Repository of Research and Investigative Information Isfahan University of Medical Sciences
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Disadvantages of various methods of gastrointestinal feeding in patients admitted to the intensive care unit: A systematic review
No full textBackground: Gastrointestinal tube feeding is one of the most important and beneficial methods of nutrition in patients admitted to the intensive care unit. There is still no consensus on the best nutritional method that will lead to fewer complications. This study aimed to investigate the disadvantages of different methods of tube feeding in patients admitted to the adult intensive care unit. Methods: The present study is a review study conducted in 2022. Articles published in the English language databases including Web of Science, Scopus, Science Direct, and PubMed, between 2000 and 2022 were used. Results: In the initial search phase, 2893 articles were obtained. In the next step, after the review of titles and abstracts, 760 articles remained. Finally, based on inclusion criteria and full text review, 14 related articles were selected. Disadvantages of tube feeding methods were classified into four categories: "respiratory complications", "gastrointestinal complications", "metabolic complications" and "bed occupancy". Conclusions: Based on the results of this study, in terms of complications, intermittent and continuous methods are safer and more preferable than the bolus method. However, low-speed bolus feeding has fewer side effects
Application of human breast acellular dermal matrix (hbADM) in sling surgery for female stress urinary incontinence: a phase 1 clinical trial
No full textPurpose To evaluate the safety and feasibility of human breast acellular dermal matrix (hbADM) as an alternative to synthetic mesh and autologous fascia in sling surgery for female stress urinary incontinence (SUI), and to assess its preliminary efficacy in a phase 1 clinical trial. Methods Twenty-five women with pure SUI underwent hbADM sling surgery at two centers. The primary outcomes were safety (adverse events) and feasibility. Secondary outcomes included changes in International Consultation on Incontinence Questionnaire-Short Form (ICIQ-SF) scores, Patient Global Impression of Improvement (PGI-I), cough stress test results, and uroflowmetry parameters. Patients were followed up for 3 years. Statistical analysis included descriptive statistics, paired t-tests, and Wilcoxon signed-rank tests. Results The hbADM sling procedure was performed as planned in all patients. Adverse events occurred in 10 patients (40). Intraoperative and early postoperative events (9/25, 36) were mild and consistent with standard sling procedures. Late complications, observed in 2 patients (8), were limited to recurrent urinary tract infections (UTIs); one of these patients had also presented a UTI in the early phase. No cases of sling erosion or chronic pain were observed. Objective cure rates (negative cough stress test) remained high at 100 at 1 year and 95 at 3 years. However, patient-reported success (PGI-I <= 2) declined from 92 at 1 month to 65 at 3 years. The mean ICIQ-SF score improved significantly from 15.3 +/- 3.4 at baseline to 5.8 +/- 2.4 at 3 years post-surgery (p < 0.001). Uroflowmetry parameters remained stable throughout the follow-up. The recurrence rate was 10 at 3 years. Conclusion This phase 1 trial demonstrates the safety and feasibility of hbADM slings for female SUI treatment, with promising efficacy outcomes up to 3 years post-surgery. These results support further investigation of hbADM sling in larger, randomized controlled trials. Clinical trial registration This study was registered in the Iranian Registry of Clinical Trials (IRCT). Registration Number: IRCT201611278554N3 Registration Date: 2017-05-28
Insights from the eyes: a systematic review and meta-analysis of the intersection between eye-tracking and artificial intelligence in dementia
No full textObjectivesDementia can change oculomotor behavior, which is detectable through eye-tracking. This study aims to systematically review and conduct a meta-analysis of current literature on the intersection between eye-tracking and artificial intelligence (AI) in detecting dementia.MethodPubMed, Embase, Scopus, Web of Science, Cochrane, and IEEE databases were searched up to July 2023. All types of studies that utilized eye-tracking and AI to detect dementia and reported the performance metrics, were included. Data on the dementia type, performance, artificial intelligence, and eye-tracking paradigms were extracted. The registered protocol is available online on PROSPERO (ID: CRD42023451996).ResultsNine studies were finally included with a sample size ranging from 57 to 583 participants. Alzheimer's disease (AD) was the most common dementia type. Six studies used a machine learning model while three used a deep learning model. Meta-analysis revealed the accuracy, sensitivity, and specificity of using eye-tracking and artificial intelligence in detecting dementia, 88 95% CI (83%-92%), 85% 95% CI (75%-93%), and 86% 95% CI (79%-93%), respectively.ConclusionEye-tracking coupled with AI revealed promising results in terms of dementia detection. Further studies must incorporate larger sample sizes, standardized guidelines, and include other dementia types
Noise-induced hearing loss and blood factors: results from a comprehensive cross-sectional study in Iran
No full textBackgroundNoise-induced hearing loss (NIHL) is a common occupational hazard and a leading cause of hearing impairment among industrial workers. Previous studies have primarily focused on the association between physiological parameters and excessive noise exposure (above 85 dB). This study investigates the impact of sound exposure below the permissible limit (between 82 and 85 dB) on blood factors and hearing loss.MethodsThis cross-sectional analytical study examined 8946 male facility technicians from various industries in Iran, who were exposed to sound levels between 82 and 85 decibels (action limit) over a period of one year. The study examined various blood factors, including complete blood cell count (CBC), blood group (BG), fasting blood glucose (FBS), lipid factors such as triglycerides (TG) and cholesterol (Chol), and also blood pressure (BP). Additionally, the hearing status of participants was evaluated using pure tone audiometry for both ears.ResultsThe results indicated that age, work experience, SBP, FBS, Chol, Hb, Plt, and Hct were the main factors influencing hearing loss. FBS showed the highest impact on workers' hearing loss, accounting for 36.70 of the variance. Furthermore, Hb and PLT followed with weights of 19.10 and 12.4, respectively. However, no significant relationship was observed concerning the blood group type.ConclusionExposure to noise levels below the permissible limit can lead to hearing loss in individuals. Moreover, FBS, Hb, and PLT were identified as blood factors affecting hearing loss in people. Understanding this will provide the basis for future guidelines on how to care for these workers
The association between dietary diversity score and food insecurity and novel cardiovascular risk factors in type 2 diabetes mellitus patients: a cross-sectional study
No full textObjectivesAn efficient approach to monitor the risks associated with chronic diseases is to use a dietary diversity score (DDS). To our knowledge, there has been no study conducted on the correlation between DDS and cardiovascular risk factors in individuals with diabetes. Hence, the objective of this study is to ascertain the correlation between these traits.MethodsIn this cross-sectional investigation, 490 individuals with type 2 diabetes were included. The patients' food consumption was assessed using a 168-item food frequency questionnaire (FFQ), and a dietary diversity score (DDS) was computed. Traditional CVD risk variables were used to evaluate cardiovascular risk factors, including Castelli risk index 1 and 2 (CRI-I and II), atherogenic index of plasma (AIP), lipid accumulation product (LAP), and cholesterol index (CI). We evaluated the anthropometric indicators that predict CVD, including the abdominal volume index (AVI), body roundness index (BRI), and body shape index (ABSI).ResultsIn the final model adjusted for all the considered confounders, there was a significant association between DDS and LAP (OR: 1.33; 95 CI: 0.61, 0.82; p-trend = 0.03). Moreover, there was a significant association between DDS and AVI (OR: 1.99; 95 CI: 1.17,3.35; p-trend = 0.04). We could not find any association between food security and DDS among the participants of the current study.ConclusionsIn the present study, it was found that DDS may result in higher LAP and AVI which are markers of abdominal obesity and cardiovascular diseases. Therefore, despite the probable positive effect of having a diverse diet on cardiovascular health and wide recommendations for that, using healthier food groups should be considered
A method for rapid assessment of visual ergonomics and lighting conditions (RAVEL): An in-depth development and psychometrics study
No full textBACKGROUND: In workplaces heavily reliant on visual tasks, various factors can significantly influence an individual's performance, necessitating the use of reliable tools to identify and mitigate these factors.OBJECTIVE: This study aimed to develop a swift assessment method for visual ergonomics and lighting conditions, evaluating its validity in real-world scenarios.METHODS: The questionnaire's content validity was determined by a panel of experts using the content validity ratio (CVR) and content validity index (CVI). Construct validity was assessed through exploratory factor analysis (EFA), confirmatory factor analysis (CFA), and latent class analysis (LCA). Internal consistency was measured using Cronbach's alpha coefficient. The RAVEL index, derived from the calculated effect coefficients of items, classified total scores through receiver operator curves (ROCs).RESULTS: The rapid assessment method, comprising two parts with 30 items, demonstrated acceptable reliability with CVR, CVI, and Cronbach's alpha coefficient (alpha) at 0.75, 0.87, and 0.896, respectively. The EFA on the first part's 22 items identified three factors, confirmed by CFA. The LCA on the second part's eight items revealed that a two-class model best fit the data, with Bayesian information criterion (BIC) = 24249, 17, Akaik information criterion (AIC) = 2179.89, and an entropy R-squared of 0.83, indicating appropriate subject classification based on the model. The RAVEL score was categorized into three levels, with optimal cut points of 55 and 63.CONCLUSIONS: In conclusion, the study demonstrated that this method based on visual ergonomics serves as a rapid and reliable tool for assessing visual ergonomic risks of display users in the workplace
Adherence to diabetes risk reduction diet is associated with metabolic health status in adolescents with overweight or obesity
No full textBackgroundInsufficient evidence exists regarding the relationship between diabetes risk reduction diet (DRRD) and metabolic health status in adolescents. The current study aimed to investigate the relationship between DRRD and metabolic health status in Iranian adolescents with overweight/obesity.MethodsIn this cross-sectional study, a multistage cluster random sampling method was used to select 203 overweight/obese adolescents. Dietary intakes were evaluated using a validated 147-item food frequency questionnaire. The following parameters were measured: blood pressure, anthropometric indices, fasting glucose, insulin, and lipid profiles. Participants were classified to metabolically healthy overweight/obese (MHO) or metabolically unhealthy overweight/obese (MUO), based on 2 methods: International Diabetes Federation (IDF) criteria and a combination of IDF and Homeostasis Model Assessment Insulin Resistance (HOMA-IR).ResultsBased on IDF criteria, highest vs. lowest adherence to DRRD was associated with a lower odds of having an MUO phenotype in both crude (OR = 0.05; 95CI: 0.02-0.12) and fully adjusted model (OR = 0.06; 95CI: 0.02-0.20). Based on IDF/HOMA-IR criteria, similar findings were obtained. This relationship was significant in both genders and was especially significant among adolescents with obesity. In both crude and fully adjusted model, adherence to DRRD was significantly lower the likelihood of having high fasting blood glucose, triglycerides, and HOMA-IR.ConclusionAdolescents who adhered more strictly to DRRD were less likely to be MUO, and have high fasting blood glucose, triglycerides, and HOMA-IR. Additional large-scale prospective studies are necessary to affirm these results
Personality traits and quality of life: a cross-sectional study in a middle-aged Iranian general population
No full textIntroduction Despite considerable research on the association between Personality Traits (PT) and Quality of Life (QoL) in patients and older adults, this association remains poorly understood among the middle-aged general population.This investigation examines how each PT is associated with total QoL and its dimensions. Methods The present investigation utilized data collected from a cross-sectional survey involving 786 families in Isfahan (644 female/wife respondents), Iran. QoL and PT were assessed using the validated WHOQOL-BREF and NEO-FFI questionnaires. Other data including demographic and socioeconomic status (SES) were also collected. Statistical analyses included bivariate correlation and simple and multiple linear and logistic regressions. Results Mean value of Psychological health Mean difference = -4.34, P = 0.003, Physical health mean difference = -3.93, P = 0.004, and total score of QoL mean difference = -3.21, P = 0.049 were all significantly lower in women than men. Higher SES score was consistently associated with greater QoL scores (r > 0, P 1, P 0, P < 0.05). Conclusion This study provides robust evidence about the significant association of PT with QoL outcomes in middle aged people. This significant association highlights the importance of considering these traits in clinical applications, as tailored interventions based on personality profiles can effectively enhance the well-being of middle-aged individuals
Three Different Primary Cancers, Including Breast, Esophagus, and Renal in a Single Patient: A Case Report
No full textThere are different combinations of multiple primary cancers; however, the combination of breast, esophagus, and renal cancer has been reported in a few cases. Given the rising prevalence of multiple primary cancers over the past decade, understanding the risk factors for early detection is crucial
Global research trends on DPP-4 inhibitors and cardiovascular outcomes: a comprehensive bibliometric analysis
No full textBackground:Dipeptidyl peptidase-4 (DPP-4) inhibitors are oral antihyperglycemic agents commonly prescribed for type 2 diabetes (T2DM). Due to the intricate relationship between glucose regulation and cardiovascular diseases (CVDs), DPP-4 inhibitors have attracted attention for their cardiovascular safety and efficacy. This bibliometric analysis aims to provide insights into the global research landscape on DPP-4 inhibitors and cardiovascular outcomes (CVOs).Methods:A bibliometric analysis was performed, using the Web of Science Core Collection. Data were analyzed using VOSviewer, CiteSpace, and Biblioshiny.Results:The United States led in publication output, followed by Japan and China. Harvard University and the University of Toronto were the leading institutions. The most influential journals were Cardiovascular Diabetology and Diabetes Obesity & Metabolism. Darren K. McGuire was the most prolific author followed by Rury R. Holman. The most commonly occurring keyword was heart failure. Cluster analysis revealed key thematic areas in the field, including "incretin-based therapy," "dipeptidyl peptidase-4 inhibition," and "cardiovascular safety." Emerging clusters, such as "atrial fibrillation," have gained attention in recent years, highlighting evolving areas of investigation.Conclusion:This study underscores the importance of CVOs in the research on DPP-4 inhibitors. The high frequency of keywords such as "heart failure," along with recent terms like "mortality" and "risk," highlights a strong focus on cardiovascular safety and complications in the literature. Our analysis reflected that most studies address these critical aspects of cardiovascular health, discussing the potential role of DPP-4 inhibitors in mitigating adverse outcomes, particularly in patients with T2DM