masoud salehi

Success in COVID-19 vaccination depends on understanding why people refuse or hesitate to take the vaccine. This study aims to explore vaccine refusal and hesitancy among Iranians who participated in the national COVID-19 vaccine hesitancy survey.   

A qualitative content analysis approach was used. Twenty-six participants were selected by purposive sampling. In-depth, semi-structured telephone interviews were conducted during the year 2022. A directed content analysis approach was used for analyzing the data by extracting the codes, subcategories, and categories.   

Four major categories and their respective subcategories related to refusal and/ or hesitancy against COVID-19 vaccination emerged: “lack of confidence” (distrust in policymakers and pharmaceutical companies, distrust in national media, belief in conspiracy theory, and lack of confidence in the vaccine's safety and effectiveness), “complacency” (Fatalism and philosophical beliefs, low perceived risk, and belief in the adequacy of the precautionary principles), “constrains” (personal and psychological barriers), and “coercion” (coercion by relatives and unsteady imposed mandatory vaccination by the government).   

Distrust, fatalism, low perceived risk, and overconfidence in traditional Persian medicine were important barriers to COVID-19 vaccine acceptability needing a variety of measures for improving COVID-19 vaccine uptake, including enhancing public trust in government and policymakers, clarifying vaccine safety and effectiveness, dealing with religious fatalism, and regulating anti-science messages on social media.

Vaccination seems to be the most critical means of halting the COVID-19 pandemic. It is crucial to understand the factors that influence COVID-19 vaccine acceptance to avoid low vaccination rates. This study intended to monitor the COVID-19 vaccine acceptance and its association with socio-demographic factors and prior diagnosis of COVID-19 in Iranian adults during the COVID-19 pandemic.

The study utilized data from the COVID-19 Population Survey of Iran (COPSIR), a repeated national survey designed to monitor COVID-19-related behavioral insights. From April 2020 to November 2021, thirteen iterations of a series of cross-sectional studies involving computer-assisted telephone interviews were conducted.

The COVID-19 vaccine acceptance rate remained above 80% until the ninth wave in February 2021, when it dropped to 62.9%. However, throughout the next four surveys, it rose gradually from 72.0% to 85.7%. The multilevel regression model revealed that the COVID-19 vaccine acceptance was significantly and positively linked with age and education.

Despite the relatively high COVID-19 vaccine acceptance rate among Iranian adults, after the emergence of vaccines on the global market and controversies about their safety in Iran, the initially high vaccine acceptance rate dropped significantly, and then increased over time and returned to its peak level (85%). According to the Commodity Theory, this rise in vaccine acceptance can be attributed to the COVID-19 vaccine shortage in the country between January and July 2022. For Iranian adults to accept vaccines more readily, health promotion programs should target the youth and the less literate adults.

 Colorectal cancer (CRC) accounts for a large proportion of the global burden of cancer and is the fourth leading cause of cancer-related mortality worldwide. Fecal Immunochemical Testing (FIT) can be used for CRC screening programs due to its high accuracy and compliance. The present study reports the preliminary results of the CRC screening program in Iran among all people aged 50 to 69 years.  

 This cross-sectional study was carried out on 2,669,625 participants referred to health centers in Iran for CRC screening programs in 2018 and 2019. The data required for this study was taken from the CRC screening program.  Relevant information for all individuals aged 50 to 69 referred to the health system that was called for colorectal cancer screening was extracted from the Integrated Electronic Health Records (SIB) database. Finally, the standards indices were calculated for all provinces. Gender, history of inflammatory bowel disease (IBD) (Crohn's disease or ulcerative colitis), history of colon cancer or adenoma in a first-degree family (father, mother, siblings or children), history of colon cancer in a second-degree family if occurred under the age of fifty (aunt, uncle, grandparents), lower gastrointestinal bleeding in a prior month, constipation in the prior month (with or without diarrhea, abdominal pain and feeling of fullness in the colon after defecation), more than ten percent weight loss in the last six months and FIT were assessed.   

 Among a total number of over 2.6 million, 56.3% were female, and the number of people evaluated by health care providers for CRC screening programs in 2018 and 2019 were 1,365,248 (14.23%) and 1,304,377 (12.89%), respectively. The number of people with positive FIT evaluated for the CRC screening program in 2018 and 2019 was 33,299 (3.09%) and 33,583 (2.57%), respectively. Bushehr province (0.59%) and Isfahan province (7.35%) had the lowest and highest positive FIT rate in 2018, respectively. Also, the correlation between the above-mentioned variables and the number of people with a positive FIT across gender was statistically significant (p<0.05). The study of the relationship between the number of positive FIT cases and the variables examined by Behvarz and community health worker showed that the number of people with a family history of colon cancer in second-degree relatives under the age of 50 and also the number of people with an individual history of inflammatory bowel disease had a significant association with the number of positive FIT cases (p<0.05) (β=-0.718, 95% CI; -2.557-14.992, β=0.388, 95% CI; 0.322-16.737, respectively). The relationship between the number of positive FIT cases and effective variables was not statistically significant (p>0.05). 

 Positive cases should be referred for further evaluation and colonoscopy. Before performing a screening program, the conditions for performing colonoscopy for these people must be assessed and prepared. The FIT for CRC screening program can be easily promoted in 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.

Financial management system acts as a driving force and the first important principle of health sector reform. This study aimed to prepare a framework for new financial management system in Iran health sector.

This qualitative study was conducted by content analysis approach and 15 key informant participants selected through purposive sampling consisted of three minsters of Ministry of Health and Medical Education (MOHME), three vice‑chancellors in the Center of Resource Development and Management, Two members of the Health Assembly of the Islamic Consultative, four Medical Sciences university’s presidents, and three managers in Budgeting and performance Monitoring Center of MOHME in 2017. Data were collected through semi‑structured interviews and they were analyzed using Atlas T6 software.

Six main themes were emerged as follow: “legal reform,” “removing barriers to set up accrual accounting,” “cost price calculation,” “operational planning and budgeting,” “human resources’ organization, recruitment, and moderation,” and “financial system output utilization (management accounting techniques) as the base for evidence‑based policymaking and decision‑making practices.”

Any efforts for improving the current situation and reducing of mentioned limitations could be useful in providing required space for future phases of reforms and calculation of unit cost, operational budgeting, and management of cost and productivity. This can be achieved through an integrated system of recording and producing standard and accrual financial information. Furthermore, changing the accounting process and the financial system that complies with one single encoding in the country is a key issue.

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.

If people feel that the decisions made by health authorities are the result of the public’s points of view, they will accept them without any question. This is a descriptive‐analytic cross‐sectional study in which we used the DCE (Discrete choice experiment) technique to elicit the public’s preferences for individuals with different education levels in Tehran in 2017. The study findings indicated that for individuals with a bachelor’s degree, treatment of patients suffering from communicable diseases is the top priority (odds ratio = 2.79), while for those with a master’s and doctoral degree, the most important criteria for prioritizing resources were severity of disease (odds ratio = 2.66) and benefit from treatment (odds ratio = 2.38), respectively. The study results will help healthcare policy and decision-makers to better understand and analyze the causes of differences in society members' behaviors.

Musculoskeletal disorder (MSD) is one of the important problems concerning the staffschr('39') health and productivity in the workplace. Nutritional status and consumption of some foods are also among the determining factors of MSD. So, this study aimed to evaluate the correlation of diet and consumed food groups with MSD.

This cross-sectional study was conducted on 100 office workers. The participantschr('39') anthropometric parameters and their dietary information were collected using a semi-quantitative food frequency questionnaire. The findings were categorized into nine levels. The total scores were calculated for all the items per food group and per person. Nordic musculoskeletal questionnaire was also administered to evaluate the MSD symptoms in nine parts of body.

The score of consumed food groups was compared between individuals “with pain” and “without pain” in nine parts of the body. The scores of fruit intake in individuals “with pain” and “without pain” were 2.94 ± 1.27 vs. 3.29 ± 1.16 and 2.81 ± 1.10 vs. 3.49 ± 1.38 in terms of neck and wrists, respectively. The difference between the two groups were significant (P < 0.05). Furthermore, the participants with pain in the neck consumed significantly lower amounts of cereals and nuts (P = 0.03, 0.04). In the case of the shoulder pain, consuming legumes and nuts in the “without pain” group was higher than the group of participants who had pain (P = 0.01, P = 0.03). Fat intake was higher in the patients who had pain in their hips (P = 0.02).

Less pain was reported in the musculoskeletal system by higher consumption of fruits, nuts, and legumes. It seems that plant-based dietary pattern is more effective in musculoskeletal health.

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.

Female breast cancer is known as one of the top five cancers in terms of mortality. Regarding contradictory reports about the mortality trend of this cancer and its association with the socio-economic status of the world countries, we aimed at assessing the global trend of female breast cancer mortality rate and investigate the relationship between its mortality rate and development status.

The breast cancer Age Standardized Mortality Rate (ASMR) per 100,000 and Human Development Index (HDI) for 179 world countries were extracted, respectively from the Global Burden of Disease (GBD) 2017 study and the United Nations Development Programme (UNDP) database, for the period 1990 to 2017. The marginal modeling methodology was employed to analyze the global trend of ASMR and examine the relationship between ASMR and HDI.

The results showed a slightly constant curve for the global trend of breast cancer ASMR from 1990 to 2017 (around 17 per 100,000). Moreover, it was indicated that the ASMR is strongly related to development status. While countries with higher levels of HDI have experienced a declining trend of breast cancer mortality rate, countries with lower HDI levels experienced an ascending trend at this period.

In general, the findings showed that mortality due to breast cancer is still a major health problem in total world countries. Hence, more efforts should be made to screen the patients in the early stages of the disease and promote the level of care, especially in countries with lower levels of economic development.

Many people facing life difficulties are unable to sort out these problems.

A study was designed to determine students’ life skills at the Iran University of Medical Sciences (IUMS).

This cross-sectional study was conducted at IUMS in 2016 - 17 with a sample of 342 students. A questionnaire was used with multi-choice questions from poor to high skills. Latent class models were applied for data analysis using Mplus. Bayesian information criterion (BIC) and Bootstrap likelihood ratio tests were used to determine the number of classes.

A two-class model had the best fit since the BIC had the lowest amount. Almost 76% and 24% of the cases entered the high and moderate skill classes of the model, respectively. The level of education (LOE) was the only significant variable (P = 0.004) for classifying the students.

The model could predict the probability of high life skilled students. Also, LOE had a high impact on the probability of high life skills.

Regarding lack of resources in the health‑care sector, prioritization of these resources is inevitable. The objective of the current study was to elicit public preference in prioritizing and allocating health resources using a discrete choice experiment technique, which is currently the most commonly applied method in this field of researches.

In this discrete choice study, five attributes were selected through interview with 25 health experts to elicit people preferences in Tehran (Iran) in 2017. Eighteen choice tasks were arranged within 3 blocks, and this would be achieved with a sample size of 579. Choice data were modeled using generalized estimating equation method and STATA 14 software.

Five attributes including level of emergency, severity of disease, communicable, benefit from treatment, and age are the most important attributes in the prioritizing health resources from the expert’s point of view. As well as among these attributes, communicable (odds ratio = 2.81) is the most important attributes from the public’s point of view.

The results of this study could be very useful for prioritizing resources which is one of the most challenging measurements of the health system. By identifying the importance of each patient’s characteristic, patients can be categorized in groups with different priorities, as well as the diagnosis‑related group system, based on which resources are allocated.

This study aimed to determine effective factors on geographic distribution of the Incidence of Colorectal Cancer (CRC) in Tehran, Iran using Geographically Weighted Poisson Regression Model.

This ecological study was carried out at neighborhood level of Tehran in 2017-2018. Data for CRC incidence was extracted from the population-based cancer registry data of Iran. The socioeconomic variables, risk factors and health costs were extracted from the Urban HEART Study in Tehran. Geographically weighted Poisson regression model was used for determination of the association between these variables with CRC incidence. GWR 4, Stata 14 and ArcGIS 10.3 software systems were used for statistical analysis

The total number of incident CRC cases were 2815 in Tehran from 2008 to 2011, of whom, 2491 cases were successfully geocoded to the neighborhood. The  median IRR for local variables were : unemployed people over 15 year old (median IRR: 1.17), women aged 17 years or older with university education (median IRR: 1.17), women head of household (median IRR: 1.06), people without insurance coverage (median IRR: 1.10), households without daily consumption of milk (median IRR: 0.85), smoking households (median IRR: 1.07), household’s health expenditure (median IRR: 1.39), disease diagnosis costs (median IRR: 1.03), medicines costs of households (median IRR: 1.05), cost of the hospital (median IRR: 1.09), cost of medical visits (median IRR: 1.27).

The spatial variability was observed for most socioeconomic variables, risk factors and health costs that had effects on CRC incidence in Tehran. Spatial variability is necessary when interpreting the results and utterly helpful for implementation of prevention programs.

National surveys revealed a high prevalence of psychiatric disorders in Iran. Province-level estimates are needed to manage the resources and focus on preventive efforts more efficiently. The objective of this study was to provide province-level estimates of psychiatric disorders. In this study, Iranian Mental Health Survey (IranMHS) data (n = 7886) was used to produce province-level prevalence estimates of any psychiatric disorders among 15-64 year old males and females. Psychiatric disorders were diagnosed based on structured diagnostic interview of the Persian version of Composite International Diagnostic Interview (CIDI, version, 2.1). The Hierarchical Bayesian (HB) random effect model was used to calculate the estimates. The mental health status of half of the participants was also measured using a 28-item general health questionnaire (GHQ). A wide variation in the prevalence of psychiatric disorders was found among 31 provinces of Iran. The direct estimates ranged from 3.6% to 62.6%, while the HB estimates ranged from 12.6% to 36.5%. The provincial prevalence among men ranged from 11.9% to 34.5%, while it ranged from 18.4% to 38.8% among women. The Pearson correlation coefficient between HB estimates and GHQ scores was 0.73. The Bayesian small area estimation provides estimation with improved precision at local levels. Detecting high-priority communities with small-area approach could lead to a better distribution of limited facilities and more effective mental health interventions.

Pedestrians are considered as the most vulnerable road users. In this study, the pattern of global pedestrian deaths was assessed using Latent Growth Model and Latent Growth Mixture Model. In this longitudinal study, pedestrian deaths rates data of 195 countries from 1990 to 2015 for men, women and total of them, were extracted from the Global Barden of Disease website. Initially, the overall pedestrian death rate pattern was assessed by LGM and then the GMM was used to explore heterogeneity in the population and categorization the countries based on their pedestrian death rate patterns. All statistical analysis and drawing geographical maps were performed using Mplus 6.12 and ArcGIS 10.3, respectively. The nonlinear LGM was better fitted than the linear LGM. The nonlinear LGM results show that the estimated intercept for men, women and total of them was 10.84, 4.77 and 7.83, and the estimated slope was -1.01, -0.47 and -0.75, respectively. According to pedestrian death rate, the LGMM, classify the countries into 5 classes with five different patterns. Generally, the pedestrian deaths rates had a nonlinear decreasing pattern, but this decreasing pattern is different for each country. Therefore, in order to reduce pedestrian fatality rate in the world, different approaches need to be considered for each of five groups.

Most studies show that picture-naming test is the best task to evaluate the underlined cognitive and language function in the patients with dementia. Naming performance is the most evident linguistic symptom, which starts in the initial phase of the mild cognitive impairment (MCI) and Alzheimer’s disease (AD). The current study aimed at determining the picture-naming performance level of Persian-speaking patients with MCI and AD compared with normal peers using naming subtests of Barnes language assessment (BLA). In total, 90 subjects were selected through self-report; some relevant tests including mini-mental status examination (MMSE) and functional assessment staging (FAST) scale, as well as experts comments were employed; subjects were divided into three groups of MCI, AD, and normal control (NC) (30 cases per group). Picture-naming performance of patients in the MCI and AD groups was assessed and compared with that of the NC group using the naming subtest of the BLA. In the picture-naming test of BLA, the AD group performed worse than the NC and MCI groups (P < 0.001). Moreover, a significant difference was observed between the NC and MCI groups. While the MCI group performed worse than the NC (P < 0.001), it acted better than the AD group (P < 0.001). According to the results of the current study, picture naming test was a useful cognitive-linguistic task, which can accurately differentiate the three study groups, especially MCI from normal subjects, despite its quick and simple application.

Cardiovascular diseases are the first leading cause of death worldwide. World health organization has estimated that the morality rate due to heart diseases will mount to 23 million cases by 2030. Hence, the use of data mining algorithms will be useful in predicting coronary artery disease. The objective of the present study was to compare the accuracy of the CAD predictions made by ANN and SVM techniques.

The present study was conducted via descriptive-analytical method. The research sample included all CAD patients hospitalized in three hospitals affiliated to AJA University of Medical Sciences from March 2016 to March 2017. Totally, 1324 records with 26 characteristics affecting the disease were extracted and after normalizing, and cleaning of the data, they were entered in SPSS statistics V23.0 & IBM Excel 2013; then, R3.3.2 data mining software was used to format data.

SVM model with lower MAPE (112.03) and higher Hosmer-lemeshow statistic (16.71), sensitivity (92.23) and specificity (74.42) yielded better fitness of data and provides more accurate prediction than ANN model. On the other hand, since the area under the ROC curve in SVM algorithm was more than that in ANN, it could be concluded that this model had higher accuracy.

According to the results, SVM algorithm presented higher accuracy and better performance than ANN model and showed higher sensitivity and accuracy. It is suggested that in future studies, the results of the present study be compared with the findings resulted from applying other data mining algorithms

Attention to theorizing in information systems has been intensified in recent years, and consequently using these theories in research articles is going on. Knowing about the situation of applying these theories in recent decade can help researchers to find not only the most widely used theories, but the research gaps as well. In this regard, our study seeks to describe and analyze the actual situation of using IS theories in researches of this field in recent years. Statistical population in this research involves scientific articles, published in the world's top scientific journals in the field of IS and statistical sample includes the articles published between 2010-2016 in field of IS theories. Using social network analysis (SNA) technique, a network of relations between IS theories and articles applying them are depicted. The results show that game theory, argumentation theory, and complexity theory have the most usage; and by order technology acceptance model, prediction theory and structuration theory have the most coexistence in investigated articles. Also, studying of scientific fields from which IS theories have been adapted, shows that the field of IS has originated the most number of theories, and fields of sociology and psychology are at the next rates. The results of the research can influence the trend of theorizing in IS, by guiding researchers to concentrate on the applicability of theories.

This study aimed at investigating the relationship between number of citations and keywords used in title of articles, and was conducted in a cross-sectional design on eleven English-language journals published by Tehran University of Medical Sciences.
A total of 495 articles from these journals were searched in Google Scholar. The correlation between citations and keywords used in titles was found through Spearman correlation coefficient using SPSS.
Study results confirmed existence of a significant correlation between keywords used in titles of articles and the number of citations (P=0.009, r=0.117). There was also a significant correlation between the number of keywords specified to the article and the number of citations.
 According to the results, providing titles with appropriate structure and with main keywords of articles by authors can be effective in easy selection and examination of subject association of articles  by researchers, and in increasing citations of articles.

Changes of pulmonary tuberculosis on chest radiographs varies.According to recent studies, the incidence of unusual radiological findings has increased, but a comparison in relation to the changes before and after the treatment has been done. This study evaluates the diversity of radiographic views in pulmonary tuberculosis patients before and after treatment.
In this study, the chest radiographs of 85 patients with smear-positive TB were evaluated before and after treatment. The type and extent of parenchymal and mediastinal abnormalities was reported by a radiologist and data were analyzed with software spss 21.
The most common radiologic pattern was infiltration, 75 cases (88.2%) before treatment and 43 cases (50.5%) after treatment. Most Abnormalities were seen in the right lung. The most lobes was the left upper lobe The frequency of collapse and calcification pre-treatment and infiltration after treatment showed significant correlation with increasing age. The risk of calcification was higher in older age.
Although the disorder CXR TB patients varied, but two lesions infiltration and Hillary lymphadenopathy include the highest frequency. However chest rdiographic lesions showed no consistent pattern in patients with PTB but the radiographic findings in addition clinical findings are helpful in the preliminary assessment and response to treatment .

Correspondence analysis method and preparation of accidents and occupational hazards pattern is able to predict and anticipate accidents and is automatically prioritize the risks and injuries. The aim of this study was to present accidents and occupational hazards pattern based on risk-injury groups, which use it to manage of occupational accidents.
Material and The report of occupational accidents, registered in the social security organization was collected in a period of ten years from 2005 to 2015 (222,300 accidents). Types of risk and injuries to any of the accidents specified based on International Labor Organization criteria and risk of injury were classified in a matrix (18 × 18). Risk-injury groups were separately identified using correspondence analysis and collapse process, as patterns of accidents and occupational hazards. In the mentioned patterns, the relationship between risks and damage can be identified, as it facilitates decision-making in risk assessment in companies covered by the social security organization.
According to the findings, three groups of occupational accidents were obtained and variables of these three groups extracted from the obtained patterns. The first group included six risks and seven injuries that the risks variables were: contact with hot materials, accidents caused by caustic and corrosive substances, contact with chemicals, accidents caused by toxic substances, contact with electrical equipment, explosion and fire, and injuries were: burns, other injuries, multiple injuries, gas poisoning, suffocation, poisoning, environmental hazards. The second group included seven risks and six injuries that the risks variables were: accidents caused by displacement, projections of fragments or particles, accidents caused by machine tools, slipping, falling people, falling objects, other accidents and injuries were: twists and sprains, dipping the objects in the body, objects in the eyes, cuts and amputations, superficial wounds, deep wounds. Finally, the third group included five risks and five injuries that risks variables were: Falling under the rubble, accident with vehicle, accidents caused by displacement, colliding of persons against objects, projections of fragments or particles, accidents caused by manual tools, trapped between objects, accidents caused by machine tools and injuries were: fractures, dislocation, back pain, hitting, contusions and crushing. It should be noted that the study of these patterns can be used to identify and prioritize of occupational accidents.
The proposed groups make new opportunities for development of the applications to analyze, interpret and automate management of occupational accidents in order to minimize uncertainty and increase its objectivity. Its advantage over other similar analyses can be considering both the risks and injury and to obtain groups of two variables. Due to the frequency and distribution of mass of risk and injury variables in the groups, the risk and injury variables of group 3 are the most important, and the risk and injury variables of group 2 are less important and the risk and injury variables of group 1 have the least importance.

correspondence analysis method and preparation of accident and occupational hazards pattern enables forecasts and predictions of accidents and prioritizations of risks and injuries to be obtained automatically. The procedure for any company, regardless of its size is applicable. This study presents the first model accidents and occupational hazards as a first step to identify and predict accident in the workforces.
initially was collected reports of occupational accidents registered in the Social Security for a period of ten years (2005 – 2015) (222,300 accidents) and the type of risk and injury related to any of the accidents have been codified following the criteria of the International Labor Organization. In the next step, the average annual occupational accidents summarized in a contingency table, include of risk (R) as row and injury (A) as column, it called risk-injury matrix. Correspondence analysis was selected as the suitable method for optimizing the risk-injury matrix functions. Thus, we were used statistical software STATISTICA and correspondence analysis test for data analysis.
The obtained risk-injury group (the first pattern accidents and occupational hazards) include of six risks and seven injuries that the obtained pattern is composed of two dimensions: dimention1, with eigenvalue =0/562, dimention2, eigenvalue 0/419% is 78/6% of the total variance. The greatest affinities are contact with hot material (R11) with burn (A12); Accidents caused by burning and corrosive materials (R12) with other injuries (A18) and multiple injuries (A17); Contact with chemicals (R14) and accidents caused by toxic substances (R15) with gas shock (A14); Contact with electrical equipment (R13), explosions and fires (R17) with suffocation (A16) and poisoning (A13) and environmental hazards (A15) is the least affinity with other variables. Overall, mentioned variables have less affinity than other 23 variables.
This obtained risk-injury group includes all the of risk and injury variables related to the appearance of historically recent technological problems, the industrial revolution and scientific and technical development. In this group the Industrial accidents are identified in this group as risks associated with the work environment, and injuries being caused by the environment. This study is the first step to anticipate accidents and occupational hazards and prioritize risks and injuries and we can use these results fully to the goals came in the later stages.

Multiple pregnancies are an important complication of assisted reproductive technology (ART). The present study aims to indentify the risk factors for multiple pregnancies independent of the number of transferred embryos.
This retrospective study reviewed the medical records of patients who underwent intracytoplasmic sperm injection (ICSI) cycles in Royan Institute between October 2011 and January 2012. We entered 12 factors that affected the number of gestational sacs into the poisson regression (PR) model. Factors were obtained from two study populations-cycles with double embryo transfer (DET) and cycles that transferred three embryos (TET). We sought to determine the factors that influenced the number of gestational sacs. These factors were entered into multivariable logistic regression (MLR) to identify risk factors for multiple pregnancies.
A total of 1000 patients referred to Royan Institute for ART during the study period. We included 606 eligible patients in this study. PR analysis demonstrated that the quality of transferred embryos and woman’s age had a significant effect on the number of observed sacs in patients who underwent ICSI with DET. There was no significant predictive variable for multiple pregnancies according to MLR analysis. Our findings demonstrated that both regression models (PR and MLR) had the same outputs. A significant relation existed between age and fertilization rate with multiple pregnancies in patients who underwent ICSI with TET.
Single embryo transfer (SET) should be considered with the remaining embryos cryopreserved to prevent multiple pregnancies in women younger than 35 years of age who undergo ICSI cycles with high fertilization rates and good or excellent quality embryos. However, further prospective studies are necessary to evaluate whether SET in women with these risk factors can significantly decrease multiple pregnancies and improve cycle outcomes.