Shiraz Emedical Journal
Volume:23 Issue: 7, Jul 2022

This study was done to extract the evaluation criteria to assess the effects of decision support systems integrated with computerized provider order entry (CPOE) systems.

A Scoping review search was carried out on papers published in nine electronic databases, including PubMed, Embase, ProQuest, Scopus, Web of Science, Cochrane, Science Direct, ACM digital library, and IEEE Xplore Digital Library up to February 2019. This study was conducted based on the PRISMA flow diagram. Two investigators independently worked on identifying papers published in English electronic clinical decision supports physicians used that to help decision-making during medical orders. Finally, the criteria for effects of clinical decision support systems (CDSSs) in CPOE were extracted from the selected papers.

Eighty-seven studies were identified matching the inclusion criteria. The most significant number of effects belonged to the medication order decision support system. Medication order decision support system studies were classified into five categories by effects: clinical effects (8 dimensions), the process of care effects (3 dimensions), user workload effects (8 dimensions), economic effects (2 dimensions), and implementation effects (5 dimensions).

It can be concluded that the most substantial effect is related to medication decision supports within the CPOE system. These studies provide wide-ranging criteria to evaluate CDSS integrated into CPOE. It helps identify weaknesses and strengths of CDSSs within CPOE systems.

Alzheimer's disease (AD) is a neurodegenerative illness that causes memory loss and cognitive impairment. For neurodegenerative illnesses, the therapeutic properties and healthy advantages of brewed coffee (BC) intake have been widely explored.

This research aimed to look into the findings of sub-chronic BC administration on long-term potentiation (LTP) as a model of synaptic plasticity that supports memory function in the hippocampus in rat models of AD.

In this study, 32 male Wistar rats were utilized as test subjects. The animals were randomly divided into four groups with eight rats in each group as follows: (1) Sham (animals that received normal saline (NS)), (2) streptozotocin (STZ), (3) BC, and (4) BC-STZ. Animals were treated for three weeks.

The amplitude of excitatory postsynaptic potentials (EPSPs) in the BC + STZ (164.23 ± 11.33%; n = 8) group significantly increased compared to the STZ group at 0.25 h after HFS (P = 0.0330). Also, it significantly increased in the BC + STZ group at 0.5, 0.75, 1, 1.25, 1.5, 1.75, and 2 h (P = 0.4481, P = 0.4609, P = 0.1239, P = 0.0017, P = 0.0413, P = 0.0851, P = 0.1323) after HFS. Moreover, the slope of EPSPs in the BC-STZ group showed an overall improvement compared to the STZ group at 0.25, 0.5, 0.75, 1, 1.25, 1.5, 1.75, and 2 h (P = 0.1511, P = 0.0004, P = 0.0394, P = 0.0038, P = 0.0002, P = 0.0059, P = 0.0245, and P = 0.4126, respectively) after HFS during LTP recording time.

In conclusion, the present study found that BC consumption improved synaptic plasticity and memory in rat models of AD induced by STZ. However, more studies are needed to elucidate BC's neuroprotective mechanisms.

Early screening and diagnosis of breast cancer (BC) is critical for improving the quality of care and reducing the mortality rate.

This study aimed to construct and compare the performance of several machine learning (ML) algorithms in predicting BC.

This descriptive and applied study included 1,052 samples (442 BC and 710 non-BC) with 30 features related to positive and negative BC diagnoses. The data mining (DM) process was implemented using the selected algorithm, including J-48 and random forest (RF) decision tree (DT), multilayer perceptron (MLP), Naïve Bayes (NB), Adaboost (AB), and logistics regression (LR) classifier. Then, we obtained the best algorithm by comparing their performances using the confusion matrix and area under the receiver operator characteristics (ROC) curve (AUC). Finally, we adopted the best model for BC prognosis.

The results of evaluating various DM algorithms revealed that the J-48 DT algorithm had the best performance (AUC = 0.922), followed by the AB, MLP, LR, and RF algorithms (AUC: 0.899, 0819, 0.716, and 0.703, respectively). Also, the NB algorithm achieved the lowest performance in this regard (AUC = 0.669).

The ML presents a reasonable level of accuracy for an early diagnosis and screening of breast malignancies. Also, the empirical results showed that the J-48 DT algorithm yielded higher performance than other classifiers.

The main role of women’s caregivers is to provide supportive care. This research aimed to determine the relationship between women’s satisfaction with personnel’s support during labor, fear of childbirth, and duration of labor stages.

Following a cross-sectional design, this study was performed on 301 women at Taleghani and Alzahra hospitals of Tabriz, Iran. Fear of childbirth was assessed using Delivery Fear Scale (DFS) at 3 - 4 cm dilatation, and satisfaction with the personnel’s support was measured with Mackey’s satisfaction scale within 12 - 24 hours after delivery. The partograph diagram was used to assess the duration of the labor stages. The Pearson correlation test, independent t-test, one-way ANOVA, and multiple linear regression were used for data analysis.

The mean ± SD score of satisfaction with personnel’s support equaled 52.12 ± 13.9 (score range: 17 to 85), and the mean score of FSD equaled 40.2 ± 20.2 (score range: 10 to 100). Satisfaction with the personnel’s support showed a significant negative correlation with the fear of childbirth (r = -0.782, P < 0.001), duration of the active phase of labor (r = -0.14, P = 0.013), and total duration of labor (r = -0.14, P = 0.013). The multiple linear regression model indicated that fear of childbirth (β = -0.53; 95% CI: -0.58 to -0.48; P < 0.001) and total duration of labor (β = -0.007, 95% CI: -0.013 to -0.001; P = 0.029) were inversely related with the women’s satisfaction with the personnel’s support.

This study demonstrated that the FOC and prolonged labor can decrease satisfaction with the personnel’s support during labor.

Considering the high prevalence of hot flashes and the controversies in its treatments, the present study evaluated the effect of Pimpinella anisum extract on the treatment and recurrence of hot flashes in women referred to the health centers of medical sciences universities in Tehran, Iran in 2019.

The present double-blind controlled parallel-group clinical trial included 72 menopausal women with chief complaint of hot flashes. The participants were randomly assigned into two equal groups (n = 36 each) of experimental (receiving three P. anisum capsules) and control. The severity and frequency of hot flashes were measured by Visual Analogue Scale (VAS) before the treatment, eight weeks after the treatment, and four weeks after discontinuation of the medication. The data of patients, including their diet, were recorded in the questionnaires and information forms. The data were analyzed using SPSS 19, and the intra-group results were analyzed using the repeated measures analysis of variance (ANOVA). Also, to compare the scores between the groups, t-test, and Mann-Whitney-Wilcoxon (MWW) were used.

The frequency of hot flashes in the P. anisum group was 7.89 ± 5.67 before the treatment, 1.04 ± 1.24 eight weeks after the treatment, and 4.21 ± 2.03 in the four-week follow-up period. The severity of hot flashes among the P. anisum group was 11.50 ± 9.78, 1.90 ± 2.77, and 5.78 ± 1.92 before the treatment, eight weeks after the treatment, and four-week follow-up (P = 0.001), respectively. However, the severity and frequency of hot flashes did not change significantly in the placebo group (P = 0.75). No side effects were seen in any of the groups.

Pimpinella anisum was effective in reducing the frequency and severity of hot flashes.

Intravenous cannulation is needed in about 90% of patients admitted to hospitals to administer medications or replace fluids, which is difficult to perform in obese patients with diabetes.

The present study aimed to assess the effect of using near-infrared vein finder technology on the success rate of cannulation in obese patients with diabetes.

This randomized controlled trial was conducted on 92 eligible patients with type 2 diabetes and obesity at Al-Rusafa hospitals in Baghdad, Iraq, in September 2021. The subjects were divided into the intervention (n = 46) and control (n = 46) groups. However, cannulation using near-infrared vein finder technology was only performed for the intervention group. The data were collected using a demographic and clinical data questionnaire and a chronometer.

The success rates of cannulation for the first time were 60.9% and 15.2% in the intervention and control groups, respectively. The mean values of procedural time were 53.2 ± 28.9 and 94.3 ± 41.5 seconds in the intervention and control groups, respectively. The independent effects of patients’ body mass index (P = 0.002) and skin color (P = 0.040) on procedural time were significant.

The use of near-infrared vein finder technology in obese diabetic patients reduces procedural time and venipuncture attempts.

Patients with a low level of pregnancy-associated plasma protein-A (PAPP-A) experience more placental disorders in the second trimester.

We aimed to assess UtA-Doppler and placental size to predict adverse pregnancy outcomes in a woman with placental insufficiency and low PAPP-A.

Following a cross-sectional design, 83 singleton pregnant women with normal chromosomes and PAPP-A ≤ 0.5 were examined at 11 - 13 + 6 weeks of gestation. All participants with PAPP-A ≤ 0.5 were tested in the Nilo laboratory of Tehran from 2018 to 2019. The placental size and Doppler uterine artery were assessed at 18 - 20 weeks. Three cases were excluded due to abortion and aneuploidy. All participants were assigned to placenta lengths of < 10 cm and > 10 cm. All comparisons between two groups were assayed by the independent t-test, Mann-Whitney U test, χ2-test or Fisher exact test, and Logistic regression model.

Of 80 women, 48 (60%) had placenta length of < 10 cm and 32(40%) had placenta length of > 10 cm. Fourteen (17.5%) were preterm (< 32 weeks), and 36(45%) were IUGR. According to the logistic regression model, in participants with a placenta length of < 10 cm, the risk of IUGR was higher by 9-time than those with placenta length of > 10 cm (OR = 9, CI95% = 3.20 - 25.29). Also, the risk of preterm labor was 3.47 fold higher in the group with placenta length of < 10 cm, OR: 3.47;( CI95% = 1.27 - 9.44). Sensitivity of placenta length of < 10 cm for predicting IUGR was 75% (CI95% = 56.60 - 88.54).

Placental length measurement in the second trimester can help predict adverse pregnancy outcomes in pregnant women with low PAPP-A. Placenta evaluation can assist in planning future pregnancy care to detect the pathology of fetal growth restriction.

As a promising revascularization therapy, percutaneous coronary intervention (PCI) is widely used in patients with coronary artery disease. No-reflow and low thrombolysis in myocardial infarction (TIMI) flow are two adverse periprocedural events.

This study aimed to compare the effectiveness of atorvastatin and rosuvastatin in reducing the no-reflow phenomenon in patients undergoing primary PCI.

Following a randomized control design, 280 eligible patients with no history of MI or ischemic heart disease (IHD) with ST-elevation myocardial infarction (STEMI) who were candidates for coronary angioplasty underwent angioplasty from May 2020 to December 2020.

Our results showed that TIMI flow III was significantly higher in the rosuvastatin group, while the no-reflow was not seen in this group (P < 0.001). Also, ST resolution after 90 minutes of PCI was significantly better in the rosuvastatin group.

This study demonstrated that using a loading dose of rosuvastatin could reduce the no-reflow phenomenon in patients undergoing primary PCI.

According to the importance of postpartum sexual dysfunctions and their effects of these cases on the quality of life of the couple, this study aimed to determine vaginal postpartum sexual function and dyspareunia.

This descriptive-analytical study was performed on 400 women with a history of natural childbirth in 2020 - 2021 in Hormozgan Province, Iran. The demographic and obstetric checklist, sexual function, and postpartum dyspareunia questionnaires (Carol Scale) were used. For data analysis, “SPSS 18.0” Software and for Partial least squares (PLS) modeling, Smart PLS Software was used.

The mean age of the women was 26.74 ± 6.12 years, and the average overall sexual function and postpartum dyspareunia score were 27.18 ± 8.62. All amounts of cross-validated communality indicated the appropriate and acceptable quality of the present research model. The absolute goodness of fit (GOF) for the tested model was 0.41, indicating the tested model's appropriate fit. Age, spouse age, education, the average number of intercourse, and marital satisfaction directly affected sexual function after vaginal birth. In contrast, age, spouse age, education, duration of marriage were indirectly correlated with sexual function after vaginal birth through marital satisfaction (P < 0.01). In the present study, age, spouse, and education had a direct and indirect effect on sexual function after vaginal birth.

Poor marital satisfaction can cause sexual dysfunction after vaginal delivery. Therefore, it is hoped that by using the present study results and similar ones to identify the factors affecting sexual function, by training couples and healthcare providers, sexual relations and emotional performance between couples will be established and strengthened more than before.

Little evidence has noted that psychological factors are risk factors of post-operative pain intensity in women undergoing cesarean section.

The aim of study was to determine predictive psychosocial factors for post-cesarean pain intensity using assessment of depression, anxiety, self-efficacy, and quality of relationship.

This prospective descriptive-analytic study was carried out on 150 healthy women scheduled for cesarean section under spinal anesthesia. The day before the surgery, the patients completed three questionnaires including Hospital Anxiety and Depression Scale (HADS), and General Self-efficacy. Also, 24 hours after the surgery, the intensity of pain in the patients was assessed with filling McGill Pain Questionnaire (MPQ). Linear regression was used to predict the factors of pain intensity.

The anxiety was a positive predictor of pain intensity of women after C-section (β = 0. 0.22, P = 0.014). However, depression score, and self-efficacy were not predicting factors of pain intensity of women after C-section.

Preoperative anxiety increases post-operative pain intensity in women undergoing cesarean section.