Abstract Background Colorectal cancer is the second most prevalent cause of death from malignancies globally. The present study was conducted targeting the influence of an educational intervention ...based on the health belief model (HBM) on colorectal cancer screening behaviors in people 50 years old and older. Methods All 134 samples were included in this quasi-experimental study from Fasa City Health Service Center, equal halves were random into experimental group and control group. The data collection tool was a questionnaire that contained questions on demographic variables, knowledge, and HBM constructs (perceived sensitivity, perceived intensity, perceived benefits, perceived barriers, self-efficacy, and screening behaviors). Both groups answered the questionnaire before and two months following the intervention. There were six 90-minute instruction sessions for the intervention group. SPSS 22 and descriptive and analytical tests (independent t-test, paired t-test, and Chi-square test) were used for data analysis ( P < 0.05). Results 59 women and 75 men took part in this study. A majority of participants were married and had at least high school diploma. The findings indicated that the mean scores for knowledge, each of the HBM’s constructs, and cancer screening behaviors did not differ significantly from one another before the intervention between the test group and the control group. However, post the intervention, the intervention group exhibited a significant rise in all mentioned dimensions. Conclusion In light of the outcomes, the application of the HBM on colorectal cancer screening behaviors in people 50 years and older was successful. This approach might serve as a helpful foundation for planning, carrying out, and overseeing colorectal cancer screening programs.
Sarcopenia is more common in the elderly and causes adverse outcomes with increased morbidity and mortality. This prospective cohort study assessed the association of sarcopenia risk with the ...severity of COVID-19 at the time of admission and during hospitalisation and the length of hospital stay. Two hundred patients (aged ≥ 60 years) who were hospitalised for COVID-19 were enrolled using consecutive sampling between 29 December 2020 and 20 May 2021. The sarcopenia score of the patients was assessed using the Strength, Assistance in walking, Rising from a chair, Climbing stairs, and Falls questionnaire. The severity of COVID-19 was determined using the modified National Early Warning Score (m-NEWS) system for 2019 n-CoV-infected patients at admission (T1), day three (T2) and at discharge (T3). Data were analysed using SPSS, version 22 and STATA, version 14. Of the 165 patients included, thirty four (20·6 %) were at risk of sarcopenia. The length of hospital stay was slightly longer in patients with sarcopenia risk, but the difference was not significant (
= 0·600). The adjusted OR of respiratory rate (RR) > 20 /min at T1 for the sarcopenia risk group was 6·7-times higher than that for the non-sarcopenic group (
= 0·002). According to generalised estimating equations, after adjusting for confounding factors, the m-NEWS score was 5·6 units higher in patients at risk of sarcopenia (
< 0·001). Sarcopenia risk could exacerbate COVID-19 severity and increase RR at admission, as well as the need for oxygen therapy at discharge.
Without an adequate immune response, SARS-CoV2 virus can simply spread throughout the body of the host. Two of the well-known immunonutrients are selenium (Se) and zinc (Zn). Se and Zn deficiency ...might lead to inflammation, oxidative stress, and viral entry into the cells by decreasing ACE-2 expression; three factors that are proposed to be involved in COVID-19 pathogenesis. Thus, in the current study we aimed at evaluating the correlation between serum Se and Zn status and COVID-19 severity. Eighty-four COVID-19 patients were enrolled in this observational study. Patients were diagnosed based on an infectious disease specialist diagnosis, using WHO interim guidance and the recommendations of the Iranian National Committee of Covid-19. The patients with acute respiratory tract infection symptoms were checked for compatibility of chest computed tomography (CT) scan results with that of Covid-19 and Real-time polymerase chain reaction (RT-PCR) for corona virus infection. The severity of Covid-19 was categorized into three groups (mild, moderate, and severe) using CDC criteria. Serum Zn and Se level of all subjects was measured. The severity of the disease was determined only once at the onset of disease. According to the results of linear regression test, there was a significant association between Zn and Se level and COVID-19 severity (beta = - 0.28, P-value = 0.01 for Se; beta = - 0.26, P-value = 0.02). However the significance disappeared after adjusting for confounding factors. Spearman correlation analysis showed a significant negative association between serum Zn, Se and CRP level (r = - 0.35, P-value = 0.001 for Se; r = - 0.41, P-value < 0.001 for Zn).
Ziziphora persica
(Lamiaceae) has been used as infusions and decoctions in traditional medicine for various purposes such as sedative, carminative, and stomach pain. In the proliferation stage of ...shoot culture, MS medium was treated with different concentrations of methyl jasmonate (MJ) and salicylic acid (SA) (50, 100 and 150 µM) either individually or in combination with various concentrations (25 µM SA + 25 µM MJ, 25 µM SA + 50 µM MJ, 50 µM SA + 25 µM MJ, 50 µM SA + 50 µM MJ). In the present study, we investigated the quantitative changes in pigments, growth parameters, and volatile compounds in the shoot culture of nodal segments. Volatile compounds were extracted and subsequently analyzed using GC-mass spectrometry. The highest amounts of chlorophyll
a
and carotenoids were detected in SA
25
+ MJ
25
treatment, whereas chlorophyll
b
was highly found in the control treatment. Besides, significant amounts of detected volatile compounds belonged to alkane hydrocarbons, whereas mono and sesquiterpenes were found in low amounts.
Key message
SA show higher toxic effect than MJ and affective than synergic use of elicitors on the organ culture of
Z. persica
. Elicitors can increase volatile compounds in different pattern compared to the previously in vivo production.
Background:
Poor muscle strength, balance, and functional mobility have predicted falls in older adults. Fall prevention guidelines recommend highly challenging balance training modes to decrease ...falls; however, it is unclear whether certain modes are more effective. The purpose of this study was to determine whether traditional balance training (BT), virtual reality balance training (VR), or combined exercise (MIX) relative to a waitlist control group (CON) would provoke greater improvements in strength, balance, and functional mobility as falls risk factor proxies for falls in older men.
Hypothesis:
We hypothesized that 8 weeks of MIX will provoke the greatest improvements in falls risk factors, followed by similar improvements after BT and VR, relative to the CON.
Study Design:
Single-blinded randomized controlled trial NCT02778841 (ClinicalTrials.gov identifier).
Level of Evidence:
Level 2.
Methods:
In total, 64 community-dwelling older men (age 71.8 ± 6.09 years) were randomly assigned into BT, VR, MIX, and CON groups and tested at baseline and at the 8-week follow-up. The training groups exercised for 40 minutes, 3 times per week, for 8 weeks. Isokinetic quadriceps and hamstrings strength on the dominant and nondominant legs were primary outcomes measured by the Biodex Isokinetic Dynamometer. Secondary outcomes included 1-legged stance on firm and foam surfaces, tandem stance, the timed-up-and-go, and gait speed. Separate one-way analyses of covariance between groups were conducted for each outcome using baseline scores as covariates.
Results:
(1) MIX elicited greater improvements in strength, balance, and functional mobility relative to BT, VR, and CON; (2) VR exhibited better balance and functional mobility relative to BT and CON; and (3) BT demonstrated better balance and functional mobility relative to CON.
Conclusion:
The moderate to large effect sizes in strength and large effect sizes for balance and functional mobility underline that MIX is an effective method to improve falls risk among older adults.
Clinical Relevance:
This study forms the basis for a larger trial powered for falls.
Highlights • The results of this study demonstrate that Xbox Kinect exercise training improved knee proprioception among elderly people. • Exergames have been reported to improve balance and mobility ...in elderly people. • Xbox Kinect exercises increase knee joint proprioception on dominant and non-dominant leg. • Xbox Kinect exercises effect on multiple knee joint angles proprioception.
Background
Notwithstanding the encouraging results of previous studies reporting on the efficiency of deep learning (DL) in COVID‐19 prognostication, clinical adoption of the developed methodology ...still needs to be improved. To overcome this limitation, we set out to predict the prognosis of a large multi‐institutional cohort of patients with COVID‐19 using a DL‐based model.
Purpose
This study aimed to evaluate the performance of deep privacy‐preserving federated learning (DPFL) in predicting COVID‐19 outcomes using chest CT images.
Methods
After applying inclusion and exclusion criteria, 3055 patients from 19 centers, including 1599 alive and 1456 deceased, were enrolled in this study. Data from all centers were split (randomly with stratification respective to each center and class) into a training/validation set (70%/10%) and a hold‐out test set (20%). For the DL model, feature extraction was performed on 2D slices, and averaging was performed at the final layer to construct a 3D model for each scan. The DensNet model was used for feature extraction. The model was developed using centralized and FL approaches. For FL, we employed DPFL approaches. Membership inference attack was also evaluated in the FL strategy. For model evaluation, different metrics were reported in the hold‐out test sets. In addition, models trained in two scenarios, centralized and FL, were compared using the DeLong test for statistical differences.
Results
The centralized model achieved an accuracy of 0.76, while the DPFL model had an accuracy of 0.75. Both the centralized and DPFL models achieved a specificity of 0.77. The centralized model achieved a sensitivity of 0.74, while the DPFL model had a sensitivity of 0.73. A mean AUC of 0.82 and 0.81 with 95% confidence intervals of (95% CI: 0.79–0.85) and (95% CI: 0.77–0.84) were achieved by the centralized model and the DPFL model, respectively. The DeLong test did not prove statistically significant differences between the two models (p‐value = 0.98). The AUC values for the inference attacks fluctuate between 0.49 and 0.51, with an average of 0.50 ± 0.003 and 95% CI for the mean AUC of 0.500 to 0.501.
Conclusion
The performance of the proposed model was comparable to centralized models while operating on large and heterogeneous multi‐institutional datasets. In addition, the model was resistant to inference attacks, ensuring the privacy of shared data during the training process.
Depression and health-related quality of life (HRQoL) are closely interrelated among hemodialysis (HD) patients and associated with negative impacts on patients' clinical outcomes. Considering ...previous reports on clinical benefits of omega-3 fatty acids in major depression and HRQoL in other patient populations, this study examined effects of omega-3 fatty acids on depression and HRQoL in chronic HD patients. In this randomized placebo-controlled trial, 40 adult patients with a Beck Depression Inventory (BDI) score of ≥16 and HD vintage of at least 3 months were randomized to ingest 6 soft-gel capsules of either omega-3 fatty acids (180 mg eicosapentaenoic acid and 120 mg docosahexaenoic acid in each capsule) or corresponding placebo, daily for 4 months. At baseline and after 4 months, 2 questionnaires of BDI and the Medical Outcome Study 36-Item Short-Form Health Survey were completed by each patient. Although baseline BDI score was comparable between the 2 groups, it was significantly lower in the omega-3 group compared with the placebo group at the end of the study (P = 0.008). Except for mental health, social functioning, and general health, other domains of HRQoL showed significant improvement in the omega-3 group compared with the placebo group at month 4 of the study (P < 0.05 for all). Regression analysis revealed that ameliorated BDI score by omega-3 treatment had considerable role in the improvement of overall HRQoL score, physical and mental component dimensions, and score of physical functioning, role-physical, and bodily pain. Supplemental use of omega-3 fatty acids in HD patients with depressive symptoms seems to be efficacious in improving depressive symptoms and HRQoL.
Background: The B vitamins can potentially help prevent migraine. This study was designed to examine the effects of supplementation with thiamine (B1), pyridoxine (B6), cobalamin (B12), folic acid ...(B9), and a combination of these vitamins on women with episodic migraine (EM).
Methods: This study was a double-blind, placebo-controlled, randomized, clinical trial conducted on 120 women with EM. The participants were divided into the 6 groups of B1 (n = 20), B6 (n = 20), B12 (n = 20), B9 (n = 20), vitamin B complex (n = 20), and placebo (n = 20). Subjects received 1 capsule daily for 12 weeks. As part of the baseline and post-intervention phases, paper-based headache diaries were used to record the number of abortive drugs consumed and the frequency of headache attacks, and the Migraine Disability Assessment Questionnaire (MIDAS) was used to assess migraine disability.
Results: A 16-week study on women with EM revealed that the mean changes in the frequency of headache attacks decreased significantly in all vitamin groups in comparison with the placebo group (P < 0.001). In contrast to the placebo, there was also a significant improvement in the migraine disability score in each vitamin group (P < 0.001). The 12-week supplementation with vitamins B9, B1, B6, B12, and B complex also brought on a significant decrease in the use of abortive drugs compared to the placebo group (P = 0.032).
Conclusion: The results of this study showed that B1, B6, B12, and B9, and a combination of these vitamins could be effective as an adjuvant in treatment and prophylaxis of EM. Further large trials with long-term follow-ups will be required to confirm our results.
Objectives
Periodic fasting (PF) was suggested to display antiepileptic and neuroprotective effects, which is in stark contrast to severe fasting or starvation. However, these beneficial effects seem ...to depend on the type and duration of the used feeding protocol. There are discrepancies concerning both antiepileptic and neuroprotective effects of a PF-diet during repetitive seizures in different epilepsy models. This study was designed to evaluate the effects of different PF protocols on behavioural and histopathological consequences of epilepsy in adult rats.
Methods
Recurrent generalized seizures were caused by repetitive injection of pentylenetetrazol (PTZ) for a period of 4 weeks every other day. While control animals had free access to food and water, animals on a PF-diet were on intermittent fasting for 24 hours every 48 hours for 4 weeks before (T1), after (T2), or both before and after (T3) the injection of PTZ. Behavioural studies were carried out after PTZ injections and histological investigations were performed after the experiments were completed.
Results
Seizure assessment showed that the severity of seizures was significantly decreased in groups T1 and T3 when compared with control rats. Dark neuron densities in hippocampal CA1 and CA3 areas were decreased in PF groups, but never in the temporal cortex. The PF-diet also decreased the number of terminal deoxynucleotidyl transferase-mediated dUTP nick end-labelling-positive neurons in the hippocampus in both areas and all PF-diet protocols.
Discussion
These results support the idea that a PF-diet has anticonvulsive and neuroprotective effects on epileptic rats but underlines that different PF-diet protocols can have varying effects. Anticonvulsive effects were strongest when the PF-diet started before the onset of excitotoxic injuries, the number of dark neurons was decreased and apoptosis was prevented by all PF-diet protocols investigated in this work. Further evaluation of PF-diet protocols for possible clinical anticonvulsant and neuroprotective effects is suggested.
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