Cross-cultural comparison of mental illness stigma and help-seeking attitudes: a multinational population-based study from 16 Arab countries and 10,036 individuals

BackgroundThere is evidence that culture deeply affects beliefs about mental illnesses\u27 causes, treatment, and help-seeking. We aimed to explore and compare knowledge, attitudes toward mental illness and help-seeking, causal attributions, and help-seeking recommendations for mental illnesses across various Arab countries and investigate factors related to attitudes toward help-seeking.MethodsWe carried out a multinational cross-sectional study using online self-administered surveys in the Arabic language from June to November 2021 across 16 Arab countries among participants from the general public.ResultsMore than one in four individuals exhibited stigmatizing attitudes towards mental illness (26.5%), had poor knowledge (31.7%), and hold negative attitudes toward help-seeking (28.0%). ANOVA tests revealed a significant difference between countries regarding attitudes (F = 194.8, p \u3c .001), knowledge (F = 88.7, p \u3c .001), and help-seeking attitudes (F = 32.4, p \u3c .001). Three multivariate regression analysis models were performed for overall sample, as well as Palestinian and Sudanese samples that displayed the lowest and highest ATSPPH-SF scores, respectively. In the overall sample, being female, older, having higher knowledge and more positive attitudes toward mental illness, and endorsing biomedical and psychosocial causations were associated with more favorable help-seeking attitudes; whereas having a family psychiatric history and endorsing religious/supernatural causations were associated with more negative help-seeking attitudes. The same results have been found in the Palestinian sample, while only stigma dimensions helped predict help-seeking attitudes in Sudanese participants.ConclusionInterventions aiming at improving help-seeking attitudes and behaviors and promoting early access to care need to be culturally tailored, and congruent with public beliefs about mental illnesses and their causations

Antimicrobial resistance among migrants in Europe: a systematic review and meta-analysis

BACKGROUND: Rates of antimicrobial resistance (AMR) are rising globally and there is concern that increased migration is contributing to the burden of antibiotic resistance in Europe. However, the effect of migration on the burden of AMR in Europe has not yet been comprehensively examined. Therefore, we did a systematic review and meta-analysis to identify and synthesise data for AMR carriage or infection in migrants to Europe to examine differences in patterns of AMR across migrant groups and in different settings. METHODS: For this systematic review and meta-analysis, we searched MEDLINE, Embase, PubMed, and Scopus with no language restrictions from Jan 1, 2000, to Jan 18, 2017, for primary data from observational studies reporting antibacterial resistance in common bacterial pathogens among migrants to 21 European Union-15 and European Economic Area countries. To be eligible for inclusion, studies had to report data on carriage or infection with laboratory-confirmed antibiotic-resistant organisms in migrant populations. We extracted data from eligible studies and assessed quality using piloted, standardised forms. We did not examine drug resistance in tuberculosis and excluded articles solely reporting on this parameter. We also excluded articles in which migrant status was determined by ethnicity, country of birth of participants' parents, or was not defined, and articles in which data were not disaggregated by migrant status. Outcomes were carriage of or infection with antibiotic-resistant organisms. We used random-effects models to calculate the pooled prevalence of each outcome. The study protocol is registered with PROSPERO, number CRD42016043681. FINDINGS: We identified 2274 articles, of which 23 observational studies reporting on antibiotic resistance in 2319 migrants were included. The pooled prevalence of any AMR carriage or AMR infection in migrants was 25·4% (95% CI 19·1-31·8; I2 =98%), including meticillin-resistant Staphylococcus aureus (7·8%, 4·8-10·7; I2 =92%) and antibiotic-resistant Gram-negative bacteria (27·2%, 17·6-36·8; I2 =94%). The pooled prevalence of any AMR carriage or infection was higher in refugees and asylum seekers (33·0%, 18·3-47·6; I2 =98%) than in other migrant groups (6·6%, 1·8-11·3; I2 =92%). The pooled prevalence of antibiotic-resistant organisms was slightly higher in high-migrant community settings (33·1%, 11·1-55·1; I2 =96%) than in migrants in hospitals (24·3%, 16·1-32·6; I2 =98%). We did not find evidence of high rates of transmission of AMR from migrant to host populations. INTERPRETATION: Migrants are exposed to conditions favouring the emergence of drug resistance during transit and in host countries in Europe. Increased antibiotic resistance among refugees and asylum seekers and in high-migrant community settings (such as refugee camps and detention facilities) highlights the need for improved living conditions, access to health care, and initiatives to facilitate detection of and appropriate high-quality treatment for antibiotic-resistant infections during transit and in host countries. Protocols for the prevention and control of infection and for antibiotic surveillance need to be integrated in all aspects of health care, which should be accessible for all migrant groups, and should target determinants of AMR before, during, and after migration. FUNDING: UK National Institute for Health Research Imperial Biomedical Research Centre, Imperial College Healthcare Charity, the Wellcome Trust, and UK National Institute for Health Research Health Protection Research Unit in Healthcare-associated Infections and Antimictobial Resistance at Imperial College London

X-chromosome and kidney function:evidence from a multi-trait genetic analysis of 908,697 individuals reveals sex-specific and sex-differential findings in genes regulated by androgen response elements

X-chromosomal genetic variants are understudied but can yield valuable insights into sexually dimorphic human traits and diseases. We performed a sex-stratified cross-ancestry X-chromosome-wide association meta-analysis of seven kidney-related traits (n = 908,697), identifying 23 loci genome-wide significantly associated with two of the traits: 7 for uric acid and 16 for estimated glomerular filtration rate (eGFR), including four novel eGFR loci containing the functionally plausible prioritized genes ACSL4, CLDN2, TSPAN6 and the female-specific DRP2. Further, we identified five novel sex-interactions, comprising male-specific effects at FAM9B and AR/EDA2R, and three sex-differential findings with larger genetic effect sizes in males at DCAF12L1 and MST4 and larger effect sizes in females at HPRT1. All prioritized genes in loci showing significant sex-interactions were located next to androgen response elements (ARE). Five ARE genes showed sex-differential expressions. This study contributes new insights into sex-dimorphisms of kidney traits along with new prioritized gene targets for further molecular research.</p

Surgical site infection after gastrointestinal surgery in high-income, middle-income, and low-income countries: a prospective, international, multicentre cohort study

Background: Surgical site infection (SSI) is one of the most common infections associated with health care, but its importance as a global health priority is not fully understood. We quantified the burden of SSI after gastrointestinal surgery in countries in all parts of the world. Methods: This international, prospective, multicentre cohort study included consecutive patients undergoing elective or emergency gastrointestinal resection within 2-week time periods at any health-care facility in any country. Countries with participating centres were stratified into high-income, middle-income, and low-income groups according to the UN's Human Development Index (HDI). Data variables from the GlobalSurg 1 study and other studies that have been found to affect the likelihood of SSI were entered into risk adjustment models. The primary outcome measure was the 30-day SSI incidence (defined by US Centers for Disease Control and Prevention criteria for superficial and deep incisional SSI). Relationships with explanatory variables were examined using Bayesian multilevel logistic regression models. This trial is registered with ClinicalTrials.gov, number NCT02662231. Findings: Between Jan 4, 2016, and July 31, 2016, 13 265 records were submitted for analysis. 12 539 patients from 343 hospitals in 66 countries were included. 7339 (58·5%) patient were from high-HDI countries (193 hospitals in 30 countries), 3918 (31·2%) patients were from middle-HDI countries (82 hospitals in 18 countries), and 1282 (10·2%) patients were from low-HDI countries (68 hospitals in 18 countries). In total, 1538 (12·3%) patients had SSI within 30 days of surgery. The incidence of SSI varied between countries with high (691 [9·4%] of 7339 patients), middle (549 [14·0%] of 3918 patients), and low (298 [23·2%] of 1282) HDI (p < 0·001). The highest SSI incidence in each HDI group was after dirty surgery (102 [17·8%] of 574 patients in high-HDI countries; 74 [31·4%] of 236 patients in middle-HDI countries; 72 [39·8%] of 181 patients in low-HDI countries). Following risk factor adjustment, patients in low-HDI countries were at greatest risk of SSI (adjusted odds ratio 1·60, 95% credible interval 1·05–2·37; p=0·030). 132 (21·6%) of 610 patients with an SSI and a microbiology culture result had an infection that was resistant to the prophylactic antibiotic used. Resistant infections were detected in 49 (16·6%) of 295 patients in high-HDI countries, in 37 (19·8%) of 187 patients in middle-HDI countries, and in 46 (35·9%) of 128 patients in low-HDI countries (p < 0·001). Interpretation: Countries with a low HDI carry a disproportionately greater burden of SSI than countries with a middle or high HDI and might have higher rates of antibiotic resistance. In view of WHO recommendations on SSI prevention that highlight the absence of high-quality interventional research, urgent, pragmatic, randomised trials based in LMICs are needed to assess measures aiming to reduce this preventable complication

The Identification of Target Gene to Increase Immunotherapy Response in Patients with Solid Tumors using Experimental and Computational Approaches

Conventional cancer therapies have limitations which can lead to high recurrence rates and reduced quality of life. Immune checkpoint inhibitors (ICI) have been shown to have more durable responses and fewer side effects. This makes them an alternative treatment for solid tumors like bladder cancer and MSI-high colorectal carcinoma. However, many patients do not respond to ICI or develop resistance due to factors such as the absence of CD8+ T cells in the tumor microenvironment, dysfunctional CD8+ T cells, and impaired tumor-specific memory T cells generation. This study shows that inhibiting Sun1 enhances tumor-infiltrating lymphocyte infiltration, inhibits tumor growth in mice, and improves the response to anti-PD-1 treatment. Although the role of Sun1 in chromatin organization and gene expression regulation is not fully clear, its inhibition can upregulate the immune-related genes within the knockout cell lines. This approach suggests a potential strategy for enhancing ICI effectiveness in cancer treatment

The Effect of Hydropriming on Germination Performance and Seedlings Growth in Milk Thistle (Silybum marianum) Seeds

Efficient seed germination and rapid and uniform seedling emergence are important in commercial agriculture. Therefore, the use of strategies to improve germination and seedling establishment is necessary for increasing productivity. Hydropriming has been suggested as a simple pre-germination strategy to improve seed performance. In this study, the effects of different durations of hydropriming (10, 24, 48 and 72 hours) at different temperatures (10 and 25 ˚C) compared to unprimed seeds on the vigor and germination performance of five milk thistle accessions (Ahvaz, Sari, Esfahan, Dezfol and Gachsaran) were evaluated. An experiment was conducted as a factorial experiment based on a completely randomized design with three replications. Germination performance was evaluated by final germination percentage, mean daily germination, mean germination time, the coefficient of germination, Timson's index, time to reach 50% the final germination percentage, germination value, coefficient of uniformity of germination, length and dry weight of seedlings and vigor index. The results show that germination capacity, germination rate and seedling vigor indexes increase significantly in hydro primed seeds at a temperature of 10˚C, whereas a decrease in hydro primed seeds at a temperature of 25˚C. Our results also show that the efficacy of hydropriming on seedling emergence and vigor traits depends on the priming duration and temperature. Hydropriming at 10˚C indicated the most effective on germination indicators and seedling vigor when compared to unprimed seeds. In addition, the comparison of germination and growth indicators in different durations of hydropriming in five milk thistle accessions indicated that the best duration of hydropriming for Ahvaz and Gajsaran is 72h, for Sari and Dezfol is 48 and 72h and for Esfahan is 10 and 24h. Therefore, the effect of hydropriming on germination performance and seedling vigor depends on plant association and hydropriming time and therefore, the selection of the best condition for hydropriming will improve the seed germinability and vigor

The Relationship between Brand Transformational Leadership Style and Brand Citizenship Behavior Considering the Mediating Role of the Staff Trust in Sales and Marketing in the Ceramic and Tile Industry

In the area of ​​organizational behavior, leadership is one of the most prominent factors influencing the behavior of the organization's staff toward brand performance. The present study aims to investigate the role of transformational leadership style in promoting brand citizenship behavior with regards to the mediating role of employee-based trust to the brand. The present study is descriptive in nature and correlative. The data were evaluated based on structural equation modeling. The statistical population consists of all the sales and marketing staff of tile and ceramic companies linked with Iran Tile and Ceramic Association. Using random stratified sampling method, 210 individuals were selected as the statistical sample for the study. To collect data, three self-made questionnaires were used to evaluate leadership, brand trust and brand citizenship behavior. The collected data were analyzed using SPSS and AMOS software. The results of structural equation showed that the direct effect of trust on brand citizenship behavior of employees is 0.574. There was a significantly positive direct effect for leadership style on employee trust (p = 0.601) and also there was a significantly positive effect for trust, as the mediator, on the relationship between leadership style and brand citizenship behavior (p = 0.84)

The effect of multimodal balanced anaesthesia and long term gabapentin on neuropathic pain, nitric oxide and interleukin-1β following breast surgery

AbstractObjectivesTo evaluate the effect of multimodal balanced anaesthesia and gabapentin (6months) on neuropathic pain qualities, nitric oxide (NO) and interleukin 1-beta (IL-1β).MethodologyThis randomized study was conducted on 50 women scheduled for conservative breast surgery for cancer followed by chemotherapy and/or radiotherapy. Women enrolled into two groups; either to receive balanced general anaesthesia (GA) (control group) or ultrasound guided thoracic paravertebral with GA, multimodal balanced anaesthesia, (intervention group). Nociceptive pain was evaluated for 24h. Neuropathic pain was evaluated using pain questionnaire 1month postoperatively and neuropathic pain scale at 1, 3, 6 and 9months. Gabapentin was prescribed to women reporting neuropathic pain 1month postoperatively and for 6months. NO and IL-1β were measured before operation, 1, 3, 6 & 9months, postoperatively. Their relationship with neuropathic pain was assessed.ResultsNociceptive pain was less in intervention group than control group immediately post operative, 4h after surgery at rest and 8h with movement. Neuropathic pain started few days postoperatively, in both groups. Its onset, sites, duration and precipitating factors did not differ between the groups. Sensitive, hot pain and unpleasantness reduced significantly 1month postoperatively, in intervention group. Two months later, itchy, dull and sharp pain was significantly less in intervention group. At 6months, most of neuropathic pain items except sharp and deep pain lowered significantly in intervention group. At 9months, hot and superficial pain was still less in intervention group. NO decreased significantly 1 and 3months postoperatively, while IL-1β was significantly lower through different times, in intervention group. IL-1β correlated well with neuropathic pain intensity and unpleasantness.ConclusionBreast surgery for cancer was associated with neuropathic pain that continued for 9months after surgery. Multimodal balanced GA had positive impact on acute nociceptive and neuropathic pain. Gabapentin reduced almost all neuropathic pain qualities