farid zayeri

 Metabolic dysfunction-associated steatotic liver disease (MASLD) represents a significant global health burden without established curative therapies. Early detection and preventive strategies are crucial for effective MASLD management. This study aimed to develop and validate machine-learning (ML) algorithms for accurate MASLD screening in a geographically diverse, large-scale population.

 Data from the prospective Fasa Cohort Study, initiated in rural Fars province, Iran (March 2014), were employed for this purpose. The required data were collected using blood tests, questionnaires, liver ultrasonography, and physical examinations. A two-step approach identified key predictors from over 100 variables: (1) statistical selection using mean decrease Gini in random forest and (2) incorporation of clinical expertise for alignment with known MASLD risk factors. The hold-out validation approach (with a 70/30 train/validation split) was utilized, along with 5-fold cross-validation on the validation set. Logistic regression, Naïve Bayes, support vector machine, and light gradient-boosting machine (LightGBM) algorithms were compared for model construction with the same input variables based on area under the receiver operating characteristic curve (AUC), sensitivity, specificity, positive predictive value (PPV), negative predictive value (NPV), and accuracy.

 A total of 6,180 adults (52.7% female) were included in the study, categorized into 4816 non-MASLD and 1364 MASLD cases with a mean age (±standard deviation [SD]) of 48.12 (±9.61) and 49.47 (±9.15) years, respectively. Logistic regression outperformed other ML algorithms, achieving an accuracy of 0.88 (95% confidence interval [CI]: 0.86-0.89) and an AUC of 0.92 (95% CI: 0.90-0.93). Among more than 100 variables, the key predictors included waist circumference, body mass index (BMI), hip circumference, wrist circumference, alanine aminotransferase levels, cholesterol, glucose, high-density lipoprotein, and blood pressure.

 Integration of ML in MASLD management holds significant promise, particularly in resource-limited rural settings. Additionally, the relative importance assigned to each predictor, particularly prominent contributors such as waist circumference and BMI, offers valuable insights into MASLD prevention, diagnosis, and treatment strategies.

Disasters, both natural or manmade, have been a serious threat to human life and property for many years. The shortest response time is certainly the most important factor in increasing the survival of victims in disasters. Considering the vital importance of time in relief operations, the aim of this study is to investigate the response time in various incidents and disasters by the aid workers of the RCS by the provinces of the country during the years 2012 to 2020.

This descriptive-quantitative study is cross-sectional and data was collected by the Rescue and Relief Organization of IRCS during the years 2012 to 2020 in all Emergency Operation Centers (EOC) of the country. The variables contain the year, the province, the time interval between the occurrence of the disasters and the notification by the RCS aid workers, the time interval between their notification and presence at the scene of the disaster. The median (first and third quartile) after removing the outliers was used to report these times by year and province in the three years of 2012, 2016 and 2020. A line chart was applied to examine the trend changes during the study period.

The results show that the maximum minutes between the occurrence of road accidents and the notification of RCS aid worker was not reported in any province in 2012, and in many provinces, this time are equal to 5 minute. The highest mean minutes were seen 7 in Gilan province and 6 in Zanjan, East Azerbaijan, Fars, Khuzestan and Yazd provinces in 2020. Also, this figure has decreased from 5 in 2012 to 4 minute in 2020 in the country. The highest mean of minutes in 2012 and 2020 belongs to Qom province with 11.5 and 13 minute. The median of these minute has increased from 5 in 2012 to 9 in 2020. In urban accidents, the median time of notification and presence of aid workers at the scene has decreased from 5 to 4 and increased from 5 to 7 minute, respectively. On the other hand, in mountain incidents, a decrease of one minute (from 10 to 9) and an increase from 20 to 36 minute can be seen in the mean of the times of notification of the accident and presence at the scene, respectively.

According to the type of accident disasters and the climatic and geographical conditions of the provinces, the duration of disaster relief is different and determining the standard criteria for it depends on various factors. It seems that the time between the occurrence of a natural disaster and the notification and the time between the notification and the presence at the scene in road, urban and mountain incidents are at a favorable level in the RCS. Hence, it is recommended to conduct detailed analytical studies to determine the standard measure of relief time and prepare special provincial guidelines to reduce rescue duration.

Objective (s):

 In a situation where the vaccine was not completely accurate and up-to-date against different strains of the virus in all people of the world, compliance with health guidelines was the main key to prevent transmission. But what is clear is that compliance with health protocols is not the same among all communities and depends on factors. This article examines the effects and attitudes of health protocols.

This research was a descriptive-quantitative cross-sectional study, which was conducted among 385 students of Shahid Beheshti University of Medical Sciences, Iran in the last week of May 2022. Factors affecting the adherence to water hygiene behaviors due to covid-19 were investigated using a questionnaire and the results were analyzed and reported in ordinal regression with SPSS 25 software.

The ratio of the average score of compliance (19.08) from the total of eight health behaviors to the maximum score (25) was reported as 76%. It was reported that the score of awareness was very high, 94%, and the average score of attitude was about 75%. In the ordinal regression, it was found that having knowledge was not effective in following all health protocols and only two behaviors of avoiding attending gatherings and avoiding losing when meeting acquaintances showed a statistically significant relationship. In other words, with the increase of each score of awareness, the chance of having higher compliance scores in these two behaviors increased by about 1.5 times. On the other hand, the attitude score had a statistically significant relationship with most of the behaviors, except the compliance of coughing and sneezing into a handkerchief or the corner of the arm, and it had a positive simultaneous effect on the compliance of the behaviors.

The high level of awareness among the studied community can partially indicate the effectiveness of interventions in increasing awareness, but the gap between awareness, attitude and behavior indicates the need to pay attention to other factors affecting attitude and behavior.

Pregnant women have poor knowledge of oral hygiene during pregnancy. One problem with the follow‑up of dental caries in this group is zero accumulation in the decayed, missing, and filled teeth (DMFT) index, for which some models must be used to achieve valid results. The studied population may be heterogeneous in longitudinal studies, leading to biased estimates. We aimed to assess the impact of oral health education on dental caries in pregnant women using a suitable model in a longitudinal experimental study with heterogeneous random effects.

This longitudinal, experimental research was carried out on pregnant women who visited medical centers in Tehran. The educational group (236 cases) received education for three sessions. The control group (200 cases) received only standard training. The DMFT index assessed oral and dental health at baseline, 6 months, and 24 months after delivery. The Chi‑square test was used for comparing nominal variables and the Mann–Whitney U test for ordinal variables. The zero‑inflated Poisson (ZIP) model was applied under heterogeneous and homogeneous random effects using R 4.2.1, SPSS 26, and SAS 9.4. The level of significance was set at 0.05.

Data from 436 women aged 15 years and older were analyzed. Zero accumulation in the DMFT was mainly related to the filled teeth (51%). The heterogeneous ZIP model fitted better to the data. On average, the intervention group exhibited a higher rate of change in filled teeth over time than the control group (P = 0.021).

The proposed ZIP model is a suitable model for predicting filled teeth in pregnant women. An educational intervention during pregnancy can improve oral health in the long‑term follow‑up.

 Today, cardiovascular disease (CVD) is the most important cause of death around the world. In this study, our main aim was to predict CVD using some of the most important indicators of this disease and present a tree-based statistical framework for detecting CVD patients according to these indicators.

 We used data from the baseline phase of the Fasa Cohort Study (FACS). The outcome variable was the presence of CVD. The ordinary Tree and generalized linear mixed models (GLMM) were fitted to the data and their predictive power for detecting CVD was compared with the obtained results from the GLMM tree. Statistical analysis was performed using the RStudio software.

 Data of 9499 participants aged 35‒70 years were analyzed. The results of the multivariable mixed-effects logistic regression model revealed that participants’ age, total cholesterol, marital status, smoking status, glucose, history of cardiac disease or myocardial infarction (MI) in first- and second-degree relatives, and presence of other diseases (like hypertension, depression, chronic headaches, and thyroid disease) were significantly related to the presence of CVD (P<0.05). Fitting the ordinary tree, GLMM, and GLMM tree resulted in area under the curve (AUC) values of 0.58 (0.56, 0.61), 0.81 (0.77, 0.84), and 0.80 (0.76, 0.83), respectively, among the study population. In addition, the tree model had the best specificity at 81% but the lowest sensitivity at 65% compared to the other models.

 Given the superior performance of the GLMM tree compared with the standard tree and the lack of significant difference with the GLMM, using this model is suggested due to its simpler interpretation and fewer assumptions. Using updated statistical models for more accurate CVD prediction can result in more precise frameworks to aid in proactive patient detection planning.

The mixed effects logistic regression model is a common model for analysing correlated binary data as longitudinal data. The between and within subject variances are typically considered to be homogeneous but longitudinal data often show heterogeneity in these variances. This study proposes a Bayesian mixed effects location scale model to accommodate heteroscedasticity in binary data analysis.

This study was carried out in two stages; first, the simulation study was used to evaluate the accuracy of the proposed model with the Bayesian approach and then the proposed model was applied to a real data. In simulation study, the data were generated from the mixed effects location scale model with different correlations between the random location effect and random scale effect and different sample sizes. In order to evaluate the accuracy of the estimations, the Root Mean Square Error, bias and Coverage Probability were calculated and the deviance information criterion was used to select the appropriate model. At the end we utilized this model to analyse uric acid levels of patients with haematological disorders.

The simulation results show the accuracy of model parameter estimates as well as the correlation between random location and scale effects. They also display that if a random scale effect is present in the data, it should be accounted for in model. Otherwise, the model is forced to assign the within subject variation due to these subject random effects to the error term. The results of real data are also in line with this. The odds of having normal UA levels increases by a factor of 26% per week. Due to the positive value of the covariance parameter, patients with higher mean of UA levels show higher variation in UA levels. Furthermore, the significance of the covariates in the between subject and within subject variances model, as well as the significance of the random scale variance determines the heterogeneity across subjects.

Bayesian mixed effects location scale model provides a useful tool for analysing correlated binary data with heteroscedasticity because it considers data correlation and modelling mean and variance simultaneously. Furthermore, it improves the accuracy of statistical inference in longitudinal studies compared to classic mixed effects models.

Osteoporosis, a prevalent bone malady, is prevalent in Iran. Several studies have represented the role of dietary antioxidants on osteoporosis. The dietary antioxidant index (DAI) is a valid and reliable index, which indicates a comprehensive view of dietary antioxidant capacity. This study aimed to survey the relationship of the DAI with the risk of osteoporosis in postmenopausal women in Iran. This research aimed to examine the association between the DAI and the risk of osteoporosis among postmenopausal women in Iran.

In this case–control study, 440 postmenopausal women (220 cases and 220 controls) were enrolled. The dietary intake of contributors was evaluated using a 147?item food frequency questionnaire. To estimate the DAI, the amount of six antioxidant micronutrients such as Vitamins A, C, and E, selenium, manganese, and zinc was standardized. Then, the DAI was estimated by collecting the standardized  onsumption of these antioxidant micronutrients.

Our findings representedthe participants in the first (crude odds ratio [OR] = 1.79, 95% confidence interval [CI]: 1.13–2.85, P = 0.013) and second (crude OR = 1.60, 95% CI: 1.01–2.55, P = 0.043) tertiles of the DAI scores had significantly higher odds of osteoporosis compared to those in the third one; while after modifying for confounding factors, this significant reverse relationship was observed just between women in the first and third tertiles of the DAI scores (adjusted OR = 1.90, 95% CI: 1.34–3.18, P = 0.015).

The consequence of this study suggested that adherence to a diet rich in antioxidant compounds may have protective effects against osteoporosis.

Family members of patients hospitalized in intensive care unit experience high levels of depression, anxiety and stress. Therefore, the present study was conducted with the aim of assessing depression, anxiety and stress in the family members of patients hospitalized in the intensive care units of selected hospitals in Tehran, Iran

This was a cross-sectional study in which depression, anxiety and stress of 160 family members of patients hospitalized in the intensive care units were examined. The samples were selected using a multi-stage cluster sampling method (from February to December 2022). The data were collected using the Persian version of DASS-21 and were analyzed with descriptive statistics and linear regression model.

The results of the present study showed that the mean anxiety score of family members was 17.84(SD = 7.92), the average depression score was 17.49(SD = 8.34), and the average stress score was 18.35(SD = 7.50). The linear regression model simultaneously showed that for an increase of one year in age, the anxiety score of family members decreased by 0.11, and this decrease was significant (P<0.01). An increase of one year in age, the depression score in family members decreased by 0.09, and this decrease was significant (P<0.05). Also, an increase of one year in age, the stress score of family members decreased by 0.12, and this decrease was significant (P<0.05). There was no significant relationship between other demographic variables with depression, anxiety and stress.

The anxiety of the family members of patients admitted to the intensive care unit was severe and depression and stress were moderate. With increasing age, the level of depression, anxiety and stress of the patients' family members decreased. Nurses are working in intensive care unit can play an important role in educating families about these units and also providing psychological support to them.

 Mental health is a serious concern for burn survivors. Burn injuries can bring long-term complications that begin at the moment of injury and last throughout a burn victim’s life.

 This study aimed to determine the effectiveness of a home care plan in the mental health status of burn survivors six months after hospital discharge.

 This randomized clinical trial with intervention and control groups was conducted in Kermanshah, Iran. Eligible samples (n = 90) were allocated into the two groups by a randomized block design. The intervention group received a home care plan for six months. The General Health Questionnaire-28 (GHQ-28) was responded to by the samples at three time points, baseline (T1: hospital discharge) and 3 (T2), and six months (T3) after the intervention.

 The mean scores of the GHQ-28 showed a descending trend in the intervention group during six months (T1: 32.48 ± 15.83, T2: 25.15 ± 15.11, and T3: 19.37 ± 14.11). However, the mean scores of the GHQ-28 were increased in the control group (T1: 32.29 ± 17.66, T2: 39.35 ± 14.59, and T3: 40.44 ± 15.59). There were significant differences between the two groups in 3- and 6-month measurements (P < 0.001).

 A 6-month home care plan improved the mental health of burn survivors in the intervention group in comparison to the controls; nevertheless, there were still survivors who needed help. Therefore, it is suggested to develop a home care plan with longer regular follow-ups for burn survivors based on their needs in the healthcare system of Iran.

A cure rate survival model was developed based on the assumption that the number of competing reasons for the event of interest has the Geometric distribution and the time allocated to the event of interest follows the Generalized Birnbaum-Saunders distribution.

The Geometric GB-S distribution was defined and two useful representations were represented for its density function which contributes to the creation of some mathematical properties. Furthermore, the parameters of the model with cure rate were estimated by using the maximum likelihood method.

Several simulations were performed and a real data set was analyzed from the medical area for different sample sizes and censoring percentages.

By considering the advantages of the GGB-S model, the model can be implemented as an appropriate alternative to explain or predict the survival time for long-term individuals.

Colorectal cancer is a major health problem both in developing and developed countries. This cancer is among the top three commonly diagnosed cancers in males and females. In this context, assessing the Incidence, Prevalence and Mortality Rate trend of this cancer is of great importance.

We used the data from the GBD 2017 study to assess the global trend of 3 important indicators of colorectal cancer burden and to examine the relationship between trends of these indicators with Human Development Index (HDI). We used the multivariate mixed effects modeling framework with time and HDI as the covariates.

Trend analysis of colorectal cancer burden indicators showed a rather steady trend for mortality rate, while it revealed increasing slopes for both the incidence and prevalence rates. In addition, our findings showed a direct relationship between prevalence and incidence rates of this cancer and HDI level and indirect association between mortality rate and level of HDI.

There were significant changes in indicators of colorectal cancer during the study period. The inverse relationship between mortality due to this cancer and socio-economic status of the countries indicated an urgent need for screening the patients and promoting the level of care in countries with lower levels of HDI.

The focused question of this systematic review was “does hyaluronic acid (HA) injection in areas of interdental papillary deficiency reduce black triangles?”

A systematic literature search was performed to find clinical studies on human patients with a minimum of 6-month follow-up, published in English from 2005 to May 2020. There were two outcome variables: black triangle area (BTA) change after treatment at different measurement time points compared with baseline, and patient reported outcome measures (PROMs), when available.

Of eight eligible articles (2 randomized clinical trials (RCTs) and 6 non-randomized, non-placebo controlled clinical studies), seven reported that HA injections had a positive impact on reduction of BTA and subsequent papillary augmentation. Six studies were included in meta-analysis and showed that the intervention led to a pooled reduction percentage of 57.7% in BTA after 6 months. Although there were clinical diversities between the studies, all the studies applied the same concentration of HA (approximately 2%), 2-3 mm apical to the papilla tip in several intervals. Some degrees of relapse were reported in some studies.

Within the limits of this study, this systematic review and meta-analysis showed that HA injection can serve as an efficient minimally-invasive treatment for small interdental papillary deficiencies. It is essential to conduct further randomized clinical studies with prolonged follow-ups in order to support this conclusion.

Coronary Artery Disease (CAD) despite physical disorders can also lead to significant mental disturbances like anxiety and depression. Therefore, the present study was conducted in order to assess the level of anxiety and depression in the elderly with acute coronary syndromes hospitalized in selected hospitals in Tehran 1400.

The current study is a cross-sectional, quantitative and descriptive-analytical study that was conducted in 2021. The study population included the elderly male and female patients (over 60 years old) who suffered from acute coronary syndrome hospitalized in selected hospitals in Tehran. For this purpose, 229 people were randomly selected to participate in the study. The Abbreviated Mental Test (AMT) and Hospital Anxiety and Depression Scale (HADS) were used as questionnaries in this study.

Findings showed that with an increase of one unit of the anxiety score, if other variables were fixed, the depression score increased by an average of 0.45 units. Also, the results for other demographic variables showed that people with low education, having non-personal residence, lack of social support, families with more than four children, unemployed people and male gender had a higher depression score.

Considering the existence of a significant relationship between anxiety and depression with the mentioned variables, it is suggested that health service providers and their families pay attention to elderly patients in order to reduce the level of anxiety and depression.

Vulvovaginal atrophy (VVA) usually occurs during and after menopause due to low estrogen levels and can cause frustrating symptoms. Existing treatments such as estrogen compounds have undesired side effects.

This study was conducted to assess the effectiveness of a chicken tallow product for vaginal use on subjective symptoms of VVA in women with breast cancer.

Menopause induced by chemical drugs with subjective symptoms of VVA were selected from the Oncology-Radiotherapy Clinic of Shohadaye Tajrish Hospital between March and July 2020. Informed consent was obtained. Patients were instructed to apply 5g cream every other night before bedtime for 2 weeks, and 2 nights a week for the next 2 weeks and stop themedication. Patients were assessed at the time of initiation of medication, and 2, 4, 6, and 8 weeks after initiation of the trial, and VVA subjective symptoms were assessed. VVA subjective symptom score (VVA-SSS) form was used to assess itching, burning, dryness, and dyspareunia, using a 5-point Likert scale. Data were, then, analyzed.

Fifty women were included in the study (age above 18 years). All 5 monitored indices (itching, burning, dryness, dyspareunia, and VVA subjective symptoms score) diminished after initiation of intervention and reached a minimum level after 4 weeks of intervention (1.10 ± 1.16 baseline to 0.04 ± 0.20 at 4 weeks for itching, 1.42 ± 1.09 to 0.04 ± 0.20 for burning, 2.68 ± 0.91 to 0.30 ± 0.54 for dryness, 2.96± 0.88 to 0.50 ± 0.61 for dyspareunia, and 8.12 ± 2.70 to 0.86 ± 1.07 for VVA-SSS). During the 4 weeks following discontinuation of treatment, the symptoms slightly increased but remained significantly lower than the baseline (P-value < 0.001 for all 5 indices at all monitored time points).

The proposed treatment, rooted in Persian traditional medicine, may offer a safe and effective treatment for VVA symptoms in BCS.

Household health expenses (HHE) are an important problem in any area. This national study aimed to investigate the determinants of HHE using quantile regression methodology. This cross-sectional national survey data was collected through the Iranian households’ income and expenditure survey, administered by the Statistical Centre of Iran (SCI) in 2014. In total, 38299 households were selected by a three-stage stratified cluster sampling method. The data were collected using a standard SCI-made Household Income and Expenditure questionnaire. A quantile regression (QR) approach was employed to determine the key predictor variables of HHE. R programming language (ver. 3.3.0) was used for data analysis. The findings indicated that the median annual medical expenses per capita was 1020000 Rls (= 48.02 USD) for Iranian households. The results of QR modeling revealed that age, income, region, gender, literacy, and occupational status had significant effect on HHE. Among households with moderate HHE, families with older-female-higher income heads experienced more HHE, while among high HHE households, families with older-rural-higher income heads spent more on HHE. Since inequality at HHE was revealed by age, income, region, gender, literacy, and occupational status among Iranian households, more attention will be needed from policymakers and health sectors on population subgroups of Iran.

 Life expectancy is one of the key indicators for investigating the overall health status of a population. Thus, analyzing the trend of this demographic measure is of great importance for planning health and social services in different societies. In this study, we aimed to model the trends of life expectancy in Asia, regions of Asia, and Iran over the past six decades.

 The annual life expectancy at birth data sets were extracted for Iran and the total Asia population between 1960 and 2020  from the database provided by the Our World in Data website. The trend analysis was performed using the joinpoint regression model.

 During the study period, Iranians and Asians have, respectively, experienced about 32 and 28.6 years increase in life expectancy. The results from joinpoint regression showed that the average annual percent change (AAPC) of life expectancy was positive for all regions of Asia, and ranged from 0.4% for Central Asia to 0.9% for Southern Asia. In addition, the estimated AAPC in Iranian people was about 0.1 higher than the total Asian population (0.9% vs. 0.8%).

 Despite protracted wars, poverty, and social inequality in some parts of Asia, life expectancy has drastically increased in this continent over the last decades. However, life expectancy in Asia (and Iran) is still remarkably lower than in more developed parts of the world. To elevate life expectancy to a higher level, the policymakers in Asian countries should put more effort into improving the standards of living and access to health facilities in their societies.

Body image is known as an important factor affecting different aspects of adolescents’ health; however, its relationship with lifestyle, body mass index (BMI), and health-related quality of life (HRQoL) in Iranian adolescents has not been addressed in a conceptual model.

This study aimed to investigate the network relationship among body image, lifestyle, BMI, and HRQoL in adolescent boys and girls.

The present study examined 760 adolescents (15 - 18 years) from Tehran. Adolescents reported their weight and height, according to which the participants’ BMIs were calculated. The adolescents’ body image, lifestyle, and health-related quality of life were assessed using a set of questionnaires, including the Iranian Body Image Scale (IBIS), Modifiable Activity Questionnaire (MAQ), Eating Habits Checklist, Eating Attitudes Test (EAT-26), and Pediatric Quality of Life Inventory (PedsQLTM).

The participants’ mean age and BMI were 16.5 ± 1.0 years and 22.4 ± 4.6 kg/m2, respectively. More than one-third of boys (39.9%) and less than a quarter of girls (22.6%) were overweight/obese. In the final model, body image was significantly and directly associated with physical activity, disordered eating, eating habits, and HRQoL in both genders (P < 0.05). Moreover, body image was directly correlated with screen time in boys (P = 0.012) and BMI in girls (P = 0.001). Body image was indirectly correlated with BMI regarding the mediating role of disordered eating in girls. Moreover, body image was indirectly associated with HRQoL regarding the mediating role of physical activity and eating habits in both genders and screen time only in boys.

The network relationships among body image, lifestyle, BMI, and HRQoL revealed a gender-specific pattern among the study population. Body image was a significant determinant of lifestyle and HRQoL in both genders and excessive weight in girls. The present findings would contribute to designing and implementing relevant health promotion interventions.

Gastric cancer has been one of the major causes of death in the past decades. It is the fifth most prevalent cancer and the third leading cause of neoplasm death worldwide. Thus, to know more about this health problem, assessing the burden of this cancer and its association with socioeconomic status of countries is of great importance. In this study, we aimed to evaluate the mean trend of gastric cancer mortality-to-incidence ratio (GCMIR) in different super regions defined by the Institute for Health Metrics and Evaluation (IHME) and investigate the relationship between GCMIR and Human Development Index (HDI) in the period 2000-2016.

We used the data from the Global Burden of Disease (GBD) 2016 study to calculate GCMIR for 185 world countries in the period 2000–2016. We also extracted the HDI data for each year under study from the Updates of the UNDP website. To attain the analytic aims, marginal modeling and generalized estimating equations (GEE) were utilized.

Sub-Saharan Africa was the only super region with a positive slope of GCMIR, and high-income countries had the greatest decreasing slope of GCMIR during the study period. Moreover, there was a negative association between GCMIR and HDI in these years.

Our findings revealed that gastric cancer could be thought not only as a biological disease but also as a social event that will be more controllable with the improvement of economic status and other social determinants of health.

Despite global efforts, human immunodeficiency virus/ acquired immunodeficiency syndrome (HIV/AIDS) is still one of the major public health problems in the entire world. In this context, assessing the burden of this disease in different parts of the world is of great importance. In this study, we aimed to investigate the trends of HIV/AIDS incidence and mortality in Iran during 1990 and 2017.  

The HIV/AIDS burden data, including the age-standardized incidence rate (ASIR) and the mortality rate (ASMR), was extracted from the Global Burden of Diseases 2017 study for the total Iranian population and by gender from 1990 to 2017. The trend analysis was performed using joinpoint regression modeling approach.

The obtained results showed that in 2017, the HIV/AIDS ASIR and ASMR were, respectively, more than 12 and 10 times of these rates in 1990. Also, the estimated average annual percent change (AAPC) was 9.8% and 8.7%, respectively for the ASIR and the ASMR. In this period, women have experienced a sharper slope of ASIR and ASMR trends compared with Iranian men.  

The increasing trend of HIV/AIDS burden is a serious alarm for the Iranian health policymakers. To achieve the United Nations Programme on HIV and AIDS goals, there is an urgent need for an efficient national action plan that breaks the HIV/AIDS taboo in the society, promote access to HIV testing and prevention facilities, especially among the key populations, and provide care and treatments for all infected people.

Tuberculosis (TB) is still a serious health problem with a remarkable global burden. In this study, we aimed to assess the trend of TB mortality in Asian and North African countries in the period 1990-2017 and provide a new classification according to TB mortality trend.

TB mortality rates from 1990 to 2017 were extracted from the Global Burden of Disease website for 55 Asian and North African countries. Trend analysis of TB mortality rates for males, females, and the total population was performed using the marginal modeling approach. Moreover, the latent growth mixture modeling (LGMM) framework was applied to classify these 55 countries based on their trend of TB mortality rate 

In the period between 1990 and 2017, South Asia and High Income Asia-Pacific regions had the highest and lowest death rates due to TB, respectively. The marginal modeling results showed that the Asian and North African countries had experienced a downward trend with an intercept of 28.79 (95%CI: 19.64, 37.94) and a slope (mean annual reduction) of -0.67 (95%CI: -0.91, -0.43)  per 100,000 the study period. Finally, the LGMM analysis classified these 55 countries into four distinct classes.

In general, our findings revealed that although the countries in Asia and North Africa super region experienced a descending TB mortality trend in the past decades, the slope of this reduction is quite small. Also, our new classification may be better suited for combating TB through future healthcare planning in lieu of the commonly used geographic classifications.

The risk of obesity commonly changes with age, which is a longitudinal (aging) effect. Moreover, the individuals who enter the study at the same age have similar living conditions that may influence their obesity risk in a particular way; this is a cross-sectional effect. Both cross-sectional and longitudinal effects of age should be considered for a better understanding of the effect of age on obesity and the related factors.

The present study aimed to (i) assess both the cross-sectional and longitudinal effects of age on obesity and (ii) determine how obesity changes with age in the target population using a Marginal Logistic Regression (MLR) model.

The current study made use of the information of individuals who had participated in the Isfahan Cohort Study. Participants were a large group of Iranian adults over 35 years of age who lived in the central region of Iran in 2001. Repeated measurements were obtained in 2001, 2007, and 2013.

From 2001 to 2013, the percentage of obesity in men and women raised from 13% and 31% to 18% and 44%, respectively. Both cross-sectional and longitudinal effects of age were significantly associated with the odds ratio of obesity. There was a rise in the probability of obesity for individuals aged 35-60 years at baseline and a decline for the older ones. The odds of obesity had about a 2% increase (on average) per year, regardless of the baseline age.

The obtained results pointed to a difference between the cross-sectional and longitudinal effects of age on the probability of obesity in the target population. The high and rising prevalence of obesity was a serious public health issue among participants, especially women, aged 35-60 years. The assessment of changes in obesity in a population-based study provides opportunities to target subpopulations that need more care and attention in public health interventions.

Statistical models are used to investigate the relationship between variables in statistical studies. Considering the variety of statistical models, finding the most suitable model is a complex work. This study aimed to compare different models in the treatment of infantschr('39') colic and the misspecification of specificity.

This randomized clinical trial was conducted on 100 infants with colic in the pediatric clinic of Amir Kabir Hospital in Arak, the intervention and control groups were randomly divided into two groups. The collection and analysis of the data was performed in 2016. After teaching massage to mothers of the intervention group, they were asked to perform massage on infants three times a day during the week. In the control group, mothers can relieve the symptoms of colic by shaking the infant. Parents recorded the number and severity of crying daily in the checklist. Finally, by using different models, R software, SAS, and goodness of fit, the best model was introduced.

In the massage group, the mean crying intensity of infants with colic decreased from 5.01 units on the first day to 2.47 units on the seventh day. On the other hand, the difference in mean sleep time changed from 1.81 hours in favor of the shaking group on the first day to 1.26 hours in favor of the massage group on the seventh day. Also, the severity of crying in the infants of the massage group was significantly higher than the impulse group. Regarding the grace of marginal models, the first-order self-return correlation structure was the best grace and for some variables, the model had random effects with a gamma distribution for the random component.

Massage can reduce infantschr('39') colic. Statistically, in the case of a nonlinear model, the variance of estimates is more than estimated to be influenced by the misspecification of the correlation structure.

Chronic lymphoid leukemia (CLL) is one of the most prevalent types of leukemia, which is responsible for a remarkable mortality rate in the world. This study aimed to investigate the global trend of this cancer from 1990 to 2015 and to determine the relationship between trend of CLL mortality rate and Human Development Index (HDI) throughout the world.

The age-standardized mortality rate data of all countries of the world (per 100,000) were extracted from the GBD database. In addition, the HDI values for the studied countries in different years were obtained from the UNDP database. The statistical analysis was performed using the mixed-effects location-scale model in the SAS software, version 9.4.

The findings of the statistical modeling showed a downward slope for CLL Age Standardized Mortality Rate (ASMR) for total world countries ( ). We also find a significant association between CLL ASMR and HDI. Countries with higher HDI had higher level of CLL ASMR in years 1990 to 2015 with a negative slope. Furthermore, countries with lower HDI had Lower level of CLL ASMR with rather fixed rates in this period.

These findings showed a decreasing trend of global CLL ASMR in the previous decades, although, the fixed trend of CLL ASMR in countries with low HDI is worrisome. The health policymakers should make more efforts to decrease the mortality due to this cancer in these countries.

Preterm birth is the most important in children under 5 yr mortality. In this study, we used the Global Burden of Disease Data (GBD) to evaluate the trend of preterm infant mortality rate for all countries from 1990 to 2017 and to assess the effect of development factors on this trend.

The preterm infant mortality rate data from 196 countries of the world, from 1990 to 2017, were extracted from the GBD database. To study the trend of preterm infant mortality rate, a mixed-effects log-linear regression model was fitted separately for each IHME super-region. In the next step of data analysis, the development factor was included in the model to determine its effect on this trend for all countries under study.

The average rate mortality rate has declined about 2% per year throughout the world over the mentioned period. The highest and lowest decreasing trends were observed in high-income countries (about 4.0%) and Sub-Saharan Africa (about 1.0%), respectively. Including the effect of development factor in the mentioned model revealed that in 1990, the rate of preterm infant mortality in developed countries was 2.2 times of this rate in developing countries and this rate ratio has increased to 2.69 in year 2017.

Although the preterm infant mortality rate were decreasing in all super regions, there is a remarkable gap in this rate between developing and developed countries yet. Therefore, preventative strategies are needed to reduce preterm birth and its burden, especially in the developing world.

Today, cardiovascular disease is a major threat to advanced human societies, and is acting as a major cause of disability in many aspects of a patient and family members' lives, including their quality of life. Therefore, the aim of the present study is to provide models for classifying and determining the factors influencing the allocation of family-centered empowerment model to further improve the psychological quality of life of these patients.

In this study, data from a clinical trial study were used in which 70 patients with myocardial infarction who randomly received a family-centered empowerment pattern and control group. A model of linear mixed effects and then learning algorithms were used to predict the success or failure of the empowerment model.

In this study, the decision tree model was ableto accurately predict more than 96% of patients (Kappa=0.828, ROC=0.96). Physical functions, walking status, creatinine level, EF level, employment status, gender, stress level and body mass index were identified as the effective factors in assigning a family-centered empowerment pattern (P value <0.05). This process was done through software of SPSS24, SAS9.1 and WEKA 3.6.9

The decision tree model was able to correctly classify more than 96% of patients; if a family-centered empowerment model was assigned, this model would improve the psychological dimension of their quality of life.