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Discovering the Clinical Knowledge about Breast Cancer Diagnosis Using Rule-Based Machine Learning Algorithms
No full textAims: Breast cancer represents one of the most prevalent cancers and is also the main cause of cancer-related deaths in women globally. Thus, this study was aimed to construct and compare the performance of several rule-based machine learning algorithms in predicting breast cancer. Instrument & Methods: The data were collected from the Breast Cancer Registry database in the Ayatollah Taleghani Hospital, Abadan, Iran, from December 2017 to January 2021 and had information from 949 non-breast cancer and 554 breast cancer cases. Then the mean values and K-nearest neighborhood algorithm were used for replacing the lost quantitative and qualitative data fields, respectively. In the next step, the Chi-square test and binary logistic regression were used for feature selection. Finally, the best rule-based machine learning algorithm was obtained based on comparing different evaluation criteria. The Rapid Miner Studio 7.1.1 and Weka 3.9 software were utilized. Findings: As a result of feature selection the nine variables were considered as the most important variables for data mining. Generally, the results of comparing rule-based machine learning demonstrated that the J-48 algorithm with an accuracy of 0.991, F-measure of 0.987, and also AUC of 0.9997 had a better performance than others. Conclusion: It’s found that J-48 facilitates a reasonable level of accuracy for correct BC risk prediction. We believe it would be beneficial for designing intelligent decision support systems for the early detection of high-risk patients that will be used to inform proper interventions by the clinicians. © 2022, Tarbiat Modares University. All rights reserved
Assessment of hospitAls prepAredness in roAd trAffic crAshes with mAss cAsuAlty: The cAse of irAn
No full textINTRODUCTION: Road traffic crashes (RTCs) annually cause about 1.35 million deaths and 20–50 million injuries. Hospitals have the main role in responding to road traffic injuries (RTIs) and decreasing the number of disabilities and deaths. This study aimed to assess the preparedness of selected Iranian hospitals in responding to road traffic crashes with mass casualties. MATERIAL AND METHODS: This cross-sectional study was carried out among 13 hospitals in four provinces including Tehran, Alborz, West Azerbaijan, and Hamedan in 2019. the valid and reliable questionnaire of hospital preparedness assessment in RTIs was used for data collection (Kappa coefficient = 0.89; CVR: 0.98; CVI: 0.97). Using SPSS 16, the level of hospital preparedness was categorized into three parts as weak (less than 34), moderate (34–66), and high (more than 66). RESULTS: Preparedness of the selected hospitals was at a moderate level (= 65.25). Although the level of preparedness in the aspects of command and control (72.7), safety and security (71.54), infrastructure and medical equipment (74.12), and coordination (71.15) was satisfactory, hospitals were weak in the training and exercise aspect (48.46). The level of access to specific equipment needed for responding to trauma injuries was high (79.56). CONCLUSIONS: Based on the findings, a response plan is required to make hospitals more prepared to respond to road traffic injuries. The plan may include training and development, as well as health facilities preparedness in terms of structure, equipment, and human resources. In addition, assessing the effectiveness of all response plans requires exercise and practice. Copyright © 2022 Via Medic
Role of vitamin D on knee osteoarthritis pain: a systematic review
No full textVitamin D3 (Cholecalciferol) has the chemical formula of (C27H44O), molecular weight (384.6), exact mass (384.339216023), and mono-isotopic mass (384.339216023). The researchers conducted this study to examine the role of Vitamin D on the knee osteoarthritis pain. The original published articles (interventional or correlational) aimed to investigate the role of vitamin D on Knee OA pain. The search was done by using the keywords "pain, knee osteoarthritis, osteoarthritis, Vitamin D, Vitamin D3, knee, Cholecalciferol, and vitamin D deficiency" and these mentioned keywords were used by "OR" and "AND" search methods. Regarding gray texts, all related articles and their references were reviewed. Based on the findings of 15 articles, there was no relationship between vitamin D and pain in 2 articles, pain was lower in the high vitamin D group (No significance < 0.05) in 1 article, and increasing vitamin D reduced pain in 12 articles. In 9 articles, the search method was Randomized Trial, and in 6 ones, it was cross-sectional. According to the findings, although in most reviewed articles, vitamin D led to the reduction of Knee OA pain, in some of them, the difference in pain reduction between the group receiving vitamin D and the placebo group was not significant. Therefore, acceptable evidence for its effectiveness is not available and it is necessary to conduct more studies in this field. © Global Journal of Engineering Education.All right reserved
Comparison of Two Statistical Models for Predicting Mortality in COVID-19 Patients in Iran
No full textBackground: Today, the COVID-19 pandemic is ever-increasingly challenging healthcare systems globally with many uncertainties and ambiguities regarding disease behavior and outcome prediction. Thus, machine learning (ML) algorithms could be potentially demanding to tackle these challenges. Objectives: The present study aimed to construct and compare two prediction models based on statistical and computational ML algorithms to predict mortality in COVID-19 hospitalized patients and, finally, adopt the best-performing algorithm, accordingly. Methods: Having considered a single-center registry, we scrutinized 482 records of laboratory-confirmed COVID-19 hospitalized patients admitted from February 9, 2020, to December 20, 2020. The most important clinical parameters for COVID-19 mortality prediction were identified using the Phi coefficient technique. In the next step, two statistical and computational ML models, ie, logistic regression (LR) and artificial neural network (ANN), were evaluated through the metrics derived from the confusion matrix. Results: Predictive models were trained using 16 validated features. The results indicated that the best performance pertained to the ANN classifier with a positive predictive value (PPV) of 0.96, a negative predictive value (NPV) of 0.86, the sensitivity of 0.94, specificity of 0.94, and accuracy of 0.93. Conclusions: According to the results, ANN predicted mortality in hospitalized patients with COVID-19 with an acceptable level of accuracy. Therefore, it would be extremely reasonable to develop intelligent decision support systems to early detect high-risk patients, helping clinicians come up with proper interventions. © 2022, Author(s)
Restricting tumor lactic acid metabolism using dichloroacetate improves T cell functions
No full textBackground Lactic acid produced by tumors has been shown to overcome immune surveillance, by suppressing the activation and function of T cells in the tumor microenvironment. The strategies employed to impair tumor cell glycolysis could improve immunosurveillance and tumor growth regulation. Dichloroacetate (DCA) limits the tumor-derived lactic acid by altering the cancer cell metabolism. In this study, the effects of lactic acid on the activation and function of T cells, were analyzed by assessing T cell proliferation, cytokine production and the cellular redox state of T cells. We examined the redox system in T cells by analyzing the intracellular level of reactive oxygen species (ROS), superoxide and glutathione and gene expression of some proteins that have a role in the redox system. Then we co-cultured DCA-treated tumor cells with T cells to examine the effect of reduced tumor-derived lactic acid on proliferative response, cytokine secretion and viability of T cells. Result We found that lactic acid could dampen T cell function through suppression of T cell proliferation and cytokine production as well as restrain the redox system of T cells by decreasing the production of oxidant and antioxidant molecules. DCA decreased the concentration of tumor lactic acid by manipulating glucose metabolism in tumor cells. This led to increases in T cell proliferation and cytokine production and also rescued the T cells from apoptosis. Conclusion Taken together, our results suggest accumulation of lactic acid in the tumor microenvironment restricts T cell responses and could prevent the success of T cell therapy. DCA supports anti-tumor responses of T cells by metabolic reprogramming of tumor cells
Immunoinformatics Insights into the Internalin A and B Proteins to Design a Multi-Epitope Subunit Vaccine for L. monocytogenes
No full textAs an important foodborne pathogen, Listeria monocytogenes is associated with high hospitalization and case-fatality rates. Outbreaks due to foods contaminated with this pathogen continue to occur globally. A suitable vaccine can protect susceptible populations against this infection. In this study, two essential surface proteins (internalins A and B) of L. monocytogenes which are used for the entry of bacteria into different host cells were selected as candidates for the design of a multi-epitope protein vaccine by powerful immunoinformatics servers and soft wares. Epitopes were selected based on scores of antigenic properties, cytokine induction potential and allergenicity. To construct the multi-epitope vaccine, the selected cytotoxic T lymphocytes epitopes were linked together by an AAY linker, whereas GPGPG linkers were used to link the helper T lymphocytes epitopes. Physiochemical characterization, and the secondary and tertiary structures of the protein vaccine were determined. After refinement, validation and energy minimization, the immune simulation was conducted by the C-ImmSim server. The obtained results showed that the designed vaccine is stable and could effectively trigger the immune response. Overall, the results of this study demonstrated that the designed vaccine is specific, antigenic, non-allergenic, and can effectively prevent L. monocytogenes infections. Further clinical trials are required to check the efficacy of this vaccine
Antiinflammatory potential of nano-curcumin as an alternative therapeutic agent for the treatment of mild-to-moderate hospitalized COVID-19 patients in a placebo-controlled clinical trial
No full textThe present study conducted a placebo-controlled clinical trial to evaluate the impact of nano-curcumin on the inflammatory cytokines in mild-to-moderate hospitalized COVID-19 patients. A total of 60 COVID-19 patients were randomly divided into nano-curcumin and control groups, and then they received 240 mg/day nano-curcumin for 7 days. The clinical manifestation and laboratory parameters in patients were recorded on days 0 and seven. Also, SYBR Green real-time PCR and ELISA techniques were implicated in assessing the mRNA expression of IFN-gamma, IL-1 beta, IL-6, MCP-1, and TNF-alpha and the serum levels of IL-1 beta, IL-6, and TNF-alpha inflammatory mediators, respectively. Although the clinical manifestations and laboratory parameters improved via the nano-curcumin treatment, the mRNA expression of IFN-gamma (p = 0.006) and TNF-alpha (p = 0.04) were significantly reduced. Besides, a considerable difference was observed between the nano-curcumin and control groups in the expression of IFN-gamma (p = 0.001), IL-1 beta (p = 0.0002), and IL-6 (p = 0.008). In addition, there was a significant difference between the nano-curcumin and control groups in the serum levels of IL-1 beta (p = 0.042). The evidence demonstrated that nano-curcumin could be implicated as a complementary medication to act as an antiinflammatory agent and inhibit inflammatory complications
Prevalence of urinary schistosomiasis in women: a systematic review and meta-analysis of recently published literature (2016-2020)
No full textBackground Urinary schistosomiasis is a serious threat in endemic territories of Africa and the Middle East. The status of female urinary schistosomiasis (FUS) in published literature between 2016 and 2020 was investigated. Methods A systematic search in PubMed, Scopus, Google Scholar, and Web of Science, based on the 'Preferred Reporting Items for Systematic Reviews and Meta-analyses' checklist, and a meta-analysis using random-effects model to calculate the weighted estimates and 95 confidence intervals (95 CIs) were done. Results Totally, 113 datasets reported data on 40,531 women from 21 African countries, showing a pooled prevalence of 17.5 (95 CI: 14.8-20.5). Most studies (73) were performed in Nigeria, while highest prevalence was detected in Mozambique 58 (95 CI: 56.9-59.1) (one study). By sample type and symptoms, vaginal lavage 25.0% (95% CI: 11.4-46.1%) and hematuria 19.4% (95% CI: 12.2-29.4%) showed higher FUS frequency. Studies using direct microscopy diagnosed a 17.1% (95% CI: 14.5-20.1%) prevalence rate, higher than PCR-based studies 15.3% (95% CI: 6.1-33.2%). Except for sample type, all other variables had significant association with the overall prevalence of FUS. Conclusions More studies are needed to evaluate the true epidemiology of FUS throughout endemic regions
Antiviral effects of azithromycin: A narrative review
No full textViral infections have a great impact on human health. The urgent need to find a cure against different viruses led us to investigations in a vast range of drugs. Azithromycin (AZT), classified as a macrolide, showed various effects on different known viruses such as severe acute respiratory syndrome coronavirus (SARS-CoV), Zika, Ebola, Enterovirus (EVs) and Rhinoviruses (RVs), and Influenza A previously; namely, these viruses, which caused global concerns, are considered as targets for AZT different actions. Due to AZT background in the treatment of known viral infections mentioned above (which is described in this study), in the early stages of COVID-19 (a new zoonotic disease caused by a novel coronavirus called severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2)) development, AZT drew attention to itself due to its antiviral and immunomodulatory effects as a valuable candidate for COVID-19 treatment. AZT usage instructions for treating different viral infections have always been under observation, and COVID-19 is no exception. There are still debates about the use of AZT in COVID-19 treatment. However, eventually, novel researches convinced WHO to announce the discontinuation of AZT use (alone or in combination with hydroxychloroquine) in treating SARS-CoV-2 infection. This research aims to study the structure of all of the viruses mentioned above and the molecular and clinical effects of AZT against the virus
Oral contraceptive pill and metabolic syndrome: Fasa Persian Cohort Study (Descriptive study)
No full textBACKGROUND AND AIMS: The contraceptive use is 56 and prevalence of metabolic syndrome (MetS) is 30 in Iran. The aim of this study investigates relationship between oral contraceptive pills (OCP) use and MetS in women in the cohort population of Fasa city. METHODS: In a cross-sectional study, 5489 women aged 35-70 years were studied for 5 years in the Sheshdeh area in 2016. MetS were calculated using adult treatment panel III (ATP III) and international diabetes federation (IDF) methods. The odds ratio (OR) with a 95 confidence interval (CI) was reported. Linear regression was used to eliminate the confounding effect. RESULTS: The OR of developing MetS in the OCP recipients was estimated as higher than the non-recipients. The OR of developing MetS using IDF criteria in OCP recipients was (OR = 0.896,95 CI:0.800-1.004). that increased to (OR = 1.230,95 CI:1.084-1.395) after adjusting for confounding variables. Also, the odds ratio using ATP (III) criteria was (OR = 0.900,95 CI:0.804-1.009). that increased to (OR = 1.245,95 CI:1.098-1.413) after adjusting for confounding variables. Also, the OR of developing MetS in OCP recipients decreased with increasing the number of MetS components from 1.199 to 0.812,95 CI:0.771-1.864,0.467-1.413, but after adjustment, increased from 1.151 to 1.747,95 CI:0.733-1.805,0.815-3.746. CONCLUSION: The results of the present study showed that the OR of developing MetS in OCP recipients using both IDF and ATP (III) methods was higher after adjusting by confounder effects so it is recommended monitoring by physicians