Scaling-up a new socio-mental health service model in Iran to reduce burden of neuropsychiatric disorders: an economic evaluation study

Background: The integration of core packages of mental health care into routine primary health care has been introduced as an effective way to achieve universal health coverage in mental health care. Based on the transition of mental health care in Iran, from introducing basic mental health care in PHC to the experience of community-based mental health centers for urban areas, a new socio-mental health service model has been so far proposed. This study aimed to estimate the impact of scaling-up the new socio-mental health model at the national level as well as its associated costs. Methods: This study was a cost-consequence analysis following One Health Tool methodology. The data required for the study were collected in the first quarter of the year 2020 with a time horizon from 2020 to 2030. The selected metric for summarizing health effects is healthy life years gained. Resources used in terms of drug and supply, staff salaries and outpatient visits were documented and associated costs were subsequently estimated in order to estimate the average cost of each intervention per case. Results: The health impacts are calculated in terms of healthy life years gained for 2020�2030, after adjusting the prevalence and incidence rates for each disorder. In total, 1,702,755 healthy life years were expected to be gained. Considering total 1,363,581,654 US dollars cost in base case scenario, each healthy life years gained will cost around 801 US dollars. Based on the WHO criteria for cost-effectiveness threshold, all of the values ranged from 724 to 1119 US dollars obtained through eight different scenarios were considered as cost-effective given the GDP per capita of 5550 US dollars for Iran in 2018. Conclusions: Mental health budget in Iran equals to about three percent of total health expenditure while the mental health cost per capita is estimated to be 1.73 US dollar which are relatively low considering the share of the MNS disorders in the national burden of diseases. The results of current study showing the cost of 16.4 US dollar per capita for scaling up this comprehensive mental health service model can convince high-level policy-makers to increase the share of mental health budget accordingly. The present study demonstrated that the cost in this new socio-mental services model is not substantial compared with GDP per capita of Iran. © 2021, The Author(s)

Integrative omics identifies conserved and pathogen-specific responses of sepsis-causing bacteria

Even in the setting of optimal resuscitation in high-income countries severe sepsis and septic shock have a mortality of 20–40%, with antibiotic resistance dramatically increasing this mortality risk. To develop a reference dataset enabling the identification of common bacterial targets for therapeutic intervention, we applied a standardized genomic, transcriptomic, proteomic and metabolomic technological framework to multiple clinical isolates of four sepsis-causing pathogens: Escherichia coli, Klebsiella pneumoniae species complex, Staphylococcus aureus and Streptococcus pyogenes. Exposure to human serum generated a sepsis molecular signature containing global increases in fatty acid and lipid biosynthesis and metabolism, consistent with cell envelope remodelling and nutrient adaptation for osmoprotection. In addition, acquisition of cholesterol was identified across the bacterial species. This detailed reference dataset has been established as an open resource to support discovery and translational research

Integrative omics identifies conserved and pathogen-specific responses of sepsis-causing bacteria

Even in the setting of optimal resuscitation in high-income countries severe sepsis and septic shock have a mortality of 20–40%, with antibiotic resistance dramatically increasing this mortality risk. To develop a reference dataset enabling the identification of common bacterial targets for therapeutic intervention, we applied a standardized genomic, transcriptomic, proteomic and metabolomic technological framework to multiple clinical isolates of four sepsis-causing pathogens: Escherichia coli, Klebsiella pneumoniae species complex, Staphylococcus aureus and Streptococcus pyogenes. Exposure to human serum generated a sepsis molecular signature containing global increases in fatty acid and lipid biosynthesis and metabolism, consistent with cell envelope remodelling and nutrient adaptation for osmoprotection. In addition, acquisition of cholesterol was identified across the bacterial species. This detailed reference dataset has been established as an open resource to support discovery and translational research

A new cyclone design with adjustable inlet angle and external geometry for optimal PM10 removal

In this study, a 2D2D cyclone layout was used as the base structure for the design of a new cyclone with an adjustable inlet angle and vortex finder height. The optimal conditions for the removal of fine particles were studied analytically and experimentally in the laboratory. The purpose of this study is to optimize the performance of the cyclone with different inlet angles to enhance particulate matter PM10 removal efficiency. The ASTMD3685 method was used for sampling and testing the main factors. To determine the relationship between the variables and the study purpose, the data were analyzed using Minitab software (19). The results showed that the efficiencies of the removal of PM and particles with diameters of 10 μm, 4.7 μm, and 1 μm were 73.5, 90, 75, and 60, respectively. The cyclone was effective under a low suction pressure and 90° inlet angle, and a vortex finder height hvf=12D. By optimizing the geometric structure, cyclones can be used as the main device to remove particulates, especially those of 1�10 μm, in a variety of industries and in particular sensitive industries. © 2019, Islamic Azad University (IAU)

Right ventricular myxoma originating from a papillary muscle: a case report

Very few cases of ventricular myxoma originate from a papillary muscle. Patients with a cardiac myxoma and a history of colorectal carcinoma are also rare. Here, we present a case of an extremely large right ventricular myxoma that originated from the posteromedial papillary muscle in a patient with a history of colorectal carcinoma. © 2016, Wiley Periodicals, Inc