Introducing a new auto edge detection technique capable of revealing cervical root resorption in CBCT scans with pronounced metallic artifacts.

Cervical resorption is a serious threat to the longevity of the teeth. In this study, the Canny edge-detection algorithm was applied on CBCT images to compare the accuracy of original and Canny views for diagnosing cervical resorption in endodontically treated teeth. Intracanal metallic posts were inserted in 60 extracted teeth being randomly divided into three groups: control, 0.5 mm, and 1 mm cervical resorption. CBCT scans of the teeth were presented to three observers in both original and Canny formats with the accuracy being determined by receiver operating characteristic (ROC) analysis. The DeLong test was used for paired comparisons with the significance level set at 0.05. The highest accuracy belonged to Canny images in 1 mm resorption, followed by Canny images in 0.5 mm resorption, original images in 1 mm resorption, and original images in 0.5 mm resorption, respectively. The Canny images were significantly more accurate in the diagnosis of 0.5 mm (p < 0.001) and 1 mm (p = 0.009) resorption. Application of the Canny edge-detection algorithm could be suggested as a new technique for facilitating the diagnosis of cervical resorption in teeth that are negatively affected by metallic artifacts.

Evaluation of matrix metalloproteinase-1, -2, -3, -7, and -13 gene polymorphisms in patients with chronic periodontitis and healthy controls.

OBJECTIVES: The current study aimed to investigate the association of matrix metalloproteinase- (MMP-) 1, -2, -3, -7, and -13 gene polymorphisms with chronic periodontitis (CP) in an Iranian population. MATERIALS AND METHODS: In this case-control study, 87 subjects with CP and 89 periodontally healthy subjects were allocated to case and control groups, respectively. Subjects' venous blood samples (5 cc) were collected, and DNA extraction was performed. A spectrophotometer was utilized to assess the concentration of extracted DNAs. The desired gene polymorphisms were examined using restriction fragment length polymorphism polymerase chain reaction (RFLP-PCR) followed by electrophoresis. Statistical analyses were done using the Pearson Chi-Square test, odds ratio, and t-Test using SPSS Version 28. RESULTS: The MMP-1 (-1607 1G/2G) rs1799750, MMP-3 (-1171 5A/6A) rs3025058, and MMP-7 (-181 A/G) rs11568818 gene polymorphisms significantly differed between case and control groups (PV = 0.019, 0.007, and 0.028, respectively). In contrast, the gene polymorphisms of MMP-2 (-1306 C/T) rs243865 and MMP-13 (-77 A/G) rs2252070 did not make a significant difference. Regarding allele frequencies, the presence of the 2G allele in the MMP-1 (-1607) rs1799750 genotype increased the CP susceptibility significantly, while subjects with the 6A allele in their MMP-3 (-1171) rs3025058 genotype showed significantly lower susceptibility to CP (PV = 0.008 and < 0.001, respectively). CONCLUSION: In the studied population, gene polymorphisms in the DNA sequences of MMP-1 (-1607 1G/2G) rs1799750, MMP-3 (-1171 5A/6A) rs3025058, and MMP-7 (-181 A/G) rs11568818 may have impacts on CP incidence. CLINICAL RELEVANCE: Clinicians should be cautious about the association between MMP-1, MMP-3, and MMP-7 gene polymorphisms and the incidence of chronic periodontitis during periodontal treatment planning.

Association between air pollution and sudden sensorineural hearing loss (SSHL): A systematic review and meta-analysis.

Recent studies have indicated that air pollution (AP) has harmful effects on hearing and ear diseases such as Sudden Sensorineural Hearing Loss (SSHL). The purpose of this study was to evaluate the impact of exposure to AP on SSHL incidence. Valid electronic databases were searched to retrieve studies published until December 1, 2022, using appropriate keywords. The result of the search was 1146 studies, and after screening according to the defined criteria, in total 8 studies were obtained. The risk of bias (ROB) in the studies and their quality were assessed. Finally, the meta-analysis with a significance level of 5% was performed. The findings revealed that the mean level of SO2, CO, NO2, and PM10 in the patient group was more than that of the control group, and p-values were 0.879, 0.144, 0.077, and 0.138, respectively. There was an indirect relation between air pollutants and SSHL, and PM2.5 showed a significant effect (p < 0.05). Given the limited research and the use of different statistical methods, more research is suggested to confirm this association and to determine the mechanisms by which AP exposure may cause SSHL.

A comparative study of electronic and pen-paper safety inspections: A mixed method study design for assessing ergonomic parameters.

BACKGROUND: Workplace inspections are applied to facilitate the adherence to the occupational health and safety regulations. The Iranian Ministry of Health introduced a new software system for tablets to inspect workplaces. OBJECTIVES: The aim of this study was to take measurements of the usability, mental workload, and mood of inspectors. METHODS: Inspectors used both pen-and-paper and tablet methods to inspect the automotive industry in a mixed-method procedure. The NASA-TLX score, QUIS score, I-PANAS (SF) situation, inspection time, and number of errors were collected throughout the procedure. The differences were investigated using a paired sample and the Wilcoxon signed ranks test. RESULTS: In terms of efficacy, using the tablet resulted in lower error rates, but it took longer to complete the inspection task (P < 0.001). Participants perceived a lower workload when inspecting with a tablet rather than the traditional method. (Mental Demand: p < 0.002, Performance: p < 0.009, Effort: p < 0.012, TLX: p < 0.002 based on various subcomponents of NASA-TLX). The newly introduced system's usability was insufficient. CONCLUSION: Although the use of tablets has improved safety inspections, ergonomic redesign of the system and consideration of a user-centered approach, as well as inspector training, can make the system more likely to succeed.

A diagnostic accuracy study on an innovative auto-edge detection technique for identifying simulated implant fractures on radiographic images.

Implant fracture is a rare but devastating complication of treatment in partially or fully edentulous patients which requires prompt diagnosis. Nevertheless, studies on defining the most accurate technique for the detection of implant fractures are lacking. In the present study, the Canny edge detection algorithm was applied on multiple radiographic modalities including parallel periapical (PPA), oblique periapical (OPA), and cone beam CT (CBCT) with and without metal artifact reduction (MAR) to examine its accuracy for diagnosis of simulated implant fractures. Radiographs were taken from 24 intact implants and 24 implants with artificially created fractures. Images were evaluated in their original and Canny formats. The accuracy of each radiograph was assessed by comparison with a reference standard of direct observation of the implant. The greatest area under the receiver operating characteristic curve belonged to Canny CBCT with MAR (0.958), followed by original CBCT with MAR (0.917), original CBCT without MAR = Canny CBCT without MAR = Canny OPA (0.875), Canny PPA (0.833), original PPA = original OPA (0.792), respectively. The Canny edge detection algorithm is suggested as an innovative method for accurate diagnosis of clinically suspected implant fractures on CBCT and periapical radiographies.

Eating- and oral health-related quality of life in patients under fixed orthodontic treatment.

OBJECTIVE: The eating problems and changes in the diet and dietary intake of patients under orthodontic treatment are of great importance, and the available studies on this topic are mostly qualitative. Thus, this study aimed to assess the oral health-related quality of life (OHRQoL) and the eating-related quality of life (ERQoL) of patients under fixed orthodontic treatment. MATERIALS AND METHODS: This prospective study evaluated 105 patients (65 males, 40 females) with a mean age of 26 ± 1.1 years, who required fixed orthodontic treatment. All participants filled out the Oral Health Impact Profile-14 (OHIP-14) questionnaire before treatment (T0), and at 1 (T1), 3 (T2), and 6 (T3) months after treatment, and the ERQoL questionnaire at 1 (T1), 3 (T2), and 6 (T3) months after treatment. Data were analyzed using repeated measures analysis of variance with Greenhouse-Geisser and Huynh-Feldt corrections and Bonferroni test for pairwise comparisons (α = .05). RESULTS: The OHIP-14 total score increased at T1 and decreased at T2 and T3, with significant differences between all four time points (p < .001). The ERQoL total score decreased over time, and significant differences were noted between all three time points (p < .001). No significant difference existed in OHRQoL or ERQoL with regard to gender at any time point (p > .05). CONCLUSION: The reduction in OHRQoL due to fixed orthodontic treatment was temporary and improved over time. The eating problems also decreased with time.

Association between rs11614913 Polymorphism of The MiR-196-a2 Gene and Colorectal Cancer in The Presence of Departure from Hardy-Weinberg Equilibrium.

OBJECTIVE: Colorectal cancer (CRC) is the fourth most common and the second most lethal cancer worldwide. CRC mortality is increasing in Iran. In the current study, we aimed to investigate association between rs11614913 polymorphism of the miR-196-a2 gene and CRC. MATERIALS AND METHODS: In this case-control study, we assessed association of the rs11614913 polymorphism in 194 patients with CRC (case) and 286 healthy individuals (control). The expectation-maximization (EM) algorithm method was used to adjust deviation from Hardy-Weinberg equilibrium (HWE). RESULTS: There was no significant difference between genotypic frequencies of rs11614913 polymorphism in the control and case groups. Genotypic frequencies differed in the adjusted and unadjusted deviations from the HWE. Analysis of unadjusted and adjusted independent variables showed that age, sex, alcohol consumption, and drug use were statistically significant. CONCLUSION: Our findings showed that rs11614913 polymorphism was not associated with CRC risk. Deviation from HWE affected the results. It is recommended to perform further studies to establish HWE. Ignoring the equilibrium can cause in consistencies in the results of studies.

Association study between superoxide Dismutases gene polymorphisms and development of diabetic retinopathy and cataract in Iranian patients with type two diabetes mellitus.

PURPOSE: Reactive oxygen species (ROS) plays pathological roles on development of diabetic retinopathy (DR) and cataract. Superoxide dismutases (SODs) are a set of enzymes to eliminate ROS and cell protection. Based on the diminished activities of SOD1 during DR and cataract, the polymorphisms within SOD1 gene may be associated with these disorders. This study assessed the relationship between SOD1 -251A/G (rs2070424) and SOD1 + 35A/C (rs2234694) gene polymorphisms and DR and cataract in Iranian patients with type 2 diabetes mellitus (T2DM). METHODS: Totally, 141 cases (73 patients with cataract and 68 with DR) with a at least five years history of T2DM and 119 age/gender matched persons without history of DM were included in the case and control groups, respectively. Genomic DNA was extracted from peripheral venous blood cells and genotyping of 251A/G and + 35A/C polymorphisms was done using PCR-RFLP technique. Statistical analysis was done using SPSS version 22. RESULTS: Results showed SOD1 -251A/G and + 35A/C genotype frequency were significantly associated (1.9 folds) with cataract (P = 0.045, OR = 0.524, 95% CI = 0.277-0.991 and P = 0.037, OR = 0.505, 95% CI = 0.265-.0965, respectively). Instead, no significant differences found between SOD -251A/G (P = 0.053, OR = 0.52, 95% CI = 0.276-1.014) and + 35A/C (P = 0.073, OR = 0.547, 95% CI = 0.281-1.063) polymorphisms and DR. Multivariate Logistic Regression model showed significant relationship between BMI, HDL and TC levels and independent predictors of T2DM (P < 0.05). CONCLUSIONS: Based on the results, there was significant association between SOD1 gene polymorphisms and cataract in patients with T2DM. Therefore, SOD1 gene polymorphisms might be a potential marker for increased risk of cataract in patients with T2DM.

Application of an auto-edge counting method for quantification of metal artifacts in CBCT images: a multivariate analysis of object position, field of view size, tube voltage, and metal artifact reduction algorithm.

OBJECTIVE: The objective was to assess the effects of object position, field of view (FOV) size, peak kilovoltage (kVp), and a metal artifact reduction (MAR) algorithm on metal artifacts in cone beam computed tomography (CBCT) as measured with an auto-edge counting method. STUDY DESIGN: A titanium implant and a stainless steel intracanal post in a root were inserted in bovine rib blocks. CBCT scans were acquired with changes in object position (incisor, canine, and premolar-molar areas), FOV, kVp, and MAR (on or off) mode. Images were quantitatively analyzed in MATLAB by using the Canny edge detection algorithm. Four-way analysis of variance and Tukey tests were applied for data analysis. RESULTS: The implant produced no significant differences in number of artifacts among the object positions through changing the kVp and MAR mode for all FOV sizes (P > .05). The intracanal post scanned with the medium-sized FOV, high kVp, and MAR off mode generated significant differences among object positions (P = .033). Among the variables assessed, FOV size and MAR mode had a significant influence on the number of artifacts (P ≤ .039). CONCLUSION: Reduction of FOV size and application of the MAR tool significantly decreased the number of streak artifacts. The Canny edge detection algorithm could be an efficient method of metal artifact quantification.

Assessment of IL-10, IL-1ß and TNF-α gene polymorphisms in patients with peri-implantitis and healthy controls.

Peri-implantitis (PI) is a multifactorial condition caused by the interactions of pathogens and the host immune response. Previous studies have demonstrated a relationship between PI and specific gene polymorphisms, particularly cytokine genes involved in the pathogenesis of PI. This study aimed to evaluate the frequency of single nucleotide polymorphisms (SNPs) of interleukin-10 (IL-10), interleukin 1ß (IL-1ß), and tumor necrosis factor-α (TNF-α) genes in PI patients and healthy controls. A total of 50 patients with PI and 89 periodontally healthy controls were recruited for this study. Venous blood samples (5 cc) were collected, and DNA was extracted. After DNA purification, the relevant gene segments were amplified by polymerase chain reaction (PCR). Restriction fragment length polymorphism (RFLP) and electrophoresis were performed to assess the polymorphisms of the related genes. The analysis revealed that allele and genotype frequencies of IL-10 ─ 819 C/T, IL-10 ─ 592 C/A, and IL-1ß + 3954 C/T significantly differed between PI patients and healthy controls. The analysis revealed no significant association between TNF-α ─ 857 G/A and TNF-α ─ 308 G/A polymorphisms and PI. Our results indicated that specific gene polymorphisms of IL-10 ─ 819 C/T, IL-10 ─ 592 C/A, and IL-1ß + 3954 C/T may play a role in the pathogenesis of PI, and increase its risk of occurrence.

Fractal analysis of the trabecular bone pattern in the presence/absence of metal artifact-producing objects: Comparison of cone-beam computed tomography with panoramic and periapical radiography.

OBJECTIVES: The effect of metallic objects on the fractal dimension (FD), bone area fraction (BAF) and gray scale values (GSVs) of cone-beam CT (CBCT) images was assessed. Also, FD, BAF and GSV were compared among CBCT, digital periapical and panoramic radiographies. METHODS: Digital periapical and panoramic radiographs were acquired from six blocks of bovine rib. Additionally, different arrangements of titanium implants and intracanal metallic posts were created in the bone blocks and CBCT scans were taken from the different implant-root arrangements. The three radiographical modalities were compared by analysis of variance. Pairwise comparisons between the modalities were performed by the Tukey test (significance level set at 0.05). RESULTS: Different root-implant arrangements in the CBCT images revealed no significant differences in the FD (p = 0.920), BAF and GSV values (p = 0.623). FD differed significantly among the three modalities (p < 0.001). Significant differences were found between CBCT and each of the periapical and panoramic techniques (p < 0.001), while no remarkable differences were observed in the FD of the periapical and panoramic images (p = 0.294). BAF and GSV showed significantly different results among the three radiographical techniques (p < 0.001). The difference was remarkable between CBCT and periapical (p < 0.001), CBCT and panoramic (p < 0.001) and periapical and panoramic (p = 0.008). CONCLUSION: Presence of titanium implants and intracanal posts does not produce different results in the fractal analysis (FA) of the CBCT images. The trabecular bone pattern is best assessed by FA of the periapical radiographs followed by the panoramic and CBCT techniques, respectively.

High cost of illness in fibromyalgia patients in Iran, irrespective of disease severity: A prospective cost study.

AIMS: This study aimed to estimate the economic burden of fibromyalgia (FM) in 6 months, using a cost-diary, and to evaluate its relationship with the disease severity. METHODS: This is a prospective cost-of-illness study on 62 participants with an FM diagnosis within a 6 month period. Patients completed the questionnaires, including FIQR (Revised Fibromyalgia Impact Questionnaire) and SF-12 (12-item short-form survey). The cost-diary method was used to track the cost of the disease. The participants received six cost-diary booklets during the study period to report their FM-related costs, hours, and days of productivity loss. The final costs are reported in US dollars. RESULTS: Most of the participants were women (90.3%) with a mean (±SD) age of 40.80 (±5.50) years and a mean (±SD) FIQR score of 54.38 (±14.13). Moreover, 45.2% of patients fulfilled all six booklets, whereas 24.2% returned only one booklet. The participants showed a mean (±SD) direct healthcare, non-healthcare, and indirect cost of $ 2817.08 (±$ 1860.04), $ 1497.98(±$ 1358.21), and $ 1449.05(±$ 3637.41) per patient for 6 months, respectively. CONCLUSION: Fibromyalgia is associated with high health-related and non-health-related costs in our country, irrespective of its severity. This study warrants urgent consideration in managing the disease burden on both patients and society.

Musculoskeletal Consequences in Cyber-Addicted Students - Is It Really A Matter of Health? A ROC Curve Analysis for Prioritizing Risk Factors.

BACKGROUND: The high prevalence and also multiple consequences of addiction to various online content, including online games and social networks, have become a major challenge. The ability to predict musculoskeletal disorders from this addiction can help reveal in students' health status in the near future. The aim of this study was to determine the prevalence of this addiction and the ability to predict neck pain from this matter in students. STUDY DESIGN: A cross sectional study. METHODS: This study was carried out among 665 students. Data collection was performed through three questionnaires on problematic use of online games, social networking addiction, and Nordic musculoskeletal disorders. Data were compared with Chi-square and independent T-test, and the logistic regression model was then presented at a significant level of 0.05. Finally, the area under the receiver operating characteristic (ROC) curve and Discriminant analysis were conducted to clarify associations. RESULTS: The prevalence of Internet-related content addiction was 32.8%. The results showed that addiction to social networks and online games can increase the risk of neck disorder. Also 0.58 area under ROC curve depicted the ability to predict neck pain from this addiction. CONCLUSION: In students with internet - related content addiction, neck disorder can be predicted. Given the high prevalence of internet addiction in students, it is essential to take immediate and appropriate interventions to avoid the associated adverse effects such as neck problems.

A Bayesian analysis for investigating the association between rs13266634 polymorphism in SLC30A8 gene and type 2 diabetes.

PURPOSE: The purpose of this study was to evaluate the association between rs13266634 polymorphism in SLC30A8 gene and type 2 diabetes in Iranian population, and also to provide a way for adjusting the deviation from the Hardy-Weinberg equilibrium. METHODS: This was a case-control study, the patients were selected from the East Azerbaijan province, Iran. In this study, 125 patients with type 2 diabetes (cases) and 125 healthy individuals (controls) were studied. Genotype and allele frequencies were determined in both groups, and the deviations from the Hardy-Weinberg equilibrium were assessed using Bayesian analysis. RESULTS: A statistically significant association was observed between rs13266634 polymorphism in SLC30A8 gene and type 2 diabetes. In genotype assessing, data analysis showed that, TT genotype play a role in diabetes type 2 risk (P = 0.001). Subjects with TT genotype had a lower risk of diabetes compared to those with CC and CT genotypes. Also, there was no significant relationship between this polymorphism and type 2 diabetes mellitus in the absence of Hardy-Weinberg equilibrium. CONCLUSION: Our findings show that, rs13266634 polymorphism was associated with the type 2 diabetes risk in the population of Eastern Azerbaijan province; however, the low number of TT homozygous genotypes affected the precision of the results. Also, the deviation from HWE affected the results. It is recommended to perform further studies to establish Hardy-Weinberg equilibrium. The inconsistency in the results may be due to the ignorance of this equilibrium.

Antibiotic resistance pattern and phylogenetic groups of the uropathogenic Escherichia coli isolates from urinary tract infections in Hamedan, west of Iran.

BACKGROUND AND OBJECTIVES: Escherichia coli is the most common causative agent of urinary tract infections (UTIs) in 90-80% of patients in all age groups. Phylogenetic groups of these bacteria are variable and the most known groups are A, B1, B2 and D. The present study aimed to evaluate the phylogenetic groups of E. coli samples obtained from UTIs and their relation with antibiotic resistance patterns of isolates. MATERIALS AND METHODS: In this study 113 E. coli isolates were isolated from distinct patients with UTIs referred to Hamadan hospitals. After biochemical and molecular identification of the isolates, typing and phylogenetic grouping of E. coli strains were performed using multiplex PCR targeting chu, yjaA and TSPE4.C2 genes. The anti-microbial susceptibility of the isolates to amikacin, ampicillin, trimethoprim-sulfamethoxazole, amoxicillin/clavulanic acid, ciprofloxacin, cefotaxime, imipenem, aztreonam, gentamicin, meropenem, nitrofurantoin, nalidixic acid and cefazolin was determined using disk diffusion method. RESULTS: Of 113 isolates, 50 (44.2%), 35 (31%), 23 (20.4%) and 5 (4.4%) of samples belonged to group B2, group D, group A and group B1 phylogenetic groups respectively. All isolates were susceptible to meropenem, imipenem (100%), followed by amikacin (99.1%). The highest resistance rates were observed against ampicillin (74.3%) and nalidixic acid (70.8%). Correlation between phylogenetic groups and antibiotic susceptibilities was significant only with co-amoxiclav (P = 0.006), which had the highest resistance in phylogenetic group A. CONCLUSION: Prevalence of different phylogroup and resistance associated with them in E. coli samples could be variable in each region. Therefore, investigating of these items in E. coli infections, could be more helpful in selecting the appropriate antibiotic treatment and epidemiological studies.

Psychometric properties of the Persian version of the Patient Measure of Safety (PMOS).

Background: Patient safety practice reduces the adverse events that may occur in the health care system during procedures, diseases, and diagnoses. Failure and negligence in identifying and resolving health care system errors may result in financial and physical harm. Thus, this study aimed to investigate the psychometric properties of the Patient Measure of Safety in Hospitals (PMOS). Methods: This study was conducted on 264 patients in 4 hospitals. The patient measure of safety questionnaire has 44 items and 9 domains. To translate the PMOS questionnaire, standardized forward-backward procedure was used, and a panel of experts assessed the face and content validity of the Persian version. Internal consistency, confirmatory factor analysis (CFA), and test-retest method were used to test the validity and reliability of the instrument. Also, AMOS (version 23) and SPSS (version 16) software were used for data analysis and modeling. Results: The average CVI score was 0.85, indicating well results in the Persian context. CVR score was 0.65. The indices of goodness of fit were acceptable for Iranian sample (CFI=0.91, TLI=0.89, RMSEA=0.063, relative/normal Chi-Square Statistic (X2/df)=2.85). All items were significantly loaded on the domains, except the 33rd and 38th items that were related to the eighth domain. Thus, the final Persian version was developed with 8 domains and 42 items. Internal consistency was acceptable for these domains, and test-retest method showed a good reliability (r=0.984). Conclusions: The Persian version of PMOS is an appropriate instrument to assess the safety of patients in Persian language communities. Also, PMOS is an optimal tool to identify and avoid preventable errors.

Downregulation of hedgehog ligands in human simple steatosis may protect against nonalcoholic steatohepatitis: Is TAZ a crucial regulator?

The conversion of simple steatosis into nonalcoholic steatohepatitis (NASH) in patients with nonalcoholic fatty liver disease (NAFLD) has attracted many attentions in recent years. The role of the hedgehog (HH) pathway in the regulation of lipogenesis has been addressed in the literature. This study aimed to investigate the levels of the sonic hedgehog (SHH) and Indian hedgehog (IHH) ligands and the correlation of these ligands with levels of proteins involved in the transforming growth factor-ß1 (TGF-ß1) pathway, as well as the evaluation of the transcriptional coactivator with PDZ binding motif (TAZ) expression in human simple steatosis, NASH cirrhosis, and controls. Patients were divided into two groups: the first group consisted of patients diagnosed with simple steatosis (n = 16) and the second group included those diagnosed with NASH cirrhosis (n = 15). As a control group, 18 histologically normal liver tissues were collected in this study. The expression of the TGF-ß1pathway components and SHH and IHH ligands were analyzed by means of the quantitative real-time polymerase chain reaction and western blot analyses. A significant decrease was found in the hepatic expression of the SHH, IHH, and TGF-ß1 pathways along with the expression of TAZ in tissue specimens with simple steatosis in comparison with patients affected by NASH cirrhosis and controls. Also, the levels of SHH and IHH proteins were significantly correlated with the expression of proteins involved in the TGF-ß1 pathway. Moreover, the expression of the HH pathway ligands was positively associated with the expression of TAZ, supporting the notion that TAZ may play a role in the activation of the HH pathway thereby regulating the expression of its ligands. It seems that in patients with NAFLD, the downregulation of the HH pathway ligands may stem from steatosis; however, at the same time, it may prevent the conversion of simple steatosis into NASH in patients with liver diseases. © 2019 IUBMB Life, 71(9):1382-1390, 2019.

Teaching ethics using games: Impact on Iranian nursing students' moral sensitivity.

This study seeks to develop a method of teaching ethics to nursing students using games. We used the one-group pretest-posttest design with 30 undergraduate nursing students as participants. Professional ethics education was provided for 17 weeks in 90-minute sessions. The Lutzen ethical sensitivity questionnaire and a checklist of the satisfaction levels of games used measured the effects of training. Repeated-measures ANOVA and the Greenhouse-Geisser correction were used to measure ethics game satisfaction. After training, total moral sensitivity questionnaire scores increased significantly (p = 0.02). The score on awareness of the relationship with the patient and the application of ethics concepts in ethical decisions from the subdomain of moral sensitivity increased significantly. Card sorting and drawing or art production earned the highest scores of satisfaction. The results show that playing games is a useful approach to developing moral sensitivity among nursing students to make them more sensitive toward ethics issues in their professional environment.

Relationship between Urbanization and Cancer Incidence in Iran Using Quantile Regression.

Quantile regression is an efficient method for predicting and estimating the relationship between explanatory variables and percentile points of the response distribution, particularly for extreme percentiles of the distribution. To study the relationship between urbanization and cancer morbidity, we here applied quantile regression. This cross-sectional study was conducted for 9 cancers in 345 cities in 2007 in Iran. Data were obtained from the Ministry of Health and Medical Education and the relationship between urbanization and cancer morbidity was investigated using quantile regression and least square regression. Fitting models were compared using AIC criteria. R (3.0.1) software and the Quantreg package were used for statistical analysis. With the quantile regression model all percentiles for breast, colorectal, prostate, lung and pancreas cancers demonstrated increasing incidence rate with urbanization. The maximum increase for breast cancer was in the 90th percentile (ß=0.13, p-value<0.001), for colorectal cancer was in the 75th percentile (ß=0.048, p-value<0.001), for prostate cancer the 95th percentile (ß=0.55, p-value<0.001), for lung cancer was in 95th percentile (ß=0.52, p-value=0.006), for pancreas cancer was in 10th percentile (ß=0.011, p-value<0.001). For gastric, esophageal and skin cancers, with increasing urbanization, the incidence rate was decreased. The maximum decrease for gastric cancer was in the 90th percentile(ß=0.003, p-value<0.001), for esophageal cancer the 95th (ß=0.04, p-value=0.4) and for skin cancer also the 95th (ß=0.145, p-value=0.071). The AIC showed that for upper percentiles, the fitting of quantile regression was better than least square regression. According to the results of this study, the significant impact of urbanization on cancer morbidity requirs more effort and planning by policymakers and administrators in order to reduce risk factors such as pollution in urban areas and ensure proper nutrition recommendations are made.