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Background: Diabetes and hypertension are important non-communicable diseases and their prevalence is important for health authorities. The aim of this study was to determine the predictive precision of the bivariate Logistic Regression (LR) and Artificial Neutral Network (ANN) in concurrent diagnosis of diabetes and hypertension. Methods: This cross-sectional study was performed with 12000 Iranian people in 2013 using stratified- cluster sampling. The research questionnaire included information on hypertension and diabetes and their risk factors. A perceptron ANN with two hidden layers was applied to data. To build a joint LR model and ANN, SAS 9.2 and Matlab software were used. The AUC was used to find the higher accurate model for predicting diabetes and hypertension. Results: The variables of gender, type of cooking oil, physical activity, family history, age, passive smokers and obesity entered to the LR model and ANN. The odds ratios of affliction to both diabetes and hypertension is high in females, users of solid oil, with no physical activity, with positive family history, age of equal or higher than 55, passive smokers and those with obesity. The AUC for LR model and ANN were 0.78 (p=0.039) and 0.86 (p=0.046), respectively. Conclusion: The best model for concurrent affliction to hypertension and diabetes is ANN which has higher accuracy than the bivariate LR model. [ABSTRACT FROM AUTHOR]

Background: Women-headed households are more exposed to social damages than other women. Such condition remarkably influences the women's health-related life quality. The present study is aimed to investigate the effect of an educational intervention in quality of life of women-headed households under protection of Tehran Welfare Organization, in 2015. Methods: In this quasi-experimental study with control group, 180 women-headed households participated. Sampling method was random allocation. Data collection tools were Life Quality standard questionnaire (WHOQOL-BREF) and a researcher-made questionnaire about structures of ecological and educational diagnosis phase of PRECEDE-PROCEED model. Validity and reliability of the questionnaire approved in a primary study. Based on the results obtained from the primary study, the intervention was performed in the case group only. Participants were followed one and three months after intervention. Data were analyzed through SPSS v. 15 software using descriptive and analytical tests. Results: Before intervention no significant difference was observed among the mean scores of life quality, behavioral factors, and knowledge, enabling, and reinforcing factors in the two groups. But, one month and three months after intervention a significant difference was observed between the mean scores of these variables (in five instances p<0.001). Conclusion: Intervention through the PRECEDE-PROCEED model improved the women-headed households' quality of life. The innovation of this study is using such intervention on quality of life in women-headed households for the first time. [ABSTRACT FROM AUTHOR]

Background: The number of failed courses and semesters in students are indicators of their performance. These amounts have zero inflated (ZI) distributions. Using ZI Poisson and negative binomial distributions we can model these count data to find the associated factors and estimate the parameters. This study aims at to investigate the important factors related to the educational performance of students. Methods: This cross-sectional study performed in 2008-2009 at Iran University of Medical Sciences (IUMS) with a population of almost 6000 students, 670 students selected using stratified random sampling. The educational and demographical data were collected using the University records. The study design was approved at IUMS and the students' data kept confidential. The descriptive statistics and ZI Poisson and negative binomial regressions were used to analyze the data. The data were analyzed using STATA. Results: In the number of failed semesters, Poisson and negative binomial distributions with ZI, students' total average and quota system had the most roles. For the number of failed courses, total average, and being in undergraduate or master levels had the most effect in both models. Conclusion: In all models the total average have the most effect on the number of failed courses or semesters. The next important factor is quota system in failed semester and undergraduate and master levels in failed courses. Therefore, average has an important inverse effect on the numbers of failed courses and semester. [ABSTRACT FROM AUTHOR]

Objective:Traffic crashes are multifactorial events caused by human factors, technical issues, and environmental conditions. The present study aimed to determine the role of human factors in traffic crashes in Iran using the proportional odds regression model. Methods:The database of all traffic crashes in Iran in 2010 (n= 592, 168) registered through the “COM.114” police forms was investigated. Human risk factors leading to traffic crashes were determined and the odds ratio (OR) of each risk factor was estimated using an ordinal regression model and adjusted for potential confounding factors such as age, gender, and lighting status within and outside of cities. Results:The drivers’ mean age ± standard deviation was 34.1 ± 14.0 years. The most prevalent risk factors leading to death within cities were disregarding traffic rules and regulations (45%), driver rushing (31%), and alcohol consumption (12.3%). Using the proportional odds regression model, alcohol consumption was the most significant human risk factor in traffic crashes within cities (OR = 6.5, 95% confidence interval [CI], 4.88–8.65) and outside of cities (OR = 1.73, 95% CI, 1.22–3.29). Conclusions:Public health strategies and preventive policies should be focused on more common human risk factors such as disregarding traffic rules and regulations, drivers’ rushing, and alcohol consumption due to their greater population attributable fraction and more intuitive impacts on society. [ABSTRACT FROM PUBLISHER]

Oral feeding difficulties are common in children with cerebral palsy (CP). The effect of oral- motor dysfunction on feeding problems has been proved in several studies. The purpose of the present study was to evaluate the effect of oral sensorimotor stimulations on feeding performance in children with spastic cerebral palsy. A total of 12 children with spastic cerebral palsy underwent 24 sessions of oral-motor stimulations (3 days per week). The effect of the intervention was assessed after the 12 and 24 sessions. Feeding skills were assessed using Oral Motor Assessment Scale (OMAS). Data were analyzed using Friedman test and intra class correlation coefficient (ICC). The results of the study revealed a significant improvement in feeding skills including mouth closure, lip closure on the utensil, lip closure during deglutition, control of the food during swallowing, mastication, straw suction and control of liquid during deglutition. There were more improvement in mouth closure and less in straw suction. This study showed sensorimotor stimulation is useful for the treatment of the feeding problems, but the progress was not perfect. This could be due to the role of the position and cognitive skills in feeding functions. Thus, other strategies should be considered to achieve more improvement in feeding performance. [ABSTRACT FROM AUTHOR]

Background: Quality of life evaluates the general well-being of individuals and it can be considered as one of the important aspects in programming and giving service to disabled people. Blindness is one of the most important kinds of physical disability that has a direct effect on quality of life, so this study aimed to explore how war blindness influences the quality of life. Methods: In this cross-sectional study, data from 71 blind war (Iran-Iraq) veterans in 2010 were collected using the Short Form Health Survey instrument (SF36). Rasch model was fitted by running WINSTEPS software and then item parameter (β ), i.e. difficulty of items, and person parameter (θ), i.e. the ability or attainment level of respondents, were estimated. Results: In a total of 71 cases, 69 cases (97 %) were male with a mean (±SD) age and blindness duration range of 48.97 (±10.655) yrs and 25.74 (±3.692) yrs, respectively. Item difficulty ranged from 2.962 to 4.441. Comparison of the SF36 scores and Rasch measurements showed that standard error of Rasch model estimates in physical and total scores are less than SF36 scores. Conclusion: Due to the advantages and higher accuracy of the Rasch model, using this model can be a good alternative for the traditional models. With due regard to the relative low quality of life of blind war veterans in this study and other similar study, further investigation are recommended to be carried out to this group of society. [ABSTRACT FROM AUTHOR]

Background: The purpose of the present study was to evaluate the psychometric properties (validity and reliability) of the Persian version of the Sustained Auditory Attention Capacity Test in children with attention deficit hyperactivity disorder. Methods: The Persian version of the Sustained Auditory Attention Capacity Test was constructed to assess sustained auditory attention using the method provided by Feniman and colleagues (2007). In this test, comments were provided to assess the child's attentional deficit by determining inattention and impulsiveness error, the total scores of the sustained auditory attention capacity test and attention span reduction index. In the present study for determining the validity and reliability of in both Rey Auditory Verbal Learning test and the Persian version of the Sustained Auditory Attention Capacity Test (SAACT), 46 normal children and 41 children with Attention Deficit Hyperactivity (ADHD), all right-handed and aged between 7 and 11 of both genders, were evaluated. Results: In determining convergent validity, a negative significant correlation was found between the three parts of the Rey Auditory Verbal Learning test (first, fifth, and immediate recall) and all indicators of the SAACT except attention span reduction. By comparing the test scores between the normal and ADHD groups, discriminant validity analysis showed significant differences in all indicators of the test except for attention span reduction (p< 0.001). Conclusion: The Persian version of the Sustained Auditory Attention Capacity test has good validity and reliability, that matches other reliable tests, and it can be used for the identification of children with attention deficits and if they suspected to have Attention Deficit Hyperactivity Disorder. [ABSTRACT FROM AUTHOR]

Background and Aim: Concerning the important role of parents of hearing-impaired children in auditory-verbal therapy, this study mainly focused on preparing a Persian version of the 'Parental needs questionnaire' and analyzing its validity and reliability. Methods: First, the original English version of the questionnaire 'the needs of hearing-impaired Children's Parents in Auditory-Verbal Therapy' translated to Persian, based on the approved translation protocol of International Quality of Life Assessment by world health organization. Then, the Persian version presented to seven experts for validating the content and their feedbacks were applied into the questionnaire. Finally, the questionnaire presented to parents of 51 hearing-impaired children who attend in auditory-verbal therapy, and the collected results were analyzed statistically. Results: The overall mean of content validity index in 32 items of the questionnaire was 0.87. The overall Cronbach's alpha of this questionnaire was 0.86 in the test and 0.99 in the re-test phases. Conclusion: Based on the obtained results, the Persian version of the questionnaire has a satisfactory content validity and reliability and could be used in clinics and medical centers for analysis of parental needs. [ABSTRACT FROM AUTHOR]

Background and Aim: Studies have shown that long-term use of monaural hearing aid in symmetrical hearing losses may lead to physiological changes. In this research, the possibility of plasticity occurrence in bilaterally hearing impaired listeners fitted with only one hearing aid was investigated. Methods: Our study was carried out on 12 elderly listeners with a mean age of 61.92 years who had symmetrical moderate to severe sensory neural hearing loss in both ears. All of the participants had minimum monaural hearing aid experience of 2 years. We used auditory brainstem response (ABR) testing in order to compare absolute latency and amplitude of wave V between the two ears of cases. Air conduction click stimuli were presented monaurally at 80, 90 and 100 dB nHL. Results: Despite the shorter absolute latency of wave V in the fitted ear, no significant difference was found between the two ears (p>0.389). The difference between wave V amplitude of both ears was greater in 90 dB nHL level (p=0.043). Women showed shorter mean latency than men and the mean amplitude of women was greater than men. Significant gender difference was observed in absolute latency of wave V (p<0.037). Conclusion: Our findings indicate that the use of monaural hearing aid in symmetrical hearing losses can induce neural plasticity within auditory brainstem pathways which can be displayed by auditory brainstem response test. [ABSTRACT FROM AUTHOR]

We apply the standard union bound to turbo-coded modulation systems with maximum-likelihood decoding. To illustrate the methodology, we explicitly derive the bounds for the 2-bits/s/Hz 16 QAM system. Generalization of this bound to other turbo-coded modulation systems is straightforward. As in the case of the standard union bound for turbo codes, we expect these bounds to be useful for rather large values of signal-to-noise ratios, i.e., signal-to-noise ratios for which the code rate is smaller than the corresponding cutoff rate. The bound is based on "uniform interleaving" just as its counterpart for standard turbo coding. The derived bound provides a tool for comparing coded modulation schemes having different component codes, interleaver lengths, mappings, etc., using maximum-likelihood decoding. It is also useful in studying the effectiveness of various suboptimal decoding algorithms. The bounding technique is also applicable to other coded-modulation schemes such as serially concatenated coded modulation. Index Terms - Coded modulation, error probability bounds, parallel concatenated codes, turbo-coded modulation, turbo codes.

Introduction: Neonatal hyperbilirubinemia is one of the most important factors affecting the auditory system and can cause sensorineural hearing loss. This study investigated the relationship between behavioral hearing thresholds in children with a history of jaundice and the maximum level of bilirubin concentration in the blood. Materials and Methods: This study was performed on 18 children with a mean age of 5.6 years and with a history of neonatal hyperbilirubinemia. Behavioral hearing thresholds, transient evoked emissions and brainstem evoked responses were evaluated in all children. Results: Six children (33.3%) had normal hearing thresholds and the remaining (66.7%) had some degree of hearing loss. There was no significant relationship (r=-0.28, P=0.09) between the mean total bilirubin levels and behavioral hearing thresholds in all samples. A transient evoked emission was seen only in children with normal hearing thresholds however in eight cases brainstem evoked responses had not detected. Conclusion: Increased blood levels of bilirubin at the neonatal period were potentially one of the causes of hearing loss. There was a lack of a direct relationship between neonatal bilirubin levels and the average hearing thresholds which emphasizes on the necessity of monitoring the various amounts of bilirubin levels. [ABSTRACT FROM AUTHOR]

Background: Early stage gastric cancer diagnosis has ensued different approaches in resection strategies. In order to increase the proportion of cases which have undergone radical resection or have reduced the recurrence rate, different preoperative treatments have introduced. Here, we have verified an active preoperative chemotherapeutic regimen in locally advanced gastric cancer patients. Methods: Forty nine patients who have found eligible to enter this phase 2 trial have treated with oxaliplatin 100 mg/m2 IV, docetaxel 50 mg/m2 IV, plus capecitabine 625 mg/m2 PO (TOX). Clinical staging has been following the first 2 cycles of induction chemotherapy. Patients that have further undergone radical surgery, have evaluated for pathological response rate. Results: Anemia (10.2%), nausea (10.2%) and vomiting (6.1%) were the most frequent grade 3 or 4 adverse effects. Regarding the pathologic staging, 6 patients (12.2%) had complete response (95% CI 3% to 21.4%), 18 of them (36.7%) had partial response (95% CI 23.2% to 50.2%), then 3 patients (6.1%) had stable disease (95% CI 0%-12.8%). Among the patients who had surgery, 22% had pathologic complete response. Conclusion: Preoperative chemotherapeutic regimen of TOX seems to be an active and safe neoadjuvant therapy in non metastatic gastric cancer. It should further be considered with concurrent radiotherapy. [ABSTRACT FROM AUTHOR]

Background and Aim: Preterm birth is one of the risk factors need comprehensive audiological assessment. In this study, the effect of sex and rate of stimulation on response of children with history of preterm birth was investigated by auditory brainstem response (ABR). Methods: This cross-sectional study was conducted using convenience sampling. Click-evoked auditory brainstem response test with both low (21.1 c/s) and high (51.1 c/s) stimulus rates was recorded in 30 children with a history of preterm birth and 30 ones with history of term labor, as controls. Results: Significant differences were observed in inter-peak latencies of I-III in both rates, III-V in the low rate, I-V in the high rate, and absolute latency of III wave between high and low stimulus rates (p<0.05 for all). Rate of stimulus affect on auditory brainstem response of preterm birth group was more than controls. Sex also affected on some parameters of auditory brainstem response test. Conclusion: Preterm birth group showed longer latencies than normal group in both rates. Rate of stimulus had significant effect on results of children with history of preterm birth compared normal group. These findings may reflect the negative effect of preterm birth on neural synchronization function in response to transient stimuli. [ABSTRACT FROM AUTHOR]