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Prediction of Breast Cancer Metastasis Via Decision Tree Modeling
No full textBackground: Nowadays, breast cancer (BC) metastasis is a nightmare for women and one of the main challenges among researchers worldwide. Unlike traditional statistical methods that are not able to handle and take into account the complexity of effects and existence of interactions among predictor variables, the decision trees can overcome these problems. This study aimed to predict and identify the main prognostic factors of BC metastasis status (binary response) using decision tree modeling. Methods: This retrospective cohort study was conducted on 375 patients with BC who had registered with the Comprehensive Cancer Control Center from 1998 to 2013. Some demographic features related to the conditions of the Person’s disease and the type of treatment received were recorded. We applied a tree-based approach using the Gini index as the homogeneity criterion to explore the factors affecting metastasis occurrence in BC patients. Results: The mean (SD) age of BC patients with and without metastasis was 55.7 (12.4) and 43.1 (7.2) years, respectively (P<0.001). The rate of metastasis was 33.3. The five most important risk factors for metastasis of tumor proposed by tree diagram were age at diagnosis, grade of tumor, type of surgery, number of deliveries, and axillary surgery. The prediction accuracy of the proposed model was 84.3, and its sensitivity and specificity were 66.4 and 93.2, respectively. Conclusion: Age at diagnosis was the most important factor for predicting breast cancer metastasis, so that breast cancer patients aged over 54 were at high risk of metastasis
Effect of Different Approaches to Intravenous Nutrition on the Pattern of Weight Gain in Very Low Birth Weight Preterm Neonates: A Randomized Clinical Trial
No full textBackground: Low birth weight neonates have low energy reserves; thus, postpartum feeding is required to meet their ongoing nutritional requirements. Total parenteral nutrition (TPN) provides critical nutrients for the metabolism and development of neonates; however, few studies have investigated the effect of TPN on the early growth patterns of neonates. The present study examined the effects of TPN on preterm neonate anthropometric characteristics using two commonly used TPN calorie introduction techniques. Methods: This randomized clinical trial studied preterm neonates with birth weights of less than 1500 g. Calories were initiated at a rate of 3 g/kg for lipids and 3.5 g/kg for amino acids in the intervention group. In the control group, the amino acid solution was begun at 1 g/kg/day and the lipid solution at 0.5 g/kg/day, and both were increased daily by 1 g/kg to a maximum of 3.5 and 3 g/kg/day for amino acids and lipids, respectively. In this group, all neonates reached full calorie intake at 3 to 5 days of age. The trend of change in the anthropometric parameters was evaluated and compared. Results: Although both groups showed an increase in neonatal weight, length and head circumference, no statistically significant difference was observed between them. Both groups had similar lengths of hospital stay. Conclusion: Based on the findings of the present study, TPN feeding done using two approaches to amino acid and lipid administration had no significant influence on hospital stay, TPN duration, or growth indices in preterm neonates weighing less than 1500 g
Effect of resistance and endurance training with ursolic acid on oxidative stress and cognitive impairment in hippocampal tissue in HFD/STZ-induced aged diabetic rats
No full textObjective(s): The increase in age-related cognitive impairment (CIs) and diabetes mellitus is a global health concern. Exercise training has been reported to activate the Nrf2/Keap1/ARE signaling and enhance the antioxidant defense pathways in some animal models. This study aimed to investigate the effects of ursolic acid (UA) associated with resistance or endurance training on antioxidant markers, and the Nrf2/Keap1/ARE pathway in the brain of older diabetic rats. Materials and Methods: 23-month-aged diabetes induced male Wistar rats were randomly assigned to seven groups (n=8). UA supplementation (250 mg/kg, daily) was administered along with resistance (60 maximum capacity of voluntary carrying MVCC, 14-20 climbs) or endurance training (60-75% velocity at maximal oxygen uptake vVO2max), five days/week for eight weeks. Cognitive-motor functioning was assessed through open-field and passive avoidance response tests. Nrf2, Keap1, and antioxidant markers including SOD, CAT, GPx, and GSH were measured in the hippocampus tissue. Results: The results showed positive effect of resistance training (P≤0.001) on Nrf2. There was endurance training with supplementation main effect (P=0.018) on Keap1 concentration. SOD revealed a significant endurance/resistance training by supplementation interaction effect (P≤0.05); however, there was no main training or UA supplementation effects on CAT, GPx, and GSH, despite improving spatial memory changes in exercise or UA groups. Conclusion: It appears that UA treatment with resistance or endurance exercise has some beneficial effects on Nrf2 and some antioxidant markers. However, more research is needed to elucidate UA’s interaction effects and exercise interventions in diabetic situations
The effect of the supportive care program based on Bandura's self-efficacy on stress and participation of the mothers of the neonates admitted to neonatal intensive care unit
No full textBACKGROUND: Maternal stress can affect both the neonate and the mother and deter them from participating in the care of preterm neonates. The purpose of the study was to determine the effect of the supportive care program (SCP) based on Bandura’s self‑efficacy on stress and participation of mothers of neonates admitted to the neonatal intensive care unit. MATERIALS AND METHODS: This quasi‑experimental study was performed in 2020 on 90 mothers of premature infants admitted to the NICU of Hajar Hospital in Shahrekord, Iran. First, the control group and then the experimental group were selected and a training package based on Bandura’s self‑efficacy theory was implemented for the intervention group. The research instruments in this study were the Heidari mothers stress questionnaire and Melnyk mother’s participation questionnaire which was completed before and after the intervention. The analysis was performed based on SPSS (version 24) and Chi‑square, independent t‑test, and paired tests. RESULTS: The results indicated that the demographic variables of mothers and neonatal characteristics of the two groups did not have significant differences except for the history of abortion and infertility in mothers and the weight of preterm neonates (P < 0.05). Mothers in the experimental group had less stress (t (88) = 29.50, P < 0.001) and more participation than the control group (t (88) = −27.18, P < 0.001) after the intervention. CONCLUSIONS: Using self‑efficacy‑based SCP for maternal education besides routine education could positively affect the reduction of stress and the increase of maternal participation in caring for preterm neonates during hospitalization. Thus, using this supportive program is suggested for mothers with preterm neonates admitted to NICU
Life style in women with breast cancer: a narrative review study
No full textObjective: The present review study aimed to assess the lifestyle of women with breast cancer. Methods: In this study, information on Life style in women with breast cancer was obtained from Persian and English databases using Persian keywords and their English equivalent for “Life style, Breast Cancer” based on MeSH (medical subject headings) from 2000 to 2020. Among all the articles searched, 48 studies were included in the review research. To collect information from the studies, the articles were carefully reviewed and the results were extracted. Results: According to the available scientific evidence, lifestyle has an effect on health and some related factors such as inadequate physical activity, stress, eating patterns, bad behaviors such as smoking and drinking alcohol are associated with breast cancer. Conclusion: Therefore, interventions and trainings should be planned to provide a suitable and sufficient ground for guiding women towards healthy lifestyles and behavioral habits
The Role of the Mosque as an Emergency Shelter in Disasters: A Systematic Review
No full textBackground: Providing emergency shelter for disaster victims is a part of disaster risk mitigation strategies. International organizations have proposed a framework for appropriate planning and emergency shelter design. These agencies are encouraging local authorities to manage events to use existing structures such as schools, community centers, etc., as emergency shelters for the victims. According to the social religious and spiritual status of mosques in communities, these centers are one of the crucial elements to create a safe and trusted shelter during disasters. This study aims to identify the role of mosques as emergency shelters in disasters. Materials and Methods: This study was a systematic study that searched the words related to the research title (disaster management, emergency shelter, mosque) with AND, OR operators in PubMed, Web of Sciences, Science Direct, and Scopus databases, and the Google scholar search engine, as well as Persian language databases of SID, Magiran, Irandoc, and Iran Medex. A three-step screening process was used to select studies using the Preferred Reporting Items for Systematic Reviews And Meta-Analyses (PRISMA) checklist. Finally, the data were analyzed thematically. Results: Out of a total of 175 articles found, 6 articles were relevant to the purpose of the study and were analyzed. The results of the present study showed that mosques can be suitable shelters for risk management during accidents and disasters. Also, in this regard, a range of strategies for designing programs for public participation and mosques were identified. Conclusion: The services and the role of mosques in disaster occurrence as a shelter are very effective and these valuable services can be further extended using social capital, attracting the attention of religious institutions, and public participation
Therapeutic effect and molecular associated mechanisms of silymarin on osteoarthritis: A systematic review
No full textBackground and aims: Osteoarthritis (OA) is a degenerative joint and common skeletal disease around the world. We aimed to review silymarin and its major active constituent effects and underlying mechanisms for relieving OA. Methods: The study protocol was designed according to the PRISMA statement. An extensive search was performed in several main databases including PubMed, Web of Science, EMBASE, and Scopus. Considering the inclusion and exclusion criteria of the study, finally, 11 studies were included. The desired data were extracted from the studies and registered into an Excel form and the consequences and mechanisms were surveyed. Results: Silymarin, inhibits or downregulates IL (interleukin)-1β, IL-6, IL-8, IL-17, tumour necrosis factor alpha (TNF-α), prostaglandin E2 (PGE2), matrix metalloproteinase (MMP)-1, MMP-3, MMP-13, inducible nitric oxide synthase (iONS), cyclooxygenase-2 (COX-2), and high-sensitivity C-reactive protein (hs-CRP). In terms of antioxidant capacity, it decreased reactive oxygen species (ROS), malondialdehyde (MDA), and lipid peroxidation in serum and synovial fluid. In addition, it reduced alkaline phosphatase (ALP), leukocytes (Th17), and HB levels. Silymarin increases superoxide dismutase (SOD), catalase (CAT), glutathione (GSH), and glutathione peroxidase (GPx). Moreover, it can up-regulate and increases the anabolism of sirtuin1 (Sirt1), SRY-box transcription factor 9 (SOX9), IL-10, IL-4, tissue inhibitor of metalloproteinase (TIMP-1), Collagen type II and extracellular matrix (ECM) homeostasis. Conclusion: Because silymarin is a potent anti-inflammatory and antioxidant polyphenolic flavonoid, it can be effectively used as adjunctive therapy in the treatment of OA; however, more clinical trial studies are still needed to determine its side and analgesic effects
The impact of a theory of planned behavior-based training on the behavioral intention of childless couples in Shahrekord
No full textBackground and aims: Childbearing is known to be the most critical change factor in population construction. So, the present study was conducted to investigate the impact of childbearing education based on the theory of planned behavior (TPB) on the behavioral intention of childless couples.
Methods: The present field trial was conducted on 70 childless referred to holistic health centers in Shahrekord in 2022. The study setting was selected by cluster sampling, and the participants were selected by convenience sampling. The instruments used were a checklist of demographic characteristics/childbearing and a questionnaire of childbearing intention. Both groups completed the questionnaire before, immediately, and one month after the intervention. Data were analyzed using SPSS 26. A P value<0.05 was considered a significance level.
Results: At baseline, there was no significant difference in the mean scores of TPB constructs, i.e., attitude, social norm, perceived behavioral control, and behavioral intention, between the two groups (P>0.05). However, the mean scores obtained for the constructs in the intervention group immediately and one month after the intervention were significantly different from those in the control group (P<0.05). Also, the mean scores on the constructs in the intervention group increased immediately and one month after the intervention, indicating education’s impact on the childbearing intention (P<0.05).
Conclusion: Training based on TPB increases the childbearing intention in childless couples; it is therefore recommended to create a social support system and design interventions with a further focus on using this model in educational programs related to population growth policies and encouraging couples to have children.
Keywords: Education, Intention, Reproductive behavior, Theory of planned behavior, Childles
The Effect of Suture Simulation Method on Animal Skin on Skills and Anxiety Caused by Suturing in Operating Room Students
No full textBackground and Aim: Operating room students have experienced anxiety for various reasons that affect their educational process such as stitching. Due to the effective role of simulation in improving the education of students, this study was conducted with the aim of the effect of animal skin suturing simulation on the skill level and anxiety level of operating room students. Materials and Methods: In this study, 30 people (75) of the samples were aged 18-25 and 10 people (25) of them were 26-35. 10 people (25) were men and 30 people (75) were women. Also, in terms of marriage, 7 people (17.5) were married and 33 people (82.5) were single. The present quasi-experimental study was performed with a two-group plan before and after with 40 operating room students of Shahrekord University of Medical Sciences (Shahrekord, Broujen) in 2020. The samples were randomly assigned to two test and control groups using the method based on the purpose of selection. Data were collected before and after the intervention by Spielberger Anxiety Tool and Suturing Skills Questionnaire and analyzed by SPSS software and descriptive and analytical statistical tests (Chi-square test, t-test, paired t-test). Results: The t-test test showed that the mean of obvious anxiety in the intervention group (36.35±10.22) and the control group (41.15±7.92) after the intervention was not significant (P=0.346). Also, the mean hidden anxiety in the intervention group (36.65±10.47) and the control group (38.65±6.13) had no significant difference (P=0.089). The t-test test showed that there was a significant difference in sewing skills after the intervention in the two intervention groups (28.2±58.22) and the control group (23.42±3.12) (P=0.04). Conclusion: The texture of suture mannequins is very different from human skin in terms of consistency, and it does not convey the same feeling of sutures on natural skin to students. On the other hand, it is easier to enter and exit and move the needle and thread in the sheepskin, and this provides the students with the possibility of stitching more easily. Therefore, it is suggested to buy and prepare sheep skin for training students and teach them stitches on it
Comparing depression, anxiety, and quality of life in individuals with cardiac and non-cardiac chest pain
No full textBackground: Psychological factors are often overlooked as potential contributors to cardiovascular disease. This study aimed to investigate the relationship between depression, anxiety, and quality of life with chest pain origin. Method: This cross-sectional study was performed from 2019 to 2020 and included participants from multiple medical centers across Shahrekord, Iran. Participants were recruited through advertisements in medical centers. Participants were divided into three groups: healthy control (n = 67), chest pain with cardiac origin (CCP) (n = 70), and chest pain with non-cardiac origin (NCCP) (n = 73). Data were collected using the Beck’s Anxiety scale, Beck’s Depression scale, and Short-Form Health Survey questionnaires. The chi-square, exact test, t-test, Kruskal–Wallis, and logistic regression models were used for statistical analysis. All analysis was performed using SPSS 26. Results: The mean scores of depression and anxiety in the NCCP group (depression = 17.03 ± 11.93, anxiety = 17.18 ± 11.37) were significantly higher than those in the CCP (depression = 9.73 ± 5.76, anxiety = 8.77 ± 5.96) and healthy (depression = 7.00 ± 7.61, anxiety = 6.18 ± 7.63) groups (p < 0.05). The mean score of quality of life in the NCCP group (54.87 ± 12.66) was significantly lower than that in the CCP (76.31 ± 12.49) and healthy (80.94 ± 15.78) groups (p < 0.05). Patients with NCCP had higher odds of having depression (adjusted OR = 4.39, 95% CI: 1.25, 15.35) and lower odds for having mental quality of life scores than the CCP and health groups, respectively (adjusted OR = 0.90, 95% CI: 0.87, 0.94). Conclusion: Our findings suggest that collaboration between psychiatrists and other specialists may be necessary to improve patients’ health conditions and quality of lif