpression and used for in vitro and in vivo functional assays. Subdural xenograft meningioma tumours were generated to study the invasion of tumour cells into brain parenchyma using cell lines with altered MMP16 expression. RESULTS: We establish that the expression level of MMP16 was significantly elevated in both bone-invasive and brain invasive meningiomas. Gain- and loss-of-function experiments indicated a role for MMP16 in meningioma cell movement, invasion and tumour cell growth. Furthermore, MMP16 was shown to positively regulate MMP2, suggesting this mechanism may modulate meningioma invasion in invasive meningiomas. CONCLUSIONS: Overall, the results support a role for MMP16 in promoting invasive properties of the meningioma tumours. Further studies to explore the potential value for clinical use of matrix metalloproteinases inhibitors are warranted.

An ethanol extract of Origanum vulgare attenuates cyclophosphamide-induced pulmonary injury and oxidative lung damage in mice.

CONTEXT: Injury to normal tissues is the major limiting side effect of using cyclophosphamide (CP), an antineoplastic alkylating compound. OBJECTIVE: This study was undertaken to evaluate the protective effect of an extract of Origanum vulgare L. (Lamiaceae), an antioxidative medicinal plant, against CP-induced oxidative lung damage in mice. MATERIALS AND METHODS: Mice were pre-treated with various doses of O. vulgare extract (50, 100, 200, and 400 mg/kg) for 7 consecutive days followed by an injection with CP (200 mg/kg b.w.) One hour after the injection of O. vulgare on the last day, mice were injected with CP; 24 h later, they were euthanized, their lungs were immediately removed, and biochemical and histological studies were conducted. RESULTS: A single dose of CP markedly altered the levels of several biomarkers associated with oxidative stress in lung homogenates. Pretreatment with O. vulgare significantly reduced the levels of lipid peroxidation and attenuated the alterations in glutathione content and superoxide dismutase activity induced by CP in lung tissue. In addition, O. vulgare effectively alleviated CP-induced histopathological changes in lung tissue. CONCLUSIONS: Our results revealed that O. vulgare protects lung tissues from CP-induced pulmonary damage and suggest a role for oxidative stress in the pathogenesis of lung disease produced by CP. Because O. vulgare has been extensively used as an additive agent and is regarded as safe, it may be used concomitantly as a supplement for reducing lung damage in patients undergoing chemotherapy.

Spatial health risk assessments of nickel in the groundwater sources of a mining-impacted area.

Mining activities have increased the potential risks of metal pollution to the groundwater resources in arid areas across the globe. Therefore, this study aimed to examine the health risk associated with nickel (Ni) in the groundwater sources of a mining-impacted area, South Khorasan, Eastern Iran. A total of 110 stations were included in the study, comprising 62 wells, 40 qanats, and 8 springs in summer, 2020. Initially, the collected samples were tested for temperature, pH, and electrical conductivity (EC). Subsequently, the samples were filtered and treated with nitric acid (HNO3) to measure the concentration of Ni using Inductively Coupled Plasma Mass Spectrometry (ICP-MS). Hazard quotient (HQ) and non-carcinogenic risk assessments were employed to evaluate the potential risks of Ni to the inhabitants. The findings revealed that the concentration of Ni ranged from 0.02 to 132.39 µg l-1, and only two stations exhibited Ni concentrations above the WHO standards (20 µg l-1). The results demonstrated that 98.21% of the sampled locations had HQ values below one, indicating negligible risk, while 1.78% of the stations exhibited HQ values of one or higher, representing a high non-carcinogenic risk for water consumers. Overall, the concentration of nickel in the groundwater of South Khorasan exceeded the World Health Organization (WHO) limit solely in the Halvan station, posing a non-carcinogenic risk for the residents in that area, and therefore, additional efforts should be made to provide healthier groundwater to consumers in this region.

A Systematic Review of Health Management Mobile Applications in COVID-19 Pandemic: Features, Advantages, and Disadvantages.

Introduction: With the increasing accessibility of smartphones, their use has been considered in healthcare services. Mobile applications have played a pivotal role in providing health services during COVID-19. This study is aimed at identifying the features, advantages, and disadvantages of health management mobile applications during COVID-19. Methods: This systematic review was conducted in PubMed, Scopus, and Web of Science using the related keywords up to November 2021. The original articles in English about the health management mobile applications in COVID-19 were selected. The study selection was done by two researchers independently according to inclusion and exclusion criteria. Data extraction was done using a data extraction form, and the results were summarized and reported in related tables and figures. Results: Finally, 12 articles were included based on the criteria. The benefits of mobile health applications for health management during COVID-19 were in four themes and 19 subthemes, and the most advantages of the application were in disease management and the possibility of recording information by users, digital tracking of calls, and data confidentiality. Furthermore, the disadvantages of them have been presented in two themes and 14 subthemes. The most common disadvantages are reduced adherence to daily symptom reports, personal interpretation of questions, and result bias. Conclusion: The study results showed that mobile applications have been effective in controlling the prevalence of COVID-19 by identifying virus-infested environments, identifying and monitoring infected people, controlling social distancing, and maintaining quarantine. It is suggested that usability, ethical and security considerations, protection of personal information, and privacy of users be considered in application design and development.

Machine Learning Prediction of Treatment Response to Biological Disease-Modifying Antirheumatic Drugs in Rheumatoid Arthritis.

Background: Disease-modifying antirheumatic drugs (bDMARDs) have shown efficacy in treating Rheumatoid Arthritis (RA). Predicting treatment outcomes for RA is crucial as approximately 30% of patients do not respond to bDMARDs and only half achieve a sustained response. This study aims to leverage machine learning to predict both initial response at 6 months and sustained response at 12 months using baseline clinical data. Methods: Baseline clinical data were collected from 154 RA patients treated at the University Hospital in Erlangen, Germany. Five machine learning models were compared: Extreme Gradient Boosting (XGBoost), Adaptive Boosting (AdaBoost), K-nearest neighbors (KNN), Support Vector Machines (SVM), and Random Forest. Nested cross-validation was employed to ensure robustness and avoid overfitting, integrating hyperparameter tuning within its process. Results: XGBoost achieved the highest accuracy for predicting initial response (AUC-ROC of 0.91), while AdaBoost was the most effective for sustained response (AUC-ROC of 0.84). Key predictors included the Disease Activity Score-28 using erythrocyte sedimentation rate (DAS28-ESR), with higher scores at baseline associated with lower response chances at 6 and 12 months. Shapley additive explanations (SHAP) identified the most important baseline features and visualized their directional effects on treatment response and sustained response. Conclusions: These findings can enhance RA treatment plans and support clinical decision-making, ultimately improving patient outcomes by predicting response before starting medication.

Outcome of early breast cancer treated in an urban and a rural breast cancer unit in Germany.

BACKGROUND: Conflicting evidence has been published concerning survival disadvantages in the outcome of breast cancer patients in relationship to their residency in urban or rural communities. METHODS: The primary aim of this study was to evaluate differences in patients and treatment characteristics between an urban and a rural breast cancer unit. Therefore, all early breast cancer patients treated consecutively between 1999 and 2007 in a rural and an urban breast cancer unit were included. Patient and tumor characteristics, treatment strategies, and guideline adherence were included to evaluate the prognoses of both populations. RESULTS: Overall, data from 2,566 patients were included in this analysis. The 610 patients treated in the rural unit showed significantly more negative prognostic criteria than the 1,956 patients treated in the urban center. No differences were observed with respect to surgical and systemic treatment after adjustment for prognostic parameters. Adherence to national guidelines did not differ significantly between both settings and ranged between 78.0 and 95.6%. Furthermore, no differences regarding recurrence-free and overall survival were observed. CONCLUSIONS: The stage-adjusted pattern of care was similar in 2 German breast care units in a rural region and an urban area. Nevertheless, an earlier diagnosis of breast cancer should be enforced in rural areas to avoid extended treatment burden.

A bibliometric analysis of scientific research trends in monitoring systems for measuring ship emissions.

The maritime sector plays a key role in transportation in the world, and over 90% of world trade is carried by ocean shipping. However, ships are large contributors to global emissions. Hence, a vast majority of research publications have focused on different emission monitoring techniques, which are essential to establishing required policies and regulations that reduce maritime transport emissions. Various documents have been published on monitoring maritime transport emissions affecting air quality since 1977. This paper presents a bibliometric analysis to explore evolution trends, gaps, challenges, and productive countries, as well as the most cited publications with high scholarly impacts. The annual growth of 9.64% in publications demonstrates an increasing interest in reducing maritime vessel emissions. Journal articles constitute 69% of publications, followed by conference papers (25%). China and the USA play a leading role in this field of research. Regarding active resources, the "Atmospheric Environment" journal accounts for the highest relevant publications, H-index, and total citations. Eventually, the temporal evolution of keywords shows the increasing trend towards sustainable maritime transport.

Pulsed sonodynamic therapy of melanoma cancer cells using nanoparticles of and mesoporous platinum.

OBJECTIVE: Noble metal nanomaterials have been introduced as ideal sonosensitizers for sonodynamic therapy (SDT) of cancer. In this research, platinum nanoparticles (PtNPs) and mesoporous platinum (MPt) were first synthesized and then evaluated as novel sonosensitizers. METHODS: Ultrasound waves were radiated at two different power densities and two different pulse ratios to develop a pulsed radiation route for SDT of the malignant melanoma cell line C540 (B16/F10). Fluorescence emission was recorded as an indicator of intracellular reactive oxygen generation during the treatment. RESULTS: Platinum nanoparticles had an average diameter of 12 ± 7 nm and a zeta potential of -17.6 mV; also, MPt had a sponge-like and highly porous structure with a pore size <11 nm and a zeta potential of -39.5 mV. Both PtNPs and MPt, particularly the latter, enhanced the rate of inhibition of tumor cell growth on ultrasound radiation at an output power density of 1.0 W cm-2 and pulse ratio of 30% over 10 min without intensifying temperature. CONCLUSION: Use of the developed pulsed (rather than continuous) radiation in SDT and PtNPs or MPT, without hyperthermia, resulted in a new effective cancer treatment method based on the mechanisms of cavitation and/or ROS generation.

Fractionated Sonodynamic Therapy Using Gold@Poly(ortho-aminophenol) Nanoparticles and Multistep Low-Intensity Ultrasound Irradiation to Treat Melanoma Cancer: In Vitro and In Vivo Studies.

OBJECTIVE: Cancer treatment using ultrasound irradiation with low intensities along with a sonosensitizer has been found to have significant advantages, such as high penetration depth in tissues, non-invasive therapeutic character, minor side effects, good patient adherence and preferential tumor area treatment. In the present study, gold nanoparticles covered by poly(ortho-aminophenol) (Au@POAP NPs) were synthesized and characterized as a new sonosensitizer. METHODS: We investigated Au@POAP NPs efficacy on fractionated ultrasound irradiation for treatment of melanoma cancer in vitro as well as in vivo. DISCUSSION: In vitro examinations revealed that although Au@POAP NPs (with a mean size of 9.8 nm) alone represented concentration-dependent cytotoxicity against the B16/F10 cell line, multistep ultrasound irradiation (1 MHz frequency, 1.0 W/cm2 intensity, 60 s irradiation time) of the cells in the attendance of Au@POAP NPs led to efficient cell sonodynamic therapy (SDT) and death. Histological analyses revealed that in vivo fractionated SDT toward melanoma tumors of male balb/c mice led to no residual viable tumor cell after 10 d. CONCLUSION: A deep sonosensitizing effectiveness of Au@POAP NPs on fractionated low-intensity ultrasound irradiation was attained with the main mechanism of tumor cell eradication of promotion of apoptosis or necrosis through dramatically increased reactive oxygen species levels.

Management of Cancer Patients in the COVID-19 Crisis Using Telemedicine: A Systematic Review.

BACKGROUND: Telemedicine can provide a solution for disease management during the COVID-19 pandemic. This literature review aims to explore the role of telemedicine during the COVID-19 pandemic for management of cancer patients. METHOD: A comprehensive systematic search was conducted in PubMed, Science Direct, EMBASE, and Web of Science databases for the papers published until April 2021. Studies were included in case they had practically used telemedicine in the management of cancer patients during the COVID-19 crisis. RESULTS: After screening 2614 titles and abstracts and reviewing 305 full-texts, 16 studies were found to be eligible. The results indicated that most of the patients contacted by telemedicine services mostly used to intract with patients breast cancer (n=4, 25%). The most common use of telemedicine was the provision of virtual visit services (n=10, 62.25%). Besides, communication was most frequently provided by live video conferences (n=11, 68.75%). CONCLUSION: Telemedicine can provide continued access to necessary health services in oncology care and serve as an important role in pandemic planning and response.

Estimating brain effective connectivity from EEG signals of patients with autism disorder and healthy individuals by reducing volume conduction effect.

Studying brain connectivity has shed light on understanding brain functions. Electroencephalogram signals recorded from the scalp surface comprise inter-dependent multi-channel signals each of which is a linear combination of simultaneously active brain sources as well as adjacent non-brain sources whose activity is widely volume conducted to the scalp through overlapping patterns. Evaluation of brain connectivity based on multivariate autoregressive (MVAR) model identification from neurological time series can be a proper tool for brain signal analysis. However, the MVAR model only considers the lagged influences between time series while ignoring the instantaneous effects (zero-lagged interactions) among simultaneously recorded neurological signals. Hence predicting instant interactions may result in fake connectivity, which may lead to misinterpreting in results. In this study, we aim to find instantaneous effects from coefficients of the MVAR model acquired using an ADALINE neural network and investigate the efficiency of the proposed algorithm by applying it to a simulated signal. We show that our coefficients are estimated accurately from channels of the simulated signal. Moreover, we apply the proposed method on a dataset of a group of 18 healthy children and 10 children with autism by comparing their effective connectivity estimated by direct directed transfer function method using new and old coefficients. Finally, to show the efficiency of the algorithm we exploit the support vector machine method for classifying the dataset. We show that there is a significant improvement in the results obtained from the proposed method.

Helicobacter pylori infection in pediatrics with gastrointestinal complaints.

BACKGROUND: Helicobacter pylori is one of the most important pathogenic bacteria in gastric mucosa both in adults and pediatrics. Here we aimed to investigate the prevalence of Helicobacter pylori in pediatrics with gastrointestinal complaints by the endoscopic method and using pathology reports. METHODS: This is a cross-sectional study that was performed in 2019-2020 in Imam Hossein hospital affiliated to Isfahan University of Medical Sciences on medical documents of pediatrics that underwent gastric or duodenal biopsy via endoscopy. We collected data regarding patients' age, gender, place of residence, type of gastrointestinal complaints, and prevalence of Helicobacter pylori infection from the medical reports. We also investigated the possible correlation between the presence of Helicobacter pylori and the type of complaints among patients. RESULTS: A total number of 400 pediatrics entered the study. Abdominal pain was the most common complaint (42%). Helicobacter pylori infection was found in 31 cases (7.8%). The prevalence of Helicobacter pylori infection in boys (10.7%) was significantly higher than in girls (4.6%) (P = 0.02) and was significantly related to the age group of children (P<0.001) in the way that Helicobacter pylori infection was more common in higher ages. There was no significant relationship between the prevalence of Helicobacter pylori infection and the type of complaint (P = 0.29). CONCLUSION: We showed that the prevalence of Helicobacter pylori infection is low among pediatrics with gastrointestinal complaints and this issue could cast doubt on the high prevalence rates and importance of this infection in children.

Helicobacter pylori Infection and Non-alcoholic Fatty Liver Disease: A Systematic Review and Meta-Analysis.

Since numerous studies have stated that there may be a relationship between Helicobacter pylori infection and nonalcoholic fatty liver disease, and because of the high prevalence of both conditions worldwide, this study investigated the risk of non-alcoholic fatty liver disease in patients infected with H. pylori. Following a systematic review of PubMed, Scopus, Web of Science and Embase, and a search in Google Scholar using MeSH terms such as H. pylori and non-alcoholic fatty liver disease, the relevant papers up to November 2020 were reviewed. All cohort, case-control, and cross-sectional studies that examined the risk of developing non-alcoholic fatty liver disease in patients infected with H. pylori entered this study. A meta-analysis was conducted in STATA 11. This systematic review examined 22 papers with 117 117 participants (33 711 patients infected with H. pylori and 83 406 participants as control) and 20 studies were subjected to meta-analysis The results indicated a 22% to 27% increase in the risk of developing non-alcoholic fatty liver disease in patients infected with H. pylori (crude odds ratio: 1.27, 95% CI: 1.17-1.33; and adjusted odds ratio: 1.22, 95% CI: 1.09-1.35). According to the subgroup analysis, the study region, sample size, and the method of diagnosing H. pylori were the factors contributing to the high heterogeneity. The meta-analysis revealed the increased risk of developing non-alcoholic fatty liver disease in patients infected with H. pylori. This indicates that H. pylori is a serious risk factor in patients susceptible to NAFLD.