Artificial Intelligence-Based Triage for Patients with Acute Abdominal Pain in emergency Department; a Diagnostic Accuracy Study

Introduction: Artificial intelligence (AI) is the development of computer systems which are capable of doing human intelligence tasks such as decision making and problem solving. AI-based tools have been used for predicting various factors in medicine including risk stratification, diagnosis and choice of treatment. AI can also be of considerable help in emergency departments, especially patients’ triage. Objective: This study was undertaken to evaluate the application of AI in patients presenting with acute abdominal pain to estimate emergency severity index version 4 (ESI-4) score without the estimate of the required resources. Methods: A mixed-model approach was used for predicting the ESI-4 score. Seventy percent of the patient cases were used for training the models and the remaining 30% for testing the accuracy of the models. During the training phase, patients were randomly selected and were given to systems for analysis. The output, which was the level of triage, was compared with the gold standard (emergency medicine physician). During the test phase of the study, another group of randomly selected patients were evaluated by the systems and the results were then compared with the gold standard. Results: Totally, 215 patients who were triaged by the emergency medicine specialist were enrolled in the study. Triage Levels 1 and 5 were omitted due to low number of cases. In triage Level 2, all systems showed fair level of prediction with Neural Network being the highest. In Level 3, all systems again showed fair level of prediction. However, in triage Level 4, decision tree was the only system with fair prediction. Conclusion: The application of AI in triage of patients with acute abdominal pain resulted in a model with acceptable level of accuracy. The model works with optimized number of input variables for quick assessment

Quality of life and knee function in patients with knee dislocation

Background: Knee dislocations are uncommon (Objectives: The objective of this study was to evaluate the clinical outcome of knee dislocation management. Subjects and Methods: A total of 20 consecutive adult patients with knee dislocation were enrolled in this cross-sectional study between 2011 and 2014. A single knee surgeon examined all the patients for knee instability for subjective evaluation of knee function using the Lysholm Knee Questionnaire, Knee Society Score (KSS), and Short Form-36 (SF-36). Results: The average Lysholm Knee Scores and KSS were 68 (range: 18100) and 65 (range: 1597), respectively. All domains of SF-36 among the studied patients were lower than that of the normal population. We could not find any correlation between age, body mass index, and interval between initial trauma and operation with outcome variables (Lysholm Knee Score, KSS, and SF-36 Physical Component Score, and SF-36 Mental Component Score). Conclusions: The knee function after proper management of dislocation is reasonable, but prolonged course of management and multiple operations may decrease the patients' quality of life

Is prior use of renin-angiotensin system (RAS) inhibitors associated with more favourable outcome in COVID-19 hospitalized patients?

Objective: We aimed to investigate the extent of pulmonary involvement and adverse outcomes in patients receiving angiotensin-converting enzyme inhibitor (ACEI)/ angiotensin II receptor blocker (ARB) versus who did not, in hospitalized coronavirus infectious disease 2019 (COVID-19) patients. Methods: All COVID-19 patients with a positive polymerase chain reaction (PCR) test, who were admitted to our tertiary referral hospitals in Tehran, Iran between January 2021 and May 2021, and had an on-admission chest computed tomography (CT) scan, were included. The patients were divided into two groups (receiving ACEI/ARB and who did not) for further analysis. The outcomes of interest in our study were the extent of pulmonary involvement, intensive care unit (ICU) admission, and death. Results: A total of 893 participants (mean age of 58.6±15.4 years; female, 522 (58.4%)) were enrolled. Among them, 368 (41.2%) participants had hypertension, and use of ACEI/ARB was reported in 183 (20.5%) participants. Of all, 409 (45.8%) participants required ICU admission, and 259 (29%) participants succumbed to death. We found that participants who received ACEI/ARB were less likely to progress critical disease and experienced significantly lower ICU admission (P=0.022) and death (P<0.001). On multivariable analysis adjusting for age, sex, and comorbidities, this relationship remained statistically significant for death [OR: 0.23 (0.14-0.38); P<0.001] and ICU admission [OR: 0.49 (0.32-0.73); P=0.001]. Conclusion: Our findings showed that COVID-19 patients who receiving ACEI/ARB prior to hospitalization vs. those who did not, had more favorable outcomes

Investigating the impact of organizational spirituality on human resources productivity in manufacturing organizations

Human resource productivity is one of the vital notions in the management of modern organizations. Many studies concerned with this notion have tried to identify the factors affecting productivity and its improvement. One of these important factors is organizational spirituality. The present study investigated the impact of organizational spirituality, from an Islamic perspective, on human resources productivity in BELFA Co., Iran, as a manufacturing organization. The study relied on a descriptive survey method and used structural equation modeling to analyze data in Smart-PLS software to fit the measurement model and the structural model. Results revealed that spirituality could predict 26% of the variance of Human resources productivity in the company, proving to be an effective factor

Association of catechol-o-methyl transferase gene polymorphism with prostate cancer and benign prostatic hyperplasia

Abstract BACKGROUND: A single nucleotide variation within catechol-o-methyl transferase (COMT) gene may alter the COMT enzyme activity level. Polymorphism of Val158Met in the COMT gene has been related to malignancy. In this regard, a study was carried out to find a possible association between the COMT gene polymorphism in patients with sporadic prostate cancer (PCa) and benign prostatic hyperplasia (BPH)