Prognostic value of red blood cell distribution width and D-Dimer in diffuse large B-cell lymphoma: Systematic review and meta-analysis

BACKGROUND

The significant role of red blood cell distribution width (RDW) and D-Dimer as prognostic factors in patients with some blood malignancies has been reported recently.

AIM

We designed and performed a meta-analysis to investigate the prognostic roles of RDW and D-Dimer in subjects with diffuse large B-cell lymphoma (DLBCL).

MATERIALS AND METHODS

We systematically reviewed PubMed-Medline, SCOPUS, EMBASE, Web of Science Core Collection, and Google Scholar up to the present to look for publications on prognostic effects of RDW and D-Dimer in DLBCL patients. For investigation of the associations between RDW and D-Dimer with the overall survival (OS) and progression-free survival (PFS) of the DLBCL cases, hazard ratio (HR) with 95% confidence intervals (CIs) was used.

RESULTS

We included 13 eligible studies in the present meta-analysis. The results of pooled analysis showed that increased levels of RDW was related to poor OS (HR = 2.01, 95% CI: 1.62-2.48, p value <.01, I2  = 0%) and poor PFS (HR = 1.52, 95% CI: 1.24-1.85, p value <.01, I2  = 16%) among the DLBCL patients. Similarly, a significant relationship was found between increased D-Dimer and poor OS (HR = 2.30, 95% CI: 1.03-5.14, p value <.05, I2  = 95%) of the DLBCL patients as well. In addition, there was no significant heterogeneity in OS (p value H = 0.65) and PFS (p value H = 0.31) related to RDW among studies included in the meta-analysis.

CONCLUSION

Our finding clearly confirmed that elevated RDW levels and D-Dimer were associated with adverse OS and PFS in DLBCL.

Surfactant administration methods for premature newborns: LISA vs. INSURE comparative analysis

INTRODUCTION

Respiratory Distress Syndrome (RDS) is the most common respiratory disorder among premature infants. The use of surfactant has significantly reduced respiratory complications and mortality. There are two conventional methods for administering surfactant: Intubate-Surfactant-Extubate (INSURE) and Less Invasive Surfactant Administration (LISA). This study aims to compare the effects of surfactant administration using these two methods on the treatment outcomes of premature newborns.

MATERIALS AND METHODS

In this retrospective cohort study, we included 100 premature newborns with RDS and spontaneous breathing who were admitted to the Neonatal Intensive Care Unit of Besat Hospital in Sanandaj city in 2021. Exclusion criteria comprised congenital anomalies and the needing for intubation for resuscitation at birth. The outcomes of epmericaly trated with two methods were compared: the LISA (50 neonates) and the INSURE (50 neonates). Our interesting outcomes were needing for mechanical ventilation, duration of ventilation, pneumothorax, pulmonary hemorrhage, severe retinopathy, CPAP duration, and bronchopulmonary dysplasia. Finally, we entered the data into STATA-14 statistical software and analyzed it using chi-square and t-tests.

RESULTS

In this study, 69% of the neonates were boys. The LISA group exhibited significantly lower rates of need for mechanical ventilation (P = 0.003) and ventilation duration (P < 0.001) compared to the INSURE group. Conversely, there were no significant differences between the two groups (P > 0.05) in terms of pneumothorax, pulmonary hemorrhage, severe retinopathy, CPAP duration, and bronchopulmonary dysplasia rates.

CONCLUSION

The results of this study suggest that the LISA method is a safe and non-invasive approach for surfactant administration. Notably, it resulted in a reduced need for mechanical ventilation and decreased ventilation duration compared to the INSURE method.

The effect of a low-calorie, high-protein diet on psychometric variables in obese individuals: a Randomized Clinical Trial

INTRODUCTION

The last decade has seen the increased prevalence of obesity as a public health challenge, particularly in low- and middle-income countries. At the same time, studies have shown that there is a two-way relationship between low-calorie diets and depression in obese individuals. This study was designed and implemented to investigate the effect of a low-calorie high-protein diet on psychometric variables in obese individuals.

MATERIALS AND METHODS

The present study is a Randomized Clinical Trial. Individuals meeting the inclusion criteria were randomly assigned to either the intervention group (low-calorie diet with increased protein percentage) or the control group (standard protein percentage) using block stratification. Psychometric characteristics of the participants were evaluated using the DASS-21 questionnaire.

RESULTS

There were no significant differences in enrollment between the two groups with respect to anthropometric variables, body composition, and physical activity (p-value > .05). Similarly, no significant differences were observed between the two groups in terms of psychological variables (depression, anxiety and stress) (p-value > .05). However, the intervention groups had significantly lower depression and anxiety scores 15 days into the intervention (p-value < .05). After 30 and 60 days of intervention, significant differences were observed between the 2 groups in terms of depression, stress, and anxiety (p-value < .05), indicating a relative improvement in psychometric variables in the intervention group (p-value < .05).

CONCLUSION

The results of this study showed that low-calorie diets with a high-protein percentage can significantly improve psychometric variables in obese people.Trial registration: Iranian Registry of Clinical Trials identifier: IRCT20221101056371N1..

Microstructural examination and mechanical characterization of Ti/HA and Ti/SiO2 functionally graded materials fabricated at different loading rates

Functionally graded material (FGM) is a heterogeneous composite material that consists of two or more constituent phases with continuous changes in the microstructure from one material to another with adjustable through thickness properties. FGMs are utilized in medical applications, such as dental implants, due to their excellent mechanical and tribological properties. In this study, the powder metallurgy method (PMM) is used to produce Titanum/Hydroxyapatite (Ti/HA) and Titanum/Silicon dioxide (Ti/SiO2) FGM samples. A new designed blender is employed to mix the particles constituting the FGM samples. The mixed particles are then compacted at different strain rates from quasi static loading, using a universal testing apparatus, to dynamic loadings, using a drop hammer and a split Hopkinson bar. The effect of strain rate on mechanical properties and microstructure of specimens is studied by conducting various tests such as indentation and compression tests and by microstructural examinations using scanning electron microscopy (SEM). The results showed that the relative density of fabricated specimens was increased with the increase of the strain rate. The highest relative density for the Ti/HA composite was achieved for the specimens produced by the split Hopkinson bar. For both of Ti/HA and Ti/SiO2 FGMs the maximum indentation force and indentation energy, obtained from the load-penetration depth curve, and the ultimate strength, obtained from the compressive stress-strain curve, were increased with the increase in strain rate. The results also indicated that the increase in volume fraction of reinforcing ceramic particles (HA or SiO2) led to the decrease of the maximum indentation force and indentation energy.

The effectiveness of COVID-19 vaccines in reducing the incidence, hospitalization, and mortality from COVID-19: A systematic review and meta-analysis

Background

Vaccination, one of the most important and effective ways of preventing infectious diseases, has recently been used to control the COVID-19 pandemic. The present meta-analysis study aimed to evaluate the effectiveness of COVID-19 vaccines in reducing the incidence, hospitalization, and mortality from COVID-19.

Methods

A systematic search was performed independently in Scopus, PubMed via Medline, ProQuest, and Google Scholar electronic databases as well as preprint servers using the keywords under study. We used random-effect models and the heterogeneity of the studies was assessed using I ² and χ² statistics. In addition, the Pooled Vaccine Effectiveness (PVE) obtained from the studies was calculated by converting based on the type of outcome.

Results

A total of 54 studies were included in this meta-analysis. The PVE against SARS-COV 2 infection were 71% [odds ratio (OR) = 0.29, 95% confidence intervals (CI): 0.23-0.36] in the first dose and 87% (OR = 0.13, 95% CI: 0.08-0.21) in the second dose. The PVE for preventing hospitalization due to COVID-19 infection was 73% (OR = 0.27, 95% CI: 0.18-0.41) in the first dose and 89% (OR = 0.11, 95% CI: 0.07-0.17) in the second dose. With regard to the type of vaccine, mRNA-1273 and combined studies in the first dose and ChAdOx1 and mRNA-1273 in the second dose had the highest effectiveness in preventing infection. Regarding the COVID-19-related mortality, PVE was 68% (HR = 0.32, 95% CI: 0.23-0.45) in the first dose and 92% (HR = 0.08, 95% CI: 0.02-0.29) in the second dose.

Conclusion

The results of this meta-analysis indicated that vaccination against COVID-19 with BNT162b2 mRNA, mRNA-1273, and ChAdOx1, and also their combination, was associated with a favorable effectiveness against SARS-CoV2 incidence rate, hospitalization, and mortality rate in the first and second doses in different populations. We suggest that to prevent the severe form of the disease in the future, and, in particular, in the coming epidemic picks, vaccination could be the best strategy to prevent the severe form of the disease.

Systematic review registration

PROSPERO International Prospective Register of Systematic Reviews: http://www.crd.york.ac.uk/PROSPERO/, identifier [CRD42021289937].

Relationship between Noise Annoyance and High Blood Pressure in Workers Exposed to Chronic Noise Among the Workers of an Automotive Industry

Background:

Chronic exposure to noise in workplaces is one of the most important physical agents that affects workers’ health and causes social and individual problems. The aim of this study was to investigate the relationship between noise annoyance and blood pressure (BP) of workers of an automotive industry.

Methods:

In this cross-sectional study, 250 workers were randomly selected. The subjects were classified in two groups based on the exposure to sound pressure levels lower and higher than 85 dB (106 and 144 workers, respectively). In this study, BP was measured using an ALPK2 mercury pressure gauge. To measure annoyance levels, an annoyance questionnaire containing a numerical question numbered 0–11 was used.

Results:

The mean age of the subjects was 36.19 (±3.75) years. The results showed that the systolic (SBP) and diastolic blood pressure (DBP) of the subjects exposed to the sound pressure levels higher than 85 dB were significantly higher than those exposed to a sound pressure level lower than 85 dB (P < 0.01). Also, the results of the multivariate regression showed a significant relationship between the annoyance and DBP and SBP caused by chronic exposure to noise and sound pressure levels (P < 0.01).

Conclusion:

The results of this study showed that the annoyance caused by exposure to chronic noise in the workplace causes stress in the workers and, in the long term, could increase the risk of high SBP and DBP.

Combined Effect of Noise and Smoking on the Cognitive Performance of Automotive Industry Workers

Introduction:

Noise is an environmental stressor and can cause or exacerbate mental disorders, and affect the individual performance in certain conditions. This study aimed to evaluate the combined effects of noise and smoking on the cognitive performance of the workers in the automotive industry.

Methods:

This research is a descriptive-analytical study with a cross-sectional design conducted on 300 workers randomly assigned into two groups of noise-exposed and nonexposed. They were examined using computerized tests, including the Tower of London test (TOL), Continuous Performance test (CPT), and Stroop test. The sound pressure levels were measured based on an 8-hour equal-loudness contour in each group according to ISO 9612 standard, using the Testo CEL-815 sound level meter.

Results:

The study of combined effects of noise and smoking on 12 CPT indicators using the 2-way Analysis of Variance (ANOVA) indicate that noise and smoking factors had a significant impact on the mean number of errors and correct responses in the third 50-stimuli stage, the mean number of errors and correct responses in the second 50-stimuli stage with P<0.001, P<0.001, P=0.012 and P<0.001 for smoking respectively, but only noise affected the other 7 indicators (P<0.001).

Conclusion:

Smoking and noise have negative impacts on concentration, attention, and cognitive processing speed, which can lead to an individual’s mistakes and delayed decision making at the workplace.

Association between JC virus and colorectal cancer: systematic review and meta-analysis

Objective: Given the probable role of JC virus in associate with increasing the odds of colorectal cancer, this study was conducted systematically to evaluate the association between JC virus and colorectal cancer.Materials and methods: Systematic reviews of the articles published prior to January 1, 2019 without time and place limitations were done independently through the PubMed, ISI, EMBASE and Medline main databases. The heterogeneity rate was assessed through I2, Chi2 and Tau2, and the sensitivity analysis and meta-regression were used to investigate the source of heterogeneity among the studies.Results: 24 studies with a sample size of 2576 were finally entered into the meta-analysis. The results showed that the prevalence of JC virus in colorectal cancer tissues was about 43% (95% CI: 29% -58%). The meta-analysis results also showed that the presence of JCV in colorectal tissues increased the odds of colorectal cancer 4.70 times as much (OR Pooled = 4.70; 95% CI: 2.95-7.50). Also, the results of the sub-group analysis indicated that the presence of JC virus, compared with the tissues adjacent to the tumour and the healthy control tissues, increased the odds of colorectal cancer (OR Pooled = 4.50, 95% CI: 2.09-9.65 and OR Pooled = 4.70, 95% CI: 2.95-7.50) respectively.Conclusion: The meta-analysis showed that as an oncogene virus, JC could increase the odds of colorectal cancer, reinforcing the hypothesis on the role of viral factors in the pathogenesis of cancers.

Magnetic resonance imaging radiomic feature analysis of radiation-induced femoral head changes in prostate cancer radiotherapy

Background and Purpose

As a feasible approach, radiotherapy has a great role in prostate cancer (Pca) management. However, Pca patients have an increased risk of femoral head damages including fractures after radiotherapy. The mechanisms of these complications are unknown and time of manifestations is too long; however, they may be predicted by early imaging. The main purpose of this study was to assess the early changes in femoral heads in Pca patients treated with intensity-modulated radiation therapy (IMRT) using multiparametric magnetic resonance imaging (mpMRI) radiomic feature analysis.

Materials and Methods

Thirty Pca patients treated with IMRT were included in the study. All patients underwent two mpMRI pre- and postradiotherapy. Thirty-four robust radiomic features were extracted from T1, T2, and apparent diffusion coefficient (ADC) obtained from diffusion-weighted images. Wilcoxon signed-rank test was performed to assess the significance of the change in the mean T1, T2, and ADC radiomic features postradiotherapy relative to preradiotherapy values. The percentage change values were normalized based on the natural logarithm base ten. Features were also ranked based on their median changes.

Results

Sixty femoral heads were analyzed. All radiomic features have undergone changes. Significant postradiotherapy radiomic feature changes were observed in 20 and 5 T1- and T2-weighted radiomic features, respectively (P < 0.05). ADC features did not vary significantly postradiotherapy. The mean radiation dose received by femoral heads was 40 Gy. No fractures were observed within the follow-up time. Different features were found as high ranked among T1, T2, and ADC images.

Conclusion

Early structural change analysis using radiomic features may contribute to predict postradiotherapy fracture in Pca patients. These features can be identified as being potentially important imaging biomarkers for predicting radiotherapy-induced femoral changes.

Risk factors contributing to the incidence and mortality of acute childhood poisoning in emergency department patients in Iran: a hospital-based casecontrol study

OBJECTIVES

Since poisoning is one of the most important preventable factors contributing to the hospitalization and death of children who present to emergency departments, this study was carried out to investigate the risk factors contributing to the incidence and mortality of acute childhood poisoning.

METHODS

This hospital-based case-control study included 243 cases and 489 controls, drawn from daily admissions to the emergency departments of the included hospitals according to the inclusion and exclusion criteria.

RESULTS

Gastrointestinal poisoning was the most common poisoning type, found in 87.7% of subjects, and medications were the most common cause of poisoning (49.8%). Multiple logistic regression analysis showed that a history of poisoning (odds ratio [OR], 10.44; 95% confidence interval [CI], 5.58 to 19.51; p<0.001) and the availability of poisonous substances (OR, 8.88; 95% CI, 5.41 to 14.56; p<0.001) were among the most important predictors of childhood poisoning. Respiratory poisoning (OR, 6.72; 95% CI, 1.40 to 32.07; p<0.05) and the presence of addiction in the family (OR, 4.54; 95% CI, 1.10 to 18.68; p<0.05) were the most important predictors of mortality among children with poisoning.

CONCLUSIONS

Addiction and the presence of physical or psychological disorders in family members, a history of poisoning, and the availability of poisonous substances were significantly associated with the incidence of childhood poisoning and resultant mortality.

Relationship Between Noise Annoyance and Cognitive Performance in Automotive Workers Exposed to Chronic Noise

Among the most important complaints of people exposed to noise are the feelings of resentment and annoyance, and the changes in mental conditions, which are among the main psychological consequences affecting the concentration and accuracy of workers. This study was designed to investigate the relationship between annoyance and cognitive performance of workers exposed to chronic noise. This is a descriptive-analytical study conducted on workers in an automotive company. Three hundred workers exposed to noise were entered into the study in two groups: administrative (150 people) and industrial (150 people). The Tower of London and the Stroop computerized psychological tests were used to determine the cognitive status of the workers, and a questionnaire with numbered questions (numbered 1 to 11) was used in order to determine their level of annoyance. There was a significant correlation between the workers' cognitive performance and annoyance levels (P value <0.001). Linear regression results showed that cognitive performance had a significant relationship with the received sound intensity, while the workers' annoyance had a significant relationship with cognitive performance only in the number of wrong answers, the number of unanswered questions, and the number of correct answers in the Stroop test (P value <0.001). The researchers concluded that exposure to chronic noise in work environments could bring about occupational annoyance, and consequently, cognitive disorders, which could increase the risk of errors. More studies are needed to further explore this relationship.

The role of brain natriuretic peptides as a marker for diagnosing cardiac syncope: A narrative review

Cardiac disease is the second common cause of syncope in emergency departments. Patients with Cardiac syncope have a higher risk of mortality than those who have a non-cardiac problem. Brain natriuretic peptide (BNP) as a cardiac marker has not thoroughly been evaluated in patients with syncope. This article focuses on the studies that have assessed BNP and NT-pro-BNP in cardiac and non-cardiac syncope patients in emergency departments.

Effect of Chronic Noise Exposure on Aggressive Behavior of Automotive Industry Workers

Background:

Noise pollution is one of the important harmful physical factors in work environment in developed and developing countries. It not only causes a variety of physiological effects, but also accounts for psychological disorders.

Objective:

To investigate the effects of chronic exposure to noise on aggression in automotive industry workers.

Methods:

In a cross-sectional study conducted in an Iranian automotive industry, a group of workers were randomly selected from different parts of the paint shop. The workers' aggression level was measured using the Buss and Perry's questionnaire. The noise level was also measured at the workplace. Using linear regression analysis, the relationship between the level of aggression and noise level was evaluated.

Results:

250 workers with a mean age of 36.1 (SD 3.7) years were studied. There was a significant (p<0.05) correlation between the measured noise intensity and the aggression level of the studied workers.

Conclusion:

Exposure to noise in work environment increases the incidence of tension and inappropriate behavior associated with aggression. Controlling noise through use of protective equipment might reduce the deleterious effects of noise on workers.

Determination and Diversity of Bovine Coccidia in Zabol, East of Iran

The present study was designed to investigate the prevalence of Eimeria spp. in Zabol, east of Iran. The samples were examined microscopically for the presence of oocysts from February 2015 to December 2016. Out of 196 cattle, 124 (63.26%) were identified to be positive for Eimeria species. Eight species of Eimeria were found as follows: E. bovis (42.54%), E. zuernii (38.67%), E. subspherica (5.52%), E. brasiliensis (4.97%), E. ellipsoidalis (4.41%), E. cylindrical (1.65%), E. pellita (1.65%), and E. wyomingensis (0.55%). Multiple infections with two or three species were identified in 56 (45.16%) and 2 (1.61%) cases, respectively. The infection rate was observed to be higher in calves (75%) as compared to adult cattle (59.02%). The prevalence of Eimeria was greater in female cattle (67.94%). The highest prevalence and mean number of oocysts were observed in winter (69%) and autumn (209.09), respectively. All the faecal samples had an oocysts per gram of feces (OPG) less than 1000. The prevalence of infection and mean OPG were directly correlated with rainfall and relative humidity and inversely correlated with temperature. Considering the high prevalence of bovine coccidiosis in Zabol, increasing awareness of farmers and veterinarians regarding the economic importance of bovine coccidiosis should be regarded as an important factor in preventing and controlling the infection.

Problems of providing services to people affected by HIV/AIDS: service providers and recipients perspectives

This qualitative study aimed to identify the health-care problems of people living with HIV (PLHIV) in 2 large cities: Tehran and Kermanshah. Two main groups of stakeholders - service providers (policy-makers, managers, physicians and counsellors) and service recipients (PLHIV and their relatives) - participated in focus group discussions and in-depth interviews. We identified 24 themes covering the major health problems of PLHIV, including: incomplete and inadequate coverage of health-care services; patients' substance abuse; patients' fear of stigma; occupational burnout of certain service providers; patients' dissatisfaction with some of the services provided by counselling centres/clinics; medical staff's failure to observe confidentiality; and patients' lack of access to required specialized services. The problems and needs identified can inform the design and implementation of health programmes in our country and elsewhere in the Eastern Mediterranean Region.