Risky decision-making and the intensity of opioid drug dependency in early phase of methadone maintenance protocol

Several studies show positive effect of MMT on decision-making in substance dependents, but severity of the disorder has been ignored by most of them. This study used Iowa Gambling Task(IGT) to find correlation between severity of the disorders in early phase of MMT and risky decision-making in three groups of subjects (mild, sever, control). The study shows no significant difference among groups in risky decision-making, which might be related to the effect of opioid on cognitive functions independent of the severity of the disorder, and stabilization in MMT can repair deficit in decision making shortly during the early phase

From Diagnosis to Cure: Innovations in Disease Diagnosis and Treatment

Chapter1: Advancements in diagnosis and treatment of neurological disorders Chapter2: Advancements in diagnosis and treatment of mental disorders Chapter3: Advancements in diagnosis and treatment of cardiovascular disease Chapter4: Advancements in surgical procedures Chapter5: New developments in surgical procedure

Assessment of Standard Operating Procedures (SOPs) Preparing Hygienic Condition in the Blood Donation Centers during the Outbreak of COVID-19

Background: The coronavirus disease 2019 (COVID-19) outbreak has led to an alteration in hygienic conditions. In this situation, improving standard operating procedures (SOPs) in blood donation centers is critical. The purpose of this study was the assessment of SOPs in the blood donation centers during the outbreak of COVID-19 by regular blood donors as external audits. Materials and Methods: Regular donors were selected as external inspectors in 31 provinces of Iran. The questionnaire containing 10 closed questions was provided to assess the hygienic SOPs of blood transfusion centers in the prevention of COVID-19 transmission. Comparison and evaluation of questionnaires were conducted by assigning an importance coefficient (IC)  score to each question. Results: Assessment of SOPs in blood donation departments by regular donors in 31 provinces of Iran showed that 18 centers (58.1%) received IC scores >10(Strong performance), 7 centers (22.6%) received the range of IC scores between7-10(acceptable performance), and 6 centers (19.4%) received IC scores <7(poor performance). The difference in IC scores between provinces was not statistically significant. Conclusion: This study confirms that the assessment of blood donation centers through regular blood donor inspection is a reliable method to identify the strengths and weaknesses of blood transfusion center services and ultimately leads to corrective intervention and improvement of hygienic SOPs to prevent COVID-19 transmission

Global age-sex-specific mortality, life expectancy, and population estimates in 204 countries and territories and 811 subnational locations, 1950–2021, and the impact of the COVID-19 pandemic: a comprehensive demographic analysis for the Global Burden of Disease Study 2021

Background: Estimates of demographic metrics are crucial to assess levels and trends of population health outcomes. The profound impact of the COVID-19 pandemic on populations worldwide has underscored the need for timely estimates to understand this unprecedented event within the context of long-term population health trends. The Global Burden of Diseases, Injuries, and Risk Factors Study (GBD) 2021 provides new demographic estimates for 204 countries and territories and 811 additional subnational locations from 1950 to 2021, with a particular emphasis on changes in mortality and life expectancy that occurred during the 2020–21 COVID-19 pandemic period. Methods: 22 223 data sources from vital registration, sample registration, surveys, censuses, and other sources were used to estimate mortality, with a subset of these sources used exclusively to estimate excess mortality due to the COVID-19 pandemic. 2026 data sources were used for population estimation. Additional sources were used to estimate migration; the effects of the HIV epidemic; and demographic discontinuities due to conflicts, famines, natural disasters, and pandemics, which are used as inputs for estimating mortality and population. Spatiotemporal Gaussian process regression (ST-GPR) was used to generate under-5 mortality rates, which synthesised 30 763 location-years of vital registration and sample registration data, 1365 surveys and censuses, and 80 other sources. ST-GPR was also used to estimate adult mortality (between ages 15 and 59 years) based on information from 31 642 location-years of vital registration and sample registration data, 355 surveys and censuses, and 24 other sources. Estimates of child and adult mortality rates were then used to generate life tables with a relational model life table system. For countries with large HIV epidemics, life tables were adjusted using independent estimates of HIV-specific mortality generated via an epidemiological analysis of HIV prevalence surveys, antenatal clinic serosurveillance, and other data sources. Excess mortality due to the COVID-19 pandemic in 2020 and 2021 was determined by subtracting observed all-cause mortality (adjusted for late registration and mortality anomalies) from the mortality expected in the absence of the pandemic. Expected mortality was calculated based on historical trends using an ensemble of models. In location-years where all-cause mortality data were unavailable, we estimated excess mortality rates using a regression model with covariates pertaining to the pandemic. Population size was computed using a Bayesian hierarchical cohort component model. Life expectancy was calculated using age-specific mortality rates and standard demographic methods. Uncertainty intervals (UIs) were calculated for every metric using the 25th and 975th ordered values from a 1000-draw posterior distribution. Findings: Global all-cause mortality followed two distinct patterns over the study period: age-standardised mortality rates declined between 1950 and 2019 (a 62·8% [95% UI 60·5–65·1] decline), and increased during the COVID-19 pandemic period (2020–21; 5·1% [0·9–9·6] increase). In contrast with the overall reverse in mortality trends during the pandemic period, child mortality continued to decline, with 4·66 million (3·98–5·50) global deaths in children younger than 5 years in 2021 compared with 5·21 million (4·50–6·01) in 2019. An estimated 131 million (126–137) people died globally from all causes in 2020 and 2021 combined, of which 15·9 million (14·7–17·2) were due to the COVID-19 pandemic (measured by excess mortality, which includes deaths directly due to SARS-CoV-2 infection and those indirectly due to other social, economic, or behavioural changes associated with the pandemic). Excess mortality rates exceeded 150 deaths per 100 000 population during at least one year of the pandemic in 80 countries and territories, whereas 20 nations had a negative excess mortality rate in 2020 or 2021, indicating that all-cause mortality in these countries was lower during the pandemic than expected based on historical trends. Between 1950 and 2021, global life expectancy at birth increased by 22·7 years (20·8–24·8), from 49·0 years (46·7–51·3) to 71·7 years (70·9–72·5). Global life expectancy at birth declined by 1·6 years (1·0–2·2) between 2019 and 2021, reversing historical trends. An increase in life expectancy was only observed in 32 (15·7%) of 204 countries and territories between 2019 and 2021. The global population reached 7·89 billion (7·67–8·13) people in 2021, by which time 56 of 204 countries and territories had peaked and subsequently populations have declined. The largest proportion of population growth between 2020 and 2021 was in sub-Saharan Africa (39·5% [28·4–52·7]) and south Asia (26·3% [9·0–44·7]). From 2000 to 2021, the ratio of the population aged 65 years and older to the population aged younger than 15 years increased in 188 (92·2%) of 204 nations. Interpretation: Global adult mortality rates markedly increased during the COVID-19 pandemic in 2020 and 2021, reversing past decreasing trends, while child mortality rates continued to decline, albeit more slowly than in earlier years. Although COVID-19 had a substantial impact on many demographic indicators during the first 2 years of the pandemic, overall global health progress over the 72 years evaluated has been profound, with considerable improvements in mortality and life expectancy. Additionally, we observed a deceleration of global population growth since 2017, despite steady or increasing growth in lower-income countries, combined with a continued global shift of population age structures towards older ages. These demographic changes will likely present future challenges to health systems, economies, and societies. The comprehensive demographic estimates reported here will enable researchers, policy makers, health practitioners, and other key stakeholders to better understand and address the profound changes that have occurred in the global health landscape following the first 2 years of the COVID-19 pandemic, and longer-term trends beyond the pandemic

Global incidence, prevalence, years lived with disability (YLDs), disability-adjusted life-years (DALYs), and healthy life expectancy (HALE) for 371 diseases and injuries in 204 countries and territories and 811 subnational locations, 1990–2021: a systematic analysis for the Global Burden of Disease Study 2021

Background: Detailed, comprehensive, and timely reporting on population health by underlying causes of disability and premature death is crucial to understanding and responding to complex patterns of disease and injury burden over time and across age groups, sexes, and locations. The availability of disease burden estimates can promote evidence-based interventions that enable public health researchers, policy makers, and other professionals to implement strategies that can mitigate diseases. It can also facilitate more rigorous monitoring of progress towards national and international health targets, such as the Sustainable Development Goals. For three decades, the Global Burden of Diseases, Injuries, and Risk Factors Study (GBD) has filled that need. A global network of collaborators contributed to the production of GBD 2021 by providing, reviewing, and analysing all available data. GBD estimates are updated routinely with additional data and refined analytical methods. GBD 2021 presents, for the first time, estimates of health loss due to the COVID-19 pandemic. Methods: The GBD 2021 disease and injury burden analysis estimated years lived with disability (YLDs), years of life lost (YLLs), disability-adjusted life-years (DALYs), and healthy life expectancy (HALE) for 371 diseases and injuries using 100 983 data sources. Data were extracted from vital registration systems, verbal autopsies, censuses, household surveys, disease-specific registries, health service contact data, and other sources. YLDs were calculated by multiplying cause-age-sex-location-year-specific prevalence of sequelae by their respective disability weights, for each disease and injury. YLLs were calculated by multiplying cause-age-sex-location-year-specific deaths by the standard life expectancy at the age that death occurred. DALYs were calculated by summing YLDs and YLLs. HALE estimates were produced using YLDs per capita and age-specific mortality rates by location, age, sex, year, and cause. 95% uncertainty intervals (UIs) were generated for all final estimates as the 2·5th and 97·5th percentiles values of 500 draws. Uncertainty was propagated at each step of the estimation process. Counts and age-standardised rates were calculated globally, for seven super-regions, 21 regions, 204 countries and territories (including 21 countries with subnational locations), and 811 subnational locations, from 1990 to 2021. Here we report data for 2010 to 2021 to highlight trends in disease burden over the past decade and through the first 2 years of the COVID-19 pandemic. Findings: Global DALYs increased from 2·63 billion (95% UI 2·44–2·85) in 2010 to 2·88 billion (2·64–3·15) in 2021 for all causes combined. Much of this increase in the number of DALYs was due to population growth and ageing, as indicated by a decrease in global age-standardised all-cause DALY rates of 14·2% (95% UI 10·7–17·3) between 2010 and 2019. Notably, however, this decrease in rates reversed during the first 2 years of the COVID-19 pandemic, with increases in global age-standardised all-cause DALY rates since 2019 of 4·1% (1·8–6·3) in 2020 and 7·2% (4·7–10·0) in 2021. In 2021, COVID-19 was the leading cause of DALYs globally (212·0 million [198·0–234·5] DALYs), followed by ischaemic heart disease (188·3 million [176·7–198·3]), neonatal disorders (186·3 million [162·3–214·9]), and stroke (160·4 million [148·0–171·7]). However, notable health gains were seen among other leading communicable, maternal, neonatal, and nutritional (CMNN) diseases. Globally between 2010 and 2021, the age-standardised DALY rates for HIV/AIDS decreased by 47·8% (43·3–51·7) and for diarrhoeal diseases decreased by 47·0% (39·9–52·9). Non-communicable diseases contributed 1·73 billion (95% UI 1·54–1·94) DALYs in 2021, with a decrease in age-standardised DALY rates since 2010 of 6·4% (95% UI 3·5–9·5). Between 2010 and 2021, among the 25 leading Level 3 causes, age-standardised DALY rates increased most substantially for anxiety disorders (16·7% [14·0–19·8]), depressive disorders (16·4% [11·9–21·3]), and diabetes (14·0% [10·0–17·4]). Age-standardised DALY rates due to injuries decreased globally by 24·0% (20·7–27·2) between 2010 and 2021, although improvements were not uniform across locations, ages, and sexes. Globally, HALE at birth improved slightly, from 61·3 years (58·6–63·6) in 2010 to 62·2 years (59·4–64·7) in 2021. However, despite this overall increase, HALE decreased by 2·2% (1·6–2·9) between 2019 and 2021. Interpretation: Putting the COVID-19 pandemic in the context of a mutually exclusive and collectively exhaustive list of causes of health loss is crucial to understanding its impact and ensuring that health funding and policy address needs at both local and global levels through cost-effective and evidence-based interventions. A global epidemiological transition remains underway. Our findings suggest that prioritising non-communicable disease prevention and treatment policies, as well as strengthening health systems, continues to be crucially important. The progress on reducing the burden of CMNN diseases must not stall; although global trends are improving, the burden of CMNN diseases remains unacceptably high. Evidence-based interventions will help save the lives of young children and mothers and improve the overall health and economic conditions of societies across the world. Governments and multilateral organisations should prioritise pandemic preparedness planning alongside efforts to reduce the burden of diseases and injuries that will strain resources in the coming decades. Funding: Bill &amp; Melinda Gates Foundation

Experimental and numerical analyses of progressive damage in non-circular metal/composite hybrid vessels under internal pressure

status: publishe

تحلیل نوعي لآراء الأخصائیین الإیرانیین حول دور العقیدة الروحیة والدینیة المؤثرة في السیطرة علی العواطف والمشاعر

سابقه و هدف: دین و باورهای دینی در بیشتر جوامع نقش مهمی در زندگی انسان­ها ایفا می­کند؛ در جامعۀ ایرانی با ‌توجه به شرایط فرهنگی این نقش بارزتر است. ازاین‌رو پژوهش حاضر با هدف تحلیل کیفی نظر متخصصان ایرانی دربارۀ نقش باورهای معنوی و اعتقادی مؤثر در تنظیم هیجان انجام شد. روش کار: مطالعۀ حاضر از نوع کیفی و به‌روش تحلیل محتوای نهفته است. جامعۀ آماری متخصصان و صاحب‌نظران تنظیم هیجان در ایران بودند که با روش نمونه‌گیری هدفمند تا حد اشباع با 11 نفر از آنان مصاحبۀ نیمه­ساختاریافته صورت گرفت. در این پژوهش همۀ موارد اخلاقی رعایت شده است و مؤلفان تضاد منافعی گزارش نکرده‌اند. یافته‌ها: با اتمام مصاحبه‌­ها، پس از حذف و همسان‌سازی کدهای مشابه و تکراری، نتایج تحلیل داده­‌ها به سه طبقۀ اصلی و شش زیر‌طبقه منجر شد. طبقات شامل نگرش­‌های مذهبی و معنوی، آموزه­های معنوی/ مذهبی تنظیم­کنندۀ هیجان و تمایز باور­ها از خرافات بود. &nbsp; نتیجه‌گیری: یافته‌ها نشان داد که باورهای معنوی و اعتقادی نقش پررنگی در تنظیم هیجان افراد دارند؛ بنابراین به مشاوران و درمانگران سلامت روان پیشنهاد می‌­شود که در ارتباط با مراجعان و در جلسات درمانی به این مهم توجه ویژه‌ای داشته باشند.Background and Objective: Religion and religious beliefs play an important role in human life in many societies, Therefore, the present study aimed to qualitatively analyze the opinion of Iranian experts about the role of spiritual and doctrinal beliefs affecting emotion regulation. Methods: The present study had a qualitative design and was conducted by content analysis. The participants were specialists and experts working in the field of emotion regulation in Iran and were selected through purposeful sampling method. Semi-structured interviews were conducted with 11 experts until the saturation point was reached. In this study, all ethical considerations were observed and the authors reported no conflict of interests. Results: After conducting the interviews, similar and duplicate codes were removed and matched. The results of data analysis yielded three main categories with six sub-themes. The main categories included religious and spiritual attitudes, taught spiritual/religious emotion regulation, and differentiating beliefs from superstitions. Conclusion: The results showed that spiritual and doctrinal beliefs played a significant role in the way individuals regulated their emotions. Therefore, counselors and mental health therapists are recommended to pay attention to this important issue while interacting with the clients during treatment sessions.خلفية البحث وأهدافه: یؤدي الدین والعقیدة الدینیة دوراً بارزاً في معظم المجتمعات البشریة؛ ویتجلی تأثیر هذه العقیدة في المجتمع الإیراني بشکل أکبر نظراً للخلفیة الثقافیة والدینیة. ولهذا تسعی هذه الدراسة أن تسلط الضوء علی هذه الظاهرة لکي تقدم تحلیلاً نوعیاً لآراء الأخصائیین الإیرانیین حول دور النزعة الروحانیة والعقیدة الدینیة في السیطرة علی العواطف والمشاعر. منهجية البحث: المنهج الذي اعتمدت علیه الدراسة هو منهج نوعي وتحلیل المحتوی الکامن. اما الجمعیة الإحصائیة فقد شملت الأخصائیین وأصحاب الرأي الإیرانیین في مجال تنظیم المشاعر وتحسین السلوك العاطفي. وقد اختیر المشارکون عبر أخذ العینات الهادفة القصوی وتم اختیار 11 أخصائیاً لإجراء المقابلة معهم. یذکر أنّه تمت مراعاة جمیع الموارد الأخلاقیة في هذا البحث وإضافة إلی ذلك فإن مؤلفي البحث لم یشیروا إلی أيّ تضارب في المصالح. المعطیات: تحلیل المعطیات الحاصلة من اللقاءات والمحاضرات مع الأخصائیین في هذا المجال ومسح النتائج المشابهة والمکرورة وغربلة کامل المعطیات أدت إلی نتائج ملموسة یمکن صیاغتها بثلاث أجزاء أساسیة وستة أجزاء متفرعة منها. وهذه الأجزا هي: النزعة الدینیة والروحیة، والتعالیم الروحیة/ الدینیة التي تقوم بتنظیم المعتقد الدیني والسیطرة علی العواطف والمشاعر وتواجه العقائد الخرافیة/ الأساطیریة واللامنطقیة. الاستنتاج: أظهرت النتائج أنّ العقیدة الدینیة والنزعة الروحیة بشکل عام تؤدي دوراً حاسماً في السلوك السلیم وتنظیم العواطف؛ ولهذا ننصح الإستشاریین النفسیین والمعالجین النفسیین أخذ النزعة الدینیة والروحیة بعین الإعتبار والنظر إلی علاج المرضی ومساعدتهم من هذا المنطلق والإقتناع بأنّ هذا الأمر یؤدي دوراً إیجابیاً کبیراً في تحسین مستوی سلوکهم العاطفي

Exploring Neural Correlates of Different Dimensions in Drug Craving Self-Reports among Heroin Dependents

Introduction: Drug craving could be described as a motivational state which drives drug dependents towards drug seeking and use. Different types of self-reports such as craving feeling, desire and intention, wanting and need, imagery of use, and negative affect have been attributed to this motivational state. By using subjective self-reports for different correlates of drug craving along with functional neuroimaging with cue exposure paradigm, we investigated the brain regions that could correspond to different dimensions of subjective reports for heroin craving. Methods: A total of 25 crystalline-heroin smokers underwent functional magnetic resonance imaging (fMRI), while viewing heroin-related and neutral cues presented in a block-design task. During trial intervals, subjects verbally reported their subjective feeling of cue induced craving (CIC). After fMRI procedure, participants reported the intensity of their “need for drug use” and “drug use imagination” on a 0-100 visual analog scale (VAS). Afterwards, they completed positive and negative affect scale (PANAS) and desire for drug questionnaire (DDQ) with 3 components of “desire and intention to drug use,” “negative reinforcement,” and “loss of control.” Results: The study showed significant correlation between “subjective feeling of craving” and activation of the left and right anterior cingulate cortex, as well as right medial frontal gyrus. Furthermore, the “desire and intention to drug use” was correlated with activation of the left precentral gyrus, left superior frontal gyrus, and left middle frontal gyrus. Subjects also exhibited significant correlation between the “need for drug use” and activation of the right inferior temporal gyrus, right middle temporal gyrus, and right parahippocampal gyrus. Correlation between subjective report of “heroin use imagination” and activation of the cerebellar vermis was also observed. Another significant correlation was between the “negative affect” and activation of the left precuneus, right putamen, and right middle temporal gyrus. Discussion: This preliminary study proposes different neural correlates for various dimensions of subjective craving self-reports. It could reflect multidimensionality of cognitive functions corresponding with drug craving. These cognitive functions could represent their motivational and affective outcomes in a single item “subjective craving feeling” or in self-reports with multiple dissociable items, such as intention, need, imagination, or negative feeling. The new psychological models of drug craving for covering various dimensions of subjective craving self-reports based on their neurocognitive correspondence could potentially modify craving assessments in addiction medicine

Assessment of QT and JT intervals in patients with left bundle branch block

Background: Prolongation of the QT interval is considered a risk factor for cardiac adverse events and mortality. Left bundle branch block (LBBB) lengthens the QT interval. The corrected QT interval (QTc) is most likely overestimated because its prolongation is caused by increases in depolarization duration and not in repolarization. Objectives: In this study, we aimed to apply corrected JT interval (JTc) as an appropriate measure of ventricular repolarization for predicting QTc in a formula. Patients and Methods: The study population consisted of 101 patients with sinus rhythm (SR) and narrow QRS complexes (< 120 milliseconds). All patients underwent electrophysiology studies or ablation. A diagnostic catheter was positioned in the right ventricular apex (RVA) to induce LBBB at two different cycle lengths (CLs; 600 and 700 mv). The intrinsic QRS complex, QT time, and JT time were measured during SR and subsequent RVA pacing. The JTc was derived simply by subtracting the QRS duration from the QTc. Results: Stimulation from the RVA increased the QTc from 456.20 ± 38.63 ms to 530.67 ± 47.73 ms at a CL of 600 (P < 0.0001) and to 502.32 ± 47.26 ms at 700 CL (P < 0.0001). JTc showed no significant changes with stimulation from the RVA (102.97 ± 11.35 ms vs. 103.59 ± 10.67 ms, P = 0.24). There was no significant correlation between JTc and QRS complex duration. A significant correlation was seen between QRS and QTc at both CLs. The ROC curve indicated that sensitivity of 80% and specificity of 67% were obtained with JTc duration of 92.6 ms. Conclusions: Right ventricular pacing increases the QT interval without increasing the JT interval. Our results confirm that JTc, as an index of repolarization, is independent of ventricular depolarization. Therefore, it can be applied for predicting QTc in patients with LBBB

A nor-diterpene from Salvia sahendica leaves

Phytochemical investigation of n -hexane extract of Salvia sahendica by normal phase column chromatography resulted in the isolation of six compounds. Structures were established by 1D and 2D NMR spectroscopy, and HRMS, as a new norditerpene 1 , and known terpenoids, sclareol ( 2 ), oleanolic acid ( 3 ), β-sitosterol ( 4 ), salvigenin ( 5 ) and 3 α -hydroxy-11 α ,12 α -epoxyoleanan-28,13 β -olide ( 6 ). The absolute configuration of 1 was confirmed by a combination of X-ray single crystal analysis and electronic circular dichroism spectroscopy. In vitro cytotoxic activity on breast cancer cell line (MDA-MB-231) and also the antimicrobial activity of the pure compounds were tested against Staphylococcus aureus , Bacilus cereus and Escherichia coli