Self-reported health-related quality of life (HRQoL) and factors affecting HRQoL among individuals with health insurance in Iran

Ali Kazemi Karyani,Arash Rashidian,Sarar Emamgholipour Sefiddashti,Ali Akbari Sari 한국역학회 2016 Epidemiology and Health Vol.38 No.-

OBJECTIVES: The aim of this study was to measure the health-related quality of life (HRQoL) and to evaluate the factors affecting HRQoL in individuals with health insurance in Tehran, Iran. METHODS: A cross-sectional analytical study was conducted using the 3-level EuroQol 5-dimensions (EQ-5D) questionnaire. In order to estimate the determinants of HRQoL, information about participants’ demographic, socioeconomic, and health status was gathered. The cluster sampling technique was used to collect data from May to June, 2016. The chi-square test and weighted least squares method were employed for data analysis. Data were analyzed using Stata version 11.0. RESULTS: A total of 600 Iranians with insurance completed the study, of whom 327 (54.5%) were male and 273 (45.5%) were female. The mean age of the participants was 41.48 years (standard deviation [SD], 14.60 years). Meanwhile, the mean duration of education was 12.36 years (SD, 4.68 years). The mean EQ-5D score was 0.74 (SD, 0.16). The most common health problems in the participants were anxiety/depression (42.3%), followed by pain/discomfort (39.2%). Sex, age, years of schooling, income, chronic disease, and body mass index had a significant effect on HRQoL (p<0.05). Healthy insured individuals, on average, had a HRQoL score 0.119 higher than that of people with a chronic disease, all else being equal (p<0.001). CONCLUSIONS: Among all determinants of HRQoL, chronic disease was found to be the highest priority for interventions to improve the health status of Iranians with insurance. This finding can help policymakers and health insurance organizations improve their planning to promote the HRQoL of individuals with insurance and society as a whole in Iran.

S1000A12, Chitotriosidase, and Resolvin D1 as Potential Biomarkers of Familial Mediterranean Fever

Ali Taylan,Oguz Gurler,Burak Toprak,Ali Riza Sisman,Hulya Yalcin,Ayfer Colak,Ismail Sari 대한의학회 2015 Journal of Korean medical science Vol.30 No.9

Familial Mediterranean fever (FMF) is an auto-inflammatory disease characterised by periodic inflammatory attacks. We investigated changes in monocyte-granulocyte derived S10012A and chitotriosidase in both the attack and silent period of FMF for better estimation of inflammation. Endogenous resolvin was determined for utility to restrict inflammation. This study included 29 FMF patients (15 M/14 F) and 30 healthy controls (15 M/15 F). Serum levels of highly sensitive C-reactive protein, serum amiloid A (SAA), S100A12, chitotriosidase, and resolvin D1 were measured. Age, sex, body mass indexes, and lipids were similar between patients and controls. Biomarkers including hs-CRP, SAA, S100A12, chitotriosidase, and resolvin D1 were higher in the attack period of FMF patients compared to controls (P < 0.001). When FMF patients in the silent period were compared with their attack period, hs-CRP, SAA, and chitotriosidase were found elevated in the attack period (P < 0.001, P < 0.001, and P = 0.02 respectively). Serum levels of SAA, S100A12, chitotriosidase, and resolvin D1 in the silent period of FMF patients were still found elevated compared to healthy controls, indicating subclinical inflammation (P < 0.001, P < 0.001, P = 0.009, and P < 0.001 respectively ). In subgroup analysis, patients with M694V homozygote and heterozygote mutations had higher S10012A and hs-CRP compared to other mutation carriers. Our findings indicate that chitotriosidase and S10012A are useful in diagnosis and detection of subclinical inflammation and/or assessment of disease activity in FMF patients. They could be more informative for inflammation in various disease states compared to hsCRP and SAA. Resolvin D1 is elevated in both the attack and silent periods of FMF. It may be helpful to restrict inflammation.

Evaluation of unanchorage blast-resistant modular structures subjected to blast loads and human injury response

Ali Sari,Omer Faruk Nemutlu,Kadir Guler,Sayed Mahdi Hashemi 국제구조공학회 2024 Structural Engineering and Mechanics, An Int'l Jou Vol.89 No.5

An explosion from a specific source can generate high pressure, causing damage to structures and people in and around them. For the design of protective structures, although explosion overpressure is considered the main loading parameter, parts are only considered using standard design procedures, excluding special installations. Properties of the explosive, such as molecular structure, shape, dimensional properties, and the physical state of the charge, determine the results in a high-grade or low-grade explosion. In this context, it is very important to determine the explosion behaviors of the structures and to take precautions against these behaviors. Especially structures in areas with high explosion risk should be prepared for blast loads. In this study, the behavior of non-anchored blast resistant modular buildings was investigated. In the study, analyzes were carried out for cases where modular buildings were first positioned on a reinforced concrete surface and then directly on the ground. For these two cases, the behavior of the modular structure placed on the reinforced concrete floor against burst loads was evaluated with Stribeck curves. The behavior of the modular building placed directly on the ground is examined with the Pais and Kausel equations, which consider the structure-ground interaction. In the study, head and neck injuries were examined by placing test dummies to examine human injury behavior in modular buildings exposed to blast loads. Obtained results were compared with field tests. In both cases, results close to field tests were obtained. Thus, it was concluded that Stribeck curves and Pais Kausel equations can reflect the behavior of modular buildings subjected to blast loads. It was also seen at the end of the study that the human injury criteria were met. The results of the study are explained with their justifications.

An analytical approach for offshore structures considering soil-structure interaction

Ali Sari,Kasim Korkmaz Techno-Press 2024 Advances in computational design Vol.9 No.1

This paper presents an advanced analytical approach for the design and analysis of fixed offshore structures with soil structure interaction considered. The proposed methodology involves conducting case studies to illustrate and assess the structural response of a structure considering seven different earthquakes, with the primary goal of ensuring there is no global collapse in the structures. The case studies focus on developing a model for structural analysis and its topside, incorporating nonlinear axial and lateral springs to capture soil-pile interaction. Additionally, mass and damping ratios are considered through the use of dashpots in the analyses. Finite Element Software was employed for structural analyses with detailed modeling, with soil spring nodes applied in the entire structure across various depths. After the finite element analysis was carried out, a sensitivity analysis was conducted to quantify and report the effects of different parameters.

Effects of Smoking on Cost of Hospitalization and Length of Stay among Patients with Lung Cancer in Iran: a Hospital-Based Study

Sari, Ali Akbari,Rezaei, Satar,Arab, Mohammad,Majdzadeh, Reza,Matin, Behzad Karami,Zandian, Hamed Asian Pacific Journal of Cancer Prevention 2016 Asian Pacific journal of cancer prevention Vol.17 No.9

Background: Smoking is recognized as a main leading preventable cause of mortality and morbidity worldwide. It is responsible for a considerable financial burden both on the health system and in society. This study aimed to examine the effect of smoking on cost of hospitalization and length of stay (LoS) among patients with lung cancer in Iran in 2014. Materials and Methods: A total of 415 patients were included in the study. Data on age, sex, insurance status, type of hospitals, type of insurance, geographic local, length of stay and cost of hospitalization was extracted by medical records and smoking status was obtained from a telephone survey. To compare cost of hospitalization and LoS for different smoking groups, current smokers, former smokers, and never smokers, a gamma regression model and zero-truncated poisson regression were used, respectively. Results: Compared with never smokers, current and former smokers showed a 48% and 35% increase in hospitalization costs, respectively. Also, hospital LoS for current and former smokers was 72% and 31% higher than for never smokers, respectively. Conclusions: Our study indicated that cigarette smoking imposes a significant financial burden on hospitals in Iran. It is, however, recommended that more research should be done to implement and evaluate hospital based smoking cessation interventions to better increase cessation rates in these settings.

Estimating the Economic Burden of Lung Cancer in Iran

Rezaei, Satar,Sari, Ali Akbari,Woldemichael, Abraha,Soofi, Moslem,Kazemi, Ali,Matin, Behzad Karami Asian Pacific Journal of Cancer Prevention 2016 Asian Pacific journal of cancer prevention Vol.17 No.10

Objectives: Lung cancer is a major public health problem and one of the most costly illnesses. The study aimed to estimate the economic burden of lung cancer in Iran in 2014. Methods: A cross-sectional study was conducted to estimate the direct and indirect costs for patients with lung cancer using a prevalence-based approach. A human capital approach was employed to estimate the indirect costs. Data were obtained from several sources such as through patient interview using structured questionnaire, medical records, the GLOBOCAN databases, the Iranian Statistical Center, the Iranian Ministry of Cooperation, Labor and Social Welfare, and the Institute for Health Metrics and Evaluation (IHME). Results: The economic burden of lung cancer in Iran in the year 2014 was 3,225,998,555,090 IR. The main components of the cost were associated with mortality (81.9 %) and hospitalization (7.6 %). The costs of direct medical care, non-medical aspects, patient time, and mortality accounted for 10.8%, 2.7%, 4.5%, and 81.5% of the total cost, respectively. Conclusion: Findings from this study indicated that the economic burden of lung cancer is substantial both to Iran's health system and to society as a whole. Early diagnosis, strengthening cancer prevention, implementing new cancer therapy and medical technology, and effective smoking-cessation interventions could offset some of the costs associated with lung cancer in Iran.

Evaluation of MgAl LDH incorporated Gallic acid anti-corrosion impact on mild steel in tempered 3.5% NaCl solutions: Integrated electrochemical and morphological studies

Yeganeh Haji Ali Akbari,Mehran Rostami,Morteza Ganjaee Sari,Bahram Ramezanzadeh 한국공업화학회 2023 Journal of Industrial and Engineering Chemistry Vol.127 No.-

Undoubtedly, high temperature is one of the most risk factors that aggravate corrosion, which can greatlyaffect the lifespan of metal substrates. Hence, high temperature corrosion control now become one of theexciting research hotspot for researchers. For corrosion prevention, the application of corrosion inhibitorsis one of the easy and practical ways and with the emergence of nanomaterials, smart inhibitors has beenremarked as a milestone in corrosion science. In this study, layered double hydroxide (LDH) nano-carrierencapsulated gallic acid (GA) was applied to control steel corrosion in high temperature 3.5% NaCl salineenvironment. The structural evaluation of this nanocomposite has been done with the help of X-raydiffraction (XRD), Fourier transform infrared (FTIR) and Brunauer-Emmett-Teller (BET) tests and theresults have confirmed the successful synthesis of this nanocomposite. Then, polarization test predictedthe inhibition mechanism and the results shown the mixed inhibition is responsible for 68% and 60% ofcorrosion controlled in 35 and 45 environment, respectively. But in order to better evaluation, the performanceof the nanocomposite has been checked via electrochemical impedance spectroscopy (EIS)evaluations. Based on the studies, it has been found that high temperature has severely limited the performanceof the pristine GA, but LDH/GA nanocomposite has been able to achieve 72% efficiency at 35 Cand 58% efficiency at 45 C. Finally, Field emission scanning electron microscopy (FE-SEM) captures aidedto assess the morphology of immersed surfaces at different temperatures and Energy Dispersive X-RayAnalysis (EDX)/MAP tests estimated the elemental structure of the samples.

Management of Precancerous Cervical Lesions in Iran: A Cost Minimizing Study

Nahvijou, Azin,Sari, Ali Akbari,Zendehdel, Kazem,Marnani, Ahmad Barati Asian Pacific Journal of Cancer Prevention 2014 Asian Pacific journal of cancer prevention Vol.15 No.19

Background: Cervical cancer is a common, preventable and manageable disease in women worldwide. Objectives: This study was conducted to determine the cost of follow-up for suspicious precancerous cervical lesions within a screening program using Pap smear or HPV DNA test through the decision tree. Materials and Methods: Patient follow-up processes were determined using standard guidelines and consultation with specialists to design a decision tree model. Costs of treatment in both public and private sectors were identified according to the national tariffs in 2010 and determined based on decision tree and provided services (visits to specialists, colposcopy, and conization) with two modalities: Pap smear and HPV DNA test. The number of patients and the mean cost of treatment in each sector were calculated. The prevalence of lesions and HPV were obtained from literature to estimate the cost of treatment for each woman in the population. Results: Follow-up costs were determined using seven processes for Pap smear and 11 processes for HPV DNA test. The total cost of using Pap smear and HPV DNA process for each woman in the population was 36.1$ and 174$ respectively. Conclusions: The follow-up process for patients with suspicious cervical lesions needs to be included in the existing screening program. HPV DNA test is currently more expensive than Pap smear, it is suggested that we manage precancerous cervical lesions with this latter test.

Special cases in fatigue analysis of wind turbines

Onur Güneş,Elif Altunsu,Ali Sari 한국풍공학회 2021 Wind and Structures, An International Journal (WAS Vol.32 No.5

The turbine industry demands a reliable design with affordable cost. As technological advances begin to support turbines of huge sizes, and the increasing importance of wind turbines from day to day make design safety conditions more important. Wind turbines are exposed to environmental conditions that can affect their installation, durability, and operation. International Electrotechnical Commission (IEC) 61400-1 design load cases consist of analyses involving wind turbine operating conditions. This design load cases (DLC) is important for determining fatigue loads (i.e., forces and moments) that occur as a result of expected conditions throughout the life of the machine. With the help of FAST (Fatigue, Aerodynamics, Structures, and Turbulence), an open source software, the NREL 5MW land base wind turbine model was used. IEC 61400-1 wind turbine design standard procedures assessed turbine behavior and fatigue damage to the tower base of dynamic loads in different design conditions. Real characteristic wind speed distribution and multi-directional effect specific to the site were taken into consideration. The effect of these conditions on the economic service life of the turbine has been studied.

A new stability and sensitivity design and diagnosis approach

Kasim A. Korkmaz,Ali Sari 국제구조공학회 2017 Steel and Composite Structures, An International J Vol.23 No.6

In the stability and sensitivity design and diagnosis approaches, there are various methodologies available. Bond graph modeling by lumping technique is one of the universal methodologies in methodical analysis used by many researchers in all over the world. The accuracy of the method is validated in different arenas. Bond graphs are a concise, pictorial representation of the energy storage, dissipation and exchange mechanisms of interacting dynamic systems, subsystems and components. This paper proposes a bond graph modeling for distributed parameter systems using lumping techniques. Therefore, a steel frame structure was modeled to analyze employing bond graph modeling of distributed system using lumping technique. In the analytical part, the effectiveness of bond graphs to model this system is demonstrated. The dynamic responses of the system were computed and compared with those computed from the finite element analysis. The calculated maximum deflection time histories were found to be comparable. The sensitivity and the stability of the steel frame structure was also studied in different aspects. Thus, the proposed methodology, with its simplicity, can be used for stability and sensitivity analyses as alternative to finite element method for steel structures. The major value brought in the practical design is the simplicity of the proposed method for steel structures.