Challenges and advantages of electronic prescribing system: a survey study and thematic analysis.

INTRODUCTION: Electronic prescribing (e-prescribing) systems can bring many advantages and challenges. This system has been launched in Iran for more than two years. This study aimed to investigate the challenges and advantages of the e-prescribing system from the point of view of physicians. METHODS: In this survey study and thematic analysis, which was conducted in 2023, a researcher-made questionnaire was created based on the literature review and opinions of the research team members and provided to the physician. Quantitative data were analyzed using SPSS software, and qualitative data were analyzed using ATLAS.ti software. Rank and point biserial, Kendall's tau b, and Phi were used to investigate the correlation between variables. RESULTS: Eighty-four physicians participated in this study, and 71.4% preferred to use paper-based prescribing. According to the results, 53.6%, 38.1%, and 8.3% of physicians had low, medium, and high overall satisfaction with this system, respectively. There was a statistically significant correlation between the sex and overall satisfaction with the e-prescribing system (p-value = 0.009) and the computer skill level and the prescribing methods (P-value = 0.042). Physicians face many challenges with this system, which can be divided into five main categories: technical, patient-related, healthcare providers-related, human resources, and architectural and design issues. Also, the main advantages of the e-prescribing system were process improvement, economic efficiency, and enhanced prescribing accuracy. CONCLUSION: The custodian and service provider organizations should upgrade the necessary information technology infrastructures, including hardware, software, and network infrastructures. Furthermore, it would be beneficial to incorporate the perspectives of end users in the system design process.

Covid-19 outbreak associated with demographic-meteorological factors in the arid and semi-arid region Iran: case study Gonabad city, 2020-2021.

Since the (Covid-19) pandemic outbreak, questioning regarding climate and incident of Covid-19 infection rates has been debated, while there is no clear research evidence until now in Iran. This study has focused on investigating the association between Covid-19 cases and demographic -meteorological factors in arid and semi-arid zones of Iran (from March 1, 2020, to January 31, 2022) by analyzing with Via Poisson and negative binomial regression. As a result, the incidence rate of both Covid-19 hospitalization and mortality cases reached peaks in the summer followed by the autumn. Interestingly, Covid-19 hospitalization cases are associated with humidity, temperature, and wind factors seasonally and monthly, but mortality cases are just associated with wind. In conclusion, the result demonstrated that demographicand meteorological factorsare positively and negatively associated with Covid-19 cases. Therefore, identifying the environmental factors contributing to the excess Covid-19 can help to prevent future pandemic waves in Iranian arid and semi-arid zone.

Melanoma: Where we are and where we go.

Melanoma is known as an aggressive tumor which shows an increasing incidence and poor prognosis in the metastatic phase. Hence, it seems that diagnosis and effective management (including early diagnosis, choosing of the effective therapeutic platform, caring, and training of patients for early detection) are major aspects of melanoma therapy. Early detection of melanoma is a key point for melanoma therapy. There are various diagnosis options such as assessing of biopsy, imaging techniques, and biomarkers (i.e., several proteins, polymorphism, and liquid biopsy). Among the various biomarkers, assessing circulating tumor cells, cell-free DNAs, cell-free RNAs, and microRNAs (miRNAs) have emerged as powerful diagnosis tools for melanoma patients. Deregulations of these molecules are associated with melanoma pathogenesis. After detection of melanoma, choosing of effective therapeutic regimen is a key step for recovery of melanoma patients. Several studies indicated that various therapeutic approaches including surgery, immunotherapy, systematic therapy, radiation therapy and antibodies therapy could be used as potential therapeutic candidates for melanoma therapy. Caring for melanoma patients is one of the important components of melanoma therapy. Caring and training for melanoma patients could contribute to better monitoring of patients in response to various therapeutic options. Here, we summarized various diagnosis approaches such as assessing biopsy, imaging techniques, and utilization of various biomarkers (i.e., proteins, CTCs, cfDNAs, and miRNAs) as a diagnostic biomarker for detection and monitoring patients with melanoma. Moreover, we highlighted various therapeutic options and caring aspects in patients with melanoma.

The effect of a supportive educational intervention developed based on the Orem's self-care theory on the self-care ability of patients with myocardial infarction: a randomised controlled trial.

AIMS AND OBJECTIVES: The aim of this study was to assess the effect of a supportive educational intervention developed based on the Orem's self-care theory on the self-care ability of patients with myocardial infarction. BACKGROUND: Patients with cardiovascular disease suffer from the lack of knowledge about the disease and consequently are not able to fulfil their own self-care needs. DESIGN: This was a randomised controlled trial conducted in 2012. METHODS: We recruited a random sample of 66 patients with myocardial infarction who had been recently discharged from coronary care unit. The study setting was two university hospitals located in Khorasan, Iran. Patients were randomly allocated to either the experimental or the control groups. Patients in the experimental group received education, support, and counselling while patients in the control group received no intervention. We employed a demographic questionnaire and the Myocardial Infarction Self-Care Ability Questionnaire for data collection and spss version 16.00 for data analysis. FINDINGS: After the study, patients in the experimental group had higher levels of self-care knowledge, motivation and skills compared to the prestudy readings and the control group. CONCLUSION: The supportive educational intervention developed based on the Orem's self-care theory can improve nonhospitalised patients' self-care ability and positively affect public health outcomes. Consequently, using the developed programme for providing follow-up care to nonhospitalised patients is recommended. RELEVANCE TO CLINICAL PRACTICE: Having the ability to develop caring systems based on the nursing theories is a prerequisite to standard nursing practice. Identifying patients' educational needs is a fundamental prerequisite to patient education. Our findings revealed that the supportive educational intervention developed based on the Orem's self-care theory can help health care providers identify and fulfil patients' self-care needs.

The effects of topical heat therapy on chest pain in patients with acute coronary syndrome: a randomised double-blind placebo-controlled clinical trial.

AIMS AND OBJECTIVES: To investigate the effects of local heat therapy on chest pain in patients with acute coronary syndrome. BACKGROUND: Chest pain is a very common complaint in patients with acute coronary syndrome. It is managed both pharmacologically and nonpharmacologically. Pharmacological pain management is associated with different side effects. DESIGN: This was a randomised double-blind placebo-controlled clinical trial conducted in 2013. METHODS: A convenience sample of 66 patients with acute coronary syndrome was selected from a coronary care unit of a local teaching hospital affiliated to Gonabad University of Medical Sciences, Gonabad, Iran. Patients were randomly assigned to either the experimental or the placebo group. Patients in the experimental and the placebo groups received local heat therapy using a hot pack warmed to 50 and 37 °C, respectively. We assessed chest pain intensity, duration and frequency as well as the need for opioid analgesic therapy both before and after the study. The study instrument consisted of a demographic questionnaire, the McGill Pain Questionnaire, and a data sheet for documenting pain frequency and duration as well as the need for analgesic therapy. FINDINGS: The placebo heat therapy did not significantly decrease the intensity, the duration and the frequency of pain episodes. However, pain intensity, duration and frequency in the experimental group decreased significantly after the study. Moreover, the groups differed significantly in terms of the need for opioid analgesic therapy neither before nor after the intervention. CONCLUSION: Local heat therapy is an effective intervention for preventing and relieving chest pain in patients with acute coronary syndrome. RELEVANCE TO CLINICAL PRACTICE: Effective pain management using local heat therapy could help nurses play an important role in providing effective care to patients with acute coronary syndrome and in minimising adverse effects associated with pain medications.

Evaluation of risk management status in selected departments of educational hospitals of Hamadan University of Medical Sciences.

BACKGROUND: Healthcare organizations are among high-risk organizations due to the nature of their work as well as structural, physical and technological complexities. Accordingly, it is important to use risk management and control programs in all departments of these organizations. OBJECTIVE: The present study was conducted for the first time to evaluate the risk management status of the operating room and laboratory departments of Hamadan hospitals in 2022. METHODS: In this descriptive-observational cross-sectional study, laboratory and operating room departments were selected as the research environment. To conduct this research, a valid and reliable questionnaire was used to collect data, and the data were analyzed using SPSS 22 statistical software. RESULTS: The findings of the present study showed that the overall mean score of risk management status for the laboratory and operating room departments was 2.66 ± 0.15 and 2.89 ± 0.13, respectively. Furthermore, there was no statistically significant difference in the mean scores of the research components based on work experience, education level, and gender. CONCLUSION: It is suggested that the laboratory and operating room departments should focus more on adopting policies and solutions to improve the position of risk management, training and budget allocation for risk management.

Retraction notice to "The therapeutic potential of human adipose-derived mesenchymal stem cells producing CXCL10 in a mouse melanoma lung metastasis model" [Cancer Lett. 419 (2018) 30-39].

This article has been retracted: please see Elsevier Policy on Article Withdrawal (https://www.elsevier.com/about/our-business/policies/article-withdrawal). This article has been retracted at the request of the Editor. After publication, the Editors were contacted by a concerned reader regarding alleged image duplication. These allegations are in regard to Fig. 3a being duplicated from a previously published paper in the journal Stem Cells (Stem Cells. 2008 Sep;26 (9):2332-8. doi: 10.1634/stemcells.2008-0084) and Fig. 8a being duplicated from a previously published paper in the journal Molecular Cancer (Mol Cancer 13, 255 (2014). https://doi.org/10.1186/1476-4598-13-255). After a thorough investigation by the editorial team, the Editors determined that there are multiple identical details between Fig. 5A (Cancer Letters) and Fig. 3A (Stem Cells) and the authors did not produce satisfactory evidence that the published images in Cancer Letters were original. Due to this, the Editor does not have confidence in the results and conclusions presented and has made the decision to retract.

Nursing managers' perspectives on facilitators of and barriers to evidence-based practice: A cross-sectional study.

AIM: This study aimed to determine the facilitators and barriers to evidence-based practice (EBP) from the perspective of Iranian nursing managers. DESIGN: Cross-sectional study. METHODS: Data were collected from 335 top nursing managers of Iran. The research instruments included three electronic questionnaires for demographics, facilitators and barriers of evidence-based practice. Descriptive statistics and appropriate analysis tests were used to clarify the strength of relationships between the factors. RESULTS: A total of 277 nursing managers participated in the study (response rate of 82%). Iranian nursing managers believed that organizational factors were the most important domain for both facilitators (34.7 ± 9.2) and barriers (28.37 ± 6.2) to EBP. Regarding the Perspectives of nursing managers on Necessity and Extent of EBP implementation, 79.8% (n = 221) considered EBP to be essential, while 45.8% (n = 127) regarded its implementation as moderate.

COVID-19 pandemic and socio-environmental inequality: A narrative review.

Background and Aims: The COVID-19 pandemic has provided preliminary evidence of the existence of health, social, and environmental inequalities. This inequality encompasses inadequate access to safe water, clean air, and wastewater management, as well as limited socioeconomic and educational opportunities. These issues have not received sufficient attention during the pandemic. The purpose of this narrative review is to provide a comprehensive summary and analysis of the existing literature on a specific topic, ultimately leading to a conclusion based on the evidence presented. Methods: The search methodology for this study involved conducting comprehensive searches of scientific databases, including PubMed, ScienceDirect, LILACS, and Google Scholar, from 2019 to 2023. The study focused on a specific theme and its relevant aspects related to global environmental health and society. Keywords such as COVID-19, inequities, and environmental health were used for searching. Additionally, the Boolean operator "AND" was used to combine these descriptors. Results: Unequal exposure to air pollution has been reported in Africa, as well as in large parts of Asia and Latin America, according to the data that has been obtained. The pandemic has also resulted in a surge in healthcare waste generation, exacerbating the environmental impact of solid waste. Furthermore, there is evidence indicating significant disparities in the severe lack of access to sanitation services between developing nations and low-income regions. The issues related to water availability, accessibility, and quality are subject to debate. It has been reported that SARS-CoV-2 is present not only in untreated/raw water, but also in water bodies that act as reservoirs. Moreover, insufficient education, poverty, and low household income have been identified as the most significant risk factors for COVID-19 infection and mortality. Conclusion: It is evident that addressing socio-environmental inequality and striving to narrow the gap by prioritizing vulnerable populations are imperative.

Effect of Local Hyperthermia on Respiratory Indices of Patients with Chronic Obstructive Pulmonary Disease.

Background: Change in respiratory indices is the most common problem in Chronic Obstructive Pulmonary Disease (COPD) patients. This problem is managed through pharmaceutical and non-pharmaceutical methods. This study aimed to determine local hyperthermia effect on respiratory parameters of COPD patients. Materials and Methods: This randomized controlled trial study was conducted on 46 patients with COPD referred to Allameh Bohlool Hospital in Gonabad, Iran in 2019. The participants were randomly assigned into two groups using quadrupled blocks. In both groups, a local pack was placed on the anterior chest for 23 min twice daily for 5 days. In the intervention group, the temperature of the hot pack was 50° and in the placebo group was the same as the body temperature. Respiratory indices including force vital capacity (FVC), forced expiratory volume in first second (FEV1), etc., were measured and compared before and after the last intervention in both groups. To gather data, demographic information form and respiratory indices record form were used. Results: Compared to before the intervention, all respiratory indices such as vital capacity (VC) (z = -4.25, p < 0.001), FEV1 (t22 = -114.18, p < 0.001), PEF (t22 = 5.91, p < 0.001) in the experimental group were increased significantly. Moreover, the difference in the mean respiratory indicators such as Pick Expiratory Flow rate (PEF) (t44 = 94.63, p < 0.001) and SPO2 (z = -3.27, p < 0.05) was also statistically significant in the two groups before and after the intervention. Conclusions: Local hyperthermia is effective in the improvement of respiratory indices among COPD patients, but it is recommended to conduct further studies before the implementation of this approach.

Psychometric properties of the Persian version of the nursing moral disengagement scale.

Moral disengagement is a set of cognitive mechanisms through which a person violates his/her moral standards without losing his/her dignity. Therefore, a tool has been designed to measure moral disengagement in nurses. This study aims to determine the psychometric properties of the Nursing Moral Disengagement scale. In this methodological study, 440 nurses working in hospitals of Mashhad were selected by the availability sampling method. The translation was carried out using the forward-backward method. The final version of the tool was psychometrically tested for validity (exploratory and confirmatory factor analysis) and reliability (internal consistency and relative stability). Four factors were extracted in the exploratory factor analysis, and since the factor loadings of all the tool items were higher than 0.3, they were all retained. The tool's general fit indices indicated the model's confirmation and optimal fit. Cronbach's alpha and relative stability coefficients for the whole questionnaire were 0.90 and 0.89, respectively. The study results showed that this tool has good validity and reliability and can therefore measure behaviors related to moral disengagement in nurses, so that appropriate interventions can be designed to reduce these harmful behaviors.

Characteristics and specifications of dashboards developed for the COVID-19 pandemic: a scoping review.

Aim: The use of information-based solutions such as dashboards is on the rise for taking fact-based actions against the COVID-19 crisis. This scoping review aimed to comprehensively investigate COVID-19 dashboards from different technical perspectives. Subject and methods: Three main bibliographic databases, PubMed, Web of Science, and Scopus, were searched on 28 August 2021 to retrieve relevant studies. Arksey and O'Malley's (Int J Soc Res Methodol 8(1):19-32, 2005) methodological framework and the enhanced version of this methodology developed by Levac et al. (Implement Sci 5(1):1-9, 2010) were adopted for conducting this review. Results: In total, 26 articles were included. The COVID-19 dashboards mainly focused on the infected (n = 25), deceased (n = 17), and recovered cases (n = 13), as well as the performed test (n = 10). Most of the dashboards were interactive, with public accessibility targeting various user groups. While some dashboards were both informative and supportive (38%), most were mainly informative (92%). The dashboard data were generally analyzed using simple techniques (58%) and delivered through web-based applications (88%). Conclusion: Dashboards can help immediately manage, analyze, and summarize a huge amount of information about a COVID-19 outbreak. The findings revealed that the developed COVID-19 dashboards share more or less analogous characteristics that could lay the groundwork for designing and developing dashboards for any other pandemic.

Effect of static magnetic field therapy on diabetic neuropathy and quality of life: a double-blind, randomized trial.

BACKGROUND: Diabetic peripheral neuropathy (DPN) is a common complication of diabetes mellitus (DM) that can cause annoying symptoms. To address this condition, several treatment approaches have been proposed, including static magnetic field (SMF) therapy, which has shown promise in treating neurological conditions. Therefore, this study aimed to investigate the effects of SMF therapy on symptomatic DPN and the quality of life (QoL) in patients with type 2 diabetes. METHODS: A double-blind, randomized, placebo-controlled trial was conducted from April to October 2021. Sixty-four DPN patients (20 males, 44 females) were recruited for the study via invitation. The participants were divided into two groups: the magnet group, which used magnetic ankle bracelets (155 mT) for 12 weeks, and the sham group, which used non-magnetic ankle bracelets for the same duration. Neuropathy Symptom Score (NSS), Neuropathic Disability Score (NDS), and Visual Analogue Scale (VAS) were used to assess neuropathy symptoms and pain. In addition, the Neuropathy Specific Quality of Life Questionnaire (Neuro-QoL) tool was used to measure the patients' quality of life. RESULTS: Before treatment, there were no significant differences between the magnet and sham groups in terms of the NSS scores (P = 0.50), NDS scores (P = 0.74), VAS scores (P = 0.17), and Neuro-QoL scores (P = 0.82). However, after 12 weeks of treatment, the SMF exposure group showed a significant reduction in NSS scores (P < 0.001), NDS scores (P < 0.001), VAS scores (P < 0.001), and Neuro-QoL scores (P < 0.001) compared to the baseline. The changes in the sham group, on the other hand, were not significant. CONCLUSION: According to obtained data, SMF therapy is recommended as an easy-to-use and drug-free method for reducing DPN symptoms and improving QoL in diabetic type-2 patients. Trial registration Registered at Iranian Registry of Clinical Trials: IRCT20210315050706N1, 2021/03/16.

Virtual Reality and Cardiac Diseases: A Systematic Review of Applications and Effects.

Introduction: Cardiac diseases have grown significantly in recent years, causing many deaths globally. Cardiac diseases can impose a significant economic burden on societies. The development of virtual reality technology has attracted the attention of many researchers in recent years. This study aimed to investigate the applications and effects of virtual reality (VR) technology on cardiac diseases. Methods: A comprehensive search was carried out in four databases, including Scopus, Medline (through PubMed), Web of Science, and IEEE Xplore to identify related articles published until May 25, 2022. Preferred Reporting Items for Systematic Reviews and Meta-Analyzes (PRISMA) guideline for systematic reviews was followed. All randomized trials that investigated the effects of virtual reality on cardiac diseases were included in this systematic review. Results: Twenty-six studies were included in this systematic review. The results illustrated that virtual reality applications in cardiac diseases can be classified in three categories of physical rehabilitation, psychological rehabilitation, and education/training. This study revealed that the use of virtual reality in psychological and physical rehabilitation can reduce stress, emotional tension, Hospital Anxiety and Depression Scale (HADS) total score, anxiety, depression, pain, systolic blood pressure, and length of hospitalization. Finally, the use of virtual reality in education/training can enhance technical performance, increase the speed of procedures, and improve the user's skills, level of knowledge, and self-confidence as well as facilitate learning. Also, the most limitations mentioned in the studies included small sample size and lack of or short duration of follow-up. Conclusions: The results showed that the positive effects of using virtual reality in cardiac diseases are much more than its negative effects. Considering that the most limitations mentioned in the studies were the small sample size and short duration of follow-up, it is necessary to conduct studies with adequate methodological quality to report their effects in the short term and long term.

Facing the challenges and building solutions in clinical psychiatric nursing in Iran: a qualitative study.

Psychiatric nurses play an important role in the process of caring for mentally ill patients and are continually faced with the numerous challenges and complex issues related to this field. This study aimed to understand the perspectives of psychiatric nurses regarding the issues they face while providing care and examine the possible solutions for improvement of inpatient care in clinical settings. The study adopted a qualitative approach that utilized a content analysis of audio taped, semi-structured interviews that had been conducted with 24 nurses. Two main themes emerged from the data. The first, Challenges in Providing Care within Psychiatric Wards, had the following subthemes: Politics and Rules of Organization, Safety and Security Issues, Uncertainty about the Role, Lack of Trained Staff, and Sociocultural Issues. The second theme, Solutions for Improving Psychiatric Care, had the subthemes of Empowerment across four domains: Psychiatric Nurses, Mentally Ill Patients and their Families, The Psychiatric Mental Health System, and the Cultural Context. The results indicated that if nurses are expected to provide optimal nursing care within a psychiatric ward, then there is a need for a stable and responsible organizational structure, skilled psychiatric nurses, and community-based care along with an anti-stigma program.

Evaluation of the effects of diabetes self-management education based on 5A model on the quality of life and blood glucose of women with gestational diabetes mellitus: an experimental study in eastern Iran.

Introduction: Gestational diabetes mellitus (GDM) is an important condition during pregnancy. The aim of the current study was to evaluate the effects of self-management education based on 5A model on the quality of life and blood glucose level of women with GDM. Methods: This quasi-experimental study was conducted on 54 pregnant women referred to the urban health care centers affiliated to the Gonabad University of Medical Sciences from March 2019 to March 2020 based on purposive sampling method. Participants were randomly allocated into intervention and control groups based on stratified random sampling using permuted block randomization method. The intervention group received self-management education program based on 5A model in five sessions during two months. Demographic data, blood glucose level, and diabetes quality of life (DQOL) questionnaire were collected for each participant. Data analysis was performed using the SPSS software version 16 and the level of statistical significance was set at 0.05. Results: Mean age of the participants was 33.11 ± 5.35 years old. At the end of the intervention, the mean blood glucose level of the participants in the intervention group was significantly lower compared to the control group (p < 0.001). The quality of life in the intervention group was significantly improved at the end of the intervention compared to the control group (p < 0.001). Conclusions: Self-management education based on 5A model can effectively improve quality of life and blood glucose levels in women with GDM.

Socio-Environmental Determinants and Human Health Exposures in Arid and Semi-Arid Zones of Iran-Narrative Review.

Lifestyle is different in arid and semi-arid zones. However, where people are born and live have a lasting influence on their social and environmental exposure. This review focuses on the, various dimensions of environmental health imbalance inequality especially in significant environmental sources such as (ie, air, water, soil) among provinces that creates a big health gap in the center, East and the Southeast of Iran. Thus, the population of the arid and semi-arid zones of Iran is facing respiratory, cardiovascular, cancer and infection diseases linked to environmental problems such as chemical and microbial pollution due to air pollution and unsafe water sources, respectively. The prevalence of certain types of cancer such as skin, stomach, bladder, prostate and colorectal cancer together with some respiratory and cardiovascular diseases in arid and semiarid zones such as Kerman, Yazd, etc., has been reported in comparison with other provinces frequently. These impacts have effects on multiple levels of health security in those zones. Based on these concerns, we propose key questions that should guide research in the context of the socio environmental science to support science-based management actions in Iran and other similar semi-arid areas worldwide.

Use of Hospital Information System to Improve the Quality of Health Care from Clinical Staff Perspective.

Background: The development of hospital information systems (HISs) has a significant effect on care processes. In this regard, the clinical staff's perspective is very important in evaluating the success of these systems. The present study aimed to evaluate the clinical staff's perspective at hospitals affiliated to Neyshabur University of Medical Sciences on the effectiveness of the HIS in improving their performance and strategies for increasing the system effectiveness. Materials and Methods: In the present cross-sectional study, 120 clinical staff who actively worked with the HIS were included. A two-part questionnaire was used for data gathering. Results: From the perspective of the research population, the effective score of HIS was %64.42 in improving their performance, and %81.85 in the case of developed HIS according to the suggested strategies. According to the research scale, the effectiveness of the system could be improved from good to excellent in the case of implementation of strategies, so that there was a statistically significant difference between the pre- and post-effectiveness (P<0.001). Conclusion: Positive population perspective on the effectiveness of HIS in-performance improvement of the clinical staff indicated that there was a good context for the development and utilization of information technology in the hospitals. The clinical staff's opinions and work needs as the primary group of patient care should be taken into consideration in order to increase the effectiveness of the HIS.

Timely Diagnosis of Acute Lymphoblastic Leukemia Using Artificial Intelligence-Oriented Deep Learning Methods.

BACKGROUND: Leukemia is fatal cancer in both children and adults and is divided into acute and chronic. Acute lymphoblastic leukemia (ALL) is a subtype of this cancer. Early diagnosis of this disease can have a significant impact on the treatment of this disease. Computational intelligence-oriented techniques can be used to help physicians identify and classify ALL rapidly. Materials and Method. In this study, the utilized dataset was collected from a CodaLab competition to classify leukemic cells from normal cells in microscopic images. Two famous deep learning networks, including residual neural network (ResNet-50) and VGG-16 were employed. These two networks are already trained by our assigned parameters, meaning we did not use the stored weights; we adjusted the weights and learning parameters too. Also, a convolutional network with ten convolutional layers and 2∗2 max-pooling layers-with strides 2-was proposed, and six common machine learning techniques were developed to classify acute lymphoblastic leukemia into two classes. RESULTS: The validation accuracies (the mean accuracy of training and test networks for 100 training cycles) of the ResNet-50, VGG-16, and the proposed convolutional network were found to be 81.63%, 84.62%, and 82.10%, respectively. Among applied machine learning methods, the lowest obtained accuracy was related to multilayer perceptron (27.33%) and highest for random forest (81.72%). CONCLUSION: This study showed that the proposed convolutional neural network has optimal accuracy in the diagnosis of ALL. By comparing various convolutional neural networks and machine learning methods in diagnosing this disease, the convolutional neural network achieved good performance and optimal execution time without latency. This proposed network is less complex than the two pretrained networks and can be employed by pathologists and physicians in clinical systems for leukemia diagnosis.

HIV-infected patients' adherence to highly active antiretroviral therapy: a phenomenological study.

Adherence to the treatment regimen is essential to the success of highly active antiretroviral therapy for patients who are infected with HIV. The evidence suggests that poor adherence to antiretroviral drug therapy is a major problem that has the potential to diminish effective viral suppression, promote viral resistance, and place patients at risk for hospitalization, opportunistic infections, and an increased risk of HIV transmission. The primary aim of this study was to understand patients' experiences regarding their adherence to antiretroviral drug therapy. Thus, 19 participants were recruited for in-depth interviews regarding their adherence to drug regimens. All the interviews were transcribed verbatim and analyzed by using Benner's phenomenological analysis approach. Four main themes emerged from the data: (i) choosing to live and the decision to start taking medications; (ii) strategies for adhering to the regimen and managing the side-effects; (iii) relationships with healthcare providers; and (iv) advantages of the medications as a motivator to continue one's adherence to the regimen. Studying and understanding the experiences of patients can provide new insights and strategies in order to enhance patients' adherence to highly active antiretroviral therapy.