The biotin interference within interference suppressed immunoassays.

BACKGROUND: Reports of false laboratory findings due to a biotin supplementation have raised concerns about the safety of immunoassays. According to current research, biotin is known to cause interference in immunoassays. Since up to 70% of medical decisions are based on laboratory results and the significantly increased intake of biotin supplements in the recent years, the reliability of immunoassays is essential. METHODS: To evaluate this reliability two experiments were conducted. In the first experiment 59 interference suppressed immunoassays of the manufacturer Roche Diagnostics were examined regarding their sensitivity to a biotin interference. In the second experiment the pharmacokinetic of biotin was examined by supplementing volunteers with biotin. RESULTS: A combination of the results of both experiments suggests that a biotin interference in laboratory findings is probable. Contrary to the current state of research on sandwich immunoassays, falsely elevated test results occur more frequently than falsely low results. CONCLUSION: The interference suppressed immunoassays have shown in the experiment that they are susceptible to a biotin interference. Therefore, laboratory institutions, medical staff and patients must be aware of the possibility of a biotin interference. As a result, Roche Diagnostics may consider reviewing the interference suppression and their indications of the tests.

Assessing research misconduct in Iran: a perspective from Iranian medical faculty members.

BACKGROUND: Research misconduct is a global concern in biomedical science. There are no comprehensive data regarding the perception and situation of scientific misconduct among the Iranian medical faculty members. We conducted a nationwide survey to assess the research misconduct among the medical faculty members in Iran. METHODS: We used the Persian version of the research misconduct questionnaire (PRMQ) on the Google Forms platform. We sent the survey link to a systematic random sample of medical faculty members in Iran (N = 4986). Descriptive analyses were performed on the individual items of the PRMQ, with frequencies and percentages for categorical and Likert-type response items, and means and standard deviation (S.D.) for continuous variables. Chi-square analysis was conducted to test hypotheses examining differences in the frequency of responses related to factors influencing misconduct. We also defined four tenure categories (TC) based on the working years of the participants as tenured faculty members. All the analyses were performed using R 3.6.0. RESULTS: The response rate was 13.8% (692 responses). Nearly 70% of the respondents agreed that their publication output would be of higher quality if there were no publication pressure. Approximately three-quarters (N =499, 72.1%) of the respondents had been aware of some instances of research misconduct during the previous year according to their understanding of misconduct. Among the participants, 18.5% perceived the effectiveness of their associated organisation's rules for reducing research misconduct to be high or very high. Pressure for tenure was identified as the item most frequently perceived with a strong behavioural influence on engaging in research misconduct (80.2%). CONCLUSIONS: This study confirms that research misconduct needs to be actively addressed among the medical faculty members. Making policies with a focus on boosting awareness regarding the occasions of scientific misconduct and its management seems to be indispensable in the future in Iran.

Accredited cardiac arrest centers facilitate eCPR and improve neurological outcome.

BACKGROUND: Out-of-hospital cardiac arrest (OHCA) remains a frequent medical emergency with low survival rates even after a return of spontaneous circulation (ROSC). Growing evidence supports formation of dedicated teams in scenarios like cardiogenic shock to improve prognosis. Thus, the European Resuscitation Council (ERC) recommended introduction of Cardiac Arrest Centers (CAC) in their 2015 guidelines. Here, we aimed to elucidate the effects of newly introduced CACs in Germany regarding survival rate and neurological outcome. METHODS: A multicenter retrospective observational cohort study was performed at three university hospitals and outcomes after OHCA were compared before and after CAC accreditation. Primary outcomes were survival until discharge and favorable neurological status (CPC 1 or 2) at discharge. RESULTS: In total 784 patients (368 before and 416 after CAC accreditation) were analyzed. Rates of immediate percutaneous coronary intervention (40 vs. 52%, p = 0.01) and implementation of extracorporeal CPR (8 vs. 13%, p < 0.05) increased after CAC accreditation. Likelihood of favorable neurological status at discharge was higher after CAC accreditation (71 vs. 87%, p < 0.01), whereas overall survival remained similar (35 vs. 35%, p > 0.99). CONCLUSION: CAC accreditation is linked to higher rates of favorable neurological outcome and unchanged overall survival.

Using Deep Learning to Distinguish Highly Malignant Uveal Melanoma from Benign Choroidal Nevi.

Background: This study aimed to evaluate the potential of human-machine interaction (HMI) in a deep learning software for discerning the malignancy of choroidal melanocytic lesions based on fundus photographs. Methods: The study enrolled individuals diagnosed with a choroidal melanocytic lesion at a tertiary clinic between 2011 and 2023, resulting in a cohort of 762 eligible cases. A deep learning-based assistant integrated into the software underwent training using a dataset comprising 762 color fundus photographs (CFPs) of choroidal lesions captured by various fundus cameras. The dataset was categorized into benign nevi, untreated choroidal melanomas, and irradiated choroidal melanomas. The reference standard for evaluation was established by retinal specialists using multimodal imaging. Trinary and binary models were trained, and their classification performance was evaluated on a test set consisting of 100 independent images. The discriminative performance of deep learning models was evaluated based on accuracy, recall, and specificity. Results: The final accuracy rates on the independent test set for multi-class and binary (benign vs. malignant) classification were 84.8% and 90.9%, respectively. Recall and specificity ranged from 0.85 to 0.90 and 0.91 to 0.92, respectively. The mean area under the curve (AUC) values were 0.96 and 0.99, respectively. Optimal discriminative performance was observed in binary classification with the incorporation of a single imaging modality, achieving an accuracy of 95.8%. Conclusions: The deep learning models demonstrated commendable performance in distinguishing the malignancy of choroidal lesions. The software exhibits promise for resource-efficient and cost-effective pre-stratification.

A 10-year performance trajectory of top nutrition journals' impact factors.

BACKGROUND AND AIM: This study was performed to evaluate the impact factors (IFs) and total citations of ISI-indexed nutrition journals in a 10-year period from 1999 to 2008 in order to assess the quality of nutrition journals. MATERIALS AND METHODS: For this retrospective study, the IF and total citation data from 1998 to 2008 were collected through Journal Citation Reports of Thomson Scientific Corporation Web of Knowledge. We selected five highly cited journals in the "nutrition and dietetics" category for our analysis. These journals include Annual Reviews in Nutrition (ANNU REV NUTR), American Journal of Clinical Nutrition (AJCN), Progress in Lipid Research (PROG LIPID RES), Journal of Nutrition (J NUTR), and International Journal of Obesity (INT J OBESITY) RESULTS: All five selected journals were ranked as one of the top ten "nutrition and dietetics" journals between 1999 and 2008 in ISI database. Most of selected journals' IF had an upward trend during the 10-year period with fluctuation in some cases. AJCN consistently received the greatest number of total citations during the study period, although its IF was not the highest among the five journals studied. CONCLUSION: The IF illustrated changes in relative rankings of five highly cited journals included in the "nutrition and dietetics" category of the Web of Knowledge. Rank according to the absolute number of citations received, however, did not correlate with rank according to IF.

Risk of Bias in Iranian Randomized Trials Included in Cochrane Reviews.

BACKGROUND: Among interventional studies, randomized controlled trials (RCTs) provide the highest level of evidence. However, RCTs can be susceptible to the risk of bias (RoB). Systematic reviews can be performed to appraise RoB in the included articles using evaluative tools. This study aimed to describe the main characteristics and focus on the RoB of RCTs conducted in Iran and included in Cochrane Reviews (CRs). METHODS: We searched "Iran" by selecting the "Search All Text" and "Review" fields in the Cochrane Database of Systematic Reviews within Ovid. CRs that included the RCTs conducted in Iran were retrieved. A trial was selected only if it was included in CRs, described as a controlled clinical trial, involved human subjects and CR authors assessed its RoB. The trials were characterized by investigating the relevant articles and the table "Characteristics of included studies" in each CR. The RoB was investigated by collecting the review authors' judgments based on RoB assessment tables in the CRs. RESULTS: Out of 1166 Iranian RCTs included by 571 CRs, low RoB was found in 44.9% for random sequence generation, 20.8% for allocation concealment, 32.3% for blinding of participants/personnel, 36.5% for blinding of outcome assessors, 56.3% for incomplete outcome data, 41.3% for selective outcome reporting and 53.8% for other sources of bias. CONCLUSION: The RoB in Iranian RCTs was found to be mostly high or unclear. While this is similar to the global situation, it is recommended that the methodological quality of conducting and reporting RCTs be addressed in Iran.

Psychometric properties of Persian version of the research misconduct questionnaire (PRMQ).

Assessment of scientific misconduct is considered to be an increasingly important topic in medical sciences. Providing a definition for scientific research misconduct and proposing practical methods for evaluating and measuring it in various fields of medicine discipline are required. This study aimed at assessing the psychometric properties of Scientific Research Misconduct-Revised (SMQ-R) and Publication Pressure Questionnaires (PPQ). After translation and merging of these two questionnaires, the validity of the translated draft was evaluated by 11-member expert panel using Content Validity Index (CVI) and Content Validity Ratio (CVR). Reliability of the final questionnaire, completed by 100 participants randomly chosen from medical academic members, was assessed by calculating Cronbach's alpha coefficient. The final version was named Persian Research Misconduct Questionnaire (PRMQ) and consisted of 63 question items. The item-level content validity indices of 61 questions were above 0.79, and reliability assessment showed that 6 out of 7 subscales had alpha values higher than 0.6. Hence, PRMQ can be considered an acceptable, valid and reliable tool to measure research misconduct in biomedical sciences researches in Iran.

Achievements of the Cochrane Iran Associate Centre: Lessons Learned.

Healthcare decision-making is a process that mainly depends on evidence and involves increasing numbers of stakeholders, including the consumers. Cochrane evidence responds to this challenge by identifying, appraising, integrating and synthesizing high-quality evidence. Recently, a collaborative effort has been initiated in Iran with Cochrane to establish a representative local entity. A variety of multifaceted interventions were conducted according to Cochrane's strategy to 2020, such as producing evidence, making Cochrane evidence accessible, advocating for evidence and building an effective and sustainable organization. In this report, the authors present the two and half year performance and achievements of Cochrane Iran based on a comprehensive and systematic approach. This case might be an example of health diplomacy, which is initiated by a successful international collaboration and proceed with recognizing the importance of adherence to the strategic action plans and goals.

Traditional, complementary and alternative medicine in children constipation: a systematic review.

OBJECTIVES: This review aims to evaluate the efficacy and safety of complementary and alternative medicine methods for constipation in the pediatric population. EVIDENCE ACQUISITION: Medical literature search was performed in several databases for a variety of Traditional, Complementary and Alternative Medicine in childhood constipation. Databases included Web of Science, Scopus, Embase, Cochrane Library, PubMed, ScienceDirect, Google scholar and a number of Persian databases including IranDoc, Magiran and SID. No time limitation was determined. Clinical trials or case series that had evaluated the effectiveness of CAM therapies in functional constipation of 1-18 year old children were included. Papers not in English or Persian language were excluded. Related articles were screened independently by two reviewers according to their titles and abstracts. A data extraction form was filled in for each eligible paper. Quality assessment of eligible documents was also performed. RESULTS: 30 studies were included, comprising 27 clinical trials and 3 case series. Ten documents were on herbal medicine, nine on traditional medicine, ten on manual therapies and one on homeopathy. Except for two herbal and one reflexology interventions, all studies reported positive effects on childhood constipation, with the majority being statistically significant. As the number of studies in each method was limited, we could not perform a meta-analysis. CONCLUSION: The scarcity of research on the efficacy and safety of different types of complementary and alternative medicine methods in children with constipation necessitates conducting more studies in each field. Graphical abstract.

Assessing the Prevalence of Publication Misconduct among Iranian Authors Using a Double List Experiment.

BACKGROUND: This study was done to determine the prevalence of publication misconduct among Iranian authors. METHODS: Data were collected through an email survey of corresponding authors of papers published in Iranian journals indexed in Scopus during 2009-2011. Using the double list experiment, these individuals were indirectly questioned about committing one of the five misconducts including duplicate publication, falsification, guest authorship, plagiarism, and fabrication over the past year. RESULTS: The survey was sent to 2321 individuals; 100 emails bounced, and of the remaining, 813 (36.60%) people responded to the questions. The prevalence rates were 4.15% for fabrication, 4.90% for plagiarism, 18.10% for guest authorship, 12.65% for falsification of the study methods, and -5.40% for duplicate publication. Among respondent 56.50% trusted the method and confidentiality of the survey and 6.50% did not trust the method or confidentiality at all. CONCLUSION: We found that the double list experiment method is simple and reliable for use in the academic community, and it can be conducted easily in an e-survey. According to our results, the most common misconducts among Iranian authors are guest authorship and falsification of the methodology. In light of the negative and maleficent impact of publication misconduct in the scientific society, we recommend raising awareness and educating authors and investigators in this regard. To determine the accuracy of the method used in this study, further studies on publication misconduct using a control group and direct questioning, as well as other indirect methods are suggested.

Physical activity, sex, and socioeconomic status: A population based study.

BACKGROUND: The purpose of the present study was to investigate physical activity by socioeconomic status (SES) and sex in an Iranian adult population. METHODS: In a cross-sectional study, 6622 adults, who participated in the Isfahan Healthy Heart program (IHHP) surveys in 2004 and 2005 and were living in urban areas, were studied. Daily leisure time, household, occupational, and transportation physical activity, and total physical activity were calculated and compared in 3 socioeconomic status groups classified by the two-step cluster analysis procedure. RESULTS: Statistically significant variations were found in all physical activity levels, except transportation, by sex. Men were more active than women in all fields, except household physical activity. Leisure time physical activity of men and women were significantly higher in higher SES levels. There was an opposite correlation between SES and total physical activity in men. CONCLUSION: Considering the importance of physical activity as a component of a healthy lifestyle, differences among varying socioeconomic status and sex must be considered while planning for healthy lifestyle programs. Women with low SES, in particular, may need more attention.

The influence of gender and place of residence on cardiovascular diseases and their risk factors. The Isfahan cohort study.

OBJECTIVE: To determine the impact of gender and place of residence on cardiovascular disease (CVD) events and related risk factors. METHODS: In a prospective cohort study, 6323 participants free of CVD (3255 women), with age of more than 35 years from 3 cities (Isfahan, Najafabad, and Arak) and their rural districts in central Iran were followed-up from 2001 to 2007. This study was carried out at the Cardiovascular Research Institute of Isfahan University of Medical Sciences, Isfahan, Iran. Endpoints were defined as fatal- and nonfatal myocardial infarction, sudden cardiac death, unstable angina and stroke that constituted CVD events. RESULTS: Subjects in the rural area had significantly better risk factor profile in terms of most CVD risk factors in both genders, but it was reverse for low density lipoprotein (LDL)-cholesterol in both genders, and smoking in men. Except for smoking, men had an overall better risk factor profile compared to women. The age and risk factors adjusted hazard ratio of living in rural area was 0.71 (95% confidence interval [CI]: 0.51-0.99) for men, and 0.63 (95% CI: 0.44-0.91) for women. The age of CVD occurrence was similar in men and women, and in rural and urban areas. Hypertension was the strongest predictor of these events except for rural men showing that high LDL-cholesterol was the strongest risk factor. CONCLUSION: The findings in this study documented differences in CVD risk factors affecting the occurrence of CVD events according to gender and place of residence. Such differences should be taken into account in future preventive public health strategies for CVD prevention.

Evidence-based medical practice in developing countries: the case study of Iran.

RATIONALE, AIMS AND OBJECTIVES: Attitude towards and knowledge of various groups of health care providers regarding evidence-based medicine (EBM) have been assessed worldwide. Also, barriers to practising EBM have been found to be different in different countries. However, there is little evidence on the place of EBM among some developing countries, like Iran. The aim of this study was to explore the current status of EBM among different medical specialists in Iran. METHODS: This cross-sectional study was conducted from August 2007 until March 2009 on a sample of 181 doctors in different medical specialties practising in Isfahan, Iran, not including faculty members. Attitude towards EBM and the barriers in practice and awareness of technical terms were investigated through a self-administered questionnaire. RESULTS: Less than half (41%) of the doctors reported they use EBM in their practice. They believed EBM improves the quality of health care services (70%); however, their understanding of the technical terms used in EBM was poor. The barrier to practising EBM identified by most respondents (74.3%) was the lack of EBM training courses in their academic curriculum. CONCLUSION: Despite the general welcoming attitude of all groups of specialists, they had insufficient knowledge and inadequate use of EBM in their practice. Designing and conducting EBM training courses and its integration into the general practitioners' training curriculum should be considered.

Science production in Iran: The scenario of Iranian medical journals.

In Iran, the number of published articles has increased significantly in the basic and applied sciences including medicine and its subspecialties during the recent years. The present study reviewed Iranian science production in medicine, focusing on Iranian medical journals and assessing the current status of Iranian medical journals in several information databases. The study revealed that only a few number of Iranian biomedical journals were indexed by Web of Science, Medline, Scopus and Biological abstract, but most of them have been covered by Index Copernicus and Index Medicus for Eastern Mediterranean Region. Observing some important factors such as journal's basic publishing standards may increase the number of Iranian medical journals indexed by reputable information databases and improve Iranian contribution to the world science.