Baqiyatallah University of Medical Sciences

Early prediction of hospital-acquired pressure injuries (HAPIs) is crucial for delivering prompt therapeutic interventions and personalised preventive measures to hospitalised patients. However, existing pressure injury (PI) assessment tools often lack transparency, objectivity, comprehensiveness and reliability. This study protocol aims to identify risk factors, develop a screening tool (Pressure Injury after Hospital Admission - PIAHA), and conduct a two-step validation for the early prediction of PI after hospital admission. This multiphase, multicentre, sequential research design comprises five phases. The first phase involves an umbrella review to synthesise comprehensive information on PI risk factors in hospitalised patients from published review studies. The second phase will use conventional content analysis and qualitative interviews with national and international experts to identify context-specific predictors of HAPIs. The third phase will employ a three-round E-Delphi method to integrate findings and establish a structured list of potential predictors. In the fourth phase, a cross-sectional study will evaluate the predictive value of identified risk factors for HAPI development among hospitalised patients, contributing to the development of the PIAHA screening tool. The final phase consists of a two-step validation: (1) a cross-sectional comparison of the PIAHA tool against the gold standard and (2) a cluster randomised controlled trial to compare the effectiveness and cost-effectiveness of the novel 'IDEAL SKIIN CARES' prevention bundle, administered by trained wound specialist nurses, vs routine standard care. Ethical approval was granted by Baqiyatallah University of Medical Sciences (IR.BMSU.REC.1402.059) covering all study phases. Written informed consent will be obtained from participants or their legal representatives. The study follows the Declaration of Helsinki. Results will be disseminated via peer-reviewed publications, conferences, webinars, policy briefs and public engagement through social media, educational videos and podcasts. The PIAHA tool promises to enhance early detection of HAPI risk, facilitating individualised prevention and optimising clinical resource allocation. Implementation of the IDEAL SKIIN CARES bundle may improve patient outcomes and reduce healthcare costs by standardising evidence-based preventive care. CRD42024532133. NCT06369688.

Introduction: Evidence regarding the prognostic value of maternal Complete blood cell count (CBC) with foetal growth during pregnancy is lacking. Literature has shown that maternal hem constriction has been linked to pre-eclampsia. As well, preeclampsia, placental abruption and Intrauterine growth restriction (IUGR) share the same pathophysiology. This study wish investigate whether there is an association between maternal CBC indices and IUGR. A potential association may help physicians for early diagnosis and to establish a path for more rapid screening. Materials and Methods: The current case-control study was conducted on pregnant women admitted in the Baqiyatallah Hospital, Obstetrics ward from 2017 to 2022. The case group included pregnancies complicated with IUGR and the control group consisted of pregnant women with appropriate foetal growth. The two case and control groups were matched for variables such as patient age, gestational age, parity, miscarriage history and successful pregnancies. The specific biochemical variable of interest in this study was the complete blood count (CBC. diff) test. To determine the simultaneous effect of the investigated variables and the occurrence of IUGR, logistic regression was employed. Results: In this study, 90 cases (36.1%) and 146 (63.9%) controls were compared. There was not any significant difference between the two groups in terms of maternal age ( P = 0.87), gestational age ( P = 0.78), gravidity ( P = 0.84), parity ( P = 0.88), the number of previous miscarriages ( P = 0.70) and live birth ( P = 0.85). However, the mean counts of white blood cell WBC ( P < 0.001), neutrophils ( P < 0.001), lymphocytes ( P = 0.038), haemoglobin ( P = 0.047) and haematocrit ( P = 0.037), and platelet counts ( P = 0.002) were statistically higher in the case group. Logistic regression also showed WBC was correlated with IUGR occurrence (odds ratio: 1.306, confidence interval: 1.12–1.52, P = 0.001). Conclusion: In the third trimester of pregnancy, an increase of the leucocyte counts is associated with an increase in chance of having IUGR. Other variables from the complete blood test did not exhibit any significant associations in this regard.

Self-care is one of the most critical factors in disease prevention. Adults with pre-diabetes are at 5 to 15 times higher risk of developing type 2 diabetes compared with others. Without self-care behaviours to promote health and prevention, more than 70% will ultimately develop type 2 diabetes during their lives. This study aimed to design and psychometrically evaluate the self-care of adults with pre-diabetes. This study was a sequential exploratory mixed-methods study. In the first phase of the mixed-methods study, a qualitative study was conducted with a directed content analysis approach according to Riegel etal.'s middle-range theory as a guide. This qualitative-directed content analysis was conducted on prediabetes from June 2023 to October 2023. The experiences of 39 adults with pre-diabetes and 6 healthcare workers were assessed through individual, face-to-face, semi-structured interviews. The data were analysed based on the Elo and Kyngäs's method. The psychometric properties of the primary tool were evaluated in the second phase. Face and content validity, item analysis, structural validity, internal consistency, relative and absolute reliability, interpretability, responsiveness, and feasibility were evaluated, and the scoring method was determined. The concept of self-care in prediabetes includes behaviours that are performed to return blood sugar to a normal state in a routine and usual way (self-maintenance) and behaviours in response (self-management) to the changes that have been detected following the follow-up and interpretation of symptoms, periodic examinations and tests (self-monitoring). The primary tool entered the psychometric evaluation phase with 57 items (blueprint). After performing face and content validity and item analysis, the number of items was reduced to 29 items. Exploratory factor analysis was performed with 29 items and 207 people with prediabetes, and finally, three subscales with 19 items were formed, which explain 38% of the total extracted variance. The results of confirmatory factor analysis with 200 samples indicated the acceptable fit of the model. The Cronbach's alpha of all subscales was higher than 0.7, and the intraclass correlation coefficient of the scale was higher than 0.90. The standard error of measurement was 1.340, the minimum detectable change was 6.57, and the minimal important change was 3.71. The total score of the questionnaire had no ceiling and floor effect; the percentage of unanswered items was within the acceptable range. The results show that the self-care questionnaire for prediabetes has good psychometric properties and can measure self-care in adults with pre-diabetes.

ABSTRACT Accurate geometrical representation of stenosis is essential for stent design, surgical planning, and computational fluid dynamics (CFD) simulations, as even minor shape variations significantly alter hemodynamic predictions. This review systematically compiles and classifies the diverse stenosis geometries proposed in prior studies, creating a foundational reference for researchers. We catalog models ranging from idealized analytical shapes (e.g., axisymmetric cosine, Gaussian, and asymmetric profiles), patient‐specific reconstructions to parametric frameworks, highlighting their mathematical formulations, hemodynamic implications, and clinical applications. By consolidating these geometries, this article enables researchers to: (1) identify the most suitable existing model for their specific study, (2) understand inconsistencies in results across studies due to geometrical differences, and (3) develop new models informed by prior morphological variations. Crucially, we emphasize how stenosis geometry governs key hemodynamic parameters such as wall shear stress and pressure gradients and influences stent performance, underscoring why shape selection cannot be overlooked. This structured classification is intended to guide model selection and study design by aligning geometric fidelity with specific research objectives and practical constraints, rather than to imply predictive accuracy or clinical superiority.

Central sensitization (CS) is increasingly recognized as a key mechanism underlying chronic low back pain (CLBP), and has been linked to disturbed sleep, psychological distress, altered hypothalamic-pituitary-adrenal (HPA) axis function, low-grade inflammation, and cognitive dysfunction. However, few studies have simultaneously examined these domains in patients with different levels of CS compared with pain-free individuals. In this cross-sectional study, adults with CLBP were classified into severe and mild CS groups using the Central Sensitization Inventory and were compared with healthy controls. Sleep quality, psychological distress, and pain-related cognition were assessed using the Pittsburgh Sleep Quality Index, Depression Anxiety Stress Scales-21, and pain measures. Morning salivary cortisol, interleukin-6 (IL-6), and fasting blood glucose were obtained as biological markers, and cognitive performance was evaluated using the Corsi Block-Tapping and Tower of London tasks. Group differences were analyzed using one-way ANOVA with Tukey post-hoc tests. Forty-two participants (patients with CLBP and pain-free controls) completed the study. Compared with both mild CS patients and controls, the severe CS group showed markedly poorer sleep quality and higher levels of psychological distress. Morning cortisol concentrations were significantly elevated only in the severe CS group, whereas no statistically significant differences were detected for fasting glucose or IL-6 between groups. On the Corsi Block-Tapping task, healthy controls outperformed both CS groups, indicating reduced visuospatial working memory in patients, whereas no significant group differences were observed on the Tower of London planning task. Severe central sensitization in CLBP is associated with poor sleep, increased emotional distress, elevated morning cortisol, and deficits in visuospatial working memory, even in the absence of clear differences in IL-6 or fasting glucose. These findings support a biopsychosocial profile characterized by both neuroendocrine and cognitive alterations in patients with high levels of CS and highlight potential targets for multimodal assessment and intervention.