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Millions of people witnessing early, repeated media coverage of wars are at heightened risk of developing mental health conditions. However, most literature available on the field is based on measures with unverified psychometric qualities. This study aimed to design and validate a new self-report scale to measure the extent of exposure to media content related to war, the War-related Media Exposure Scale (WarMES).
Methods
A cross-sectional study based on 2635 community adults (73.1% females, mean age of 23.98 ± 7.55 years) from 5 countries (Tunisia, Kuwait, Egypt, Jordan, Oman). To verify the factor structure, we carried out an Exploratory Factor Analysis in a first subsample (N = 859) then a Confirmatory Factor Analysis on the remaining subsample (N = 1777) using SPSS AMOS.
Results
Based on an initial pool of 18 items, results showed that a 9-item one-factor model fits the data well. Support for internal consistency was provided by a Cronbach’s α = 0.96. The factor structure was equivalent across sex and country groups. Evidence for concurrent validity was provided by demonstrating that WarMES scores positively correlated with stress and depression.
Conclusions
Findings suggest that the WarMES is valid, reliable and allows to accurately measure the amount of time spent viewing war-content on media.
The global challenge of closing the treatment gap highlights the need for innovative interventions. Problem Management Plus (PM+), developed by the World Health Organization (WHO), is an evidence-based brief psychological intervention designed to address this gap by involving non-specialist helpers. In this study, ‘non-specialists’ or ‘helpers’ are individuals without formal training in mental health, who have been trained in and have been delivering individual PM+ for more than 1.5 years. To enhance quality in mental health care, especially with non-specialists, WHO and the United Nations International Children’s Emergency Fund (UNICEF) have launched the Ensuring Quality in Psychosocial and Mental Health Care (EQUIP) platform, an open-access resource for competency-based training. This study evaluates the acceptability and preliminary utility of EQUIP assessment tools. Thirteen helpers were assessed using the ENhancing Assessment of Common Therapeutic Factors (ENACT) and the PM+ assessment tool, culturally adapted and translated for Arabic-speaking helpers in Switzerland. The results indicate that the EQUIP tools can identify strengths and areas for improvement, provide valuable feedback for training, and thus have great potential for enhancing mental health care quality.
Dementia with Lewy bodies (DLB) and Parkinson’s disease dementia (PDD) are collectively called as Lewy body dementia (LBD). Despite the urgent clinical need, there is no reliable protein biomarker for LBD. Hence, we conducted the first comprehensive systematic review of all Differentially Abundant Proteins (DAP) in all tissues from people with LBD for advancing our understanding of LBD molecular pathology that is essential for facilitating discovery of novel diagnostic biomarkers and therapeutic targets for LBD.
Methods:
We identified eligible studies by comprehensively searching five databases and grey literature (PROSPERO protocol:CRD42020218889). We completed quality assessment and extracted relevant data. We completed narrative synthesis and appropriate meta-analyses. We analysed functional implications of all reported DAP using DAVID tools.
Results:
We screened 11,006 articles and identified 193 eligible studies. 305 DAP were reported and 16 were replicated in DLB. 37 DAP were reported and three were replicated in PDD. Our meta-analyses confirmed six DAP (TAU, SYUA, NFL, CHI3L1, GFAP, CLAT) in DLB, and three DAP (TAU, SYUA, NFL) in PDD. There was no replicated blood-based DAP in DLB or PDD. The reported DAP may contribute to LBD pathology by impacting misfolded protein clearance, dopamine neurotransmission, apoptosis, neuroinflammation, synaptic plasticity and extracellular vesicles.
Conclusion:
Our meta-analyses confirmed significantly lower CSF TAU levels in DLB and CSF SYUA levels in PDD, when compared to Alzheimer’s disease. Our findings indicate promising diagnostic biomarkers for LBD and may help prioritising molecular pathways for therapeutic target discovery. We highlight ten future research priorities based on our findings.
Agriculture, as the largest consumer of freshwater, plays a crucial role in managing limited water resources. However, uncertainties in water supply, particularly in water-scarce regions, hinder further agricultural development. Balancing agricultural development with environmental sustainability is especially demanding in the Karkheh River Basin (KRB), western Iran. Traditional irrigation networks in the upper KRB are inefficient, exacerbated by unregulated water use and over-extraction. This study explores the Water Supply-Demand Balance (WSDB) dynamics under current cropping patterns in the semi-arid Honam sub-basin of the upper KRB. Time-series Landsat imagery and Machine Learning (ML) algorithms classified crop types and estimated major crop cultivation areas during 2019–2021. Regional Crop Water Requirement (ETcreg) and Regional Net Irrigation Requirement (INETreg) estimated the Regional Gross Irrigation Water Demand (GIWDreg), while inflow-outflow analyses determined Surface Irrigation Water Supply (SIWS). The study achieved high crop classification accuracy, facilitating precise water demand estimation across large-scale traditional irrigation networks. Results indicated the highest GIWDreg in 2020 (11.3 × 106 m3/year), driven by increased forage cultivation with crop water requirements (ETc) exceeding 1000 mm. That year also recorded the maximum SIWS (14.8 × 106 m3/year). The Water Scarcity Index (WSI) classified shortages as severe to extreme, indicating WSDB instability due to drought and cropping pattern shifts. This study highlights the necessity for government initiatives promoting water-efficient cropping to align agriculture with water availability. The proposed approach offers practical insights for policymakers seeking to optimize food security while ensuring sustainable water management in traditional irrigation networks, where cropping patterns are difficult to assess.
Some Iranian local sainfoin landraces were studied to evaluate morphologic diversity and some related parameters according to 31 characteristics. Results indicated remarkable diversity for all characteristics whereas the phenotypic and genotypic CV (coefficient of variation) amounts were high for most of the measured characteristics. The magnitudes of heritability and genetic gain showed good potential in all of the sainfoin landraces. Also, the genetic advance as a mean per cent (breeding potential) for four characteristics was low while for 11 characteristics like thousand seed weight was moderate whereas for the other 16 remaining characteristics like total fresh and dry yield as well as seed yield was high, so the genetic advance of most characteristics was high and moderate and they can be improved by suitable selection strategy. Sainfoin landraces were categorized into four clusters via Wilks' lambda in both years whereas cluster-I with 10 common landraces at both years were early flowering and maturing while the seven common landraces of cluster-II and four common landraces of cluster-III indicated moderate values for most of sainfoin's traits. The three common landraces of cluster-IV (G14 from Azna, G19 from Kahlaran, and G25 from Saqqez) indicated higher values for most characteristics of sainfoin, and can be advised for releasing as the superior cultivars or used in crossbreeding programmes for generating the new cultivars with high-yield performance as well as high quality.
This study on distribution of Ophiothrix savignyi was carried out from 2017 to 2022 in the Iranian waters of the Persian Gulf. Nineteen locations were sampled from coastal waters, including 16 newly reported areas. O. savignyi was epizoic, associated mostly with sponges, sea urchins, and soft corals. This survey shows O. savignyi as the most common and widespread brittle star in the northern and eastern Persian Gulf. In this study, O. savignyi, has been described again from the Persian Gulf.
This study investigates the voice onset time (VOT) of stops in Bahdini Kurdish, which are characterized by a three-way laryngeal contrast of voiceless unaspirated, voiceless aspirated and voiced stops. Thirty native speakers read a forty-word list three times, which included three examples of each stop in pre-vocalic onset position. Words were chosen based on specific contextual factors to account for place of articulation, laryngeal state, following vowel height, and length contrasts. The findings show that VOT distinguishes stop categories in Kurdish, with voicing lead indicating voiced stops, short lag for voiceless unaspirated stops and long lag for voiceless aspirated stops. Results of the linear mixed-effects model show that laryngeal state, place of articulation, following vowel height and length had significant effects on VOT. The gender of the participants, however, showed no significant effect on VOT. In line with most research on the effect of place of articulation on VOT, in voiceless aspirated stop categories, bilabials had the shortest VOT, followed by dentals and velars. Voiceless unaspirated bilabials had the shortest VOT values, followed by dentals, uvulars and then velars. Voiced stops do not show such a pattern. These results are compatible with other research on Indo-Iranian languages with three-way laryngeal categories.
Previous research has focused on the significance of occupational burnout and the role of emotional intelligence and poor coping abilities among physicians.
Our study aimed to assess the prevalence of occupational burnout among first-year medical residents in Oman, exploring the relationship between trait emotional intelligence subscales and the three dimensions of burnout syndrome, and examining the association between sociodemographic covariates and the three dimensions of burnout syndrome.
The outcome measures included various indices of the abbreviated Maslach Burnout Inventory. The Trait Emotional Intelligence Questionnaire (TEI) and its subscales were examined.
The data showed a high burnout rate of 25.8%. Specifically, among the residents, 57.5% reported high levels of emotional exhaustion, 50.8% reported high depersonalisation and 49.2% reported a low sense of personal achievement. Age was significantly associated with depersonalisation (P < 0.003) and personal achievement (P < 0.0001). Marital status was the only variable significantly associated with emotional exhaustion (P = 0.001). Single residents had considerably lower emotional exhaustion than married residents (P = 0.001). The global mean score for the TEI was 4.77 (±0.64). A statistically significant relationship was found between personal achievement and emotional intelligence (r = 0.203, P = 0.026).
This study compares tumor control probability (TCP) and normal tissue complication probability (NTCP) across different hypo-fractionated (HypoRT) and conventional breast radiotherapy regimens using radiobiological models.
Materials and methods:
Computed tomography data from 30 patients with left breast-conserving surgery were used to evaluate three HypoRT regimens (39 Gy and 41·6 Gy in 13 fractions, and 40 Gy in 15 fractions) and a conventional regimen (50 Gy in 25 fractions). Dose-volume histograms (DVHs) were extracted for radiobiological calculations using Equivalent Uniform Dose (EUD) and Poisson models for TCP, and EUD and LKB (Lyman-Kutcher-Burman) models for NTCP.
Results:
Conventional treatment achieved significantly higher TCP (95%) than all HypoRT regimens (p < 0·001), with no significant differences between HypoRT regimens (p > 0·05. The 39 Gy/13 fraction regimen showed the lowest lung NTCP (p < 0·05). HypoRT regimens had significantly lower NTCP for the lungs and heart compared to the conventional regimen (p < 0·01). TCP and NTCP values from Poisson and LKB models were higher than those from the EUD model (p < 0·01).
Conclusion:
HypoRT regimens reduced NTCP, with the lowest values in the regime of 39 Gy/13 fractions regimen, though the conventional regimen had higher TCP.
Problem Management Plus (PM+) has been effective in reducing mental health problems among refugees at three-month follow-up, but there is a lack of research on its long-term effectiveness. This study examined the effectiveness of PM+ in reducing symptoms of common mental disorders at 12-month follow-up among Syrian refugees in the Netherlands.
Methods
This single-blind, parallel, controlled trial randomised 206 adult Syrians who screened positive for psychological distress and impaired functioning to either PM+ in addition to care as usual (PM+/CAU) or CAU alone. Assessments were at baseline, 1 week and 3 months after the intervention and 12 months after baseline. Outcomes were psychological distress (Hopkins Symptom Checklist [HSCL-25]), depression (HSCL-25 subscale), anxiety (HSCL-25 subscale), posttraumatic stress disorder symptoms (PCL-5), functional impairment (WHODAS 2.0) and self-identified problems (PSYCHLOPS).
Results
In March 2019–December 2022, 103 participants were assigned to PM+/CAU and 103 to CAU of which 169 (82.0%) were retained at 12 months. Intention-to-treat analyses showed greater reductions in psychological distress at 12 months for PM+/CAU compared to CAU (adjusted mean difference −0.17, 95% CI −0.310 to −0.027; p = 0.01, Cohen’s d = 0.28). Relative to CAU, PM+/CAU participants also showed significant reductions on anxiety (−0.19, 95% CI −0.344 to −0.047; p = 0.01, d = 0.31) but not on any of the other outcomes.
Conclusions
PM+ is effective in reducing psychological distress and symptoms of anxiety over a period up to 1 year. Additional support such as booster sessions or additional (trauma-focused) modules may be required to prolong and consolidate benefits gained through PM+ on other mental health and psychosocial outcomes.
The two related notions of honour and reputation are closely associated with the social status of individuals (male or female), particularly in a society governed by traditional, patriarchal moral values. However, writing about honour and reputation in Iraq (and in the Middle East in general) means talking about women's chastity and their sexual morality specifically. Eclipsing honour and societal reputation to women's bodies are deep-rooted patriarchal norms that stigmatize women's involvement in sexual relations (mainly outside marriage codes) and exclude men from this adultery framework. The current paper investigates the concepts of honour, chastity and reputation in relation to gender norms in Iraq through two contemporary Iraqi plays. First, the article introduces the two concepts through the social, traditional and religious context in the Middle East, focusing on Iraq. The discussion in the second section moves to tackle Ali Al Zaidi's play Rubbish (1995), while the third section deals with Amir Al-Azraki's The Widow (2014). In these two sections the study looks critically at how the two plays dramatize the concepts of honour and chastity through their characters. Being written respectively during and after wars, the two plays are seen as reactions to such issues. Hence they represent the new complex visions of two male perspectives challenging dramatically and shaking the settlement of such notions of morals and their impact on women as well as on society.
Preservation of the genetic diversity of sour cherry in Iran is imperative for the development of improved cultivars tailored to specific ecological conditions. Addressing gaps in research concerning ecological adaptation, resource management and international collaboration related to sour cherry genetic resources in Iran is essential. Bridging these research lacunae can facilitate the implementation of sustainable cultivation practices, optimize production systems and enhance the global utilization of sour cherry genetic diversity. A comprehensive analysis of the morphology and ultrastructure of pollen grains from ten native sour cherry genotypes in Iran was conducted over a two-year period using scanning electron microscopy (SEM). The examination revealed that all pollen grains were unipolar, radially symmetrical and tricolpate. The length and width of pollen grains varied among genotypes, with lengths ranging from 42.17 to 57.57 μm and widths from 20.28 to 28.13 μm. Furthermore, all genotypes exhibited prolate pollen grains, with differing colpus lengths. Examination of pollen exine revealed striate shapes with varying numbers of ridges, ranging from 18.5 to 8.5 furrows per 50 m2. The horizontal area of pollen grains varied from 333.28 to 1491.69 μm. Polar perspective analysis showed considerable variation in the distance between mesocolpium endpoints. Sour cherry displays significant genetic diversity in Iran, and the application of SEM has proven instrumental in characterizing this diversity. This understanding will aid in further breeding research aimed at enhancing sour cherry varieties and their adaptation to specific ecological conditions.
Safflower, a semiarid crop, contains a healthy oil with high unsaturated fatty acids. Genetically diverse accessions are important for genetic maintenance of safflower and breeding proposes. The objectives of present investigation were to evaluate the morphological variation of 100 safflower accessions across two years (2022 and 2023), to explore similar genotypic groups and to identify the higher contribution of traits with to the observed variability. The highest coefficient of variation (CV) was observed for seeds per secondary capitulum, number of capitula per plant and weight of lateral capitulum in the first year and the highest CV values were observed for number of capitula per plant and capitula per lateral branch in the second year. The factor analysis identified five factors in the first year and six factors in the second as yield components, height, seed yield, capitulum diameter and phonology while number of branches was identified as the extra factor in the second year. Results showed that the variation of morphologic traits was made up of from the most measured traits of safflower. We defined seven distinct clusters, which made it possible to differentiate safflower accessions based on measured traits across two years. Of 45 accessions were grouped in similar clusters across two years, without any or similar genotype by environment interaction. Some high yielding accessions like C-47 and Lesaf-175 can be entered directly in multi-environmental trials for cultivar release proposes. The recognized variation improves as a good resource, indicating an important issue for future projects for safflower germplasm maintenance and breeding.
Although it is customary to end an article with an acknowledgment, I would like instead to begin by recognizing the contribution of my close friend and coauthor, Shireen Abu Akleh, who was known to both Arab and international audiences as “the face of the Second Intifada,” reported on Palestinian suffering and resistance with the utmost professionalism and courage, and was shot dead by an Israeli sniper on May 11, 2022 while reporting from a Jenin refugee camp. This article is a personal and political commemoration of a dear and much-missed friend, and is intended to fulfill her personal wish to publish an academic article that related to her journalistic work.
Background: Fluctuation-related pain (worse in OFF periods) is a frequent and disabling symptom in Parkinson’s disease (PD). As evidence-based treatments to treat pain in PD are limited, exploring alternatives to treat it are imperative. Apomorphine is the only antiparkinsonian agent compatible with levodopa in improving PD motor symptoms and is usually well tolerated. We explored the effects of apomorphine in PD fluctuation-related pain. Methods: Small pilot double-blind, placebo controlled, randomized crossover study evaluating the safety and efficacy of subcutaneous apomorphine vs. placebo on fluctuation-related PD pain including participants experiencing pain during OFF periods. Primary outcomes: changes in a Visual Analogue Scale for pain and MDS-UPRDS III from baseline to 30 and 60 minutes after injections (two doses, separated by 60 min) and adverse events. Domperidone was used as premedication to avoid nausea/vomiting. Results: 16 patients were screened and 11 completed the study. All participants tolerated both treatments without significant side effects. Efficacy results remain blinded until the end of February 2023 and will be shown at the conference. Conclusions: Apomorphine, recently approved by Health Canada as an adjunctive therapy in PD patients and experiencing “off” periods, has shown to be safe when used to treat fluctuation-related PD pain. Efficacy outcomes will be soon available.
The Mahidasht region is a vital cultural sphere on the Great Khorasan Road that has provided substantial evidence for administrative activity, which is considered to be an indicator of economic and political complexity in late prehistoric societies. This article discusses a corpus of bureaucratic artefacts from the site of Tapeh Tyalineh in the Kouzaran plain in the north of Mahidasht, including 52 jar sealings and 12 door sealings. The artefacts were found during the recent surveys conducted by two of the authors at Tapeh Tyalineh after reports were received of illegal diggings at the site by villagers who had used its soil to plaster the roofs of their houses and to level and cultivate their farmland. Tyalineh seal impressions are studied here in terms of style and iconography in order to date the corpus of administrative artefacts. Furthermore, applying a functionalist approach, the artefacts are examined to answer questions regarding the nature and function of the site. The results suggest that the corpus dates to the proto-Elamite era. The significance of the door sealings, as the most important artefact type from Tyalineh, is that at least a part of the site was devoted to administrative affairs, which probably involved holding certain commodities in rather small closed-mouthed jars and then securing them behind locked doors. The administrative technology not only at Tyalineh but also at Chogha Maran and Dehsavar in Mahidasht and Godin VI:1 in Kangavar attest to well-established Early Bronze Age administrative and economic institutions along the Khorasan Road in the Central Zagros, which were involved in interregional commercial interactions.
To explore the psychological and economic effects of the COVID-19 epidemic and identify those at higher risk of suffering financial consequences.
Methods:
A cross-sectional study using an online survey was conducted in Saudi Arabia between June 27 and September 27, 2020. Logistic regression was conducted to determine who was more likely to suffer financially from the COVID-19 epidemic.
Results:
A total of 440 individual participated in this study, of whom, 86.8% were aged 19 – 49 years, and 60.0% were females. Around 57.0% reported that they have been affected economically by the pandemic. Around 11.0% of the participants reported that they feel anxious; around 18.0% reported feeling depressed or fearful because of COVID-19. Males were around twice (OR: 1.83; 95% CI: 1.24 – 2.72) as likely to be affected economically during the COVID-19 pandemic (P < 0.01). Saudis were 59.0% less likely to be affected (OR: 0.41; 95% CI: 0.27 – 0.60; P < 0.001).
Conclusions:
The COVID-19 pandemic has affected the psychological and economic status of individuals in Saudi Arabia deeply. To prevent long-term psychological and economic deterioration and to hasten social recovery, mental, financial, supportive strategies, and programs to aid the entire community in coping with the pandemic are recommended.
Bentonite-based tablets offer multiple advantages over other types of formulated tablets, including being biocompatible and cost-effective, and they can be used to develop gel-like matrices that have potential for use in sustained-release formulations. Developing a high-load sustained-release formulation has been reported to be challenging; therefore, the aim of this study was to develop systematically bentonite-based sustained-release tablets for a high-load active agent (ibuprofen) and investigate their release kinetics. Ibuprofen-loaded tablets (800 mg) were prepared using wet and dry granulation followed by enteric coating of the tablets. Fourier-transform infrared spectroscopy, differential scanning calorimetry and X-ray powder diffraction were used to evaluate the compatibility of ibuprofen with bentonite. The results show that these tablets comply with compendial requirements. In addition, the release profile of the formulations reveals that the drug follows a non-Fickian release model. The present formulation demonstrates a new use of bentonite as a safe and cost-effective excipient with adequate binding and compaction for preparing sustained-release tablets.
This experiment aimed to investigate the effects of inulin supplementation on milk production and composition, feed intake, nutrient digestibility and rumen fermentation parameters in lactating ewes. The experimental treatments were (1) control group (basal diet), (2) basal diet plus 2% inulin (w/w) and (3) basal diet plus 4% inulin (w/w). The experiment was carried out for 21 d in a fully randomized design involving eighteen Ghezel ewes. Production and composition (percentages of fat, protein, lactose and fat-free solids and fatty acid profiles) of milk were measured. Faeces were collected in the last 3 days of the experiment to determine digestibility. On the last day of the experiment, rumen fluid samples were taken from the esophagus 3 h after feeding and fermentation parameters (pH, ammonia nitrogen (N-NH3), volatile fatty acids (VFA) and protozoal population) were examined. Daily milk production was not significantly affected by inulin supplementation, but the fat and protein content of the milk was increased whilst urea nitrogen (MUN) and unsaturated fatty acids were decreased (P < 0.05). The dry matter (DM) intake results showed that there was no significant difference between different diets. The highest digestibility of DM and NDF belonged to the inulin fed group (P < 0.05). Inulin consumption numerically increased the pH of the rumen fluid of the animals and significantly decreased the rumen N-NH3 value (P < 0.05). Inulin supplementation also significantly increased total VFA, acetate, and butyrate levels (P < 0.05). In general, it can be concluded that inulin supplementation can improve rumen fermentation, DM and NDF digestibility,as well as compositional aspects of the ewe's milk production.