Iranian Population Research Articles

The Association Between Hematological Indices and Type 2 Diabetes Mellitus in Iranian Population

Background: Hematological alterations have been observed in diabetes, with some studies showing controversial associations between specific hematologic parameters and type 2 diabetes mellitus (T2DM). Objectives: This study aims to determine the association between hematological indices, specifically white blood cell (WBC) count, red cell distribution width (RDW), and platelet distribution width (PDW), and the presence of T2DM in an Iranian population, using data from the Bandare-Kong non-communicable diseases (BKNCD) cohort. Methods: Data from the BKNCD cohort, which includes 4063 individuals aged 35 - 70 years, was used in this study. After excluding participants with conditions that could interfere with the analysis, 2318 subjects remained for final evaluation. Results: Among the 2318 individuals, T2DM was present in 530 (22.9%). Binary logistic regression analysis revealed that the odds of T2DM increased by approximately 7% for every 109/L increase in WBC count, after adjusting for variables such as occupation, age, body mass index, sex, place of residence, education, smoking, marital status, systolic and diastolic blood pressure (DBP), and physical activity (adjusted odds ratio (aOR) = 1.066, 95% confidence interval (CI) = 1.003; 1.133, P = 0.039). Additionally, elevated PDW was associated with a 63% increase in the odds of T2DM (aOR = 1.625, 95% CI 1.159; 2.279, P = 0.005), while increased RDW was associated with decreased odds of T2DM (aOR = 0.801, 95% CI 0.716; 0.895, P < 0.001). Conclusions: Elevated PDW and WBC counts in T2DM patients in this study suggest an inflammatory state and hypercoagulability. However, the paradoxically decreased RDW may be linked to poor glycemic control in these patients.

Identification of optimal waste-to-energy strategies for sustainable development in Iran: SWOT analysis, hybrid MCDM methods, and game theory

The growing global focus on environmental sustainability and the pressing need for efficient waste management and energy crisis mitigation have prompted extensive investigations into sustainable waste management strategies. Given Iran's economic development and population growth, the country faces challenges in energy supply and waste management, making waste-to-energy (WtE) applications a promising solution for sustainable waste management. This study employs a combination of SWOT (Strengths, Weaknesses, Opportunities, and Threats) analysis, Multi-Criteria Decision-Making (MCDM) approaches, and game theory to explore WtE technologies and processes, evaluate their applicability within Iran's context, and identify the most effective WtE strategies for the country. Furthermore, game theory and fuzzy Shapley value analysis were utilized to determine the optimal combination of WtE development strategies. The strategy player “SO” held the highest position of power, with a fuzzy Shapley value of (0.391, 1.744, 3.264), resulting in the identification of the optimal strategy combination of SO2ST2WO1WT2, with a value of (0.429, 0.679, 0.893). The recommended combination emphasizes landfill with gas capture, development of incineration power plants, and integrated resource recovery through residue-derived fuel (RDF) implementation. Achieving these objectives necessitates energy policy reforms, pricing adjustments, improvements in the energy subsidy system, and infrastructure and market development.

Assessing public trust in road traffic injuries prevention policies in Iran: a cross-sectional study.

Road Traffic Injuries (RTIs) represent the predominant cause of morbidity and mortality globally. Thus, impactful interventions and trustworthy authorities are imperative to mitigate traffic accidents. The present study seeks to assess public trust in traffic accident diminution policies and measures within the country of Iran. This cross-sectional study utilized a questionnaire comprising 31 questions distributed across eight dimensions. The questionnaire's design was informed by a literature review and semi-structured interviews with experts specializing in traffic accidents. The target population consisted of Tabriz city residents, who were selected via convenience sampling. The collected data were then analyzed using SPSS-16 software, employing the T-test, One-way ANOVA, and Pearson correlation coefficient to present the study's results. structural equation modeling (SEM) was conducted using R 4-4-2 programming language. A total of 681 participants completed the questionnaire, yielding a commendable response rate of 88.6%. The majority of participants were male (60.8%), and 86.2% identified as drivers, with 61.8% having experienced driving accidents. The overall score for public trust in RTIs policies was calculated to be 46.9%. The individual scores for specific domains of trust in traffic safety were as follows: safer roads (43.1%), safe vehicle (43.3%), safety laws (48.8%), safe user (51.1%), safe technology (51.5%), road safety management (46.8%). All the latent variables except education are significantly effective on public trust. The study findings indicate relatively low levels of public trust in RTIs policies among the Iranian population. These results emphasize the need for targeted interventions to enhance public confidence in specific aspects of traffic safety. Policymakers can use these insights to implement effective measures, thus contributing to the RTIs and the promotion of road safety in the country.

A dimensional design of tractor seat based on Iranian anthropometric characteristics.

The dimensional seat design process should consider both the users' tasks and their physical characteristics. To use an approach for the design and evaluation of seat dimensions based on the anthropometric characteristics of the Iranian population and the requirements of tractor operators. Some existing equations relating the seat dimensions to anthropometric characteristics were modified according to logical justifications and international standards. A new mathematical-statistical method was used to extract the equations estimating the constant seat dimensions based on the theoretical maximizing of the accommodation level. In addition, an Overall Seat Accommodation Score (OSAS) was developed to represent the mean of seat dimensions accommodation level and dimensional accommodation equality, simultaneously. The dimensional seat design can be affected under different conditions of adjustability, esthetic, and space limitations. However, it was shown that it is possible to improve the design of tractor seats without any significant increase in the final cost and complexity. A new approach was used for tractor seats for a sample of Iranian operators and can be used for the design and evaluation of tractor seats for other target populations.

Establishing Wideband Tympanometry Clinical Normative Data for the Iranian Young Adult Population

Background and Objectives: Wideband acoustic immittance (WBT) is a new method for assessing middle ear status by using a wide spectrum stimulus instead of the traditional 226 Hz probe tone. This study focuses on establishing normative data for WBT in the Iranian young adults. We aim to provide clinicians with specific norms for the Iranian population to enhance accuracy in diagnosing middle ear conditions and diseases. Methods: The research involved 20 healthy Iranian young adults who underwent WBT measurements. Results: Results showed differences in the WBT parameters compared to other populations, emphasizing the importance of using ethnicity-specific norms in clinical evaluations. Conclusion: The findings can help in diagnosing various middle ear disorders and monitoring treatment progress.

Incidence and risk factors for chronic pain following primary total knee arthroplasty in an irish surgical population.

To identify the incidence and characteristics of chronic post-surgical pain (CPSP) following total knee arthroplasty and determine peri-operative influencing factors. A representative, retrospective random sample was taken of patients who underwent total knee arthroplasty in the South Infirmary University Hospital Cork for an 18-month period. Two hundred fourteen patient charts were reviewed out of a total of 507 charts for that period to provide a 90% confidence interval. The incidence of CPSP in an Irish population 6months after total knee arthroplasty was found to be 36.5%. The following factors were found to be statistically significant with respect to the incidence of CPSP: female sex, lack of multimodal analgesia (consisting of paracetamol, NSAID, and opioids), general anaesthesia, and lower Oxford Knee Scores at 6months post-surgery. Age, the knee operated on, ASA grade, or greatest acuity pain, were not found to be statistically significant factors in the development of CPSP. CPSP is common after total knee arthroplasty with an incidence of 36.5% at 6months post procedure. Female sex, lack of multimodal analgesia, and lower Oxford Knee Scores were associated with increased CPSP.

Inflammatory and genomic interactions within keratoconus susceptible patients: a nationwide registered case–control study

PurposeThis study aimed to investigate the association between variants in the interleukin (IL)-1 gene cluster and susceptibility to keratoconus (KC) in an Iranian population.MethodsIn the case group, there were 188 KC patients diagnosed by clinical findings and corneal tomography. The control group included all 205 healthy controls with no personal or family history of eye-related, metabolic, or immune system-related disease. Using the standard salting out extraction procedure, genomic DNA was isolated from peripheral blood leukocytes. The genotypes were determined by applying agarose gel electrophoresis for the IL-1RN 86 bp VNTR and polymerase chain reaction-restriction fragment length polymorphism (PCR–RFLP) for rs16944 and rs1143634.ResultsThe results showed a significant association between the IL-1β rs1143634 (rs1143634 T allele, P = 0.008) and IL-1RN 86 bp VNTR polymorphisms (LL and LS genotype, P = 0.048 and 0.012 respectively) and susceptibility to KC in the Iranian population. The genotype distributions of rs1143634 (P = 0.004) and rs2234663 (P = 0.042) significantly differed between case and control groups, with certain genotypes demonstrating a protective effect against KC. Logistic regression analysis revealed a protective effect of the IL-1RN L allele [odds ratio (OR) = 0.367, 95% confidence interval (CI): 0.240–0.562; P = 0.000] and certain haplotypes (OR = 0.628, 95% CI: 0.447–0.884; P = 0.007) against KC. However, no significant association was found for the IL-1β rs16944 polymorphism.ConclusionThis study provides evidence for an association between variants in the IL-1 gene cluster and susceptibility to KC in an Iranian population. Further research on larger and more diverse populations is warranted to validate these findings and explore the underlying mechanisms involved.

Patterns of pain medication usage and self-reported pain in older Irish adults with osteoarthritis: A latent class analysis of data from the Irish Longitudinal Study on Ageing

BackgroundThis study aimed to identify and describe links between pain medication use and self-reported pain among people aged ≥ 50 years with osteoarthritis (OA) in an Irish population, and to examine the relationships between pain, medication usage and socioeconomic and clinical characteristics.MethodsSecondary data analysis of wave 1 cross-sectional data from The Irish Longitudinal Study on Ageing (TILDA) was undertaken of 1042 people with self-reported doctor-diagnosed OA. We examined use of medications typically included in OA clinical guidelines, including non-opioid analgesics (e.g. paracetamol), topical and oral non-steroidal anti-inflammatory drugs (NSAIDs), opioids and nutraceuticals. Latent Class Analysis (LCA) was used to identify underlying clinical subgroups based on medication usage patterns, and self-reported pain severity. Multinomial logistic regression was used to explore sociodemographic and clinical characteristic links to latent class membership.ResultsA total of 358 (34.4%) of the 1042 people in this analysis were taking pain medications including oral NSAIDs (17.5%), analgesics (11.4%) and opioids (8.7%). Nutraceutical (glucosamine/chondroitin) use was reported by 8.6% and topical NSAID use reported by 1.4%. Three latent classes were identified: (1) Low medication use/no pain (n = 382, 37%), (2) low medication use/moderate pain (n = 523, 50%) and (3) moderate medication use/high pain (n = 137, 13%). Poorer self-rated health and greater sleep disturbance were associated with classes 2 and 3; depressive symptoms and female gender were associated with class 2, and retirement associated with class 3.ConclusionsWhilst pain medication use varied with pain severity, different medication types reported broadly aligned with OA guidelines. The two subgroups exhibiting higher pain levels demonstrated poorer self-rated health and greater sleep disturbance.

Prevalence and Severity of Temporomandibular Disorders in A Group of Iranian Musicians

ObjectiveAllegedly playing a musical instrument is a contributing factor to developing TMD signs and symptoms, but the literature is incoherent. The main aim of this study was to evaluate the prevalence of TMD among amateur musicians for the first time in the Iranian population. MethodsThis is a descriptive questionnaire-based cross-sectional study that includes 140 amateur musicians (35 international wind instrumentalists, 35 traditional wind instrumentalists, 35 international string instrumentalists, and 35 traditional string instrumentalists). Forty-eight violinists were studied separately from other study groups. The Fonseca questionnaire was used to evaluate TMD in this sample. A P-value of 0.05 was considered significant. ResultsThe Prevalence of the study sample was 72.8%. The prevalence of TMD and the mean severity score among musicians of international wind instruments, traditional wind instruments, international string instruments, and traditional string instruments were 77.1%, 67.6%, 82.8%, and 62.8%, and 30.00 ± 15.52, 32.42 ± 14.92, 30.71 ± 18.75, and 28.57 ± 19.87, respectively. The study groups did not show any significant differences regarding the TMD severity score. The prevalence of TMD was higher among women (P = 0.000017) and wind instrumentalists (P = 0.009). The prevalence of TMD and the mean severity score among violinists were 62.85% and 26.85 ± 20.68, respectively. ConclusionsRegardless of class or category, the prevalence of TMD is high among musicians compared to the available statistics reported previously on the Iranian population in the literature. Moreover, TMD prevalence is higher among wind instrumentalists than string instrumentalists.

Association of C4 and CH50 levels with cough and rhinorrhea in COVID-19 patients: A retrospective analysis in the Iranian population

Association of C4 and CH50 levels with cough and rhinorrhea in COVID-19 patients: A retrospective analysis in the Iranian population

Identification and characterization of NMNAT1 gene mutations in an Iranian patient with Leber congenital amaurosis 9.

The discovery of compound heterozygous NMNAT1 mutations (c.245T>C; p.Val82Ala and c.575A>G; p.Asp192Gly) provides a genetic explanation for Leber congenital amaurosis 9 in an Iranian patient. The proband's symptoms-including severe visual impairment, nystagmus, night blindness, and retinal degeneration-align with Leber congenital amaurosis 9 clinical features. This case underscores the value of exome-sequencing in diagnosing rare genetic disorders and highlights its role in guiding personalized genetic counseling and potential treatments. Leber congenital amaurosis is a severe early-onset inherited retinal dystrophy. This study delves into the genetic basis of Leber congenital amaurosis, pinpointing compound heterozygous mutations in the NMNAT1 gene as significant causative factors. While one mutation validates previous findings (c.245T>C; p.Val82Ala), the second (c.575A>G; p.Asp192Gly) proves novel, expanding the genetic landscape of Leber congenital amaurosis 9. Both mutations, inherited independently from nonconsanguineous parents, contribute to the intricate genetic basis of light on Leber congenital amaurosis 9 in this case. The identified mutations shed light on Leber congenital amaurosis genetics in the Iranian population, showcasing the efficacy of exome-sequencing for molecular diagnoses in hereditary retinal degeneration. These findings provide valuable insights for tailored genetic counseling and potential therapeutic interventions.

Assessing the Concordance of Clinical and Pathological Diagnoses in Basal Cell Carcinoma Among the Iranian Population: A Cross-Sectional Analysis of 229 Cases.

Nonmelanoma skin cancer (NMSC) is the most prevalent malignancy globally, with basal cell carcinoma (BCC) being the most common type. This study aims to evaluate the concordance between clinical and pathological diagnoses of BCC, emphasizing the importance of early detection. In this cross-sectional study, we conducted a retrospective review of clinical and pathological records for 229 patients diagnosed with BCC between 2020 and 2024. The analysis focused on gender, age, lesion location, and diagnostic accuracy. Among the 229 patients, 193 were men (84.3%), and 131 (57.2%) had recorded clinical diagnoses. The mean age of diagnosed patients was 67.72 years. Lesions were primarily located on the scalp (29.5%), face (26.4%), and nose (13.9%). Of the pathological evaluations, 184 cases (80.3%) confirmed BCC, while 45 cases had alternative diagnoses. Notably, 94.6% of clinically diagnosed patients were suspected to have BCC by their physicians. A significant portion of cases (42%) lacked prior clinical diagnoses, reflecting a potential gap in education among nondermatologists regarding BCC recognition. The study found high concordance between clinical and pathological diagnoses of BCC, underscoring the need for improved clinical assessment skills among healthcare providers. Collaboration with dermatologists is essential for accurate diagnosis and improved patient outcomes. Enhanced training in recognizing BCC symptoms is recommended to address the identified gaps in clinical suspicion.

HLA Genetic Variants in COVID-19 Susceptibility: Assessing Diversity in Indian and Global Populations

Background: The rapid spread of the SARS-CoV-2 virus has had a global impact on various ethnic groups. In order to assess the genetic predisposition of the Indian population towards COVID-19, a comparative analysis was conducted using the Human Leukocyte Antigen (HLA) to investigate the frequencies of polymorphisms directly or potentially associated with COVID-19 susceptibility, severity, immune response, and fatal outcomes in comparison to other major populations. Objectives: The objective of this study is to evaluate the genetic predisposition of the Indian population to COVID-19 by analyzing the frequencies and associations of Human Leukocyte Antigen (HLA) polymorphisms. In addition, by delineating the role of specific HLA variants in the Indian context, the study seeks to enhance our understanding of genetic factors influencing COVID-19 impact and contribute to personalized approaches for disease management and prevention across diverse ethnic groups. Methods: We collected allelic information for DRB1 gene from 653 populations globally, as documented in The Allele Frequency Net Database (AFND). Data on COVID-19 susceptibility, severity, mortality, and protective factors were obtained from a previous global study. This study aimed to compare the specific frequencies of HLA-DRB1* in different ethnic groups, including other Indian populations with COVID-19-associated alleles and protective factors. Results: HLA-DRB1*01 was identified as a significant determinant of COVID-19 susceptibility among patients in 28 states of Mexico, whereas DRB1*08 in Saudi Arabian populations, DRB1*09:01 in Japanese populations, and DRB1*15:01 in Italian populations also showed this association. Likewise, DRB1*04 in the Iranian population played a role in disease severity, and DRB1*08 in the Italian population was associated with mortality in COVID-19 patients. In addition, alleles DRB1*01:01 and DRB1*04:01 were found to exhibit a protective role in Northeast England, whereas DRB1*04 demonstrated protective effects in Saudi Arabian populations. Conclusion: The involvement of HLA in COVID-19 requires further investigation, and epidemiological studies should focus on HLA profiles as determinants of the host immune system. Prolonged homozygosity in particular genomic regions could potentially increase susceptibility to COVID-19 infection. Therefore, prudent management strategies are recommended for this pandemic in isolated communities in India and worldwide.

Global San Francisco and the Irish of the New Pacific

Abstract Following the discovery of gold in the Sierra Nevada Mountains in January 1848, San Francisco established itself as the premier city of the western Americas. From the outset, its substantial Irish immigrant population enjoyed the standing of a charter group and exhibited high levels of political power and cultural influence, characteristics that were frequently noted by contemporaries and continued well into the twentieth century. While San Francisco's Irish population shared much in common with their compatriots in other American cities, the Golden City developed its own unique identity and quickly emerged as a truly global Irish city. Key features that account for its experience include the city's distinctive nineteenth-century population composition, which included a large Chinese component; the notable confidence of its Irish-born population compared with that in other American urban centers; and the unique westward orientation of the city and its people that contributed to San Francisco's pivotal role in emerging transnational Pacific networks.

Psychometric properties evaluation of the Persian version of the self-report outcome scale for lupus disease Lupus_PRO version 1.7.

Systemic Lupus Erythematosus (SLE) significantly affects both the quality of life related to health and non-health aspects. This study aims to evaluate the psychometric properties of the Persian version of the Lupus_PRO questionnaire, version 1.7. The questionnaire serves as a specific self-report outcome scale for assessing the treatment outcomes of Lupus disease. The Lupus_PRO questionnaire, version 1.7, was translated into Persian using the standard forward-backward method. After being completed by 218 patients with Lupus, the psychometric properties of the instrument were examined. The Convergent and Discriminant Validity of the scale were assessed using Average Variance Extracted and Cross Loadings, respectively. The construct validity of the questionnaire was also evaluated through Confirmatory Factor Analysis (CFA). Cronbach's alpha was calculated to assess the reliability of the questionnaire dimensions. Out of the 218 patients with lupus who participated in the current study, 13 (6%) were male, and 205 (94%) were female. The mean (SD) age of participants was 40.29 (10.94) years. The Average Variance Extracted (AVE) for HRQOL and Non-HRQOL constructs, except for the Coping and Cognition dimension, was greater than 0.50, indicating satisfactory convergent validity. The interdimensional correlation coefficient (Discriminant Validity) for each dimension with other questionnaire dimensions was less than 0.10, indicating that the questionnaire has good convergent and discriminant validity. Additionally, the results of the Confirmatory Factor Analysis (CFA) indicated that the questionnaire was a suitable fit. In terms of reliability, Cronbach's alpha for the various questionnaire dimensions ranged from 0.51 to 0.91, indicating good internal consistency. The Persian version of the Lupus_PRO questionnaire, version 1.7, demonstrates acceptable validity and reliability in the Iranian population. This instrument can effectively measure various aspects of the quality of life in patients with lupus.

Comprehensive investigation of long non-coding RNA HOTAIR polymorphisms and cancer risk: a current meta-analysis encompassing 96,458 participants.

Cancer ranks as the second leading cause of mortality worldwide, prompting extensive investigations into factors contributing to its development. Among these factors, genetic variations, known as genotypic polymorphisms, have been identified as significant influencers in the susceptibility to various types of cancer. Recent research has focused on exploring the connection between polymorphisms in the Long Non-coding RNA HOTAIR and cancer risk. However, the results from these studies have been inconsistent, leading to ambiguity and controversy. To address this uncertainty, we conducted a systematic analysis by gathering relevant studies from PubMed, EMBASE, and Google Scholar. Specifically, we focused on three well-studied polymorphisms within the HOTAIR lncRNA (HOTAIR rs920778 C > T, HOTAIR rs1899663 G > T, HOTAIR rs4759314 A > G) and their association with cancer risk. Our meta-analysis included data from 48 case-control studies involving 42,321 cases and 54,137 controls. The results of our updated meta-analysis revealed a significant correlation between HOTAIR rs1899663 G > T and HOTAIR rs4759314 A > G polymorphisms and overall cancer risk, particularly in the homozygous and recessive genetic models. Subgroup analysis further revealed that these associations were notably pronounced in the Asian population but not observed in the Iranian population. Furthermore, our findings underscore the potential of HOTAIR polymorphisms as diagnostic markers for overall cancer risk, particularly in gynecological cancers, precisely, HOTAIR rs1899663 G > T polymorphism in breast cancer. In conclusion, our systematic analysis provides compelling evidence that Long Non-coding RNA HOTAIR polymorphisms are linked to cancer risk, particularly in certain populations and cancer types, suggesting their potential clinical relevance as diagnostic indicators.

Genetic Variations of (SOD2; Rs5746136) and (PON2; Rs705379) are Associated with the Risk Of PCOS and Influence Metabolic Profile Among the Iranian Population

Polycystic ovarian syndrome (PCOS) is one of the most prevalent disorders affecting women's metabolic, psychological, and reproductive features. This study investigated the roles of superoxide dismutase 2 (SOD2; rs5746136) and paraoxonase 2 (PON2; rs705379) gene polymorphisms on the risk of PCOS and oxidative stress and clinical indices in Iranian women. This cross-sectional study included 56 patients (female) with PCOS and 54 healthy women (control group), and single nucleotide polymorphisms (SNPs) of rs5746136 and rs705379 were genotyped. The results showed that there were no detectable variations in frequency between PCOS and control groups in SOD2 genotypes and alleles (p>0.05). Compared with controls, the frequency of rs705379-CC genotype was higher in PCOS individuals [adjusted OR (95%CI) = 2.171 (1.098-4.313), P=0.016], which showed a significant association. While the frequency of the TT genotype was higher in the reference group (OR= 0.464 (0.236-0.97), P=0.015). Patients with the A and C alleles exhibited considerably greater serum levels of luteinizing hormone (LH) and LH/FSH (follicle-stimulating hormone) than the control group. Our results revealed that the PON1 gene (C>T) polymorphism is related to the risk of PCOS. However, the SOD2 gene (G>A) polymorphism in our study population did not show any relation to PCOS. Importantly, oxidative stress parameters showed a significant relationship with PON1 rs705379-genotype.

External Validation of the TWIST Algorithm for Predicting Walking Independence Post-Acute Stroke: An Irish Prospective Cohort Study

Abstract Background Early prediction of walking dependency post-stroke is important for clinician and patient decision-making. National stroke guidelines recommend using the ‘Time to Walking Independently after Stroke’ (TWIST) model to predict walking independence post-stroke. External validation of the TWIST model is required prior to its clinical integration. This study aimed to evaluate whether the TWIST model is a valid predictor of walking independence post-stroke in an Irish population. Methods This prospective cohort study recruited patients admitted to a tertiary hospital with an acute stroke from July-November 2023. The Trunk Control Test (TCT) and paretic-limb hip extensor strength (Medical Research Council (MRC) scale) were assessed within 3 days post-stroke. Walking independence (Functional Ambulatory Category) was measured at 6 or 12 weeks post-stroke based on TWIST algorithm predictions. Predictive performance was measured using the area under the curve (AUC), accuracy, sensitivity, specificity, positive and negative predictive value. Results Sixty-one participants (38 male, median (interquartile range) age 74 years (68-86) and National Institutes of Health Stroke Scale 7 (4-11.5)) were included. The AUC (95% CI) was 0.88 (0.81-0.96) and 0.7 (0.21-1) at 6 and 12 weeks post-stroke respectively. Predictive accuracy (95% CI) was higher at 6 weeks (88.52% (77.78-95.26)) than 12 weeks post-stroke (86.96% (66.41-97.22)). Overall, the TWIST model made accurate predictions for 83.61% (71.91-91.85) of participants. Conclusion The TWIST model demonstrated fair-good predictive performance when externally validated. However, it performed poorly at 12 weeks post-stroke for those with poor post-stroke trunk control (TCT < 40) but moderate hip extensor strength (≥ 3 MRC scale). Further research is needed to explore its utility in this subgroup. Implication of Findings The TWIST model may benefit clinicians and patients by accurately predicting walking independence post-stroke. Further research is needed to explore its utility in specific subgroups, particularly those with poor post-stroke trunk control but moderate hip extensor strength.

Applying the 2023 ESH Hypertension Guidelines to the Irish Population- findings from the Irish Longitudinal Study on Ageing (TILDA)

Abstract Background Hypertension (HTN) is an important risk factor for cardiovascular disease (CVD), the leading cause of mortality worldwide. The aim of this study was to apply the latest European Society of Hypertension (ESH) Guidelines 2023 to the Irish general population. Methods This study used data from Wave 1 (2009-2010) and Wave 3 (2014-2015) of the Irish Longitudinal Study on Ageing (TILDA). TILDA is a prospective cohort study based on stratified random sampling, which is representative of the community living older population in Ireland (Aged 50 years and over). Using this data, the prevalence of HTN in the general population by grade and stage, as set out in the ESH 2023 guidelines, was calculated. Population awareness of diagnosis, treatment status, control on treatment and adherence to recommended anti-hypertensive medication classes were assessed. Subgroup analyses were explored in alignment with specified groups highlighted in the Guidelines including those over 80 years old with and without frailty, those with chronic kidney disease and those with home blood pressure (BP) measurements. Inverse probability weighting was applied to account for the complex survey design used in TILDA and data analysis was conducted using Stata 15.1. Results Results from Wave 3 (N=5,329): The prevalence of hypertension was 64.0% (95% confidence interval (CI) 62.4-65.6%). Of those with HTN, 55.5% (95% CI 53.3-57.7) were aware of their HTN diagnosis and 70.4% (95% CI 68.3-72.2%) were on antihypertensive treatment. Of those on treatment, 53.2% were controlled (BP < 140/90), and only 20.0% (95% CI 18.3-21.8) were on a recommended dual therapy. 55.2% were on at least one agent recommended by the ESH guidelines. Conclusion This study indicates a high prevalence of HTN in the general population in Ireland aged 50+ years with low levels of awareness, control, and poor adherence to the most recent ESH HTN guidelines.

Alternative Scenarios for Projected Prevalence of Stroke and Post-Stroke Dementia to 2046 in Ireland: A Model-Based Analysis

Abstract Background Understanding future population need is key for informing stroke service planning. This study aims to evaluate alternative scenarios for future trends in stroke age-specific incidence and case-fatality and estimate impact on projected stroke and post-stroke dementia prevalence in Ireland. Methods We used a probabilistic Markov model to project and track incidence and prevalence of stroke and post-stroke dementia in the Irish population aged 40-89 years to 2046. Using systematic review and observational evidence, we extrapolated trends in stroke age-specific incidence and case-fatality from 1990-2019 to 2016-2046. We defined optimistic, realistic and pessimistic scenarios, including scenarios where trends decelerated over time. Results The stable (pessimistic) scenario indicates a projected 95,278 stroke survivors in 2046 (95% uncertainty interval, UI = 91,404-99,487) (30.1 per 1000 pop), an increase of 53% from 2022 to 2046. The most optimistic scenario would involve a 3.2% increase from 2022 to 2046, to a projected 61,000 survivors. More realistic scenarios based on lower rates of incidence/case-fatality decline, or rates of decline slowing over time, imply an increase ranging between 22.9% and 37.2%. There will be a projected 19,430 with post-stroke dementia in 2046 (95% UI 17,182-21,904), an increase of 69.2% from 2022. In the most optimistic scenario, the increase would be 22.6%, with realistic scenarios implying an increase ranging between 38.9% and 53.2%. Conclusion Future stroke healthcare needs will vary substantially depending on epidemiological trends. A large increase in post-stroke dementia is projected across scenarios. Further work is needed to identify optimal policies to promote continuing decline in stroke incidence.