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In this work, we characterize the fixed points of the doubly stochastic operators defined on discrete spaces $ \ell ^p(I) , $ ℓ p (I) , where I is a nonempty set and $ p\in [1,+\infty). $ p ∈ [ 1 , + ∞). We use our results to characterize all Markov chains with infinite state space and doubly stochastic transition probability matrix that have at least one stationary distribution vector. [ABSTRACT FROM AUTHOR]

Labor induction despite an unriped cervix is one of the most common indications of the use of prostaglandines. This clinical trial was performed to compare the effectiveness of oxytocin with misoprostol for induction of labor in Bahonar Hospital, Kerman/Iran from 1999 to 2000. Sixty pregnant women with indication for labor induction were randomly assigned to receive misoprostol or oxytocin. Misoprostol in tablet form. 25 µg, was placed in the posterior fornix and was repeated every four hours in the first group (to a maximum of 100 µg). The second group received intravenous oxytocin (21 µm/min). The results showed that 83.3% of women in the misoprostol group were delivered vaginally within 3.5-21 hours of the initiation of induction versus 76.7% within 4.5-17.5 hours in oxytocin group and there was no significant difference between them. The total cesarean rate was between them. The total cesarean rate was approximately similar in the two groups. Women receiving oxytocin had higher rate of cesarean for distocia (5 versus 1). The mean and median interval from induction to delivery were not significantly different between the two groups, (685±223 and 710 minutes in the first group compared with 685±198 and 690 minutes in the second group, respectively). There were no significant differences in Apgar score and meconium staining between the two groups. Hyperstimluation was seen in a patient in the first group with neither low Apgar score nor adverse neonatal outcomes. This study showed that the outcome of induction was not significantly different in the two groups. Therefore regarding the advantages of misoprostol, it is recommended as an alternative to oxytocin.

Background and Objective: The excessive and inappropriate use of the internet may lead to addiction. According to the fact that students spend many hours online to do their homework, study their lessons, and do research, their general health is in danger. This study aimed to determine the relationship between internet addiction and general health in Shahroud University of Medical Sciences in 2015. Materials and Methods: In this cross-sectional study, 187 nursing students were attending in second semester of 2014-2015 in Shahroud University of Medical Sciences. Data were collected through census method using three questionnaires including demographic characteristics, internet addiction test (IAT), and Goldberg general health questionnaire (GHQ). Data were analyzed using independent t-test, one-way ANOVA, and chi-square test. Results: The mean and standard deviation of age of students who participated in this study was 21.63±3.25 years. Fifty two point four percent of the students were female and 89.8% were single. Also, the mean and standard deviation of the hours of using the social networks was 2.65±1.14 per day. There was a statistically significant relation between internet addiction and general health (p<0.001), normal users of internet were less exposed to the dangers of damage to general health. Conclusion: General health was damaged in one third of the students and with regard to its relationship to internet addiction, preventing interactions seem necessary. [ABSTRACT FROM AUTHOR]

Plasma levels of six protease inhibitors have been measured in patients with chronic urticaria, chronic urticaria with angio-ocdema, cold and cholinergic urticaria. In chronic urticaria C1 esterase inhibitor activity was increased compared with a reference control population but there was no detectable abnormality of any other protease inhibitor. Patients with chronic urticaria/angio-oedema showed a reduction in inter-α trypsin inhibitor. They also manifested a rise in C1 esterase inhibitor. In cold urticaria there was a significant lowering of α1 antichymotrypsin. The reduction in α1 antitrypsin in this group probably reflects a genetic difference compared with the control population. Patients with cholinergic urticaria also showed a reduction of α1 antichymotrypsin. The elevated levels of α2 macroglobulin in the three groups are probably due to differences in the mean age of these groups compared with the reference population. Comparison of levels in subgroups of patients with and without active lesions suggest that a consumptive effect may contribute to the reduced values, although it seems unlikely to account for them entirely. The results suggest that involvement of pharmacologically active products of protein digestion may be involved in the pathogenesis of urticaria and should prompt attempts to identify these agents and encourage trial of medications which lead to inhibition of proteolytic activity in urticaria. [ABSTRACT FROM AUTHOR]

In a double-blind placebo-controlled study, danazol, an attenuated androgen, was effective in reducing exercise-induced weals in cholinergic urticaria. Danazol treatment also caused significant elevations of several protease inhibitors, particularly antichymotrypsin which has been reported previously to be low in cholinergic urticaria. [ABSTRACT FROM AUTHOR]

Deep-learning tools that extract prognostic factors derived from multi-omics data have recently contributed to individualized predictions of survival outcomes. However, the limited size of integrated omics-imaging-clinical datasets poses challenges. Here, we propose two biologically interpretable and robust deep-learning architectures for survival prediction of non-small cell lung cancer (NSCLC) patients, learning simultaneously from computed tomography (CT) scan images, gene expression data, and clinical information. The proposed models integrate patient-specific clinical, transcriptomic, and imaging data and incorporate Kyoto Encyclopedia of Genes and Genomes (KEGG) and Reactome pathway information, adding biological knowledge within the learning process to extract prognostic gene biomarkers and molecular pathways. While both models accurately stratify patients in high- and low-risk groups when trained on a dataset of only 130 patients, introducing a cross-attention mechanism in a sparse autoencoder significantly improves the performance, highlighting tumor regions and NSCLC-related genes as potential biomarkers and thus offering a significant methodological advancement when learning from small imaging-omics-clinical samples., Competing Interests: Declaration of interests The authors declare no competing interests., (Copyright © 2024 The Author(s). Published by Elsevier Inc. All rights reserved.)

Background: A high workload may negatively impact the surgical team's performance and jeopardize patient safety. The aim of this study was to measure the workload of the surgical team across different surgical roles, specialties, and techniques in several hospitals., Methods: This cross-sectional multicenter study was performed in the operating rooms of eight teaching hospitals affiliated with Isfahan University of Medical Sciences, Iran. At the conclusion of each surgical procedure, all members of the surgical team completed the Surgery Task Load Index (SURG-TLX) questionnaire to assess workload levels. Descriptive statistics, analysis of variance (ANOVA), and Pearson correlations, were performed to compare surgical roles, specialties, techniques, and surgical time on workload overall and by subscale., Results: A total of 409 workload questionnaires were obtained from 76 surgical teams or cases, involving 346 surgical team members. The total workload among all participants was 32.41 ± 17.21. Surgical complexity, physical demands, and mental demands were the highest workload subscales and distraction was the lowest workload subscale. Cardiovascular specialty had a higher workload compared to other specialties. Open techniques resulted in a higher workload compared to minimally invasive techniques. Surgical technologists who act in both the role of circulating and scrub nurse (C&Ss) experienced the highest workload, followed by surgical residents and surgeons., Conclusions: The results of the study showed that the workload for some members of the surgical team is disproportionately high and is influenced by factors such as specialty, technique, role, and surgical duration. By knowing the distribution of workload among the members of the surgical team, efforts can be made to optimize the team members' workload., (© 2023. The Author(s).)

Microscopic observation correlated with chemical-mineralogical characterization was performed on pigment samples from "Abrigo del Lince" rock art site (V-IV millennium BC), in order to provide contributions to the study of prehistoric schematic art on granite in the province of Badajoz (Spain). The research objectives include the understanding of technological and cultural aspects, as well as of conservation and deterioration issues related to the pictographs. The multi-analytical approach encompasses the integration of microscopic observation, SEM-EDS analysis, micro-Raman spectroscopy, and ATR-FTIR and allowed to achieve a multispectral overview of the samples and to describe their varied composition and the alteration pattern which connects them. The main phases overlying the granitic bedrock and involved in this sequence are as follows: hematite, whewellite, and gypsum. While hematite could be stratigraphically considered the most ancient layer and assigned to the use of red ochre as a pigment, whewellite and gypsum are the main constituent of the alteration layer which forms a patina over the pictographs, due to weathering processes. Finally, the role of biofilms in rock art conservation is discussed, suggesting that, especially for what concern thin and homogenous layers of oxalates, their presence should not be necessarily considered an issue., (© 2022. The Author(s).)

Background and Objectives: Diabetic retinopathy (DR) is the leading cause of blindness worldwide, and therefore its early detection is important in order to reduce disease-related eye injuries. DR is diagnosed by inspecting fundus images. Since microaneurysms (MA) are one of the main symptoms of the disease, distinguishing this complication within the fundus images facilitates early DR detection. In this paper, an automatic analysis of retinal images using convolutional neural network (CNN) is presented., Methods: Our method incorporates a novel technique utilizing a two-stage process with two online datasets which results in accurate detection while solving the imbalance data problem and decreasing training time in comparison with previous studies. We have implemented our proposed CNNs using the Keras library., Results: In order to evaluate our proposed method, an experiment was conducted on two standard publicly available datasets, i.e., Retinopathy Online Challenge dataset and E-Ophtha-MA dataset. Our results demonstrated a promising sensitivity value of about 0.8 for an average of >6 false positives per image, which is competitive with state of the art approaches., Conclusion: Our method indicates significant improvement in MA-detection using retinal fundus images for monitoring diabetic retinopathy.

The lack of publicly available datasets of computed-tomography angiography (CTA) images for pulmonary embolism (PE) is a problem felt by physicians and researchers. Although a number of computer-aided detection (CAD) systems have been developed for PE diagnosis, their performance is often evaluated using private datasets. In this paper, we introduce a new public dataset called FUMPE (standing for Ferdowsi University of Mashhad's PE dataset) which consists of three-dimensional PE-CTA images of 35 different subjects with 8792 slices in total. For each benchmark image, two expert radiologists provided the ground-truth with the assistance of a semi-automated image processing software tool. FUMPE is a challenging benchmark for CAD methods because of the large number (i.e., 3438) of PE regions and, more especially, because of the location of most of them (i.e., 67%) in lung peripheral arteries. Moreover, due to the reporting of the Qanadli score for each PE-CTA image, FUMPE is the first public dataset which can be used for the analysis of mortality and morbidity risks associated with PE. We also report some complementary prognosis information for each subject.

Background: Stress urinary incontinence in women is a common problem that impairs the quality of life in patients. The extraordinary number of procedures to treat stress urinary incontinence reflects a lack of consensus on an appropriate intervention for this problem., Objectives: The current study aimed to compare the results of transobturator tape (TOT) procedure and anterior colporrhaphy with the Kelly's Plication to treat women with stress urinary incontinence., Patients and Methods: This randomized clinical trial was conducted on 60 patients with stress urinary incontinence referred to Afzalipour Hospital in Kerman, Iran. The patients were randomly divided into two surgery groups and were subsequently assessed regarding the outcomes of the procedures, incontinence symptoms and complications during the follow-up period., Results: The cure rates at follow-up period of one month, six months and one year after surgery were 86.7%, 80% and 80% in the TOT group versus 80%, 70% and 66.7% in the anterior colporrhaphy with the Kelly's Plication group, respectively. There were no significant differences between the two groups in the aforementioned follow-up periods (P = 0.68, P = 0.54 and P = 0.22, respectively)., Conclusions: The current results showed no significant differences between the outcomes of the two procedures at short-term follow-up. However, the results might have changed in the long term.

Background: Integrons are the major reasons of multidrug resistance (MDR) among enteropathogenic bacteria. Occurrence of horizontal gene transfer between integron-carrying microorganisms and other enteric bacteria may increase the rate of emergence of integron-associated antibiotic resistance., Objectives: The objective of this study was to investigate class 1 integrons among members of enteropathogenic bacteria isolated from patients in Iran., Materials and Methods: A total of 120 enteropathogenic bacterial isolates from diarrhoeal patients were included in this study. Identities of the isolates were investigated by biochemical tests and confirmed by genus or species specific PCRs. Antimicrobial susceptibility testing was performed according to the Clinical and Laboratory Standards Institute (CLSI) guidelines. Presence of class 1 integron among the isolates was investigated using primers specific for the integrase gene conserved region., Results: The result of this study showed the highest resistance to trimethoprim and cotrimoxazole, especially in enteropathogenic Escherichia coli (EPEC) (100%), Shigella sonnei (93.7%) and Vibrio cholerae (95%). The results showed that 16 (57.1%) of the 28 EPEC, 9 (25%) of the 36 Salmonella enterica, 32 of the 13 (40.6%) Sh. sonnei, and only 1 (4.2%) of the 24 V. cholerae isolate harbored class 1 integron., Conclusions: The data obtained in the present study suggested that class 1 integrons are widely distributed among members of Enterobacteriaceae. The resistance patterns of our E. coli, S. sonnei, and S. enterica isolates were nearly identical, suggesting the same genetic elements involved in attainment of multi-drug resistance.

Objectives: The aim of this study was to investigate the occurrence and resistance gene content of class 1 and 2 integrons among Shigella spp. and to study the genetic diversity of isolates using the pulsed-field gel electrophoresis (PFGE) method., Methods and Results: A total of 32 Shigella spp. were identified from 700 stool samples of patients with diarrhea from two provinces in Iran. S. sonnei (70.8%) and S. flexneri (62.5%) were the most frequent serogroups in Tehran and Razavi Khorasan provinces, respectively. Class 2 integrons were more frequent among Shigella spp. in comparison with class 1 integrons. Three different resistance gene arrays were identified among class 1 integrons. Dihydrofolate reductase (dfrA) gene cassette was detected in 78.9% of total integrons (class 1 and 2). PFGE analysis revealed clonal dissemination (62.5%) of a single clone with identical class 2 resistance gene content in Tehran province. Comparison of our Shigella pulsotypes with those published from other countries showed similar pulsotypes in India and Korea, with identical resistance profiles, which suggests dissemination of this (these) clone(s) in Asian countries., Conclusions: Class 2 integrons were found to be predominant among our Shigella spp. This reflects the need to monitor the acquisition and dissemination of different resistant gene cassettes among integrons. Comparison of PFGE pattern through standard procedures promoted the molecular epidemiological surveys and identification of clonal isolates in Iran and other Asian countries.

Background: Pregnant women with previous gestational diabetes mellitus are at increased risk of progressive carotid artery disorders. The current study evaluated carotid intima-media thickness (IMT) in pregnant women with gestational diabetes at two time points of mid-term and full-term pregnancy to determine whether gestational diabetes mellitus causes increased IMT., Methods: This cross-sectional study carried out at Afzalipour Hospital (Kerman, Iran) between 2009 and 2010, recruited 50 women who were at high risk of gestational diabetes during pregnancy and had an oral glucose challenge test (OGCT) as screening for gestational diabetes. B-mode ultrasound scans were performed at baseline and at two time points of mid-term pregnancy (20 to 24 weeks) and full-term pregnancy (36 to 38 weeks) on all the participants. The mean IMT of common carotids and internal carotid arteries from two walls (near and far walls) at four different angles was assessed., Results: An overall comparison between the impaired OGCT test group and the control group revealed significant differences in carotid IMT in the mid-term (0.65 ± 0.07 vs. 0.59 ± 0.06 mm; p value = 0.002) and full-term (0.65 ± 0.05 vs. 0.59 ± 0.04 mm; p value < 0.001) pregnancy; however, the trend of the changes in carotid IMT during mid to full-term pregnancy was insignificant in each group (p value > 0.05)., Conclusion: Carotid IMT was significantly higher in the women with gestational diabetes than that in the normoglycemic group in different trimesters. This finding denotes that atherosclerosis might start years before the diagnosis of gestational diabetes in vulnerable women.

Objective: To evaluate subsequent pregnancy outcome and impact of gestational age at onset of HELLP on long-term prognosis after HELLP over an average follow-up of 5 years, Study Design: One hundred twenty-eight patients with a history of HELLP filled out questionnaires and sent their medical records. Hemolysis, elevated liver enzymes, and low platelets data were stratified according to gestational age at onset of HELLP < or =28 weeks and >28 weeks., Results: Fifty-three patients had subsequent pregnancies with 24% complicated by HELLP and 28% by preeclampsia. During follow-up, 33% of the patients had new onset hypertension develop, 32% had depression develop, 26% had anxiety develop, and 2.4% required dialysis. There was no significant difference in long-term outcome between comparison groups., Conclusion: Patients with a history of HELLP are at increased risk for preeclampsia and HELLP as well as long-term morbidities as depression and chronic hypertension. Gestational age at the onset of HELLP could be a predictor for long-term outcome.

Objective: Infertility is one of the most common causes of women refer to gynecology clinics. Galactorrhea is defined as one of the causes of infertility caused by luteal phase defect and anovulatory cycles. The study aim was to investigate the effect of bromocriptine on pregnancy rate in infertile women with galactorrhea with or without high prolactin level., Materials and Methods: In a prospective study, consecutive women with infertility and galactorrhea who referred to Afzalipour Hospital and a private clinic during 5 years from May 2001 to May 2006 were included. The study was conducted on 205 infertile women (18-39 years) with galactorrhea. They were treated with 2.5 mg bromocriptine BID for up to 6 months., Results: The mean duration of sterility was 43.1 +/- 37.1 months (range, 12-16). 76.1% of patients showed positive signs for pregnancy. The pregnancy rate was 81.7% in the patients with high prolactin level (>20 ng/dl) and 74.3% in the patients with normal prolactin level (P = 0.26). There was a significant difference between mean duration of treatment with bromocriptine in women with and without pregnancy, 103.71 and 193.03 days, respectively (P < 0.001)., Conclusion: Considering the efficacy of bromocriptine in the treatment of infertile women with galactorrhea, we suggest treatment with bromocriptine in these patients regardless of serum prolactin level.

Background: Abnormal uterine bleeding is one of the most common gynecological problems in women aged 15-45 years. The relationship of hyperprolactinemia with reproductive disorders, amenorrhea and irregular menstrual cycles has been known. The aim of the present study was to determine the frequency of hyperprolactinemia and galactorrhea in 15-45-year-old females with abnormal uterine bleeding., Methods: This analytic descriptive study was carried out on 100 women referred to a gynecology clinic for vaginal bleeding without any organic disorder. Consecutive sampling was performed., Results: Among the cases 61% had hyperprolactinemia and galactorrhea was reported in 48% of these patients. There was a significant association between hyperprolactinemia and galactorrhea (p = 0.003); 46% of patients with galactorrhea and 75% of patients without galactorrhea had a high level of prolactin. Galactorrhea and hyperprolactinemia had no significant association with the type of abnormal uterine bleeding. Among patients with undiagnosed vaginal bleeding, hyperprolactinemia was present in more than 50% of them and in 46% it was associated with galactorrhea., Conclusion: Hyperprolactinemia that presents a gynecological problem may or may not be accompanied by galactorrhea, and galactorrhea cannot be a certain index for hyperprolactinemia.

The HI-antihistamine chlorpheniramine and the H2-antihistamine cimetidine, given alone and in combination, have been compared with placebo in twenty patients with factitious urticaria (dermographism), in a double-blind, randomized cross-over trial. Of these regimes, the combination was the only treatment which significantly reduced weal size, flare size and duration of weal, compared with placebo, although other treatments approached statistical significance. Continuation of the most effective of the four treatments in nineteen of the patients for a further 3 months without breaking the randomization code provided further evidence of the great effectivness of combined cimetidine and chlorpheniramine. No significant side effects were note.