Annals of Military and Health Sciences Research
Volume:21 Issue: 1, Mar 2023

Context: 

Artificial intelligence refers to a set of systems that are capable of performing functions similar to human intelligent functions. Today, artificial intelligence has been successfully incorporated into clinical decision support systems (CDSS).

Evidence Acquisition: 

The current study aimed to briefly present a narrative mini-review on clinical reasoning and artificial intelligence. Data were gathered from Google Scholar, ScienceDirect, and PubMed databases using the "clinical decision support system, artificial intelligence, and clinical reasoning" keywords.

 Clinical decision support systems are divided into two categories: knowledge-based and data-driven. The first category is called the rule-based expert system, and the second category is also named the machine-learning system. The usefulness of the mentioned systems and artificial intelligence in interpreting algorithmic and statistical information, where the human element can easily make a mistake, is that they are much more efficient and work with fewer errors. However, when it comes to dealing with a patient and his complaints and symptoms, because of the requirement for clinical judgment, the human element works much better in obtaining a mental image of the patient’s condition. Artificial intelligence is specifically used in scenarios such as the diagnosis of electrolyte disorders, interpreting ECG findings, and recognizing the causes of myocardial hypertrophy. Nonetheless, artificial intelligence has challenges, such as a lack of responsibility for medical decisions and treatment errors.

 Referring to the above-mentioned benefits and challenges of artificial intelligence, artificial and human intelligence cannot be superior to each other, and both have an irreplaceable role in clinical decision-making. The new view is that the goal of CDSS is to help the physician make better decisions by processing vast pieces of information as a whole entity rather than individually.

 A lack of enough light in educational-academic spaces causes a wide range of damages and, most importantly, a destructive effect on the learning of students and researchers.

 In this study, the intensity of light (in terms of lux) in the classrooms and laboratories of the faculties of health and paramedicine, medicine, nursing and midwifery, and dentistry of Qazvin University of Medical Sciences, Qazvin, Iran, was measured in 2020.

 In this descriptive-cross-sectional study, the numbers of classes and laboratories were 35 and 23, respectively. Natural and artificial light measurements were carried out in the morning and evening. The average readings were compared to international and national standards. Data analysis was performed using R software (version 4.1.0).

 The classes of the Faculty of Dentistry and Faculty of Medicine had the highest and lowest average intensity of general and artificial lighting, respectively. Moreover, 78% and 82.4% of the general lighting intensity readings in the morning and evening were within the standard range, respectively. However, only 36.8% and 26% of the total readings of artificial light intensity in the morning and evening were outside the defined standard range, respectively. The classes with western and eastern windows had significantly higher general lighting intensity than the northern geographic windows (P < 0.001).

 In the classrooms and laboratories of Qazvin University of Medical Sciences, the general and artificial lighting in the Faculty of Medicine classrooms and in the majority of laboratories need to be improved.

Many rheumatologic conditions are associated with thrombocytopenia due to antibody-mediated platelet destruction. Knowing the rate of ITP patients who develop vascular collagen diseases and the developed type can help predict future treatments and even take preventive measures.

This study aimed to know the frequency of immune thrombocytopenic purpura (ITP) in collagen vascular disorders.

The present retrospective cross-sectional study was conducted in 2020 on the health records of 447 eligible patients. First, the patient’s details, such as age, gender, marital status, age at diagnosis, time from the diagnosis of ITP to the development of lupus, and the patients’ ANA and anti-dsDNA test results, were extracted from their records and entered into the preparation checklist. Finally, the data were entered into SPSS-23 and analyzed at a statistically significant level of 0.05.

The mean interval between the initial diagnosis of ITP and vascular collagen disease diagnosis was 2.1 ± 0.9 years. The records of 336 patients with systemic lupus erythematosus (SLE) were also assessed, of whom 15 (4.5%) had first developed ITP and then lupus. Hence, of the 447 patients included in the study, 17 (3.8%) with a history of ITP then developed lupus.

Comparing the present findings with the results of other studies shows that Iranian patients with ITP develop vascular collagen disease at a lower rate.

 Sedentary lifestyle and lack of exercise cause cardiovascular diseases and metabolic syndrome. Decreased movement in recent decades has caused cardiovascular diseases.

 In this research, 35 male Wistar rats weighing 220 ± 20 g were divided into 5 groups (seven rats in each group) by a simple random method. The first and second experimental groups were given 100 grams per liter of fructose with water for 6 weeks, and the third experimental group received this for 14 weeks. The training group performed the interval training protocol on the treadmill for eight weeks and 5 days a week. One-way analysis of variance (ANOVA) was used to compare the groups.

 The use of the fructose diet for 6 weeks and 14 weeks caused metabolic syndrome in male Wistar rats. Induction of metabolic syndrome increased the plasma levels of PTX3, VACM-1, and CRP at the end of 6 weeks (P = 0.001, P = 0.018, and P = 0.004, respectively) and the fourteenth week (P = 0.001, P = 0.001, and P = 0.001, respectively). Eight weeks of interval training significantly reduced PTX3, VACM-1, and CRP (P = 0.034, P = 0.027 and P = 0.021, respectively).

 The fructose diet caused metabolic syndrome and a significant increase in inflammatory markers in rats, and high-intensity interval training significantly reduced inflammatory factors in them.

The coronavirus disease 2019 (COVID-19) pandemic has increased the psychological problems of people all over the world. In this crisis, nurses experienced complex physical and psychological stress.

This study aimed to determine the relationship of perceived stress with moral distress and the spiritual intelligence of clinical nurses in the context of COVID-19.

This cross-sectional study was conducted on 285 clinical nurses working in public hospitals in the city of Shahroud, Iran. Data collection instruments included a demographic data sheet, the Perceived Stress Scale (PSS), Corley’s Moral Distress Scale (MDS), and King’s Spiritual Intelligence Scale (SISRI-24). Descriptive (frequency, mean, and standard deviation) and inferential statistics (the independent t-test, Pearson correlation coefficient, and logistic regression analysis) were used to analyze the data.

The findings showed that nurses reported high levels of perceived stress (36.12 ± 5.14). Perceived stress was positively and significantly correlated with moral distress (P = 0.001, r = 0.09). Perceived stress was also significantly correlated with age (P < 0.01, r = 0.29) and work experience (P = 0.001, r = -0.85).

According to the findings, nurses must strive to reduce moral distress during the COVID-19 pandemic. For this purpose, psychosocial support for clinical nurses, stress management courses, and providing welfare facilities for nurses are essential.

Insulin-loaded Trimethyl Chitosan (TMC)/tragacanth microspheres were prepared by microemulsion dispersion and triggered in situ gelation. Microspheres were characterized by their mean size and distribution by laser diffraction spectroscopy and Brunauer-Emmet-Teller theory. Insulin encapsulation efficiency and in vitro release were determined by Bradford protein assay, and bioactivity was assessed in vitro using an enzyme-linked immunoassay diagnostic kit and in vivo using Wistar diabetic rats. TMC/tragacanth particles suppressed insulin release in acidic media and promoted a sustained release at near-neutral conditions. Micro-capsulated insulin was bioactive, demonstrated by both in vivo and in vitro bioassays.

The present study aimed to estimate the age, gender, and height of the Iranian population based on the characteristics of the 10th and 11th thoracic vertebrae for identification. This cross-sectional study measured the T10 and T11 indices in axial, sagittal, and coronal computed tomography (CT) scan images. The measured indices included vertebral length (VL), endplate depth (EPD), endplate width (EPW), foramen diameter (FD), foramen width (FW), transverse process distance (TDm), spinal process height (SPH), spinal process length (SPL), vertebral body height (VBH), pedicle height (PH), pedicle width (PW), articular process height inferior (APHi), articular process height superior (APHs), and maximum distance between articular processes (ADm). The mean differences of the T10 and T11 indices between the two groups of men and women, except FW, FD, and APHi, were higher in men, which were statistically significant (P < 0.006). VL, EPD, EPW, FW, TDm, VBH, PH, and ADm in men, and VL, EPD, EPW, TDm, SPH, SPL, PH, APHs, and ADm in women were significantly correlated with height in the T10 vertebra (P < 0.05). Moreover, FD in T10 was found to be negatively correlated with women’s height (P = 0.04). In addition, in the T11, the VL, EPD, EPW, FW, FD, TDm, and VBH indices in men and the VL, EPW, TDm, SPL, PH, APHs, and PW in women were significantly correlated with height (P < 0.05). Moreover, VL, EPD, TDm, SPH, SPL, and APHi in women and VL in men were significantly and positively correlated with age in T10 (P < 0.05), similar to the T11 APHs correlation with age in men and VL, EPW, EPD, SPL, and APHi in women. The current study showed that the T10 and L11 vertebral indices were significantly correlated with gender, height, and age.

 During the Iran-Iraq war (1980 - 1988), Iran was subjected to chemical attacks for over five years. These attacks left many mental injuries, especially for the veterans exposed to chemical weapons.

 This case-control study compared mental disorder symptoms and brain executive functions of veterans exposed to chemical weapons with healthy individuals.

 The present study was conducted on veterans exposed to chemical weapons during the war. The control group comprised healthy individuals matched to the cases based on age, gender, occupation, level of education, and place of residence. One hundred seventy participants were included in the study, with 85 individuals in each group. The Symptom Checklist-90-Revised (SCL-90-R) and Nejati questionnaire were used to collect data on the symptoms of mental disorders and brain executive functions. Multivariate analysis of variance was used for data analysis.

 The findings revealed that the total effect of the subscales of mental disorders in all nine domains was significantly higher in veterans exposed to chemical weapons than in healthy individuals (P < 0.05). In addition, the actual impact of the subscales of the executive brain functions of veterans exposed to chemical weapons was significantly lower compared to healthy individuals (P < 0.05).

 Our findings showed that veterans exposed to chemical weapons exhibited higher mental disorder symptoms across all domains than the control group. Moreover, veterans demonstrated weaker cognitive functions in terms of executive brain functions compared to healthy individuals. The implications of these findings are significant for mental health specialists working with veterans exposed to chemical weapons.