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Background: During the last decades, the role of economic status and wealth-related variables in relation to the mortality and incidence of a wide range of diseases have received increased attention. This study focused on clustering the economic status of a population-based study using partitioning around the medoid (PAM) and then investigating the association between the obtained economic clusters and the incidence of non-communicable diseases (NCDs).Methods: The present study was based on data from Shahrekord Cohort Study (SCS). This study considered nine NCDs, including cardiac disease, myocardial infarction, diabetes, hypertension, stroke, all types of malignancies, chronic lung disease, depression, and obesity, among 7034 participants aged 35 and 70 from the urban population of Sharekord (IRAN) in 2022. Four quantitative and four qualitative variables were used to cluster the economic status. The NbClust package was used to determine the optimal number of clusters, and the K-med package in R software (version 4.2.1) was used for PAM clustering. Descriptive statistics were reported as frequency (%) or median (IQR), and statistical analysis was performed using the Chi square test and Mann-Whitney test in SPSS software (version 19.0). P

Abstract Background Recent research has found that strengthening hip joint stability can considerably affect foot mechanics. The purpose of this study was to determine the effect of short foot exercises (SFEs), combined exercises (CEs), and SFEs with isometric hip abduction (IHA) on navicular drop (ND), static parameters (SP), and postural sway in women with flat foot (FF). Methods This study recruited 45 women with flexible FF. The participants were divided into three groups: the CEs group, who performed a series of strengthening, stretching, and balancing exercises, the SFEs group, and the SFEs with IHA group. The groups carried out their assigned regimens daily for six weeks. ND, SP, and postural sway (center of pressure (CoP) parameters) were measured using the ND test and pedoscan device. The data was analysed using a repeated-measures ANOVA statistical test (p≤0.05). Results The results showed that all three groups decreased in ND, surface, and foot rotation in the post-test compared to the pre-test (P

Abstract Background Sex differences exist in type 2 diabetes (T2D), and androgens have been implicated in the etiology of T2D in a sex-specific manner. We therefore aimed to investigate whether androgens play a role in explaining sex differences in glucose homeostasis and incidence of T2D. Methods We used observational data from the German population-based KORA F4 study (n = 1975, mean age: 54 years, 41% women) and its follow-up examination KORA FF4 (median follow-up 6.5 years, n = 1412). T2D was determined through self-reporting and confirmed by contacting the physicians and/or reviewing the medical charts. Multivariable linear and logistic regression models were employed to explore associations. Mediation analyses were performed to assess direct effects (DE) and indirect effects (IE), and the mediating role of androgens (total testosterone (TT), dehydroepiandrosterone (DHEA), dehydroepiandrosterone-sulfate (DHEAs)) in the association between sex (women vs. men) and glucose- and insulin-related traits (cross-sectional analysis) and incidence of T2D (longitudinal analysis). Results After adjustment for confounders, (model 1: adjusted for age; model 2: model 1 + smoking + alcohol consumption + physical activity), women had lower levels of TT, DHEAs, fasting glucose levels, fasting insulin levels, 2 h-glucose levels and HOMA-IR, compared to men. An inverse association was observed for TT and glucose- and insulin-related traits in men, while a positive association was observed for TT and fasting glucose levels in women. We found a mediatory role of TT on the association of sex with fasting glucose levels (IE: β = 3.08, 95% CI: 2.04, 4.30), fasting insulin levels (IE: β = 0.39, 95% CI:0.30, 0.47), 2 h-glucose levels (IE: β = 12.77, 95% CI: 9.01, 16.03) and HOMA-IR (IE: β = 0.41, 95% CI: 0.33, 0.50). Also, the inconsistent mediatory role of TT was seen on the association of sex with incidence of T2D (DE: 0.12, 95% CI: 0.06, 0.20 and IE: OR = 7.60, 95% CI: 3.43, 24.54). The opposing DE and IE estimates suggest that the association between sex and either glucose homeostasis or the incidence of T2D may differ when TT is considered as a potential mediator, with higher TT levels being beneficial for glucose metabolism or incidence of T2D in men, while in women, detrimental. No mediatory role was observed for either DHEA or DHEAs on glucose homeostasis or the incidence of T2D. Conclusions The dimorphic mediatory role of TT highlights its complex role in metabolic health, contributing differently to the glucose dysregulation and risk of T2D in men and women.

Abstract FADS1 rs174556 polymorphism influences on dietary fats metabolism and type 2 diabetes (T2DM). This study aimed to compare the effect of three oils of sesame, canola and sesame-canola on cardio metabolic factors across genotypes of rs174556 variant in patients with type 2 of diabetes. This study was a randomized triple-blind three-way cross-over clinical trial. 95 Subjects with T2DM replaced their regular dietary oil with sesame oil, canola oil, or sesame-canola oil for three 9-week phases and completed the study. There were three anthropometric measurements, blood sampling and biochemical assessments at the beginning, middle, and at the end of each phase for assessments. Genotyping was conducted using the polymerase chain reaction-restriction fragment length polymorphism (PCR–RFLP) method. In the crude model, there was an interaction between consumed oils and rs174556 variant on serum concentration of Apolipoprotein A-I (ApoA-1). During intake of sesame oil, lower levels of triglycerides (TG) were observed in individuals with TT genotype compared to C allele carriers’ allele, which remained significant in adjusted models. Compared to C allele carrier’s, the people with TT genotype experienced significant increase and decrease in serum levels of HDL and TG, respectively in adjusted models. Also, the subjects who consumed sesame-canola oil had lower serum concentrations of fasting blood glucose than those who received sesame and canola oils, regardless of used oils and genotypes. FADS1 Gene variant (rs174556) might modify cardiometabolic changes following dietary vegetable oils. Larger longitudinal studies especially randomized clinical trials are needed to clarify these associations.

Abstract Background Healthcare providers (HCPs) practice and correct management of suspected malaria (CMSM) are central components of malaria elimination and prevention of re-establishment (POR) in countries in the elimination phase. However, knowledge of malaria surveillance systems and HCPs practices often wanes in countries aiming to eliminate malaria due to the low numbers of cases. The study aimed to implement a valid Simulated Malaria Online Tool (SMOT) for assessment HCP performance in CMSM and POR in a malaria-free area. Methods HCPs were evaluated using SMOT tool based on four criteria including presenting a suspected malaria case for detection of HCPs’ failures in recognition (a), diagnosis (b), appropriate treatment (c), and urgent reporting (d); and compared with simulated patients (SP). Multiple logistic regression analysis was carried out to estimate adjusted odds ratios (ORs) for the risk of HCPs failures. Results The overall failure proportion was 237 (83%), and the majority of failures were in recognition (a). There was no significant difference between the SMOT and SP based on all failure criteria (P > 0.05). The private clinic (93%) and the public specialized clinic (70%) had the highest and lowest failure proportions. After passing the recognition stage (a), the overall failure proportions decreased to 47.8% and 25.0% for total HCPs and infectious disease specialists, respectively. In the final analysis, private sector (AOR = 4.36: 1.25–15.2), not-specialist providers (AOR = 2.84: 1.29–6.25) and HCPs with ≥ 5 years’ experience (AOR = 2.03: 1.01–6.25) increased the risk of failure. Conclusion Findings confirmed the implementation of SMOT tool in settings where malaria transmission is low or interrupted. The tool is able to identify sub-groups of providers needing strengthening, and contributes to the prevention of malaria re-establishment.

In recent years, there has been a notable increase in the application of near-surface mounted fiber-reinforced polymer (FRP) reinforcement in reinforced concrete structures. Nevertheless, there is a discernible disparity in the accessibility of accurate and customize measures for augmenting flexural strength through the use of near-surface mounted (NSM) reinforcement techniques. Although several basic models have been proposed to predict the flexural capacity achievable with this technology, established codes have not yet provided mathematical equations for this specific purpose. This study presents two separate methodologies with the objective of enhancing the development of suitable code provisions. In the first stage, A comprehensive and reliable database has been developed to leverage the predictive accuracy of neural networks in the computation of the flexural capacity of reinforced beams that utilize near-surface mounted reinforcement. Following this, the results obtained from the neural network are employed to construct a linear equation using the group method of data handling (GMDH) technique. The presented equation has been carefully formulated to produce a concise and simple mathematical expression that enables the determination of the flexural strength of a beam on the field. The evaluation of the accuracy and effectiveness of both the neural network and the suggested equation is conducted in accordance with the requirements specified in ACI 440.R2 for externally bonded reinforcements. The neural network's prediction has a mean absolute error of just 5% in comparison to the experimental results and the GMDH equations exhibit a noteworthy level of concurrence with the experimental outcomes, as they display a mean absolute error of 16%.