Health Science Reports最新文献

Background and Aims

Urban fires pose a significant threat in terms of property damage and potential loss of life. Firefighters play an important role in managing these incidents, so their safety is a top priority for fire departments and emergency responders. The purpose of this study is to predict the probability of firefighter injury and entrapment before dispatching the operational team or the initial stages of the urban firefighting operations.

Methods

In this study, we compare the performance of eight machine learning algorithms in predicting the occurrence of firefighter injuries and entrapment during urban fire incidents. We use data from the Fire Department Operations and Management System (FOMS) of Mashhad's city fire and safety services organization. Specifically, we assess the effectiveness of the generated models through five stages, two of which use additional features calculated using the built-in FOMS functions.

Results

We found that the Multi-Layer Perceptron and Kernel Naive Bayes algorithms achieved the highest predictive accuracy for the occurrence of firefighter injuries and entrapments, 96.7% and 96.0%, respectively.

Conclusions

The generated models can help to reduce the incidence of injuries and entrapments among firefighters by providing the decision-makers with early prediction of the risk factors associated with an ongoing urban firefighting operation.

Introduction

Hepatitis C virus (HCV) infection is a major global health issue. Injecting drug users (IDUs) are an important group at risk of HCV infection. Therefore, this study was undertaken to determine the related high-risk behavioral factors and the effectiveness of addiction treatment centers in preventing the transmission of HCV among IDUs referring to governmental methadone maintenance treatment (MMT) centers in Southeast Iran.

Methods

This analytical study was conducted as a pre- and post-intervention assessment without a control group in first 6 months of 2022. 313 IDUs receiving methadone from five governmental MMT centers in Kerman were interviewed in the form of a census. Effectiveness was measured using mathematical formulas and patterns based on high-risk injecting behaviors.

Results

Of the 313 participants, 299 (95.84%) were men, the mean age ± SD was 41.06 ± 8.73 years and HCV prevalence was 113 (36.1%). The results showed that MMT centers avoided 23.55 new cases of HCV per 100 people. The studied IDUs reported minor rate of risky injecting and sexual behavior after participation in MMT program. The communal incidence of HCV per 100 IDUs due to shared injection and unsafe sexual connection with MMT program were 13.89 (95% CI: 5.43–19.63), 0.0003 (0.0002–0.0007) and without it 37.44 (24.34–46.78) and 0.0002 (0.0001–0.0004) respectively.

Conclusion

The MMT program is an effective intervention to prevent HCV infection, a comparison of its effectiveness with other interventions is needed.

Background and Aims

Studies have shown that the knowledge and skills of clinical coders impact the quality of clinical coding, and professional training for clinical coders is essential to ensure coding quality. Like other countries, Iran should establish the required infrastructure to promptly implement ICD-11. One of the essential infrastructures is clinical coders' familiarity with and skills in utilizing ICD-11. The purpose of this study was to investigate clinical coders' knowledge of ICD-11, their educational requirements, and their willingness to assume new responsibilities following the implementation of ICD-11.

Methods

This was a survey conducted during 2021–2022. A researcher-made questionnaire including five parts was applied as an instrument. Ten experts confirmed the content validity of the questionnaire, and CVR and CVI were applied to measure content validity. In addition, test retest was used to assess the reliability. A Likert scoring scale was used to measure the responses. The research population consisted of all clinical coders working in Iranian health facilities. Data were analyzed using descriptive statistics, Pearson's χ², and Independent Samples t-test.

Results

Totally, 453 people responded to the questionnaire. Twenty-nine percent of the participants were familiar with the ICD-11. The relationship between the level of familiarity with ICD-11 and age, gender, ICD-10 coding skills, and work experience was not statistically significant. Moreover, the lack of training courses was the main reason for not being familiar with ICD-11. In addition, the participants believed that skill in using ICD-11 tools had more priority than other educational axes. According to the majority of clinical coders, they may not be ready to accept new roles if ICD-11 is implemented.

Conclusion

This study revealed that familiarity with ICD-11 was low. Therefore, a training program is necessary to meet the needs of the target groups for nationwide ICD-11 education.

Background and Aims

Postpartum depression (PPD) is a significant concern globally, emerging from various factors including hormonal changes, genetic influences, and environmental stressors. Conventional treatments such as psychotherapy and antidepressants have been the standard approach, but the recent U.S. Food and Drug Administration (FDA) approval of zuranolone presents a promising alternative with rapid onset of action and potential for increased treatment accessibility. This review aims to evaluate the efficacy and safety of zuranolone in treating PPD, considering its impact on symptom relief and patient outcomes.

Methods

This review examines the multifaceted nature of PPD, focusing on its epidemiology, pathophysiology, and therapeutic interventions. Relevant literature was identified through systematic searches of databases, including PubMed and Google Scholar, using keywords related to PPD, hormonal changes, genetic factors, and treatment modalities.

Results

Two rigorous phase 3 trials involving female participants diagnosed with PPD demonstrated that patients treated with zuranolone exhibited significantly greater improvement in depressive symptoms compared to those receiving a placebo. The treatment effect persisted 4 weeks after the last dose of zuranolone, indicating sustained benefits. Zuranolone showed notable effectiveness in reducing PPD symptoms as early as the third day of therapy. Its ease of administration, dosage flexibility, and potential for early intervention contribute to its promise in addressing severe PPD.

Conclusion

PPD poses a significant challenge globally, and zuranolone represents a historic advancement in its treatment. While conventional therapies remain vital, zuranolone offers rapid relief and increased treatment accessibility. However, concerns regarding its safety for breastfeeding women and potential side effects necessitate further research and cautious use. Despite these challenges, zuranolone offers hope for improved outcomes and enhanced quality of life for individuals affected by PPD.

Background and Aims

Hypertension exacerbates cardiovascular risks in patients with type 1 diabetes mellitus (T1DM), necessitating effective blood pressure (BP) management. Vitamin D deficiency is common in T1DM patients and is associated with an increased risk of cardiovascular diseases. This systematic review aimed to evaluate the impact of vitamin D supplementation on BP in T1DM patients.

Methods

PubMed, Web of Science, Embase, Scopus, and Google Scholar were searched until March 2024. Clinical trials reported BP outcomes in patients with T1DM after vitamin D supplementation were included. Other types of studies and studies that did not report BP outcomes and those that had populations other than patients with T1DM were excluded. The National Institutes of Health (NIH) tool was used for the risk of bias assessment.

Results

In total, eight studies, involving 328 participants, were included in this review. They were conducted between 2014 and 2024, with mostly conducted in Brazil (n = 5). While one study demonstrated a significant reduction in morning systolic and diastolic BP after vitamin D supplementation, five studies found no significant differences in systolic or diastolic BP. Another study noted a significant reduction in morning systolic and diastolic BP, with no significant changes in 24-h ambulatory monitoring. Also, paricalcitol therapy did not significantly reduce systolic and diastolic ambulatory BP compared to placebo.

Conclusion

The current evidence on the effect of vitamin D supplementation on blood pressure in patients with T1DM remains inconclusive. Nonetheless, more randomized controlled studies with larger sample sizes and longer follow-up durations are essential to establish the association between vitamin D and BP in this population.

Background and Aim

During staging computed tomography (CT) of patients with cancer, lesions that are too small to characterize (TSTC) on the liver are frequently observed. Considering the significance of these lesions, this study aimed to evaluate the relevance and progression of TSTC lesions on hepatic CT scans in patients with a history of cancer.

Method

This cross-sectional study was carried out on 50 patients with a history of cancer who underwent contrast-enhanced abdominal CT scans. These patients were referred to Ghaem Hospital and Imam Reza Hospital, Mashhad, between March 2022 and 2023. In this study, demographic and clinical information were documented. The CT scans of all patients included in the study were evaluated by two experienced radiologists who assessed the number and size of TSTC lesions. Next, each patient was called to perform a follow-up CT scan 6 months later. Then, the size and number of TSTC lesions were compared with the values recorded in the previous round, and their progress was evaluated.

Results

The study included 50 patients, of which 46% were male and 54% were female. The mean patients' age was 54.88 ± 13.60 years. In the following CT scan, among the patients with TSTC lesions, nine (18%) had liver metastases, while 41 (82%) did not. There was no significant difference between the groups with and without metastases in terms of the number of TSTC lesions (p = 0.051), the size of the largest TSTC lesion (p = 0.960), and the duration of chemotherapy (p = 0.330). However, the history of chemotherapy was statistically significant between the two groups (p < 0.001).

Conclusion

The incidence of metastasis in individuals with TSTC lesions was 18%, higher than that reported in similar studies. The identification of these lesions is crucial for accurate diagnosis and treatment planning.

Background and Aims

Skin aging is a common concern among individuals, and laser treatments are recognized as one of the most effective approaches to mitigate the aging process. The study aims to compare a multibeneficial formula serum versus a blank formulation in achieving maximum efficacy following a single treatment of nonablative fractional laser for facial skin rejuvenation.

Methods

This study was a double-blind, split-face, monocentric, randomized clinical trial in China (September 24, 2023–March 07, 2024), and 37 patients seeking the Fotona 4D laser treatment for aging-related facial changes were enrolled. After one full-face laser treatment, each patient applied the test serum to one side and the blank formulation to the other, randomly, twice daily for 28 days. Two dermatologists assessed facial skin quality and aging signs at baseline and Day 0 (D0, immediately after the laser treatment), D3, D7, D14, and D28. Noninvasive measurement and self-assessment questionnaires were also administered at each visit. According to the types of variables, appropriate statistical tests, including the Friedman test, ANOVA test, and Wilcoxon signed-rank test, were used to examine the within-groups or between-groups differences.

Results

Thirty-three women, aged 35–49 years, completed the study. After 28 days of the test serum application, the visual clinical scores rated by investigators showed more significantly beneficial changes on the test side than those on the control. More significant improvements in index parameters for the test sides were also found both in wrinkles with a 21.14% decrease of SEw value from the baseline and in elasticity with a 14.99% decrease of R2 value, while the corresponding reductions were 3.83% for SEw and 4.10% for R2 found on the control sides. The reduction of the nasolabial folds area proportion, analyzed by Primos, was 10.61% on the test sides and 3.39% on the control. No adverse events were reported.

Conclusion

The serum with a multi-beneficial composition can contribute to achieving a more significant and sustainable efficacy after the Fotona 4D treatment in skin rejuvenation improvement.

ClinicalTrials.gov ID: NCT06140628.

Background

Mitochondria have emerged as a significant and promising area of research in hypertrophic cardiomyopathy (HCM). However, there is a notable scarcity of bibliometric studies in this field. Our aim is to conduct a bibliometric analysis of mitochondrial research in HCM, delineating research hotspots and trends to aid in understanding the focal points and evolving trajectories of both basic and clinical research.

Methods

Articles and reviews related to mitochondrial research in hypertrophic cardiomyopathy (HCM) from 2003 to 2023 were filtered from the Web of Science database. CiteSpace software was utilized to generate knowledge maps including keyword analysis, authorship networks, countries of origin, and journal distributions.

Results

A total of 285 relevant articles on HCM and mitochondria were included, with publication output steadily increasing over the years. These publications originated from 47 countries and regions, with the United States and China contributing the most publications. Primary research institutions included UDICE-French Research Universities, Centro de Investigacion Biomedica en Red, and Institut National de la Sante et de la Recherche Medicale (Inserm). J BIOL CHEM and P NATL ACAD SCI USA emerged as prominent journals with substantial research output and authority. We identified 520 authors, with Rachid Boutoual and Scot C Leary having the highest publication outputs, while BJ Maron and D Ghezzi were cited most frequently. Through hotspot analysis, we identified frequently occurring keywords such as Hypertrophic cardiomyopathy, Oxidative stress, Heart failure, Lactic acidosis, Mutations, Disease, Dilated cardiomyopathy, Cardiomyopathy, Deficiency, and Cardiac hypertrophy. Mitochondrial diseases associated with HCM, including Leigh syndrome, Barth syndrome (BTHS), heart failure, arrhythmias, and cardiovascular diseases, represent current and evolving research areas.

Conclusion

Through bibliometric methods, we have elucidated the research hotspots and trends concerning hypertrophic cardiomyopathy (HCM) and mitochondria. The investigation of mitochondria, particularly in the context of cardiovascular medicine and HCM, demonstrates an unstoppable momentum. Research on mitochondria in HCM predominantly focuses on mechanisms, cardiovascular diseases, and therapeutic approaches, which will serve as pivotal areas for future exploration.

Background and Aims

Pediatric infectious diseases pose a global health challenge, causing 13.7 million deaths in 2019 and three million in children under four. Early recognition and management are vital, and challenges in effectively addressing this persist, particularly in resource-limited areas. Digital health tools, such as telemedicine and mHealth, offer promising solutions. In this review, we aim to evaluate digital health applications in managing pediatric infectious diseases from patient and healthcare perspectives.

Methods

A literature search was conducted using PubMed, Google Scholar, and Scopus with keywords including “digital health,” “telemedicine,” and “pediatric infectious disease.” Studies published up to January 2024 were included and critically reviewed.

Results

Digital health technologies aid in real-time monitoring and early diagnosis of infectious diseases, improving access to specialized care for pediatric populations. Tools like telemedicine and mHealth enhance communication between patients, caregivers, and physicians, facilitating shared decision-making. Wearable devices and mobile applications enable proactive health management and timely interventions. Despite access challenges in resource-limited settings, caregivers report benefits such as improved healthcare coordination, reduced delays in care, and better health outcomes for children.

Conclusion

Digital health shows promise in addressing pediatric infectious disease management, particularly in resource-limited settings, enhancing outcomes through timely interventions and better communication.

Background and Aim

In Erbil, Iraq, emergency nurses frequently encounter complex legal issues in their professional practice, impacting their knowledge, attitudes, and interference with legal matters. This study aimed to analyze the level of legal knowledge, attitudes toward legal issues, and the extent of legal interference among emergency nurses in Erbil.

Methods

This cross-sectional study was conducted from January 1 to February 5, 2024, in eight major public hospitals in Erbil. Purposive sampling was used to collect data using a comprehensive questionnaire. The questionnaire included demographic information and the Emergency Nursing Legal Issues Assessment Scale (ENLIAS), which measured legal knowledge, attitudes toward legal issues, and interference with legal matters. Statistical analysis was performed using Stata version 12 (StataCorp LLC, College Station, TX). Pearson correlation analyses and multiple linear regression were conducted to assess the correlations between legal knowledge, attitudes, interference with legal issues, and demographic variables.

Results

A total of 254 emergency nurses participated in the study. The mean score for legal knowledge was 6.00 ± 3.25, indicating a moderate level of knowledge. The mean score for attitudes toward legal issues was 5.35 ± 2.08, also reflecting a moderate level. The mean score for interference with legal issues was 24.69 ± 5.16, indicating medium interference. There was a significant positive correlation between legal knowledge and good attitude (r = 0.47, p < 0.001), suggesting that higher legal knowledge is associated with a more positive attitude toward legal issues. Conversely, there was a significant negative correlation between legal knowledge and interference with legal issues (r = −0.55, p < 0.001), indicating that greater legal knowledge is associated with lower interference in legal matters.

Conclusions

The study demonstrated that emergency nurses in Erbil have moderate levels of legal knowledge and attitudes toward legal issues, with medium levels of interference in legal matters. Policymakers and healthcare providers should develop targeted educational interventions to enhance legal literacy and support nurses in effectively managing legal issues.