Background The identification of statistical models for the accurate forecast and timely determination of the outbreak of infectious diseases is very important for the healthcare system. Thus, this study was conducted to assess and compare the performance of four machine-learning methods in modeling and forecasting brucellosis time series data based on climatic parameters. Methods In this cohort study, human brucellosis cases and climatic parameters were analyzed on a monthly basis for the Qazvin province-located in northwestern Iran-over a period of 9 years (2010-2018). The data were classified into two subsets of education (80%) and testing (20%). Artificial neural network methods (radial basis function and multilayer perceptron), support vector machine and random forest were fitted to each set. Performance analysis of the models were done using the Root Mean Square Error (RMSE), Mean Absolute Error (MAE), Mean Absolute Root Error (MARE), and R 2 criteria. Results The incidence rate of the brucellosis in Qazvin province was 27.43 per 100,000 during 2010-2019. Based on our results, the values of the RMSE (0.22), MAE (0.175), MARE (0.007) criteria were smaller for the multilayer perceptron neural network than their values in the other three models. Moreover, the R 2 (0.99) value was bigger in this model. Therefore, the multilayer perceptron neural network exhibited better performance in forecasting the studied data. The average wind speed and mean temperature were the most effective climatic parameters in the incidence of this disease.
Purpose:To investigate the effect of single session Extracorporeal Shock Wave Therapy (ESWT) over the ankle plantar flexor muscles on the spasticity, muscle architecture, and gait in chronic stroke patients. Methods:This quasi-experimental, single group study had a repeated measures design. A total of 17 post-stroke patients were selected by convenience sampling method, and received 2000 shots of ESWT on the ankle plantar flexor muscles of the affected side in one session. Outcome measures consisted of Modified Modified Ashworth Scale (MMAS), bilateral leg circumference, and muscle architecture parameters (pennation angle, fascicle length, and muscle thickness) of the medial head of the gastrocnemius muscle, timed up and go (TUG) test, self-reported visual analog scale (VAS) of spasticity, and ankle passive Range of Motion (pROM). All outcomes were measured at 2 times: before the intervention and 30 minutes after the intervention. The muscle architecture parameters and leg circumference were also measured immediately after the intervention. Statistical analysis was done using SPSS 18.0. Repeated measures analysis of variance (ANOVA) was performed to evaluate the effects of intervention in time.Results: Wilcoxon test revealed significant improvement in MMAS. Significant improvement in VAS, pROM, and TUG test results is also noted by means of the paired t test. ANOVA showed significant time×side interaction for the pennation angle and leg circumference. Significant effect of time was also shown by ANOVA for leg circumference. Post hoc analyses showed a significant difference for the leg circumference before the intervention and 30 minutes after it. ANOVA showed no significant change in fascicle length and muscle thickness. Spearman's rho revealed significant positive correlation between the changes of the ankle pROM and improvement of the fascicle length. Conclusion:According to the results single session of ESWT over the spastic plantar flexors muscle can improve clinical measures of muscle spasticity and motor function. More studies are needed to clarify the underlying mechanisms for the antispastic effect of ESWT.
Abstract- As dissemination of Tuberculosis (TB) to soft tissue is not a usual finding, sometimes it is not considered for differential diagnosis and, if so, is overlooked by most health care professionals. Although rare, TB should be considered in the differential diagnosis of cysts of the thigh, especially in endemic areas. We report the case of an 80-year-old female presented with cyst with purulent discharge in her lateral left thigh that was persistent to other surgical and antibiotic treatments. Polymerase chain reaction (PCR) showed positive results for TB. Anti-tubercular therapy had promising results. Our case serves to highlight the importance of considering a reactivated TB infection in individuals with chronic discharge, especially if symptoms are not classic or fail to respond to conventional therapy. Histological study and MRI are useful tools to guide diagnosis, with confirmation provided by PCR.
Background: Human infection affected by severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) has been recognized as a global health concern. We report the epidemiological and clinical characteristics of patients with a familial cluster of SARS-CoV-2 from Qazvin province (located in the northwest of Iran). Methods: In this cross-sectional study, we enrolled 332 hospitalized patients that were confirmed SARS-CoV-2 diseases with laboratory-based (PT-PCR) test in Qazvin province, Iran. Having family infection transmission and subsequently, family clustering of SARS-COV-2 disease was assessed with the Generalized Estimating Equation model in patients. Results: Crude odds ratio estimates of creating family clustering of SARS-CoV-2 infection was 0.47 times [95% CI: 0.23, 0.98, p=0.045] less for female compared to the males; 2.26 [95% CI: 1.11, 4.58, p=0.024] and 2.69 [95% CI: 1.47, 4.93, p=0.001] for SARS-CoV-2 patients that had digestive and muscle pain in comparison with those did not this mentioned symptoms, respectively. 1.52 [95% CI: 1.05, 2.23, p=0.024] for patients with a longer hospitalization compared with patients that had shorter duration of hospitalization and adjusted odds ratio estimates were 2.13 [95% CI: 1.12, 4.03, p=0.020] for patients who receive public health services in comparison those did not receive public health services. Conclusion: Our findings confirm the person-to-person transmission of this novel coronavirus in family settings and hospitals, and the reports of infected travelers in other geographical regions. Major gaps in our knowledge about the potential factors in creating family clustering of SARS-CoV-2 infection, epidemiology, duration of human transmission and etc. need fulfillment by future studies.
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