12014 research outputs found
Sort by
The Impact of Low Advanced Glycation End Products Diet on Metabolic Risk Factors: A Systematic Review and Meta-Analysis of Randomized Controlled Trials
Full text linkSeveral randomized clinical trials have investigated the effect of dietary advanced glycation end products (AGEs) on metabolic syndrome risk factors in adults. However, the results of these studies were conflicting. Therefore, our aim was to assess the effect of dietary AGEs on metabolic syndrome risk factors. We searched the PubMed-MEDLINE, Scopus, Cochrane Databases, Google Scholar, Web of Science, and Embase databases for papers published up to October 2019 that investigated the effect of dietary AGEs on metabolic syndrome risk factors. From the eligible trials, 13 articles were selected for inclusion in this systematic review and meta-analysis. The meta-analysis was performed using a random-effects model. Heterogeneity was determined by I2 statistics and Cochrane Q test. Pooled results from the random-effects model showed a significant reduction for insulin resistance weighted mean difference (WMD): -1.204; 95% CI: -2.057, -0.358; P = 0.006, fasting insulin (WMD: -5.472 μU/mL; 95% CI: -9.718, -1.234 μU/mL; P = 0.011), total cholesterol (WMD: -5.486 mg/dL; 95% CI: -10.222, -0.747 mg/dL; P = 0.023), and LDL (WMD: -6.263 mg/dL; 95% CI: -11.659, -0.866 mg/dL; P = 0.023) in the low-AGEs groups compared with the high-AGEs groups. There were no changes in the other components of the metabolic syndrome. The results of this review suggest that a diet with a low AGEs content has beneficial effects on insulin resistance, fasting insulin, total cholesterol, and LDL. Moreover, following a diet low in AGEs may be a helpful strategy to decrease the burden of metabolic syndrome risk factors in adults and particularly in patients with diabetes. © 2020 The Author(s). Published by Oxford University Press on behalf of the American Society for Nutrition
Epidemiology of candidemia in Shiraz, southern Iran: A prospective multicenter study (2016-2018)
No full textSystematic candidemia studies, especially in southern Iran, are scarce. In the current prospective study, we investigated candidemia in three major healthcare centers of Shiraz, the largest city in southern Iran. Yeast isolates from blood and other sterile body fluids were identified by matrix-assisted laser desorption/ionization time-of-flight mass spectrometry and subjected to antifungal susceptibility testing (AFST) using the broth microdilution method. Clinical data were retrieved from patients' medical records. In total, 113 yeast isolates were recovered from 109 patients, over 60 of whom received fluconazole. Antifungal drugs were prescribed without considering species identification or AFST. The all-cause mortality rate was 28. Almost 30 of the patients were from intensive care units (ICUs). Candida albicans (56/113; 49.5) was the most prevalent species followed by C. glabrata (26/113; 23), C. parapsilosis (13/113; 11.5), C. tropicalis (7/113; 6.2), and C. dubliniensis (5/113; 4.4). Only five isolates showed antifungal resistance or decreased susceptibility to fluconazole: One C. orthopsilosis isolate from an azole-naïve patient and two C. glabrata, one C. albicans, and one C. dubliniensis isolates from patients treated with azoles, who developed therapeutic failure against azoles later. Our results revealed a low level of antifungal resistance but a notable rate of azole therapeutic failure among patients with candidemia due to non-albicans Candida species, which threaten the efficacy of fluconazole, the most widely used antifungal in southern regions of Iran. Candidemia studies should not be confined to ICUs and treatment should be administered based on species identification and AFST results. © 2020 The Author(s) 2020. Published by Oxford University Press on behalf of The International Society for Human and Animal Mycology
Graphene oxide: Opportunities and challenges in biomedicine
Full text linkDesirable carbon allotropes such as graphene oxide (GO) have entered the field with sev-eral biomedical applications, owing to their exceptional physicochemical and biological features, including extreme strength, found to be 200 times stronger than steel; remarkable light weight; large surface-to-volume ratio; chemical stability; unparalleled thermal and electrical conductivity; and enhanced cell adhesion, proliferation, and differentiation properties. The presence of functional groups on graphene oxide (GO) enhances further interactions with other molecules. Therefore, recent studies have focused on GO-based materials (GOBMs) rather than graphene. The aim of this research was to highlight the physicochemical and biological properties of GOBMs, especially their significance to biomedical applications. The latest studies of GOBMs in biomedical applications are critically reviewed, and in vitro and preclinical studies are assessed. Furthermore, the challenges likely to be faced and prospective future potential are addressed. GOBMs, a high potential emerging material, will dominate the materials of choice in the repair and development of human organs and medical devices. There is already great interest among academics as well as in pharmaceutical and biomedical industries. © 2021 by the authors. Licensee MDPI, Basel, Switzerland
Machine learning-based prognostic modeling using clinical data and quantitative radiomic features from chest CT images in COVID-19 patients
Full text linkObjective: To develop prognostic models for survival (alive or deceased status) prediction of COVID-19 patients using clinical data (demographics and history, laboratory tests, visual scoring by radiologists) and lung/lesion radiomic features extracted from chest CT images. Methods: Overall, 152 patients were enrolled in this study protocol. These were divided into 106 training/validation and 46 test datasets (untouched during training), respectively. Radiomic features were extracted from the segmented lungs and infectious lesions separately from chest CT images. Clinical data, including patients� history and demographics, laboratory tests and radiological scores were also collected. Univariate analysis was first performed (q-value reported after false discovery rate (FDR) correction) to determine the most predictive features among all imaging and clinical data. Prognostic modeling of survival was performed using radiomic features and clinical data, separately or in combination. Maximum relevance minimum redundancy (MRMR) and XGBoost were used for feature selection and classification. The receiver operating characteristic (ROC) curve and the area under the ROC curve (AUC), sensitivity, specificity, and accuracy were used to assess the prognostic performance of the models on the test datasets. Results: For clinical data, cancer comorbidity (q-value < 0.01), consciousness level (q-value < 0.05) and radiological score involved zone (q-value < 0.02) were found to have high correlated features with outcome. Oxygen saturation (AUC = 0.73, q-value < 0.01) and Blood Urea Nitrogen (AUC = 0.72, q-value = 0.72) were identified as high clinical features. For lung radiomic features, SAHGLE (AUC = 0.70) and HGLZE (AUC = 0.67) from GLSZM were identified as most prognostic features. Amongst lesion radiomic features, RLNU from GLRLM (AUC = 0.73), HGLZE from GLSZM (AUC = 0.73) had the highest performance. In multivariate analysis, combining lung, lesion and clinical features was determined to provide the most accurate prognostic model (AUC = 0.95 ± 0.029 (95CI: 0.95�0.96), accuracy = 0.88 ± 0.046 (95 CI: 0.88�0.89), sensitivity = 0.88 ± 0.066 (95 CI = 0.87�0.9) and specificity = 0.89 ± 0.07 (95 CI = 0.87�0.9)). Conclusion: Combination of radiomic features and clinical data can effectively predict outcome in COVID-19 patients. The developed model has significant potential for improved management of COVID-19 patients. © 2021 The Author(s
Efficacy and safety of non-thermal nitrogen plasma versus long-pulsed Nd:YAG laser for hand rejuvenation
No full textThis randomized controlled study aimed to investigate the efficacy and safety of multiple treatment sessions of pulsed non-thermal atmospheric pressure nitrogen plasma compared with long-pulsed Nd:YAG laser for hand rejuvenation. To optimize the nitrogen plasma mode for rejuvenation, the relative intensity of reactive species and skin temperature was compared at different input powers and time periods. Twenty-five patients with mild-moderate photodamaged skin were recruited; one hand was randomly selected for eight weekly treatment sessions with plasma (two passes), while the other was subjected to three monthly treatments with laser (until erythema became obvious). A blinded dermatologist scored the mean wrinkle and dyschromia improvement at 1 and 2 months after the first treatment and 1 and 3 months after the last treatment. The patients� satisfaction and the biomechanical characteristics of the skin including cutaneous resonance running time (CRRT), melanin, transepidermal water loss (TEWL), and hydration were evaluated. Clinically, both methods gave rise to a similar, significant improvement in wrinkles (49.09 ± 19.18 and 39.32 ± 18.21 after plasma and laser, respectively) and dyschromia (45.00 ± 26.32 and 30.62 ± 24.99 after plasma and laser, respectively) (P < 0.05). A significant decrease in CRRT and melanin was seen following treatment with either method (P < 0.05). Notably, plasma therapy led to a significant decrease in TEWL and boosted skin hydration. This is while laser therapy augmented the TEWL and reduced skin hydration. Our findings corroborate that cold plasma is as effective and safe as long-pulsed Nd:YAG laser, with less discomfort and dryness during treatment. The protocol was approved by the Iranian Registry of Clinical Trials. IRCT20160320027109N4. Registered 9 April 2019 (This manuscript is only a part of this registered project.). © 2021, Springer-Verlag London Ltd., part of Springer Nature
World competitive contest-based artificial neural network: A new class-specific method for classification of clinical and biological datasets
No full textMany data mining methods have been proposed to generate computer-aided diagnostic systems, which may determine diseases in their early stages by categorizing the data into some proper classes. Considering the importance of the existence of a suitable classifier, the present study aims to introduce an efficient approach based on the World Competitive Contests (WCC) algorithm as well as a multi-layer perceptron artificial neural network (ANN). Unlike the previously introduced methods, which each has developed a universal model for all different kinds of data classes, our proposed approach generates a single specific model for each individual class of data. The experimental results show that the proposed method (ANNWCC), which can be applied to both the balanced and unbalanced datasets, yields more than 76 (without applying feature selection methods) and 90 (with applying feature selection methods) of the average five-fold cross-validation accuracy on the 13 clinical and biological datasets. The findings also indicate that under different conditions, our proposed method can produce better results in comparison to some state-of-art meta-heuristic algorithms and methods in terms of various statistical and classification measurements. To classify the clinical and biological data, a multi-layer ANN and the WCC algorithm were combined. It was shown that developing a specific model for each individual class of data may yield better results compared with creating a universal model for all of the existing data classes. Besides, some efficient algorithms proved to be essential to generate acceptable biological results, and the methods' performance was found to be enhanced by fuzzifying or normalizing the biological data. © 2020 Elsevier Inc
MicroRNAs and SARS-CoV-2 life cycle, pathogenesis, and mutations: biomarkers or therapeutic agents?
Full text linkTo date, proposed therapies and antiviral drugs have been failed to cure coronavirus disease 2019 (COVID-19) patients. However, at least two drug companies have applied for emergency use authorization with the United States Food and Drug Administration for their coronavirus vaccine candidates and several other vaccines are in various stages of development to determine safety and efficacy. Recently, some studies have shown the role of different human and severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) microRNAs (miRNAs) in the pathophysiology of COVID-19. miRNAs are non-coding single-stranded RNAs, which are involved in several physiological and pathological conditions, such as cell proliferation, differentiation, and metabolism. They act as negative regulators of protein synthesis through binding to the 3� untranslated region (3� UTR) of the complementary target mRNA, leading to mRNA degradation or inhibition. The databases of Google Scholar, Scopus, PubMed, and Web of Science were searched for literature regarding the importance of miRNAs in the SARS-CoV-2 life cycle, pathogenesis, and genomic mutations. Furthermore, promising miRNAs as a biomarker or antiviral agent in COVID-19 therapy are reviewed. © 2020 Informa UK Limited, trading as Taylor & Francis Group
Comparison of Vitamin B12, Vitamin D, and Folic Acid Blood Levels in Plumbism Patients and Controls in Eastern Iran
No full textThe aim of this study was to evaluate the blood levels of folic acid, vitamin B12, and 25-hydroxyvitamin D (25-OHD) in patients with lead poisoning compared with control subjects in Eastern Iran. This analytical case-control study was conducted on 40 lead-poisoned patients who were referred to Imam Reza Hospital in Birjand from 2018 to 2019. Blood samples were collected from an additional 40 individuals without lead poisoning as a control group. The results indicated that the mean vitamin B12, vitamin D, and folic acid levels for the case group were 356.5 ± 200.1 pg/ml, 24.38 ± 9.5 ng/ml, and 7.4 ± 3.7 ng/ml, respectively. Mean folic acid level in the case group was significantly lower than control group (7.4 ng/ml vs. 12.70 pg/ml, P = 0.001), whereas the mean of the vitamin D levels at the case group was significantly higher than that of the control group (24.3 ng/ml vs. 20.1 ng/ml, P = 0.03). Moreover, mean vitamin B12 levels were significantly lower in the case group in comparison with the control group (356.5 pg/ml vs. 500.8 pg/ml) (P < 0.001). In the control group, 3 patients had folic acid below normal level (< 6 ng/mL) while 12 cases had folic acid below normal (P < 0.05). Also, none of the control group had low vitamin B12 concentrations (< 180 pg/ml), while 7 cases had vitamin b12 below normal (P < 0.05). Our results suggest that lead may induce folate and vitamin B12 dysregulation. Although we found that vitamin D levels were insufficient in both case and control groups, they were significantly higher in the case group. The interpretation of this result is unclear given inconsistent literature reports on this relationship. © 2020, Springer Science+Business Media, LLC, part of Springer Nature
Efficacy of allogeneic cord blood platelet gel on wounds of dystrophic epidermolysis bullosa patients after pseudosyndactyly surgery
No full textEpidermolysis bullosa (EB) is a rare genetic disorder characterized by the formation of blisters and wounds in skin and mucous membranes; it is classified into four types and has various methods of treatment. Management of previous wounds and prevention of formation of new lesions are the most important strategies in the course of therapy to improve patient's quality of life; lack of wound management can lead to further complications such as infection. The current study investigated the therapeutic effects of allogeneic platelet gel (prepared from umbilical cord blood) in a group of children diagnosed with dystrophic epidermolysis bullosa (DEB) eligible for surgical correction of pseudosyndactyly in the hand. The post-surgical clinical outcome in this group was compared with the clinical outcomes of DEB patients receiving the standard treatment (paraffin gauze wound dressing and topical antibiotics) after corrective surgery. The current study results showed an increase in the rate of recovery and promotion of tissue granulation, complete wound healing, and a decrease in pain level and treatment period. The application of cord blood platelet gel topical dressing was not a conventional method of treatment in patients with DEB wounds and blisters. However, the current study results demonstrated that this gel dressing could effectively accelerate epithelialization and healing of the wounds and decrease patients' pain and post-surgical recovery period, which altogether leads to improvements in patients' overall quality of life. © 2020 by the Wound Healing Societ
Indicators of Quality of Care in Individuals With Traumatic Spinal Cord Injury: A Scoping Review
Full text linkStudy Design: Scoping review. Objectives: To identify a practical and reproducible approach to organize Quality of Care Indicators (QoCI) in individuals with traumatic spinal cord injury (TSCI). Methods: A comprehensive literature review was conducted in the Cochrane Central Register of Controlled Trials (CENTRAL) (Date: May 2018), MEDLINE (1946 to May 2018), and EMBASE (1974 to May 2018). Two independent reviewers screened 6092 records and included 262 full texts, among which 60 studies were included for qualitative analysis. We included studies, with no language restriction, containing at least 1 quality of care indicator for individuals with traumatic spinal cord injury. Each potential indicator was evaluated in an online, focused group discussion to define its categorization (healthcare system structure, medical process, and individuals with Traumatic Spinal Cord Injury related outcomes), definition, survey options, and scale. Results: A total of 87 indicators were identified from 60 studies screened using our eligibility criteria. We defined each indicator. Out of 87 indicators, 37 appraised the healthcare system structure, 30 evaluated medical processes, and 20 included individuals with TSCI related outcomes. The healthcare system structure included the impact of the cost of hospitalization and rehabilitation, as well as staff and patient perception of treatment. The medical processes included targeting physical activities for improvement of health-related outcomes and complications. Changes in motor score, functional independence, and readmission rates were reported as individuals with TSCI-related outcomes indicators. Conclusion: Indicators of quality of care in the management of individuals with TSCI are important for health policy strategists to standardize healthcare assessment, for clinicians to improve care, and for data collection efforts including registries. © The Author(s) 2021