Protective factors for psychological distress in hospital staff during the Coronavirus pandemic

Background and Objective: The aim of the current study was to investigate three factors, including coping, resilience, and spiritual well-being as protective factors for the development of PD among hospital staff during the COVID-19 pandemic. Materials and Methods: In the current research, convenience sampling method was used to select 300 hospital staff from various hospitals in Tehran. The collected data were analyzed using multiple statistical methods, i.e., Pearson’s correlation coefficient, Structural Equation Modeling, and regression analysis. Results: The findings revealed that nearly 40 percent of the study sample experienced a severe mental disorder. Also, the study findings showed that there was a significant positive correlation between various aspects of spiritual well-being among hospital staff, i.e., communication with self and with God (P<0.01, r=0.676), communication with others and with God (P<0.01, r=0.605) and with self (P<0.01, r=0.626), and lastly communication with nature and with God (P<0.01, r=0.686) and with self (P<0.01, r=0.722) and with others (P<0.01, r=0.640). The results of the simultaneous regression analysis indicated that the three variables of coping, resilience, and spiritual well-being explained 0.072% of the total variance in psychological distress among the hospital staff sample. Conclusions: The findings of the current study suggested that the three factors of coping, resilience, and spiritual well-being may have a minimal protective role in PD development among the hospital staff population. More research is necessary to draw a conclusion on the role of these variables regarding P

Association between Cardiovascular Risk Factors and High-risk Features in Myocardial Perfusion Imaging: A Multicenter Study

Background: Myocardial perfusion imaging (MPI) is a noninvasive method with acceptable sensitivity and specificity in diagnosing coronary artery disease (CAD) in moderate-risk patients, including those with CAD risk factors. Methods: The present cross-sectional, prospective study was conducted on 4886 patients from April 2020 through March 2023 at Chamran and Tehran Heart Center hospitals. A questionnaire regarding anthropometric variables, demographic characteristics, CAD risk factors, and MPI findings was designed. Results: Totally, 2179 patients (44.6%) had abnormal MPI. Patients with abnormal MPI were significantly older than those with normal MPI. Older age (OR, 1.64; 95% CI, 1.2 to 1.72; P<0.001), diabetes mellitus (DM) (OR, 1.36; 95% CI, 1.1 to 1.48; P=0.012), hypertension (OR, 1.24; 95% CI, 1.04 to 1.37; P=0.032), and dyslipidemia (OR, 1.54; 95% CI, 1.25 to 1.8; P<0.001) were associated with abnormal MPI independently. Patients with more CAD risk factors were more likely to have abnormal MPI. Thus, in patients without or at most with 1 risk factor and those with 8 CAD risk factors, the likelihood of abnormal MPI was 3.7% and 76.2%, respectively. The frequency of left ventricular dilation and right ventricular prominence was significantly higher in patients with older age (P<0.001 and P=0.043, respectively), dyslipidemia (P<0.001 and P=0.007, respectively), DM (P<0.001 and P<0.001, respectively), and hypertension (P=0.048 and P=0.057, respectively). Conclusion: Individuals with CAD risk factors, especially those with older age, DM, hypertension, or dyslipidemia, require meticulous attention during CAD evaluation, particularly via MPI

The Characteristics of Physicians and Medical Students, According to Ali ibn Sahl Rabban al-Tabari

Research on Persian medical literature has revealed a long history of moral excellence and devotion to the medical field. Ali Ibn Rabban Tabari also emphasized the importance of these qualities, as Islamic culture highly values the traits of physicians. In our discussion, we will explore the qualities of physicians and medical students from the perspective presented by Ali ibn Sahl Rabban al-Tabari in his widely read book, Firdous al-Hikma. One section of this work focuses on the professional, ethical, and physical qualities that define a doctor and a medical student. The book stands out as one of Iran’s medical encyclopedias.Among them is Ali ibn Rabban Tabari, a prominent figure in the history of Persian Medicine, who made significant contributions to the establishment of ethical principles in the field of medicine. His perspectives and insights hold considerable value as one of the earliest endeavors in this area, exerting a substantial influence on the advancement of medical ethics

Silicon Echoes: Non-Invasive Trojan and Tamper Detection using Frequency-Selective Impedance Analysis

The threat of chip-level tampering and its detection has been widely researched. Hardware Trojan insertions are prominent examples of such tamper events. Altering the placement and routing of a design or removing a part of a circuit for side-channel leakage/fault sensitivity amplification are other instances of such attacks. While semi- and fully-invasive physical verification methods can confidently detect such stealthy tamper events, they are costly, time-consuming, and destructive. On the other hand, virtually all proposed non-invasive side-channel methods suffer from noise and, therefore, have low confidence. Moreover, they require activating the tampered part of the circuit (e.g., the Trojan trigger) to compare and detect the modifications. In this work, we introduce a non-invasive post-silicon tamper detection technique applicable to different classes of tamper events at the chip level without requiring the activation of the malicious circuit. Our method relies on the fact that physical modifications (regardless of their physical, activation, or action characteristics) alter the impedance of the chip. Hence, characterizing the impedance can lead to the detection of the tamper events. To sense the changes in the impedance, we deploy known RF tools, namely, scattering parameters, in which we inject sine wave signals with high frequencies to the power distribution network (PDN) of the system and measure the “echo” of the signal. The reflected signals in various frequency bands reveal different tamper events based on their impact size on the die. To validate our claims, we performed measurements on several proof-of-concept tampered hardware implementations realized on FPGAs manufactured with a 28 nm technology. We further show that deploying the Dynamic Time Warping (DTW) distance can distinguish between tamper events and noise resulting from manufacturing process variation of different chips/boards. Based on the acquired results, we demonstrate that stealthy hardware Trojans, as well as sophisticated modifications of P&R, can be detected

Effects of a curriculum integrating critical thinking on medical students’ critical thinking ability in Iran: a quasi-experimental study

Purpose Improving physicians’ critical thinking abilities could have meaningful impacts on various aspects of routine medical practice, such as choosing treatment plans, making an accurate diagnosis, and reducing medical errors. The present study aimed to measure the effects of a curriculum integrating critical thinking on medical students’ skills at Tehran University of Medical Sciences, Iran. Methods A 1-group pre-test, post-test quasi-experimental design was used to assess medical students’ critical thinking abilities as they progressed from the first week of medical school to middle of the third year of the undergraduate medical curriculum. Fifty-six participants completed the California Critical Thinking Skills Test twice from 2016 to 2019. Results Medical students were asked to complete the California Critical Thinking Skills Test the week before their first educational session. The post-test was conducted 6 weeks after the 2 and half-year program. Out of 91 medical students with a mean age of 20±2.8 years who initially participated in the study, 56 completed both the pre- and post-tests. The response rate of this study was 61.5%. The analysis subscale showed the largest change. Significant changes were found in the analysis (P=0.03), evaluation (P=0.04), and inductive reasoning (P<0.0001) subscales, but not in the inference (P=0.28), and deductive reasoning (P=0.42) subscales. There was no significant difference according to gender (P=0.77). Conclusion The findings of this study show that a critical thinking program had a substantial effect on medical students’ analysis, inductive reasoning, and evaluation skills, but negligible effects on their inference and deductive reasoning scores

Highly regioselective and diastereoselective synthesis of novel pyrazinoindolones via a base-mediated Ugi-N-alkylation sequence

An efficient base-mediated/metal-free approach has been developed for the synthesis of 1-oxo-1,2,3,4-tetrahydropyrazino[1,2-a]indole-3-carboxamide derivatives via intramolecular indole N–H alkylation of novel bis-amide Ugi-adducts. In this protocol the Ugi reaction of (E)-cinnamaldehyde derivatives, 2-chloroaniline, indole-2-carboxylic acid and different isocyanides was designed for the preparation of bis-amides. The main highlight of this study is the practical and highly regioselective preparation of new polycyclic functionalized pyrazino derivatives. This system is facilitated by Na2CO3 mediation in DMSO and 100 °C conditions

Impact of COVID-19 on cardiovascular testing in the United States versus the rest of the world

Objectives: This study sought to quantify and compare the decline in volumes of cardiovascular procedures between the United States and non-US institutions during the early phase of the coronavirus disease-2019 (COVID-19) pandemic. Background: The COVID-19 pandemic has disrupted the care of many non-COVID-19 illnesses. Reductions in diagnostic cardiovascular testing around the world have led to concerns over the implications of reduced testing for cardiovascular disease (CVD) morbidity and mortality. Methods: Data were submitted to the INCAPS-COVID (International Atomic Energy Agency Non-Invasive Cardiology Protocols Study of COVID-19), a multinational registry comprising 909 institutions in 108 countries (including 155 facilities in 40 U.S. states), assessing the impact of the COVID-19 pandemic on volumes of diagnostic cardiovascular procedures. Data were obtained for April 2020 and compared with volumes of baseline procedures from March 2019. We compared laboratory characteristics, practices, and procedure volumes between U.S. and non-U.S. facilities and between U.S. geographic regions and identified factors associated with volume reduction in the United States. Results: Reductions in the volumes of procedures in the United States were similar to those in non-U.S. facilities (68% vs. 63%, respectively; p = 0.237), although U.S. facilities reported greater reductions in invasive coronary angiography (69% vs. 53%, respectively; p < 0.001). Significantly more U.S. facilities reported increased use of telehealth and patient screening measures than non-U.S. facilities, such as temperature checks, symptom screenings, and COVID-19 testing. Reductions in volumes of procedures differed between U.S. regions, with larger declines observed in the Northeast (76%) and Midwest (74%) than in the South (62%) and West (44%). Prevalence of COVID-19, staff redeployments, outpatient centers, and urban centers were associated with greater reductions in volume in U.S. facilities in a multivariable analysis. Conclusions: We observed marked reductions in U.S. cardiovascular testing in the early phase of the pandemic and significant variability between U.S. regions. The association between reductions of volumes and COVID-19 prevalence in the United States highlighted the need for proactive efforts to maintain access to cardiovascular testing in areas most affected by outbreaks of COVID-19 infection

Stress, Depression and Obesity among Adolescents: A Narrative Review

Adolescents try to eat as a way to stress relief, while they suffer from overweight and obesity and feel depressed later. This is a review and analysis of the results of published research literature since 1980 on the relationship of obesity with stress and depression among adolescents. The current review tries to evaluate and describe the effect of stress on obesity and subsequently on depression among adolescents. The literature reveals obvious differences in various emotional problems for boys and girls. However, some studies focused on stress and obesity among adolescents, some others reported depression among obese adolescents. Descriptive design was used for quantitative studies as well as using theories which were used for qualitative studies. Interview and questionnaires were used for data collection. Studies revealed that stress results in overweight and obesity among adolescents through decreasing physical activity and increasing food intake. Consequently, obesity among adolescents as a result of negative body image and concept of proper appearance can cause depression. On the other hand, gender, age and ethnicity affect stress and depression as well as obesity during adolescence

Prevalence of depression and anxiety and their association with body mass index among high school students in Qazvin, Iran, 2013-2014

Background: Evidence shows that mental disorders among adolescents are associated with suicide, drug abuse, acute infectious diseases and low educational performances. Objective: To determine the prevalence of depression and anxiety and their associations with body mass index (BMI) among high school students in Qazvin, Iran in 2013-2014. Methods: A descriptive and analytical cross-sectional study using cluster-sampling method recruited 1,040 students among high schools in Qazvin, Iran from March 2013 to April 2014. Data were collected using questionnaires including demographic, Beck depression inventory and Beck anxiety inventory, and were analyzed with SPSS-19 by descriptive analyses, t-test, Chi-square and Pearson correlation. Results: The prevalence of depression and anxiety was 31.8% and 14.9%, respectively and these amounts were significantly higher in girls than in boys (p<0.05). Respondents showed 23.75% and 11.07% mild to moderate symptoms of depression and anxiety, respectively as well as 8.08 and 3.75% severe symptoms of depression and anxiety, respectively. There was a positive and significant association between depression and anxiety (r=0.256, p<0.001) and between depression and body mass index (BMI) (r=0.333, p<0.001), however there was an inverse association between anxiety and BMI (r=0.086, p<0.006). Conclusion: The current study made a significant step forward in assessment of mental disorders and BMI to show the significance of depression and anxiety among adolescents in Qazvin. Therefore, effective interventions are necessary to improve this situation as well as the evaluation of the effectiveness of the interventions