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The incidence and prevalence of breast cancer in Iraq are alarming. Breast cancer is one of the most common cancers among Iraqi women, and its rates have been steadily increasing over the years. The exact reasons for the high incidence are not yet fully understood, but it is believed to be influenced by a combination of genetic, environmental, and lifestyle factors. The research objectives of this study revolve around two main goals. Firstly, the study aims to establish baseline values for the amount of uranium present in blood samples. Secondly, the study aims to assess the potential relationship between uranium levels in blood and the development of cancer. The investigation includes 16 blood samples from women diagnosed with breast cancer and 20 blood samples from women without breast cancer. The nuclear fission track analysis method using CR-39 solid-state nuclear track detectors will be employed to analyze the uranium contents in women’s cancer blood (CB) samples. The methodology adopted for this study involved utilizing the SPSS program to conduct a comprehensive statistical analysis. The results of the study indicate that there is a variation in uranium concentration among both the patient women and healthy women. The uranium concentration among patient women ranged from 3.259 ppb to 1.918 ppb, while among healthy women, it varied from 2.105 ppb to 0.59 ppb. These findings suggest that there may be a correlation between the presence of certain health issues and higher uranium levels.

Abstract Background Mental health service providers are increasingly interested in patient perspectives. We examined rates and predictors of patient-reported satisfaction and perceived helpfulness in a cross-national general population survey of adults with 12-month DSM-IV disorders who saw a provider for help with their mental health. Methods Data were obtained from epidemiological surveys in the World Mental Health Survey Initiative. Respondents were asked about satisfaction with treatments received from up to 11 different types of providers (very satisfied, satisfied, neither satisfied nor dissatisfied, somewhat dissatisfied, very dissatisfied) and helpfulness of the provider (a lot, some, a little, not at all). We modelled predictors of satisfaction and helpfulness using a dataset of patient-provider observations (n = 5,248). Results Most treatment was provided by general medical providers (37.4%), psychiatrists (18.4%) and psychologists (12.7%). Most patients were satisfied or very satisfied (65.9-87.5%, across provider) and helped a lot or some (64.4-90.3%). Spiritual advisors and healers were most often rated satisfactory and helpful. Social workers in human services settings were rated lowest on both dimensions. Patients also reported comparatively low satisfaction with general medical doctors and psychiatrists/psychologists and found general medical doctors less helpful than other providers. Men and students reported lower levels of satisfaction than women and nonstudents. Respondents with high education reported higher satisfaction and helpfulness than those with lower education. Type of mental disorder was unrelated to satisfaction but in some cases (depression, bipolar spectrum disorder, social phobia) was associated with low perceived helpfulness. Insurance was unrelated to either satisfaction or perceived helpfulness but in some cases was associated with elevated perceived helpfulness for a given level of satisfaction. Conclusions Satisfaction with and perceived helpfulness of treatment varied as a function of type of provider, service setting, mental status, and socio-demographic variables. Invariably, caution is needed in combining data from multiple countries where there are cultural and service delivery variations. Even so, our findings underscore the utility of patient perspectives in treatment evaluation and may also be relevant in efforts to match patients to treatments.

Abstract Objective The standard method of generating disorder‐specific disability scores has lay raters make rankings between pairs of disorders based on brief disorder vignettes. This method introduces bias due to differential rater knowledge of disorders and inability to disentangle the disability due to disorders from the disability due to comorbidities. Methods We propose an alternative, data‐driven, method of generating disorder‐specific disability scores that assesses disorders in a sample of individuals either from population medical registry data or population survey self‐reports and uses Generalized Random Forests (GRF) to predict global (rather than disorder‐specific) disability assessed by clinician ratings or by survey respondent self‐reports. This method also provides a principled basis for studying patterns and predictors of heterogeneity in disorder‐specific disability. We illustrate this method by analyzing data for 16 disorders assessed in the World Mental Health Surveys (n = 53,645). Results Adjustments for comorbidity decreased estimates of disorder‐specific disability substantially. Estimates were generally somewhat higher with GRF than conventional multivariable regression models. Heterogeneity was nonsignificant. Conclusions The results show clearly that the proposed approach is practical, and that adjustment is needed for comorbidities to obtain accurate estimates of disorder‐specific disability. Expansion to a wider range of disorders would likely find more evidence for heterogeneity.

In this study, we aimed to improve the performance of the photovoltaic-thermal (PV/T) system by incorporating phase change material (PCM) into the heat exchanger. A new design for the finned tube heat exchanger layout was introduced, and a comprehensive mathematical model was developed to analyze the heat transfer process and operational efficiency of the PV/T system. The temperature variation of the PV/T system was simulated and validated using real climatic conditions in Baghdad and Tehran. To conduct our analysis, we utilized the OpenFOAM software and enhanced our solver to accurately capture the melting process in the PCM. We also investigated the effects of wind velocity and atmospheric pressure on the performance of the PV/T system. Our findings showed that an increase in wind velocity led to an increase in PV/T efficiency, while an increase in atmospheric pressure resulted in a decrease in efficiency. Additionally, we observed that the Baghdad climate was more sensitive to variations in wind velocity compared to Tehran. In Baghdad and Tehran, the highest obtained water temperatures were 54.3 and 50.1 °C, respectively. Furthermore, a study was conducted to assess the viability of using PV/T (photovoltaic-thermal) technology for hot water production in the Multi-Effect Desalination and Adsorption Desalination cycle. The proposed PV/T system demonstrated an average performance improvement of 26% compared to traditional PV/T systems. During warmer months, the system was capable of producing 0.11 and 0.10 m3/h of potable water per month in Baghdad and Tehran, respectively. Furthermore, the system had the potential to generate 170 and 140 kW h of electricity for the respective cities.

تلخصت الدراسة بدراسة العلاقة بين النشاط البشري السائد في مدينة القاسم ،من خلال التركيز على اهم الانشطة التي تعد المصدر الاساسي لتلوث هواء المنطقة وبين نسب ملوثات الهواء التي تم رصدها ،عن طريق الاسلوب الاحصائي (بيرسون) ، وتفصل الملوثات الى غازات وعناصر ثقيلة ، فالغازات هي (CO2 ، CO ، N2O، CH4، NO2، SO2، C2H6O ، CH3)2C)، C2H5)2O) ، C6H6، C3H9N ، PH3 ، HCN ، HF) ،اما العناصر الثقيلة هي (,Fe pb, Cd, Cu, Cr ,Zn, Ni ) ، أما الانشطة البشرية فقد تنوعت في مدينة القاسم والتي تعد مصدراً لتلوث الهواء فيها ، وفي مقدمتها النقل وعدد المولدات الاهلية (الصغيرة والكبيرة) والافران المخابز ،وعدد المساحات الخضراء المنتشرة ضمن قطاعات المدينة وغيرها من العوامل البشرية ذات التأثير المباشر على تلوث هواء المدينة . ، وانتهت الدراسة بمجموعة من الاستنتاجات والتوصيات التي من شأنها ان تضع حلول مناسبة من اجل التخلص او التقليل من حجم هذه المشكلة .

Abstract Background Mental healthcare is delivered across service sectors that differ in level of specialization and intervention modalities typically offered. Little is known about the perceived helpfulness of the combinations of service sectors that patients use. Methods Respondents 18 + years with 12-month DSM-IV mental or substance use disorders who saw a provider for mental health problems in the year before interview were identified from WHO World Mental Health surveys in 17 countries. Based upon the types of providers seen, patients were grouped into nine mutually exclusive single-sector or multi-sector ‘treatment profiles’. Perceived helpfulness was defined as the patient’s maximum rating of being helped (‘a lot’, ‘some’, ‘a little’ or ‘not at all’) of any type of provider seen in the profile. Logistic regression analysis was used to examine the joint associations of sociodemographics, disorder types, and treatment profiles with being helped ‘a lot’. Results Across all surveys combined, 29.4% (S.E. 0.6) of respondents with a 12-month disorder saw a provider in the past year (N = 3221). Of these patients, 58.2% (S.E. 1.0) reported being helped ‘a lot’. Odds of being helped ‘a lot’ were significantly higher (odds ratios [ORs] = 1.50–1.89) among the 12.9% of patients who used specialized multi-sector profiles involving both psychiatrists and other mental health specialists, compared to other patients, despite their high comorbidities. Lower odds of being helped ‘a lot’ were found among patients who were seen only in the general medical, psychiatrist, or other mental health specialty sectors (ORs = 0.46–0.71). Female gender and older age were associated with increased odds of being helped ‘a lot’. In models stratified by country income group, having 3 or more disorders (high-income countries only) and state-funded health insurance (low/middle-income countries only) were associated with increased odds of being helped ‘a lot’. Conclusions Patients who received specialized, multi-sector care were more likely than other patients to report being helped ‘a lot’. This result is consistent with previous research suggesting that persistence in help-seeking is associated with receiving helpful treatment. Given the nonrandom sorting of patients by types of providers seen and persistence in help-seeking, we cannot discount that selection bias may play some role in this pattern.

Abstract Background Treatment guidelines for generalized anxiety disorder (GAD) are based on a relatively small number of randomized controlled trials and do not consider patient-centered perceptions of treatment helpfulness. We investigated the prevalence and predictors of patient-reported treatment helpfulness for DSM-5 GAD and its two main treatment pathways: encounter-level treatment helpfulness and persistence in help-seeking after prior unhelpful treatment. Methods Data came from community epidemiologic surveys in 23 countries in the WHO World Mental Health surveys. DSM-5 GAD was assessed with the fully structured WHO Composite International Diagnostic Interview Version 3.0. Respondents with a history of GAD were asked whether they ever received treatment and, if so, whether they ever considered this treatment helpful. Number of professionals seen before obtaining helpful treatment was also assessed. Parallel survival models estimated probability and predictors of a given treatment being perceived as helpful and of persisting in help-seeking after prior unhelpful treatment. Results The overall prevalence rate of GAD was 4.5%, with lower prevalence in low/middle-income countries (2.8%) than high-income countries (5.3%); 34.6% of respondents with lifetime GAD reported ever obtaining treatment for their GAD, with lower proportions in low/middle-income countries (19.2%) than high-income countries (38.4%); 3) 70% of those who received treatment perceived the treatment to be helpful, with prevalence comparable in low/middle-income countries and high-income countries. Survival analysis suggested that virtually all patients would have obtained helpful treatment if they had persisted in help-seeking with up to 10 professionals. However, we estimated that only 29.7% of patients would have persisted that long. Obtaining helpful treatment at the person-level was associated with treatment type, comorbid panic/agoraphobia, and childhood adversities, but most of these predictors were important because they predicted persistence rather than encounter-level treatment helpfulness. Conclusions The majority of individuals with GAD do not receive treatment. Most of those who receive treatment regard it as helpful, but receiving helpful treatment typically requires persistence in help-seeking. Future research should focus on ensuring that helpfulness is included as part of the evaluation. Clinicians need to emphasize the importance of persistence to patients beginning treatment.

BackgroundTraumatic events are common globally; however, comprehensive population-based cross-national data on the epidemiology of posttraumatic stress disorder (PTSD), the paradigmatic trauma-related mental disorder, are lacking.MethodsData were analyzed from 26 population surveys in the World Health Organization World Mental Health Surveys. A total of 71 083 respondents ages 18+ participated. The Composite International Diagnostic Interview assessed exposure to traumatic events as well as 30-day, 12-month, and lifetime PTSD. Respondents were also assessed for treatment in the 12 months preceding the survey. Age of onset distributions were examined by country income level. Associations of PTSD were examined with country income, world region, and respondent demographics.ResultsThe cross-national lifetime prevalence of PTSD was 3.9% in the total sample and 5.6% among the trauma exposed. Half of respondents with PTSD reported persistent symptoms. Treatment seeking in high-income countries (53.5%) was roughly double that in low-lower middle income (22.8%) and upper-middle income (28.7%) countries. Social disadvantage, including younger age, female sex, being unmarried, being less educated, having lower household income, and being unemployed, was associated with increased risk of lifetime PTSD among the trauma exposed.ConclusionsPTSD is prevalent cross-nationally, with half of all global cases being persistent. Only half of those with severe PTSD report receiving any treatment and only a minority receive specialty mental health care. Striking disparities in PTSD treatment exist by country income level. Increasing access to effective treatment, especially in low- and middle-income countries, remains critical for reducing the population burden of PTSD.

Urine sample analysis is an efficient technique in order to oversee the internal exposure of radioactive pollutants in the human body. This study aims to assess the uranium levels in urine samples collected from twenty healthy individuals, with an equal distribution of ten males and ten females, residing in Al-Muthanna Governorate in southern Iraq. The fission tracking method was employed in this study to quantify uranium levels in urine samples using the CR-39 nuclear track detector. Urinary uranium levels varied among 0.53 ± 0.07 µg/l and 2.73 ± 0.12 µg/l, with an average of 1.40 ± 0.06 µg/l. Urinary uranium contents are above the ICRP standard median of 0.5 µg/l. Urinary uranium amounts vary with gender, age, and tobacco use behaviors. [ABSTRACT FROM AUTHOR]

In ophthalmology, using fundus images to identify ocular diseases early may pose challenges for clinicians. Manually diagnosing ocular conditions is time-consuming, difficult, and requires experimentation. As a result, technology was created to help computers differentiate between ocular diseases. It is possible to create a system of this type due to different learning algorithms based on visual capabilities. Recent breakthroughs in deep learning and machine learning have led to the development of intelligent systems that improve accuracy and efficiency in classifying eye diseases. The purpose of this study is to conduct a comprehensive survey of modern systems that classify ocular problems using different methods, including pre-trained deep learning networks, using the Ocular Disease Intelligent Recognition (ODIR) dataset. The goal is to build and train a model that can recognize and classify ocular disorders. Previous research indicates the increasing use of deep learning techniques. CNN-based methods have spread widely in this field, compared to traditional manual procedures, due to their outstanding results. The most prominent deep learning techniques are convolutional neural networks (CNNs), recurrent neural networks (RNNs), and various learning methods for increasing and transferring data. The survey highlights the potential of these systems to enhance classification accuracy and sensitivity while addressing challenges such as data availability, interpretability, and integration with clinical practice. [ABSTRACT FROM AUTHOR]

The effective technique of RAD7 has been applied to determine the concentrations of radon and annual effective dose of mineral water samples collected from Iraqi local markets. The results show that the level of radon concentrations in mineral water samples ranged between 0.035 and 0.248 Bq/L with an average value of 0.120 Bq/L. In addition to the annual effective dose ranged from 0.129 to 0.905 ?Sv/y with an average value of 0.440 ?Sv/y. It was found that the mean value of radon concentration and annual effective dose in all the studied mineral water samples were within the acceptable limits according to the International Commission on Radiological Protection (ICRP) and World Health Organization (WHO).

ObjectiveWe investigated the associations between DSM-IV mental disorders and subsequent arthritis onset, with and without mental disorder comorbidity adjustment. We aimed to determine whether specific types of mental disorders and increasing numbers of mental disorders were associated with the onset of arthritis later in life.MethodData were collected using face-to-face household surveys, conducted in 19 countries from different regions of the world (n=52,095). Lifetime prevalence and age at onset of 16 DSM-IV mental disorders were assessed retrospectively with the World Health Organization (WHO) Composite International Diagnostic Interview (WHO-CIDI). Arthritis was assessed by self-report of lifetime history of arthritis and age at onset. Survival analyses estimated the association of initial onset of mental disorders with subsequent onset of arthritis.ResultsAfter adjusting for comorbidity, the number of mood, anxiety, impulse-control, and substance disorders remained significantly associated with arthritis onset showing odds ratios (ORs) ranging from 1.2 to 1.4. Additionally, the risk of developing arthritis increased as the number of mental disorders increased from one to five or more disorders.ConclusionThis study suggests links between mental disorders and subsequent arthritis onset using a large, multi-country dataset. These associations lend support to the idea that it may be possible to reduce the severity of mental disorder-arthritis comorbidity through early identification and effective treatment of mental disorders.

Introduction: Natural radioactivity in the soil is considered a major indicator of radiological contamination. Primordial radionuclides are the main source of natural radioactivity. Natural radioactivity transfers radionuclides into the environment and poses radiation hazards to people's health. Therefore, the present study aimed to determine the radon concentration and surface exhalation rate in soil samples collected from different locations of industrial, agricultural, and residential of Al-Diwaniyah governorate, southern Iraq. Material and Methods: In the present study, five different depths of 0, 10, 20, 30, and 40 cm were taken from each location. The radon concentration and exhalation rate were measured using CR-39 detectors (Pershore Moulding Ltd, UK). The CR-39 detectors were left inside plastic cans with soil samples. The tracks of nuclear particles were recorded using an optical microscope. Results: Results of the present study showed that the radon concentrations in soil samples ranged from 163.58 to 689.89 Bq/m3 with a mean value of 350.64 Bq/m3, while surface exhalation rate was found to be ranged from 0.015 Bq/m2.h to 0.063 Bq/m2.h with an average value of 0.031 Bq/m2.h. The obtained results demonstrated that the radon concentration and exhalation rate decreased with increased depth of soil. Conclusion: Based on the current findings, it was found that radon concentrations in all the examined soil samples were within the acceptable value of 600 Bq/m3, according to the International Commission on Radiological Protection and International Atomic Energy Agency. However, the sample S13 from AL-Hamad village with a mean value of 642.51±22.95 Bq/m3 was an exception.

Objective: The standard method of generating disorder‐specific disability scores has lay raters make rankings between pairs of disorders based on brief disorder vignettes. This method introduces bias due to differential rater knowledge of disorders and inability to disentangle the disability due to disorders from the disability due to comorbidities. Methods: We propose an alternative, data‐driven, method of generating disorder‐specific disability scores that assesses disorders in a sample of individuals either from population medical registry data or population survey self‐reports and uses Generalized Random Forests (GRF) to predict global (rather than disorder‐specific) disability assessed by clinician ratings or by survey respondent self‐reports. This method also provides a principled basis for studying patterns and predictors of heterogeneity in disorder‐specific disability. We illustrate this method by analyzing data for 16 disorders assessed in the World Mental Health Surveys (n = 53,645). Results: Adjustments for comorbidity decreased estimates of disorder‐specific disability substantially. Estimates were generally somewhat higher with GRF than conventional multivariable regression models. Heterogeneity was nonsignificant. Conclusions: The results show clearly that the proposed approach is practical, and that adjustment is needed for comorbidities to obtain accurate estimates of disorder‐specific disability. Expansion to a wider range of disorders would likely find more evidence for heterogeneity. [ABSTRACT FROM AUTHOR]

Abstract Background Specific phobia (SP) is a relatively common disorder associated with high levels of psychiatric comorbidity. Because of its early onset, SP may be a useful early marker of internalizing psychopathology, especially if generalized to multiple situations. This study aimed to evaluate the association of childhood generalized SP with comorbid internalizing disorders. Methods We conducted retrospective analyses of the cross-sectional population-based World Mental Health Surveys using the Composite International Diagnostic Interview. Outcomes were lifetime prevalence, age of onset, and persistence of internalizing disorders; past-month disability; lifetime suicidality; and 12-month serious mental illness. Logistic and linear regressions were used to assess the association of these outcomes with the number of subtypes of childhood-onset (

Background: Radon gas is one of the sources of radiation in nature. It is a radioactive gas whose danger lies in the fact that it can enter the human body through breathing, causing possible lung cancer. Materials and Methods: Radon gas was measured by using the Columbia resin-39 (CR-39) alpha track detectors in 42 locations of different nature industrial, residential, and agricultural and investigated the exhalation rates from surface soil. Results: The results demonstrated that the radon gas concentrations varied from (173.31 to 507.80 Bq /m³) and the average value of the radon exhalation rate in soil was 0.026 Bq /m².h. Conclusion: The results can be used as baseline data to evaluate any changes in the radioactive background level due to human activities. [ABSTRACT FROM AUTHOR]

Radioactive pollution is caused when radioactive materials are deposited in the environment or atmosphere, particularly when their presence is inadvertent, and poses harm to the environment owing to the radioactive decay of the radioactive elements. Exposure to uranium in the workplace or environment can damage cells and increase cancer risk. Uranium, a heavy metal of the actinide family, has negative consequences due to its chemical and radioactive toxicity. The fission-track method with CR-39 evaluated the uranium content in blood samples collected from healthy persons and cancer patients. This method counted the fission tracks in a detector after the nuclear reaction. The data reveal that the lowest value in the group of people with cancer is 1.84±0.36 ppb, while the highest is 2.95±0.32 ppb. This population has an average uranium content of 2.52± 0.32 ppb. The highest result was 1.88± 0.22 ppb, while the lowest was 0.39±0.15 ppb in the healthy group. This population has a mean uranium content of 1.09±0.27 ppb. The statistics show that the uranium content in cancer patients' blood is much higher than that in the blood of healthy individuals. [ABSTRACT FROM AUTHOR]

This study delves into the performance assessment of Photovoltaic Thermal (PV/T) systems under the specific climate conditions prevalent in Tehran, Iran, utilizing a methodical approach that encompasses both experimental and numerical analyses. Central to this investigation is the application of energy and exergy analyses, which are instrumental in elucidating the intricacies of renewable energy integration. This is imperative for advancing towards a sustainable and clean energy paradigm. The focus of this research lies in the theoretical examination of the PV/T system, scrutinizing the influence of pivotal factors such as global radiation, cooling fluid flow rate, ambient temperature, wind speed, and fluid inlet temperature. A bespoke code was developed to meticulously evaluate the system's performance, paying special attention to four distinct fluid inlet temperatures: 25, 37.3, 49.45, and 62°C. Findings from this study reveal a notable trend: an increase in the reduced temperature difference correlates with a decline in thermal efficiency. Optimal thermal efficiency, recorded at 23.3%, was achieved under solar radiation intensity of 996 W/m². The research further highlights the significant role of ambient temperature in influencing heat loss rates from PV/T systems, underscoring the necessity for effective insulation and thermal management strategies. Conversely, it was observed that higher wind speeds contribute to diminished energy efficiency while simultaneously enhancing electrical exergy efficiency. This comprehensive analysis not only augments the existing body of knowledge in the field but also serves as a vital reference for future advancements in the integration of renewable energy systems. [ABSTRACT FROM AUTHOR]

Abstract Background There is evidence that social anxiety disorder (SAD) is a prevalent and disabling disorder. However, most of the available data on the epidemiology of this condition originate from high income countries in the West. The World Mental Health (WMH) Survey Initiative provides an opportunity to investigate the prevalence, course, impairment, socio-demographic correlates, comorbidity, and treatment of this condition across a range of high, middle, and low income countries in different geographic regions of the world, and to address the question of whether differences in SAD merely reflect differences in threshold for diagnosis. Methods Data from 28 community surveys in the WMH Survey Initiative, with 142,405 respondents, were analyzed. We assessed the 30-day, 12-month, and lifetime prevalence of SAD, age of onset, and severity of role impairment associated with SAD, across countries. In addition, we investigated socio-demographic correlates of SAD, comorbidity of SAD with other mental disorders, and treatment of SAD in the combined sample. Cross-tabulations were used to calculate prevalence, impairment, comorbidity, and treatment. Survival analysis was used to estimate age of onset, and logistic regression and survival analyses were used to examine socio-demographic correlates. Results SAD 30-day, 12-month, and lifetime prevalence estimates are 1.3, 2.4, and 4.0% across all countries. SAD prevalence rates are lowest in low/lower-middle income countries and in the African and Eastern Mediterranean regions, and highest in high income countries and in the Americas and the Western Pacific regions. Age of onset is early across the globe, and persistence is highest in upper-middle income countries, Africa, and the Eastern Mediterranean. There are some differences in domains of severe role impairment by country income level and geographic region, but there are no significant differences across different income level and geographic region in the proportion of respondents with any severe role impairment. Also, across countries SAD is associated with specific socio-demographic features (younger age, female gender, unmarried status, lower education, and lower income) and with similar patterns of comorbidity. Treatment rates for those with any impairment are lowest in low/lower-middle income countries and highest in high income countries. Conclusions While differences in SAD prevalence across countries are apparent, we found a number of consistent patterns across the globe, including early age of onset, persistence, impairment in multiple domains, as well as characteristic socio-demographic correlates and associated psychiatric comorbidities. In addition, while there are some differences in the patterns of impairment associated with SAD across the globe, key similarities suggest that the threshold for diagnosis is similar regardless of country income levels or geographic location. Taken together, these cross-national data emphasize the international clinical and public health significance of SAD.

Background: Cross-national variance in smoking prevalence is relatively well documented. The aim of this study is to estimate levels of smoking persistence across 21 countries with a hypothesized inverse relationship between country income level and smoking persistence. Methods: Data from the World Health Organization World Mental Health Survey Initiative were used to estimate cross-national differences in smoking persistence—the proportion of adults who started to smoke and persisted in smoking by the date of the survey. Results: There is large variation in smoking persistence from 25% (Nigeria) to 85% (China), with a random-effects meta-analytic summary estimate of 55% with considerable cross-national variation. (Cochran’s heterogeneity Q statistic = 6845; p < 0.001). Meta-regressions indicated that observed differences are not attributable to differences in country’s income level, age distribution of smokers, or how recent the onset of smoking began within each country. Conclusion: While smoking should remain an important public health issue in any country where smokers are present, this report identifies several countries with higher levels of smoking persistence (namely, China and India).

Rhinophyma is a benign condition characterized by a large, bulbous nose with prominent pores. It is commonly associated with untreated cases of rosacea. The disease can carry a substantial psychological impact that causes patients to seek advice about how to improve their physical appearance. Many treatment options are available for rhinophyma, but there is no standard treatment protocol. Here, we describe the case of a 65-year-old man with a large rhinophyma that caused him cosmetic and psychosocial embarrassment. The condition was treated by surgical excision and bipolar electrocautery. No complications occurred after the procedures, and healing was completed 2 weeks later by secondary intention and reepithelialization. A simple surgical removal using a scalpel to shave off the abnormal tissue with electrocauterization of the bleeding points can be considered as a good treatment option for rhinophyma, as it results in an excellent cosmetic outcome and has short recovery time.