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Predicting hospital readmission risk in patients with COVID-19: A machine learning approach
No full textIntroduction: The Coronavirus 2019 (COVID-19) epidemic stunned the health systems with severe scarcities in hospital resources. In this critical situation, decreasing COVID-19 readmissions could potentially sustain hospital capacity. This study aimed to select the most affecting features of COVID-19 readmission and compare the capability of Machine Learning (ML) algorithms to predict COVID-19 readmission based on the selected features. Material and methods: The data of 5791 hospitalized patients with COVID-19 were retrospectively recruited from a hospital registry system. The LASSO feature selection algorithm was used to select the most important features related to COVID-19 readmission. HistGradientBoosting classifier (HGB), Bagging classifier, Multi-Layered Perceptron (MLP), Support Vector Machine ((SVM) kernel = linear), SVM (kernel = RBF), and Extreme Gradient Boosting (XGBoost) classifiers were used for prediction. We evaluated the performance of ML algorithms with a 10-fold cross-validation method using six performance evaluation metrics. Results: Out of the 42 features, 14 were identified as the most relevant predictors. The XGBoost classifier outperformed the other six ML models with an average accuracy of 91.7, specificity of 91.3, the sensitivity of 91.6, F-measure of 91.8, and AUC of 0.91. Conclusion: The experimental results prove that ML models can satisfactorily predict COVID-19 readmission. Besides considering the risk factors prioritized in this work, categorizing cases with a high risk of reinfection can make the patient triaging procedure and hospital resource utilization more effective
Investigation on the Catalytic Performance of Clinoptilolite Exchanged with Various Metallic Ions for Toluene Removal
No full textThe catalytic efficiency of different metallic ions-modified clinoptilolite zeolite was investigated on the removal of toluene. Various metals including divalent ions of manganese, iron, zinc and copper were added in to zeolite via ion-exchange procedure. XRF, SEM, XRD, BET and TPD analyses were used to determine all the catalysts properties. The catalytic behavior through ion-exchanged clinoptilolite zeolites for the oxidation of toluene was compared with raw clinoptilolite. The results showed that the ion-exchange catalysts (Zn-CLP, Fe-CLP, Cu-CLP and Mn-CLP) had a noteworthy increase in toluene oxidation due to change in the dispersion of the acid sites content with altered intensity and increase in the surface area. The conversion efficiency of toluene was increased up to 100 for Mn-CLP at 300 degrees C. It can be concluded that clinoptilolite zeolite modified with divalent ions of manganese had a much higher efficiency in the removal of toluene from air flow than the rest zeolite
The Status of Carbapenem Resistance in Cystic Fibrosis: A Systematic Review and Meta-Analysis
No full textBackground: Antibiotic resistance in cystic fibrosis (CF) is a well-known phenomenon. However, the comprehensive epidemiological impact of antibiotic resistance in CF is not clearly documented. So, this meta-analysis evaluated the proportion rates of carbapenem resistance (imipenem, meropenem, and doripenem) in CF based on publication date (1979-2000, 2001-2010, and 2011-2021), continents, pathogens, and antimicrobial susceptibility testing (AST). Methods: We searched studies in PubMed, Scopus, and Web of Science (until April 2021). Statistical analyses were conducted using STATA software (version 14.0). Results: The 110 studies included in the analysis were performed in 25 countries and investigated 13,324 pathogens associated with CF. The overall proportion of imipenem, meropenem, and doripenem resistance in CF were 43 (95 CI 36-49), 48 (95 CI 40-57), 28 (95 CI 23-33), and 45 (95 CI 32-59), respectively. Our meta-analysis showed that trends of imipenem, meropenem, and doripenem-resistance had gradual decreases over time (1979-2021). This could be due to the limited clinical effectiveness of these antibiotics to treat CF cases over time. Among the opportunistic pathogens associated with CF, the highest carbapenem resistance rates were shown in Stenotrophomonas maltophilia, Burkholderia spp., Pseudomonas aeruginosa, and Staphylococcus aureus. The highest and lowest carbapenem resistance rates among P. aeruginosa in CF patients were shown against meropenem (23) and doripenem (39). Conclusions: We showed that trends of carbapenem resistance had decreased over time (1979-2021). This could be due to the limited clinical effectiveness of these antibiotics to treat CF cases over time. Plans should be directed to fight biofilm-associated infections and prevent the emergence of mutational resistance. Systematic surveillance for carbapenemase-producing pathogens in CF by molecular surveillance is necessitated
Personal protective equipment-associated headaches in health care workers during COVID-19: A systematic review and meta-analysis
No full textIntroductionHealth Care Workers (HCWs) use Personal Protective Equipment (PPE) during the COVID-19 pandemic to protect themselves and prevent the transmission of the disease. The use of PPE, especially respiratory masks, has adverse consequences, including headaches, which have been secondary and unusual. The aim of the present systematic review and meta-analysis study was to investigate the prevalence of PPE-associated headaches in HCWs during COVID-19 pandemic. MethodsThe present review study was performed based on the PRISMA guideline. The protocol of the present study was registered in PROSPERO with the code CRD42022304437. Valid data resources such as Scopus, PubMed, Web of Science, Science Direct, Google Scholar, Embase were used to identify and extract relevant studies. The searches were conducted between the beginning of 2020 and the end of January 2022. A random effects model was used for meta-analysis and I-2 index was used to investigate between-study heterogeneity. Data were analyzed using STATA ver. 14. ResultsA total of 539 articles were first identified through initial search and finally 26 final studies were selected to undergo the meta-analysis phase. According to the results of meta-analysis, the prevalence of headache after and before the use of PPE was 48.27 (95 CI: 40.20-56.34, I-2 = 99.3, p = 0 < 001) and 30.47 (95 CI: 20.47-40.47, I-2 = 97.3, p = 0 < 001), respectively. ConclusionThe results of the present study showed that the prevalence of PPE-associated headache in HCWs was relatively high, so, the use of PPE during COVID-19 pandemic can be considered as one of the causes of headache. Therefore, management strategies such as regular screening of HCWs for headaches and regular rest periods without the use of PPE can be effective in reducing the prevalence of headaches
The Relationship between Moral Intelligence and Aggression in Nurses
No full textBackground & Aim: Moral intelligence is one of the dimensions of intelligence that can provide a framework for the proper functioning of human beings. Anger can have a significant impact on the quality of nursing care. The aim of this study was to determine the relationship between moral intelligence and anger in the nurses of Ilam city in 2019. Methods & Materials: In a study, a group of 69 nurses working in emergency and individual departments were chosen. Data collection was done with a demographic profile form and Lanic and Kiel's moral intelligence questionnaires (2011) and Buss and Perry's aggression questionnaires (1992). Data were analysed via SPSS-22 software. A coefficient of 0.05 was implemented. Results: The average Moral Intelligence score of all the nurses was 149.04 +/- 17.90, and Average aggression score of all the nurses was 72.62 +/- 17.34. Between moral intelligence and aggression of all nurses (r=-0.33, p=0.007) and emergency ward nurses (r=-.053, p=0.0020) There was a significant inverse correlation. Conclusion: Considering nurses 'day-to-day confrontation with work-related problems, it is necessary to pay attention to moral intelligence and its relationship with anger. Inclusion of the necessary training on the relationship between moral intelligence and anger management are suggested in nursing and nursing student curricula
Microhardness change of human dental enamel due to power bleaching with different gels
No full textSince the introduction of bleaching treatments in the office, different lights have been suggested to accelerate the bleaching reaction. This study aimed to evaluate the microhardness of tooth enamel after office bleaching using different materials
Comparison of Immune Response in Mice Immunized with Recombinant PreS2/S-C18-27 Protein Derived from Hepatitis B Virus with Commercial Vaccine
No full textBACKGROUND & OBJECTIVE: The vaccine available to prevent Hepatitis B virus disease is ineffective in 5 of people due to the use of HBsAg as a weak immunogenic factor. In the present study, PreS2/S fused to C18-27 peptide fragment as an effective antigen and is proposed as a promising vaccine candidate compared with the conventional vaccine prescribed in the vaccination program. METHODS: After the synthesis of PreS2/S genes and C18-27 peptide fragment in pET28a, the recombinant protein was confirmed by Western blotting. The efficacy of the PreS2/S-C18-27 protein was compared with the conventional vaccine injected into five groups of rats. Finally, the cytokine level of IF-r, IL-2, IL-4, IL-10, TNF-a, IgG1, and IgG2a were measured using the ELISA method. RESULTS: This study showed no significant difference between the recombinant vaccine group and PBS control group in the IF-r test, but there was a significant difference between groups testing IL-2 and IL-10. In addition, the group receiving the recombinant vaccine with CPG adjuvant at a dilution of 1/10 in the IgG total test on days 14 and 45 after the first injection showed a significant difference in comparison with other groups. CONCLUSION: This study showed no statistically significant difference between the recombinant protein vaccine group and the conventional vaccine group. The Th1- mediated immune responses obtained from recombinant proteins with and without CPG performed better than conventional vaccines, possibly due to the functional deficiency of the available vaccines
Rate and Causes of Suicide in Ilam: A Report of the Suicide Registry
No full textObjective: Suicide is one of the most important health problems in the world. Financial, academic, social, and environmental difficulties along with genetic, physical, and mental disorders affect suicide attempts. This study aimed to find risk factors for completed suicide in Ilam province according to the suicide registry in Ilam province. Method : This was a prospective study and was performed based on suicide case registration data, pre-determined checklist data, and death registration data in Ilam province from March 2019 to September 2020. Logistic regression models and the Chi-square test were used to determine the relationship between completed suicide and its risk factors. Results: Among 1,410 attempted suicides, 66 (4.7 ) were executed. Rate of completed suicides was higher in men (6.5) compared to women (4.5), (p = 0.005), age groups over 65 years (P < 0.001), retirees and farmers (P = 0.009), illiterate people (P < 0.001), villagers (P = 0.02), people motivated due to physical problems (P = 0.016), suicide by physical methods (P < 0.001) and self-immolation (P < 0.001). Logistic regression showed that incidence of completed suicide was significantly higher in the age group over 65 years, illiterate people, people using physical methods, villagers, and men. Multivariate logistic regression also showed that men and individuals using physical methods of suicide were significantly more successful in suicide. Conclusion: Men, the elderly, illiterates, villagers, and people who used physical suicide methods were in high-risk groups. Despite lower prevalence of suicide, a higher rate of completed suicide was demonstrated. To decrease completed suicide rates, we must pay attention to these groups
Comparing the Effects of Early Clinical Exposure on the Attitude and Motivation of First-year Medical Students from Ilam University of Medical Sciences Based on Video-based Education and Learning-in-hospital Settings Methods
No full textBackground: Exposure to an unfamiliar clinical environment is highly important for medical students since it affects their atti-tudes. Objectives: This study aimed to determine the effect of implementing a short course of familiarity with the clinical environment through video-based education and learning-in-hospital settings on the attitudes of first-year medical students. Methods: In the present quasi-experimental study with a pretest-posttest design, 59 first-year medical students were divided into two groups of “learning-in-hospital settings” and “video-based education”. Students’ attitudes and motivations were measured using questionnaires, and the obtained data were analyzed using SPSS 22. Results: The attitude of most students from learning-in-hospital settings group was positive before and after the exposure. The attitude of most students from the video-based education group, on the other hand, was positive after watching the video while it was negative before the intervention; this difference, however, was not statistically significant (P = 0.1). In pre-exposure and post-exposure stages, the motivation of students in video-based education group was higher than that of students in learning-in-hospital settings group, but this difference was not statistically significant (P = 0.6). Female students in video-based education group had a higher positive attitude (P = 0.02) than male students (P = 0.01) before and after the exposure, and were highly motivated. Conclusions: Early clinical exposure to learning-in-hospital settings and, particularly, to video-based education may have been an effective factor contributing to motivating and encouraging the medical students. © 2022, Author(s)
The desire thinking questionnaire-Persian version (DTQ-P) and its association with addictive behaviors in individuals with alcohol use disorder, nicotine dependence, and problematic social media use
No full textDesire thinking is an emerging construct which has been shown to play a role in addictive behaviors. The present study sought to validate a translated Persian version of the Desire Thinking Questionnaire (DTQ) in three groups of individuals with Alcohol Use Disorder (AUD; n = 300), nicotine dependence (n = 300), and problematic social media use (n = 300). All three groups completed the translated Persian version of the DTQ, the Barratt Impulsiveness Scale-15 (BIS-15), the White Bear Suppression Inventory (WBSI), and the Depression Anxiety and Stress Scale-21 (DASS-21). Measures of alcohol use, nicotine dependence and problematic social media use were also collected. The results confirmed a two-factor structure of the Persian version of the DTQ with good reliability and validity in all three groups. Furthermore, both the verbal perseveration and imaginal prefiguration com-ponents of the Persian version of the DTQ were found to predict addictive behaviors beyond demographic and clinical characteristics, negative affect, impulsiveness, and thought suppression. The study confirms the psy-chometric properties of the Persian version of the DTQ and the role of desire thinking as an independent pre-dictor of AUD, nicotine dependence, and the problematic use of social media