Health Science Reports最新文献

Background: The protective effect of a healthy diet against chronic diseases has been confirmed in several primary studies. This study identifies the dominant food patterns using factor analysis and determining its relationship with metabolic syndrome in female employees participating in the Persian cohort study.

Methods: Female participants with metabolic syndrome (based on the National Cholesterol Education Program (NCEP ATP III) were studied using a cross-sectional design. Demographic, clinical and anthropometric information of the subjects were analyzed after checking the inclusion and exclusion criteria. Also, dietary intake based on the food frequency questionnaire (FFQ) was extracted from the participants' records.

Results: Waist circumference and HDL were significantly correlated with the healthy food pattern (p < 0.05). In the unadjusted model, a significant relationship was observed between healthy food patterns and low HDL (p = 0.035, OR = 0.674, 95% CI for OR: 0.467-0.973). After adjusting for confounding factors, a significant relationship was observed between low HDL and the third and fourth quartiles of healthy food pattern (p < 0.001, OR = 420, 95% CI for OR: 0.257-0.684, and p < 0.001, OR = 0.294, 95% CI for OR: 0.148-0.585, respectively), indicating that being in the third and fourth quartiles of dietary health was associated with 58% and 70.6% decreased risk of low HDL, respectively.

Conclusions: The results indicated that only healthy dietary patterns could have a preventive role against low HDL criterion of the metabolic syndrome among women.

Background: This study aimed to evaluate the service quality in Iranian hospitals from patients' perspectives based on the SERVQUAL model.

Materials and methods: A thorough exploration of online electronic databases, including Scopus, PubMed, Web of Science, IranMedex, and the Scientific Information Database (SID), was undertaken using keywords extracted from Medical Subject Headings such as "Quality of Health Care," "Hospital," and "Patients" spanning from the earliest available records up to August 11, 2023.

Results: In the context of 25 cross-sectional studies encompassing a collective participant pool of 8021 hospitalized patients in Iranian medical facilities, an assessment of patients' perspectives on the quality of hospital services revealed a mean perception score of 3.54 (SE = 0.08). Concurrently, the mean expectation score for the quality of services was determined to be 4.43 (SE = 0.06). Using the SERVQUAL model, the overall disparity between patients' perceptions and expectations was calculated as -0.89. Subsequent examination of specific dimensions within the SERVQUAL framework revealed gaps between patients' perceptions and expectations in the tangibility dimension (-0.84), reliability dimension (-0.94), responsiveness dimension (-0.91), assurance dimension (-0.89), and empathy dimension (-0.82).

Conclusion: Therefore, healthcare administrators consider the study's findings as a motivating force to initiate measures aimed at improving service quality in Iranian hospitals. Tackling the recognized shortcomings and areas requiring enhancement holds the promise of raising patient satisfaction levels and, consequently, improving overall healthcare outcomes.

Background and aims: Narrative competence is essential for good communication between medical staff and patients. It is a powerful instrument for the delivery of holistic healthcare. However, little research focuses on the influencing factors of narrative competence and the relationships among resilience, self-efficacy, and narrative competence. The study aims to explore the influence factors of narrative competence of medical staff and confirm the relationships among self-efficacy, resilience, and narrative competence.

Methods: A cross-sectional survey was conducted among 606 medical staff from two affiliated hospitals in Zhejiang and Heilongjiang provinces, respectively. The participants were scored using the Chinese narrative competence scale, the brief Chinese version of the resilience scale, and the Chinese version of the self-efficacy scale.

Results: This study showed that the score of narrative competence was 149.76 ± 28.70, including the scores of listening dimension (48.01 ± 9.36), understanding dimension (67.75 ± 13.55), and reflecting dimension (34.00 ± 6.77). A high narrative competence score was associated with hospital location and parallel chart writing (p < 0.01). Pearson's correlation analysis showed resilience and self-efficacy were positively related to narrative competence.

Conclusion: Medical staff's narrative competence is intermediate in China. Parallel chart writing and resilience would impact this competence, which should be further improved.

Background and aim: Coronary artery bypass grafting (CABG) is a key treatment for coronary artery disease, but accurately predicting patient survival after the procedure presents significant challenges. This study aimed to systematically review articles using machine learning techniques to predict patient survival rates and identify factors affecting these rates after CABG surgery.

Methods: From January 1, 2015, to January 20, 2024, a comprehensive literature search was conducted across PubMed, Scopus, IEEE Xplore, and Web of Science. The review adhered to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines. Inclusion criteria included studies that evaluated survival rates and predictors associated with CABG patients during the specified period.

Results: After eliminating duplicates, a total of 1330 articles were identified. Following a systematic screening, 24 studies met the inclusion criteria. Our findings revealed 43 distinct factors influencing survival rates in patients undergoing CABG. Notably, five factors-age, ejection fraction, diabetes mellitus, a history of cerebrovascular disease or accidents, and renal function-were consistently identified across multiple studies as significant predictors of postsurgical survival.

Conclusion: This systematic review identifies key factors influencing survival rates after CABG surgery and highlights the role of machine learning in improving predictive accuracy. By identifying high-risk patients through these key factors, our findings offer practical insights for healthcare providers, enhancing patient management and customizing therapeutic strategies after CABG. This study significantly enhances existing literature by combining machine learning techniques with clinical factors, thereby improving the understanding of patient outcomes in CABG surgery.

Background and aims: Pectus carinatum (PC) is the second most common deformity of the anterior chest wall, resulting in detrimental effects on body image and quality of life. This study evaluated the safety, effectiveness, and factors associated with the treatment of PC using a sandwiched bar and screw fixation system, first performed in Vietnam at the University Medical Center Ho Chi Minh City in 2016.

Methods: This retrospective cohort study was conducted from March 2016 to February 2023 in patients with PC and PC-mixed pectus excavatum (PE) deformities. All patients underwent corrective surgery using the sandwiched bar and screw fixation system. Data were collected on demographic characteristics, operative time, length of hospital stay, Haller Index (HI), and postoperative complications. The effectiveness of the procedure was evaluated based on changes in the HI. Statistical analyses were performed using paired t-tests to compare preoperative and postoperative HI values, and multivariate linear regression was used to identify factors associated with postoperative outcomes.

Results: Of the 39 consecutive patients, 12 (30.8%) had symmetric PC, 10 (25.6%) asymmetric PC, and 17 (43.6%) had PC with an excavatum complex. The mean operative time was 68.1 ± 35.8 min, and the length of stay was 5.3 ± 1.1 days. The preoperative and postoperative Haller index (HI) values were 1.96 ± 0.13 and 2.49 ± 0.14, respectively (p < 0.001). Independent variables correlated to postoperative HI included the asymmetry index absolute value (coefficient (β) = 0.649, p < 0.001) and angle of sternal rotation (β = -0.008, p < 0.001). The percentage of patients with good outcomes was 97.4%. No serious procedure-related complications were observed.

Conclusion: Minimally invasive repair using the sandwiched bar and screw fixation system is an effective and safe treatment for PC. Sternal rotation and asymmetry index contribute to its effectiveness by correlating to postoperative HI.

Background and aim: Epilepsy is a major neurological challenge, especially for pediatric populations. It profoundly impacts both developmental progress and quality of life in affected children. With the advent of artificial intelligence (AI), there's a growing interest in leveraging its capabilities to improve the diagnosis and management of pediatric epilepsy. This review aims to assess the effectiveness of AI in pediatric epilepsy detection while considering the ethical implications surrounding its implementation.

Methodology: A comprehensive systematic review was conducted across multiple databases including PubMed, EMBASE, Google Scholar, Scopus, and Medline. Search terms encompassed "pediatric epilepsy," "artificial intelligence," "machine learning," "ethical considerations," and "data security." Publications from the past decade were scrutinized for methodological rigor, with a focus on studies evaluating AI's efficacy in pediatric epilepsy detection and management.

Results: AI systems have demonstrated strong potential in diagnosing and monitoring pediatric epilepsy, often matching clinical accuracy. For example, AI-driven decision support achieved 93.4% accuracy in diagnosis, closely aligning with expert assessments. Specific methods, like EEG-based AI for detecting interictal discharges, showed high specificity (93.33%-96.67%) and sensitivity (76.67%-93.33%), while neuroimaging approaches using rs-fMRI and DTI reached up to 97.5% accuracy in identifying microstructural abnormalities. Deep learning models, such as CNN-LSTM, have also enhanced seizure detection from video by capturing subtle movement and expression cues. Non-EEG sensor-based methods effectively identified nocturnal seizures, offering promising support for pediatric care. However, ethical considerations around privacy, data security, and model bias remain crucial for responsible AI integration.

Conclusion: While AI holds immense potential to enhance pediatric epilepsy management, ethical considerations surrounding transparency, fairness, and data security must be rigorously addressed. Collaborative efforts among stakeholders are imperative to navigate these ethical challenges effectively, ensuring responsible AI integration and optimizing patient outcomes in pediatric epilepsy care.

Background and aims: Non-Alcoholic Steatohepatitis (NASH), a severe form of Non-Alcoholic Fatty Liver Disease (NAFLD), is characterized by inflammation and fibrosis in the liver, often progressing to cirrhosis and hepatocellular carcinoma. Despite its rising prevalence and significant disease burden, effective pharmacological treatments have been limited to lifestyle modifications and surgical interventions. Recently, resmetirom, a thyroid hormone receptor-β agonist, received FDA approval for treating NASH, offering new hope to patients. This review explores the current understanding of NASH and the role of resmetirom as a breakthrough therapeutic option.

Methods: This study is a comprehensive literature review analyzing peer-reviewed articles, clinical trial data, and public health reports. No original analyses were conducted, and no statistical software was utilized in this review.

Results: Resmetirom demonstrated efficacy in resolving NASH without fibrosis progression and improving fibrosis scores in patients with biopsy-confirmed NASH. In a randomized Phase 3 trial, significant histological improvements were observed in 25.9% and 29.9% of patients receiving 80 and 100 mg doses, respectively, compared to 9.7% in the placebo group. Similar trends were noted in fibrosis improvement, with 24.2% and 25.9% of patients showing ≥ 1 stage improvement compared to 14.2% in the placebo group. Adverse effects, including nausea and diarrhea, were reported more frequently in the treatment groups, but the rates of serious adverse events were comparable across groups.

Conclusion: The approval of resmetirom marks a significant advancement in the treatment of NASH, addressing the limitations of lifestyle-based interventions. As the obesity epidemic drives the increasing prevalence of NASH, resmetirom provides a promising therapeutic option, paving the way for improved patient outcomes and future research.

Background and aims: In the current study, we aimed to identify the association between major and minor electrocardiographic abnormalities and cardiovascular risk factors.

Methods: We used the Tehran cohort study baseline data, an ongoing multidisciplinary, longitudinal study designed to identify cardiovascular disease risk factors in the adult population of Tehran. The electrocardiograms (ECGs) of 7630 Iranian adults aged 35 years and above were analyzed. ECG abnormalities were categorized into major or minor groups based on their clinical importance. Results were obtained by multivariable logistic regression and are expressed as odds ratios (ORs).

Results: A total of 756 (9.9%) participants had major ECG abnormalities, while minor abnormalities were detected in 2526 (33.1%). Males comprised 45.8% of the total population, and 41.8% of them had minor abnormalities. Individuals with older age, diabetes (OR = 1.35; 95% CI: 1.11-1.64), and hypertension (OR = 2.21; 95% CI: 1.82-2.68) had an increased risk of major ECG abnormalities. In contrast, intermediate (OR = 0.69; 95% CI: 0.57-0.84) and high physical activity levels (OR = 0.66; 95% CI: 0.51-0.86) were associated with a lower prevalence of major abnormalities. Male sex, older age, hypertension, and current smoking were also associated with an increased prevalence of ECG abnormalities combined (major or minor).

Conclusion: Major and minor ECG abnormalities are linked with important cardiovascular risk factors such as diabetes and hypertension. Since these abnormalities have been associated with poor outcomes, screening patients with cardiovascular risk factors with an ECG may distinguish high-risk individuals who require appropriate care and follow-up.

Background and aims: Rhinoplasty, a prevalent cosmetic surgery, often involves lateral osteotomy, which can lead to ocular complications such as edema and ecchymosis. A potential complication is increased intraocular pressure (IOP) postoperatively. This study aims to investigate the impact of lateral osteotomy during rhinoplasty on IOP in patients.

Methods: This prospective before-and-after cross-sectional study evaluated the effect of lateral osteotomy during rhinoplasty on IOP in 96 patients. Preoperative ophthalmologic examinations included best-corrected visual acuity, slit lamp biomicroscopy, Goldmann tonometry, and dilated fundoscopy. IOP measurements were taken three times per eye at baseline, during surgery, on the first postoperative day, after nasal pin removal on the seventh postoperative day, and on the thirtieth postoperative day using a Goldmann tonometer. The mean IOP was recorded at each time point.

Results: The study found no significant changes in IOP at 1, 7, or 30 days postsurgery (p = 0.194). Additionally, the type of surgery did not significantly affect ocular internal pressure (p = 0.622).

Conclusion: Rhinoplasty with lateral osteotomy appears to be safe concerning IOP. However, monitoring IOP during rhinoplasty is advisable.