Publications by authors named "Mohammad-Reza Malekpour"

16 Publications

  • Page 1 of 1

Quality of care of peptic ulcer disease worldwide: A systematic analysis for the global burden of disease study 1990-2019.

PLoS One 2022 1;17(8):e0271284. Epub 2022 Aug 1.

Non-Communicable Diseases Research Center, Endocrinology and Metabolism Population Sciences Institute, Tehran University of Medical Sciences, Tehran, Iran.

Background: Peptic ulcer disease (PUD) affects four million people worldwide annually and has an estimated lifetime prevalence of 5-10% in the general population. Worldwide, there are significant heterogeneities in coping approaches of healthcare systems with PUD in prevention, diagnosis, treatment, and follow-up. Quantifying and benchmarking health systems' performance is crucial yet challenging to provide a clearer picture of the potential global inequities in the quality of care.

Objective: The objective of this study was to compare the health-system quality-of-care and inequities for PUD among age groups and sexes worldwide.

Methods: Data were derived from the Global Burden of Disease Study 1990-2019. Principal-Component-Analysis was used to combine age-standardized mortality-to-incidence-ratio, disability-adjusted-life-years-to-prevalence-ratio, prevalence-to-incidence-ratio, and years-of-life-lost-to-years-lived-with-disability-into a single proxy named Quality-of-Care-Index (QCI). QCI was used to compare the quality of care among countries. QCI's validity was investigated via correlation with the cause-specific Healthcare-Access-and-Quality-index, which was acceptable. Inequities were presented among age groups and sexes. Gender Disparity Ratio was obtained by dividing the score of women by that of men.

Results: Global QCI was 72.6 in 1990, which increased by 14.6% to 83.2 in 2019. High-income-Asia-pacific had the highest QCI, while Central Latin America had the lowest. QCI of high-SDI countries was 82.9 in 1990, which increased to 92.9 in 2019. The QCI of low-SDI countries was 65.0 in 1990, which increased to 76.9 in 2019. There was heterogeneity among the QCI-level of countries with the same SDI level. QCI typically decreased as people aged; however, this gap was more significant among low-SDI countries. The global Gender Disparity Ratio was close to one and ranged from 0.97 to 1.03 in 100 of 204 countries.

Conclusion: QCI of PUD improved dramatically during 1990-2019 worldwide. There are still significant heterogeneities among countries on different and similar SDI levels.
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http://journals.plos.org/plosone/article?id=10.1371/journal.pone.0271284PLOS
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC9342757PMC
August 2022

Rheumatic Heart Disease Is a Neglected Disease Relative to Its Burden Worldwide: Findings From Global Burden of Disease 2019.

J Am Heart Assoc 2022 Jul 22;11(13):e025284. Epub 2022 Jun 22.

Institute for Health Metrics and Evaluation University of Washington Seattle WA.

Background Rheumatic heart disease (RHD) takes a heavy toll in low- and middle-income countries. We aimed to present worldwide estimates for the burden of the RHD during 1990 to 2019 using the GBD (Global Burden of Disease) study. Methods and Results Sociodemographic index (SDI) and age-period-cohort analysis were used to assess inequity. The age-standardized death, disability-adjusted life years, incidence, and prevalence rates of RHD were 3.9 (95% uncertainty interval, 3.3-4.3), 132.9 (95% uncertainty interval, 115.0-150.3), 37.4 (28.6-46.7), and 513.7 (405.0-636.3) per 100 000 in 2019, respectively. The age-standardized incidence and prevalence rates increased by 14.4% and 13.8%, respectively. However, disability-adjusted life years and death rates decreased by 53.1% and 56.9%, respectively. South Asia superregion had the highest age-standardized disability-adjusted life years and deaths. Sub-Saharan Africa had the highest age-standardized incidence and prevalence rates. There was a steep decline in RHD burden among higher-SDI countries. However, only age-standardized deaths and disability-adjusted life years rates decreased in lower-SDI countries. The age-standardized years of life lost and years lived with disability rates for RHD significantly declined as countries' SDI increased. The coefficients of birth cohort effect on the incidence of RHD showed an increasing trend from 1960 to 1964 to 2015 to 2019; however, the birth cohort effect on deaths attributable to RHD showed unfailingly decreasing trends from 1910 to 1914 to 2015 to 2019. Conclusions There was a divergence in the burden of RHD among countries based on SDI levels, which calls for including RHD in global assistance and funding. Indeed, many countries are still dealing with an unfinished infectious disease agenda, and there is an urgency to act now to prevent an increase in future RHD burden.
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http://dx.doi.org/10.1161/JAHA.122.025284DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC9333364PMC
July 2022

Estimates of incidence, prevalence, mortality, and disability-adjusted life years of lung cancer in Iran, 1990-2019: A systematic analysis from the global burden of disease study 2019.

Cancer Med 2022 Jun 13. Epub 2022 Jun 13.

Non-Communicable Diseases Research Center, Endocrinology and Metabolism Population Sciences Institute, Tehran University of Medical Sciences, Tehran, Iran.

Background: Lung cancer is one of the leading cancers, with a high burden worldwide. As a developing country, Iran is facing with population growth, widespread tobacco use, demographic and epidemiologic changes, and environmental exposures, which lead to cancers becoming a severe concern of public health in Iran. We aimed to examine the burden of lung cancer and its risk factors in Iran.

Methods: We utilized the Global Burden of Disease 2019 data and analyzed the total burden of the lung cancer and seven related risk factors by sex, age at national and sub-national levels from 1990 to 2019.

Results: The lung cancer age-standardized death rate increased from 11.8 (95% Uncertainty Interval: 9.7-14.4) to 12.9 (11.9-13.9) per 100,000 between 1990 and 2019. This increase was among women from 5 (4.2-7.1) to 8 (7.2-8.8) per 100,000; in contrast, there was a decline among men from 18.5 (14.8-22.6) to 17.8 (16.2-19.4) per 100,000. The burden of lung cancer is concentrated in the advanced age groups. Smoking with 53.5% of total attributable deaths (51.0%-55.9%) was the leading risk factor. At the provincial level, there was a wide range between the lowest and highest, from 8.3 (7.0-10.0) to 19.1 (16.4-22.0) per 100,000 population in the incidence rate and from 8.7 (7.3-10.3) to 20.6 (17.7-24.0) per 100,000 population in mortality rate, respectively in Tehran and West Azerbaijan provinces in 2019.

Conclusion: The increasing trend of lung cancer burden among the entire Iranian population, the inter-provincial disparities, and the significant rise in burden of this cancer in women necessitate the urgent implementation and development of policies to prevent and manage lung cancer burden and strategies to reduce exposure to risk factors.
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http://dx.doi.org/10.1002/cam4.4792DOI Listing
June 2022

A cross-sectional multicenter linkage study of hospital admissions and mortality due to methanol poisoning in Iranian adults during the COVID-19 pandemic.

Sci Rep 2022 06 13;12(1):9741. Epub 2022 Jun 13.

Social Determinants of Health Research Center, Shahid Beheshti University of Medical Sciences, Tehran, Iran.

A methanol poisoning outbreak occurred in Iran during the initial months of coronavirus disease 2019 (COVID-19) pandemic. We aimed to evaluate the epidemiology of the outbreak in terms of hospitalizations and deaths. A cross-sectional linkage study was conducted based on the hospitalization data collected from thirteen referral toxicology centers throughout Iran as well as mortality data obtained from the Iranian Legal Medicine Organization (LMO). Patient data were extracted for all cases aged > 19 years with toxic alcohol poisoning during the study period from February until June 2020. A total of 795 patients were hospitalized due to methanol poisoning, of whom 84 died. Median [interquartile ratio; IQR] age was 32 [26, 40] years (range 19-91 years). Patients had generally ingested alcohol for recreational motives (653, 82.1%) while 3.1% (n = 25) had consumed alcohol-based hand sanitizers to prevent or cure COVID-19 infection. Age was significantly lower in survivors than in non-survivors (P < 0.001) and in patients without sequelae vs. with sequelae (P = 0.026). Twenty non-survivors presented with a Glasgow Coma Scale (GCS) score > 8, six of whom were completely alert on presentation to the emergency departments. The time from alcohol ingestion to hospital admission was not significantly different between provinces. In East Azerbaijan province, where hemodialysis was started within on average 60 min of admission, the rate of sequelae was 11.4% (compared to 19.6% average of other provinces)-equivalent to a reduction of the odds of sequelae by 2.1 times [95% CI 1.2, 3.7; p = 0.009]. Older patients were more prone to fatal outcome and sequelae, including visual disturbances. Early arrival at the hospital can facilitate timely diagnosis and treatment and may reduce long-term morbidity from methanol poisoning. Our data thus suggest the importance of raising public awareness of the risks and early symptoms of methanol intoxication.
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http://dx.doi.org/10.1038/s41598-022-14007-1DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC9189800PMC
June 2022

Assessing the effect of socioeconomic factors on prevalence of dyslipidemia among iranian adult population; district level analysis from 2016 STEPS national study using small area estimation.

J Diabetes Metab Disord 2022 Jun 5;21(1):647-655. Epub 2022 Apr 5.

Non-Communicable Diseases Research Center, Endocrinology and Metabolism Population Sciences Institute, Tehran University of Medical Sciences, Tehran, Iran.

Background: Atherosclerotic Cardiovascular Disease (CVD) is the leading cause of death globally and dyslipidemia plays a critical role in the development of this condition. This study aimed to analyze the potential impact of socioeconomic factors on the prevalence of dyslipidemia at district level in Iran. Understanding these factors is important for development of future risk factor control programs.

Methods: We used the nationwide Iran STEPwise approach to risk factor Surveillance (STEPS) 2016 survey as a representative dataset on the Non-Communicable Diseases (NCDs) risk factors in Iran. To obtain a district level dyslipidemia estimates, we utilized the small area estimation method with a Bayesian spatial hierarchical multilevel regression and multilevel mixed models. The principal component analysis was applied to derive household wealth index. For evaluation of education, successful years of schooling was calculated at district level. Urbanization ratio was defined as the proportion of residents in the urban area to the urban and rural areas for each district.

Results: The highest difference was found for hypercholesterolemia coverage with 9.11 times difference among the lowest and highest prevalence across the country's district for males. Men with lower income, lower urbanization, and lower education levels had lower values of high-density lipoprotein (HDL) cholesterol, and higher level of hypercholesterolemia, and hypertriglyceridemia (P-value < 0.001). Triglyceride levels were directly correlated with all analyzed socioeconomic factors in both females and males (P-value < 0.001).

Conclusion: We demonstrated that there is an inverse relationship between socioeconomic levels and dyslipidemia indices as populations with higher socioeconomic levels consistently had higher mean dyslipidemia levels. Our findings provide an excellent fundamental framework for healthcare administrators and policymakers to set goals and pursue effective preventive strategies.

Supplementary Information: The online version contains supplementary material available at 10.1007/s40200-022-01027-x.
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http://dx.doi.org/10.1007/s40200-022-01027-xDOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC9167271PMC
June 2022

Safety and immunogenicity of an inactivated virus particle vaccine for SARS-CoV-2, BIV1-CovIran: findings from double-blind, randomised, placebo-controlled, phase I and II clinical trials among healthy adults.

BMJ Open 2022 04 8;12(4):e056872. Epub 2022 Apr 8.

Clinical Trial Center (CTC), Tehran University of Medical Sciences, Tehran, Iran

Objective: Assessing safety and immunogenicity of an inactivated whole virus particle vaccine.

Design: Single-centre, double-blind, randomised, placebo-controlled, phase I (stage I: 18-50, stage II: 51-75 years), phase II (18-75 years) clinical trials.

Setting: 29 December 2020 to 22 April 2021.

Participants: Stage I-phase I: 56 participants; stage II-phase I: 32; phase II: 280.

Intervention: During stage I, participants randomly (3:3:1) received 3 µg, 5 µg vaccine or placebo in a 14-day interval. Participants in stage II received two shots of 5 µg vaccine or placebo (3:1). In phase II, participants received 5 µg vaccine or placebo (4:1) in a 28-day interval.

Primary And Secondary Outcome Measures: Safety assessment and immunogenicity assessment via antibody response and conventional virus neutralisation test (cVNT).

Results: All adverse events (AEs) were mild or moderate and transient in both phase I and phase II, and no AEs of special interest were reported. The seroconversion-rate of neutralising, antireceptor binding-domain (RBD) and anti-spike-glycoprotein (anti-S) antibodies 14-days after second dose of 5 µg vaccine in stage I was 70.8% (95% CI 48.9% to 87.4%), 87.5% (95% CI 67.6% to 97.3%), 91.7% (95% CI 73.0% to 99.0%). The antibody titres increased more among 5 µg than 3 µg. The corresponding rates for 3 µg vaccine were 45.8% (95% CI 25.6% to 67.2%), 54.2% (95% CI 32.8% to 74.5%) and 70.8% (95% CI 48.9% to 87.4%), respectively. In stage II, 100% (95% CI 84.6% to 100%), 86.4% (95% CI 65.1% to 97.1%) and 86.4% (95% CI 65.1% to 97.1%) of participants seroconverted for neutralising, anti-RBD and anti-S antibodies. In phase II, the seroconversion rate of neutralising-antibody was 82.8% (95% CI 77.0% to 87.6%), anti-RBD 77.0% (95% CI 70.7% to 82.6%) and anti-S 79.9% (95% CI 73.8% to 85.1%) on day 42. In the cVNT, the sera at 1/64 times dilution would neutralise SARS-CoV-2 among 91.7%, 77.3% and 82.5% of vaccinated participants in phase I-stage I, phase I-stage II and phase II clinical trials, respectively.

Conclusions: These results support further evaluation of this inactivated whole virus particle vaccine.

Trial Registration Numbers: IRCT20201202049567N1 and IRCT20201202049567N2 for phase I and IRCT20201202049567N3 for phase II.
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http://dx.doi.org/10.1136/bmjopen-2021-056872DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC8995575PMC
April 2022

Trends in Global, Regional, and National Burden and Quality of Care Index for Liver Cancer by Cause from Global Burden of Disease 1990-2019.

Hepatol Commun 2022 07 8;6(7):1764-1775. Epub 2022 Feb 8.

Non-communicable Diseases Research Center, Endocrinology and Metabolism Population Sciences Institute, Tehran University of Medical Sciences, Tehran, Iran.

Despite the tremendous burden of liver cancer and its underlying causes on humankind, there appear to be heterogeneities in coping approaches. The objective of this study was to compare the burden and the quality-of-care of liver cancer by causes among different countries and regions in both sexes and various age groups 1990-2019. Data of liver cancer and underlying causes, including hepatitis B virus (HBV), hepatitis C virus (HCV), alcohol use, nonalcoholic steatohepatitis (NASH), and other causes were obtained from the Global Burden of Diseases 2019. Incidence, prevalence, death, and disability-adjusted life-years (DALYs) were assessed. Principal component analysis was used to combine age-standardized mortality-to-incidence ratio, DALY-to-prevalence ratio, prevalence-to-incidence ratio, and years of life lost-to-years lived with disability into a single proxy named Quality of Care Index (QCI). Globally, the age-standardized incidence, DALYs, and death rates decreased from 1990 to 2019, while the QCI scores increased by 68.5%. The QCI score of liver cancer was from as high as 83.3 in high Sociodemographic Index (SDI) countries to values as low as 26.4 in low SDI countries in 2019. Japan had the highest QCI score (QCI = 100). The age-standardized death rates of liver cancer due to all underlying causes were decreasing during the past 30 years, with the most decrease for HBV. Consistently, the global QCI scores of liver cancer due to HBV, HCV, alcohol use, NASH, and other causes reached 53.5, 61.8, 54.3, 52.9, and 63.7, respectively, in 2019. Conclusion: Although the trends in burden are decreasing and the QCI improved from 1990 to 2019 globally, there is a wide gap between countries. Given the inequities in health care quality, there is an urgent need to address discrimination and bridge the gap.
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http://dx.doi.org/10.1002/hep4.1910DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC9234674PMC
July 2022

Global, regional, and national quality of care of gallbladder and biliary tract cancer: a systematic analysis for the global burden of disease study 1990-2017.

Int J Equity Health 2021 12 18;20(1):259. Epub 2021 Dec 18.

Non-Communicable Diseases Research Center, Endocrinology and Metabolism Population Sciences Institute, Tehran University of Medical Sciences, Tehran, Iran.

Background: To improve health outcomes to their maximum level, defining indices to measure healthcare quality and accessibility is crucial. In this study, we implemented the novel Quality of Care Index (QCI) to estimate the quality and accessibility of care for patients with gallbladder and biliary tract cancer (GBBTC) in 195 countries, 21 Global Burden of Disease (GBD) regions, Socio-demographic Index (SDI) quintiles, and sex groups.

Method: This cross-sectional study extracted estimates on GBBTC burden from the GBD 2017, which presents population-based estimates on GBBTC burden for higher than 15-year-old patients from 1990 to 2017. Four secondary indices indicating quality of care were chosen, comprising Mortality to incidence, Disability-Adjusted Life Year (DALY) to prevalence, prevalence to incidence, and years of life lost (YLL) to years lived with disability (YLD) ratios. Then, the whole dataset was analyzed using Principal Component Analysis to combine the four indices and create a single all-inclusive measure named QCI. The QCI was scaled to the 0-100 range, with 100 indicating the best quality of care among countries. Gender Disparity Ratio (GDR) was defined as the female to male QCI ratio to show gender inequity throughout the regions and countries.

Results: Global QCI score for GBBTC was 33.5 in 2017, which has increased by 29% since 1990. There was a considerable gender disparity in favor of men (GDR = 0.74) in 2017, showing QCI has moved toward gender inequity since 1990 (GDR = 0.85). Quality of care followed a heterogeneous pattern among regions and countries and was positively correlated with the countries' developmental status reflected in SDI (r = 0.7; CI 95%: 0.61-0.76; P value< 0.001). Accordingly, High-income North America (QCI = 72.4) had the highest QCI; whereas, Eastern Sub-Saharan Africa (QCI = 3) had the lowest QCI among regions. Patients aged 45 to 80 had lower QCI scores than younger and older adults. The highest QCI score was for the older than 95 age group (QCI = 54), and the lowest was for the 50-54 age group (QCI = 26.0).

Conclusions: QCI improved considerably from 1990 to 2017; however, it showed heterogeneous distribution and inequity between sex and age groups. In each regional context, plans from countries with the highest QCI and best gender equity should be disseminated and implemented in order to decrease the overall burden of GBBTC.
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http://dx.doi.org/10.1186/s12939-021-01596-yDOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC8684179PMC
December 2021

COVID-19 in patients with diabetes: factors associated with worse outcomes.

J Diabetes Metab Disord 2021 Dec 28;20(2):1605-1614. Epub 2021 Oct 28.

Present Address: Endocrinology and Metabolism Research Center, Endocrinology and Metabolism Clinical Sciences Institute, Tehran University of Medical Sciences, Tehran, Iran.

Purpose: Diabetes is one of the major comorbidities associated with COVID-19. We aimed to determine the clinical and epidemiological factors associated with the mortality of COVID-19 in diabetic patients in Iran, and also the impact of prescribed antiviral and antibiotics on patients' status.

Methods: In this study, we used the national registry of hospitalized patients with Severe Acute Respiratory Syndrome (SARS) Symptoms with diabetes from February 18, 2020, to December 22, 2020. Demographic, clinical features, treatments, concurrent comorbidities, and their associations with mortality and severity outcomes were assessed using logistic regression.

Results: 78,554 diabetic in-patients with SARS symptoms were included from 31 provinces of whom 37,338 were PCR positive for COVID-19. Older age and male gender are associated with COVID-19 mortality in diabetic patients. CVD is the most frequent comorbidity (42%). CVD, kidney disease, liver disease, and COPD are associated comorbidities which increased the risk of mortality. The mortality rate is higher in diabetic patients comparing to patients with no comorbidities, particularly in younger age groups. The frequency of antiviral, and antibiotics in COVID-19 positive patients was 34%, and 31%, respectively. Antibiotic treatment has no association with mortality in COVID-19 patients.

Conclusions: Diabetic patients indicate higher mortality comparing to patients without any underlying comorbidities. Restrict strategies on increasing effective health care utilization must be considered in diabetic patients, especially in those with parallel underlying comorbidities. Regarding the antibiotic resistance issue and the noticeable use of antibiotics in diabetic patients, it is recommended to prioritize an antibiotic guideline prescription in COVID-19 patients for better stewardship by countries.
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http://dx.doi.org/10.1007/s40200-021-00910-3DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC8553287PMC
December 2021

Unmet need for hypercholesterolemia care in 35 low- and middle-income countries: A cross-sectional study of nationally representative surveys.

PLoS Med 2021 10 25;18(10):e1003841. Epub 2021 Oct 25.

Department of Economics & Centre for Modern Indian Studies, University of Goettingen, Göttingen, Germany.

Background: As the prevalence of hypercholesterolemia is increasing in low- and middle-income countries (LMICs), detailed evidence is urgently needed to guide the response of health systems to this epidemic. This study sought to quantify unmet need for hypercholesterolemia care among adults in 35 LMICs.

Methods And Findings: We pooled individual-level data from 129,040 respondents aged 15 years and older from 35 nationally representative surveys conducted between 2009 and 2018. Hypercholesterolemia care was quantified using cascade of care analyses in the pooled sample and by region, country income group, and country. Hypercholesterolemia was defined as (i) total cholesterol (TC) ≥240 mg/dL or self-reported lipid-lowering medication use and, alternatively, as (ii) low-density lipoprotein cholesterol (LDL-C) ≥160 mg/dL or self-reported lipid-lowering medication use. Stages of the care cascade for hypercholesterolemia were defined as follows: screened (prior to the survey), aware of diagnosis, treated (lifestyle advice and/or medication), and controlled (TC <200 mg/dL or LDL-C <130 mg/dL). We further estimated how age, sex, education, body mass index (BMI), current smoking, having diabetes, and having hypertension are associated with cascade progression using modified Poisson regression models with survey fixed effects. High TC prevalence was 7.1% (95% CI: 6.8% to 7.4%), and high LDL-C prevalence was 7.5% (95% CI: 7.1% to 7.9%). The cascade analysis showed that 43% (95% CI: 40% to 45%) of study participants with high TC and 47% (95% CI: 44% to 50%) with high LDL-C ever had their cholesterol measured prior to the survey. About 31% (95% CI: 29% to 33%) and 36% (95% CI: 33% to 38%) were aware of their diagnosis; 29% (95% CI: 28% to 31%) and 33% (95% CI: 31% to 36%) were treated; 7% (95% CI: 6% to 9%) and 19% (95% CI: 18% to 21%) were controlled. We found substantial heterogeneity in cascade performance across countries and higher performances in upper-middle-income countries and the Eastern Mediterranean, Europe, and Americas. Lipid screening was significantly associated with older age, female sex, higher education, higher BMI, comorbid diagnosis of diabetes, and comorbid diagnosis of hypertension. Awareness of diagnosis was significantly associated with older age, higher BMI, comorbid diagnosis of diabetes, and comorbid diagnosis of hypertension. Lastly, treatment of hypercholesterolemia was significantly associated with comorbid hypertension and diabetes, and control of lipid measures with comorbid diabetes. The main limitations of this study are a potential recall bias in self-reported information on received health services as well as diminished comparability due to varying survey years and varying lipid guideline application across country and clinical settings.

Conclusions: Cascade performance was poor across all stages, indicating large unmet need for hypercholesterolemia care in this sample of LMICs-calling for greater policy and research attention toward this cardiovascular disease (CVD) risk factor and highlighting opportunities for improved prevention of CVD.
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http://dx.doi.org/10.1371/journal.pmed.1003841DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC8575312PMC
October 2021

How the scientific community responded to the COVID-19 pandemic: A subject-level time-trend bibliometric analysis.

PLoS One 2021 30;16(9):e0258064. Epub 2021 Sep 30.

Non-Communicable Diseases Research Center, Endocrinology and Metabolism Population Sciences Institute, Tehran University of Medical Sciences, Tehran, Iran.

Background: COVID-19 has triggered an avalanche of research publications, the various aspects of which need to be assessed. The objective of this study is to determine the scientific community's response patterns to COVID-19 through a bibliometric analysis of the time-trends, global contribution, international collaboration, open-access provision, science domains of focus, and the behavior of journals.

Methods: The bibliographic records on COVID-19 literature were retrieved from both PubMed and Scopus. The period for searching was set from November 1, 2019, to April 15, 2021. The bibliographic data were coupled with COVID-19 incidence to explore possible association, as well as World Bank indicators and classification of economies.

Results: A total of 159132 records were included in the study. Following the escalation of incidences of COVID-19 in late 2020 and early 2021, the monthly publication count made a new peak in March 2021 at 20505. Overall, 125155 (78.6%) were national, 22548 (14.2%) were bi-national, and 11429 (7.2%) were multi-national. Low-income countries with 928 (66.8%) international publications had the highest percentage of international. The open-access provision decreased from 85.5% in February 2020 to 62.0% in April 2021. As many as 82841 (70.8%) publications were related to health sciences, followed by life sciences 27031 (23.1%), social sciences 20291 (17.3%), and physical sciences 15141 (12.9%). The top three medical subjects in publications were general internal medicine, public health, and infectious diseases with 28.9%, 18.3%, and 12.6% of medical publications, respectively.

Conclusions: The association between the incidence and publication count indicated the scientific community's interest in the ongoing situation and timely response to it. Only one-fifth of publications resulted from international collaboration, which might lead to redundancy without adding significant value. Our study underscores the necessity of policies for attraction of international collaboration and direction of vital funds toward domains of higher priority.
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http://journals.plos.org/plosone/article?id=10.1371/journal.pone.0258064PLOS
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC8483337PMC
October 2021

Evaluation of the effect of fixed speed cameras on speeding behavior among Iranian taxi drivers through telematics monitoring.

Traffic Inj Prev 2021 23;22(7):559-563. Epub 2021 Aug 23.

Non-Communicable Diseases Research Center, Endocrinology and Metabolism Population Sciences Institute, Tehran University of Medical Sciences, Tehran, Iran.

Objective: Installation of speed cameras is a common strategy to reduce over-speeding; however, there is evidence that their efficacy in speed reduction is limited to the proximity of the camera. This study aimed to evaluate driving speeds in relation to the position of cameras among Iranian taxi drivers.

Methods: Speed data were collected from April 2020 to January 2021 via telematics devices (using on-board computer, gyroscope, and GPS) installed on taxis in southern Tehran, Iran. All drivers were males above 20 years of age. Throughout the study, taxi drivers were not changed. Eligible road segments were selected based on: a) not containing any obstacle that would cause speed reduction; b) having ≤5 entry/exit points; c) absence of park and ride or taxi stations; and d) availability of at least 5,000 datapoints. The average speed was compared between the camera- and non-camera zones. Camera zone was defined as the area within 300 meters of the speed cameras.

Results: The telematics system included 2,644,846 datapoints gathered from 50 taxis. Two highways' segments with three lanes in each direction were included: Tehran-Varamin (18 taxis, 18,978 datapoints) and Ghadir (17 taxis, 8,203 datapoints). On both highways, speed was significantly lower in the camera zones (Tehran-Varamin: 84.9 ± 12.2 km/h versus 86.7 ± 13.7 km/h;  = 0.005; Kolmogorov-Smirnov test (KS)  < 0.001/Ghadir: 68.7 ± 13.7 versus 73.1 ± 11.3;  = 0.008; KS  < 0.001), indicating a V-shaped distribution of speed near the position of cameras (Presence of Kangaroo effect). Drivers were more likely to exceed speed limits in the non-camera zones compared to camera zones (Tehran-Varamin: 14.6% versus 8.4%/Ghadir: 23.1% versus 17.3%). This effect of the cameras was consistently observed in a subgroup analysis based on time of day (daytime versus nighttime).

Conclusions: Among Iranian taxi drivers in southern Tehran, average speed was significantly lower in the vicinity of speed cameras, suggesting the presence of camera manipulation. Alternative speed control interventions are required to improve the safety of the taxi service.
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http://dx.doi.org/10.1080/15389588.2021.1957100DOI Listing
October 2021

Knowledge, Attitudes, and Safety Practices About COVID-19 Among High School Students in Iran During the First Wave of the Pandemic.

Front Public Health 2021 4;9:680514. Epub 2021 Aug 4.

Social Determinants of Health Research Center, Shahid Beheshti University of Medical Sciences, Tehran, Iran.

School closures have inevitably deprived students of their traditional source of information. The objective of this study was to determine knowledge, attitudes, and safety practices about COVID-19 among high school students in Iran. This study was conducted from March 24th-April 3rd, 2020. Data were collected via an online-parent-administrative questionnaire. Responses of 704 students were analyzed. Students' mean (SD) knowledge score was 21.5 (4.6) of 30. More than 90% of students knew about the cause of the disease, the routes of transmission, and the most renowned symptoms: dyspnea and cough. Social-and- audiovisual-media were the leading information source. Most students believed that people need to keep safe physical distancing, everyone should isolate themselves upon symptoms onset, people should avoid unnecessary in-person contact with family and friends, and that cities need to go under lockdowns if needed. Students' mean (SD) practice score was 20.2 (2.5) of 24. Most students did not go on a trip, and more than 80% said they would wear facemasks when going outside. High school students' knowledge and safety practices about COVID-19 were somewhat satisfactory, and their attitudes toward the disease were mainly positive. Nevertheless, some witnessed knowledge gaps, negative attitudes, and unsafe practices in the study highlighted the need for targeted education on the pandemic. Social and mass media's significant role and potential could be utilized to battle misinformation and deliver proper knowledge to young adolescents.
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http://dx.doi.org/10.3389/fpubh.2021.680514DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC8371395PMC
August 2021

A global, regional, and national survey on burden and Quality of Care Index (QCI) of hematologic malignancies; global burden of disease systematic analysis 1990-2017.

Exp Hematol Oncol 2021 Feb 8;10(1):11. Epub 2021 Feb 8.

Non-Communicable Diseases Research Center, Endocrinology and Metabolism Population Sciences Institute, Tehran University of Medical Sciences, Tehran, Iran.

Background: Hematologic malignancies (HMs) are a heterogeneous group of cancers that comprise diverse subgroups of neoplasms. So far, despite the major epidemiologic concerns about the quality of care, limited data are available for patients with HMs. Thus, we created a novel measure-Quality of Care Index (QCI)-to appraise the quality of care in different populations.

Methods: The Global Burden of Disease data from 1990 to 2017 applied in our study. We performed a principal component analysis on several secondary indices from the major primary indices, including incidence, prevalence, mortality, years of life lost, years lived with disability, and disability-adjusted life-years (DALYs) to create the QCI, which provides an overall score of 0-100 of the quality of cancer care. We estimated the QCI for each age group on different scales and constructed the gender disparity ratio to evaluate the gender disparity of care in HMs.

Results: Globally, while the overall age-standardized incidence rate of HMs increased from 1990 to 2017, the age-standardized DALYs and death rates decreased during the same period. Across countries, in 2017, Iceland (100), New Zealand (100), Australia (99.9), and China (99.3) had the highest QCI scores for non-Hodgkin lymphoma, multiple myeloma, Hodgkin lymphoma, and leukemia. Conversely, Central African Republic (11.5 and 6.1), Eritrea (9.6), and Mongolia (5.4) had the lowest QCI scores for the mentioned malignancies respectively. Overall, the QCI score was positively associated with higher sociodemographic of nations, and was negatively associated with age advancing.

Conclusions: The QCI provides a robust metric to evaluate the quality of care that empowers policymakers on their responsibility to allocate the resources effectively. We found that there is an association between development status and QCI and gender equity, indicating that instant policy attention is demanded to improve health-care access.
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http://dx.doi.org/10.1186/s40164-021-00198-2DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7869509PMC
February 2021

Improved dynamics of sharing research findings in the COVID-19 epidemic compared with the SARS and Ebola epidemics.

BMC Public Health 2021 01 9;21(1):105. Epub 2021 Jan 9.

Social Determinants of Health Research Center, Shahid Beheshti University of Medical Sciences, Tehran, Iran.

Background: When a new or re-emergent pathogen, such as SARS-CoV-2, causes a major outbreak, rapid access to pertinent research findings is crucial for planning strategies and decision making. We researched whether the speed of sharing research results in the COVID-19 epidemic was higher than the SARS and Ebola epidemics. We also researched whether there is any difference in the most frequent topics investigated before and after the COVID-19, SARS, and Ebola epidemics started.

Methods: We used PubMed database search tools to determine the time-period it took for the number of articles to rise after the epidemics started and the most frequent topics assigned to the articles.

Results: The main results were, first, the rise in the number of articles occurred 6 weeks after the COVID-19 epidemic started whereas, this rise occurred 4 months after the SARS and 7 months after the Ebola epidemics started. Second, etiology, statistics & numerical data, and epidemiology were the three most frequent topics investigated in the COVID-19 epidemic. However, etiology, microbiology, and genetics in the SARS epidemic, and statistics & numerical data, epidemiology, and prevention & control in the Ebola epidemic were more frequently studied compared with other topics. Third, some topics were studied more frequently after the epidemics started.

Conclusions: The speed of sharing results in the COVID-19 epidemic was much higher than the SARS and Ebola epidemics, and that there is a difference in the most frequent articles' topics investigated in these three epidemics. Due to the value of time in controlling epidemics spread, the study highlights the necessity of defining more solutions for rapidly providing pertinent research findings in fighting against the next public health emergency.
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http://dx.doi.org/10.1186/s12889-020-10116-6DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7794630PMC
January 2021

Transcultural Adaptation and Validation of Persian Version of Celiac Disease Questionnaire (CDQ); A Specific Questionnaire to Measure Quality of Life of Iranian Patients.

Galen Med J 2018 19;7:e1106. Epub 2018 May 19.

Gastroenterology and Liver Diseases Research Center, Research Institute for Gastroenterology and Liver Diseases, Shahid Beheshti University of Medical Sciences, Tehran, Iran.

Background: The assessment of health-related quality of life has become an important primary or secondary outcome measure in clinical and epidemiologic studies. The aim of this study was to validate a Persian version of Celiac Disease Questionnaire (CDQ) for Celiac disease (CD) among Iranian patients.

Materials And Methods: The English version of the CDQ adapted to the Persian language by a forward-backward translation by 3 professional bilingual translators (1 medical, 2 nonmedical). The content validity of translated questionnaire were studied by 5 experts who complete the validity form regarding the questionnaire. Then in a pilot study, translated CDQ completed by 81 CD patients who referred to Taleghani Hospital, Tehran. For assessing the validity and reliability of the questionnaire, confirmatory factor analysis and Cronbach's alpha coefficient have been done, using Lisrel and SPSS software.

Results: Of 81 CD patients entered to this study with mean age of 30.54 years old, 71.6% were female. Also, 56.8% were married and 45.7% were high educated. The mean of CDQ total score was 119.18±34. The calculated Cronbach's alpha coefficient for CDQ questionnaire was 0.9. Also, for each subgroups the Cronbach's alpha coefficient were calculated as the following; emotion: 0.92, Social: 0.89, Worries: 0.73, Gastrointestinal: 0.78. Confirmatory factor analysis indicated that all questions could be remain in questionnaire respectively.

Conclusion: The reliability of the Persian version of CDQ was excellent with Cronbach's alpha coefficients and Persian version of CDQ retains the psychometric properties of the original instrument and should be useful to assess outcome in studies and clinical trials involving Iranian patients with CD.
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http://dx.doi.org/10.22086/gmj.v0i0.1106DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC8343596PMC
May 2018
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