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Aim:We think that the nasopharyngeal swab sample should be taken bilaterally to improve the sensitivity of the real-time-reverse transcriptase-polymerase chain reaction (RT-PCR) test since there may be pathologies that cause nasal obstruction, such as nasal septum deviation (NSD). In this context, we investigated the effect of the nasopharyngeal swab sampling method and the presence of nasal obstruction on the detection of severe acute respiratory syndrome-coronavirus-2 (SARS-CoV-2).Methods:This prospective clinical study was conducted from March 2021 to January 2022. Forty-four hospitalized patients with NSD were included in the study group, and 44 hospitalized patients without NSD were included in the control group. The results of the RT-PCR test studied with a unilateral nasopharyngeal swab sample taken during hospitalization and the RT-PCR test studied with a bilateral nasopharyngeal swab sample taken on the 2nd day of hospitalization and the visual analog scale (VAS) scores showing the patients’ pain during the first sampling were determined.Results:In the first test, 23 (52.3%) patients in the study group and 32 (72.7%) patients in the control group were evaluated as SARS-CoV-2 positive. The first test sensitivity was significantly higher in the control group (p=0.048). The VAS score was significantly higher in the study group (p=0.00008). In the second test, 35 (79.5%) patients in the study group and 37 (84.1%) patients in the control group were evaluated as SARS-CoV-2 positive. The sensitivity increases in the study group and in the population were statistically significant (p=0.007 and p=0.004, respectively). The consistency of the first and second test results increased in patients without NSD and in patients with low VAS scores [odds ratio (OR)=3.779; p=0.001, OR=2.572; p=0.005, respectively].Conclusion:Nasopharyngeal swab sampling may be affected by nasal congestion and the sampling method. To avoid this, it may be more appropriate to take a nasopharyngeal swab sample through the bilateral nasal cavity.

Background: Irritable bowel syndrome (IBS) is the most common gastrointestinal disease. The present study was conducted to compare the effectiveness of self-efficacy-based training and compassion-focused therapy on depression, self-care behaviors, and quality of life (QOL) of patients with IBS. Methods: The present study was a quasi-experimental research with a pretest-posttest design and a control group. The statistical population consisted of all patients with IBS referred to Khorshid Hospital in Isfahan city, Iran, between September and November 2019. The study participants were 45 patients with IBS, who were randomly divided into 2 equal-sized groups of intervention and control. The data were collected using the Beck Depression Inventory (Beck, 1988), the Self-Care Questionnaire (Alizadeh Aghdam‎, Koohi, & Gholizadeh‎, 2016), and the Quality of Life Scale (Ware & Sherbourne, 1992). The collected data were analyzed using multivariate analysis of covariance (MANCOVA) in SPSS software. Results: The results indicated that self-efficacy-based training and compassion-focused therapy positively affected depression (P < 0.001), self-efficacy behaviors (P < 0.001), and QOL (P < 0.001) of patients with IBS. However, compassion-focused therapy was more effective in the treatment of depression and the improvement of self-care behaviors and QOL than self-efficacy-based training (P < 0.001). Conclusion: It can be concluded that compassion-focused therapy was more effective in the treatment of depression and the improvement of self-care behaviors and QOL than self-efficacy-based training.

Objective: To assess the health care costs and utilization in patients with hereditary hemorrhagic telangiectasia (HHT) in the United States. Patients and Methods: Retrospective analysis of patients with HHT diagnosed between 2007 and 2017 was performed using deidentified administrative claims data from the OptumLabs Data Warehouse. Adult patients with new (incident) diagnosis of HHT between January 1, 2007, and December 31, 2017, were included. Comparisons were made using the Wilcoxon rank sum test. Results: Three thousand nine hundred seventy-seven patients with a first diagnosis of HHT between 2007 and 2017 were identified, of which 3590 were matched 1:1 to non-HHT patients with similar baseline characteristics and comorbidities. These 3590 patients with HHT were 63.1% female and 83.9% white with a mean age of 51.1 ± 18.5 years, and a mean follow-up period of 3.2 ± 2.2 years (range, 1.0-11.7 years). Compared with the control group, the cumulative 5-year median total health care cost for patients with HHT was 41.4% higher ($21,118 vs $14,929; P < .001) in those with private commercial insurance and 31.7% higher ($35,462 vs $26,925; P < .001) in those with Medicare Advantage coverage. The median annual health care costs were significantly higher in patients with HHT with commercial insurance and Medicare Advantage in the first year after diagnosis ($4,333 vs $1,804; P < .001), and ($7,322 vs $5,245; P < .001), respectively, and remained higher throughout the duration of follow-up. Further analysis showed that outpatient clinic visits, hospital admission, imaging rates, invasive procedures, iron infusions, and blood transfusions were all significantly higher in the HHT group. Conclusion: Patients with HHT have significantly higher health care costs compared with a matched control group. A better understanding of the reasons underlying these cost differences will provide opportunities for patients, providers, and other stakeholders to better manage this rare condition.

Bevacizumab is now an emerging treatment option for severe hereditary hemorrhagic telangiectasia–related bleeding including epistaxis and gastrointestinal tract bleeding. The impact of long-term intravenous bevacizumab therapy on cardiac structure and function is unknown. We describe 3 patients receiving intravenous bevacizumab therapy for severe hereditary hemorrhagic telangiectasia–related bleeding who were found to have abnormal mobile masses on the mitral valve (n=2) and aortic valve (n=1). The clinical impact of these findings is unknown and requires further study.

Background and Objectives: In obese people, 5-10% reduction in initial weight can decrease the obesity induced risks. Therefore, it is important to identify the predictive factors effective in weight loss maintenance. The present research was conducted to determine the role of important predictive factors in weight loss maintenance. Methods: For this purpose, a total of 200 women with obesity, were selected using convenience sampling. After explaining the study aims and obtaining the permission to enter the study, they were asked to complete the research tools, including Multidimensional Self-Body Relationship Questionnaire, Three-Factor Eating Behavior Questionnaire, Treatment Outcome Expectations, Weight Lifestyle Self-Efficacy Questionnaire, Caring Environment Questionnaire, Rosenberg Self-Esteem Scale, Depression, Anxiety, and Stress Scale (DASS-21), Multidimensional Perceived Social Support Scale (MSPSS), and Dichotomous Thinking in Eating Disorders Scale (DTEDS). Data were analyzed using SPSS software and Pearson correlation and step by step regression statistical methods. Significance level was considered to be p

BackgroundTeaching and learning about topics such as bias are challenging due to the emotional nature of bias-related discourse. However, emotions can be challenging to study in health professions education for numerous reasons. With the emergence of machine learning and natural language processing, sentiment analysis (SA) has the potential to bridge the gap. ObjectiveTo improve our understanding of the role of emotions in bias-related discourse, we developed and conducted a SA of bias-related discourse among health professionals. MethodsWe conducted a 2-stage quasi-experimental study. First, we developed a SA (algorithm) within an existing archive of interviews with health professionals about bias. SA refers to a mechanism of analysis that evaluates the sentiment of textual data by assigning scores to textual components and calculating and assigning a sentiment value to the text. Next, we applied our SA algorithm to an archive of social media discourse on Twitter that contained equity-related hashtags to compare sentiment among health professionals and the general population. ResultsWhen tested on the initial archive, our SA algorithm was highly accurate compared to human scoring of sentiment. An analysis of bias-related social media discourse demonstrated that health professional tweets (n=555) were less neutral than the general population (n=6680) when discussing social issues on professionally associated accounts (χ2 [2, n=555)]=35.455; P

Background and Objectives: Sleep is one of the essential and vital needs for human and is an effective factor in the child growth and development. The basic foundations of learning sleep habits are formed during childhood and a person tries to maintain it during lifetime. This study aimed to determine the sleep habits of primary school students of Nahavand city from the point of view of parents. Methods: In this correlational descriptive study, 240 students aged 6-11 years, were selected using random cluster sampling in Nahavand city in 2017. Data were collected by demographic information questionnaire and Children's Sleep Habits Questionnaire (CSHQ). The questionnaires were completed as self report by the parents (mother or father). Data were analyzed using descriptive statistics methods and independent t-test. Results: The mean score of the students' sleep habits was 64.32±9.33 and the highest mean score of sleep habits was related to the dimension of sleeping behavior, 26.87±4.75, and the lowest mean score was related to the dimension of night awake, 4.35±1.48, which, in other words, the high mean was indicative of sleep habits’ disorder, and the low mean indicated less sleep habits’ disorder. Conclusion: The findings of this study showed that sleep habits’ disorders affect various aspects of the child's life.

Background: The purpose of this study was to determine the effectiveness of cognitive-behavioral stress therapy on stress, depression and distress in patients with cancer.Cases Report: In a cross-sectional study of consecutive patients (Aged 32-70 years, progression of their disease was at levels 1 to 3, high cycle education, and 3 months of chemotherapy, of which 40, were randomly available from this group (20 experimental and 20 Control group). The instrument was a McGill Pain Questionnaire (1997) and the Hazards and Anxiety and Depression Scale (HADS) questionnaire. Data were analyzed using two methods of Kolmogorov-Smirnov inferential statistics and multivariate analysis of covariance using software software Spss17.Conclusion: Correlation analysis showed that the experimental group had a significant reduction in depression and anxiety in the posttest after the control group compared with the control group. The short-term cognitive-behavioral stress management program can reduce, depression and anxiety in cancer patients.

Background and Objectives: Emotion regulation and management play a determinant role in health and prevention of mental disorders in patients with chronic disease. In this research the moderating role of cognitive emotion regulation strategies was studied on the relationship between personality traits and quality of life in dialysis patients. Method: The present study was conducted as a descriptive correlational study on 100 dialysis patients referred to hospitals of Qom province. All participants were asked to complete World Health Organization Quality-of-Life Scale (WHOQOL-BREF), Cognitive Emotion Regulation Questionnaire (CERQ) and NEO personality inventory. The research data were analyzed using Pearson correlation coefficient and regression analysis. Results: The results of moderated regression analysis revealed that maladaptive cognitive emotion regulation strategies affect the relationship between all personality traits, except openness and quality of life, and adaptive cognitive emotion regulation strategies have a moderating role only in the relationship among extraversion, agreeableness, and quality of life. Conclusion: Based on the results of this research, personality traits play an important role in emotion regulation strategies as well as quality of life in dialysis patients.