Effect of oral vitamin C on atrial fibrillation development after isolated coronary artery bypass grafting surgery: A prospective randomized clinical trial

Background: Some evidences have shown the role of antioxidant vitamins in preventing atrial fibrillation (AF) after coronary artery bypass grafting (CABG) surgery. We sought to determine the effect of oral vitamin C on the incidence of postoperative AF in patients undergoing elective isolated on-pump CABG surgery. Methods: One-hundred patients who underwent isolated CABG surgery were prospectively assigned into two groups: Group 1 — 50 patients received 2 g of oral vitamin C before and 500 mg twice daily lasting for 5 days after surgery; Group 2 — 50 patients as the control group did not receive any. All patients were continuously monitored after surgery in the intensive careunit (ICU), and then Holter monitoring was implemented for 72 h. Results: The mean of patients’ age was 61.31 ± 6.42 years. Postoperative AF occurred in 16 and 4 patients in control and treatment groups, respectively (32% vs. 8%, p = 0.003). The ICU stay was 1.79 ± 0.313 and 2.10 ± 0.61 days for vitamin C and control groups, respectively (p = 0.002). The hospital stay was significantly lower in vitamin C group compared with that of the control group (5.32 ± 0.59 vs. 5.74 ± 1.30 days, respectively, p = 0.041). Baseline erythrocyte sedimentation rate (OR 1.030, 95% CI 1.003–1.058, p = 0.030) and taking vitamin C (OR 8.068, 95% CI 1.783–36.517, p = 0.007) were the independent predictors of postoperative AF. Conclusions: Oral vitamin C can be safely used to decrease the incidence of postoperative AF in patients undergoing elective isolated on-pump CABG surgery.

Relationships of Students’ Mental Well-being with Mothers’ Emotional Breakdown and Marital Justice Mediated by Mothers’ Marital Intimacy

Background: Students’ mental well-being can be influenced by various maternal characteristics due to their close relationships with their mothers. These factors have an impact on their overall mental health. This study aimed to investigate the relationships between students’ mental well-being, mothers’ emotional breakdown, and marital justice, with the mediating role of mothers’ marital intimacy in Ahvaz, Iran.Methods: The statistical population of this descriptive-correlational study included all female and male senior high school students in Ahvaz, Iran, and their mothers during the 2022–23 academic year. A stratified cluster sampling method was employed, and 300 students and their mothers were selected as the research sample. The research utilized several tools, including the Psychological Well-being Scale, the Love Trauma Inventory, the Marital Justice Scale, and the Marital Intimacy Questionnaire. Path analysis was conducted using SPSS version 27 and AMOS version 25 to evaluate the proposed model.Results: The mean and standard deviation (SD) of students’ mental well-being, mothers’ emotional breakdown, mothers’ marital justice, and mothers’ marital intimacy were as follows: 59.69 (12.94), 19.29 (5.11), 59.36 (8.87), and 67.99 (12.34), respectively. The findings indicated that all direct paths to students’ mental well-being were significant (P<0.001), except for the marital justice of mothers. Furthermore, mothers’ marital intimacy significantly mediated the indirect path between mothers’ emotional breakdown and students’ mental well-being (P<0.001). Similarly, the relationship between mothers’ marital justice and students’ mental well-being was significantly mediated by mothers’ marital intimacy (P<0.001).Conclusion: The study revealed a direct positive relationship between mothers’ marital intimacy and students’ mental well-being. Therefore, it is expected that enhancing mothers’ marital intimacy will have a positive impact on students’ mental well-being. To achieve this, training workshops should be conducted to improve marital justice between spouses, thereby enhancing mothers’ marital intimacy and boosting students’ mental well-being

Possible association of vitamin D status with lung involvement and outcome in patients with COVID-19: a retrospective study

Purpose: Vitamin D deficiency has been reported as a key factor in the development of infectious diseases such as respiratory tract infections and inflammatory processes like acute respiratory distress syndrome. However, the impact of vitamin D on the severity and outcome of COVID-19 is still not fully known. Herein, we aimed to evaluate the prognostic role of serum vitamin D concentration on the extent of lung involvement and final outcome in patients with COVID-19. Methods: Seventy-three subjects with confirmed diagnosis of COVID-19 were investigated in this study. The patients had been admitted to our academic hospital from February 28, 2020 to April 19, 2020. Demographic and clinical data, serum 25(OH)D levels, and findings of initial chest computed tomography were recorded. Linear and binary logistic regression, cox regression and ROC curve tests were used for statistical analysis. Results: The mean age of patients was 55.18 ± 14.98 years old; 46.4 were male. Mean serum 25(OH)D concentration was significantly lower in the deceased (13.83 ± 12.53 ng/ mL compared with discharged patients (38.41 ± 18.51 ng/mL) (P < 0.001). Higher levels of 25(OH)D were associated with significantly less extent of total lung involvement (β = � 0.10, P = 0.004). In addition, vitamin D deficiency 25(OH) D < 25 ng/mL was associated with a significant increase in the risk of mortality (hazard ratio = 4.15, P = 0.04). Conclusion: This study suggests that serum vitamin D status might provide useful information regarding the clinical course, extent of lung involvement and outcome of patients with COVID-19. However, further studies with larger sample size are needed to confirm these findings. © 2020, Springer-Verlag GmbH Germany, part of Springer Nature

Mapping local patterns of childhood overweight and wasting in low- and middle-income countries between 2000 and 2017

A double burden of malnutrition occurs when individuals, household members or communities experience both undernutrition and overweight. Here, we show geospatial estimates of overweight and wasting prevalence among children under 5 years of age in 105 low- and middle-income countries (LMICs) from 2000 to 2017 and aggregate these to policy-relevant administrative units. Wasting decreased overall across LMICs between 2000 and 2017, from 8.4% (62.3 (55.1–70.8) million) to 6.4% (58.3 (47.6–70.7) million), but is predicted to remain above the World Health Organization’s Global Nutrition Target of <5% in over half of LMICs by 2025. Prevalence of overweight increased from 5.2% (30 (22.8–38.5) million) in 2000 to 6.0% (55.5 (44.8–67.9) million) children aged under 5 years in 2017. Areas most affected by double burden of malnutrition were located in Indonesia, Thailand, southeastern China, Botswana, Cameroon and central Nigeria. Our estimates provide a new perspective to researchers, policy makers and public health agencies in their efforts to address this global childhood syndemic

Global age-sex-specific fertility, mortality, healthy life expectancy (HALE), and population estimates in 204 countries and territories, 1950-2019 : a comprehensive demographic analysis for the Global Burden of Disease Study 2019

Background: Accurate and up-to-date assessment of demographic metrics is crucial for understanding a wide range of social, economic, and public health issues that affect populations worldwide. The Global Burden of Diseases, Injuries, and Risk Factors Study (GBD) 2019 produced updated and comprehensive demographic assessments of the key indicators of fertility, mortality, migration, and population for 204 countries and territories and selected subnational locations from 1950 to 2019. Methods: 8078 country-years of vital registration and sample registration data, 938 surveys, 349 censuses, and 238 other sources were identified and used to estimate age-specific fertility. Spatiotemporal Gaussian process regression (ST-GPR) was used to generate age-specific fertility rates for 5-year age groups between ages 15 and 49 years. With extensions to age groups 10–14 and 50–54 years, the total fertility rate (TFR) was then aggregated using the estimated age-specific fertility between ages 10 and 54 years. 7417 sources were used for under-5 mortality estimation and 7355 for adult mortality. ST-GPR was used to synthesise data sources after correction for known biases. Adult mortality was measured as the probability of death between ages 15 and 60 years based on vital registration, sample registration, and sibling histories, and was also estimated using ST-GPR. HIV-free life tables were then estimated using estimates of under-5 and adult mortality rates using a relational model life table system created for GBD, which closely tracks observed age-specific mortality rates from complete vital registration when available. Independent estimates of HIV-specific mortality generated by an epidemiological analysis of HIV prevalence surveys and antenatal clinic serosurveillance and other sources were incorporated into the estimates in countries with large epidemics. Annual and single-year age estimates of net migration and population for each country and territory were generated using a Bayesian hierarchical cohort component model that analysed estimated age-specific fertility and mortality rates along with 1250 censuses and 747 population registry years. We classified location-years into seven categories on the basis of the natural rate of increase in population (calculated by subtracting the crude death rate from the crude birth rate) and the net migration rate. We computed healthy life expectancy (HALE) using years lived with disability (YLDs) per capita, life tables, and standard demographic methods. Uncertainty was propagated throughout the demographic estimation process, including fertility, mortality, and population, with 1000 draw-level estimates produced for each metric. Findings: The global TFR decreased from 2·72 (95% uncertainty interval [UI] 2·66–2·79) in 2000 to 2·31 (2·17–2·46) in 2019. Global annual livebirths increased from 134·5 million (131·5–137·8) in 2000 to a peak of 139·6 million (133·0–146·9) in 2016. Global livebirths then declined to 135·3 million (127·2–144·1) in 2019. Of the 204 countries and territories included in this study, in 2019, 102 had a TFR lower than 2·1, which is considered a good approximation of replacement-level fertility. All countries in sub-Saharan Africa had TFRs above replacement level in 2019 and accounted for 27·1% (95% UI 26·4–27·8) of global livebirths. Global life expectancy at birth increased from 67·2 years (95% UI 66·8–67·6) in 2000 to 73·5 years (72·8–74·3) in 2019. The total number of deaths increased from 50·7 million (49·5–51·9) in 2000 to 56·5 million (53·7–59·2) in 2019. Under-5 deaths declined from 9·6 million (9·1–10·3) in 2000 to 5·0 million (4·3–6·0) in 2019. Global population increased by 25·7%, from 6·2 billion (6·0–6·3) in 2000 to 7·7 billion (7·5–8·0) in 2019. In 2019, 34 countries had negative natural rates of increase; in 17 of these, the population declined because immigration was not sufficient to counteract the negative rate of decline. Globally, HALE increased from 58·6 years (56·1–60·8) in 2000 to 63·5 years (60·8–66·1) in 2019. HALE increased in 202 of 204 countries and territories between 2000 and 2019

Global burden of 369 diseases and injuries in 204 countries and territories, 1990–2019: a systematic analysis for the Global Burden of Disease Study 2019

Background: In an era of shifting global agendas and expanded emphasis on non-communicable diseases and injuries along with communicable diseases, sound evidence on trends by cause at the national level is essential. The Global Burden of Diseases, Injuries, and Risk Factors Study (GBD) provides a systematic scientific assessment of published, publicly available, and contributed data on incidence, prevalence, and mortality for a mutually exclusive and collectively exhaustive list of diseases and injuries. Methods: GBD estimates incidence, prevalence, mortality, years of life lost (YLLs), years lived with disability (YLDs), and disability-adjusted life-years (DALYs) due to 369 diseases and injuries, for two sexes, and for 204 countries and territories. Input data were extracted from censuses, household surveys, civil registration and vital statistics, disease registries, health service use, air pollution monitors, satellite imaging, disease notifications, and other sources. Cause-specific death rates and cause fractions were calculated using the Cause of Death Ensemble model and spatiotemporal Gaussian process regression. Cause-specific deaths were adjusted to match the total all-cause deaths calculated as part of the GBD population, fertility, and mortality estimates. Deaths were multiplied by standard life expectancy at each age to calculate YLLs. A Bayesian meta-regression modelling tool, DisMod-MR 2.1, was used to ensure consistency between incidence, prevalence, remission, excess mortality, and cause-specific mortality for most causes. Prevalence estimates were multiplied by disability weights for mutually exclusive sequelae of diseases and injuries to calculate YLDs. We considered results in the context of the Socio-demographic Index (SDI), a composite indicator of income per capita, years of schooling, and fertility rate in females younger than 25 years. Uncertainty intervals (UIs) were generated for every metric using the 25th and 975th ordered 1000 draw values of the posterior distribution. Findings: Global health has steadily improved over the past 30 years as measured by age-standardised DALY rates. After taking into account population growth and ageing, the absolute number of DALYs has remained stable. Since 2010, the pace of decline in global age-standardised DALY rates has accelerated in age groups younger than 50 years compared with the 1990–2010 time period, with the greatest annualised rate of decline occurring in the 0–9-year age group. Six infectious diseases were among the top ten causes of DALYs in children younger than 10 years in 2019: lower respiratory infections (ranked second), diarrhoeal diseases (third), malaria (fifth), meningitis (sixth), whooping cough (ninth), and sexually transmitted infections (which, in this age group, is fully accounted for by congenital syphilis; ranked tenth). In adolescents aged 10–24 years, three injury causes were among the top causes of DALYs: road injuries (ranked first), self-harm (third), and interpersonal violence (fifth). Five of the causes that were in the top ten for ages 10–24 years were also in the top ten in the 25–49-year age group: road injuries (ranked first), HIV/AIDS (second), low back pain (fourth), headache disorders (fifth), and depressive disorders (sixth). In 2019, ischaemic heart disease and stroke were the top-ranked causes of DALYs in both the 50–74-year and 75-years-and-older age groups. Since 1990, there has been a marked shift towards a greater proportion of burden due to YLDs from non-communicable diseases and injuries. In 2019, there were 11 countries where non-communicable disease and injury YLDs constituted more than half of all disease burden. Decreases in age-standardised DALY rates have accelerated over the past decade in countries at the lower end of the SDI range, while improvements have started to stagnate or even reverse in countries with higher SDI. Interpretation: As disability becomes an increasingly large component of disease burden and a larger component of health expenditure, greater research and developm nt investment is needed to identify new, more effective intervention strategies. With a rapidly ageing global population, the demands on health services to deal with disabling outcomes, which increase with age, will require policy makers to anticipate these changes. The mix of universal and more geographically specific influences on health reinforces the need for regular reporting on population health in detail and by underlying cause to help decision makers to identify success stories of disease control to emulate, as well as opportunities to improve. Funding: Bill & Melinda Gates Foundation. © 2020 The Author(s). Published by Elsevier Ltd. This is an Open Access article under the CC BY 4.0 licens

Studying the Intervening Role of Social Capital in the Effect on Corporate Social Media on Quality of Knowledge and Innovational Performance

Today service organizations operate in highly dynamic and competitive environment where improving performance depends on effective utilization of intangible assets. Accordingly, this study investigated the intervening role of social capital in the effect of social media assimilation on the quality of organizational knowledge and innovational performance. This study has been done in a sample of 280 employees of Saderat bank branches in Mazandaran province. The present study was an applied and descriptive research. The structural equation modeling through SPSS22 and Warp PLS software were used for date analyzing. The results showed that assimilation of social media had a positive and significant impact on quality of organizational knowledge and innovational performance. Social capital has a significant intervening role in these relations. Furthermore, improving the quality of organizational knowledge can promote innovational performanc

Defending The Arguments for the Necessity of Infallibility of Imam to Clear up Fakhr-E- Razi’s Doubts

Contrary to Sunny scholars, Shia scholars believe that infallibility and immunity of Holy Prophet's successors (peace be upon him and his progeny) from any mistake, sin, error, and fault is a necessary and essential condition. Therefore, Imams (peace be upon them) must be infallible and immune from any sin and error. Shia theologians and scholars, particularly Khawja Nasir al-din Tusi, have provided several transmitted and rational arguments for the necessity of infallibility of Imams (peace be upon them) who are the successors of Holy Prophet. Therefore, any neglect of divine injunctions and commands, whether intentionally or unintentionally, overt or covert, is inconsistent with taking the position of Imam and succeeding Holy Prophet.  Fakhr Razi and his followers, however, cast doubt on and even denied the necessity of the condition of infallibility for Holy Prophet's successors and finally reduced infallibility into justice. The present paper elaborates on the most important arguments of Muslim theologians, particularly Mohaqqeq Tusi, for the necessity and exigency of infallibility of Imams, criticizes and rejects Fakhr Razi's most important doubts and objections, and finally concludes that infallibility is a necessary and essential condition for Holy Prophet's successors

An Artificial Neural Network to Predict Depression Symptoms Through Emotional Divorce and Spiritual Beliefs in Married University Students

Background and Objectives: Spirituality and spiritual beliefs are among the factors playing key roles in preventing psychological disorders. The present study aimed to investigate the relationship between depression symptoms with emotional divorce and spiritual beliefs using artificial neural networks (ANN) in married university students. Methods: The statistical population of this descriptive-correlational study included all married students at the Islamic Azad University of Ahvaz (Khuzestan Province, Iran) during the 2021–22 academic year. The convenience sampling technique was adopted to select 301 married students as the research sample. An ANN was employed and data collection was done using the Beck’s depression inventory, emotional divorce scale, and religious orientation scale. Data analysis was performed through the Pearson correlation coefficient, stepwise regression, and an ANN. Results: The results showed a significant positive relationship between emotional divorce and depression symptoms, whereas there was a significant negative relationship between intrinsic religious beliefs and depression symptoms (P<0.001). However, a significant positive relationship existed between extrinsic religious beliefs and depression symptoms (P<0.001). Furthermore, depression symptoms were associated with emotional divorce and intrinsic/extrinsic religious beliefs in married university students. The results of the ANN also showed that emotional divorce had the most relationship with the depression symptoms of married students. Conclusion: The ANN appropriately predicted depression symptoms through an emotional divorce and spiritual beliefs among married university students. The results indicated the necessity of paying more attention to marital relationships, emotional divorce improvement, and depression alleviation

Efficacy evaluation of activated carbon prepared from date stones in cyanide adsorption from synthetic wastewater

Background and Aim: Availability and low cost of date stones make them useful as raw material in the preparation of activated carbon. Cyanide, because of its toxicity for humans and aquatic organisms, is one of the most important health problems. The aim of the present study was to evaluate cyanide removal from aqueous solutions and determine influencing parameters in its adsorption into activated carbon prepared from date stones. Materials and Methods: In this experimental study, activated carbon was prepared by using an electrical furnace giving out 750°C temperature for 100 min. The effect of pH (2-12), cyanide concentration (100-300 mg/L) and activated carbon dosage (0.25-2 g/L) on the absorption process were explored. All experiments were conducted in triplicate and the mean absorption rate was reported. Results: The maximum adsorption capacity of 50.21 mg/g corresponded with Langmuir model. Kinetic evaluation indicated that the adsorption of cyanide ions by the adsorbent clearly followed the pseudo-second order rate reaction. The absorption was pH dependent and the maximum adsorption was done by solutions having pH 9. At an optimum pH 9, over 97% removal of 100 mg/L cyanide was attained for an adsorbent dose of 1.25 g/L during a 40 min contact time. Conclusion: Activated carbon prepared from date stones is an efficient and low-cost adsorbent for removing of different concentrations of cyanide from water and wastewater