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Background Gold standard methods of type 2 diabetes mellitus are expensive and therefore not practical for large scale studies in low‐income countries. We have investigated the total cholesterol, high density lipoprotein (HDL), and glucose (CHG) index for diagnosis of type 2 diabetes mellitus index which is derived from fasting state. In this study we aimed to compare the accuracy of with CHG index and triglycerides (TG) and glucose levels (TyG) as surrogates of type 2 diabetes mellitus. Methods A total of 9,704 individuals between 35 and 65 years of age were recruited as part of the Mashhad stroke and heart atherosclerotic disorder (MASHAD) study. They were categorized into two groups, those with and without type 2 diabetes mellitus. The cut‐off in groups to detection of type 2 diabetes mellitus was fasting blood glucose ≥126 mg/dL in blood sample. Receiver operating characteristic (ROC) curve analysis was used to establish the cut‐off of indices to evaluate the sensitivity and specificity of them. Results The best cut‐off of CHG index for diagnosis of type 2 diabetes mellitus was 5.57 which was associated with a sensitivity of 70.38% and specificity of 89.82% values. This was in comparison to the TyG index. LR+ CHG index was 6.91 compared to 3.47 for the TyG index and the AUC of CHG index was 0.864 (0.857, 0.871) compared with 0.825 (0.818, 0.833) for the TyG index. This indicates that the CHG index has a higher efficiency value to diagnose of type 2 diabetes mellitus. Conclusions The CHG index could be useful for the detection of type 2 diabetes mellitus. A novel index for diagnosis of type 2 diabetes mellitus. Comparing the new index with other well‐known indices. The presented index is useful for detecting type 2 diabetes mellitus compared to the TyG index.

This study conducts an examination of the Ilam watershed, utilizing the InVEST and SDR models to assess soil retention, erosion, and transport. It incorporates factors like rainfall erosivity, soil erodibility, DEM, land use, vegetation, and conservation practices to explore the complex interplay between ecosystem services (ES) and disservices. The study found that the average soil retention in the watershed is 94.5 tons/ha/year, the average erosion potential is 62.8 tons/ha/year, and the average sediment transport is 10.5 tons/ha/year. Forest areas retain a significant portion of sediment (60%) with low discharge (13%), while agricultural and urban regions contribute more to erosion. This highlights the importance of integrating ES into land management strategies to mitigate environmental degradation. The study highlights the crucial role of ES in maintaining ecological balance and supporting human well-being. It advocates for innovative policies and customized solutions to mitigate land use impacts on soil conservation and sediment retention, thereby fostering awareness among managers and decision-makers for more sustainable land use planning.

The present study aims to investigate the relationship between reduced air pollution and ecosystem services in Karaj metropolis, Iran. To the end, the trends in the concentrations of O 3 , NO 2 , CO, SO 2 , PM 10 , and PM 2.5 as the main atmospheric pollutants of Karaj were studied. Five time series models of autoregressive (AR), moving average (MA), autoregressive moving average (ARMA), autoregressive integrated moving average (ARIMA), and seasonal autoregressive integrated moving average (SARIMA) were used to predict changes in air pollutant concentrations. Air pollution zoning is conducted via ArcGIS 10.3 by using spline tension interpolation method. Then, normalized difference vegetation index (NDVI) was obtained from Landsat Thematic Mapper (TM) and Operational Land Imager (OLI) images to analyze vegetation dynamics as an index of ecosystem functioning. NDVI thresholds were selected to present guidelines for qualitative and quantitative changes in green cover and were divided into five different categories. Based on the results, AR (1) and ARIMA (1,2,1) were recognized as appropriate models for predicting the concentration of air pollutants in the study area. A decrease in very dense vegetation coverage and increase in poor vegetation areas, followed by an increase in air pollution, revealed that the loss of urban green coverage and decreased ecosystem services were positively related. Furthermore, the expansion of urban lands toward the north and the west from the baseline to future condition led to great changes in the land cover and losses in vegetation along these axes, which finally resulted in increased air pollution in these areas. Thus, the results of this study can be directly used in decision-making in the area of air pollution.

In this paper, we are going to investigate the association between Hypertension (HTN) and routine hematologic indices in a cohort of Iranian adults. The data were obtained from a total population of 9704 who were aged 35-65 years, a prospective study was designed. The association between hematologic factors and HTN was assessed using logistic regression (LR) analysis and a decision tree (DT) algorithm. A total of 9704 complete datasets were analyzed in this cohort study (N = 3070 with HTN [female 62.47% and male 37.52%], N = 6634 without HTN [female 58.90% and male 41.09%]). Several variables were significantly different between the two groups, including age, smoking status, BMI, diabetes millitus, high sensitivity C-reactive protein (hs-CRP), uric acid, FBS, total cholesterol, HGB, LYM, WBC, PDW, RDW, RBC, sex, PLT, MCV, SBP, DBP, BUN, and HCT (P < 0.05). For unit odds ratio (OR) interpretation, females are more likely to have HTN (OR = 1.837, 95% CI = (1.620, 2.081)). Among the analyzed variables, age and WBC had the most significant associations with HTN OR = 1.087, 95% CI = (1.081, 1.094) and OR = 1.096, 95% CI = (1.061, 1.133), respectively (P-value < 0.05). In the DT model, age, followed by WBC, sex, and PDW, has the most significant impact on the HTN risk. Ninety-eight percent of patients had HTN in the subgroup with older age (≥58), high PDW (≥17.3), and low RDW (<46). Finally, we found that elevated WBC and PDW are the most associated factor with the severity of HTN in the Mashhad general population as well as female gender and older age.

The present study aims at predicting future land use/land cover (LULC) and quantifying and mapping the ecosystem services (ESs) of water yield, outdoor recreation opportunity and food production in current (here, 2017) and future landscapes in Northern Iran, using the InVEST, Recreation Opportunity Spectrum (ROS) and yield models. To that end, two LULC scenarios known as business as usual (BAU) and protection-based (PB) plan were applied for 2028, using the Markov Artificial Neural Network and Multi-objective land allocation (MOLA) models. The results show that rapid urbanisation, caused by the expansion of human settlements and industrial areas, has led to a decline in the ESs in the region. Compared to the ESs in 2017, the service of water yield increases as urban expansion increases, whereas food production and recreation services decrease as urban expansion increases, under the BAU scenario. On the other hand, in the PB scenario, relatively better conditions can be observed for all three ESs. Considering that the ecological structures of this region have been severely affected by rapid urban expansion, the results of this research will be useful for maintaining the existing ESs and can greatly affect planning and decision-making regarding future development towards urban sustainability.

Intussusception is a condition in which a segment of the gastrointestinal tract invaginates into the lumen of another segment. Adult intussusception is less common than juvenile intussusception in terms of cause, appearance, and treatment. Because the clinical picture can be quite atypical and difficult to interpret, it is frequently misdiagnosed at first. Herein, we report the case of a previously healthy 23‐year‐old female patient who presented to the Emergency Department (ED) with acute abdominal pain, vomiting, and diarrhea for 1 day following her last menstrual period. Ileocecal intussusception was discovered throughout the investigation. She was rushed for open abdominal surgery. Meckel's diverticulum was found as a pathologic lead point in the resected specimen, with no evidence of malignancy. Although intussusception is rare in adults, it should be considered in patients who have nonspecific stomach pain. Intussuception in adults is a rare cause of intestinal obstruction. Early imaging like ultrasonography and CT scan can lead us to make the diagnosis soon. Laparotomy is the choice of surgery for small bowel obstruction. The extension of resection depends on the pathologic cause of intussusception as the lead point.

Gastrointestinal bleeding (GIB), which includes both upper GIB (variceal and non-variceal) and lower GIB, represents a significant cause of emergency department referrals. Given the potential risks of blood transfusion, re-bleeding, and mortality in these patients, it is essential to establish a system for prioritizing critical patients. Several risk stratification scoring systems have been developed based on patients' clinical characteristics and/or endoscopic findings. However, the optimal scoring system for each clinical scenario remains uncertain. In this study, we design the first comprehensive review and compare almost all of the upper gastrointestinal bleeding (UGIB), as well as lower gastrointestinal bleeding (LGIB) risk stratification scoring systems individually regarding their advantages, disadvantages, and limitations.

The main purpose of current research is to quantify multiple Ecosystem Services (ESs) for the Ilam dam watershed, Western Iran. In this sense, the Integrated Valuation of Ecosystem Services and Tradeoffs (InVEST) was applied to quantify water yield, sediment retention, and habitat quality, and Recreation Opportunity Spectrum (ROS) to model recreation for the current landscape (here 2021). Due to the inevitable exchanges between different types of ESs, in this study, Getis-ord Gi ∗ statistics were also used to describe the characteristics of service bundles spatial variation. This tool is used to measure spatial clusters – i.e. hotspots and coldspot –within the grid, which helps prioritize conservation measures. The results show that changes in water yield are mainly influenced by changes in precipitation, sediment retention and other actions of multiple factors such as Land use/cover (LULC) type, precipitation and temperature, while changes in recreation and habitat quality have the most dominant influence by LULC type. Moreover, the results of the spatial ESs bundle indicate that the hotspots show high value for a wide variety of services, which are occupied by high forests and grassland proportions. Otherwise, the ESs coldspots bundle has shallow values for most of the services. The low percentage of current hotspots indicates the difficulty of obtaining multiple ESs from one area, suggesting a protective priority to stop the loss of various services. Given that the increasing demand for ESs has put a lot of pressure on natural ecosystems, politicians and urban decision makers need to focus on the sustainable use of ecosystems so that the supply of ESs is not disrupted. Hence, this research can be crucial as detailed instructions to raise politician’s awareness and design a policy on ESs.

Sinusitis, one of the most prevalent and undertreated disorders, is a term used to describe inflammation of the paranasal sinuses caused by either infectious or non-infectious sources. Bacterial, viral, or fungal infections can all cause sinusitis. Sinusitis is classified into 3 types: acute, subacute, and chronic. Acute sinusitis lasts for less than 1 month, subacute sinusitis lasts from 1 to 3 months, and chronic sinusitis persists for over 3 months. This condition affects a significant portion of the population, imposing a substantial burden on the healthcare system. Antibiotics are the gold standard of bacterial sinusitis treatment. However, due to the rise of antimicrobial resistance, especially in immune-compromised patients, it is necessary to investigate potential adjunctive therapies. Based on the literature, vitamins (eg, vitamin D) have antioxidant, anti-inflammatory, and immune-modulatory properties and may effectively treat sinusitis and reduce mucous membrane inflammation. Besides vitamins, many other supplements like quercetin, sinupret, and echinacea have immunomodulatory effects and have shown promising results in sinusitis treatment. In this review, we look at the therapeutic role, safety, and efficacy of vitamins and nutritional supplements in sinusitis treatment.

Models for land cover/land use simulation are appropriate and important tools for decision-makers, helping them build future plausible landscape scenarios. Due to the fact that the simulation results of different models may be different, it is sometimes difficult for users to choose a suitable model. Therefore, in this study, an integrated approach is used, combining the data obtained from remote sensing and GIS with Land Change Modeler (LCM) and Integrated Valuation of Ecosystem Services and Tradeoffs (InVEST) models to simulate and predict land cover/land use changes for 2028 in Karaj metropolis (Northern Iran as a poor region—in terms of data—which is under intense and rapid urbanization. In this sense, three land cover/land use maps related to the study area were primarily generated using satellite image data for the period 2006, 2011, and 2017. They were used as a basis to define two scenarios: business-as-usual (BAU) scenario and participatory plausible scenario (PPS) for 2028. Afterwards, the necessary input data used in running of both models were prepared and, then, the outputs of the models were interpreted and compared. According to the results, while human-made coverage and low-density grasslands increased by about 74% and 12%, respectively, it was from 2006 to 2017 that agricultural lands, gardens, and high-density grasslands decreased by 42%, 34%, and 7%, respectively. According to the business-as-usual scenario, which was projected using the LCM model, the increase in human-made cover will continue by about 29% by 2028, and the reduction rate of agricultural lands, gardens, and low-dense and dense grasslands will experience decrease by about 20%, 3%, 11%, and 9%, respectively. The participatory plausible scenario for 2028, which was defined using the InVEST model, confirmed the same results, but having different quantities. Accordingly, while human-made cover will increase by about 73%, the reduction rate of agricultural lands, gardens, and low-dense and dense grasslands will decrease by about 41%, 10%, 16%, and 1%, respectively. The output quantities of InVEST scenario model seem to be closer to reality with less uncertainty, because this model estimates the quantity of demand for land and its suitability for different uses, based on the views of different stakeholders, and considers landscape development future policies and plans. In contrast, the LCM model is based solely on trend extrapolation from the past to current time and changes in the landscape structure.