Identifying interactions among factors related to death occurred at the scene of traffic accidents: Application of "logic regression" method.

Aim: Traffic accidents are caused by several interacting risk factors. This study aimed to investigate the interactions among risk factors associated with death at the accident scene (DATAS) as an indicator of the crash severity, for pedestrians, passengers, and drivers by adopting "Logic Regression" as a novel approach in the traffic field. Method: A case-control study was designed based on the police data from the Road Traffic Injury Registry in northwest of Iran during 2014-2016. For each of the pedestrians, passengers, and drivers' datasets, logic regression with "logit" link function was fitted and interactions were identified using Annealing algorithm. Model selection was performed using the cross-validation and the null model randomization procedure. Results: regarding pedestrians, "The occurrence of the accident outside a city in a situation where there was insufficient light" (OR = 6.87, P-value<0.001) and "the age over 65 years" (OR = 2.97, P-value<0.001) increased the chance of DATAS. "Accidents happening in residential inner-city areas with a light vehicle, and presence of the pedestrians in the safe zone or on the non-separate two-way road" combination lowered the chance of DATAS (OR = 0.14, P-value<0.001). For passengers, "Accidents happening in outside the city or overturn of the vehicle" combination (OR = 8.55, P-value<0.001), and "accidents happening on defective roads" (OR = 2.18, P-value<0.001) increased the odds of DATAS; When "driver was not injured or the vehicle was two-wheeled", chance of DATAS decreased for passengers (OR = 0.25, p-value<0.001). The odds of DATAS were higher for "drivers who had a head-on accident, or drove a two-wheeler vehicle, or overturned the vehicle" (OR = 4.03, P-value<0.001). "Accident on the roads other than runway or the absence of a multi-car accident or an accident in a non-residential area" (OR = 6.04, P-value<0.001), as well "the accident which occurred outside the city or on defective roads, and the drivers were male" had a higher risk of DATAS for drivers (OR = 5.40, P-value<0.001). Conclusion: By focusing on identifying interaction effects among risk factors associated with DATAS through logic regression, this study contributes to the understanding of the complex nature of traffic accidents and the potential for reducing their occurrence rate or severity. According to the results, the simultaneous presence of some risk factors such as the quality of roads, skill of drivers, physical ability of pedestrians, and compliance with traffic rules play an important role in the severity of the accident. The revealed interactions have practical significance and can play a significant role in the problem-solving process and facilitate breaking the chain of combinations among the risk factors. Therefore, practical suggestions of this study are to control at least one of the risk factors present in each of the identified combinations in order to break the combination to reduce the severity of accidents. This may have, in turn, help the policy-makers, road users, and healthcare professionals to promote road safety through prioritizing interventions focusing on effect size of simultaneous coexistence of crash severity determinants and not just the main effects of single risk factors or their simple two-way interactions.

The association between diet quality indices and oxidative stress biomarkers in male footballers and healthy active controls.

OBJECTIVE: The aim of the present study was the association between the relationship between Dietary Quality Index-International (DQI-I) and Healthy Eating Index (HEI) and the urinary levels of F2alpha-isoprostane (F2a-IP) and 8-hydroxy-2'-deoxyguanosine (8-OHdG) was investigated as indicators of oxidative stress. RESULTS: Based on HEI (low, moderate, and good), the diet quality of both groups was classified as moderate. In all participants, HEI (ß=-0.29; P = 0.04) and DQI-I (ß=-0.46; P = 0.005) were inversely associated with 8-OHdG. Furthermore, a negative correlation was found between HEI (mean ß=-3.53; P = 0.04) and DQI-I (mean ß=-5.53; P = 0.004) with F2a-IP. The quality of the footballers' diet was higher than that of the control group. Following a high-quality diet, which is rich in antioxidants, is likely to effectively reduce oxidative stress.

Survival, mortality and epidemic risk status of COVID-19: a population-based Study in Golestan province, Iran.

BACKGROUND: Appreciating the various dimensions of the coronavirus disease 2019 (COVID-19) pandemic can improve health systems and prepare them to deal better with future pandemics and public health events. This study was conducted to investigate the association between the survival of hospitalized patients with COVID-19 and the epidemic risk stratification of the disease in Golestan province, Iran. METHODS: In this study, all patients with COVID-19 who were hospitalized in the hospitals of Golestan province of Iran from February 20, 2020, to December 19, 2022, and were registered in the Medical Care Monitoring Center (MCMC) system (85,885 individuals) were examined.The community's epidemic risk status (ERS) was determined based on the daily incidence statistics of COVID-19. The survival distribution and compare Survival in different subgroups was investigated using Kaplan-Meier and log-rank test and association between the survival and ERS by multiple Cox regression modeling. RESULTS: Out of 68,983 individuals whose data were correctly recorded, the mean age was 49 (SD = 23.98) years, and 52.8% were women. In total, 11.1% eventually died. The length of hospital stay was varying significantly with age, gender, ERS, underlying diseases, and COVID-19 severity (P < 0.001 for all). The adjusted hazard ratio of death for the ERS at medium, high, and very high-risk status compared to the low-risk status increased by 19%, 26%, and 56%, respectively (P < 0.001 for all). CONCLUSIONS: Enhancing preparedness, facilitating rapid rises in hospital capacities, and developing backup healthcare capacities can prevent excessive hospital referrals during health crises and further deaths.

The effects of an educational intervention based on the protection motivation theory on the protective behaviors of emergency ward nurses against occupational hazards: a quasi-experimental study.

BACKGROUND: Emergency ward nurses face a variety of occupational hazards due to the nature of their occupational and professional duties, which can negatively affect their health. Therefore, this study aimed to evaluate the effects of an educational intervention based on the protection motivation theory on the protective behaviors of emergency ward nurses against occupational hazards in Tehran, Iran, in 2023. METHODS: The present quasi-experimental study was conducted with two intervention and control groups, using a pretest-posttest design. A total of 124 nurses working in the emergency wards of four hospitals (two hospitals for the intervention group and two hospitals for the control group by random assignment) were selected by multistage sampling method. The educational intervention based on the protection motivation theory was implemented for the intervention group for three weeks. The nurses of both groups completed a demographic questionnaire and the scale of emergency ward nurses' protective behaviors against occupational hazards before, immediately, and one month after the intervention. Data analysis was performed using descriptive and inferential methods. RESULTS: The two groups were similar in terms of demographic characteristics at the baseline (p > 0.05). Protective behaviors of emergency nurses against occupational hazards and their sub-scales (physical, chemical, biological, ergonomics, and psychosocial hazards) were higher in the intervention group than in the control group immediately and one month after the educational intervention. In addition, the measurement over time also showed the positive effect of time and educational intervention on the protective behaviors of emergency nurses against occupational hazards and their sub-scales in the intervention group. CONCLUSION: These findings showed that the educational intervention based on the protection motivation theory can be effective and helpful in improving the protective behaviors of emergency ward nurses against occupational hazards and their sub-scales. Future studies can focus on a more specific design of this kind of intervention based on the type of occupational hazards and needs of nurses in different wards.

Association between loneliness and cigarette smoking attitudes among university students in Iran: a cross-sectional study.

OBJECTIVES: During the last two decades, cigarette smoking witnessed a global increase in use, especially among youth. Loneliness is one of the possible psychosocial determinants of smoking. This study examined the association between loneliness and attitudes towards cigarette smoking among university students of Iran. DESIGN: Cross-sectional study. SETTING AND PARTICIPANTS: This study was conducted among 538 university students, who were recruited using the cluster random sampling method. Loneliness and smoking attitudes of the samples were assessed using the revised version of the University of California Los Angeles Loneliness Scale and the Scale of Cigarette Smoking Attitude (CSA). Descriptive statistics, Pearson's correlation coefficient and multivariable regression analysis were used to analyse the data. RESULTS: From a total of 538 participants, 301 (59.9%) students were young women. The mean age of the students was 22.2±2.9 years. Only 56 (10.4%) of the students were married and 370 (87.9%) of them were lived with their families. 131 (24.3%) students experienced cigarette smoking. In terms of university-related characteristics, 205 (38.1%) of the students studied in the faculty of medicine. Also, 30% of the students had a positive or indifferent attitude towards smoking, while 26.4% of the students reported feeling lonely. The mean scores for loneliness and CSA were 41.42±11.29 and 48.64±11.2, respectively. Statistically, a significant positive correlation was found between loneliness and CSA (r=0.289; p<0.001). After controlling for potential confounders by regression analysis, loneliness scores were also positively associated with CSA scores (B: 0.14; 95% CI 0.097 to 0.18). CONCLUSIONS: According to the positive association between loneliness and students' CSA, paying more attention to the state of loneliness in college students, examining situations and reasons that increase it and identifying the interventions that might reduce it are necessary. Reducing loneliness among college students can correct their attitudes towards smoking.

The efficacy of topical sodium pentaborate formulation on hemorrhoid disease: A randomized, double-blind, placebo-controlled trial.

Background: The topical application of boron has been significantly associated with intensifying wound healing. Using 3% boric acid in deep wounds significantly contributes to wound healing and reduces the duration of hospitalization in the intensive care. The objective of this study was to assess the therapeutic impact of a topical gel containing sodium pentaborate pentahydrate on the management of wounds resulting from grade 1 to 3 hemorrhoids. Methods: In this randomized double-blind placebo-controlled trial, we applied a topical gel consisting of sodium pentaborate pentahydrate 3% on 206 eligible patients with the diagnosis of grade 1, 2, and 3 hemorrhoid diseases. Then patients were randomly allocated to two groups of sodium pentaborate pentahydrate or placebo gel with a ratio of 1:1 and received the allocated gel for four weeks. Patient hemorrhoid symptoms severity, hemorrhoid degree, and anoscopy findings were compared before and after the trial. Results: Before the intervention, symptom severity (p > 0.05) and anoscopy findings (p = 0.815) were similar between the two groups. Subsequent to the intervention, a majority of patients in the intervention group experienced a reduction in anal itching compared to the placebo group [adjusted mean difference (aMD) 95% CI: -1.98 (-2.2 to -1.8), p = 0.007]. Moreover, resting pain [aMD (95% CI): -1.37 (-1.6 to -1.1), p = 0.015], pain during defecation [aMD (95% CI): -2.19 (-2.4 to -2.0), p = 0.005], feeling a lump in the anus (aMD (95% CI): -0.71 (-1.2 to -0.2), p = 0.011), bleeding during defecation (41.7% vs. 66.9%, p = 0.027), and hemorrhoid degree (p < 0.001) in the intervention group was less than the placebo group. Conclusion: Our findings indicate the effectiveness of the study gel on hemorrhoid symptoms and anoscopy findings in patients.

Effect of PM2.5 exposure on adhesion molecules and systemic nitric oxide in healthy adults: The role of metals, PAHs, and oxidative potential.

Since there is limited evidence on the impact of PM2.5 content on cardiovascular biomarkers, we conducted a cross-sectional study on 89 healthy adults from October 12 to November 21, 2021. We measured daily PM2.5 in two distinct regions during different time windows: a high-traffic urban area and an industrial suburb. The concentrations of metals, PAHs, and oxidative potential (OP) were determined using ICP-MS, GC-MS, and dithiothreitol (DTT), respectively. Systemic biomarkers, including NO, sICAM-1, sVCAM-1, MDA, and CRP, were quantified in each subject simultaneously. A generalized linear model was used to examine the association between PM2.5 toxicity and each health endpoint. Our findings indicated that daily PM2.5 concentrations exceeded the WHO-recommended level by approximately sevenfold. We found that PM2.5 exposure was associated with adverse cardiovascular outcomes. Moreover, exposure to PM2.5 mass, total PAHs, and certain trace metals (Ni, Fe, V, As, and Pb) resulted in a decline in serum NO levels. At lag 3, exposure to PM2.5 mass resulted in a significant decrease in NO levels [1.32% (95% CI: -2.27, -0.12)] and total PAHs [2.05% (95% CI: -3.93, -0.12)]. In contrast, OP exhibited a mild correlation with NO level increases. Positive associations were observed between PM2.5 and its chemical constituents (PAHs, As, Cu, OP) and adhesion molecules at different lag times. An increase of 0.16 ppb in PAH concentrations at an interquartile range was associated with a 4.74% decline (95% CI, -7.80, -0.55) in the sVCAM-1 level. However, our study did not reveal any significant trend between pollutants and other biomarkers (sICAM-1, MDA, and CRP). Consequently, our findings suggest that different PM2.5 chemical compositions exhibit diverse behavior in biological responses.

The association between diet quality index-international and dietary diversity score with preeclampsia: a case-control study.

BACKGROUND: Preeclampsia is a significant complication that occurs during the second half of pregnancy. Recent studies have indicated that dietary factors play a crucial role in the development of preeclampsia. The Diet Quality Index-International (DQI-I) and Dietary Diversity Score (DDS) are appropriate indices for assessing the quality of foods, meals, and diets. This study aimed to investigate the relationship between DQI-I, DDS, and preeclampsia. METHODS: This study utilized a case-control design. A total of 90 newly diagnosed preeclampsia cases and 90 healthy controls were included from a referral hospital in Tabriz, Iran. DQI-I and DDS were calculated based on information obtained from a reliable Food Frequency Questionnaire consisting of 168 food items, which assessed participants' usual diet. Logistic regression analysis adjusted for age, body mass index, education, family history of preeclampsia, and total energy intake was used to estimate odds ratios (ORs). RESULTS: The mean age and pre-pregnancy body mass index of the participants were: 27.14 ± 4.40 years and 26.09 ± 3.33 kg/m2, respectively. After adjusting for various confounders, we found significant inverse association between the risk of developing preeclampsia and both DQI-I and DDS. The highest quartile of DQI-I had a significantly lower risk of developing preeclampsia compared to the first quartile (OR = 0.02, 95% CI [0.005, 0.08]) (P < 0.001). Similarly, the highest quartile of DDS had a significantly lower risk of developing preeclampsia compared to the first quartile (OR = 0.09, 95% CI [0.03, 0.31]) (P = 0.001). CONCLUSIONS: Our findings suggest that maintaining a high-quality and diverse diet is associated with a lower risk of preeclampsia. Further studies are needed to confirm these associations and explore potential causal relationships.

Effect of a plant-based diet on oxidative stress biomarkers in male footballers.

Proper nutrition plays a vital role in modulating oxidative status. There is an increasing popularity of plant-based dietary patterns among athletes. Therefore, the present study aimed to determine the plant-based diet index (PDI) score among male footballers and their non-athlete controls, as well as its relationship with oxidative biomarkers by evaluating the urinary excretion of F2alpha-isoprostane (F2a-IP) and 8-hydroxy-2'-deoxyguanosine (8-OHdG). A group of footballers (n = 45) and a healthy non-athlete group (n = 45) were selected. The two groups were matched based on body mass index (BMI) and age. The mean (standard deviation (SD)) age of the subjects was 22.88 (2.41) years, and their BMI was 22.08 (1.35) kg/m2. Anthropometric indices were evaluated, and fasting morning urine samples were analyzed to measure oxidative biomarkers. The PDI, unhealthy plant-based diet index (uPDI), and healthy plant-based diet index (hPDI) were calculated using valid food frequency questionnaire data. Generalized estimating equation models were used for all analyses. Compared to the non-athlete group, the PDI score was significantly greater in the footballer group (ß = 9.8; P < 0.001), while the differences between the two groups in uPDI and hPDI scores were not significant. Overall, footballers consumed more plant-based foods. By examining the relationship between dietary indices and oxidative biomarkers, only a negative association was observed between PDI score and F2a-IP level (ß = -1.25; P = 0.03). Based on the results, footballers were more adherent to a plant-based diet than non-athletes. In addition, it seems that following plant-based diets (the higher PDI) may exert beneficial effects on lowering F2a-IP levels due to improving the body's antioxidant status.

Empagliflozin and colchicine in patients with reduced left ventricular ejection fraction following ST-elevation myocardial infarction: a randomized, double-blinded, three-arm parallel-group, controlled trial.

PURPOSE: There is accumulating evidence regarding the potential benefits of empagliflozin in individuals with acute myocardial infarction (MI). Based on the literature, colchicine could also reduce the risk of MI and death in individuals with cardiovascular disease (CVD). However, trials investigating the effects of the combination of empagliflozin with colchicine and high-dose empagliflozin monotherapy in this setting are lacking. METHODS: In this trial, 106 non-diabetic participants with reduced left ventricular ejection fraction (LVEF) following recent ST-elevation MI were randomly assigned to empagliflozin 10 mg/day, empagliflozin 10 mg/day plus colchicine 0.5 mg twice daily, or empagliflozin 25 mg/day groups within 72 h after primary percutaneous coronary intervention (PCI). The study's primary outcomes were the changes in New York Heart Association (NYHA) functional class and high-sensitivity C-reactive protein (hs-CRP) over 12 weeks. RESULTS: The baseline characteristics of individuals were statistically similar between the study groups. Changes in NYHA functional class over 12 weeks were not significantly different between the study groups. hs-CRP was significantly reduced in all groups (all P < 0.001); however, there was no significant change between the groups over the study period. Changes in tumor necrosis factor-alpha (TNF-α), LVEF, and left ventricular end-diastolic dimension (LVEDD) during the research period did not differ significantly between groups. CONCLUSION: This study showed that neither the combination treatment of empagliflozin 10 mg/day with colchicine nor the monotherapy of empagliflozin 25 mg/day was superior to empagliflozin 10 mg/day in terms of changes in clinical, inflammatory, and echocardiographic outcome parameters in patients with recent MI with reduced LVEF over 3 months. Further studies are warranted to confirm the findings. TRIAL REGISTRATION: Clinical trial ID: IRCT20111206008307N39. Registration date: 27 October 2022. https://www.irct.ir/trial/66216.

Comparison of global decolonization efficacy with mupirocin nasal drop and chlorhexidine mouthwash in acute leukemia patients: randomized clinical trial.

PURPOSE: Neutropenic fever remains a major complication in acute leukemia. Decolonization is assumed as a promising intervention for eradicating causative agents of infection. METHODS: In this randomized clinical trial, 96 patients with acute leukemia were assigned randomly to mupirocin nasal drop 2% (n = 32), chlorhexidine mouthwash 0.2% (n = 33), and control group (n = 31). In control group, patients did not receive any medication for decolonization. All patients received treatment for 5 days (2 days prior to chemotherapy until 3 days after chemotherapy). Pharynx and nasal swabs were taken prior to the intervention and at the end of decolonization period in all groups. Antibiotic susceptibility testing was performed by the disc diffusion method in order to identify bacterial isolates. RESULTS: Bacterial recovery of both nasal and pharynx swabs was observed after global decolonization with mupirocin nasal drop. Decolonization with mupirocin significantly eradicated Coagulase-negative staphylococci (CONS) in both nasal and pharynx swabs (p-value = 0.000). Moreover, mupirocin decreased Pseudomonas aeruginosa and methicillin-resistant Staphylococcus aureus (MRSA) species. Chlorhexidine mouthwash significantly eradicated CONS in pharynx swabs (p-value = 0.000). In addition, both decolonization strategies decreased both antibiotic use and frequency of fever in leukemic patients. CONCLUSION: Global decolonization with mupirocin nasal drop not only eradicates both nasal and pharynx microorganisms, but also reduces antibiotic requirement and frequency of fever in patients with acute leukemia. The protocol of the present study was approved on December 2016 (registry number: IRCT20160310026998N6).

Factors affecting quality of life in women with breast cancer: a path analysis.

BACKGROUND: Breast cancer may negatively affect people's quality of life. We investigated the predictors of quality of life in women with breast cancer with the mediating role of resilience. METHOD: In a cross-sectional design, 218 patients completed a survey referring to the Valiasr International Hospital Oncology Center in Tabriz, Iran. Four validated self-report measures assessed HRQoL as measured by the SF-12, Resilience, Hope, and Perceived Social Support (MSPs). The mediating roles of resilience between HRQoL and the fitness of the proposed model were investigated using path analysis. SPSS version 24 software and Lisrel 8.8 software were used for data analysis. RESULTS: The results of path analysis showed that the final model had a good fit to the data (Chi-Square/ degrees of freedom (Normed Chi2) = 2.08, RMSEA = 0.014, goodness fit index = 0.99, both comparative fit index = 0.99 both CFI = 0.99 and IFI = 1). In this model, age and psychosocial factors predicted health-related quality of life. CONCLUSIONS: Age and psychosocial factors especially social support are important components in predicting health-related quality of life among those suffering from breast cancer.

The role of polycystic ovary syndrome in preclinical left ventricular diastolic dysfunction: an echocardiographic approach: a systematic review and meta-analysis.

Background: Polycystic ovary syndrome (PCOS) is a common endocrine disorder affecting women of childbearing age, causing hormonal imbalances, reproductive issues, and metabolic disturbances. Women with PCOS have an increased risk of cardiovascular disease due to insulin resistance, obesity, and hyperandrogenism. Detecting impaired left ventricular (LV) function is important in managing this condition. Echocardiography, a non-invasive imaging technique, can effectively detect LV dysfunction. Aim: The goal of this systematic review was to assess whether there are any variations in echocardiographic measures between women with PCOS and those without the condition in order to determine the potential impact of PCOS on LV function. Methods: This review followed the PRISMA reporting guidelines. A thorough search of databases including PubMed, Scopus, Web of Science, and Cochrane was conducted. The quality of the selected studies was assessed using the Joanna Briggs Institute appraisal instruments. After applying strict eligibility criteria, data were extracted and organized in Microsoft Excel sheets. Review Manager (RevMan) software was used for the analysis. Results: Analysis of 29 studies revealed significant differences in echocardiographic measures related to diastolic function between women with PCOS and healthy controls. However, there were no significant differences in measures of systolic function. Conclusion: These findings indicate that PCOS may be linked to impaired LV function, thereby increasing the risk of cardiovascular disease. Further research is necessary to better understand this association and its clinical implications. Early detection and management of PCOS could potentially help prevent cardiovascular complications in affected women.

Diet diversity and food quality score in male football players and healthy non-athlete controls in relation to oxidative stress biomarkers: a descriptive-analytical study.

BACKGROUND: Dietary patterns that include high-quality and varied food groups have the potential to modulate oxidative status. This research was conducted to determine dietary diversity score (DDS) and food quality score (FQS) in football players and their matched non-athletes, also their associations with oxidative indicators assessed by the urinary levels of F2alpha-isoprostane (F2a-IP) and 8-hydroxy-2'-deoxyguanosine (8-OHdG). METHODS: Participants consisted of 45 male football players and 45 male non-athletes in two age-and body mass index (BMI)-matched groups from Shiraz City, Iran. Anthropometric measurements were performed, and urine samples were analyzed to determine oxidative biomarkers. Dietary data derived from a reliable food frequency questionnaire with 168 items was completed to determine DDS and FQS. For data analysis, an appropriate generalized estimating equation model was set up. RESULTS: Our results demonstrated that FQS (ß = 5.46; P < 0.001) and DDS (ß = 1.30; P < 0.001) scores were significantly higher in the footballers in comparison to the non-athletes. Moreover, FQS was negatively associated with 8-OHdG (ß=-0.35; P = 0.008) and F2a-IP (ß=-4.30; P = 0.01) levels in all participants. In addition, DDS was inversely related to 8-OHdG (ß=-1.25; P = 0.01) and F2a-IP (ß=-11.67; P = 0.04) levels in all participants. CONCLUSIONS: Food quality scores and dietary diversity of footballers' diets were found to be higher in comparison to the non-athletes. Furthermore, a higher FQS and DDS were associated with lower levels of oxidative biomarkers in all participants.

Empagliflozin and colchicine in patients with reduced left ventricular ejection fraction following ST-elevation myocardial infarction undergoing primary percutaneous coronary intervention: a study protocol for a randomized, double-blinded, three-arm parallel-group, controlled trial.

BACKGROUND: Patients with acute myocardial infarction are at greater risk for chronic heart failure and mortality. Currently, there is limited evidence supporting the beneficial effects of sodium-glucose cotransporter-2 inhibitors on cardiovascular outcomes in non-diabetic patients with reduced left ventricular ejection fraction following acute myocardial infarction. Furthermore, the clinical effects of the combination of standard-dose sodium-glucose cotransporter-2 inhibitors with colchicine and high-dose sodium-glucose cotransporter-2 inhibitors in this setting have not been evaluated yet. METHODS: A prospective, double-blinded, parallel-group, placebo control randomized trial will be carried out at Shahid Madani Heart Center, the largest teaching referral hospital for cardiovascular diseases, affiliated with Tabriz University of Medical Sciences. A total of 105 patients with reduced left ventricular ejection fraction (≤ 40%) following the first episode of ST-elevation myocardial infarction undergoing primary percutaneous coronary intervention with stent insertion will be randomized 1:1:1 to receive empagliflozin 10 mg daily, a combination of empagliflozin 10 mg daily and colchicine 0.5 mg twice daily, or empagliflozin 25 mg daily for 12 weeks. The primary outcomes are changes in the New York Heart Association functional classification and high-sensitivity C-reactive protein from the randomization through week 4 and week 12. DISCUSSION: The present study will be the first trial to evaluate the efficacy and safety of early treatment with the combination of standard-dose empagliflozin and colchicine as well as high-dose empagliflozin in non-diabetic patients with reduced left ventricular ejection fraction following ST-elevation myocardial infarction. The results of this research will represent a significant step forward in the treatment of patients with acute myocardial infarction. TRIAL REGISTRATION: Clinical trial ID: IRCT20111206008307N39. Registration date: 27 October 2022.

Identifying potential circulating miRNA biomarkers for the diagnosis and prediction of ovarian cancer using machine-learning approach: application of Boruta.

Introduction: In gynecologic oncology, ovarian cancer is a great clinical challenge. Because of the lack of typical symptoms and effective biomarkers for noninvasive screening, most patients develop advanced-stage ovarian cancer by the time of diagnosis. MicroRNAs (miRNAs) are a type of non-coding RNA molecule that has been linked to human cancers. Specifying diagnostic biomarkers to determine non-cancer and cancer samples is difficult. Methods: By using Boruta, a novel random forest-based feature selection in the machine-learning techniques, we aimed to identify biomarkers associated with ovarian cancer using cancerous and non-cancer samples from the Gene Expression Omnibus (GEO) database: GSE106817. In this study, we used two independent GEO data sets as external validation, including GSE113486 and GSE113740. We utilized five state-of-the-art machine-learning algorithms for classification: logistic regression, random forest, decision trees, artificial neural networks, and XGBoost. Results: Four models discovered in GSE113486 had an AUC of 100%, three in GSE113740 with AUC of over 94%, and four in GSE113486 with AUC of over 94%. We identified 10 miRNAs to distinguish ovarian cancer cases from normal controls: hsa-miR-1290, hsa-miR-1233-5p, hsa-miR-1914-5p, hsa-miR-1469, hsa-miR-4675, hsa-miR-1228-5p, hsa-miR-3184-5p, hsa-miR-6784-5p, hsa-miR-6800-5p, and hsa-miR-5100. Our findings suggest that miRNAs could be used as possible biomarkers for ovarian cancer screening, for possible intervention.

Long and Short-term Metformin Consumption as a Potential Therapy to Prevent Complications of COVID-19.

Purpose: The aim of the study is to evaluate the effect of metformin in complication improvement of hospitalized patients with COVID-19. Methods: This was a randomized clinical trial that involved 189 patients with confirmed COVID-19 infection. Patients in the intervention group received metformin-500 mg twice daily. Patients who received metformin before admission were excluded from the control group. Patients who were discharged before taking at least 2000 mg of metformin were excluded from the study. Primary outcomes were vital signs, need for ICU admission, need for intubation, and mortality. Results: Data showed that patients with diabetes with previous metformin in their regimen had lower percentages of ICU admission and death in comparison with patients without diabetes (11.3% vs. 26.1% (P=0.014) and 4.9% vs. 23.9% (P≤0.001), respectively). Admission time characteristics were the same for both groups except for diabetes and hyperlipidemia, which were significantly different between the two groups. Observations of naproxen consumption on endpoints, duration of hospitalization, and the levels of spO2 did not show any significant differences between the intervention and the control group. The adjusted OR for intubation in the intervention group versus the control group was 0.21 [95% CI, 0.04-0.99 (P=0.047)]. Conclusion: In this trial, metformin consumption had no effect on mortality and ICU admission rates in non-diabetic patients. However, metformin improved COVID-19 complications in diabetic patients who had been receiving metformin prior to COVID-19 infection, and it significantly lowered the intubation rates.

Prevalence of smoking, alcohol consumption, and drug abuse in Iranian adults: Results of Azar Cohort Study.

Background: Substance abuse has significant health impacts on families and society as a whole. We aimed to provide detailed prevalence estimates of substance abuse among the Azar Cohort Study respondents in Tabriz, Iran. Methods: Data on 15006 participants of Azar Cohort Study were analyzed. The variables included tobacco smoking, alcohol use, drug abuse, and socio-demographic characteristics. The prevalence of substance abuse (with a 95% confidence interval) was calculated using the direct standardization method. Results: Overall, 9.3% and 6.2% of the participants were regular and heavy cigarette smokers, respectively. Also, 1.9% and 2.1% of participants reported a history of using illicit drugs and alcohol, respectively. Substance abuse was more prevalent among males than females. Substance abuse varied significantly with age and socioeconomic variables. Conclusion: We identified specific demographic and socioeconomic groups with a higher prevalence of all studied behaviors. Such high-risk groups should be targeted when designing substance abuse prevention programs.