The effect of dialectical behavior therapy on executive function in patients with a bipolar disorder

Background: Bipolar disorder is a debilitating psychiatric disorder characterized by recurrent depression, manic and hippomanic episodes. The effect of a dialectical behavior therapy on executive functions in bipolar disorders has not been addressed so far. The aim of this study was to determine the effect of the dialectical behavior therapy on executive function in the bipolar disorder. Materials and Methods: Sixty patients with a bipolar disorder were randomly assigned to the intervention (the dialectical behavior therapy combined with medication) and control (only medication) groups. The questionnaires and tests were used at baseline, after 12 weeks intervention, and three months after the intervention. Participants in the intervention group received twelve 90-min sessions of the standard dialectical behavior therapy for the bipolar disorder. Results: The results showed that the intervention group had a lower score in mania, and depression. Also, the intervention group had a higher score in executive functions after three months intervention and three months follow-up. Conclusion: The dialectical behavior therapy in combination with medication can lead to reduce manic and depression symptoms, and improve performance of the patients in planning and problem-solving

Secondary Metabolites: Alkaloids and Flavonoids in Medicinal Plants

Secondary metabolites (SMs) are natural compounds produced mainly by bacteria, fungi, and plants. They are low molecular weight compounds that have a wide range of chemical structures and biological functions. Secondary metabolites are so named because, unlike primary metabolites such as lipids, amino acids, carbohydrates, and nucleic acids, their synthesis is not required for the organism’s development and reproduction. Today, the production of secondary metabolites is an important area of research for organic chemists, molecular biologists, and bioinformaticians. In this research, two types of secondary metabolites produced by plants, such as alkaloids and flavonoids, were studied and information was collected on the types of compounds, structures, biological activities, and commercial applications of these two types of secondary metabolites

The Prevalence of Musculoskeletal Disorders and its Relation with Fatigue and Occupational Burnout in the Staff of a Petrochemical Industry

Background: Occupational burnout is a sign of various fatigue states and can cause diseases like musculoskeletal disorders. The aim of this study was to determine the prevalence of musculoskeletal disorders and its relation with fatigue and occupational burnout in the staff of a petrochemical industry. Methods: The present study is a descriptive-analytical cross-sectional study conducted on 121 personnel working in a petrochemical industry in 2017. For data collection, the Multidimensional Fatigue Inventory (MFI) questionnaire, Nordic questionnaire, and Maslach Burnout questionnaire were used. Data were analyzed using SPSS 22 and the significance level was considered 0.05. Results: In general, 71.1% of the subjects suffered from at least one musculoskeletal disorder in their organs during the past year. There was no significant relation between musculoskeletal disorders and occupational burnout. Musculoskeletal disorders were significantly associated with decreased motivation (P=0.035), one of the fatigue domains. Musculoskeletal disorders were also significantly related with the type of occupation (P = 0.017). Conclusion: Musculoskeletal disorders are probably related with some fields of fatigue and burnout. Further studies should be done. Keywords: Musculoskeletal Disorders, Fatigue, Occupational Burnout, Petrochemical

Kliničko značenje povišene razine olova u krvi u ovisnika o opijumu s jakom boli u području abdomena

There are inconsistencies regarding the association of blood lead level (BLL) in opium addicts with severe abdominal pain. In present study, we aimed to assess BLL in opium addicts presented with severe abdominal pain. This cross-sectional study was conducted on 60 opium-addicted individuals admitted to our rehabilitation center in Zabol city during February-October 2016. BLL was measured using potentiometric-stripping analysis (PSA) method. Statistical analysis was conducted in SPSS 20 software. From 60 addicts re-cruited, 47 (78.3%) were males. The mean age was 40.3±18.1 years old. The mean BLL was 43.1±117.4 µg/ dl. Considering a threshold of 18 µg/dl, 22 (37.6%) of the addicts had elevated BLL. The mean BLL in addicts with oral, inhalation and mixed method of consumptions were 54.9±1.5 µg/dl, 47.4±9.2 µg/dl, and 10.1±95 µg/dl respectively (P=0.5). No differences were found regarding the mean BLL among different age groups or between different genders. Furthermore, there were no significant difference in neither hematological pa-rameters or liver enzyme in addicts with normal and elevated BLL. The BLL was not of significant difference in addicts with different methods of opium usage and severe abdominal pain. It is recommended to investigate the effects of factors such as the duration of opium usage and the concentration of lead in opium to influ-ence BLL.Postoje nedosljednosti u vezi povezanosti razine olova u krvi (OUK) u ovisnika o opijumu s jakim bolovima na području abdomena. U ovome radu nam je bio cilj odrediti OUK u ovisnika o opijumu s jakim bolovima u trbuhu. Provedeno je presječno instraživanje na 60 ovisnika o opijumu primljenih u naš rehabilit-acijski centar u gradu Zabol od veljače do listopada 2016. OUK je mjereno metodom potenciometrijske strip-ing analize. Statističke analize su učinjene programom SPSS 20. Od ispitanih 60 ovisnika, 47 (78,3 %) su bili muškarci. Srednja dob je bila 40.3 ± 18.1 godina. Srednja vrijednost OUK je bila 43.1 ± 117.4 μg/DL. S obzirom na prag od 18 μg/DL, 22 (37,6 %) ovisnika imalo je povišeno OUK. Srednje vrijednosti OUK u ovisnika koji su sredstvo konzumirali peroralno, inhalacijski i mješano su iznosile 54.9 ± 1,5 μg/DL, 47.4 ± 9,2 μg/DL i 10.1 ± 95 μg/DL (P = 0,5). Nisu pronađene značajne razlike srednje vrijednosti OUK među različitim dobnim skupinama ili između spolova. Nadalje, nije bilo značajne razlike ni u hematološkim parametrima ili jetrenim enzimima u ovisnika s normalnim i povišenim OUK. OUK se nije značajno razlikovalo u ovisnika s različitim načinima konzu-miranja droge i jakim bolovima u trbuhu. Preporuča se istražiti kako čimbenici kao što su trajanje konzumacije opijuma i koncentracija olova u opijum utječu na razinu OUK

Recent Advancements in Aptamer-bioconjugates: Sharpening Stones for Breast and Prostate Cancers Targeting

Breast and prostate cancers are common types of cancers with various strategies, such as chemotherapy and radiotherapy, for their therapy. Since these methods have undesired side effects and poor target affinity, neoteric strategies—known as aptamer-based smart drug delivery systems (SDDSs)—have been developed in recent years to overcome the obstacles of current treatment, and investigated for a clinical trial. The high affinity and versatility of aptamers for binding to the corresponding targets make them highly noticeable agents in the drug delivery domains. In addition to their exceptional benefits, aptamers are able to overcome tumor resistance because of their high selectivity and low toxicity. Furthermore, aptamers can conjugate with various drugs, nanoparticles and antibodies and effectively deliver them to the specific breast and prostate cells. This review highlights the current researches in aptamer-conjugate developments for targeting breast and prostate cancers, with the special focus on the nanoparticle-aptamer bioconjugates, systematic evolution of ligands by exponential enrichment (SELEX) system and SDDS, especially cutting-edge articles from 2008 to present. Finally, the future prospects and challenges are described

Soluble Fas might serve as a diagnostic tool for gastric adenocarcinoma

<p>Abstract</p> <p>Background</p> <p>Fas (Apo-1/CD95) and its specific ligand (FasL) are key elements in apoptosis. They have been studied in different malignancies but there are few published studies about the soluble forms of these markers (i.e. sFas/sFasL) in gastric cancer. We have compared the serum levels of sFas/sFasL in gastric adenocarcinoma patients and cases with pre-neoplastic lesions as potential markers for early diagnosis, and investigated their relation with clinicopathological characteristics.</p> <p>Methods</p> <p>Fifty-nine newly-diagnosed cases of gastric adenocarcinoma who had undergone gastrectomy, along with 62 endoscopically- and histologically-confirmed non-cancer individuals were enrolled in this study. sFas/sFasL serum levels were detected by Enzyme Linked Immunosurbent Assay.</p> <p>Results</p> <p>Mean serum sFas level was significantly higher in gastric cancer patients than in control group (305.97 ± 63.71 (pg/ml) vs. 92.98 ± 4.95 (pg/ml), P < 0.001); while the mean serum level of sFasL was lower in patients with gastric adenocarcinoma (0.138 ± 0.04 (pg/ml) vs. 0.150 ± 0.02 (pg/ml), P < 0.001). Mean serum levels of sFas/sFasL were significantly different in both intestinal/diffuse and cardiac/non-cardiac subtypes when compared to the control group (P < 0.001). There was an increase in the serum level of sFas from the first steps of pre-neoplastic lesions to gastric adenocarcinoma (P < 0.001). Patients who had no lymph node involvement (<it>N₀</it>) showed significantly higher serum levels of sFas compared to others (P = 0.044).</p> <p>Conclusions</p> <p>Production of sFas may play a critical role in the carcinogenesis of intestinal-type gastric cancer. sFas serum level may serve as a non-invasive tool for early diagnosis of gastric cancer.</p

Mapping 123 million neonatal, infant and child deaths between 2000 and 2017

Since 2000, many countries have achieved considerable success in improving child survival, but localized progress remains unclear. To inform efforts towards United Nations Sustainable Development Goal 3.2—to end preventable child deaths by 2030—we need consistently estimated data at the subnational level regarding child mortality rates and trends. Here we quantified, for the period 2000–2017, the subnational variation in mortality rates and number of deaths of neonates, infants and children under 5 years of age within 99 low- and middle-income countries using a geostatistical survival model. We estimated that 32% of children under 5 in these countries lived in districts that had attained rates of 25 or fewer child deaths per 1,000 live births by 2017, and that 58% of child deaths between 2000 and 2017 in these countries could have been averted in the absence of geographical inequality. This study enables the identification of high-mortality clusters, patterns of progress and geographical inequalities to inform appropriate investments and implementations that will help to improve the health of all populations

Global, regional, and national cancer incidence, mortality, years of life lost, years lived with disability, and disability-Adjusted life-years for 29 cancer groups, 1990 to 2017 : A systematic analysis for the global burden of disease study

Importance: Cancer and other noncommunicable diseases (NCDs) are now widely recognized as a threat to global development. The latest United Nations high-level meeting on NCDs reaffirmed this observation and also highlighted the slow progress in meeting the 2011 Political Declaration on the Prevention and Control of Noncommunicable Diseases and the third Sustainable Development Goal. Lack of situational analyses, priority setting, and budgeting have been identified as major obstacles in achieving these goals. All of these have in common that they require information on the local cancer epidemiology. The Global Burden of Disease (GBD) study is uniquely poised to provide these crucial data. Objective: To describe cancer burden for 29 cancer groups in 195 countries from 1990 through 2017 to provide data needed for cancer control planning. Evidence Review: We used the GBD study estimation methods to describe cancer incidence, mortality, years lived with disability, years of life lost, and disability-Adjusted life-years (DALYs). Results are presented at the national level as well as by Socio-demographic Index (SDI), a composite indicator of income, educational attainment, and total fertility rate. We also analyzed the influence of the epidemiological vs the demographic transition on cancer incidence. Findings: In 2017, there were 24.5 million incident cancer cases worldwide (16.8 million without nonmelanoma skin cancer [NMSC]) and 9.6 million cancer deaths. The majority of cancer DALYs came from years of life lost (97%), and only 3% came from years lived with disability. The odds of developing cancer were the lowest in the low SDI quintile (1 in 7) and the highest in the high SDI quintile (1 in 2) for both sexes. In 2017, the most common incident cancers in men were NMSC (4.3 million incident cases); tracheal, bronchus, and lung (TBL) cancer (1.5 million incident cases); and prostate cancer (1.3 million incident cases). The most common causes of cancer deaths and DALYs for men were TBL cancer (1.3 million deaths and 28.4 million DALYs), liver cancer (572000 deaths and 15.2 million DALYs), and stomach cancer (542000 deaths and 12.2 million DALYs). For women in 2017, the most common incident cancers were NMSC (3.3 million incident cases), breast cancer (1.9 million incident cases), and colorectal cancer (819000 incident cases). The leading causes of cancer deaths and DALYs for women were breast cancer (601000 deaths and 17.4 million DALYs), TBL cancer (596000 deaths and 12.6 million DALYs), and colorectal cancer (414000 deaths and 8.3 million DALYs). Conclusions and Relevance: The national epidemiological profiles of cancer burden in the GBD study show large heterogeneities, which are a reflection of different exposures to risk factors, economic settings, lifestyles, and access to care and screening. The GBD study can be used by policy makers and other stakeholders to develop and improve national and local cancer control in order to achieve the global targets and improve equity in cancer care. © 2019 American Medical Association. All rights reserved.Peer reviewe

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

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