Validity and reliability of anxiety literacy (A-Lit) and its relationship with demographic variables in the Iranian general population.

Introduction: Anxiety disorder is one of the most common mental disorders. This cross-sectional research aimed to determine anxiety literacy (A-Lit) psychometric properties among the Iranian population in 2022. Methods: This research was conducted on 690 people in Iran in 2022. In this study, people were selected by proportional stratified sampling, and the validity and reliability of the A-Lit designed by Griffiths were assessed. Validity of A-Lit was assessed by face validity, content validity, and confirmatory factor analysis. Reliability of A-Lit was evaluated by the McDonald's omega coefficient, Cronbach's alpha coefficient, and test- retest. In analytical sections, the tests of One-way ANOVA, Chi-squared test, and independent samples t-test were used. Results: The rates of S-CVI/Ave and CVR for A-Lit were 0.922 and 0.774, respectively. In confirmatory factor analysis, three items were deleted because the factor loading was less than 0.4, and goodness-of-fit indexes (Some of goodness-of-fit indexes: χ2/df = 4.175, GFI: 0.909, RMSEA = 0.068, PCFI = 0.745, AGFI = 0.883) were confirmed as the final model with 19 items. For all items, the Cronbach's alpha coefficient was 0.832, the McDonald's omega coefficient was 0.835, and the intraclass correlation coefficient was 0.874. According to the results of this study, 1.3% (n = 9) did not answer any questions correctly and 8.4% (n = 58) were able to answer 1-6 questions correctly. Approximately 72% (n = 495) were able to answer 7-12 questions, and eventually only 18.6% (n = 128) were able to answer 13 questions and more. There was a significant relationship between sex, age group, occupation status, marital status, and get information related to mental illness with A-Lit level (p < 0.05). Conclusion: The Persian version of A-Lit was confirmed with 19 items, and this scale is a reliable tool for measuring A-Lit in the general population. The results also showed that a few people have a higher level of anxiety literacy and that educational and intervention programs need to be designed and implemented for the public population.

Evaluation the validity and reliability of persian short form of the literacy of suicide scale (LOSS): a methodological study in 2022.

INTRODUCTION: This research was conducted with the aim of evaluating the validity and reliability of Persian short version of the Literacy of Suicide Scale (LOSS) among the general population. METHODS: This methodological study was conducted to evaluate the validity and reliability of Persian short form of LOSS among the general population, using a sample of 1175 participants in Iran, 2022. Participants were entered to study using method of proportional stratified sampling. The validity of Persian short form of LOSS was checked by four measures of validity: qualitative face validity, qualitative content validity, EFA (exploratory of factor analysis), and CFA (confirmatory factor analysis). The measure of reliability of Persian short form of LOSS was checked by three reliability of McDonald omega coefficient, ICC (Intraclass Correlation Coefficient), and Cronbach's alpha coefficient. RESULTS: Based on the findings of EFA, 4 components with eigenvalues > 1 were extracted and these 4 factors were able to explain 57.96% of variance. In EFA section, only 1 question was deleted due to entry into the non -relevant sub -scale. Based on the results of CFA, all items had the factor loading greater than 0.4 and none of the items were removed at this stage. In CFA, based the results of goodness-of-fit indexes for example: χ2/df = 2.077, NFI: 0.957, IFI = 0.977, RMSEA = 0.030, GFI: 0.988, and PGFI = 0.569, the final mode was approved with 11 items and 4 factors. In this study for all items, Cronbach's alpha coefficient was 0.739, McDonald omega coefficient was 0.753, and ICC was 0.860. Finally, the Persian short form of LOSS was approved with 11 items and four dimensions of signs/ symptoms with 3 questions, the risk factors with 2 questions, treatment/ prevention with 2 questions, and causes/ triggers with 4 questions. CONCLUSION: The Persian short form of LOSS with 11 items and four subscales is a valid and reliable scale to survey the suicide literacy status in the general population.

Blood-based microRNAs as Potential Diagnostic biomarkers for Melanoma: A Meta-analysis.

INTRODUCTION: Circulating microRNAs (miRNAs) serve as noninvasive diagnostic markers in many cancers. This meta-analysis aims to evaluate the diagnostic efficacy of circulating microRNAs for melanoma. MATERIAL AND METHODS: The pooled sensitivity, specificity, positive likelihood ratio, negative likelihood ratio, diagnostic odds ratio, and ROC curve were evaluated using the Meta-Disc V.1.4 and Comprehensive Meta-Analysis V.3.3 software packages. To investigate the heterogeneity, the I2 and Chi-square tests were used. The publishing bias was evaluated using Begg's rank correlation and Egger regression asymmetry tests. RESULTS: A total of 9 articles covering 13 studies (more than 50 miRs individually and in combination) were included, containing 1,355 participants (878 cases and 477 controls). The overall pooled sensitivity, specificity, positive likelihood ratio, negative likelihood ratio, diagnostic odds ratio (DOR), and AUC were 0.78 (95% CI: 0.76-0.81), 0.80 (95% CI: 0.77-0.83), 4.32 (95% CI: 3.21-5.82), 0.17 (95% CI: 0.09-0.32), 28.0 (95% CI: 15.34-51.09), and 0.91, respectively. According to Begg's and Egger's tests, there was no publication bias (Begg's p = 0.160 and Egger's p = 0.289). CONCLUSION: Circulating miRNAs can serve as fair and non-invasive diagnostic biomarkers for melanoma. Additionally, specific miRNAs still need to be discovered for diagnosing melanoma.

Title page: psychometric properties of literacy of suicide scale (LOSS) in iranian population: long form.

INTRODUCTION: Suicide and suicide attempts are among the most important indicators of mental health in the world. In this research, the validity and reliability of Literacy of Suicide Scale (LOSS) was examined in general people over the age of 18. METHODS: This cross-sectional psychometric study was conducted in 2022 among 952 general population in Iran. Participants were selected by two methods of proportional stratified sampling and simple random sampling. The internal consistency of the tools was assessed using Cronbach's alpha coefficient, and McDonald omega coefficient. Also, test-retest reliability was checked by Intraclass Correlation Coefficient (ICC). RESULTS: In the confirmatory factor analysis section, the factor loading of all questions were above 0.4 and one questions were deleted and final model with four factors and 25 questions was confirmed (Some of goodness-of-fit indexes: AGFI = 0.910, RMSEA = 0.050, IFI = 0.901, and χ2/df = 3.333). For all questions, the Cronbach's alpha coefficient was 0.859, McDonald omega coefficient was 0.866, and ICC was 0.895. Finally, the Persian long version of LOSS was approved with 25 items and four subscales: causes/triggers (9 items), risk factors (7 items), signs and symptoms (5 items) and treatment/prevention (4 items). CONCLUSION: The Persian long version of LOSS with four subscales and 25 items is an appropriate tool to investigate the state of suicide literacy in the public population.

Circulating progenitor cells and outcomes in patients with coronary artery disease.

BACKGROUND: Low quantities of circulating progenitor cells (CPCs), specifically CD34+ populations, reflect impairment of intrinsic regenerative capacity. This study investigates the relationship between subsets of CPCs and adverse outcomes. METHODS: 1366 individuals undergoing angiography for evaluation of coronary artery disease (CAD) were enrolled into the Emory Cardiovascular Biobank. Flow cytometry identified CPCs as CD45med blood mononuclear cells expressing the CD34 epitope, with further enumeration of hematopoietic CPCs as CD133+/CXCR4+ cells and endothelial CPCs as vascular endothelial growth factor receptor-2 (VEGFR2+) cells. Adjusted Cox or Fine and Gray's sub-distribution hazard regression models analyzed the relationship between CPCs and 1) all-cause death and 2) a composite of cardiovascular death and non-fatal myocardial infarction (MI). RESULTS: Over a median 3.1-year follow-up period (IQR 1.3-4.9), there were 221 (16.6%) all-cause deaths and 172 (12.9%) cardiovascular deaths/MIs. Hematopoietic CPCs were highly correlated, and the CD34+/CXCR4+ subset was the best independent predictor. Lower counts (≤median) of CD34+/CXCR4+ and CD34+/VEGFR2+ cells independently predicted all-cause mortality (HR 1.46 [95% CI 1.06-2.01], p = 0.02 and 1.59 [95% CI 1.15-2.18], p = 0.004) and cardiovascular death/MI (HR 1.50 [95% CI 1.04-2.17], p = 0.03 and 1.47 [95% CI 1.01-2.03], p = 0.04). A combination of low CD34+/CXCR4+ and CD34+/VEGFR2+ CPCs predicted all-cause death (HR 2.1, 95% CI 1.4-3.0; p = 0.0002) and cardiovascular death/MI (HR 2.0, 95% CI 1.3-3.2; p = 0.002) compared to those with both lineages above the cut-offs. CONCLUSIONS: Lower levels of hematopoietic and endothelial CPCs indicate diminished endogenous regenerative capacity and independently correlate with greater mortality and cardiovascular risk in patients with CAD.

The association between baseline circulating progenitor cells and vascular function: The role of aging and risk factors.

BACKGROUND: To investigate the cross-sectional and longitudinal relationships between vascular function and circulating progenitor cell (CPC) counts with respect to aging and exposure to risk factors. METHODS: In 797 adult participants, CPCs were enumerated by flow cytometry as CD45med mononuclear cells expressing CD34 epitope and its subsets co-expressing CD133, and chemokine C-X-C motif receptor 4 (CXCR4+). Arterial stiffness was evaluated by tonometry-derived pulse wave velocity (PWV) and microvascular function was assessed as digital reactive hyperemia index (RHI). RESULTS: In cross-sectional analyses, for every doubling in CD34+ cell counts, PWV was 15% higher and RHI was 9% lower, after adjusting for baseline characteristics and risk factors (p for all < 0.01). There were significant CPC-by-age-by-risk factor interactions (p <0.05) for both vascular measures. Among younger subjects (< 48 years), CPC counts were higher in those with risk factors and vascular function was better in those with higher compared to those with lower CPC counts (p for all < 0.0l). In contrast, in older participants, CPCs were not higher in those with risk factors, and vascular function was worse compared to the younger age group. A lower CPC count at baseline was an independent predictor of worsening vascular function during 2-year follow-up. CONCLUSION: A higher CPC count in the presence of risk factors is associated with better vascular function among younger individuals. There is no increase in CPC count with risk factors in older individuals who have worse vascular function. Moreover, a higher CPC count is associated with less vascular dysfunction with aging.

Pulsed-sonochemiluminescence combined with molecularly imprinted polymerized high internal phase emulsion adsorbent for determination of bentazone.

A small low-power humidifier with a simple programmable on/off switch was used as a pulsed ultrasound generator. Using this tool, a novel sonochemiluminescence (SCL) method was developed to determine bentazone. To the best of our knowledge, no chemiluminescence method has been proposed to determine this pesticide. Only five studies have been proposed for SCL quantitative applications so far. Therefore, revealing new aspects of SCL promises to develop analytical methods for the quantitative determination of different substances. A molecularly imprinted polymerized high internal phase emulsion (MIP-polyHIPE) was synthesized, bentazone separated from aqueous solutions, and pre-concentrated by the MIP-polyHIPE foam. The adsorption of bentazone on the MIP-polyHIPE adsorbent was theoretically studied by density functional theory through molecular dynamics simulation. Both experimental and simulation results indicated removal and pre-concentration of bentazone by the MIP-polyHIPE adsorbent. Using the proposed SCL method and without pre-concentration process, a linear dynamic range (LDR) of 2.5 × 10-7-5.0 × 10-5 mol L-1 and a limit of detection (LOD) of 8.4 × 10-8 mol L-1 were obtained for bentazone with a relative standard deviation of 2.64%. The LDR and LOD were improved to 2.6 × 10-9-2.0 × 10-7 mol L-1 and 8.8 × 10-10 mol L-1, respectively, using MIP-polyHIPE adsorbents. The method's application was evaluated by removing and pre-concentration of bentazone from water samples, including well, river, and tap water. The results showed that the pre-concentration factor and recovery percentages were 113-131 times and 93-106%, respectively, using the MIP-polyHIPE absorbent.

Flow injection chemiluminescence determination of ethion and computational investigation of the adsorption process on molecularly imprinted polymerized high internal phase emulsion.

The lack of sufficient selectivity is the main limitation of chemiluminescence (CL) methods; because the CL reagent is not restricted to a specific analyte. This study investigated the preconcentration and determination of ethion using a flow injection CL (FIA-CL) method using a molecularly imprinted poly high internal phase emulsion (MIP-polyHIPE) adsorbent. Preliminary studies showed that ethion could be determined with high sensitivity in the Ru(bipy)3 2+ -acidic Ce(IV) CL system. A MIP-polyHIPE adsorbent was synthesized and used for preconcentration to increase the selectivity and sensitivity of the method. The adsorption of ethion on the adsorbent was investigated using density functional theory (DFT) and molecular dynamics (MD), UV-vis and FTIR spectrophotometry and liquid chromatography-tandem mass spectrometry (LC-MS-MS). Response surface methodology (RSM) and central composite design (CCD) were used to find optimized concentrations of variables. The linear dynamic range (LDR) and limit of detection (LOD) for ethion in the FIA-CL method were calculated 1.0 ⨯ 10-9 to 2.0 ⨯ 10-7 and 6.0 ⨯ 10-10  mol L-1 , respectively. The percentage of relative standard deviation for five repetitive measurements of 5.0 ⨯ 10-8  mol L-1 ethion was 4.2%. The proposed method was successfully used to separate and preconcentrate ethion from drinking and surface water sources.

Effects of Selenium and/or N-Acetyl-Cysteine Supplementation on Nonthyroidal Illness Syndrome in Hemodialysis Patients: A Factorial Randomized Controlled Trial.

INTRODUCTION: Nonthyroidal illness syndrome (NTIS) is common in hemodialysis patients (HPs). However, limited clinical trials have been conducted in this field. Therefore, the aim of this study was to investigate the effect of Se and/or N-acetyl-cysteine (NAC) on NTIS parameters in HPs. METHODS: In this factorial randomized controlled trial, 68 HPs were divided into four groups: group A received placebo of Se and NAC, group B received 600 µg per day of NAC and placebo of Se, group C received 200 µg of Se per day and placebo of NAC and group D received 200 µg of selenium and 600 µg of NAC per day for 12 weeks. Blood samples were taken at baseline and after 12 weeks to assess free tri-iodothyronine (FT3), free thyroxine (FT4), thyroid stimulating hormone (TSH), and reverse T3 (rT3) concentrations. RESULTS: Our finding demonstrated that rT3 levels were decreased in B, C, and D groups and increased nearly to baseline levels in the A group after 12 weeks, with a marked difference between the groups (p < 0.001) based on ANOVA. Although there were no significant differences in FT3 (p = 0.39), FT4 (p = 0.76), and TSH (p = 0.71) between the groups at the end of the trial. CONCLUSION: This trial showed that Se and/or NAC exert beneficial effects on rT3 levels in HPs. However, long-term clinical trials with a larger sample size using more appropriate biomarkers are recommended to evaluate the efficacy and safety of Se and/or NAC in HPs.

The impact of zinc supplementation on galectin-3 and metabolic markers in diabetic patients on hemodialysis: A randomized, double-blind, placebo-controlled trial.

Purpose: There is little information about the association between zinc sulfate (ZnSO4) supplementation and metabolic profiles in zinc-deficient diabetic patients on hemodialysis (DHPs). Therefore, we aimed to investigate the association between ZnSO4 supplementation and serum levels of galectin-3 (Gal-3) and cardiometabolic parameters in zinc-deficient DHPs. Methods: In the present randomized double-blind placebo-controlled clinical trial, 46 zinc-deficient DHPs (35-62 years) were included and assigned to receive either 220 mg/d ZnSO4 or placebo for 8 weeks. Serum levels of Gal-3, lipid profile, and blood pressure (BP) were assessed at baseline and the end of trial. Results: We found a significant effect of ZnSO4 intake on the reduction of serum Gal-3 (P = < 0.001), triglycerides (P = < 0.001), total cholesterol (P = < 0.001), low-density lipoprotein cholesterol (P = < 0.001) and increased high-density lipoprotein cholesterol (P = < 0.001) as compared to the control group. Additionally, systolic blood pressure (SBP) (P = 0.006) and diastolic blood pressure (DBP) (P = 0.01) were significantly reduced following 8 weeks of ZnSO4 supplementation. Conclusion: Taken together, 220 mg ZnSO4 supplementation per day for 8 weeks among zinc-deficient DHPs had beneficial effects on Gal-3 and metabolic profiles. Iranian Registry of Clinical Trials Identifier: IRCT20191217045765N1, date of registration: 2020-02-09.

Dental caries experience and its relationship to demographic factors in 2- to 6-year-old children in Fars-Iran in 2018.

PURPOSE: Among oral conditions, tooth decay is the most common chronic childhood disease. Children's dental caries are influenced by several factors, among which diet is one of the most highlighted ones. The present study was conducted to examine the decayed, missing and filled teeth in primary dentition (dmft) and caries-free (CF) indexes as well as the impact of nutrition and demographic factors on oral health of 2- to 6-year-old children in Fars Province. METHODS: A cross-sectional study was conducted on children aged 2-6 years old to evaluate dmft and CF indices according to the latest WHO standards as well as their demographic characteristics in 2018. A questionnaire was used for data collection. RESULTS: A total of 2220 children were recruited. The mean dmft was 1.37 ± 2.69. The components of the dmft score included decay (1.23 ± 2.6), missing (0.03 ± 0.11) and filling (0.11 ± 0.7) in primary dentition, and the prevalence of caries-free children was 66.5%. The results showed that dmft had a significant positive relationship with breastfeeding termination time, maternal education level and maternal age. Birth weight, consumption of iron, vitamin A and D supplements, age at onset of complementary feeding and maternal occupation had no significant relationship with dmft. CONCLUSIONS: The tooth decay index of 2- to 6-year-old children in Fars Province is very different from WHO global standards. Therefore, educating mothers about the duration of breastfeeding is important to achieve standard values for the dental caries index.

The Effects of Zinc Sulfate Supplementation on Serum Copeptin, C-Reactive Protein and Metabolic Markers in Zinc-Deficient Diabetic Patients on Hemodialysis: A Randomized, Double-Blind, Placebo-Controlled Trial.

We aimed to investigate the association between zinc (Zn) supplementation and serum levels of copeptin, high-sensitive C-reactive protein (hs-CRP), glycemic control, anthropometric parameters and renal function in Zn -deficient diabetic hemodialysis patients (DHPs). This randomized, double-blind, placebo-controlled trial (RCT) was conducted on 46 DHPs with Zn-deficiency. The Zn supplement group (n = 21) received a 220-mg/day Zn sulfate capsule (containing 50 mg Zn), and the control group (n = 25) received a placebo capsule (220 mg corn starch), for 8 weeks. Fasting, predialysis blood samples were taken at baseline and after 8 weeks to assess fasting blood glucose (FBG), serum insulin, copeptin, high-sensitive C-reactive protein (hs-CRP), blood urea nitrogen (BUN), creatinine (Cr) concentrations, and homoeostatic model assessment (HOMA-IR) and quantitative insulin-sensitivity check index (QUICKI). Compared to controls, serum copeptin (P < 0.001), hs-CRP (P < 0.001), BUN (P < 0.001), Cr (P < 0.001), Zn (P < 0.001), FBG (P < 0.001) levels, BMI (P < 0.001), and body weight (P < 0.001) were significantly affected following ZnSO4 supplementation for 8 weeks. In contrast, QUICKI (P = 0.57), HOMA-IR (P = 0.60), and serum insulin (P = 0.55) were not affected following Zn supplementation in comparison with patients receiving placebo. Zn sulfate supplementation appears to have favorable effects on serum copeptin and hs-CRP, FBG, and renal function in Zn-deficient DHPs. Iranian Registry of Clinical Trials Identifier: IRCT20190806044461N1.

A molecularly imprinted polymerized high internal phase emulsion adsorbent for sensitive chemiluminescence determination of clopidogrel.

A molecularly imprinted polymerized high internal phase emulsion (MIP-polyHIPE) adsorbent was used for selective separating and preconcentrating the anti-plaque drug, clopidogrel. For the first time in this study, chemiluminescence (CL) methods were evaluated for the determination of clopidogrel. The synthesis of adsorbents by the emulsion templating method showed that the sensitivity of the method can be increased up to 42 times. The determination of clopidogrel was evaluated by Ru(phen)32+-Cerium (IV), KMnO4-H2SO4, KMnO4-H2SO4-Na2SO3, and luminol-H2O2 CL systems. According to the results, only the Ru(phen)32+-Cerium (IV) CL system showed a reasonable sensitivity for clopidogrel. Using MIP-polyHIPE adsorbent, the linear range, the limit of detection, and relative standard deviation for clopidogrel in this system were respectively 1.0 × 10-9-8.0 × 10-8 mol L-1, 3.0 × 10-10 mol L-1, and 6.3% (n = 4, 1.0 × 10-8). The proposed method was employed for determining clopidogrel in pharmaceuticals and blood serum samples. The results showed the good sensitivity and accuracy of the proposed method.

Estimating costs of hepatitis B vaccination in infants: experimental evidence of the expanded program on immunization in Southern Iran.

BACKGROUND: Health costs have increased significantly around the world, and cost assessments have become important. This study aimed to collect cost of the resources used in the national hepatitis B immunization program in Southern Iran. METHODS: Costs were calculated by investigating the available documents as well as consulting with knowledgeable personnel. These costs were collected using the data from Shiraz University of Medical Sciences. According to the health payer's perspective, the indirect costs of the people were not taken into account. All current and capital costs in year 2017 were calculated and converted to US dollars (USDs). RESULTS: In 2017, 33 204 children received hepatitis B vaccine. The total cost of the national hepatitis B vaccination program in Shiraz and the cost of vaccination per child were 473 506 and 14.26 USD, respectively. However, the cost of inoculation of hepatitis B vaccine per dose was estimated at 3.20 USD. Personnel costs constituted the highest proportion (53.84%) of total costs. CONCLUSIONS: The cost of hepatitis B vaccination in Iran was lower than other countries. Considering that personnel costs had the largest proportion, it is recommended that proper measures be taken to monitor and modify these costs if necessary.

Giant High-Grade Immature Teratoma of the Central Nervous System (CNS) in an Infant: A Case Report.

BACKGROUND The central nervous system (CNS) is a rare point of origin for mature or immature teratomas. However, immature teratomas are extremely rare. CNS teratomas have been known for poor patient prognosis and recovery and also reduce survival. However, chemoradiotherapy has been reported to increase patient survival. CASE REPORT This study presents a rare giant immature teratoma invading a newborn infant's brain tissue and CNS. The tumor was surgically removed, and in a further 1-year follow-up, it did not need chemotherapy or radiotherapy according to alpha-fetoprotein (aFP) level and other serum markers. The teratoma had affected multiple loci of his brain's left hemisphere, including parietal, frontal, temporal, and occipital lobes. A teratoma was diagnosed lateral to the midline, which is not common in CNS teratomas, as they mainly occur in or near the midline. The tumor was excised completely. The patient was followed up for 1 year, and no further recurrence was observed. CONCLUSIONS Early diagnosis and treatment of immature teratomas are essential in patient prognosis. Chemotherapy is not always needed, but complete surgical removal and patient follow-up are always a necessity. In addition, adequate follow-up of these patients is critical to evaluate their further treatment plan and recurrence risk.

A comparative study of L4-L5-S1 and L5-S1 vertebral fusion in high-grade L5-S1 spondylolisthesis.

INTRODUCTION: One of the most common types of spinal diseases is spondylolisthesis, which in advanced cases requires surgical intervention. This study aimed to compare the results of L4-L5-S1 and L5-S1 vertebral fusion treatment in high-grade L5-S1 spondylolisthesis. METHODS: A study design that randomized controlled trial. A total of 70 consecutive patients who underwent surgery for the treatment of spondylolisthesis at Al-Zahra Hospital in Isfahan, Iran, were evaluated from July 2020 to February 2021 (35 patients underwent L4-L5-S1 and 35 received L5-S1 vertebral fusion treatment). The radicular and low back pain (LBP) intensity (Vanguard Australian Shares), blood loss, wound infection, reduction, and quality of life (SF-12 scores) were quantified before the surgery, 1, 3, and 6 months after surgery in two groups. RESULTS: Patients involved in the two groups had similar baseline demographic characteristics. The percent slip in L4-L5-S1 and L5-S1 group, respectively, postoperative 81.11% and 57.89%, P = 0.0001. Intraoperative blood loss and postoperative were higher in the L4-L5-S1 group when compared to the L5-S1 group (P < 0.05). The wound infection rate of the L4-L5-S1 group was similar to that of the L5-S1 group (8.6% vs. 2.9%, P = 0.303). There was no difference in radicular and LBP intensity, SF-12 scores among patients with L4-L5-S1 and L5-S1 groups (P < 0.05). CONCLUSION: Both L4-L5-S1 and L5-S1 were equally beneficial in improving short-term functional outcomes for patients with high grade L5-S1 spondylolisthesis. However, L4-L5-S1 was associated with statistically significant higher incidences of blood loss, but it was accompanied by a better reduction. Therefore, caution should be exercised when considering L4-L5-S1.

Vascular Regenerative Capacity and the Obesity Paradox in Coronary Artery Disease.

[Figure: see text].

Association of Routine Hepatitis B Vaccination and Other Effective Factors with Hepatitis B Virus Infection: 25 Years Since the Introduction of National Hepatitis B Vaccination in Iran.

Background: One of the main health problems in the world is hepatitis B virus (HBV) infection. Vaccination and other factors can affect HBV infection. As various effective factors have been reported in different regions and studies, this study aimed to investigate the association between HBV infection and routine vaccination and other effective factors 25 years since the launch of the national vaccination program in Iran. Methods: This cross-sectional study, conducted in 2017 in Shiraz (Iran), investigated factors such as demographic variables such as gender, education, and occupation, vaccination status, and the potential risk factors for HBV infection. Hepatitis B surface antigen (HBsAg) and anti-hepatitis B core antibody (HBc Ab) tests were performed to determine HBV infection status. The data were analyzed using R software (version 3.5.2), using multivariate logistic regressions and machine learning methods. The level of significance was considered below 0.05. Results: A total of 2720 individuals were enrolled in the study (194 cases with HBV infection). Based on the logistic regression analyses, factors such as a family history of the disease (OR=2.53, P<0.001), vaccination (OR=0.57, P=0.004), a history of high-risk behaviors (OR=1.48, P=0.022), and occupation (OR=1.80, P=0.035) were significantly associated with HBV infection. Based on the conditional tree method, a family history of infection (P<0.001) and vaccination (P=0.023) were two important factors in classifying individuals for HBV infection. Conclusion: Based on the different methods applied in this study, HBV infection was affected by factors such as a family history of the disease, national HBV vaccination, and occupation. It appears that HBV vaccination, launched by the Iranian Ministry of Health and Medical Education in 1993, has reduced HBV infection.

Evaluating the cost-effectiveness of universal hepatitis B virus vaccination in Iran: a Markov model analysis.

Vaccination is an essential way to prevent the transmission of hepatitis B virus (HBV). Various studies have been published on the cost-effectiveness of HBV vaccination, but since the results vary according to the target population and related health outcomes, this study examined the cost-effectiveness of the universal HBV vaccination in Iran. In this economic evaluation study, a decision tree with the Markov model was used to compare the universal HBV vaccination with a strategy of non-vaccination. Health states used in the model included healthy, chronic hepatitis B, compensated cirrhosis, decompensated cirrhosis, hepatocellular carcinoma, and death. Analyses were performed from a payer's perspective. Incremental cost-effectiveness ratio (ICER) per life-year gained, and quality-adjusted life-years (QALYs) gained were calculated at a 5% annual discount rate. The sensitivity analysis was conducted using Monte Carlo simulation. Analyses were performed using Microsoft Excel and TreeAge Pro 2011 software. In 2017, the estimated cost per dose for any HBV vaccine was $3.20 USD. The universal HBV vaccination was economically advantageous compared to non-vaccination, and the estimated cost of this program per life-year and QALY gained were $6,319 and negative (-) $1,183.85 USD, respectively. Given the uncertainty of all parameters, the model remained robust and reliable. In Iran, the universal HBV vaccination strategy for both health outcomes of QALY and life-years gained was cost-effective and advantageous. The vaccination strategy saved money, increased life years and improved quality of life. Therefore, it is recommended that this program continues to be provided.