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BACKGROUND: The worldwide prevalence of type 2 diabetes mellitus in adults is experiencing a rapid increase. This study aimed to identify the factors affecting the survival of prediabetic patients using a comparison of the Cox proportional hazards model (CPH) and the Random survival forest (RSF). METHOD: This prospective cohort study was performed on 746 prediabetics in southwest Iran. The demographic, lifestyle, and clinical data of the participants were recorded. The CPH and RSF models were used to determine the patients' survival. Furthermore, the concordance index (C-index) and time-dependent receiver operating characteristic (ROC) curve were employed to compare the performance of the Cox proportional hazards (CPH) model and the random survival forest (RSF) model. RESULTS: The 5-year cumulative T2DM incidence was 12.73%. Based on the results of the CPH model, NAFLD (HR = 1.74, 95% CI: 1.06, 2.85), FBS (HR = 1.008, 95% CI: 1.005, 1.012) and increased abdominal fat (HR = 1.02, 95% CI: 1.01, 1.04) were directly associated with diabetes occurrence in prediabetic patients. The RSF model suggests that factors including FBS, waist circumference, depression, NAFLD, afternoon sleep, and female gender are the most important variables that predict diabetes. The C-index indicated that the RSF model has a higher percentage of agreement than the CPH model, and in the weighted Brier Score index, the RSF model had less error than the Kaplan-Meier and CPH model. CONCLUSION: Our findings show that the incidence of diabetes was alarmingly high in Iran. The results suggested that several demographic and clinical factors are associated with diabetes occurrence in prediabetic patients. The high-risk population needs special measures for screening and care programs.

Asunto(s)

Diabetes Mellitus Tipo 2 , Estado Prediabético , Modelos de Riesgos Proporcionales , Humanos , Estado Prediabético/epidemiología , Masculino , Femenino , Persona de Mediana Edad , Irán/epidemiología , Adulto , Diabetes Mellitus Tipo 2/epidemiología , Diabetes Mellitus Tipo 2/mortalidad , Estudios Prospectivos , Anciano , Factores de Riesgo

RESUMEN

BACKGROUND: Acute myocardial infarction is still a leading cause of death worldwide, accounting for roughly three million deaths yearly. This study aimed to investigate the prevalence and factors associated with ST-Segment Elevation Myocardial Infarction and Non-ST Segment Elevation Myocardial Infarction in Iran. METHODS: This cross-sectional study was conducted using the databases of the Fasa Registry on Acute Myocardial Infarction (FaRMI) and the Fasa Adult Cohort Study (FACS). chi-squared and one-way ANOVA tests were utilized to calculate the unadjusted associations between the study variables. A multivariate multinomial logistic regression model was also employed to determine the adjusted association of each independent variable with the risk of ST-elevation myocardial infarction (STEMI). RESULTS: The prevalence of STEMI and non-STEMI was 31.60% and 11.80%, respectively. Multinomial logistic regression showed that older age, anemia, high WBC, and high creatinine levels were associated with higher odds of STEMI and non-STEMI compared to healthy individuals. In addition, based on the analysis being a woman(OR = 0.63,95%CI:0.51-0.78), anemia(OR = 0.67,95%CI:0.54-0.63)and hypertension (OR = 0.80,95%CI:0.65-0.97)decreased the likelihood of STEMI occurrence compared to non-STEMI, while high WBC(OR = 1.19,95%CI:1.15-1.23)increased the odds. CONCLUSION: In this study, significant predictors of MI risk included age, gender, anemia, lipid profile, inflammation, and renal function. Subsequent investigations ought to prioritize the comprehensive understanding of the underlying mechanisms that drive these connections and assess the effectiveness of specific interventions aimed at diminishing the occurrence of MI and improving patient outcomes.

Asunto(s)

Anemia , Infarto del Miocardio , Infarto del Miocardio con Elevación del ST , Adulto , Femenino , Humanos , Infarto del Miocardio con Elevación del ST/epidemiología , Estudios Transversales , Irán/epidemiología , Estudios de Cohortes , Prevalencia , Infarto del Miocardio/epidemiología , Sistema de Registros

RESUMEN

Background: The accurate diagnosis of malaria cases, especially asymptotic and low-parasitemia patients, using robust molecular methods (nested-PCR) have been emphasized. The goal of this study was to detect active cases of malaria in areas with a history of local malaria transmission focusing on the use of molecular tools to ensure that the malaria elimination program has been implemented successfully. Methods: In this cross-sectional study, 816 blood samples were taken from immigrants and local residents of malaria-endemic areas in Hormozgan province, Iran. In order to identify asymptomatic malaria parasite reservoirs, the samples were examined using microscopic, RDT, and nested-PCR techniques. Results: About twelve positive asymptomatic malaria cases were identified when the molecular method (nested-PCR) was used. The positivity rates among immigrants and local residents were 2.07% and 0.93%, respectively. No positive cases were detected using microscopic and RDT methods. Conclusions: The finding of the research emphasize that in addition to microscopy and RDTs methods, sensitive molecular tools as a standard and essential strategy are needed in the diagnosis and detection of asymptomatic parasite reservoir.