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Depression is a complex mental health disorder with highly heterogeneous symptoms that vary significantly across individuals, influenced by various factors, including sex and regional contexts. Network analysis is an analytical method that provides a robust framework for evaluating the heterogeneity of depressive symptoms and identifying their potential clinical implications.
Objective:
To investigate sex-specific differences in the network structures of depressive symptoms in Asian patients diagnosed with depressive disorders, using data from the Research on Asian Psychotropic Prescription Patterns for Antidepressants, Phase 3, which was conducted in 2023.
Methods:
A network analysis of 10 depressive symptoms defined according to the National Institute for Health and Care Excellence guidelines was performed. The sex-specific differences in the network structures of the depressive symptoms were examined using the Network Comparison Test. Subgroup analysis of the sex-specific differences in the network structures was performed according to geographical region classifications, including East Asia, Southeast Asia, and South or West Asia.
Results:
A total of 998 men and 1,915 women with depression were analysed in this study. The analyses showed that all 10 depressive symptoms were grouped into a single cluster. Low self-confidence and loss of interest emerged as the most central nodes for men and women, respectively. In addition, a significant difference in global strength invariance was observed between the networks. In the regional subgroup analysis, only East Asian men showed two distinct clustering patterns. In addition, significant differences in global strength and network structure were observed only between East Asian men and women.
Conclusion:
The study highlights the sex-specific differences in depressive symptom networks across Asian countries. The results revealed that low self-confidence and loss of interest are the main symptoms of depression in Asian men and women, respectively. The network connections were more localised in men, whereas women showed a more diverse network. Among the Asian subgroups analysed, only East Asians exhibited significant differences in network structure. The considerable effects of neurovegetative symptoms in men may indicate potential neurobiological underpinnings of depression in the East Asian population.
Spiritual care is essential for the health and well-being of patients and their families, so nursing and midwifery students should have professional competency in this field.
Objectives
The present study aimed to translate the Spiritual Care Competency Self-Assessment Tool for nursing and midwifery students into Persian and evaluate its psychometric properties.
Methods
This study has a methodological study design.
Methods measures
The present study was conducted from July 4 to November 19, 2023, at the Faculty of Nursing and Midwifery in west of Iran. The tool was translated into Persian using the forward-backward translation method. The construct validity was examined using exploratory factor analysis (EFA) and confirmatory factor analysis (CFA) with a total of 536 nursing and midwifery students. The internal consistency was assessed using Cronbach’s alpha coefficient. Also, the reliability of the tool was evaluated using the test–retest method. SPSS version 26 and Lisrel version 8 software were used in this study.
Results
Face and content validity was confirmed quantitatively and qualitatively. The results of EFA and CFA confirmed the tool with 4 factors and 28 items. CFA results indicated a well-fitting model (comparative fit index [CFI] = .97, Non-Normed Fit Index (NNFI) = .92, goodness of fit index [GFI] = .91, root mean square error of approximation [RMSEA] = .05, Standardized Root Mean Square Residual (SRMR) = .046). Pearson’s correlation coefficient confirmed a significant relationship between items, subscales, and the main scale. Also, Cronbach’s alpha coefficient (.968) and test–retest (.867) confirmed the reliability of the Persian version of the tool.
Conclusion
The present study showed that the Persian version of the EPICC Spiritual Care, with 4 factors and 28 items, was suitable for validation and that its psychometric properties were acceptable according to COSMIN criteria. In general, the results showed that the Persian version of the EPICC Spiritual Care is a valid and reliable tool that students, preceptors, and educators can use in clinical settings as a practical way of discussing and evaluating spiritual care competency in Iran.
In the course of human civilization, religion has underpinned the development of values of human respect, tolerance, peace, and the culture of peace. Unfortunately, at the same time, religion has also played the opposite role during some periods of history. Therefore, it is important to investigate how and to what extent religious faiths, or if I may say more accurately religious paradigms, have been and are ready to educate their believers in the above-mentioned value support system, and how they could set about so doing. How can religion provide us with an ambiance and a paradigm within which we can create an atmosphere of dialogue among different value systems? In this brief article, I try to seek light from the teachings of the great Persian thinker and poet, Jalaluddin Mowlavi Rumi, to be able to elaborate on this topic.
Rhinosinusitis is one of the most common reasons for a visit to otolaryngology clinics. Some patients are candidates for sinus surgery. Infiltration of 1:100 000 adrenaline in the pterygopalatine fossa was studied, with the aim of evaluating the effect on bleeding in the surgical field.
Methods
This double-blind clinical trial was conducted in 2021–2022 on 40 candidates for endoscopic sinus surgery. For each patient, one side of the pterygopalatine fossa was randomly selected to be infiltrated with a vasoconstrictor. Surgical field bleeding on each side was evaluated.
Results
Blood loss was 35.8 ± 20.9 ml in the study group and 38.4 ± 23.7 ml for the control group, with no statistically significant difference between groups (p = 0.49). In addition, there was no difference between the two groups in terms of the surgical field based on Boezaart scores.
Conclusion
Although there are some recommendations on the usage of vasoconstrictors via the pterygopalatine foramen, debate remains.
To reduce Coronavirus Disease 2019 (COVID-19)-related mortality and morbidity, widely available oral COVID-19 treatments are urgently needed. Certain antidepressants, such as fluvoxamine or fluoxetine, may be beneficial against COVID-19.
Objectives
The main objective was two-fold: (i) to test the hypothesis that the prevalence of antidepressant use in patients hospitalized with COVID-19 would be lower than in patients with similar characteristics hospitalized without COVID-19, and (ii) to examine, among patients hospitalized with COVID-19, whether antidepressant use is associated with reduced 28-day mortality. Our secondary aim was to examine whether this potential association could only concern specific antidepressant classes or molecules, is dose-dependent, and/or only observed beyond a certain dose threshold.
Methods
We included 388,945 adult inpatients who tested positive for SARS-CoV-2 at 36 AP–HP (Assistance Publique–Hôpitaux de Paris) hospitals from 2 May 2020 to 2 November 2021. We compared the prevalence of antidepressant use at admission in a 1:1 ratio matched analytic sample with and without COVID-19 (N = 82,586), and assessed its association with 28-day all-cause mortality in a 1:1 ratio matched analytic sample of COVID-19 inpatients with and without antidepressant use at admission (N = 1482) (Figure 1).
Results
Antidepressant use was significantly less prevalent in inpatients with COVID-19 than in a matched control group of inpatients without COVID-19 (1.9% versus 4.8%; Odds Ratio (OR) = 0.38; 95%CI = 0.35–0.41, p < 0.001) (Figure 2). Antidepressant use was significantly associated with reduced 28-day mortality among COVID-19 inpatients (12.8% versus 21.2%; OR = 0.55; 95%CI = 0.41–0.72, p < 0.001), particularly at daily doses of at least 40 mg fluoxetine equivalents (Figure 3). Antidepressants with high FIASMA (Functional Inhibitors of Acid Sphingomyelinase) activity seem to drive both associations.
Image:
Image 2:
Image 3:
Conclusions
Antidepressant use is associated with a reduced likelihood of hospitalization in patients infected with SARS-CoV-2 and with a reduced risk of death in patients hospitalized with COVID-19. These associations were stronger for molecules with high FIASMA activity. These findings posit that prospective interventional studies of antidepressants with the highest FIASMA activity may be appropriate to help identify variant-agnostic, affordable, and scalable interventions for outpatient and inpatient therapy of COVID-19.
Factionalism is an important element in parties' internal life, affecting their policies, strategies, electoral performance and even survival. Yet little is known about how parties manage factionalism. This study examines how radical left parties (RLPs) manage factionalism, drawing on a comparative case study of four RLPs – the Spanish Podemos and United Left (IU), and the Portuguese Left Bloc (BE) and Communist Party (PCP) – from 2010 to 2019. Drawing on original data collection, we find that parties adopt both formal and informal mechanisms to address factionalism. However, their approaches differ significantly. We identify two main approaches towards factionalism: a permissive approach, which allows internal pluralism, in the BE and IU; and a prohibitionist approach, which actively fights factionalism, in Podemos and the PCP, with competitive prohibitionism in the former and pre-emptive prohibitionism in the latter. These approaches strongly correlate with parties' origins and political orientation, but neither fully prevents intra-party conflict or splintering.
The University of Illinois at Chicago (UIC), along with many academic institutions worldwide, made significant efforts to address the many challenges presented during the COVID-19 pandemic by developing clinical staging and predictive models. Data from patients with a clinical encounter at UIC from July 1, 2019 to March 30, 2022 were abstracted from the electronic health record and stored in the UIC Center for Clinical and Translational Science Clinical Research Data Warehouse, prior to data analysis. While we saw some success, there were many failures along the way. For this paper, we wanted to discuss some of these obstacles and many of the lessons learned from the journey.
Methods:
Principle investigators, research staff, and other project team members were invited to complete an anonymous Qualtrics survey to reflect on the project. The survey included open-ended questions centering on participants’ opinions about the project, including whether project goals were met, project successes, project failures, and areas that could have been improved. We then identified themes among the results.
Results:
Nine project team members (out of 30 members contacted) completed the survey. The responders were anonymous. The survey responses were grouped into four key themes: Collaboration, Infrastructure, Data Acquisition/Validation, and Model Building.
Conclusion:
Through our COVID-19 research efforts, the team learned about our strengths and deficiencies. We continue to work to improve our research and data translation capabilities.
This study aimed to evaluate the psychometric properties of the Persian version of the food choice questionnaire (FCQ) and determine food choice motives among different study subgroups.
Design:
This cross-sectional study was conducted using self-administered questionnaires, including socio-demographic information and body weight and height data. In addition, study samples were asked to complete the Persian version of the FCQ.
Setting:
Educational and medical centres under the coverage of the Shahid Beheshti University of Medical Sciences in Tehran.
Participants:
Study samples were 871 adults (60·5 % female) selected using a convenience sampling method.
Results:
Mean ± sd age and BMI were 33·4 ± 10·7 years and 24·3 ± 5·2 kg/m2, respectively. More than one-third of the study samples were overweight/obese (35·8 %). A nine-structure model including thirty-two items of the original FCQ showed acceptable fit indices as follows: χ2/df = 3·39, goodness-of-fit index = 0·905, incremental fit index = 0·92, comparative fit index = 0·92, root mean square error of approximation (90 % CI) = 0·052 (0·049, 0·055). Regarding food choice motives, the three most important motives for food choice ranked by study samples were sensory appeal, natural content and health, respectively. Study samples ranked ethical concern as the least important food choice motive.
Conclusion:
These findings support the reliability and validity of the Iranian version of the FCQ. Additionally, results indicate the most important motives for food choice across various socio-demographic and weight status groups which can provide beneficial information for marketing practices in Iran and promote the food choices of Iranians.
Here, we are sharing our second report about children affected by Multisystem Inflammatory Syndrome in Children (MIS-C). The aim of the present study was to update our knowledge about children with MIS-C. Furthermore, we tried to compare clinical manifestations, laboratory features and final outcome of patients based on disease severity, in order to better understanding of the nature of this novel syndrome.
Methods
This retrospective study was conducted at Children's Medical Center Hospital, the hub of excellence in paediatrics in Iran, located in Tehran, Iran. We reviewed medical records of children admitted to the hospital with the diagnosis of MIS-C from July 2020 to October 2021.
Results
One hundred and twenty-two patients enrolled the study. Ninety-seven (79.5%) patients had mild to moderate MIS-C (MIS-C without overlap with KD (n = 80); MIS-C overlapping with KD (n = 17)) and 25 (20.5%) patients showed severe MIS-C. The mean age of all patients was 6.4 ± 4.0 years. Nausea and vomiting (53.3%), skin rash (49.6%), abdominal pain (46.7%) and conjunctivitis (41.8%) were also frequently seen Headache, chest pain, tachypnea and respiratory distress were significantly more common in patients with severe MIS-C (P < 0.0001, P = 0.021, P < 0.0001 and P < 0.0001, respectively). Positive anti-N severe acute respiratory syndrome coronavirus 2 IgM and IgG were detected in 14 (33.3%) and 23 (46.9%) tested patients, respectively. Albumin, and vitamin D levels in children with severe MISC were significantly lower than children with mild to moderate MIS-C (P < 0.0001, P = 0.05). Unfortunately, 2 (1.6%) of 122 patients died and both had severe MIS-C.
Conclusion
Patients with MIS-C in our region suffer from wide range of signs and symptoms. Among laboratory parameters, hypoalbuminemia and low vitamin D levels may predict a more severe course of the disease. Coronary artery dilation is frequently seen among all patients, regardless of disease severity.
Hyperglycemia during the first trimester leads to an increased risk of innate malformations as well as death at times close to delivery dates. The methylated genes include those from paternal H19 and PEG3 and those from maternal MEST and MEG3 that are necessary for the growth and regulation of the human fetus and its placenta. The aim of this study was to evaluate and compare the expression of these genes in the cord blood of healthy infants born to mothers with gestational diabetes mellitus (GDM) and healthy mothers.
This case-control study was conducted on the cord blood of 40 infants born to mothers with GDM and 35 infants born to healthy mothers. Mothers were identified by measuring oral glucose tolerance in the 24th–26th week of pregnancy. Cord blood was obtained post-delivery, and cord blood mononuclear cells were immediately extracted, using Ficoll solution. Then, RNA extraction and cDNA synthesis were performed, and gene expression of MEG3, PEG3, H19, and MEST was assessed through quantitative real-time PCR.
Findings show that the expression levels of MEG3, PEG3, H19, and MEST genes were significantly decreased in mononuclear cord blood cells of infants born to mothers with GDM when compared to those of the healthy control group.
These findings reveal that the reduction of imprinted genes in mothers with GDM is most likely due to changes in their methylation by an epigenetic process. Considering the importance of GDM due to its high prevalence and its side effects both for mother and fetus, recognizing their exact mechanisms is of high importance. This has to be studied more widely.
This study investigated the in vitro anthelmintic activity of copper oxide (CuO) and zinc oxide (ZnO) nanoparticles (NPs) against Marshallagia marshalli. The in vitro study was based on an egg hatch assay, adult and larvae motility inhibition assays, DNA damage, intensity protein profile along with several oxidative/nitrosative stress biomarkers including superoxide dismutase (SOD), catalase (CAT), glutathione peroxidase (GSH-Px), protein carbonylation (PCO), malondialdehyde (MDA), total antioxidant status (TAS) and nitric oxide (NO) content. Different concentrations of CuO-NPs and ZnO-NPs (1, 4, 8, 12 and 16 ppm) were used to assess anthelmintic effects on three stages of M. marshalli life cycle – that is, eggs, larvae and adult parasites for 24 h. The results indicated that CuO-NPs and ZnO-NPs played a significant role as anthelminthics, and the effect was dependent on time and concentration. The concentrations of 12 and 16 ppm of CuO-NPs and 16 ppm of ZnO-NPs resulted in the induction of oxidative/nitrosative stress (decreased SOD, GSH-Px and CAT, and increased MDA, PCO and NO), increased DNA damage, inhibition of adult and larval motility, egg hatch and low intensity of protein bands following sodium dodecyl sulphate–polyacrylamide gel electrophoresis, compared to control. It was concluded that CuO-NPs and ZnO-NPs could be utilized as novel and potential agents for the control and treatment of M. marshalli infection, and they have the pharmacological potential to be studied in vivo for further utilization in treating parasitic infections.
To assess the correlation of serum prestin level and audiological findings in adults with idiopathic sudden sensorineural hearing loss.
Methods
Audiometry and serum prestin measurements were performed at study entry (T0), at day 14 (end of treatment, T1) and at day 30 (T2).
Results
A total of 25 idiopathic sudden sensorineural hearing loss patients and 25 healthy adults were included. The geometric mean prestin level in the case and control groups at T0 was 227.7 pg/ml and 130.5 pg/ml, respectively. The geometric mean prestin level in the case group demonstrated a downward trend at T1 and T2 (214.0 pg/ml and 180.1 pg/ml, respectively; p < 0.001). Of 17 patients with high baseline prestin levels (over 150 pg/ml), prestin levels tended to decrease in 11 patients, and 5 of them (45.5 per cent) showed good recovery.
Conclusion
The prestin concentrations increased in two-thirds of patients with idiopathic sudden sensorineural hearing loss. Future work is recommended to determine the location of injury.
In compressed sensing (CS) a signal x ∈ Rn is measured as y =A x + z, where A ∈ Rm×n (m<n) and z ∈ Rm denote the sensing matrix and measurement noise. The goal is to recover x from measurements y when m<n. CS is possible because we typically want to capture highly structured signals, and recovery algorithms take advantage of a signal’s structure to solve the under-determined system of linear equations. As in CS, data-compression codes take advantage of a signal’s structure to encode it efficiently. Structures used by compression codes are much more elaborate than those used by CS algorithms. Using more complex structures in CS, like those employed by data-compression codes, potentially leads to more efficient recovery methods requiring fewer linear measurements or giving better reconstruction quality. We establish connections between data compression and CS, giving CS recovery methods based on compression codes, which indirectly take advantage of all structures used by compression codes. This elevates the class of structures used by CS algorithms to those used by compression codes, leading to more efficient CS recovery methods.
We investigate the validity and accuracy of two commonly used two-dimensional models of a rotating, incompressible, shallow fluid layer: the shallow-water (SW) model and the Serre/Green–Naghdi (GN) model. The models differ in just one respect: the SW model imposes the hydrostatic approximation while the GN model does not. Both models assume the horizontal velocity is independent of height throughout the layer. We compare these models with their parent three-dimensional (3-D) model, initialised with a height-independent horizontal velocity, and with a mean height small compared to the domain width. For small to moderate Rossby and Froude numbers, we verify that both models well approximate the vertically averaged 3-D flow. Overall, the GN model is found to be substantially more accurate than the SW model. However, this accuracy is only achieved using an explicit reformulation of the equations in which the vertically integrated non-hydrostatic pressure is found from a novel linear elliptic equation. This reformulation is shown to extend straightforwardly to multi-layer flows having uniform density layers.
COVID-19 and its associated disease control measures have greatly altered everyday life. The burden of these challenges has fallen disproportionately on women. Drawing on qualitative inquiry in agrarian north India and Nepal, this research note analyzes how South Asian COVID-19 lockdowns have affected women's labor responsibilities in sometimes surprising ways. We find increased responsibilities for caregiving within the household, substantial stress in responding to food insecurity, and growing expectations to fulfill public roles in disease response measures. However, we also find that the return of male migrants and youth has, in some cases, reduced women's farming responsibilities and created opportunities for household togetherness at a time of great uncertainty. We conclude that more research is needed to examine the nuanced aspects of COVID-19's gendered labor impacts to create comprehensive policy responses to address the multiple and sometimes conflicting effects the lockdown has had on agrarian women's informal labor and well-being.
Coronavirus disease 2019 (COVID-19) is an infectious disease caused by the severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) that emerged as a health problem worldwide. It seems that COVID-19 is more lethal for Iranian veterans with a history of exposure to mustard gas. There are some similarities in the pathogenesis of SARS-CoV-2 and mustard gas in immune system disruption and pulmonary infection. SARS-CoV-2 and mustard gas inducing oxidative stress, immune system dysregulation, cytokine storm, and overexpression of angiotensin-converting enzyme II (ACE2) receptor in lungs that act as functional entry receptors for SARS-CoV-2. Moreover, Iranian survivors of mustard gas exposure are more susceptible and vulnerable to COVID-19. It is suggested that the principles of COVID-19 infection prevention and control be adhered to more stringently in Iranian survivors of mustard gas exposure than others who have not been exposed to mustard gas. Therefore, in this review, we discuss the different pathologic aspects of lung injury caused by mustard gas and also the relationship between this damage and the increased susceptibility of Iranian mustard gas exposed survivors to COVID-19.