Application of Mixture and Non-mixture Cure Models in Survival Analysis of Patients With COVID-19.

Background Due to the emergence of new COVID-19 mutations and an increase in re-infection rates, it has become an important priority for the medical community to identify the factors affecting the short- and long-term survival of patients. This study aimed to determine the risk factors of short- and long-term survival in patients with COVID-19 based on mixture and non-mixture cure models. Methodology In this study, the data of 880 patients with COVID-19 confirmed with polymerase chain reaction in Fereydunshahr city (Isfahan, Iran) from February 20, 2020, to December 21, 2021, were gathered, and the vital status of these patients was followed for at least one year. Due to the high rate of censoring, mixture and non-mixture cure models were applied to estimate the survival. Akaike information criterion values were used to evaluate the fit of the models. Results In this study, the mean age of the patients was 48.9 ± 21.23 years, and the estimated survival rates on the first day, the fourth day, the first week, the first month, and at one year were 0.997, 0.982, 0.973, 0.936, and 0.928, respectively. Among the parametric models, the log-logistic mixed cure model with the logit link, which showed the lowest Akaike information criterion value, demonstrated the best fit. The variables of age and prescribed medication type were significant predictors of long-term survival, while occupation was influential in the short-term survival of patients. Conclusions According to the results of this study, it can be concluded that elderly patients should observe health protocols more strictly and consider receiving booster vaccine doses. The log-logistic cure model with a logit link can be used for survival analysis in COVID-19 patients, a fraction of whom have long-term survival.

Evaluation of Factors Affecting Neuropathy in Patients With Type 2 Diabetes Using Artificial Neural Networks.

INTRODUCTION: Neuropathy is a common and debilitating complication in type 2 diabetes, affecting quality of life and increasing healthcare costs. Identifying risk factors is essential for early intervention and management. This study aims to evaluate the factors influencing the occurrence of neuropathy in patients with type 2 diabetes using artificial neural networks. METHODS: In this cohort study, data from 371 patients with type 2 diabetes from Fereydunshahr, Iran, were analyzed over a 12-year follow-up period. Participants were selected based on diabetes screenings conducted in 2008 and 2009. Artificial neural networks with varying architectures were trained and validated, and their performance was compared to logistic regression models using receiver operating characteristic (ROC) curve analysis. RESULTS: The prevalence of neuropathy in this cohort study was 31.2%. The best-fitted artificial neural network and logistic regression model had area under the curve (AUC) values of 0.903 and 0.803, respectively. Significant risk factors identified included gender, race, family history of diabetes, type of diabetes treatment, cholesterol levels, triglyceride levels, high-density lipoprotein (HDL) levels, and duration of diabetes. Notably, women, patients with a family history of diabetes, and those using injectable or combined injectable and oral medications were at higher risk of developing neuropathy. CONCLUSION: These findings highlight the importance of vigilant monitoring and proactive management of neuropathy risk factors, especially in women, patients with a family history of diabetes, and those using injectable or combined diabetic medications.

Predictors of Marital Satisfaction Among Reproductive-Age Women Based on Personality Traits: A Study in Iran.

BACKGROUND AND OBJECTIVE: Marital satisfaction is a complex phenomenon influenced by a variety of factors, including personality traits, communication, conflict resolution, and economic stability. This study aims to examine the relationship between personality and marital satisfaction among reproductive-age women, exploring how these factors interplay and contribute to the overall dynamics of marital relationships. MATERIALS AND METHODS: A cross-sectional study was conducted among reproductive-age women to assess marital satisfaction and personality traits using established assessment tools. The demographic data were collected through a structured questionnaire, and the relationship between personality traits and marital satisfaction was analyzed using confirmatory factor analysis (CFA). Regression models were used to identify significant predictors of marital satisfaction, and the fit of the CFA model was evaluated using various indicators. RESULTS: The mean age of the participants was 33.7 (±8.09) years, while the mean age of their husbands was 38.3 (±9.27) years. The results showed that conscientiousness and agreeableness had significant positive associations with marital satisfaction. Communication and conflict resolution emerged as key components of marital satisfaction, with standardized coefficients of 0.894 and 0.818, respectively. Financial management was also found to be strongly related to marital satisfaction, indicating the importance of economic stability in maintaining marital harmony. CONCLUSION: The study underscores the significance of personality traits, communication, conflict resolution, and financial management in shaping marital satisfaction among reproductive-age women. The results suggest that interventions targeting improved communication and effective conflict-resolution strategies can enhance marital satisfaction. Additionally, addressing financial stressors and promoting economic stability could lead to better marital outcomes. These findings align with previous research, highlighting the need for a holistic approach to understanding and improving marital satisfaction. Further research is recommended to explore these relationships in different cultural contexts and with broader demographic groups.

Anemia Status Changes Among Patients With Obesity Following Bariatric Surgery.

Objective This study aims to investigate trends in anemia severity among patients with pre-existing anemia who underwent bariatric surgery due to obesity. It also examines how different bariatric surgery techniques impact anemia outcomes. Methods This prospective study included 280 patients aged 18 to 65 with obesity who underwent bariatric surgery. The patients were categorized into three groups based on the type of surgery: sleeve gastrectomy, one-anastomosis gastric bypass, and Roux-en-Y gastric bypass. Anemia severity was evaluated over a 12-month follow-up period. Chi-square tests were used to assess the homogeneity of baseline factors among the groups, and McNemar tests along with generalized estimating equations were used to compare anemia outcomes. Results Before surgery, the rates of moderate anemia across the three surgical groups ranged from 18.2% to 22.4%, with no cases of severe anemia observed. There was no significant difference among the groups (p=0.949). During the 12-month follow-up, the odds ratio for reducing anemia severity in the sleeve gastrectomy and Roux-en-Y gastric bypass groups were 2.13 and 1.91, respectively, compared to the one-anastomosis gastric bypass group. Additionally, the odds ratio for reducing anemia severity in patients with hypothyroidism was 1.84 compared to those without hypothyroidism. Conclusion The choice of bariatric surgery technique significantly affects anemia outcomes, with sleeve gastrectomy showing a higher success rate in reducing anemia severity. The role of hypothyroidism in anemia management also appears to be significant.

The relationship between the level of postural stress, Musculoskeletal Disorders, and chronic fatigue: A case study in the dairy industry.

BACKGROUND: Dairy industry workers face numerous ergonomic risk factors in their workplace, including improper posture, manual material handling, and musculoskeletal disorders (MSDs). Fewstudies have been conducted on the correlation of postural stress, MSDs, and chronic fatigue among workers in the dairy industry. OBJECTIVE: This study aimed to investigate the relationship between the level of postural stress, MSDs, and chronic fatigue in a dairy company. METHODS: In this cross-sectional study, 260 male workers were included in the research based on specific inclusion criteria. The Cornell Musculoskeletal Discomfort Questionnaire, Chalder Fatigue Scale, and a researcher-made demographic questionnaire were used to collect data. The posture of workers was evaluated using RULA and REBA software, and the evaluation of the manual lifting of loads was assessed using the WISHA lifting calculator. Finally, the collected data were entered into the SPSS software version 26.0 and analyzed. RESULTS: The findings revealed a significant statistical relationship between the level of postural stress and chronic fatigue and a significant positive correlation between MSDs and chronic fatigue. Furthermore, a statistically significant relationship was observed between MSDs, chronic fatigue, and ergonomics training experience. CONCLUSIONS: The results obtained in this study support the notion that high levels of postural stress and MSDs can produce an increase in chronic fatigue among workers, and lack of ergonomics training for workers can increase both MSDs and chronic fatigue. Therefore, it is necessary to carry out intervention measures in the field of ergonomics management in similar industries through the implementation of ergonomic intervention programs with a focus on proactive and preventive measures and the use of participatory ergonomic programs and educational demands assessment.

High inflammatory cytokines gene expression can be detected in workers with prolonged exposure to silver and silica nanoparticles in industries.

Occupational health must be strictly considered in industries particularly in nanoparticle factories where workers were exposed to different types of chemicals. We measured the serum levels of inflammatory cytokines in workers who developed skin lesions after exposure to silver and silica nanoparticles. Using a questionnaire in this cross-sectional study, we identified 110 workers in nanoparticle industries who were exposed to silver and silica nanoparticles. We also included 40 healthy subjects as controls from the administrative department of the same factories who were not exposed to nanoparticles. Peripheral blood samples used to measure the mRNA levels of inflammatory cytokines by qRT-PCR. In comparison with the control group, the workers who developed skin lesions had significantly higher levels of interleukin IL4, IL6, IL8, and TNF-α, particularly after two or three decades of exposure to silver and silica nanoparticles. Participants who were exposed to silver had higher levels of IL6 and IL8 compared with those who were exposed to silica. Necessary measures must be considered to protect workers in nanoparticle industries against the potential toxic effects of these compounds. Our network pharmacology study suggests corresponding biochemical pathways for these disorders.

A 39 Year mortality study of survivors exposed to sulfur mustard agent: A survival analysis.

Background: The primary objective of this study was to analyze the long-term survival of 48,067 chemical warfare survivors who suffered from pulmonary, cutaneous, and ocular lesions in the decades following the Iran-Iraq war. Methods: The data for this study were obtained from the Veterans and Martyr Affair Foundation (VMAF) database. The survivors were divided into two groups based on whether they were evacuated/admitted (EA) to a hospital or not evacuated/admitted (NEA) to a hospital. The proportional hazard (PH) assumption for age categories, gender, exposure statuses, and eye severity was not satisfied. Therefore, we used a Generalized Gamma (GG) distribution with an Accelerated Failure Time (AFT) model for analysis. Results: The study included a total of 48,067 observations, and among them, 4342 (9.03 %) died during the study period. The mean (SD) age of the survivors was 55.99 (7.9) years. The mortality rate increased with age, and higher rates were observed in males. Survival probabilities differed significantly among age categories, provinces, lung severity, and eye severity based on log-rank tests (p-value<0.05 for all). The GG model results showed that higher age and being male were associated with a shorter time to death. The study also found that the mortality rate was significantly higher in the EA group compared to the NEA group. Conclusion: The present study showed no significant difference in survival time between the EA and NEA groups. The findings suggest that pulmonary lesions caused by mustard gas are more likely to be fatal compared to skin and eye lesions. The results also indicate a potential association between survival time and the severity of lung damage.

Association between empirical dietary inflammatory index, odds, and severity of anxiety disorders: A case-control study.

Diet may be a modifiable factor in the prevention of psychiatric disorders by modulating inflammation. In this study, we evaluated the association between empirical dietary inflammatory index (EDII) that is designed to evaluate the inflammatory potential of diets and anxiety disorders (AD) in adults. This case-control study was carried out on 85 patients who were group matched by gender with 170 healthy subjects. Data for dietary intake were assessed by using a 147-item validated food frequency questionnaire (FFQ). Anthropometric measures were collected using standard methods. EDII score was developed according to participants' dietary intakes of 28 predefined food groups. Multivariate odds ratios (OR) with 95% confidence intervals (CI) were used to investigate the association of empirically derived inflammatory potential of the diet and anxiety disorder. We observed that after adjusting for confounders, individuals in the top category of EDII score were 2.09 fold more likely to have anxiety disorder compared with those in the bottom category (OR: 2.09, 95% CI: 1.01, 4.33). Also, higher EDII contributed to a higher GAD-7 score (p < .001). There was a significant positive linear association between EDII and AD (ß = 3.64, p < .001). After controlling for potential confounders AD had a strong positive correlation with the EDII score (r = .61, p-value <.001). In conclusion, in this case-control study, we realized that there is a positive association between the EDII score, odds, and severity of anxiety disorder. Ultimately, the potential role necessitates clarifying this association by conducting large-population prospective cohort studies.

Determinants of COVID-19 preventive health behaviors in Iranian adults based on extended parallel process model.

Performing preventive behaviors by individuals has been recognized as one of the important strategies for the prevention and control of Coronavirus Disease 2019 (COVID-19). This study aimed to assess the determinants of adopting preventive behaviors of COVID-19 in a sample of Iranian adults based on Extended Parallel Process Model (EPPM) variables. In this cross-sectional study, 300 adults from Tehran, Iran were selected using cluster sampling method from five areas of the city: north, south, west, east, and center. The participants completed a study instrument developed to assess demographic information and EPPM variables. Finally, the data were analyzed using SPSS software. The mean age of the participants was 40.11 (± 15.158) years. The results showed that 88.3% (n = 265) of the participants were in the process of danger control. Perceived self-efficacy, attitude, response efficiency, behavioral intention, and the number of hours of activity outside home were determinants of performing COVID-19 preventive behaviors among the participants. These predictors might be used to develop theory-based educational efforts based on EPPM variables due to encouraging people to adopt COVID-19 preventive behaviors. Our results suggest that because many participants were engaged in danger control, health professionals should focus on increasing perceived efficacy.

The relationship between dietary lipophilic index and load with depression, anxiety, and stress symptoms.

BACKGROUND: Dietary fatty acids can affect brain health by modifying neuronal membrane fluidity. Dietary lipophilic index (LI) and load (LL) may be related to cell membrane fluidity. This study aimed to determine the relationship between dietary LI and LL with symptoms of depression, anxiety and stress. METHODS: In this cross-sectional study, taken from the YaHS (Yazd Health Study) population-based cohort, the data of 2,982 individuals was extracted. Several questionnaires- a 178-item Food Frequency Questionnaire (FFQ), Depression, Anxiety and Stress Scale 21 (DASS 21), and International Physical Activity Questionnaire (IPAQ)- were used to obtain information on dietary intake, mental status, and physical activity, respectively. LI and LL were calculated using dietary intake and the melting point of each fatty acid. RESULTS: The analysis was performed on 2982 individuals. The odds ratio of depression in the second tertile of dietary LI compared to the first tertile was 0.815 (95% CI 0.66-1.00, P = 0.051, Ptrend = 0.017) and after adjusting confounders was 0.793 (95% CI 0.63-0.99, P = 0.043, Ptrend = 0.011). Also, LL was related inversely with anxiety (0.771, 95% CI 0.63-0.93, P = 0.003) that after multiple regression, OR of anxiety was 0.762 (95% CI 0.53-1.07, P = 0.045). The odds of stress in the third tertile of LL was 1.064 but not statistically significant (95% CI 0.88-1.28, P = 0.729). CONCLUSION: This study showed an inverse association between dietary LI and depression symptoms. Anxiety and stress did not show a significant relationship with LI or LL.

Application of Bandura's social cognitive theory to predict cigarette butt-littering behavior in male smokers: a case study in the parks in Tehran, Iran.

Cigarette butt-littering behavior is common among most smokers. The present study aimed to determine the predictors of butt-littering behavior in a sample of Iranian male current smokers based on the Bandura's social cognitive theory variables. In this cross-sectional study, 291 smokers who throw their cigarette butts in public parks in Tehran city, Iran were selected and completed the study instrument. Finally, the data were analyzed. The average number of butts littered daily by the participants was 8.59 (± 8.661). The results of multiple Poisson regression showed that knowledge, perceived self-efficacy, positive and negative outcome expectations, self-regulation, and observational learning variables were statistically significant predictors of butt-littering behavior among the participants. It is concluded that Bandura's social cognitive theory is a suitable theoretical framework for predicting butt-littering behavior and might be used to develop theory-based environmental education efforts in this field.

Adherence to the MIND diet is inversely associated with odds and severity of anxiety disorders: a case-control study.

BACKGROUND: The association between the Mediterranean-DASH diet Intervention for Neurodegenerative Delay (MIND) diet, odds, and severity of anxiety disorders (AD) is still unclear. We aimed to investigate whether adherence to MIND diet is associated with odds and severity of AD. METHODS: The present case-control study carried out on 85 patients who were group matched by gender with 170 healthy subjects. Data for dietary intake was assessed by using a 147-item validated food frequency questionnaire (FFQ). Anthropometric measures were collected using standard methods. The MIND diet score was calculated using FFQ. We assessed anxiety disorder severity using the Generalized Anxiety Disorder-7 (GAD-7) questionnaire. Multivariate odds ratios (OR) with 95% confidence intervals (CI) were used to investigate the association of MIND diet and anxiety disorder. RESULTS: We observed that higher adherence to MIND diet was associated with the lower GAD-7 score (p < 0.001). Individuals in the top category of MIND diet score were 97% less likely to have AD compared with those in the bottom category (OR: 0.03, 95% CI: 0.01, 0.09). There was significant reverse linear association between MIND diet score and AD (ß = -3.63, p < 0.001). CONCLUSIONS: In conclusion, we provided some evidence indicating negative association between adherence to MIND diet, odds, and severity of AD. Finally, due to the probable preventive role of diet, it is vital to clarify the association between diet and AD through large-scale prospective cohort studies in the future.

The effects of prognostic factors on transplant and mortality of patients with end-stage liver disease using Markov multistate model.

Background: Decompensated cirrhosis patients have a high risk of death which can be considerably reduced with liver transplantation (LT). This study aimed to simultaneously investigate the effect of some patients' characteristics on mortality among those with/without LT and also LT incident. Materials and Methods: In this historical cohort study, the information from 780 eligible patients aged 18 years or older was analyzed by the Markov multistate model; they had been listed between 2008 and 2014, needed a single organ for initial orthotopic LT, and followed at least for up to 5 years. Results: With a median survival time of 6 (5-8) years, there were 275 (35%) deaths. From 255 (33%) patients who had LT, 55 (21%) subsequently died. Factors associated with a higher risk of mortality and LT occurrence were included: higher model for end-stage liver disease (MELD) score (hazard ratio [HR] = 1.16, confidence interval [CI]: 1.09-1.24 and HR = 1.22, CI: 1.41-1.30) and ascites complication (HR = 2.34, CI: 1.74-3.16 and HR = 11.43, CI: 8.64-15.12). Older age (HR = 1.03, CI: 1.01-1.06), higher creatinine (HR = 6.87, CI: 1.45-32.56), and autoimmune disease versus hepatitis (HR = 2.53, CI: 1.12-5.73) were associated with increased risk of mortality after LT. Conclusion: The MELD and ascites are influential factors on waiting list mortality and occurrence of LT. Total life expectancy is not influenced by higher MELD.

The effect of Cornus mas fruit extract on vasomotor symptoms and sex hormones in postmenopausal women: a randomized, double-blind, clinical trial.

OBJECTIVES: Cornus mas fruit has various antioxidants and anti-inflammatory properties, so this study aims at assessing its effect on menopausal symptoms and sex hormones in postmenopausal women. METHODS: In the current randomized, double-blind clinical trial, 84 individuals (42 per group) were participated. C mas hydroalcoholic extract was prepared, and participants received 300 mg C mas extract or placebo three times a day (900 g in total) for 8 weeks. The demographic, dietary intake, and physical activity information were gathered. Anthropometric indices were measured by standard methods. Furthermore, menopause symptoms were assessed by Greene Climacteric Scale. Also, sex hormones were measured by enzyme-linked immunosorbent assay. RESULTS: Based on the results, there was a significant difference in total Greene score reduction between the intervention and placebo groups (-3.19 ± 0.54, -0.76 ± 0.32, and P < 0.001). In addition, vasomotor symptoms had a remarkable decrease in the C mas extract group (P < 0.001). Also, the intervention group demonstrated a decreasing trend in the number and duration of hot flushes. Moreover, follicle-stimulating hormone remarkably decreased and estradiol increased in the intervention group (P = 0.016 and P = 0.018). CONCLUSIONS: It has been found that the extract of C mas fruit has a favorable effect on vasomotor symptoms, sex hormones, and related complications in women experiencing menopausal symptoms.

Binocular contrast sensitivity in patients with intermittent exotropia in relation to angle of strabismus and level of compensation.

Intermittent exotropia (IXT) causes photophobia, and photophobia has been studied by measurement of contrast sensitivity (CS). CS was reduced in children with IXT. We compared binocular CS (BCS) in patients with IXT and normal subjects in relation to the angle of strabismus and control of IXT. This case-control study was performed on 40 patients with IXT and 40 normal subjects who were examined with the CSV1000 CS device in mesopic (3 cd/m2) and photopic (85 cd/m2) conditions with and without a glare stimulus at 3, 6, 12, and 18 cycle/degree (cpd) spatial frequencies. The angle of strabismus and near stereoacuity were also measured. The patient's IXT compensation was graded based on the office control scale. The mean age for IXT and normal participants were 12.30 ± 0.60 (range, 6-18) and 11.00 ± 0.78 (range, 6-18) years, respectively (P = .34). The IXT patients had lower binocular CS than controls at all spatial frequencies (P < .001). The largest decrease in CS occurred at 6 cpd spatial frequency under mesopic condition (1.61 ± 0.07 vs 1.38 ± 0.15, P < .001) and photopic condition with glare (2.03 ± 0.06 vs 1.77 ± 0.13, P < .001). Patients with better control scores had higher levels of BCS; also, the score of BCS showed a significant decrease in patients with a deviation of 25 prism diopter or more, compared to those with less deviation. BCS correlated at 3 and 6 cpd with near stereoacuity (r = -0.652, P < .001 and r = -0.613, P < .001). Binocular CS in patients with IXT correlates with the angle of strabismus and level of compensation.

Mind mapping in recalling and retrieving core contents in anesthesia technology students.

BACKGROUND: Human memory represents the ability to recall and retrieve information. Learning methods have a great impact on remembering and retrieving material. This study was conducted to investigate the effect of the mind map learning method on the amount of recall and retrieval of the core contents of anesthesia technology students. MATERIALS AND METHODS: In this quasi-experimental study, 55 undergraduate students of anesthesia technology were included in the study by census method. In both groups, teaching was done in the same way (lecture method) by a single professor. The intervention group was randomly divided into six groups. After training to work with a mind map in this group, the teaching of lessons started with the lecture method, and then the mind map was drawn by the group members. In the control group, the students followed the lecture method and note-taking. Finally, three tests were taken. Test 1 (before the start of the training), test 2 (immediately after the training (scheduled test)), and test 3 (after 2 weeks (surprise test)). RESULTS: The data obtained from the test scores were analyzed by paired t-test, independent t-test, and analysis of covariance. The analysis showed that the mind map method significantly improved the short-term (P < 0.001) and long-term memory of anesthesia technology students (P < 0.001) compared to the traditional method. Examining the effect of gender on long-term memory showed that in the intervention group, female samples had an average score of 1 more than male samples (P = 0.044). DISCUSSION: It seems that mind mapping improves short-term and long-term memory in anesthesia technology students who play a critical role in saving the lives of patients and this issue improves the quality of services in the field of health.

Artificial intelligence, BI-RADS evaluation and morphometry: A novel combination to diagnose breast cancer using ultrasonography, results from multi-center cohorts.

PURPOSE: To develop and validate a machine learning (ML) model for the classification of breast lesions on ultrasound images. METHOD: In the present study, three separate data cohorts containing 1288 breast lesions from three countries (Malaysia, Iran, and Turkey) were utilized for MLmodel development and external validation. The model was trained on ultrasound images of 725 breast lesions, and validation was done separately on the remaining data. An expert radiologist and a radiology resident classified the lesions based on the BI-RADS lexicon. Thirteen morphometric features were selected from a contour of the lesion and underwent a three-step feature selection process. Five features were chosen to be fed into the model separately and combined with the imaging signs mentioned in the BI-RADS reference guide. A support vector classifier was trained and optimized. RESULTS: The diagnostic profile of the model with various input data was compared to the expert radiologist and radiology resident. The agreement of each approach with histopathologic specimens was also determined. Based on BI-RADS and morphometric features, the model achieved an area under the receiver operating characteristic (ROC) curve (AUC) of 0.885, which is higher than the expert radiologist and radiology resident performances with AUC of 0.814 and 0.632, respectively in all cohorts. DeLong's test also showed that the AUC of the ML protocol was significantly different from that of the expert radiologist (ΔAUCs = 0.071, 95%CI: (0.056, 0.086), P = 0.005). CONCLUSIONS: These results support the possible role of morphometric features in enhancing the already well-excepted classification schemes.

The impact of emotional intelligence and personality traits on the occurrence of unsafe behaviors and needle stick injuries among the nurses.

This study was aimed to investigate the effect of emotional intelligence and some personality traits on safe behavior and needle stick injuries among the nurses. This cross-sectional study was performed on 200 nursing staff of a hospital in Iran. To collect data, individuals were asked to complete several questionnaires, including demographic questionnaire, domain-specific risk-taking questionnaire, Rosenberg self-confidence questionnaire, Buss-Perry aggression questionnaire, Goleman emotional intelligence questionnaire, and safe behavior questionnaire. Also, the number of needlestick injuries in the participants was extracted from their medical records. Data were analyzed using the SPSS software (version 22), and path analysis was performed using AMOS software. The prevalence of needle stick injuries in the subjects was estimated by 45.5 percent. The results showed that increasing risk-taking, increasing aggression, decreasing self-confidence, and decreasing emotional intelligence reduced safe behavior and increased the number of needle injuries (P < 0.001). In the present study, some personal traits affecting the occurrence of needlestick injuries were identified. It is recommended that people without these negative traits are applied in dangerous occupations with a high probability of needle stick injuries.

Tumor Microenvironment, Radiology, and Artificial Intelligence: Should We Consider Tumor Periphery?

OBJECTIVES: The tumor microenvironment (TME) consists of cellular and noncellular components which enable the tumor to interact with its surroundings and plays an important role in the tumor progression and how the immune system reacts to the malignancy. In the present study, we investigate the diagnostic potential of the TME in differentiating benign and malignant lesions using image quantification and machine learning. METHODS: A total of 229 breast lesions and 220 cervical lymph nodes were included in the study. A group of expert radiologists first performed medical imaging and segmented the lesions, after which a rectangular mask was drawn, encompassing all of the contouring. The mask was extended in each axis up to 50%, and 29 radiomics features were extracted from each mask. Radiomics features that showed a significant difference in each contour were used to develop a support vector machine (SVM) classifier for benign and malignant lesions in breast and lymph node images separately. RESULTS: Single radiomics features extracted from extended contours outperformed radiologists' contours in both breast and lymph node lesions. Furthermore, when fed into the SVM model, the extended models also outperformed the radiologist's contour, achieving an area under the receiver operating characteristic curve of 0.887 and 0.970 in differentiating breast and lymph node lesions, respectively. CONCLUSIONS: Our results provide convincing evidence regarding the importance of the tumor periphery and TME in medical imaging diagnosis. We propose that the immediate tumor periphery should be considered for differentiating benign and malignant lesions in image quantification studies.

The effect of job security on safety behavior with the moderating role of salary: a structural equation model.

This study aimed to model the relationship between job security and safety behavior with the moderating role of salary on the workers of the construction project of Qom (Iran) Subway. After determining the subjects of the study, the questionnaires on safety behavior and job security were completed by subjects. Also, the salary of the subjects was determined. Structural equation modeling used smart partial least squares software. The results revealed that job security had a direct and significant correlation with safety compliance, safety participation and safety behavior (p < 0.001). The salary as a moderator had a positive and significant effect on the relationship between job security and safety behavior (p < 0.05). Generally, it can be deduced that job security had a positive impact on safe behaviors, and the salary as a moderator enhanced this impact. To improve safety behavior in the workplace, employers should increase the job security of workers.