Progress and trends in neurological disorders research based on deep learning.

In recent years, deep learning (DL) has emerged as a powerful tool in clinical imaging, offering unprecedented opportunities for the diagnosis and treatment of neurological disorders (NDs). This comprehensive review explores the multifaceted role of DL techniques in leveraging vast datasets to advance our understanding of NDs and improve clinical outcomes. Beginning with a systematic literature review, we delve into the utilization of DL, particularly focusing on multimodal neuroimaging data analysis-a domain that has witnessed rapid progress and garnered significant scientific interest. Our study categorizes and critically analyses numerous DL models, including Convolutional Neural Networks (CNNs), LSTM-CNN, GAN, and VGG, to understand their performance across different types of Neurology Diseases. Through particular analysis, we identify key benchmarks and datasets utilized in training and testing DL models, shedding light on the challenges and opportunities in clinical neuroimaging research. Moreover, we discuss the effectiveness of DL in real-world clinical scenarios, emphasizing its potential to revolutionize ND diagnosis and therapy. By synthesizing existing literature and describing future directions, this review not only provides insights into the current state of DL applications in ND analysis but also covers the way for the development of more efficient and accessible DL techniques. Finally, our findings underscore the transformative impact of DL in reshaping the landscape of clinical neuroimaging, offering hope for enhanced patient care and groundbreaking discoveries in the field of neurology. This review paper is beneficial for neuropathologists and new researchers in this field.

Rural and urban differences in the prevalence and determinants of Type-2 diabetes in Bangladesh.

OBJECTIVE: To estimate the prevalence of Type 2 Diabetes (T2D) in urban and rural settings and identify the specific risk factors for each location. METHOD: We conducted this study using data from the 2017-18 Bangladesh Demographic and Health Survey (BDHS), sourced from the DHS website. The survey employed a stratified two-stage sampling method, which included 7,658 women and 7,048 men aged 18 and older who had their blood glucose levels measured. We utilized chi-square tests and ordinal logistic regression to analyze the association between various selected variables in both urban and rural settings and their relationship with diabetes and prediabetes. RESULTS: The prevalence of T2D was 10.8% in urban areas and 7.4% in rural areas, while pre-diabetes affected 31.4% and 27% of the populations in these respective settings. The study found significant factors influencing diabetes in both urban and rural regions, particularly in the 55-64 age group (Urban: AOR = 1.88, 95% CI [1.46, 2.42]; Rural: AOR = 1.87, 95% CI [1.54, 2.27]). Highly educated individuals had lower odds of T2D, while wealthier and overweight participants had higher odds in both areas. In rural regions, T2D risk was higher among caffeinated drink consumers and those not engaged in occupation-related physical activity, while these factors did not show significant influence in urban areas. Furthermore, urban participants displayed a significant association between T2D and hypertension. CONCLUSION: Our study outlines a comprehensive strategy to combat the increasing prevalence of T2D in both urban and rural areas. It includes promoting healthier diets to control BMI level, encouraging regular physical activity, early detection through health check-ups, tailored awareness campaigns, improving healthcare access in rural regions, stress management in urban areas, community involvement, healthcare professional training, policy advocacy like sugary drink taxation, research, and monitoring interventions. These measures collectively address the T2D challenge while accommodating the distinct features of urban and rural settings.

An adaptive ensemble deep learning framework for reliable detection of pandemic patients.

Nurses, often considered the backbone of global health services, are disproportionately vulnerable to COVID-19 due to their front-line roles. They conduct essential patient tests, including blood pressure, temperature, and complete blood counts. The pandemic-induced loss of nursing staff has resulted in critical shortages. To address this, robotic solutions offer promising avenues. To solve this problem, we developed an ensemble deep learning (DL) model that uses seven different models to detect patients. Detected images are then used as input for the soft robot, which performs basic assessment tests. In this study, we introduce a deep learning-based approach for nursing soft robots, and propose a novel deep learning model named Deep Ensemble of Adaptive Architectures. Our method is twofold: firstly, an ensemble deep learning technique detects COVID-19 patients; secondly, a soft robot performs basic assessment tests on the identified patients. We evaluate the performance of various deep learning-based object detectors for patient detection, examining implementations of You Only Look Once (YOLO), Single Shot MultiBox Detector (SSD), Region-Based Convolutional Neural Network (RCNN), and Region-Based Fully Convolutional Network (R-FCN) on a proprietary dataset comprising 32,668 hospital surveillance images. Our results indicate that while YOLO and VGG facilitate rapid detection, Faster-RCNN (Inception ResNet-v2) and our proposed Ensemble-DL achieve the highest accuracy. Ensemble-DL offers accurate results in a reasonable timeframe, making it apt for patient detection on embedded platforms. Through real-world experiments, our method outperforms baseline approaches (including Faster-RCNN, R-FCN variants, CNN+LSTM, etc.) in terms of both precision and recall. Achieving an impressive accuracy of 98.32%, our deep learning-based model for nursing soft robots presents a significant advancement in the identification and assessment of COVID-19 patients, ultimately enhancing healthcare efficiency and patient care.

Hybrid Deep Learning Approach for Accurate Tumor Detection in Medical Imaging Data.

The automated extraction of critical information from electronic medical records, such as oncological medical events, has become increasingly important with the widespread use of electronic health records. However, extracting tumor-related medical events can be challenging due to their unique characteristics. To address this difficulty, we propose a novel approach that utilizes Generative Adversarial Networks (GANs) for data augmentation and pseudo-data generation algorithms to improve the model's transfer learning skills for various tumor-related medical events. Our approach involves a two-stage pre-processing and model training process, where the data is cleansed, normalized, and augmented using pseudo-data. We evaluate our approach using the i2b2/UTHealth 2010 dataset and observe promising results in extracting primary tumor site size, tumor size, and metastatic site information. The proposed method has significant implications for healthcare and medical research as it can extract vital information from electronic medical records for oncological medical events.

UncertaintyFuseNet: Robust uncertainty-aware hierarchical feature fusion model with Ensemble Monte Carlo Dropout for COVID-19 detection.

The COVID-19 (Coronavirus disease 2019) pandemic has become a major global threat to human health and well-being. Thus, the development of computer-aided detection (CAD) systems that are capable of accurately distinguishing COVID-19 from other diseases using chest computed tomography (CT) and X-ray data is of immediate priority. Such automatic systems are usually based on traditional machine learning or deep learning methods. Differently from most of the existing studies, which used either CT scan or X-ray images in COVID-19-case classification, we present a new, simple but efficient deep learning feature fusion model, called U n c e r t a i n t y F u s e N e t , which is able to classify accurately large datasets of both of these types of images. We argue that the uncertainty of the model's predictions should be taken into account in the learning process, even though most of the existing studies have overlooked it. We quantify the prediction uncertainty in our feature fusion model using effective Ensemble Monte Carlo Dropout (EMCD) technique. A comprehensive simulation study has been conducted to compare the results of our new model to the existing approaches, evaluating the performance of competing models in terms of Precision, Recall, F-Measure, Accuracy and ROC curves. The obtained results prove the efficiency of our model which provided the prediction accuracy of 99.08% and 96.35% for the considered CT scan and X-ray datasets, respectively. Moreover, our U n c e r t a i n t y F u s e N e t model was generally robust to noise and performed well with previously unseen data. The source code of our implementation is freely available at: https://github.com/moloud1987/UncertaintyFuseNet-for-COVID-19-Classification.

Breast Cancer Dataset, Classification and Detection Using Deep Learning.

Incorporating scientific research into clinical practice via clinical informatics, which includes genomics, proteomics, bioinformatics, and biostatistics, improves patients' treatment. Computational pathology is a growing subspecialty with the potential to integrate whole slide images, multi-omics data, and health informatics. Pathology and laboratory medicine are critical to diagnosing cancer. This work will review existing computational and digital pathology methods for breast cancer diagnosis with a special focus on deep learning. The paper starts by reviewing public datasets related to breast cancer diagnosis. Additionally, existing deep learning methods for breast cancer diagnosis are reviewed. The publicly available code repositories are introduced as well. The paper is closed by highlighting challenges and future works for deep learning-based diagnosis.

Big five inventory-version 10: A two-minute personality measurement tool in Urdu.

OBJECTIVE: To translate into Urdu and validate the Big Five Inventory 10. METHODS: The study was conducted at a tertiary care hospital in Kharian Cantonment, and a university in Gilgit, Pakistan, from October to December 2020. Online video meetings were held for the translation process related to the Big Five Inventory 10. A systematic six-step process was followed for translation and validation. The volunteers recruited for the pilot and validation phases were from various different administrative regions of the country. Convergent and discriminant validity to assess construct validity, and Cronbach's alpha was calculated to assess the reliability of the scale. Data was analysed using SPSS 23. RESULTS: Of the 500 subjects, 358(71.6%) were males and 142(28.4%) were females. The overall age range was 18-48 years. The Urdu version was of the Big Five Inventory 10 was found to have a high level of construct validity supported by convergent and discriminant validity (p<0.05). The Cronbach alpha for all the sub-scales fell in the conventional range (0.71-0.88). Females scored higher on the 'agreeableness' subscale than the males (p<0.0). CONCLUSIONS: The Big Five Inventory 10 Urdu version was found to be a valid and reliable tool for researchers and clinicians having time constraints.

RF-CNN-F: random forest with convolutional neural network features for coronary artery disease diagnosis based on cardiac magnetic resonance.

Coronary artery disease (CAD) is a prevalent disease with high morbidity and mortality rates. Invasive coronary angiography is the reference standard for diagnosing CAD but is costly and associated with risks. Noninvasive imaging like cardiac magnetic resonance (CMR) facilitates CAD assessment and can serve as a gatekeeper to downstream invasive testing. Machine learning methods are increasingly applied for automated interpretation of imaging and other clinical results for medical diagnosis. In this study, we proposed a novel CAD detection method based on CMR images by utilizing the feature extraction ability of deep neural networks and combining the features with the aid of a random forest for the very first time. It is necessary to convert image data to numeric features so that they can be used in the nodes of the decision trees. To this end, the predictions of multiple stand-alone convolutional neural networks (CNNs) were considered as input features for the decision trees. The capability of CNNs in representing image data renders our method a generic classification approach applicable to any image dataset. We named our method RF-CNN-F, which stands for Random Forest with CNN Features. We conducted experiments on a large CMR dataset that we have collected and made publicly accessible. Our method achieved excellent accuracy (99.18%) using Adam optimizer compared to a stand-alone CNN trained using fivefold cross validation (93.92%) tested on the same dataset.

DSM-5 Posttraumatic Stress Disorder Symptoms in Nonclinical Samples of Chinese and Pakistani Trauma-Exposed Adults: Factor Structure and Invariance Across Culture.

ABSTRACT: The purpose of the current study was to examine the latent structure and cross-cultural measurement validity of the Diagnostic and Statistical Manual of Mental Disorders (DSM-5) posttraumatic stress disorder (PTSD) symptoms assessed by the PTSD Checklist for DSM-5. Participants comprised trauma-exposed Chinese and Pakistani undergraduate students (N = 495 and N = 186, respectively). Confirmatory factor analysis (CFA) indicated that a seven-factor hybrid model involving intrusion, avoidance, negative affect, anhedonia, externalizing behaviors, anxious arousal, and dysphoric arousal factors provided good fit in both samples. This model fit significantly better than three alternative models including the DSM-5 four-factor model and six-factor anhedonia and externalizing behaviors models. The subsequent multigroup CFA showed that the best-fitting hybrid model demonstrated cross-cultural measurement invariance. Our findings provide further empirical support for the seven-factor PTSD hybrid model and its cross-cultural invariance, and have implications for understanding and application of DSM-5's PTSD symptoms.

CNN-KCL: Automatic myocarditis diagnosis using convolutional neural network combined with k-means clustering.

Myocarditis is the form of an inflammation of the middle layer of the heart wall which is caused by a viral infection and can affect the heart muscle and its electrical system. It has remained one of the most challenging diagnoses in cardiology. Myocardial is the prime cause of unexpected death in approximately 20% of adults less than 40 years of age. Cardiac MRI (CMR) has been considered a noninvasive and golden standard diagnostic tool for suspected myocarditis and plays an indispensable role in diagnosing various cardiac diseases. However, the performance of CMR depends heavily on the clinical presentation and features such as chest pain, arrhythmia, and heart failure. Besides, other imaging factors like artifacts, technical errors, pulse sequence, acquisition parameters, contrast agent dose, and more importantly qualitatively visual interpretation can affect the result of the diagnosis. This paper introduces a new deep learning-based model called Convolutional Neural Network-Clustering (CNN-KCL) to diagnose Myocarditis. In this study, we used 47 subjects with a total number of 98,898 images to diagnose myocarditis disease. Our results demonstrate that the proposed method achieves an accuracy of 97.41% based on 10 fold-cross validation technique with 4 clusters for diagnosis of Myocarditis. To the best of our knowledge, this research is the first to use deep learning algorithms for the diagnosis of myocarditis.

Deep learning for neuroimaging-based diagnosis and rehabilitation of Autism Spectrum Disorder: A review.

Accurate diagnosis of Autism Spectrum Disorder (ASD) followed by effective rehabilitation is essential for the management of this disorder. Artificial intelligence (AI) techniques can aid physicians to apply automatic diagnosis and rehabilitation procedures. AI techniques comprise traditional machine learning (ML) approaches and deep learning (DL) techniques. Conventional ML methods employ various feature extraction and classification techniques, but in DL, the process of feature extraction and classification is accomplished intelligently and integrally. DL methods for diagnosis of ASD have been focused on neuroimaging-based approaches. Neuroimaging techniques are non-invasive disease markers potentially useful for ASD diagnosis. Structural and functional neuroimaging techniques provide physicians substantial information about the structure (anatomy and structural connectivity) and function (activity and functional connectivity) of the brain. Due to the intricate structure and function of the brain, proposing optimum procedures for ASD diagnosis with neuroimaging data without exploiting powerful AI techniques like DL may be challenging. In this paper, studies conducted with the aid of DL networks to distinguish ASD are investigated. Rehabilitation tools provided for supporting ASD patients utilizing DL networks are also assessed. Finally, we will present important challenges in the automated detection and rehabilitation of ASD and propose some future works.

Investigation of textile dyeing effluent using activated sludge system to assess the removal efficiency.

In this current work, the performance of an aerobic granular sludge (AGS) for real textile wastewater was investigated based on system operational parameters evaluation. The study was performed for 90 days, and sampling was done once a week in which textile dyeing effluent from the textile mill was collected and subjected to laboratory-scale treatment. The samples from the inlet, the outlet of the wastewater plant, and within the bioreactor were collected at various concentrations of mixed liquid suspended solids (MLSS), and hydraulic retention remained the same in the investigated period of 53 h. The objective of this study was to analyze the AGS system performance assessment by evaluating the effect of different MLSS concentrations on chemical oxygen demand (COD), total suspended solids (TSS), and oil/grease removal from real-based textile water. The results showed that removal of organic material from the process water increases with an increase in MLSS concentration in the bioreactor and gradually shifts removal of COD from 91.2% to 94.5%. As the concentration of microorganisms in the reactor (aeration tank) increases, the degradation of waste organics in the wastewater increases as well. Moreover, the % removal of TSS (83.5% to 98%) and removal of oil/grease (62.5% to 76.4%) were also increased. These results ultimately suggest that the utilization of an activated sludge system can effectively treat complex and highly polluted denim textile wastewater to avoid secondary pollution posed by this industry. PRACTITIONER POINTS: The effectiveness of aerobic granular sludge was investigated for industrial textile effluent. The increase in MLSS results in increase of % COD removal efficiency to 94.5%. The AGS system can efficiently treat complicated and highly contaminated textile wastewater.

Combining a convolutional neural network with autoencoders to predict the survival chance of COVID-19 patients.

COVID-19 has caused many deaths worldwide. The automation of the diagnosis of this virus is highly desired. Convolutional neural networks (CNNs) have shown outstanding classification performance on image datasets. To date, it appears that COVID computer-aided diagnosis systems based on CNNs and clinical information have not yet been analysed or explored. We propose a novel method, named the CNN-AE, to predict the survival chance of COVID-19 patients using a CNN trained with clinical information. Notably, the required resources to prepare CT images are expensive and limited compared to those required to collect clinical data, such as blood pressure, liver disease, etc. We evaluated our method using a publicly available clinical dataset that we collected. The dataset properties were carefully analysed to extract important features and compute the correlations of features. A data augmentation procedure based on autoencoders (AEs) was proposed to balance the dataset. The experimental results revealed that the average accuracy of the CNN-AE (96.05%) was higher than that of the CNN (92.49%). To demonstrate the generality of our augmentation method, we trained some existing mortality risk prediction methods on our dataset (with and without data augmentation) and compared their performances. We also evaluated our method using another dataset for further generality verification. To show that clinical data can be used for COVID-19 survival chance prediction, the CNN-AE was compared with multiple pre-trained deep models that were tuned based on CT images.

Epileptic Seizures Detection Using Deep Learning Techniques: A Review.

A variety of screening approaches have been proposed to diagnose epileptic seizures, using electroencephalography (EEG) and magnetic resonance imaging (MRI) modalities. Artificial intelligence encompasses a variety of areas, and one of its branches is deep learning (DL). Before the rise of DL, conventional machine learning algorithms involving feature extraction were performed. This limited their performance to the ability of those handcrafting the features. However, in DL, the extraction of features and classification are entirely automated. The advent of these techniques in many areas of medicine, such as in the diagnosis of epileptic seizures, has made significant advances. In this study, a comprehensive overview of works focused on automated epileptic seizure detection using DL techniques and neuroimaging modalities is presented. Various methods proposed to diagnose epileptic seizures automatically using EEG and MRI modalities are described. In addition, rehabilitation systems developed for epileptic seizures using DL have been analyzed, and a summary is provided. The rehabilitation tools include cloud computing techniques and hardware required for implementation of DL algorithms. The important challenges in accurate detection of automated epileptic seizures using DL with EEG and MRI modalities are discussed. The advantages and limitations in employing DL-based techniques for epileptic seizures diagnosis are presented. Finally, the most promising DL models proposed and possible future works on automated epileptic seizure detection are delineated.

Fusion of convolution neural network, support vector machine and Sobel filter for accurate detection of COVID-19 patients using X-ray images.

The coronavirus (COVID-19) is currently the most common contagious disease which is prevalent all over the world. The main challenge of this disease is the primary diagnosis to prevent secondary infections and its spread from one person to another. Therefore, it is essential to use an automatic diagnosis system along with clinical procedures for the rapid diagnosis of COVID-19 to prevent its spread. Artificial intelligence techniques using computed tomography (CT) images of the lungs and chest radiography have the potential to obtain high diagnostic performance for Covid-19 diagnosis. In this study, a fusion of convolutional neural network (CNN), support vector machine (SVM), and Sobel filter is proposed to detect COVID-19 using X-ray images. A new X-ray image dataset was collected and subjected to high pass filter using a Sobel filter to obtain the edges of the images. Then these images are fed to CNN deep learning model followed by SVM classifier with ten-fold cross validation strategy. This method is designed so that it can learn with not many data. Our results show that the proposed CNN-SVM with Sobel filter (CNN-SVM + Sobel) achieved the highest classification accuracy, sensitivity and specificity of 99.02%, 100% and 95.23%, respectively in automated detection of COVID-19. It showed that using Sobel filter can improve the performance of CNN. Unlike most of the other researches, this method does not use a pre-trained network. We have also validated our developed model using six public databases and obtained the highest performance. Hence, our developed model is ready for clinical application.

Handling of uncertainty in medical data using machine learning and probability theory techniques: a review of 30 years (1991-2020).

Understanding the data and reaching accurate conclusions are of paramount importance in the present era of big data. Machine learning and probability theory methods have been widely used for this purpose in various fields. One critically important yet less explored aspect is capturing and analyzing uncertainties in the data and model. Proper quantification of uncertainty helps to provide valuable information to obtain accurate diagnosis. This paper reviewed related studies conducted in the last 30 years (from 1991 to 2020) in handling uncertainties in medical data using probability theory and machine learning techniques. Medical data is more prone to uncertainty due to the presence of noise in the data. So, it is very important to have clean medical data without any noise to get accurate diagnosis. The sources of noise in the medical data need to be known to address this issue. Based on the medical data obtained by the physician, diagnosis of disease, and treatment plan are prescribed. Hence, the uncertainty is growing in healthcare and there is limited knowledge to address these problems. Our findings indicate that there are few challenges to be addressed in handling the uncertainty in medical raw data and new models. In this work, we have summarized various methods employed to overcome this problem. Nowadays, various novel deep learning techniques have been proposed to deal with such uncertainties and improve the performance in decision making.

An Improved Hybrid Approach for Handling Class Imbalance Problem.

Class imbalance issue that presents in many real-world datasets exhibit favouritism toward the majority class and showcases poor performance for the minority class. Such misclassifications may incur dubious outcome in case of disease diagnosis and other critical applications. Hence, it is a hot topic for the researchers to tackle the class imbalance issue. We present a novel hybrid approach for handling such datasets. We utilize simulated annealing algorithm for undersampling and apply support vector machine, decision tree, k-nearest neighbor and discriminant analysis for the classification task. We validate our technique in 51 real-world datasets and compare it with other recent works. Our technique yields better efficacy than the existing techniques and hence it can be applied in imbalance datasets to mitigate the misclassification.

Risk factors prediction, clinical outcomes, and mortality in COVID-19 patients.

Preventing communicable diseases requires understanding the spread, epidemiology, clinical features, progression, and prognosis of the disease. Early identification of risk factors and clinical outcomes might help in identifying critically ill patients, providing appropriate treatment, and preventing mortality. We conducted a prospective study in patients with flu-like symptoms referred to the imaging department of a tertiary hospital in Iran between March 3, 2020, and April 8, 2020. Patients with COVID-19 were followed up after two months to check their health condition. The categorical data between groups were analyzed by Fisher's exact test and continuous data by Wilcoxon rank-sum test. Three hundred and nineteen patients (mean age 45.48 ± 18.50 years, 177 women) were enrolled. Fever, dyspnea, weakness, shivering, C-reactive protein, fatigue, dry cough, anorexia, anosmia, ageusia, dizziness, sweating, and age were the most important symptoms of COVID-19 infection. Traveling in the past 3 months, asthma, taking corticosteroids, liver disease, rheumatological disease, cough with sputum, eczema, conjunctivitis, tobacco use, and chest pain did not show any relationship with COVID-19. To the best of our knowledge, a number of factors associated with mortality due to COVID-19 have been investigated for the first time in this study. Our results might be helpful in early prediction and risk reduction of mortality in patients infected with COVID-19.

Prospective randomized comparative study of percutaneous catheter drainage and percutaneous needle aspiration in the treatment of liver abscess.

BACKGROUND: This study aimed to assess the effectiveness and safety of percutaneous needle aspiration (PNA) and percutaneous catheter drainage (PCD) in the treatment of liver abscess. METHODS: A prospective randomized study was conducted in the Department of Surgery, JN Medical College, Aligarh Muslim University, Aligarh, UP, India, between February 2018 and August 2019, after getting approval from the institutional ethics committee. A total of 543 patients with liver abscess were randomized into two groups using computer-generated randomization method. Appropriate details regarding patients' clinico-demographic profile and investigations were also collected. The effectiveness of either treatment was measured in terms of duration of intravenous antibiotic, clinical improvement, reduction in the size of cavity, treatment success rate, duration of hospital stay including long-term outcomes such as sonographic resolution of cavity and recurrence rate at 6 months post-treatment. RESULTS: The PCD group had statistically significant rate of duration of antibiotics need, days for clinical improvement and time for 50% reduction in abscess cavity and treatment success rate with comparable long-term outcomes. CONCLUSION: PCD is more efficient than PNA and can be used primarily in the treatment of both amoebic and pyogenic liver abscesses along with systemic antibiotics. However, PNA can serve as a safe alternative when PCD is not available.

How mobile health affects primary healthcare? Questionnaire design and attitude assessment.

OBJECTIVES: The current research aimed to develop a questionnaire for the evaluation of the staff viewpoints in mobile phone use in the delivery of their services and then to assess the primary health center staff attitudes toward this area. METHODS: This was a two-stage cross-sectional study. In the initial stage, a questionnaire was constructed that tested their reliability and validity through Cronbach's alpha coefficient, multitrait/multi-item correlation matrix and multivariate method of factor analysis. In the second phase, we computed the raw score of each construct which was calculated by taking the mean of the responses of all the items in a particular construct. The normality of the scores for each construct was tested via Kolmogorov-Smirnov and various parametric/non-parametric statistical tests were applied to compare the responses of the subjects. After statistical tests, the final questionnaire was confirmed, including 28 items. RESULTS: The final questionnaires' five main axes consisted of health services efficiency, education, notices, consultation, as well as follow-up. Personnel perspective assessment indicates that there is no difference of view among individuals coming from various demographic features, including gender, age, work experience, as well as education level, to mobile phone use in their services. CONCLUSION: The attitude of public health center staff to mobile phone use in providing health services was positive in general, which would be an influential context for the effective application of mobile phones in public health; such a context would result in users' intentions to use and accept m-Health.