Association between trace elements in cancerous and non-cancerous tissues with the risk of breast cancers in western Iran.

This study aimed to assess the tissue content of essential and toxic metals including lead (Pb), cadmium (Cd), arsenic (As), silver (Ag), aluminum (Al), chromium (Cr), copper (Cu), iron (Fe), selenium (Se), and zinc (Zn) in the breast cancerous tissues compared to the non-cancerous tissue. The biopsy specimens of 63 breast cancers along with 63 adjacent healthy tissues in Kurdistan Province, Iran, were collected from 2019 to 2020 and assayed using ICP-MS (Agilent 7900). The results of the Mann-Whitney test illustrated that the concentration of Pb, Cd, As, Cr, Cu, and Se were significantly elevated in cancerous tissue (p < 0.05), while Zn was the only trace element with higher levels in healthy subjects (p < 0.05). Moreover, weak to moderate correlations between elements were observed in the cancerous group including Al-Cr (r=0.60), As-Cu (r=0.52), and Cu-Se (r=0.56). In contrast, no correlation over 0.50 was found between trace elements in the non-cancerous group. Raw risk differences (RDs) accounted for a significant effect for Pb, Cd, As, Ag, Cr, Se, and Zn on the development of breast cancer. In conclusion, elevated levels of As, Cd, Cu, Pb, and Se may contribute to enhancing the risk of breast cancer.

Semantic Web Technologies for Sharing Clinical Information in Health Care Systems.

INTRODUCTION: Semantic Web (SW) technologies is capable of facilitating the management and sharing of knowledge and promote semantic interoperability among healthcare information systems. AIM: This article is designed to provide an overview of the SW technologies. METHODS: This article was performed based on a literature review and Internet search through scientific databases such as PubMed, Scopus, Web of Science and Google Scholar. RESULT: The literature on SW addresses the technical and content aspects of SW technologies including description of ontology, interoperability standards in SW, creating ontology, types of ontologies, ontology editors, ontologies in healthcare. DISCUSSION: The discussion on this forum aims to help understand the benefits of SW technologies in healthcare. CONCLUSION: SW promotes a shift from the "syntactic" level to the "semantic" level of services, applications, and people and finally to pragmatic level by sharing knowledge among clinicians, researchers and healthcare providers.

Human reliability assessment in a 99Mo/99mTc generator production facility using the standardized plant analysis risk-human (SPAR-H) technique.

INTRODUCTION: Reducing human error is an important factor for enhancing safety protocols in various industries. Hence, analysis of the likelihood of human error in nuclear industries such as radiopharmaceutical production facilities has become more essential. METHODS: This cross-sectional descriptive study was conducted to quantify the probability of human errors in a 99Mo/99mTc generator production facility in Iran. First, through expert interviews, the production process of the 99Mo/99mTc generator was analyzed using hierarchical task analysis (HTA). The standardized plant analysis risk-human (SPAR-H) method was then applied in order to calculate the probability of human error. RESULTS: Twenty tasks were determined using HTA. All of the eight performance shaping factors (PSFS) were evaluated for the tasks. The mean probability of human error was 0.320. The highest and the lowest probability of human error in the 99Mo/99mTc generator production process, related to the 'loading the generator with the molybdenum solution' task and the 'generator elution' task, were 0.858 and 0.059, respectively. CONCLUSION: Required measures for reducing the human error probability (HEP) were suggested. These measures were derived from the level of PSFS that were evaluated in this study.

Clinical Data Warehouse: An Effective Tool to Create Intelligence in Disease Management.

Clinical business intelligence tools such as clinical data warehouse enable health care organizations to objectively assess the disease management programs that affect the quality of patients' life and well-being in public. The purpose of these programs is to reduce disease occurrence, improve patient care, and decrease health care costs. Therefore, applying clinical data warehouse can be effective in generating useful information about aspects of patient care to facilitate budgeting, planning, research, process improvement, external reporting, benchmarking, and trend analysis, as well as to enable the decisions needed to prevent the progression or appearance of the illness aligning with maintaining the health of the population. The aim of this review article is to describe the benefits of clinical data warehouse applications in creating intelligence for disease management programs.

Association between upper extremity musculoskeletal disorders and mental health status in office workers.

BACKGROUND: Musculoskeletal Disorders (MSDs) can lead to potential adverse consequences for individuals and their organizations, and in various research, its relationship to physical and mental health of workforce has been studied. OBJECTIVE: The purpose of this study was to determine the prevalence of MSDs of upper extremities among office workers and its association with mental health status. METHODS: In this cross sectional study, 1488 out of 1630 office workers completed the Standardized Nordic Musculoskeletal Disorders Ques-tionnaire and General Health Questionnaire (GHQ-28) (response rate = 91.3%). RESULTS: Upper extremity MSDs were reported in 410 (27.5%) office workers, including 269 (18.1%) shoulder, 79 (5.3%) elbow and 207 (13.9%) hand/wrist symptoms. Based on GHQ-28, 254 (17.1%) participants were found to be at risk of developing a psychiatric disorder that were observed in 26.7% of workers with MSDs symptoms. Shoulder (p < 0.001), elbow (p < 0.001) and hand/wrist (p < 0.001) MSDs were associated with poor mental health. Among the four GHQ-28 subscales (somatic symptoms, anxiety/insomnia, social dysfunction, and depression), anxiety/insomnia was strongly correlated with shoulders (P < 0.001), elbows (P = 0.002), and hands/wrists (P < 0.001) symptoms. CONCLUSION: Office workers with upper extremity MSDs were more likely to be experiencing mental distress. This indicates a need for greater emphasis on preventive programs at workplace to support their psychological well-being.

Association between overuse of mobile phones on quality of sleep and general health among occupational health and safety students.

Concerns about health problems due to the increasing use of mobile phones are growing. Excessive use of mobile phones can affect the quality of sleep as one of the important issues in the health literature and general health of people. Therefore, this study investigated the relationship between the excessive use of mobile phones and general health and quality of sleep on 450 Occupational Health and Safety (OH&S) students in five universities of medical sciences in the North East of Iran in 2014. To achieve this objective, special questionnaires that included Cell Phone Overuse Scale, Pittsburgh's Sleep Quality Index (PSQI) and General Health Questionnaire (GHQ) were used, respectively. In addition to descriptive statistical methods, independent t-test, Pearson correlation, analysis of variance (ANOVA) and multiple regression tests were performed. The results revealed that half of the students had a poor level of sleep quality and most of them were considered unhealthy. The Pearson correlation co-efficient indicated a significant association between the excessive use of mobile phones and the total score of general health and the quality of sleep. In addition, the results of the multiple regression showed that the excessive use of mobile phones has a significant relationship between each of the four subscales of general health and the quality of sleep. Furthermore, the results of the multivariate regression indicated that the quality of sleep has a simultaneous effect on each of the four scales of the general health. Overall, a simultaneous study of the effects of the mobile phones on the quality of sleep and the general health could be considered as a trigger to employ some intervention programs to improve their general health status, quality of sleep and consequently educational performance.

Developing framework for agent- based diabetes disease management system: user perspective.

BACKGROUND: One of the characteristics of agents is mobility which makes them very suitable for remote electronic health and tele medicine. The aim of this study is developing a framework for agent based diabetes information management at national level through identifying required agents. METHODS: The main tool is a questioner that is designed in three sections based on studying library resources, performance of major organizations in the field of diabetes in and out of the country and interviews with experts in the medical, health information management and software fields. Questionnaires based on Delphi methods were distributed among 20 experts. In order to design and identify agents required in health information management for the prevention and appropriate and rapid treatment of diabetes, the results were analyzed using SPSS 17 and Results were plotted with FREEPLANE mind map software. RESULTS: ACCESS TO DATA TECHNOLOGY IN PROPOSED FRAMEWORK IN ORDER OF PRIORITY IS: mobile (mean 1/80), SMS, EMAIL (mean 2/80), internet, web (mean 3/30), phone (mean 3/60), WIFI (mean 4/60). CONCLUSIONS: In delivering health care to diabetic patients, considering social and human aspects is essential. Having a systematic view for implementation of agent systems and paying attention to all aspects such as feedbacks, user acceptance, budget, motivation, hierarchy, useful standards, affordability of individuals, identifying barriers and opportunities and so on, are necessary.

Multi-agent system as a new approach to effective chronic heart failure management: key considerations.

OBJECTIVES: Given the importance of the follow-up of chronic heart failure (CHF) patients to reduce common causes of re-admission and deterioration of their status that lead to imposing spiritual and physical costs on patients and society, modern technology tools should be used to the best advantage. The aim of this article is to explain key points which should be considered in designing an appropriate multi-agent system to improve CHF management. METHODS: In this literature review articles were searched with keywords like multi-agent system, heart failure, chronic disease management in Science Direct, Google Scholar and PubMed databases without regard to the year of publications. RESULTS: Agents are an innovation in the field of artificial intelligence. Because agents are capable of solving complex and dynamic health problems, to take full advantage of e-Health, the healthcare system must take steps to make use of this technology. Key factors in CHF management through a multi-agent system approach must be considered such as organization, confidentiality in general aspects and design and architecture points in specific aspects. CONCLUSIONS: Note that use of agent systems only with a technical view is associated with many problems. Hence, in delivering healthcare to CHF patients, considering social and human aspects is essential. It is obvious that identifying and resolving technical and non-technical challenges is vital in the successful implementation of this technology.

Cancer care management through a mobile phone health approach: key considerations.

Greater use of mobile phone devices seems inevitable because the health industry and cancer care are facing challenges such as resource constraints, rising care costs, the need for immediate access to healthcare data of types such as audio video texts for early detection and treatment of patients and increasing remote aids in telemedicine. Physicians, in order to study the causes of cancer, detect cancer earlier, act in prevention measures, determine the effectiveness of treatment and specify the reasons for the treatment ineffectiveness, need to access accurate, comprehensive and timely cancer data. Mobile devices provide opportunities and can play an important role in consulting, diagnosis, treatment, and quick access to health information. There easy carriage make them perfect tools for healthcare providers in cancer care management. Key factors in cancer care management systems through a mobile phone health approach must be considered such as human resources, confidentiality and privacy, legal and ethical issues, appropriate ICT and provider infrastructure and costs in general aspects and interoperability, human relationships, types of mobile devices and telecommunication related points in specific aspects. The successful implementation of mobile-based systems in cancer care management will constantly face many challenges. Hence, in applying mobile cancer care, involvement of users and considering their needs in all phases of project, providing adequate bandwidth, preparation of standard tools that provide maximum mobility and flexibility for users, decreasing obstacles to interrupt network communications, and using suitable communication protocols are essential. It is obvious that identifying and reducing barriers and strengthening the positive points will have a significant role in appropriate planning and promoting the achievements of mobile cancer care systems. The aim of this article is to explain key points which should be considered in designing appropriate mobile health systems in cancer care as an approach for improving cancer care management.

Positive and negative effects of IT on cancer registries.

In the new millennium people are facing serious challenges in health care, especially with increasing non- communicable diseases (NCD). One of the most common NCDs is cancer which is the leading cause of death in developed countries and in developing countries is the second cause of death after heart diseases. Cancer registry can make possible the analysis, comparison and development of national and international cancer strategies and planning. Information technology has a vital role in quality improvement and facility of cancer registries. With the use of IT, in addition to gaining general benefits such as monitoring rates of cancer incidence and identifying planning priorities we can also gain specific advantages such as collecting information for a lifetime, creating tele medical records, possibility of access to information by patient, patient empowerment, and decreasing medical errors. In spite of the powerful role of IT, we confront various challenges such as general problems, like privacy of the patient, and specific problems, including possibility of violating patients rights through misrepresentation, omission of human relationships, and decrease in face to face communication between doctors and patients. By implementing appropriate strategies, such as identifying authentication levels, controlling approaches, coding data, and considering technical and content standards, we can optimize the use of IT. The aim of this paper is to emphasize the need for identifying positive and negative effects of modern IT on cancer registry in general and specific aspects as an approach to cancer care management.

Effective radiology dashboards: key research findings.

Innovative organizations have access to information for business intelligence through the objectives displayed in dashboards. In healthcare organizations, where the goal is to improve quality of care along with reducing costs, the radiology department is important from both financial and clinical aspects. Therefore, how to manage this department has critical impact on the effectiveness and efficiency of the organization. Today, since the information in this department not only has different data structure but also is gathered from different data sources, a well defined, comprehensive dashboard can be an effective tool to enhance performance.

Multi-agent systems: effective approach for cancer care information management.

Physicians, in order to study the causes of cancer, detect cancer earlier, prevent or determine the effectiveness of treatment, and specify the reasons for the treatment ineffectiveness, need to access accurate, comprehensive, and timely cancer data. The cancer care environment has become more complex because of the need for coordination and communication among health care professionals with different skills in a variety of roles and the existence of large amounts of data with various formats. The goals of health care systems in such a complex environment are correct health data management, providing appropriate information needs of users to enhance the integrity and quality of health care, timely access to accurate information and reducing medical errors. These roles in new systems with use of agents efficiently perform well. Because of the potential capability of agent systems to solve complex and dynamic health problems, health care system, in order to gain full advantage of E- health, steps must be taken to make use of this technology. Multi-agent systems have effective roles in health service quality improvement especially in telemedicine, emergency situations and management of chronic diseases such as cancer. In the design and implementation of agent based systems, planning items such as information confidentiality and privacy, architecture, communication standards, ethical and legal aspects, identification opportunities and barriers should be considered. It should be noted that usage of agent systems only with a technical view is associated with many problems such as lack of user acceptance. The aim of this commentary is to survey applications, opportunities and barriers of this new artificial intelligence tool for cancer care information as an approach to improve cancer care management.

Enhance hospital performance from intellectual capital to business intelligence.

Business intelligence (BI) refers to technologies, tools, and practices for collecting, integrating, analyzing, and presenting large volumes of information to enable better decision making. The aim of this study is to provide a general overview of BI and its impacts on improving hospital performance. In this paper, literature is reviewed on the concept, classification, and structure of intellectual capital and BI. Research on the building of BI and its impact on the performance of hospitals are briefly summarized. Some areas in healthcare which can utilize BI benefits, including radiology, are also discussed. Used properly, BI is an effective communication tool that can enable hospitals to reach strategic goals and objectives and can also help eliminate information asymmetry.