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Automatic segmentation of glioma tumors from BraTS 2018 challenge dataset using a 2D U-Net network
Zahra Papi , Iraj Abedi, Fatemeh Dalvand, Alireza Amouheidari,
Volume 80, Issue 4 (July 2022)
Abstract
Background: Glioma is the most common primary brain tumor, and early detection of tumors is important in the treatment planning for the patient. The precise segmentation of the tumor and intratumoral areas on the MRI by a radiologist is the first step in the diagnosis, which, in addition to the consuming time, can also receive different diagnoses from different physicians. The aim of this study was to provide an automated method for segmenting the tumor and intratumoral areas.
Methods: This is a fundamental-applied study that was conducted from May 2020 to September 2021 using multimodal MRI images of 285 patients with glioma tumors from the BraTS 2018 Database. This database was collected from 19 different MRI imaging centers, including multimodal MRI images of 210 HGG patients, and 75 LGG patients. In this study, a 2D U-Net architecture was designed with a patch-based method for training, which comprises an encoding path for feature extraction and a symmetrical decoding path. The training of this network was performed in three separate stages, using data from high-grade gliomas (HGG), and low-grade gliomas (LGG), and combining two groups of 210, 75, and 220 patients, respectively.
Results: The proposed model estimated the Dice Similarity Coefficient (DSC) results in HGG datasets 0.85, 0.85, 0.77, LGG datasets 0.80, 0.66, 0.51, and the combination of the two groups 0.88, 0.79, 0.77 for regions the whole tumor, tumor core, and enhancing region in the training dataset, respectively. The results related to Hussdorf Distance (HD) for HGG datasets were 8.24, 9.92, 4.43, LGG datasets 11.5, 11.31, 2.23, and the combination of the two groups 7.20, 8.82, 4.43 for regions the whole tumor, tumor core, and enhancing region in the training dataset, respectively.
Conclusion: Using the U-Net network can help physicians in the accurate segmentation of the tumor and its various areas, as well as increase the survival rate of these patients and improve their quality of life through accurate diagnosis and early treatment.

Surgical competence in general surgery assistance: a brief report
Leila Sadati, Peigham Heidarpoor, Babak Sabet , Shahram Yazdani ,
Volume 80, Issue 5 (August 2022)
Abstract
Background: The training and education of competent and qualified surgeons have been one of the challenges of the surgical profession. The concept of surgical competence has been affected widely due to a series of developments in the new disease emergence, various surgical techniques and the introduction of advanced tools and equipment into the operating. The development of surgical competence and achieving this goal requires accurate identification and analysis of the dimensions of competence. This study was done to explain the concept of surgical competence using the 8-step Walker and Avant approach.
Methods: This study is a qualitative study that was conducted from May- October 2016 at Shahid Beheshti University of Medical Sciences. The present study is a qualitative and conceptual analysis study, which is done with Walker&Avant's eight-step approach to determine the defining characteristics of the concept of surgical competence. A systematic search was conducted between 1990 and 2020 by keywords search such as surgery, surgical, operation OR laparoscopy AND competence competency development competency proficient, proficiency, expertise, clinical, in the database like Google Scholar, PubMed, SID, Magiran, Scopus, Web of Science. Twenty articles were included in the study based on inclusion and exclusion criteria. Moreover, the defining features of the concept were extracted from it.
Results: Based on the results of this study, the concept of surgical competence was defined and the four dimensions of elements, goals, components and the process of developing surgical competence were identified. Then, by clarifying the characteristics of surgical competence, a model of surgical competence development was drawn. Surgical competence development depends on the acquisition of specialized knowledge and numerous skills that are acquired through experience and deliberated practice under the supervision of others in the surgical community of practice and over time.
Conclusion: Surgical competence is a set of observable and measurable skills that allows a surgeon to manage the surgical process independently pbt while maintaining the patient's safety. It includes specialized knowledge, communication skills, cognitive and technical skills, and basic surgical skills.

Preventable risk factors of hospital readmission in stroke patients: an integrative review
Mohammad Rajabpour, Abbas Heidary , Kavian Ghandehari , Amir Mirhaghi,
Volume 81, Issue 10 (January 2024)
Abstract
Background: Despite advances in medical treatments, readmission of stroke patients remains high and has been reported between 31% and 56.1% during the first year after discharge. The difference between the risk factors of readmission and the risk factors of stroke is not clear. The purpose of this study is: 1) to determine the preventable risk factors associated with stroke readmission and 2) to provide a conceptual model for preventable factors that effective in the readmission of stroke patients.
Methods: This integrated review was performed according to Whittemore and Knafl (2005) method in five stages including problem identification, literature search, data evaluation, data analysis, and presentation. In order to find relevant articles, PubMed, Web of Science, CINAHL, Scopus databases and Google Scholar search engine were searched. The search was conducted using the keywords "stroke," "readmission," "recurrence," "re-hospitalization," "review," and "systematic review," for the period between January 2023 and September 2023, following the PRISMA guidelines. In addition to providing a qualitative synthesis of readmission factors categorized into categories, a conceptual model of these factors was also presented.
Results: Out of a total of 3785 article titles, 38 articles were included in the study for the final analysis after screening and removing duplicates. The most important risk factors for readmission in four categories: (1) knowledge deficit about the comorbidities (such as hypertension, atrial fibrillation, diabetes), (2) unhealthy diet and medicine, (3) high-risk behaviors (smoking, alcohol consumption, and tobacco use disorder), and (4) psychological distress (depression and worry about the future). In addition, the conceptual model showed that the most important preventable factor in readmission of stroke patients is of knowledge deficit about comorbidities (especially hypertension). 
Conclusion: The most important preventable risk factors that are effective in the readmission of stroke patients are knowledge deficit regarding clinical risk factors, especially high blood pressure, high-risk behaviors and unhealthy diet and medicine. Therefore, more detailed care and follow-up programs should be designed for stroke patients after discharge.

Investigation of epidemiological and histopathological features of central nervous system tumors in the samples referred to the pathology department of a referral hospital in the east of iran in a 10-year period
Yasser Hasanzadeh, Zahra Sagheb Movafagh , Atena Sahrabeygi , Hamid Heidarian Miri , Masoumeh Gharib ,
Volume 81, Issue 10 (January 2024)
Abstract
Background: Identifying the epidemiological aspects of central nervous system (CNS) tumors is the first step in implementing management protocols to control the condition of these tumors. We aimed to examine the epidemiology and histopathology of both benign and malignant tumors of the CNS in one of the referral and university centers in the east of Iran.
Methods: This cross-sectional study was conducted on all files of patients admitted to Qaem Hospital in Mashhad City, Iran, in a period of 10 years from March 2009 to February 2018 with a definitive diagnosis of benign or malignant tumors of the CNS, including tumors of the brain, cerebellum, spinal cord, or meningeal membranes. Information sources included the patients' physical files and the hospital information system (HIS). The statistical software SPSS version 28.0 for Windows (IBM SPSS, Armonk, New York, USA) was used for the statistical analysis.
Results: In total, 775 patients with benign and 771 patients with malignant CNS tumors were included in the study. Regarding epidemiological aspects of benign tumors, the incidence rate of women was almost twice that of men (68.47% versus 31.53%), with an overall average age of 45.31±19.81 years. The most common benign tumors were meningioma (72.77%), followed by schwannoma (13.67%). Regarding malignant brain tumors, the mean age of affected patients was 36.64±19.67 years, with males accounting for 53.04% of cases and females for 46.96%. The most frequent type of tumor was glioblastoma (32.68%), followed by diffuse astrocytoma (16.47%). Both benign and malignant CNS tumors were associated with significant hospital mortality; in-hospital mortality rates for benign and malignant tumors were 10.1% and 17.5%, respectively. Tumor type and its grade were the main determinants of early death in malignant CNS tumors.
Conclusion: The epidemiological characteristics of benign and malignant tumors in our study community were similar to the reports presented in other communities. Knowledge of these characteristics provides the possibility of managing patients and reducing morbidity and mortality related to these tumors.

Mobile applications as a new way to health: a systematic review
Negar Heidari , Fatemeh Rajati , Mojgan Rajati, Paria Heidari,
Volume 81, Issue 11 (February 2024)
Abstract

                                                                  
Background: Management of chronic diseases, such as hypertension and diabetes, requires a comprehensive long-term care plan. Adherence to self-management behaviours is crucial in improving health outcomes and quality of life for individuals living with these conditions. The research highlighted in this review study aimed to explore the potential of mobile health technology in enhancing primary and secondary prevention of chronic diseases. By providing personalized interventions, mobile applications can play a significant role in supporting individuals in the self-management of their hypertension and diabetes, ultimately leading to better disease control and improved overall well-being.
Methods: The present study is a systematic review of research examining the impact of mobile application interventions on the self-management of hypertension and diabetes. The review analyzes studies published between July 2013 to March 2023, retrieved from the PubMed and Scopus international databases using keywords such as Mobile Health, mHealth, adherence, Hypertension, High Blood Pressure, and Diabetes.
Results: A total of 1398 abstracts were found, of which 12 articles met the inclusion and exclusion criteria for this study. The research indicates that mobile health (mHealth) applications have significant potential to optimize healthcare processes and facilitate improved access to health information. These digital tools can combine various treatment methods with attractive, user-friendly solutions that allow patients to actively monitor a range of health indicators, such as diet, body weight, blood pressure, mood, and sleep patterns. By enabling this type of continuous self-monitoring, mHealth apps can empower individuals to take a more active role in managing their well-being. Additionally, these applications can facilitate greater collaboration between healthcare providers, patients, and their families, thereby enhancing the overall coordination and accessibility of care. As such, mHealth technologies can be effectively leveraged in conjunction with traditional medical services to improve health outcomes and expand access to critical health information.
Conclusion: The present study found a significant increase in mobile health app usage. To understand the real, long-term impact of this technology on health, further longitudinal studies are needed. Comprehensive research is crucial to guide the development of effective digital health interventions that can improve individual and population outcomes over time.


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