Effect of mental disorder on criminal responsibility and punishment

The problems which exist for a discussion about the relationship between the so-called mentally-disordered offender or accused and the notion of criminal responsibility and punishment are complex. They can not be fully understood without a consideration of the definition of crime, criminal responsibility, and of theories of punishment. Problems are not simply confined to a theoretical level. Accordingly, there is a need to understand the reality of mental disorder as perceived by psychiatrists and lawyers. This thesis, in chapter 1, looks at the concept of crime and attempts to establish a comprehensive definition. This may specify the circumstances in which the mentally disordered person is likely to become involved with the state and thereby be subject to a particular or special relationship with the law. Accordingly, chapter 1 explores the concepts of crime, its elements, and its limitations. Chapter 2 considers the various theories of punishment in order to seek to establish whether there are sufficient reasons to justify the way we deal with mentally disordered persons and whether they are rooted in concepts of fairness and justice. The next chapter explores the notion of mental disorder and examines the medical basis for understanding the condition. It attempts to examine whether the condition is "medical" and indeed whether it is an "illness". The relationship between the medical model and the legal model of mental disorder is studied in addition to the role played by psychiatrists. Chapter 4 examines the lawyer's approach to the mentally disordered person and seeks to determine whether the legal definition of insanity is in any way different from the medical concept of mental disorder and the consequences that flow from the various defences of insanity. Chapter 5 looks at the reality of the interaction between the mentally disordered person and the various institutions with which he comes into contact. Thus, state hospitals, the disposal of mentally disordered offenders or accused persons and the various sentences or restriction orders are examined. The final chapter considers possible areas for reform, and makes certain recommendations, which if implemented might serve to remove some of the difficulties that have been identified. he investigation includes the situation with regard to mental disorder and criminal responsibility in Iraqi criminal law as wel1. The main purpose of this thesis is to find out the appropriate theory of punishment which might be used to resolve the problem with mentally disordered people (both responsible and non-responsible) in respect of the sentencing process in U.

Perspectives on Novel Refractory Amorphous High-Entropy Alloys in Extreme Environments

Two new refractory amorphous high-entropy alloys (RAHEAs) within the W--Ta--Cr--V and W--Ta--Cr--V--Hf systems were herein synthesized using magnetron-sputtering and tested under high-temperature annealing and displacing irradiation using \textit{in situ} Transmission Electron Microscopy. While the WTaCrV RAHEA was found to be unstable under such tests, additions of Hf in this system composing a new quinary WTaCrVHf RAHEA was found to be a route to achieve stability both under annealing and irradiation. A new effect of nanoprecipitate reassembling observed to take place within the WTaCrVHf RAHEA under irradiation indicates that a duplex microstructure composed of an amorphous matrix with crystalline nanometer-sized precipitates enhances the radiation response of the system. It is demonstrated that tunable chemical complexity arises as a new alloy design strategy to foster the use of novel RAHEAs within extreme environments. New perspectives for the alloy design and application of chemically-complex amorphous metallic alloys in extreme environments are presented with focus on their thermodynamic phase stability when subjected to high-temperature annealing and displacing irradiation

Chemical Profiling of Significant Antioxidant and Phytotoxic Microwave-Extracted Essential Oil from Araucaria heterophylla Resin

Due to the various hazards of using synthetic chemical compounds in pharmaceutics, agriculture, and industry, scientists and researchers do their best to explore and assess new green natural compounds from natural resources with potent activity. The essential oil (EO) from the resin collected from Araucaria heterophylla Salisb. was extracted by the microwave technique and chemically characterized via GC-MS analysis. Furthermore, the extract EO was assessed for its antioxidant and phytotoxic activities. The EO has 33 compounds, mainly terpenes (98.23%), and the major compounds were α-pinene (62.57%), β-pinene (6.60%), germacrene D (5.88%), and β-caryophyllene (3.56%). The extracted EO showed substantial antioxidant activity, where it showed IC50 values of 142.42 and 118.03 mg L−1 for DPPH and ABTS, respectively. On the other hand, the EO revealed considerable phytotoxicity against the weed Chenopodium murale, where the EO showed IC50 values of 304.0, 230.1, and 147.1 mg L−1, for seed germination, seedling shoot growth, and seedling root growth, respectively. Moreover, the EO showed the same pattern of allelopathic inhibition against the weed Sonchus oleraceus, where it showed IC50 values of 295.7, 224.5, and 106.1 mg L−1, for seed germination, seedling shoot growth, and seedling root growth, respectively. The present study showed that the extraction technique affects the constituents of the EO, particularly the quantitative composition. The EO of A. heterophylla resin also revealed considerable antioxidant and phytotoxic activity against weeds. Therefore, it can be considered a promising natural resource that could be integrated into the weed management approach. However, further study is recommended for deep characterization of their authentic compounds and evaluation of their mode of action(s) on a wide spectrum of weeds

In vitro anti-inflammatory and acetylcholinesterase inhibition efficiency of plant extracts from Sinai-Egypt

635-641Ten plant extracts were prepared and tested in in vitro assays against COX-2, COX-1 and acetylcholinesterase with evaluation of their antioxidant properties. The tested extracts exhibited varied anti COX-2 effect and they were superior to celecoxibe (inhibition percentage was 42.67% at 50 µg/mL), reference drug. Lavandula coronopifolia and Scrophularia Libanotica extracts were the efficient inhibitors (100% and 91% at 50 µg/mL respectively). Launaeaspinosa and Pulicaria undulata were the powerful AChE inhibitor (IC50 values were 16.69 and 29.06 µg/mL, respectively) followed with L. coronopifolia and S.libanotica extracts (IC50 values were 61.89 and 49.83 µg/mL, respectively) and they were efficient in scavenging superoxide radicals and metal ions, nitric oxide formation inhibition, as well as, lipid peroxide production suppression. L. coronopifolia and S. Libanotica extracts can be introduced as natural cyclooxygenase-2 inhibitors without affecting cyclooxygenase-1 whereas L. spinosa and P. undulata extracts were potent suppressor for AChE with robust antioxidant properties which suggest the possibility of using the four extracts, L. coronopifolia, S. libanotica, L. spinosa and P. undulata as natural agent in treating neurodegenerative disorder

In vitro anti-inflammatory and acetylcholinesterase inhibition efficiency of plant extracts from Sinai-Egypt

Ten plant extracts were prepared and tested in in vitro assays against COX-2, COX-1 and acetylcholinesterase with evaluation of their antioxidant properties. The tested extracts exhibited varied anti COX-2 effect and they were superior to celecoxibe (inhibition percentage was 42.67% at 50 µg/mL), reference drug. Lavandula coronopifolia and Scrophularia Libanotica extracts were the efficient inhibitors (100% and 91% at 50 µg/mL respectively). Launaeaspinosa and Pulicaria undulata were the powerful AChE inhibitor (IC50 values were 16.69 and 29.06 µg/mL, respectively) followed with L. coronopifolia and S.libanotica extracts (IC50 values were 61.89 and 49.83 µg/mL, respectively) and they were efficient in scavenging superoxide radicals and metal ions, nitric oxide formation inhibition, as well as, lipid peroxide production suppression. L. coronopifolia and S. Libanotica extracts can be introduced as natural cyclooxygenase-2 inhibitors without affecting cyclooxygenase-1 whereas L. spinosa and P. undulata extracts were potent suppressor for AChE with robust antioxidant properties which suggest the possibility of using the four extracts, L. coronopifolia, S. libanotica, L. spinosa and P. undulata as natural agent in treating neurodegenerative disorder

Measuring routine childhood vaccination coverage in 204 countries and territories, 1980-2019 : a systematic analysis for the Global Burden of Disease Study 2020, Release 1

Background Measuring routine childhood vaccination is crucial to inform global vaccine policies and programme implementation, and to track progress towards targets set by the Global Vaccine Action Plan (GVAP) and Immunization Agenda 2030. Robust estimates of routine vaccine coverage are needed to identify past successes and persistent vulnerabilities. Drawing from the Global Burden of Diseases, Injuries, and Risk Factors Study (GBD) 2020, Release 1, we did a systematic analysis of global, regional, and national vaccine coverage trends using a statistical framework, by vaccine and over time. Methods For this analysis we collated 55 326 country-specific, cohort-specific, year-specific, vaccine-specific, and dosespecific observations of routine childhood vaccination coverage between 1980 and 2019. Using spatiotemporal Gaussian process regression, we produced location-specific and year-specific estimates of 11 routine childhood vaccine coverage indicators for 204 countries and territories from 1980 to 2019, adjusting for biases in countryreported data and reflecting reported stockouts and supply disruptions. We analysed global and regional trends in coverage and numbers of zero-dose children (defined as those who never received a diphtheria-tetanus-pertussis [DTP] vaccine dose), progress towards GVAP targets, and the relationship between vaccine coverage and sociodemographic development. Findings By 2019, global coverage of third-dose DTP (DTP3; 81.6% [95% uncertainty interval 80.4-82 .7]) more than doubled from levels estimated in 1980 (39.9% [37.5-42.1]), as did global coverage of the first-dose measles-containing vaccine (MCV1; from 38.5% [35.4-41.3] in 1980 to 83.6% [82.3-84.8] in 2019). Third- dose polio vaccine (Pol3) coverage also increased, from 42.6% (41.4-44.1) in 1980 to 79.8% (78.4-81.1) in 2019, and global coverage of newer vaccines increased rapidly between 2000 and 2019. The global number of zero-dose children fell by nearly 75% between 1980 and 2019, from 56.8 million (52.6-60. 9) to 14.5 million (13.4-15.9). However, over the past decade, global vaccine coverage broadly plateaued; 94 countries and territories recorded decreasing DTP3 coverage since 2010. Only 11 countries and territories were estimated to have reached the national GVAP target of at least 90% coverage for all assessed vaccines in 2019. Interpretation After achieving large gains in childhood vaccine coverage worldwide, in much of the world this progress was stalled or reversed from 2010 to 2019. These findings underscore the importance of revisiting routine immunisation strategies and programmatic approaches, recentring service delivery around equity and underserved populations. Strengthening vaccine data and monitoring systems is crucial to these pursuits, now and through to 2030, to ensure that all children have access to, and can benefit from, lifesaving vaccines. Copyright (C) 2021 The Author(s). Published by Elsevier Ltd.Peer reviewe

The global, regional, and national burden of adult lip, oral, and pharyngeal cancer in 204 countries and territories:A systematic analysis for the Global Burden of Disease Study 2019

Importance Lip, oral, and pharyngeal cancers are important contributors to cancer burden worldwide, and a comprehensive evaluation of their burden globally, regionally, and nationally is crucial for effective policy planning.Objective To analyze the total and risk-attributable burden of lip and oral cavity cancer (LOC) and other pharyngeal cancer (OPC) for 204 countries and territories and by Socio-demographic Index (SDI) using 2019 Global Burden of Diseases, Injuries, and Risk Factors (GBD) Study estimates.Evidence Review The incidence, mortality, and disability-adjusted life years (DALYs) due to LOC and OPC from 1990 to 2019 were estimated using GBD 2019 methods. The GBD 2019 comparative risk assessment framework was used to estimate the proportion of deaths and DALYs for LOC and OPC attributable to smoking, tobacco, and alcohol consumption in 2019.Findings In 2019, 370 000 (95% uncertainty interval [UI], 338 000-401 000) cases and 199 000 (95% UI, 181 000-217 000) deaths for LOC and 167 000 (95% UI, 153 000-180 000) cases and 114 000 (95% UI, 103 000-126 000) deaths for OPC were estimated to occur globally, contributing 5.5 million (95% UI, 5.0-6.0 million) and 3.2 million (95% UI, 2.9-3.6 million) DALYs, respectively. From 1990 to 2019, low-middle and low SDI regions consistently showed the highest age-standardized mortality rates due to LOC and OPC, while the high SDI strata exhibited age-standardized incidence rates decreasing for LOC and increasing for OPC. Globally in 2019, smoking had the greatest contribution to risk-attributable OPC deaths for both sexes (55.8% [95% UI, 49.2%-62.0%] of all OPC deaths in male individuals and 17.4% [95% UI, 13.8%-21.2%] of all OPC deaths in female individuals). Smoking and alcohol both contributed to substantial LOC deaths globally among male individuals (42.3% [95% UI, 35.2%-48.6%] and 40.2% [95% UI, 33.3%-46.8%] of all risk-attributable cancer deaths, respectively), while chewing tobacco contributed to the greatest attributable LOC deaths among female individuals (27.6% [95% UI, 21.5%-33.8%]), driven by high risk-attributable burden in South and Southeast Asia.Conclusions and Relevance In this systematic analysis, disparities in LOC and OPC burden existed across the SDI spectrum, and a considerable percentage of burden was attributable to tobacco and alcohol use. These estimates can contribute to an understanding of the distribution and disparities in LOC and OPC burden globally and support cancer control planning efforts

The global burden of adolescent and young adult cancer in 2019 : a systematic analysis for the Global Burden of Disease Study 2019

Background In estimating the global burden of cancer, adolescents and young adults with cancer are often overlooked, despite being a distinct subgroup with unique epidemiology, clinical care needs, and societal impact. Comprehensive estimates of the global cancer burden in adolescents and young adults (aged 15-39 years) are lacking. To address this gap, we analysed results from the Global Burden of Diseases, Injuries, and Risk Factors Study (GBD) 2019, with a focus on the outcome of disability-adjusted life-years (DALYs), to inform global cancer control measures in adolescents and young adults. Methods Using the GBD 2019 methodology, international mortality data were collected from vital registration systems, verbal autopsies, and population-based cancer registry inputs modelled with mortality-to-incidence ratios (MIRs). Incidence was computed with mortality estimates and corresponding MIRs. Prevalence estimates were calculated using modelled survival and multiplied by disability weights to obtain years lived with disability (YLDs). Years of life lost (YLLs) were calculated as age-specific cancer deaths multiplied by the standard life expectancy at the age of death. The main outcome was DALYs (the sum of YLLs and YLDs). Estimates were presented globally and by Socio-demographic Index (SDI) quintiles (countries ranked and divided into five equal SDI groups), and all estimates were presented with corresponding 95% uncertainty intervals (UIs). For this analysis, we used the age range of 15-39 years to define adolescents and young adults. Findings There were 1.19 million (95% UI 1.11-1.28) incident cancer cases and 396 000 (370 000-425 000) deaths due to cancer among people aged 15-39 years worldwide in 2019. The highest age-standardised incidence rates occurred in high SDI (59.6 [54.5-65.7] per 100 000 person-years) and high-middle SDI countries (53.2 [48.8-57.9] per 100 000 person-years), while the highest age-standardised mortality rates were in low-middle SDI (14.2 [12.9-15.6] per 100 000 person-years) and middle SDI (13.6 [12.6-14.8] per 100 000 person-years) countries. In 2019, adolescent and young adult cancers contributed 23.5 million (21.9-25.2) DALYs to the global burden of disease, of which 2.7% (1.9-3.6) came from YLDs and 97.3% (96.4-98.1) from YLLs. Cancer was the fourth leading cause of death and tenth leading cause of DALYs in adolescents and young adults globally. Interpretation Adolescent and young adult cancers contributed substantially to the overall adolescent and young adult disease burden globally in 2019. These results provide new insights into the distribution and magnitude of the adolescent and young adult cancer burden around the world. With notable differences observed across SDI settings, these estimates can inform global and country-level cancer control efforts. Copyright (C) 2021 The Author(s). Published by Elsevier Ltd.Peer reviewe

Impact of opioid-free analgesia on pain severity and patient satisfaction after discharge from surgery: multispecialty, prospective cohort study in 25 countries

Background: Balancing opioid stewardship and the need for adequate analgesia following discharge after surgery is challenging. This study aimed to compare the outcomes for patients discharged with opioid versus opioid-free analgesia after common surgical procedures.Methods: This international, multicentre, prospective cohort study collected data from patients undergoing common acute and elective general surgical, urological, gynaecological, and orthopaedic procedures. The primary outcomes were patient-reported time in severe pain measured on a numerical analogue scale from 0 to 100% and patient-reported satisfaction with pain relief during the first week following discharge. Data were collected by in-hospital chart review and patient telephone interview 1 week after discharge.Results: The study recruited 4273 patients from 144 centres in 25 countries; 1311 patients (30.7%) were prescribed opioid analgesia at discharge. Patients reported being in severe pain for 10 (i.q.r. 1-30)% of the first week after discharge and rated satisfaction with analgesia as 90 (i.q.r. 80-100) of 100. After adjustment for confounders, opioid analgesia on discharge was independently associated with increased pain severity (risk ratio 1.52, 95% c.i. 1.31 to 1.76; P < 0.001) and re-presentation to healthcare providers owing to side-effects of medication (OR 2.38, 95% c.i. 1.36 to 4.17; P = 0.004), but not with satisfaction with analgesia (beta coefficient 0.92, 95% c.i. -1.52 to 3.36; P = 0.468) compared with opioid-free analgesia. Although opioid prescribing varied greatly between high-income and low- and middle-income countries, patient-reported outcomes did not.Conclusion: Opioid analgesia prescription on surgical discharge is associated with a higher risk of re-presentation owing to side-effects of medication and increased patient-reported pain, but not with changes in patient-reported satisfaction. Opioid-free discharge analgesia should be adopted routinely