Repository of Research and Investigative Information Isfahan University of Medical Sciences
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Comparison of the two treatment methods in primary hyperparathyroidism due to solitary parathyroid adenoma, Ultrasound-guided percutaneous alcohol ablation vs. parathyroidectomy: a randomized controlled trial
No full textBackground Primary hyperparathyroidism (pHPT) is the third most common endocrine system disorder. Parathyroidectomy (PTx) is the gold standard of care in symptomatic patients. Patients who are not surgical candidates may benefit from percutaneous ethanol ablation, which is a minimally invasive procedure. This study aims to evaluate the effectiveness and safety of PTx vs. PEA. Method A single-centered randomized, not-blinded parallel clinical trial in consecutive patients with pHPT treated with percutaneous alcohol ablation (PEA) between January 2020 and November 2021. Patients with a confirmed solitary parathyroid adenoma and a biochemically verified pHPT were randomly enrolled in the PTx or PEA groups. Complications and lab data were evaluated 24 h, 2 weeks, 3 months, and 6 months following interventions. Effectiveness was defined as complete response (normal calcium and PTH), partial response (reduced but not normalized PTH with normal serum calcium), or disease persistence (elevated calcium and PTH). SPSS 22.0 was used for statistical analysis. Result The final sample comprised 68 patients in each group which 113 of whom were female (83.0). Complete response was observed in 91.1 (n = 62) of the PEA group and 98.5 (n = 67) of the PTx group. According to repeated-measures analysis, Calcium, PTH, Phosphorus, and Alkaline phosphatase fell significantly and continuously in each intervention group, except for the persistent patients. According to ROC analysis, a cutoff of > 425.5 mm3 for the adenoma volume and > 13.5 mm for its largest diameter showed a sensitivity = 75 and specificity = 69 for partial response in the PEA group (AUC = 0.81 and 0.84, respectively). PTx group experienced statistically significant higher pain according to the Visual Analogue Scale (VAS score) (p < 0.001). Conclusion PTH, serum-adjusted Calcium, and adenoma size and volume were all significantly reduced by PTx and PEA, with no significant difference between them. PEA is an effective alternative to PTx, particularly in adenomas with a volume of less than 425.5 mm3 and a maximum diameter of 13.5 mm
Predictors of Fertility Intention in Parents with Educable Intellectually Disabled Children in Isfahan, Iran
No full textBackground:The fertility rate has declined in many countries over the past decades. Fertility intention is the determinant of fertility behavior. Various factors may affect the fertility intention of couples with no or healthy children. However, some parents may also have children with intellectual disabilities that affect their childbearing. Therefore, the main objective of this study is to identify predictors of fertility intention in parents with educable intellectually disabled children. Materials and Methods:The present study was a descriptive cross-sectional study conducted on 193 parents with educable intellectually disabled children living in Isfahan. Sampling was implemented using clustering and the classification method from February to July 2019. Data were collected through a self-report questionnaire and analyzed using SPSS 20, logistic regression, and independent t-tests. Results:Approximately 83.9 of participants had negative fertility intentions. Predictors of fertility intention were perceived behavior control (95CI: 1.14- 1.42; p = 0.001; OR = 1.28), attitude (95CI: 1.06- 1.24; p = 0.001; OR = 1.14) and subjective norm (95CI: 1.08- 1.33; p = 0.001; OR = 1.20), respectively. On the other hand, the perceived behavioral control was the strongest predictor. The son preference was higher in parents with positive fertility intentions (p < 0.05). Conclusions:According to the results of the present study, it seemed that factors such as perceived behavior control, attitude, and subjective norms affected fertility intention in parents with intellectually disabled children. Therefore, it is suggested to gain knowledge about the roles of these predictors and counsel parents to choose contraceptive methods or encourage them in childbearing
CircWaveDL: Modeling of optical coherence tomography images based on a new supervised tensor-based dictionary learning for classification of macular abnormalities
No full textModeling Optical Coherence Tomography (OCT) images is crucial for numerous image processing applications and aids ophthalmologists in the early detection of macular abnormalities. Sparse representation-based models, particularly dictionary learning (DL), play a pivotal role in image modeling. Traditional DL methods often transform higher-order tensors into vectors and then aggregate them into a matrix, which overlooks the inherent multi-dimensional structure of the data. To address this limitation, tensor-based DL approaches have been introduced. In this study, we present a novel tensor-based DL algorithm, CircWaveDL, for OCT classification, where both the training data and the dictionary are modeled as higher-order tensors. We named our approach CircWaveDL to reflect the use of CircWave atoms for dictionary initialization, rather than random initialization. CircWave has previously shown effectiveness in OCT classification, making it a fitting basis function for our DL method. The algorithm employs CANDECOMP/PARAFAC (CP) decomposition to factorize each tensor into lower dimensions. We then learn a sub-dictionary for each class using its respective training tensor. For testing, a test tensor is reconstructed with each sub-dictionary, and each test B-scan is assigned to the class that yields the minimal residual error. To evaluate the model's generalizability, we tested it across three distinct databases. Additionally, we introduce a new heatmap generation technique based on averaging the most significant atoms of the learned sub-dictionaries. This approach highlights that selecting an appropriate sub-dictionary for reconstructing test B-scans improves reconstructions, emphasizing the distinctive features of different classes. CircWaveDL demonstrated strong generalizability across external validation datasets, outperforming previous classification methods. It achieved accuracies of 92.5, 86.1 , and 89.3 on datasets 1, 2, and 3, respectively, showcasing its efficacy in OCT image classification
Investigate Effects of Music Therapy on Functional Connectivity in Papez Circuit of Breast Cancer Patients Using fMRI
No full textThe aim of this study is to investigate activity and functional connectivity (FC) of Papez circuit networks associated with music processing using functional magnetic resonance imaging (fMRI) in depressed breast cancer patients. Twenty-three breast cancer patients listened to four different Iranian/Persian music paradigms during the resting-state fMRI scanning session: negative stimulation of traditional music, negative stimulation of pop music, positive stimulation of traditional music and positive stimulation of pop music. The amplitude of low-frequency fluctuation (ALFF) was used to evaluate the local characteristics of spontaneous brain activity. FC maps were created using multivariate ROI-to-ROI connectivity (mRRC) and Papez circuit-based regions of interest (ROIs) selection. We found that music increases FC within various brain networks which are involved in memory, emotion, and cognitive function, including the limbic system, the default mode network (DMN), salience network (SN), and central executive network (CEN). Moreover, it seems that the traditional types (both positive and negative) of Iranian music may be more effective to affect brain activity in the patients with breast cancer, than the Iranian pop music. These findings demonstrate that music therapy, as an effective and easily applicable approach, supports the neuropsychological recovery and can contribute to standard treatment protocols in patients with breast cancer
Evaluating hospital performance with additive DEA and MPI: the Isfahan University of Medical Science case study
No full textBackground Hospitals are a vital pillar of the health system, and measuring their performance by an appropriate quantitative model is crucial. This study evaluated the performance of hospitals affiliated with Isfahan University of Medical Sciences. It deals with the nature of dynamics (the performance of evaluation indicators over time), examining controllable, uncontrollable, and undesirable input and output indicators. Methods This study evaluated the performance of 26 Isfahan University of Medical Science hospitals in terms of efficiency and productivity with hybrid Data Envelopment Analysis (DEA) models, namely, the additive classic, Malmquist productivity index (MPI), and super-efficiency models, from 2019 through 2022. Thirteen indicators (four inputs and nine outputs) were selected as model variables by brainstorming in the expert panel. Results The average technical efficiency of hospitals during the four periods was 0.86, indicating an average inefficiency of 14. Malmquist productivity index results over four periods showed hospitals operating with an average of 11 positive growth, reflecting an overall increase in productivity. Notably, some hospitals with high technical efficiency displayed lower total productivity growth rates due to fluctuations in specific indicators. On average, in the four under study years, 12 hospitals were efficient, of which 75 (9 hospitals) had performance progress (average MPI > 1). On the contrary, among the 14 inefficient hospitals during the four studied years, more than 90 of the hospitals had improved performance. Conclusion This study introduces a multidimensional and dynamic model for evaluating hospital performance. While classic DEA models provide a statistical performance evaluation, the Malmquist Productivity Index reveals dynamic performance changes over time. These findings underscore the need for hospitals to adopt advanced quantitative models to optimize resource allocation and enhance service delivery
The effect of fermented dairy intake and abdominal obesity in adults: a systematic review and dose-response meta-analysis of cohort studies
No full textObjectivesDiverse analysis has analyzed the potential efficacy of consuming foods created through the fermentation of dairy in mitigating abdominal obesity. The current meta-analysis aims to determine the impacts of consuming fermented dairy foods and the occurrence of abdominal obesity.MethodsWeb of Science, PubMed, and Scopus databases were queried for records published before January 13, 2023, to investigate proportionate cohort studies. We employed a random-effects model to appraise the relative risk (RR); effect size was assessed through the 95 confidence interval (CI). Additionally, a one-stage dose-response analysis was executed, quality assessment was conducted through the ROBINS-E tool.ResultsConsequently, five publications, comprising 41,430 cases, were included as selected studies. The pooled effect shows an effect on the abdominal obesity risk; however, the effect was not significant. Subgroup analyses revealed a potential risk reduction effect in high- and low-fat and fermented dairy productions, although the findings were not statistically significant. Furthermore, the dose-response analysis indicated a linear decrease in risk with increasing consumption of high-fat fermented yogurt, with an HR of 0.84 (95 CI 0.71, 0.99) by 8 servings/week and an HR of 0.37 (95 CI 0.19, 0.71) by 21 servings/week.ConclusionThese findings imply the potential effectiveness of fermented dairy products, particularly high-fat yogurt, in diminishing the obesity risk. However, further research addressing the limitations of previous studies is essential to confirm these results.Evidence-based medicine level: No level of evidence: Level of evidence III.PROSPERO registration number: CRD42023387538 (http://www.crd.york.ac.uk/PROSPERO).ConclusionThese findings imply the potential effectiveness of fermented dairy products, particularly high-fat yogurt, in diminishing the obesity risk. However, further research addressing the limitations of previous studies is essential to confirm these results.Evidence-based medicine level: No level of evidence: Level of evidence III.PROSPERO registration number: CRD42023387538 (http://www.crd.york.ac.uk/PROSPERO).ConclusionThese findings imply the potential effectiveness of fermented dairy products, particularly high-fat yogurt, in diminishing the obesity risk. However, further research addressing the limitations of previous studies is essential to confirm these results.Evidence-based medicine level: No level of evidence: Level of evidence III.PROSPERO registration number: CRD42023387538 (http://www.crd.york.ac.uk/PROSPERO)
Bio-nanoparticles sensor couple with smartphone digital image colorimetry and dispersive liquid-liquid microextraction for aflatoxin B1 detection
No full textA novel nanobiosensor-based colorimetric method was developed by integrating ZnO nanoparticles functionalized with curcumin, dispersive liquid-liquid microextraction (DLLME), and smartphone digital image colorimetry for the sensitive detection of aflatoxin B1 (AFB1) in baby food samples. The unique combination of biologically-derived ZnO nanoparticles with curcumin created a sensing platform, while DLLME provided efficient pre-concentration of the target analyte. A custom-designed portable colorimetric box enabled standardized image capture and analysis using a smartphone camera and colorimetric software. Under optimized conditions using chloroform as the extraction solvent and acetonitrile as the disperser solvent, the method achieved a remarkable limit of detection of 0.09 mu g/kg within linear concentration range of 0-1 mu g/L. The calibration curves demonstrated excellent linearity (R-2 > 0.9906) with high precision (RSD < 5.52). The method was successfully validated using baby food samples, achieving high recoveries (89.8-94.2). This innovative integration of nanobiosensing, microextraction, and smartphone technology offers a rapid, highly sensitive, and cost-effective platform for on-site AFB1 detection in food safety applications, particularly beneficial for resource-limited settings
Impact of DASH and mediterranean diets on mood and happiness in young adult males: a cross-sectional study
No full textObjectiveThe association between the Mediterranean diet (MED) and the dietary approach to stop hypertension (DASH) with some mental disorders is well-documented. However, a consistent relationship with young adults as a vulnerable population has yet to be known. Therefore, we aimed to investigate the relation between Iranian young male adults' mood and happiness state with DASH/MED patterns.ResultsParticipants' mean age was 23.65 +/- 1.74 years, within the age range of 18-28 years, and their BMI was 24.23 +/- 3.82 kg/m(2). After adjusting for all covariates, those in the highest DASH tertile had 54 lower odds of poor mood compared to the lowest tertile (OR = 0.46; 95CI: 0.24, 0.88). An inverse relationship was also found between DASH and low happiness scores (OR T3 vs. T1 = 0.51, 95CI: 0.27, 0.96). No significant association was found between MED and mood or happiness. Therefore, results showed that participants who adhered more closely to the DASH diet were less likely to report being unhappy or having a poor mood. Further prospective studies are required to confirm these findings
Impact of analgesics on the risk of ovarian cancer; a systematic review and meta-analysis of cohort and case-control studies
No full textIntroduction: Ovarian cancer is the sixth leading cancer-related mortality cause in women worldwide. Analgesics may hinder the occurrence of ovarian cancer through inflammation relief. The present study seeks to examine the relationship between analgesic consumption and ovarian cancer risk through a systematic review and metaanalysis. Materials and Methods: PubMed, Scopus, Web of Science, Cochrane databases, and Google Scholar search engines were searched for works published by May 2023 using standard keywords to collect the required data sources. Acquired data were then analyzed in STATA version14, considering a significance level of P < 0.05 in statistical tests. Results: The present meta-analysis comprised 21 studies (14 case-control and 7 cohort studies) performed on 53,755 subjects. Results indicated that taking aspirin reduced the risk of ovarian cancer by 8 (OR: 0.92; 95 CI: 0.87, 0.98), whereas other non-aspirin NSAIDs (non-steroidal anti-inflammatory drugs) did not significantly affect the ovarian cancer risk (OR: 0.91; 95 CI: 0.81, 1.02). Similar results were observed in the case of ibuprofen and acetaminophen, with non-significant relationships between the risk of ovarian cancer and with the consumption of both acetaminophen (OR: 0.95; 95 CI: 0.84, 1.08) and ibuprofen (OR: 0.76; 95 CI: 0.50, 1.14). Furthermore, the duration of analgesic consumption was not significantly linked to the risk of ovarian cancer in the case of all studied drugs. Conclusion: Among aspirin, ibuprofen, acetaminophen, and non-aspirin NSAIDs, only aspirin was found to reduce the risk of ovarian cancer in women while the other studied drugs did not influence the studied risk. However, further research is recommended to confirm the results
Subcutaneous implantation of tooth germ stem cells over the masseter muscle in mice: An in vivo pilot study
No full textObjectives: This study aimed to explore the potential of tooth germ stem cells for regenerating tooth-like structures by subcutaneously implanting first molar tooth germ stem cells over the masseter muscle in mice. Methods: Five pairs of house mice, Mus musculus, were selected for mating. At gestational day 14 (E14), the fetuses were extracted, and the first molar tooth germ at the cap stage was isolated. Tooth germ stem cells were prepared into a suspension and seeded onto scaffolds, which were then implanted subcutaneously over the masseter muscle in male mice. The control group (n 1/4 5 male mice) received acellular scaffolds implanted at the same site. After 20 days, the regenerated tissues were resected and analyzed histologically using hematoxylin and eosin (H & E) staining, Masson's trichrome staining, and immunohistochemical (IHC) staining for cytokeratin (CK) and vimentin markers. Results: H & E staining showed the formation of integrated oval structures at the implant site in all samples. Masson's trichrome staining identified dispersed accumulations of cellular mineralized matrix within the connective tissue. IHC staining was positive for vimentin, confirming the mesenchymal origin of the loose tissue at the center, indicating future dental pulp development. Positive CK staining indicated the ectodermal origin of dense peripheral tissues, suggesting the future formation of inner enamel epithelium. The combined immunohistochemical results for vimentin and CK confirmed the ectomesenchymal origin of the regenerated tissue, which resembled a late bell-stage tooth germ observed around gestational days 17.5-18 and showed early indications of dentin formation (D0). Conclusion: The study indicates that tooth germ stem cells may have the potential to produce dense, tooth-like structures when implanted subcutaneously in mice. These findings provide preliminary insights into the possible applications of tooth germ stem cells in regenerative dental tissue engineering. (c) 2025 The Author(s). Published by Elsevier BV on behalf of The Japanese Society for Regenerative Medicine. This is an open access article under the CC BY-NC-ND license (http://creativecommons.org/ licenses/by-nc-nd/4.0/)