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3. Complex adaptive systems-based framework for modeling the health impacts of climate change.

Author

Talukder, Byomkesh, Schubert, Jochen, Tofighi, Mohammadali, Likongwe, Patrick, Choi, Eunice, Mphepo, Gibson, Asgary, Ali, Bunch, Martin, Chiotha, Sosten, Matthew, Richard, Sanders, Brett, Hipel, Keith, vanLoon, Gary, and Orbinski, James

Subjects
Agent-based modeling, Climate change, Clinical public health, Complex adaptive systems, Disaster risk management, Ecological services, Extreme weather, Food security, Health, Infectious disease
Abstract

INTRODUCTION: Climate change is a global phenomenon with far-reaching consequences, and its impact on human health is a growing concern. The intricate interplay of various factors makes it challenging to accurately predict and understand the implications of climate change on human well-being. Conventional methodologies have limitations in comprehensively addressing the complexity and nonlinearity inherent in the relationships between climate change and health outcomes. OBJECTIVES: The primary objective of this paper is to develop a robust theoretical framework that can effectively analyze and interpret the intricate web of variables influencing the human health impacts of climate change. By doing so, we aim to overcome the limitations of conventional approaches and provide a more nuanced understanding of the complex relationships involved. Furthermore, we seek to explore practical applications of this theoretical framework to enhance our ability to predict, mitigate, and adapt to the diverse health challenges posed by a changing climate. METHODS: Addressing the challenges outlined in the objectives, this study introduces the Complex Adaptive Systems (CAS) framework, acknowledging its significance in capturing the nuanced dynamics of health effects linked to climate change. The research utilizes a blend of field observations, expert interviews, key informant interviews, and an extensive literature review to shape the development of the CAS framework. RESULTS AND DISCUSSION: The proposed CAS framework categorizes findings into six key sub-systems: ecological services, extreme weather, infectious diseases, food security, disaster risk management, and clinical public health. The study employs agent-based modeling, using causal loop diagrams (CLDs) tailored for each CAS sub-system. A set of identified variables is incorporated into predictive modeling to enhance the understanding of health outcomes within the CAS framework. Through a combination of theoretical development and practical application, this paper aspires to contribute valuable insights to the interdisciplinary field of climate change and health. Integrating agent-based modeling and CLDs enhances the predictive capabilities required for effective health outcome analysis in the context of climate change. CONCLUSION: This paper serves as a valuable resource for policymakers, researchers, and public health professionals by employing a CAS framework to understand and assess the complex network of health impacts associated with climate change. It offers insights into effective strategies for safeguarding human health amidst current and future climate challenges.

Published
2024

4. Comprehensive review of composition, properties, clinical applications, and future perspectives of calcium-enriched mixture (CEM) cement: a systematic analysis.

Author

Asgary, Saeed, Aram, Mahtab, and Fazlyab, Mahta

Subjects
ROOT canal treatment, ROOT resorption (Teeth), CLINICAL medicine, PULPOTOMY, RESEARCH personnel
Abstract

This review aims to comprehensively explore calcium-enriched mixture (CEM) cement as a crucial biomaterial in dentistry/endodontics. With its growing clinical relevance, there is a need to evaluate its composition, chemical/physical/biological properties, clinical applications, and future perspectives to provide clinicians/researchers with a detailed understanding of its potential in endodontic procedures. Through systematic analysis of available evidence, we assess the advantages/limitations of CEM cement, offering valuable insights for informed decision-making in dental/endodontic practice. Our findings highlight the commendable chemical/physical properties of CEM cement, including handling characteristics, alkalinity, color stability, bioactivity, biocompatibility, sealing ability, and antimicrobial properties. Importantly, CEM cement has shown the potential in promoting regenerative processes, such as dentinogenesis and cementogenesis. It has demonstrated successful outcomes in various clinical applications, including vital pulp therapy techniques, endodontic surgery, open apices management, root resorption/perforation repair, and as an orifice/root canal obturation material. The efficacy and reliability of CEM cement in diverse clinical scenarios underscore its effectiveness in endodontic practice. However, we emphasize the need for well-designed clinical trials with long-term follow-up to further substantiate the full potential of CEM cement. This review serves as a robust reference for researchers/practitioners, offering an in-depth exploration of CEM cement and its multifaceted roles in contemporary dentistry/endodontics. [ABSTRACT FROM AUTHOR]

Published
2024
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5. Comprehensive review of composition, properties, clinical applications, and future perspectives of calcium-enriched mixture (CEM) cement: a systematic analysis

Author

Saeed Asgary, Mahtab Aram, and Mahta Fazlyab

Subjects
Biocompatibility, Calcium-enriched mixture cement, CEM cement, Clinical applications, Endodontics, Pulpotomy, Medical technology, R855-855.5
Abstract

Abstract This review aims to comprehensively explore calcium-enriched mixture (CEM) cement as a crucial biomaterial in dentistry/endodontics. With its growing clinical relevance, there is a need to evaluate its composition, chemical/physical/biological properties, clinical applications, and future perspectives to provide clinicians/researchers with a detailed understanding of its potential in endodontic procedures. Through systematic analysis of available evidence, we assess the advantages/limitations of CEM cement, offering valuable insights for informed decision-making in dental/endodontic practice. Our findings highlight the commendable chemical/physical properties of CEM cement, including handling characteristics, alkalinity, color stability, bioactivity, biocompatibility, sealing ability, and antimicrobial properties. Importantly, CEM cement has shown the potential in promoting regenerative processes, such as dentinogenesis and cementogenesis. It has demonstrated successful outcomes in various clinical applications, including vital pulp therapy techniques, endodontic surgery, open apices management, root resorption/perforation repair, and as an orifice/root canal obturation material. The efficacy and reliability of CEM cement in diverse clinical scenarios underscore its effectiveness in endodontic practice. However, we emphasize the need for well-designed clinical trials with long-term follow-up to further substantiate the full potential of CEM cement. This review serves as a robust reference for researchers/practitioners, offering an in-depth exploration of CEM cement and its multifaceted roles in contemporary dentistry/endodontics.

Published
2024
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8. Road to Resettlement: Understanding Post-disaster Relocation and Resettlement Challenges and Complexities Through a Serious Game

Author

Ali Asgary, Peyman Naeemi, Nilanjana Ganguli, Mohammadali Tofighi, Koorosh Attarian, and Tabata Fioretto

Subjects
Cyclone freddy, Displacement, Malawi, Post disaster recovery, Resettlement, Serious game, Disasters and engineering, TA495
Abstract

Abstract Resettlement and relocation are among the most difficult policies to put into practice, but they may be the best ways to minimize future risks to settlements exposed to natural hazards both before and after disaster events. As climate-related disasters and forced migration become increasingly common worldwide, governments, humanitarian or development actors, and policymakers must now prioritize the implementation of a dignified and effective resettlement program as part of their planning and management responsibilities. Much of this effectiveness depends on the stakeholders and beneficiaries’ understanding and knowledge of the different resettlement phases, culture and customs of affected populations, activities, and the associated implementation challenges, costs, and benefits. Serious games are used in a variety of contexts to increase awareness, train and build capacity in stakeholders and beneficiaries. This article presents a serious game developed to educate practitioners, local agencies, students, and the public to understand the complexities and challenges involved in a successful resettlement. The game is based on a real proposed resettlement project initiated in the Chiradzulu District in southern Malawi after Cyclone Freddy in March 2023, which caused widespread flooding and landslides, forcing some villages to relocate permanently. The progression in the Road to Resettlement Game consists of six primary levels: land and site preparation, housing and livelihood, water, sanitation, and hygiene, health, education, and protection. These levels are meant to be completed in a sequence that adheres to the principles of resettlement. By engaging in the serious table-top board game, players gain an understanding of the resettlement activities, their sequence, and the associated practical (technical and social) and financial challenges.

Published
2024
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9. A Virtual Reality Simulation of a Real Landslide for Education and Training: Case of Chiradzulu, Malawi, 2023 Landslide

Author

Ali Asgary, Ali Hassan, and Tricia Corrin

Subjects
landslide, virtual reality, disaster, hazard, Chiradzulu, Malawi, Environmental sciences, GE1-350
Abstract

Virtual reality (VR) is a promising new educational and training tool in the field of disaster and emergency management, especially for hazards that are not frequent or well known to the public and require spatial and situational understanding. The objective of this paper is to describe an educational VR simulation that was developed based on a landslide that really occurred in Southern Malawi during the March 2023 Cyclone Freddy. The cyclone induced several landslides that caused many casualties and significant damage. The VR simulation framework consisted of four critical steps using Unity3D for the creation of the simulation including data preparation, terrain and environmental modeling, landslide simulation development, and virtual reality interactions. The simulation scenarios were diversified to include three distinct landscapes that can help users learn how factors such as terrain can influence landslide impacts. The VR simulation offers users an intimate, firsthand experience of the landslide’s unfolding and allows users the ability to explore various facets of the landslide phenomena. This VR simulation aims to provide an educational tool to facilitate an in-depth understanding of and interaction with a real-word landslide to learn about the impacts of landslides and how different factors can influence these impacts.

Published
2024
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10. Impact assessment of self-medication on COVID-19 prevalence in Gauteng, South Africa, using an age-structured disease transmission modelling framework

Author

Wisdom S. Avusuglo, Qing Han, Woldegebriel Assefa Woldegerima, Nicola Bragazzi, Ali Asgary, Ali Ahmadi, James Orbinski, Jianhong Wu, Bruce Mellado, and Jude Dzevela Kong

Subjects
COVID-19, Epidemiology, Self-medication, Age-structured, Disease model, Public aspects of medicine, RA1-1270
Abstract

Abstract Objective To assess the impact of self-medication on the transmission dynamics of COVID-19 across different age groups, examine the interplay of vaccination and self-medication in disease spread, and identify the age group most prone to self-medication. Methods We developed an age-structured compartmentalized epidemiological model to track the early dynamics of COVID-19. Age-structured data from the Government of Gauteng, encompassing the reported cumulative number of cases and daily confirmed cases, were used to calibrate the model through a Markov Chain Monte Carlo (MCMC) framework. Subsequently, uncertainty and sensitivity analyses were conducted on the model parameters. Results We found that self-medication is predominant among the age group 15-64 (74.52%), followed by the age group 0-14 (34.02%), and then the age group 65+ (11.41%). The mean values of the basic reproduction number, the size of the first epidemic peak (the highest magnitude of the disease), and the time of the first epidemic peak (when the first highest magnitude occurs) are 4.16499, 241,715 cases, and 190.376 days, respectively. Moreover, we observed that self-medication among individuals aged 15-64 results in the highest spreading rate of COVID-19 at the onset of the outbreak and has the greatest impact on the first epidemic peak and its timing. Conclusion Studies aiming to understand the dynamics of diseases in areas prone to self-medication should account for this practice. There is a need for a campaign against COVID-19-related self-medication, specifically targeting the active population (ages 15-64).

Published
2024
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11. Nonsurgical Endodontic Retreatment of a Cystic Apical Lesion Associated with Root Resorption: A Promising Approach

Author

Saeed Asgary

Subjects
Calcium enriched mixture (CEM) cement, Endodontics, Obturation material, Periapical cyst, Root resorption, Tricalcium silicate, Medicine
Abstract

This case report highlights the successful management of a cystic apical lesion associated with root resorption through nonsurgical endodontic retreatment, utilizing calcium-enriched mixture (CEM) cement as an obturating biomaterial. A 35-year-old woman presented with mild discomfort in the mandibular right first molar (#46), with radiographic evidence of a well-defined radiolucent lesion at the apex of the mesial root. The tooth had a history of previous failed endodontic treatment with poor root canal obturation, indicating internal root resorption. Nonsurgical endodontic retreatment was performed, and the canals were filled/sealed with CEM cement. Follow-up radiographs showed a gradual reduction in the size of the cystic lesion. At 54 months, complete bone healing of the cystic apical lesion was evident. This case report provides clinical evidence supporting the potential efficacy of nonsurgical endodontic retreatment using CEM cement in managing certain cystic apical lesions, offering a promising alternative to traditional surgical enucleation, even in cases with inflammatory root resorption. Further research is needed to validate the long-term efficacy of this approach in larger patient populations.

Published
2024
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13. Mitigating the flood disaster effects through the implementation of knowledge management: A systematic literature review

Author

Maryam Yousefi Mohammadi, Enayat Abbasi, Homayoun Farhadian, and Ali Asgary

Subjects
Knowledge management, Crisis management, Disaster management, Flood disaster, Content analysis, Environmental sciences, GE1-350
Abstract

Climate change is global threat and the world is now facing its outcomes more than the last decades. Climate change has increased the frequency and intensity of flooding among other extreme weather events. The execution of knowledge management in different phases of disaster management can be effective in mitigating damages caused by floods to natural and human environments. The present study identified effective actions to implement the five stages of knowledge management in the stages before, during and after the flood event. For this purpose, a systematic review of sources and qualitative content analysis have been applied to evaluate the published research in four stages of items collection, descriptive analysis, selection and classification, and assessment. According to the findings, the pre-crisis stage requires 13 actions in knowledge creation, 20 actions in knowledge acquisition, 7 actions in knowledge organization and storage, 23 actions in knowledge sharing, and 20 actions in knowledge use and development. The crisis phase requires 12 actions in knowledge sharing and 10 actions in knowledge use. In the post-crisis stage, 5 actions in the knowledge sharing, 11 actions in the knowledge use, and 12 actions in the knowledge evaluation phases have been identified. To prevent and manage the flood crisis, knowledge improvement and management is an effective and necessary aspect that should be considered among the organizations and communities involved in emergency management.

Published
2024
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14. Managing failed vital pulp therapies in mature permanent teeth in a retrospective cohort study, with success and survival rates of managing protocols

Author

Saeed Asgary, Leyla Roghanizadeh, Mohammad Jafar Eghbal, and Alireza Akbarzadeh Baghban

Subjects
Medicine, Science
Abstract

Abstract Despite advancements in vital pulp therapy (VPT), a subset of cases fails to achieve desired outcomes. This study based on a previous large-scale cohort study involving 1257 VPT-treated teeth, aiming to describe the demographic data and clinical characteristics of all failed cases and their management protocols. Clinical records/images of 105 failed cases treated by a single endodontist (2011–2022) were examined, including 10 extracted teeth. Asymptomatic cases with PDL widening received no intervention, while others underwent management protocols, including (selective) RCT and (tampon) re-VPT. These retreatments were assessed for success (defined as radiographic evidence of healing) and survival (characterized by the retention/function of the treated tooth) using Kaplan–Meier analysis. While 51.4% of all initial failures were diagnosed due to symptoms, 48.6% were symptom-free. Notably, failed cases with symptomatic irreversible pulpitis, and apical periodontitis/widened PDL before initial treatment significantly outnumbered asymptomatic cases and normal PDL, respectively (P = 0.001). Moreover, most of the initial failures were observed in teeth with composite resin rather than amalgam restorations (P = 0.002). The success and survival rates for the management protocols were 91.78% and 95.79%, respectively, over an average follow-up period of 36.94 (± 23.30) months. RCT and re-VPT procedures provide successful outcomes for managing unsuccessful VPTs.

Published
2024
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15. Studies from R. Asgary et al Provide New Data on Cervical Cancer (Acceptability and implementation challenges of smartphone-based training of community health nurses for visual inspection with acetic acid in Ghana: mHealth and cervical cancer ...)

Subjects
Medical personnel training, Cervical cancer -- Research, Cancer screening, Otic preparations -- Research, Women's health, Cancer research, Organic acids, Nurses -- Training, Acetic acid, Smart phones, Medical personnel, Women, Editors, Health screening, Smart phone, Health, Women's issues/gender studies
Abstract

2019 AUG 1 (NewsRx) -- By a News Reporter-Staff News Editor at Women's Health Weekly -- Researchers detail new data in Oncology - Cervical Cancer. According to news reporting originating [...]

Published
2019

17. The determinants of COVID-19 case reporting across Africa

Author

Qing Han, Ghislain Rutayisire, Maxime Descartes Mbogning Fonkou, Wisdom Stallone Avusuglo, Ali Ahmadi, Ali Asgary, James Orbinski, Jianhong Wu, and Jude Dzevela Kong

Subjects
case reporting, COVID-19, Africa, determinants of case reporting, generalized additive model, hierarchical clustering on principal component analysis, Public aspects of medicine, RA1-1270
Abstract

BackgroundAccording to study on the under-estimation of COVID-19 cases in African countries, the average daily case reporting rate was only 5.37% in the initial phase of the outbreak when there was little or no control measures. In this work, we aimed to identify the determinants of the case reporting and classify the African countries using the case reporting rates and the significant determinants.MethodsWe used the COVID-19 daily case reporting rate estimated in the previous paper for 54 African countries as the response variable and 34 variables from demographics, socioeconomic, religion, education, and public health categories as the predictors. We adopted a generalized additive model with cubic spline for continuous predictors and linear relationship for categorical predictors to identify the significant covariates. In addition, we performed Hierarchical Clustering on Principal Components (HCPC) analysis on the reporting rates and significant continuous covariates of all countries.Results21 covariates were identified as significantly associated with COVID-19 case detection: total population, urban population, median age, life expectancy, GDP, democracy index, corruption, voice accountability, social media, internet filtering, air transport, human development index, literacy, Islam population, number of physicians, number of nurses, global health security, malaria incidence, diabetes incidence, lower respiratory and cardiovascular diseases prevalence. HCPC resulted in three major clusters for the 54 African countries: northern, southern and central essentially, with the northern having the best early case detection, followed by the southern and the central.ConclusionOverall, northern and southern Africa had better early COVID-19 case identification compared to the central. There are a number of demographics, socioeconomic, public health factors that exhibited significant association with the early case detection.

Published
2024
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21. Outcomes and predictive factors of vital pulp therapy in a large-scale retrospective cohort study over 10 years

Author

Saeed Asgary, Leyla Roghanizadeh, Mohammad Jafar Eghbal, Alireza Akbarzadeh Baghban, Anita Aminoshariae, and Ali Nosrat

Subjects
Medicine, Science
Abstract

Abstract This cohort study evaluated the long-term success/survival of vital pulp therapies (VPTs) after carious pulp exposure in adult teeth. Additionally, factors influencing long-term success were identified. Teeth treated during 2011–2022 in a private clinic were studied with clinical/radiographic follow-ups. Data included patient demographics, tooth specifics, and treatment details. Outcomes were classified as success/failure based on clinical/radiographic findings, with tooth functionality determining the survival rate. Encompassing 1149 patients and 1257 VPT-treated teeth, the average monitoring period was 42.2 months. Overall VPTs’ survival and success rates were 99.1% and 91.6%, respectively. Success rates for 768 direct pulp cappings, 217 miniature pulpotomies, and 272 full pulpotomies were 91.9%, 92.6%, and 90.1%, respectively (P > 0.05). Influencing factors included symptomatic irreversible pulpitis (SIP; HR 1.974, 95% CI 1.242–3.137; P = 0.004), radiographic signs of apical periodontitis (AP; HR 2.983, 95% CI 1.961–4.540; P

Published
2024
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22. Evaluating the Role of Biochanin A in Acetic acid-Induced Colitis in Rats: Involvement of Nitric Oxide Pathway

Author

Mohammad Hosein Farzaei, Atefe Tahani, Mohammad Reza Morovati, Maryam Ghanbari-Movahed, Sedigheh Asgary, and Samira Shirooie

Subjects
biochanin a, ibd, superoxide dismutase, ulcerative colitis, Pharmacy and materia medica, RS1-441
Abstract

Background and objectives: Inflammatory bowel disease (IBD) refers to idiopathic chronic and inflammatory bowel disorders such as ulcerative colitis. Considering the lack of definitive treatment and the side effects of existing drugs, finding efficient compounds is needed. Biochanin A has attracted the attention of researchers due to its wide range of medicinal activities. Until now, no study was conducted to evaluate its effects on colitis. Therefore, the aim of this study was to determine the effect of biochanin A on the nitrogen pathway in rats with acetic acid-induced colitis. Methods: Male rats were divided into five groups: normal group, negative control group, positive control group, and groups receiving biochanin A (10 and 20 mg/kg). Colitis was induced with 4% acetic acid. Next, the samples were evaluated at different macroscopic and microscopic levels, and biochemical test of superoxide dismutase (SOD) and nitric oxide activity was investigated. Results: Macroscopic and microscopic investigations showed that treatment with biochanin A decreased mucosal damage in rats with acetic acid-induced colitis. Biochanin A reduced neutrophil infiltration in the intestinal tissue. It also led to the reduction in nitric oxide and enhancement of SOD in rats. The optimal dose of biochanin A was 20 mg/kg, which had the best effect on reducing inflammation and mucosal lesions in rats. Conclusion: Biochanin A, due to its anti-inflammatory effects by reducing nitric oxide and enhancement of SOD and reducing mucosal damage in rats with acetic acid-induced colitis, can be a useful alternative drug for the prevention or treatment of IBD patients.

Published
2024
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23. Integrating Resilience into Risk Matrices: A Practical Approach to Risk Assessment with Empirical Analysis

Author

Ali Vaezi, Samantha Jones, and Ali Asgary

Subjects
risk assessment, resilience, risk matrix, disaster risk, survey data, decision making, Engineering (General). Civil engineering (General), TA1-2040, Risk in industry. Risk management, HD61
Abstract

The changing and intensifying landscape of global, national, and local disaster risks, driven by socio-political, environmental, and technological shifts, underscores the critical need for risk assessment by international agencies and governments. The Risk Matrix, introduced in 1995, has been widely used for risk assessment in different contexts, lauded for its simplicity and effectiveness. This model relies on the core risk components of consequence and likelihood, making it a favored tool for risk managers. To enhance the precision of risk assessment, various adaptations and extensions of the risk matrix have emerged; while some indirectly address resilience aspects, none explicitly integrate resilience into the matrix. This paper explores the risk matrix and its extensions, advocating for the inclusion of resilience in risk assessment. It introduces an empirical approach to quantify resilience, through a survey targeting small and medium-sized businesses in Southern Ontario, Canada. By developing two types of risk matrices—one with resilience considerations and one without—our work demonstrates how resilience alters risk prioritization, highlighting the importance of preparedness. This research underscores the pivotal role of resilience in risk assessment and urges its explicit integration into risk matrices to enhance accuracy and efficacy. Through practical examples and empirical data, the paper builds a compelling case for the central role of resilience in modern risk assessment practices.

Published
2023
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24. COVID-19 Vaccine Hesitancy and Information Diffusion: An Agent-based Modeling Approach

Author

Naderi, Pooria Taghizadeh, Asgary, Ali, Kong, Jude, Wu, Jianhong, and Taghiyareh, Fattaneh

Subjects
Physics - Physics and Society, Computer Science - Multiagent Systems, Computer Science - Social and Information Networks
Abstract

Despite the unprecedented success in the rapid development of several effective vaccines against the Cov-SARS-2, global vaccination rollout efforts suffer from vaccine distribution inequality and vaccine acceptance, leading to insufficient public immunity provided by the vaccine products. While a major current focus in vaccine acceptance research is how to model and inform vaccine acceptance based on social-demographic parameters, characteristics of vaccine acceptance are not well understood and in particular, it is not known whether and how information diffusion influences vaccine acceptance. This study examines how information diffusion can change vaccine acceptance by developing a comprehensive computational model with an agent-based simulation technique to overcome the modeling and quantification complexity associated with socio-demographics, vaccine types, population statistics, and information diffusion. Our analyses, calibrated by the vaccine acceptance survey data from the provinces and territories of Canada, provide clear evidence that the propagation of information can greatly influence vaccine acceptance rates. The results illustrate that spread of negative messages about the COVID-19 vaccines can cause significant vaccine hesitancy that challenges the goal of a high public immunity provided by the vaccines. Our findings might help solve the vaccine hesitancy problem by focusing more on individuals' opinions and behavior.

Published
2021

25. Successful Management of a Typical Class 3 Invasive Cervical Root Resorption with Modified Pulpotomy: A Case Report.

Author

Asgary, Saeed and Roghanizadeh, Leyla

Subjects
INCISORS, PULPOTOMY, MAXILLA, CALCIUM compounds, ROOT resorption (Teeth), ROOT canal treatment, DENTAL cements
Abstract

Invasive cervical root resorption (ICRR) is a rare and clinically complex condition marked by the progressive loss of dental hard tissues below the junctional epithelium. This case report outlines the management of a 32-year-old female patient presenting with ICRR class 3 affecting a maxillary incisor. Despite the absence of symptoms, the expansive nature of the defect warranted conservative surgical intervention. The procedure involved the surgical removal of inflamed tissues, followed by an ultraconservative modified pulpotomy utilizing calcium-enriched mixture (CEM) cement through a surgical window. The selected intervention is substantiated by its potential benefits, such as minimal removal of tooth structure and the inherent biocompatibility and sealing capabilities of CEM cement. A one-year follow-up revealed arrested resorption, reestablishment of periodontal attachment, and successful esthetic restoration, affirming the efficacy of vital pulp therapy in surgically addressing advanced ICRR. Accurate diagnosis, strategic treatment planning, and a patient-centered approach proved critical in achieving favorable outcomes. [ABSTRACT FROM AUTHOR]

Published
2024
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27. A successful case of maturogenesis by stepwise excavation using calcium-enriched mixture cement

Author

Saeed Asgary and Laleh Alim Marvasti

Subjects
apexogenesis, immature molar tooth, stepwise treatment, calcium-enriched mixture cement, pulp capping, Other systems of medicine, RZ201-999
Abstract

This case report demonstrates the successful induction of apexogenesis in an extensively carious lower right first molar with immature roots through the use of stepwise excavation and calcium-enriched mixture (CEM) cement as an indirect pulp capping material. The patient, an 8-year-old boy, presented with pain and carious pulp exposure. The initial treatment involved removing soft dentin and applying CEM cement as an indirect pulp cap. The patient experienced pain relief after 24 h, and subsequent follow-up appointments showed complete healing and maturation of the tooth. The case highlights the potential of indirect pulp treatment with CEM cement and emphasizes the importance of regenerative biomaterials in promoting healing and dentin bridge formation. Further clinical work and research are recommended to explore the efficacy of this treatment approach.

Published
2023
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29. Generating Simulation-Based Contacts Matrices for Disease Transmission Modelling at Special Settings

Author

Najafabadi, Mahdi M., Asgary, Ali, Tofighi, Mohammadali, and Tofighi, Ghassem

Subjects
Electrical Engineering and Systems Science - Systems and Control
Abstract

Since a significant amount of disease transmission occurs through human-to-human or social contact, understanding who interacts with whom in time and space is essential for disease transmission modeling, prediction, and assessment of prevention strategies in different environments and special settings. Thus, measuring contact mixing patterns, often in the form of a contacts matrix, has been a key component of heterogeneous disease transmission modeling research. Several data collection techniques estimate or calculate a contacts matrix at different geographical scales and population mixes based on surveys and sensors. This paper presents a methodology for generating a contacts matrix by using high fidelity simulations which mimic actual workflow and movements of individuals in time and space. Results of this study show that such simulations can be a feasible, flexible, and reasonable alternative method for estimating social contacts and generating contacts mixing matrices for various settings under different conditions.

Published
2021

31. Study the effect of ion type on the transport properties of implanted tantalum interfaces of multilayer structures

Author

Amir hoshang Ramezani, Somayeh Asgary, and Zhaleh Ebrahiminezhad

Subjects
tantalum thin film, roughness, Physics, QC1-999
Abstract

In this paper, the effect of ion type has been considered to study transport through the structures in which their interfaces have been produced by the ion implantation process. The interfaces are tantalum based and the argon and nitrogen ions have been considered at an energy of 30 keV and in different doses at ambient temperatures. For studying the surface morphology of the ion implanted rough thin films, The Atomic Force Microscopy (AFM) analysis has been used. The average roughness has been determined. Decreasing the transmission probability is the main outcome of the rough interfaces/samples. The results show that the interfaces which have been produced by argon ion implantation are rougher than nitrogen cases. Also, the peak to valley ratio reduces in two cases. Moreover, with increasing nitrogen ion doses, the current density has been reduced as a function of voltage. As it is predicted, the transmission probability decreases because of the rough interfaces which have been generated by ion implantation process. As a consequence of the scattering process (because of the interfacial roughness), the resonant tunneling peak current decreases and also, the peak to valley ratio (PVR) reduces. The samples which were prepared by argon ion implantation were rougher than nitrogen ones. Also, with increasing the nitrogen ion doses, the current density has been decreased as a function of voltage.

Published
2023
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32. Twitter-based gender recognition using transformers

Author

Zahra Movahedi Nia, Ali Ahmadi, Bruce Mellado, Jianhong Wu, James Orbinski, Ali Asgary, and Jude D. Kong

Subjects
bert, electra, gender recognition, levit, roberta, social media, swin transformer, transformers, vit, Biotechnology, TP248.13-248.65, Mathematics, QA1-939
Abstract

Social media contains useful information about people and society that could help advance research in many different areas of health (e.g. by applying opinion mining, emotion/sentiment analysis and statistical analysis) such as mental health, health surveillance, socio-economic inequality and gender vulnerability. User demographics provide rich information that could help study the subject further. However, user demographics such as gender are considered private and are not freely available. In this study, we propose a model based on transformers to predict the user's gender from their images and tweets. The image-based classification model is trained in two different methods: using the profile image of the user and using various image contents posted by the user on Twitter. For the first method a Twitter gender recognition dataset, publicly available on Kaggle and for the second method the PAN-18 dataset is used. Several transformer models, i.e. vision transformers (ViT), LeViT and Swin Transformer are fine-tuned for both of the image datasets and then compared. Next, different transformer models, namely, bidirectional encoders representations from transformers (BERT), RoBERTa and ELECTRA are fine-tuned to recognize the user's gender by their tweets. This is highly beneficial, because not all users provide an image that indicates their gender. The gender of such users could be detected from their tweets. The significance of the image and text classification models were evaluated using the Mann-Whitney U test. Finally, the combination model improved the accuracy of image and text classification models by 11.73 and 5.26% for the Kaggle dataset and by 8.55 and 9.8% for the PAN-18 dataset, respectively. This shows that the image and text classification models are capable of complementing each other by providing additional information to one another. Our overall multimodal method has an accuracy of 88.11% for the Kaggle and 89.24% for the PAN-18 dataset and outperforms state-of-the-art models. Our work benefits research that critically require user demographic information such as gender to further analyze and study social media content for health-related issues.

Published
2023
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33. Leveraging an epidemic–economic mathematical model to assess human responses to COVID-19 policies and disease progression

Author

Wisdom S. Avusuglo, Nicola Bragazzi, Ali Asgary, James Orbinski, Jianhong Wu, and Jude Dzevela Kong

Subjects
Medicine, Science
Abstract

Abstract It is imperative that resources are channelled towards programs that are efficient and cost effective in combating the spread of COVID-19, the disease caused by the Severe Acute Respiratory Syndrome Coronavirus 2 (SARS-CoV-2). This study proposed and analyzed control strategies for that purpose. We developed a mathematical disease model within an optimal control framework that allows us to investigate the best approach for curbing COVID-19 epidemic. We address the following research question: what is the role of community compliance as a measure for COVID-19 control? Analyzing the impact of community compliance of recommended guidelines by health authorities—examples, social distancing, face mask use, and sanitizing—coupled with efforts by health authorities in areas of vaccine provision and effective quarantine—showed that the best intervention in addition to implementing vaccination programs and effective quarantine measures, is the active incorporation of individuals’ collective behaviours, and that resources should also be directed towards community campaigns on the importance of face mask use, social distancing, and frequent sanitizing, and any other collective activities. We also demonstrated that collective behavioral response of individuals influences the disease dynamics; implying that recommended health policy should be contextualized.

Published
2023
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34. Fire Risk Analysis Using the FSES Method in a Educational Hospitals of Qazvin University of Medical Sciences in 2022

Author

Mahshid Asgary, Vida Zaroushani, Mehran Ghalenoei, and Yousef Akbari

Subjects
fire, hospital, safety, risk assessment, nfpa 101 a, Environmental pollution, TD172-193.5
Abstract

Introduction: Fire in hospitals and medical centers can lead to unfortunate and dire accidents due to the immobility of most patients, the presence of expensive medical equipment, and the essential role of hospitals in providing health services to people. This study aims to increase fire safety in a healthcare training center in Qazvin. Material and Methods: The latest NFPA 101A was used for fire risk assessment in seven departments of an educational hospital in Qazvin City in 2021-2022. The study calculated the residential risk factor for residents of each area, examined fire safety parameters and determined their risk factor, calculated the obtained points of the area under evaluation, determined the minimum required points in different areas of fire safety, and estimated the fire risk level. Results: ICU 1 and 2 departments, CCU 1 and 2, central warehouse, pharmacy warehouse, and hospital facilities were selected for fire risk assessment. The ICU building had the best condition with a total fire safety point of 21.1. The facility building, with a total fire safety point of -14.5, was in the worst condition. Conclusion: The results showed the need for more attention from researchers to conduct studies in outdoor environments, in various parts of the country, on development and validation of novel heat stress indices, and on implementation and evaluation of control measures in environments with high heat stress.

Published
2023

35. Complex adaptive systems-based framework for modeling the health impacts of climate change

Author

Byomkesh Talukder, Jochen E. Schubert, Mohammadali Tofighi, Patrick J. Likongwe, Eunice Y. Choi, Gibson Y. Mphepo, Ali Asgary, Martin J. Bunch, Sosten S. Chiotha, Richard Matthew, Brett F. Sanders, Keith W. Hipel, Gary W. vanLoon, and James Orbinski

Subjects
Climate change, Health, Ecological services, Extreme weather, Infectious disease, Food security, Public aspects of medicine, RA1-1270, Meteorology. Climatology, QC851-999
Abstract

Introduction: Climate change is a global phenomenon with far-reaching consequences, and its impact on human health is a growing concern. The intricate interplay of various factors makes it challenging to accurately predict and understand the implications of climate change on human well-being. Conventional methodologies have limitations in comprehensively addressing the complexity and nonlinearity inherent in the relationships between climate change and health outcomes. Objectives: The primary objective of this paper is to develop a robust theoretical framework that can effectively analyze and interpret the intricate web of variables influencing the human health impacts of climate change. By doing so, we aim to overcome the limitations of conventional approaches and provide a more nuanced understanding of the complex relationships involved. Furthermore, we seek to explore practical applications of this theoretical framework to enhance our ability to predict, mitigate, and adapt to the diverse health challenges posed by a changing climate. Methods: Addressing the challenges outlined in the objectives, this study introduces the Complex Adaptive Systems (CAS) framework, acknowledging its significance in capturing the nuanced dynamics of health effects linked to climate change. The research utilizes a blend of field observations, expert interviews, key informant interviews, and an extensive literature review to shape the development of the CAS framework. Results and discussion: The proposed CAS framework categorizes findings into six key sub-systems: ecological services, extreme weather, infectious diseases, food security, disaster risk management, and clinical public health. The study employs agent-based modeling, using causal loop diagrams (CLDs) tailored for each CAS sub-system. A set of identified variables is incorporated into predictive modeling to enhance the understanding of health outcomes within the CAS framework. Through a combination of theoretical development and practical application, this paper aspires to contribute valuable insights to the interdisciplinary field of climate change and health. Integrating agent-based modeling and CLDs enhances the predictive capabilities required for effective health outcome analysis in the context of climate change. Conclusion: This paper serves as a valuable resource for policymakers, researchers, and public health professionals by employing a CAS framework to understand and assess the complex network of health impacts associated with climate change. It offers insights into effective strategies for safeguarding human health amidst current and future climate challenges.

Published
2024
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37. Successful Management of a Rare Distant Endodontic Lesion: A Case Report.

Author

Eghbal, Mohammad Jafar, Parhizkar, Ardavan, and Asgary, Saeed

Subjects
DENTAL radiography, ENDODONTICS, ODONTOGENIC tumors, RARE diseases, COMPUTED tomography, DISEASES, PANORAMIC radiography, DENTAL pulp cavities, REOPERATION, MANDIBLE
Abstract

The current case report aims to document a rare presentation of a distant odontogenic lesion of a 35-year-old male patient with mild clinical discomfort in the mandibular right first molar; exploring the diagnostic and therapeutic intricacies of an uncommon distant endodontic pathosis ultimately resolved through meticulous nonsurgical retreatment. Despite a normal oral examination, diagnostic radiography revealed a suboptimal root canal treatment and apical lesions surrounding mesial- and distal-root apices; including a distinct radiolucency beneath the apex of the second mandibular molar discovered through panoramic radiography, and confirmed via cone-beam computed tomography. In addition, the computed tomography disclosed a previously unreported and unusually large endodontic lesion that extended toward the mandibular canal; highlighting a necessity for the continued exploration of a unique endodontic presentation. A nonsurgical endodontic retreatment led to a remarkable reduction in the radiolucent lesions within one year; emphasizing the significance of comprehensive diagnostic approaches and individualized treatments. [ABSTRACT FROM AUTHOR]

Published
2024
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38. Apical Periodontitis in Vital and Nonvital Teeth: Clinical and Radiographic Features.

Author

Asgary, Saeed, Aminoshariae, Anita, and Wesselink, Paul R.

Subjects
DIABETES complications, DENTAL pulp, CARDIOVASCULAR diseases, PERIAPICAL diseases, TREATMENT effectiveness, PULPOTOMY, ROOT canal treatment, QUALITY assurance, PREGNANCY complications, EARLY diagnosis, PERIODONTITIS, ORAL health, DISEASE complications, SYMPTOMS
Abstract

Apical periodontitis (AP) is a common inflammatory condition predominantly caused by the response of the immune system to microbial invasion within the root canal system. Contrary to conventional perception, AP may occur in vital teeth with inflamed pulp; adding complexity to diagnosis and treatment. AP, due to its frequent lack of symptoms and reliance on radiographic evaluation for detection, often presents diagnostic challenges. In addition, AP pathogenesis involves complex interactions between microbial virulence and host immune response at the cellular and molecular levels. Comprehensive diagnostic procedures, including patient history, clinical examination, and radiographic evaluation, are essential for early detection and necessary intervention, with the recognition of clinical signs and symptoms underscoring the importance of regular dental evaluations. The current review primarily discusses the radiographic and clinical features of AP in vital and non-vital teeth; introducing a new taxonomic classification to improve diagnostic precision and treatment outcomes. Moreover, it proposes different treatment categories/options for the management of AP, based on pulp status as well as clinical and radiographic findings; emphasizing vital pulp therapy and root canal treatment for vital and non-vital teeth with AP, respectively. Furthermore, the global and regional epidemiology of AP is presented, along with its association with systemic health conditions; e.g., cardiovascular diseases, diabetes mellitus, and adverse pregnancy outcomes. Moreover, future research directions are advocated to improve the efficacy and predictability of diagnosis and treatments; paving the path for clinicians in early detection, accurate diagnosis, and effective management of AP to enhance oral health outcomes. [ABSTRACT FROM AUTHOR]

Published
2024
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39. A Virtual Reality Simulation of a Real Landslide for Education and Training: Case of Chiradzulu, Malawi, 2023 Landslide.

Author

Asgary, Ali, Hassan, Ali, and Corrin, Tricia

Subjects
VIRTUAL reality, LANDSLIDES, EMERGENCY management, NATURAL disasters
Abstract

Virtual reality (VR) is a promising new educational and training tool in the field of disaster and emergency management, especially for hazards that are not frequent or well known to the public and require spatial and situational understanding. The objective of this paper is to describe an educational VR simulation that was developed based on a landslide that really occurred in Southern Malawi during the March 2023 Cyclone Freddy. The cyclone induced several landslides that caused many casualties and significant damage. The VR simulation framework consisted of four critical steps using Unity3D for the creation of the simulation including data preparation, terrain and environmental modeling, landslide simulation development, and virtual reality interactions. The simulation scenarios were diversified to include three distinct landscapes that can help users learn how factors such as terrain can influence landslide impacts. The VR simulation offers users an intimate, firsthand experience of the landslide's unfolding and allows users the ability to explore various facets of the landslide phenomena. This VR simulation aims to provide an educational tool to facilitate an in-depth understanding of and interaction with a real-word landslide to learn about the impacts of landslides and how different factors can influence these impacts. [ABSTRACT FROM AUTHOR]

Published
2024
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42. Tampon Pulpotomy: Long-term Successful Results of a Molar with Irreversible Pulpitis and Previous Vital Pulp Therapy Failure.

Author

Asgary, Saeed and Roghanizadeh, Leyla

Subjects
DENTAL pulp diseases, MOLARS, PULPOTOMY, TREATMENT failure, TREATMENT effectiveness
Abstract

Minimally invasive vital pulp therapy (VPT) techniques have become increasingly popular for treating mature permanent teeth with irreversible pulpitis. However, in cases where less invasive VPT approaches, such as miniature pulpotomy, fail to provide symptom relief and desired outcomes, alternative treatment strategies need to be explored. This case report presents the successful application of tampon pulpotomy, a modified full pulpotomy technique, in a vital molar tooth with irreversible pulpitis, after a previous miniature pulpotomy failure. The tampon pulpotomy procedure involved the placement of an endodontic biomaterial (i.e. calcium-enriched mixture cement) over the pulpal wound to stop bleeding and create a favorable environment for pulpal healing/regeneration. The patient was followed up for a period of 10 years, during which the tooth remained asymptomatic, functional, and exhibited normal periodontal ligament. This case report highlights the potential effectiveness of tampon/full pulpotomy as a retreatment option in cases where more conservative VPT techniques have shown limited success, offering a conservative approach to preserve tooth structure and pulpal vitality. [ABSTRACT FROM AUTHOR]

Published
2023
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43. SMS text intervention for uncontrolled hypertension among hypertensive homeless adults in shelter clinics of New York City: protocol for a pragmatic randomised trial study

Author

Gbenga Ogedegbe, Ramin Asgary, Leah Bauder, and Rosanna Naderi

Subjects
Medicine
Abstract

Introduction Uncontrolled hypertension (HTN) is prevalent in persons experiencing homelessness (PEH) and contributes to significant suffering and financial cost. Mobile health approaches such as short messaging service (SMS) texting have led to better control of HTN in the general population. Despite the high utilisation of mobile phones by PEH, SMS texting to support HTN control has not been evaluated among this population. We hypothesise that an SMS testing programme will enhance health communication, information management, outreach and care coordination, and provide behavioural support to address some barriers to HTN management in PEH.Methods and analysis This study will use a mixed-methods study design to address two objectives: First, it will evaluate, in a randomised controlled trial, the efficacy of a 6-month SMS texting strategy vs an attention control on blood pressure reduction and adherence to medications and clinical appointments in 120 adults PEH with uncontrolled HTN. Outcomes will be measured at 0, 2, 4 and 6 months. Second, it will assess patients’ and providers’ acceptability and experience of SMS texting using semistructured interviews with PEH (n=30) and providers (n=10). The study will be conducted in shelter clinics in New York City in collaboration with community organisations. The primary statistical analysis will be on an intention-to-treat basis. The trial results will be reported as comparative summary statistics (difference in response rate or means) with 95% CIs and in accordance with the Consolidated Standards of Reporting Trials (CONSORT). Interviews will be transcribed, coded and analysed using an inductive grounded theory analysis.Ethics and dissemination This study has been approved by the Institutional Review Board (IRB) at George Washington University. Written consent will be obtained from participants. The findings will be disseminated in peer-reviewed journals.Trial registration number NCT05187013.

Published
2023
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44. Estimation of epidemiological parameters and ascertainment rate from early transmission of COVID-19 across Africa

Author

Qing Han, Nicola Bragazzi, Ali Asgary, James Orbinski, Jianhong Wu, and Jude Dzevela Kong

Subjects
COVID-19, ascertainment rate, under-reporting, mathematical model, Africa, Science
Abstract

Country reported case counts suggested a slow spread of SARS-CoV-2 in the initial phase of the COVID-19 pandemic in Africa. Owing to inadequate public awareness, unestablished monitoring practices, limited testing and stigmas, there might exist extensive under-ascertainment of the true number of cases, especially at the beginning of the novel epidemic. We developed a compartmentalized epidemiological model to track the early epidemics in 54 African countries. Data on the reported cumulative number of cases and daily confirmed cases were used to fit the model for the time period with no or little massive national interventions yet in each country. We estimated that the mean basic reproduction number is 2.02 (s.d. 0.7), with a range between 1.12 (Zambia) and 3.64 (Nigeria). The mean overall report rate was estimated to be 5.37% (s.d. 5.71%), with the highest 30.41% in Libya and the lowest 0.02% in São Tomé and Príncipe. An average of 5.46% (s.d. 6.4%) of all infected cases were severe cases and 66.74% (s.d. 17.28%) were asymptomatic ones. The estimated low reporting rates in Africa suggested a clear need for improved reporting and surveillance systems in these countries.

Published
2023
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45. Liver dome hydatid cyst surgery: Laparotomy or thoracotomy?

Author

Manouchehr Aghajanzadeh, Mohammad Reza Asgary, Hosein Hemmati, Ghazaleh Hemmati, and Mohammad Mahdi Asgari

Subjects
laparoscopy, laparotomy, liver hydatid cyst, thoracoscopy, thoracotomy, Medicine
Abstract

Background: The liver is the most common organ of the body that is at risk of getting affected by hydatid cyst (75%). All lobes of the liver can be involved with the formation of hydatid cyst, but the right lobe is more involved than the left lobe. The rate of involvement of liver dome and segments 7 and 8 of the right lobe has not been reported so far, but the best treatment for liver hydatid cyst has been found to be surgery. Materials and Methods: In this study, 240 patients with liver hydatid cyst underwent surgery from 2005 to 2017. In this retrospective study, the variables of gender, age, number of liver cysts, involvement of lobe and segments, simultaneous involvement of liver and lung, laparotomy, thoracotomy, the number of patients referred due to the lack of finding cysts in laparotomy, and surgical complications were analyzed. Results: The results showed that the majority of patients were males with age ranging from 8 to 68 years. Right lobe involvement was observed in most of the patients. About 62 patients showed involvement of liver dome and segments 7 and 8. Therefore, 62 patients underwent thoracotomy according to the criteria introduced and the rest of the patients (n = 178) underwent laparotomy. The results showed that there was a potential for capitonnage in 46 patients in thoracotomy. The pain score was 4–5 according to the VAS criterion. The rate of using analgesic drug did not show significant difference between the two methods. Conclusion: During the manipulation, cysts might be ruptured and give rise to complications such as spread of the disease, shock, and anaphylaxis, which may be followed by legal complaints. Therefore, in order to perform the surgery successfully, a new method along with computed tomography (CT) scan has been introduced in this study, which can be very helpful.

Published
2023
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46. Big data- and artificial intelligence-based hot-spot analysis of COVID-19: Gauteng, South Africa, as a case study

Author

Benjamin Lieberman, Jude Dzevela Kong, Roy Gusinow, Ali Asgary, Nicola Luigi Bragazzi, Joshua Choma, Salah-Eddine Dahbi, Kentaro Hayashi, Deepak Kar, Mary Kawonga, Mduduzi Mbada, Kgomotso Monnakgotla, James Orbinski, Xifeng Ruan, Finn Stevenson, Jianhong Wu, and Bruce Mellado

Subjects
COVID-19, South Africa, Gauteng department of health, Hot-spot, Risk adjusted strategy, Control intervention, Computer applications to medicine. Medical informatics, R858-859.7
Abstract

Abstract The coronavirus disease 2019 (COVID-19) has developed into a pandemic. Data-driven techniques can be used to inform and guide public health decision- and policy-makers. In generalizing the spread of a virus over a large area, such as a province, it must be assumed that the transmission occurs as a stochastic process. It is therefore very difficult for policy and decision makers to understand and visualize the location specific dynamics of the virus on a more granular level. A primary concern is exposing local virus hot-spots, in order to inform and implement non-pharmaceutical interventions. A hot-spot is defined as an area experiencing exponential growth relative to the generalised growth of the pandemic. This paper uses the first and second waves of the COVID-19 epidemic in Gauteng Province, South Africa, as a case study. The study aims provide a data-driven methodology and comprehensive case study to expose location specific virus dynamics within a given area. The methodology uses an unsupervised Gaussian Mixture model to cluster cases at a desired granularity. This is combined with an epidemiological analysis to quantify each cluster’s severity, progression and whether it can be defined as a hot-spot.

Published
2023
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47. Simulation and Application of Parametric Corrections to Improve the Financial Misalignment of the Iranian Pension System

Author

Naeim Shokri, Abbas Assari Arani, ali asgary, Amirhosein Mozayani, and Nematollah Akbari

Subjects
pension system, financial misalignment, impulse response functions, parametric corrections, Economics as a science, HB71-74
Abstract

Aim and Introduction The pension system is of special place in the employment regulations of the private and public sectors of all countries of the world. In addition, pension funds are known as one of the most sensitive and complex financial institutions in today's world, whose main goal is to preserve the livelihood and dignity of people in old age. Pension funds have been created to provide social rights for citizens, and a long-term horizon is one of the main features of such funds. By receiving insurance premiums from the insured and investing the resources gathered in the early years and the so-called youth period of the fund, pension funds provide pensions for retirees during their maturity. The process of maturity of pension funds occurs naturally and if it is accompanied by the aging of the country's population, it will intensify. According to the International Monetary Fund, pension expenditures in the Social Security Organization and the civil serpents' Pension Fund will increase from 5.3% in 2015 to 11% in 2040 and 19.6% of GDP in 2080 and in the future, a large part of the country's budget should be spent on paying pensions. Methodology This study seeks to simulate and apply corrective policies to improve the financial misalignment in the Iranian pension system using dynamic stochastic general equilibrium (DSGE) model based on the overlapping generations (OLG) model. In this regard, impulse response functions were used to examine the effects of the proposed parametric corrections. The DSGE models are stochastic, microeconomic-founded, provide the possibility of dynamic evaluation of parametric changes as well as random changes of exogenous variables of the system, and give inter-temporal optimization of the behavior of economic agents. In addition, the mechanism of intergenerational transfer in the pension funds, can be well evaluated and studied by these models, so it seems to be a suitable tool for studying the effects of demographic parametric changes on the financial balance of pension funds. Findings The results show that positive shocks to the variables of years of service, birth rate, and average years of insurance, the financial misalignment of pension funds decreases. According to the results, linking the retirement age with life expectancy and increasing the years of premium payment can reduce financial misalignment and increase financial stability in the Iranian pension system. Discussion and Conclusion The government's decision to implement reforms in Iran's pension system is essential, taking into account social considerations and the step-by-step nature of these reforms. However, according to our findings, the following policies should be presented to improve the financial imbalance of Iran's pension system: 1. The results of the positive shock analysis to the years of service variable showed that the later retirement of people reduces economic dissatisfaction, and considering the past and projected increase in life expectancy in Iran, increasing the retirement age is justified and logical. According to global experience, the average retirement age should be increased from 60 to 63 years for men and from 55 to 58 years for women (one year for every two years). Also, in the future, it is suggested that the average retirement age be linked to the growth of life expectancy. 2. The analysis results of the positive shock to the birth rate variable showed that the young population reduces the financial imbalance. Therefore, it is necessary to implement policies to encourage birth in the coming years, because the population aging phenomenon will have destructive effects on the stability of the pension system. 3. A positive shock to the average variable of years of insurance has positive effects on reducing the financial imbalance of pension funds. In this regard, it is suggested to change the calculation of pensions in all pension funds, including state, military, and social security organizations, based on the average salary of the last three to five years of employment, which it is currently based on the average of the previous two years.

Published
2022

48. Challenging the Misnomer of Irreversible Pulpitis and Deliberating the Urgent Need for Reclassification of Pulpal Diseases Based on the Efficacy of Vital Pulp Therapies: An Overview of Systematic Reviews.

Author

Asgary, Saeed and Eghbal, Mohammad Jafar

Subjects
DENTAL pulp diseases, MINIMALLY invasive procedures, TREATMENT effectiveness, DENTISTRY
Abstract

Over recent decades, the definition of irreversible pulpitis (IP), as an irrevocable condition of a compromised dental pulp tissue, has forced clinicians towards invasive root canal treatments. However, the current best evidence challenges the alignment between clinical symptoms and the perceived irreversibility of a negotiated dental pulp tissue. In the above-mentioned context, vital pulp therapy (VPT) has emerged as a revolutionary and transformative approach; introducing minimally invasive techniques to sustain pulp vitality in cases of IP. The present paper aimed to rigorously examine the corresponding published systematic reviews to explore the diverse spectrum of VPT modalities and their outcomes in managing IP cases. Besides, the current review seems to have asserted the need to discard the conventional terminology of irreversible pulpitis, based on the effectiveness of VPTs in the achievement of pulp tissue healing within cases clinically diagnosed as IP. [ABSTRACT FROM AUTHOR]

Published
2023
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49. Global age-sex-specific mortality, life expectancy, and population estimates in 204 countries and territories and 811 subnational locations, 1950–2021, and the impact of the COVID-19 pandemic: a comprehensive demographic analysis for the Global Burden of Disease Study 2021

Author

Schumacher, A, Kyu, H, Aali, A, Abbafati, C, Abbas, J, Abbasgholizadeh, R, Abbasi, M, Abbasian, M, Abd ElHafeez, S, Abdelmasseh, M, Abd-Elsalam, S, Abdelwahab, A, Abdollahi, M, Abdoun, M, Abdullahi, A, Abdurehman, A, Abebe, M, Abedi, A, Abegaz, T, Abeldaño Zuñiga, R, Abhilash, E, Abiodun, O, Aboagye, R, Abolhassani, H, Abouzid, M, Abreu, L, Abrha, W, Abrigo, M, Abtahi, D, Abu Rumeileh, S, Abu-Rmeileh, N, Aburuz, S, Abu-Zaid, A, Acuna, J, Adair, T, Addo, I, Adebayo, O, Adegboye, O, Adekanmbi, V, Aden, B, Adepoju, A, Adetunji, C, Adeyeoluwa, T, Adeyomoye, O, Adha, R, Adibi, A, Adikusuma, W, Adnani, Q, Adra, S, Afework, A, Afolabi, A, Afraz, A, Afyouni, S, Afzal, S, Agasthi, P, Aghamiri, S, Agodi, A, Agyemang-Duah, W, Ahinkorah, B, Ahmad, A, Ahmad, D, Ahmad, F, Ahmad, M, Ahmad, T, Ahmadi, K, Ahmadzade, A, Ahmadzade, M, Ahmed, A, Ahmed, H, Ahmed, L, Ahmed, M, Ahmed, S, Ajami, M, Aji, B, Ajumobi, O, Akalu, G, Akara, E, Akinosoglou, K, Akkala, S, Akyirem, S, Al Hamad, H, Al Hasan, S, Al Homsi, A, Al Qadire, M, Ala, M, Aladelusi, T, AL-Ahdal, T, Alalalmeh, S, Al-Aly, Z, Alam, K, Alam, M, Alam, Z, Al-amer, R, Alanezi, F, Alanzi, T, Albashtawy, M, Albataineh, M, Aldridge, R, Alemi, S, Al-Eyadhy, A, Al-Gheethi, A, Alhabib, K, Alhalaiqa, F, Al-Hanawi, M, Ali, A, Ali, B, Ali, H, Ali, M, Ali, R, Ali, S, Ali, Z, Alian Samakkhah, S, Alicandro, G, Alif, S, Aligol, M, Alimi, R, Aliyi, A, Al-Jumaily, A, Aljunid, S, Almahmeed, W, Al-Marwani, S, Al-Maweri, S, Almazan, J, Al-Mekhlafi, H, Almidani, O, Alomari, M, Alonso, N, Alqahtani, J, Alqutaibi, A, Al-Sabah, S, Altaf, A, Al-Tawfiq, J, Altirkawi, K, Alvi, F, Alwafi, H, Al-Worafi, Y, Aly, H, Alzoubi, K, Amare, A, Ameyaw, E, Amhare, A, Amin, T, Amindarolzarbi, A, Aminian Dehkordi, J, Amiri, S, Amu, H, Amugsi, D, Amzat, J, Ancuceanu, R, Anderlini, D, Andrade, P, Andrei, C, Andrei, T, Angappan, D, Anil, A, Anjum, A, Antony, C, Antriyandarti, E, Anuoluwa, I, Anwar, S, Anyasodor, A, Appiah, S, Aqeel, M, Arabloo, J, Arabzadeh Bahri, R, Arab-Zozani, M, Arafat, M, Araújo, A, Aravkin, A, Aremu, A, Ariffin, H, Aripov, T, Armocida, B, Arooj, M, Artamonov, A, Artanti, K, Arulappan, J, Aruleba, I, Aruleba, R, Arumugam, A, Asaad, M, Asgary, S, Ashemo, M, Ashraf, M, Asika, M, Athari, S, Atout, M, Atreya, A, Attia, S, Aujayeb, A, Avan, A, Awotidebe, A, Ayala Quintanilla, B, Ayanore, M, Ayele, G, Ayuso-Mateos, J, Ayyoubzadeh, S, Azadnajafabad, S, Azhar, G, Aziz, S, Azzam, A, Babashahi, M, Babu, A, Badar, M, Badawi, A, Badiye, A, Baghdadi, S, Bagheri, N, Bagherieh, S, Bah, S, Bahadorikhalili, S, Bai, J, Bai, R, Baker, J, Bakkannavar, S, Bako, A, Balakrishnan, S, Balogun, S, Baltatu, O, Bam, K, Banach, M, Bandyopadhyay, S, Banik, B, Banik, P, Bansal, H, Barati, S, Barchitta, M, Bardhan, M, Barker-Collo, S, Barone-Adesi, F, Barqawi, H, Barr, R, Barrero, L, Basharat, Z, Bashir, A, Bashiru, H, Baskaran, P, Basnyat, B, Bassat, Q, Basso, J, Basu, S, Batra, K, Batra, R, Baune, B, Bayati, M, Bayileyegn, N, Beaney, T, Bedi, N, Begum, T, Behboudi, E, Behnoush, A, Beiranvand, M, Bejarano Ramirez, D, Belgaumi, U, Bell, M, Bello, A, Bello, M, Bello, O, Belo, L, Beloukas, A, Bendak, S, Bennett, D, Bensenor, I, Benzian, H, Berezvai, Z, Berman, A, Bermudez, A, Bettencourt, P, Beyene, H, Beyene, K, Bhagat, D, Bhagavathula, A, Bhala, N, Bhalla, A, Bhandari, D, Bhardwaj, N, Bhardwaj, P, Bhargava, A, Bhaskar, S, Bhat, V, Bhatti, G, Bhatti, J, Bhatti, M, Bhatti, R, Bhutta, Z, Bikbov, B, Binmadi, N, Bintoro, B, Biondi, A, Bisignano, C, Bisulli, F, Biswas, A, Biswas, R, Bitaraf, S, Bjørge, T, Bleyer, A, Boampong, M, Bodolica, V, Bodunrin, A, Bolarinwa, O, Bonakdar Hashemi, M, Bonny, A, Bora, K, Bora Basara, B, Borodo, S, Borschmann, R, Botero Carvajal, A, Bouaoud, S, Boudalia, S, Boyko, E, Bragazzi, N, Braithwaite, D, Brenner, H, Britton, G, Browne, A, Brunoni, A, Bulamu, N, Bulto, L, Buonsenso, D, Burkart, K, Burns, R, Burugina Nagaraja, S, Busse, R, Bustanji, Y, Butt, Z, Caetano dos Santos, F, Cai, T, Calina, D, Cámera, L, 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S, Jiang, Heng, Jin, Yingzhao, Jin, Yinzi, Johnson, Olatunji, Jomehzadeh, Nabi, Jones, Darwin Phan, Joo, Tamas, Joseph, Abel, Joseph, Nitin, Joshua, Charity Ehimwenma, Jozwiak, Jacek Jerzy, Jürisson, Mikk, Kaambwa, Billingsley, Kabir, Ali, Kabir, Hannaneh, Kabir, Zubair, Kadashetti, Vidya, Kahe, Farima, Kakodkar, Pradnya Vishal, Kalani, Rizwan, Kalankesh, Leila R, Kaliyadan, Feroze, Kalra, Sanjay, Kamath, Ashwin, Kamireddy, Arun, Kanagasabai, Thanigaivelan, Kandel, Himal, Kanmiki, Edmund Wedam, Kanmodi, Kehinde Kazeem, Kantar, Rami S, Kapoor, Neeti, Karajizadeh, Mehrdad, Karami Matin, Behzad, Karanth, Shama D, Karaye, Ibraheem M, Karim, Asima, Karimi, Hanie, Karimi, Salah Eddin, Karimi Behnagh, Arman, Karkhah, Samad, Karna, Ajit K, Kashoo, Faizan Zaffar, Kasraei, Hengameh, Kassaw, Nigussie Assefa, Kassebaum, Nicholas J, Kassel, Molly B, Katamreddy, Adarsh, Katikireddi, Srinivasa Vittal, Katoto, Patrick DMC, Kauppila, Joonas H, Kaur, Navjot, Kaydi, Neda, Kayibanda, Jeanne Françoise, 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Yiğit, Vahit, Yip, Paul, Yon, Dong Keon, Yonemoto, Naohiro, You, Yuyi, Younis, Mustafa Z, Yu, Chuanhua, Zadey, Siddhesh, Zadnik, Vesna, Zafari, Nima, Zahedi, Mohammad, Zahid, Muhammad Nauman, Zahir, Mazyar, Zakham, Fathiah, Zaki, Nazar, Zakzuk, Josefina, Zamagni, Giulia, Zaman, Burhan Abdullah, Zaman, Sojib Bin, Zamora, Nelson, Zand, Ramin, Zandi, Milad, Zandieh, Ghazal G Z, Zanghì, Aurora, Zare, Iman, Zastrozhin, Mikhail Sergeevich, Zeariya, Mohammed G M, Zeng, Youjie, Zhai, Chunxia, Zhang, Chen, Zhang, Haijun, Zhang, Hongwei, Zhang, Yunquan, Zhang, Zhaofeng, Zhang, Zhenyu, Zhao, Hanqing, Zhao, Yang, Zhao, Yong, Zheng, Peng, Zhong, Chenwen, Zhou, Juexiao, Zhu, Bin, Zhu, Zhaohua, Ziaeefar, Pardis, Zielińska, Magdalena, Zou, Zhiyong, Zumla, Alimuddin, Zweck, Elric, Zyoud, Samer H, Lim, Stephen S, and Murray, Christopher J L

Published
2024

50. Global burden and strength of evidence for 88 risk factors in 204 countries and 811 subnational locations, 1990–2021: a systematic analysis for the Global Burden of Disease Study 2021

Author

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Bhawna, Gupta, Mohak, Gupta, Rahul, Gupta, Rajat Das, Gupta, Rajeev, Gupta, Sapna, Gupta, Veer Bala, Gupta, Vijai Kumar, Gupta, Vivek Kumar, Habibzadeh, Farrokh, Habibzadeh, Parham, Hadaro, Tesfahun Simon, Hadian, Zahra, Haep, Nils, Haghi-Aminjan, Hamed, Haghmorad, Dariush, Hagins, Hailey, Haile, Demewoz, Hailu, Alemayehu, Hajj Ali, Adel, Halboub, Esam S, Halimi, Aram, Hall, Brian J, Haller, Sebastian, Halwani, Rabih, Hamadeh, Randah R, Hamdy, Nadia M, Hameed, Sajid, Hamidi, Samer, Hammoud, Ahmad, Hanif, Asif, Hanifi, Nasrin, Haq, Zaim Anan, Haque, Md Rabiul, Harapan, Harapan, Hargono, Arief, Haro, Josep Maria, Hasaballah, Ahmed I, Hasan, Ikramul, Hasan, Mohammad Jahid, Hasan, S M Mahmudul, Hasani, Hamidreza, Hasanian, Mohammad, Hashmeh, Nadim, Hasnain, Md Saquib, Hassan, Amr, Hassan, Ikrama, Hassan Zadeh Tabatabaei, Mahgol Sadat, Hassani, Shokoufeh, Hassanipour, Soheil, Hassankhani, Hadi, Haubold, Johannes, Havmoeller, Rasmus J, Hay, Simon I, Hebert, Jeffrey J, Hegazi, Omar E, Hegena, 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Iwagami, Masao, Iwu, Chidozie C D, Iwu-Jaja, Chinwe Juliana, J, Vinothini, Jaafari, Jalil, Jacob, Louis, Jacobsen, Kathryn H, Jadidi-Niaragh, Farhad, Jahankhani, Kasra, Jahanmehr, Nader, Jahrami, Haitham, Jain, Akhil, Jain, Nityanand, Jairoun, Ammar Abdulrahman, Jaiswal, Abhishek, Jakovljevic, Mihajlo, Jalilzadeh Yengejeh, Reza, Jamora, Roland Dominic G, Jatau, Abubakar Ibrahim, Javadov, Sabzali, Javaheri, Tahereh, Jayaram, Shubha, Jeganathan, Jayakumar, Jeswani, Bijay Mukesh, Jiang, Heng, Johnson, Catherine O, Jokar, Mohammad, Jomehzadeh, Nabi, Jonas, Jost B, Joo, Tamas, Joseph, Abel, Joseph, Nitin, Joshi, Vivek, Joshua, Charity Ehimwenma, Jozwiak, Jacek Jerzy, Jürisson, Mikk, Kaambwa, Billingsley, Kabir, Ali, Kabir, Zubair, Kadashetti, Vidya, Kahn, Ethan M, Kalani, Rizwan, Kaliyadan, Feroze, Kalra, Sanjay, Kamath, Rajesh, Kanagasabai, Thanigaivelan, Kanchan, Tanuj, Kandel, Himal, Kanmiki, Edmund Wedam, Kanmodi, Kehinde Kazeem, Kansal, Sushil Kumar, Kapner, Daniel John, Kapoor, Neeti, Karagiannidis, Efstratios, Karajizadeh, Mehrdad, Karakasis, Paschalis, Karanth, Shama D, Karaye, Ibraheem M, Karch, André, Karim, Asima, Karimi, Hanie, Karmakar, Shilpi, Kashoo, Faizan Zaffar, Kasraei, Hengameh, Kassahun, Woldeteklehaymanot Dagne, Kassebaum, Nicholas J, Kassel, Molly B, Katikireddi, Srinivasa Vittal, Kauppila, Joonas H, Kawakami, Norito, Kaydi, Neda, Kayode, Gbenga A, Kazemi, Foad, Keiyoro, Peter Njenga, Kemmer, Laura, Kempen, John H, Kerr, Jessica A, Kesse-Guyot, Emmanuelle, Khader, Yousef Saleh, Khafaie, Morteza Abdullatif, Khajuria, Himanshu, Khalaji, Amirmohammad, Khalil, Mariam, Khalilian, Alireza, Khamesipour, Faham, Khan, Asaduzzaman, Khan, M Nuruzzaman, Khan, Maseer, Khan, Mohammad Jobair, Khan, Moien AB, Khanmohammadi, Shaghayegh, Khatab, Khaled, Khatatbeh, Haitham, Khatatbeh, Moawiah Mohammad, Khatib, Mahalaqua Nazli, Khavandegar, Armin, Khayat Kashani, Hamid Reza, Khidri, Feriha Fatima, Khodadoust, Elaheh, Khormali, Moein, Khorrami, Zahra, Khosla, Atulya Aman, Khosrowjerdi, Mahmood, Khreis, Haneen, Khusun, Helda, Kifle, Zemene Demelash, Kim, Kwanghyun, Kim, Min Seo, Kim, Yun Jin, Kimokoti, Ruth W, Kisa, Adnan, Kisa, Sezer, Knibbs, Luke D, Knudsen, Ann Kristin Skrindo, Koh, David S Q, Kolahi, Ali-Asghar, Kompani, Farzad, Kong, Jianqiu, Koren, Gerbrand, Korja, Miikka, Korshunov, Vladimir Andreevich, Korzh, Oleksii, Kosen, Soewarta, Kothari, Nikhil, Koul, Parvaiz A, Koulmane Laxminarayana, Sindhura Lakshmi, Krishan, Kewal, Krishnamoorthy, Vijay, Krishnamoorthy, Yuvaraj, Krishnan, Bindu, Krohn, Kris J, Kuate Defo, Barthelemy, Kucuk Bicer, Burcu, Kuddus, Md Abdul, Kuddus, Mohammed, Kugbey, Nuworza, Kuitunen, Ilari, Kulimbet, Mukhtar, Kulkarni, Vishnutheertha, Kumar, Ashish, Kumar, Nithin, Kumar, Vijay, Kundu, Satyajit, Kurmi, Om P, Kusnali, Asep, Kusuma, Dian, Kutluk, Tezer, La Vecchia, Carlo, Ladan, Muhammad Awwal, Laflamme, Lucie, Lahariya, Chandrakant, Lai, Daphne Teck Ching, Lal, Dharmesh Kumar, Lallukka, Tea, Lám, Judit, Lan, Qing, 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Muhammed, Elmehrath, Ahmed O, Elmeligy, Omar Abdelsadek Abdou, Elshaer, Mohammed, Elsohaby, Ibrahim, Emeto, Theophilus I, Esfandiari, Negin, Eshrati, Babak, Eslami, Majid, Esmaeili, Sayed Vahid, Estep, Kara, Etaee, Farshid, Fabin, Natalia, Fagbamigbe, Adeniyi Francis, Fagbule, Omotayo Francis, Fahimi, Saman, Falzone, Luca, Fareed, Mohammad, Farinha, Carla Sofia e Sá, Faris, MoezAlIslam Ezzat Mahmoud, Faris, Pawan Sirwan, Faro, Andre, Fasina, Folorunso Oludayo, Fatehizadeh, Ali, Fauk, Nelsensius Klau, Fazylov, Timur, Feigin, Valery L, Feng, Xiaoqi, Fereshtehnejad, Seyed-Mohammad, Feroze, Abdullah Hamid, Ferrara, Pietro, Ferrari, Alize J, Ferreira, Nuno, Fetensa, Getahun, Feyisa, Bikila Regassa, Filip, Irina, Fischer, Florian, Fitriana, Ida, Flavel, Joanne, Flohr, Carsten, Flood, David, Flor, Luisa S, Foigt, Nataliya A, Folayan, Morenike Oluwatoyin, Force, Lisa M, Fortuna, Daniela, Foschi, Matteo, Franklin, Richard Charles, Freitas, Alberto, Friedman, Sara D, Fux, Blima, G, Sridevi, 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Maria, Hasaballah, Ahmed I, Hasan, Ikramul, Hasan, Mohammad Jahid, Hasan, S M Mahmudul, Hasani, Hamidreza, Hasanian, Mohammad, Hashmeh, Nadim, Hasnain, Md Saquib, Hassan, Amr, Hassan, Ikrama, Hassan Zadeh Tabatabaei, Mahgol Sadat, Hassani, Shokoufeh, Hassanipour, Soheil, Hassankhani, Hadi, Haubold, Johannes, Havmoeller, Rasmus J, Hay, Simon I, Hebert, Jeffrey J, Hegazi, Omar E, Hegena, Tadele Yohannes, Heidari, Golnaz, Heidari, Mohammad, Helfer, Bartosz, Hemmati, Mehdi, Henson, Claire A, Herbert, Molly E, Herteliu, Claudiu, Heuer, Austin, Hezam, Kamal, Hinneh, Thomas Kwadwo, Hiraike, Yuta, Hoan, Nguyen Quoc, Holla, Ramesh, Hon, Julia, Hoque, Mohammad Enamul, Horita, Nobuyuki, Hossain, Sahadat, Hosseini, Seyed Ehsan, Hosseinzadeh, Hassan, Hosseinzadeh, Mehdi, Hostiuc, Mihaela, Hostiuc, Sorin, Hoven, Hanno, Hsairi, Mohamed, Hsu, Johnathan M, Hu, Chengxi, Huang, Junjie, Huda, Md Nazmul, Hulland, Erin N, Hultström, Michael, Hushmandi, Kiavash, Hussain, Javid, Hussein, Nawfal R, Huynh, Chantal K, Huynh, Hong-Han, Ibitoye, Segun Emmanuel, Idowu, Oluwatope Olaniyi, Ihler, Audrey L, Ikeda, Nayu, Ikuta, Kevin S, Ilesanmi, Olayinka Stephen, Ilic, Irena M, Ilic, Milena D, Imam, Mohammad Tarique, Immurana, Mustapha, Inbaraj, Leeberk Raja, Irham, Lalu Muhammad, Isa, Mustafa Alhaji, Islam, Md Rabiul, Ismail, Faisal, Ismail, Nahlah Elkudssiah, Iso, Hiroyasu, Isola, Gaetano, Iwagami, Masao, Iwu, Chidozie C D, Iwu-Jaja, Chinwe Juliana, J, Vinothini, Jaafari, Jalil, Jacob, Louis, Jacobsen, Kathryn H, Jadidi-Niaragh, Farhad, Jahankhani, Kasra, Jahanmehr, Nader, Jahrami, Haitham, Jain, Akhil, Jain, Nityanand, Jairoun, Ammar Abdulrahman, Jaiswal, Abhishek, Jakovljevic, Mihajlo, Jalilzadeh Yengejeh, Reza, Jamora, Roland Dominic G, Jatau, Abubakar Ibrahim, Javadov, Sabzali, Javaheri, Tahereh, Jayaram, Shubha, Jeganathan, Jayakumar, Jeswani, Bijay Mukesh, Jiang, Heng, Johnson, Catherine O, Jokar, Mohammad, Jomehzadeh, Nabi, Jonas, Jost B, Joo, Tamas, Joseph, Abel, Joseph, Nitin, Joshi, 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Khalilian, Alireza, Khamesipour, Faham, Khan, Asaduzzaman, Khan, M Nuruzzaman, Khan, Maseer, Khan, Mohammad Jobair, Khan, Moien AB, Khanmohammadi, Shaghayegh, Khatab, Khaled, Khatatbeh, Haitham, Khatatbeh, Moawiah Mohammad, Khatib, Mahalaqua Nazli, Khavandegar, Armin, Khayat Kashani, Hamid Reza, Khidri, Feriha Fatima, Khodadoust, Elaheh, Khormali, Moein, Khorrami, Zahra, Khosla, Atulya Aman, Khosrowjerdi, Mahmood, Khreis, Haneen, Khusun, Helda, Kifle, Zemene Demelash, Kim, Kwanghyun, Kim, Min Seo, Kim, Yun Jin, Kimokoti, Ruth W, Kisa, Adnan, Kisa, Sezer, Knibbs, Luke D, Knudsen, Ann Kristin Skrindo, Koh, David S Q, Kolahi, Ali-Asghar, Kompani, Farzad, Kong, Jianqiu, Koren, Gerbrand, Korja, Miikka, Korshunov, Vladimir Andreevich, Korzh, Oleksii, Kosen, Soewarta, Kothari, Nikhil, Koul, Parvaiz A, Koulmane Laxminarayana, Sindhura Lakshmi, Krishan, Kewal, Krishnamoorthy, Vijay, Krishnamoorthy, Yuvaraj, Krishnan, Bindu, Krohn, Kris J, Kuate Defo, Barthelemy, Kucuk Bicer, Burcu, Kuddus, Md 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Abstract

Background: Understanding the health consequences associated with exposure to risk factors is necessary to inform public health policy and practice. To systematically quantify the contributions of risk factor exposures to specific health outcomes, the Global Burden of Diseases, Injuries, and Risk Factors Study (GBD) 2021 aims to provide comprehensive estimates of exposure levels, relative health risks, and attributable burden of disease for 88 risk factors in 204 countries and territories and 811 subnational locations, from 1990 to 2021. Methods: The GBD 2021 risk factor analysis used data from 54 561 total distinct sources to produce epidemiological estimates for 88 risk factors and their associated health outcomes for a total of 631 risk–outcome pairs. Pairs were included on the basis of data-driven determination of a risk–outcome association. Age-sex-location-year-specific estimates were generated at global, regional, and national levels. Our approach followed the comparative risk assessment framework predicated on a causal web of hierarchically organised, potentially combinative, modifiable risks. Relative risks (RRs) of a given outcome occurring as a function of risk factor exposure were estimated separately for each risk–outcome pair, and summary exposure values (SEVs), representing risk-weighted exposure prevalence, and theoretical minimum risk exposure levels (TMRELs) were estimated for each risk factor. These estimates were used to calculate the population attributable fraction (PAF; ie, the proportional change in health risk that would occur if exposure to a risk factor were reduced to the TMREL). The product of PAFs and disease burden associated with a given outcome, measured in disability-adjusted life-years (DALYs), yielded measures of attributable burden (ie, the proportion of total disease burden attributable to a particular risk factor or combination of risk factors). Adjustments for mediation were applied to account for relationships involving risk

Published
2024

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