Mental health preparedness and response to epidemics focusing on COVID-19 pandemic: a qualitative study in Iran.

BACKGROUND: During epidemics, the number of individuals whose mental health is affected is greater than those affected by the infection itself. This is because psychological factors have a direct relationship with the primary causes of the disease and mortality worldwide. Therefore, an increasing investment in research and strategic actions for mental health is essential globally, given the prevalence of infectious diseases. The aim of this study was to elucidate and describe the strategies for mental health preparedness and response during epidemics, with a focus on the COVID-19 pandemic in Iran. METHODS: A qualitative study was conducted in Iran from 2022 to 2023. Purposeful Sampling was employed, continuing until data saturation was achieved. Data collection involved semi-structured interviews and observational notes with 20 managers and experts possessing expertise, experience, and knowledge in mental health. Ultimately, the participants' opinions, based on their experiences, were analyzed using the qualitative content analysis method with a conventional approach, resulting in the categorization of data into codes, subcategories, and categories. RESULTS: The study revealed participants' opinions and experiences, categorized into two overarching categories: Preparedness, Policy-Making, and Planning Strategies (with four subcategories), and Response Strategies (comprising thirteen subcategories). CONCLUSION: The opinions and experiences of managers and experts in this study revealed that an appropriate mental health response during pandemics requires preparedness before the occurrence of such crises and the implementation of suitable response strategies after the occurrence. Managers, policymakers, and decision-makers in this field should pay attention to the solutions derived from the experiences of such crises to respond more preparedly in the future.

Effect of Myo-inositol on sperm quality and biochemical factors in cryopreserved semen of patients with Asthenospermia.

In this study, the influence of myoinositol (MYO) as an antioxidant on the inhibition of the negative impacts of cryopreservation on sperm quality in men with Asthenospermia was investigated. In this prospective study, each semen sample from 25 cases was separated into three groups: Fresh, Control (with freezing medium), Myoinositol (2 mg/ml). According to the World Health Organization criteria (WHO) (2010), total motility, progressive sperm motility, viability, normal morphology, and DNA integrity were assessed. In addition, the hypo-osmotic swelling (HOS) test and mitochondrial membrane potential (MMP) were used. Total antioxidant capacity (TAC), malondialdehyde (MDA), and antioxidant enzyme activity were determined by the ELISA method. In contrast to the fresh samples, lipid peroxidation, DNA integrity damage, DNA fragmentation, HOST, and MMP had significant enhancement in the control samples. Sperm quality was significantly decreased (p < 0.05). Mean percentage viability, normal morphology, total motility, progressive motility, and DNA integrity were significantly enhanced in the MYO group in comparison to the control group (p < 0.05). The MDA and TAC levels and DNA damage in the MYO group were significantly lower compared to the control group (p < 0.05). The findings confirm that sperm quality in patients with Asthenospermia is improved by the administration of 2 mg/ml of myoinositol together with the freezing medium after sperm cryopreservation.

Psychological distress among Iranian health-care providers exposed to coronavirus disease 2019 (COVID-19): a qualitative study.

BACKGROUND: Novel corona virus, named COVID-19, has spread rapidly to other countries like Italy, Iran and South Korea and affected all people, especially health-care providers. Therefore, due to the rapid spread of the disease in Iran, the aim of the present study was to explore psychological distress experienced by Iranian health-care providers in the first few weeks of the corona virus outbreak. METHODS: The present qualitative study was conducted on 18 Iranian health-care providers exposed to COVID - 19 using a content analysis method. Purposeful sampling was used to select the participants and continued until data saturation was reached. Data were collected using semi-structured interviews and then the qualitative data were analyzed through direct content analysis. RESULTS: By analyzing 236 primary codes, two main categories were extracted from the experiences of health-care providers during corona virus outbreak. The first category included Occupational demands with three sub-categories: nature of illness, Organizational demands and social demands. The second category was Supportive resources included personal support and social support. CONCLUSIONS: The results of this study found that there were some barriers and challenges to medical personnel exposed to COVID-19 that caused psychological distress. Some of these problems related to the nature of illness, others related to social and organizational demands and some of supportive resources buffer the relationship between occupational demands and psychological distress.

Comparison of four protocols for luteal phase support in frozen-thawed Embryo transfer cycles: a randomized clinical trial.

PURPOSE: To compare the pregnancy outcomes between four regimens of luteal phase support (LPS), including vaginal progesterone, oral dydrogesterone, combination of oral dydrogesterone and gonadotropin releasing hormone analog (GnRH-α), and combination of oral dydrogesterone and human chorionic gonadotrophin (hCG), in Frozen-thawed Embryo Transfer (FET) cycles. METHODS: This randomized clinical trial was performed during a 6-month period, including candidates for FET. Patients were randomly assigned to four groups for LPS: 400 mg vaginal progesterone suppository twice daily, 10 mg oral dydrogesterone twice daily, 10 mg oral dydrogesterone twice daily combined with injection of 0.1 mg GnRH-α, and 10 mg oral dydrogesterone twice daily combined with injection of 1500 IU hCG. Primary endpoint included clinical pregnancy rate, ongoing pregnancy rate (OPR), and miscarriage rate (MR). RESULTS: A total of 400 FET cycles were analyzed. CPR was significantly lower in dydrogesterone group (9 %) when compared to vaginal progesterone (20 %), dydrogesterone and GnRH-α (25 %), and dydrogesterone and hCG (17 %). Logistic regression showed that only dydrogesterone group had significantly lower CPR in comparison with vaginal progesterone (OR = 0.39; p = 0.03), while it was comparable between other three groups. There were no significant difference between four groups regarding to OPR and MR. CONCLUSION: Vaginal progesterone provides appropriate LPS. Yet, combination of oral dydrogesterone and GnRH-α or hCG can be more suitable option compared to vaginal progesterone for LPS in women with vaginal irritation or discharge at a lower cost.

Enhancement of carotenogenesis by Blakeslea trispora in a mixed culture with bacteria.

Among carotenoids, ꞵ-carotene has the highest biological activity and is found as an all-trans isomer in many biological systems. Blakeslea trispora is a microorganism that is of interest to industries for the commercial production of ꞵ-carotene. This study investigated the effect of different bacteria on carotenogenesis in B. trispora. The B. trispora bisexual mold was cultured in a production medium, and different bacterial cells were added to it after 24 h. Then, the culture conditions and the culture medium were optimized in the presence of the selected bacteria using the experimental design. The percentage of carotenoids obtained from the mixed culture was determined using high-performance liquid chromatography (HPLC). Results showed that Kocuria rhizophila had the greatest effect on increasing the production of carotenoids in B. trispora. The highest content of carotenoids obtained during optimization was 770 ± 7.5 mg/L, a 6.8-fold increase compared to the control. HPLC analysis of carotenoids indicated the presence of two main peaks, ꞵ-carotene and γ-carotene, in which the primary carotenoid was ꞵ-carotene followed by γ-carotene with a lower content. Therefore, due to the importance of ꞵ-carotene in industry, the use of biostimulants is one of the appropriate strategies to increase the production of this pigment in industry.

Benign hepatic schwannoma in a patient with chronic hepatitis B infection: A case report.

A primary benign hepatic schwannoma is an extremely rare disease with a good prognosis. A 55-year-old man with chronic hepatitis B was referred to our hospital because of jaundice, weight loss, and a hepatic lesion found during an ultrasound examination. Magnetic resonance image revealed a 55 × 120 mm solid mass lesion in the segment V and VIII of the liver. The mass extended directly to the segmental biliary ducts and common hepatic duct, causing obstruction of the biliary duct and upstream dilatation, particularly in the left liver lobe. Following the insertion of a percutaneous transhepatic biliary drainage, a biopsy was performed under ultrasound guidance. Histological examination confirmed a benign schwannoma, identified by characteristic pathological findings and positive immunoreactions with S-100 protein, but negative for c-kit, CD117, or CD34. The patient's tumor was removed and upon examination, it was discovered to be a mass filled with pinkish-yellow fluid, measuring 12 × 5 × 5 cm. This is the first known case of a benign schwannoma in the liver parenchyma of a patient with chronic hepatitis B. Furthermore, most previous cases of benign liver schwannomas have reported a smaller size than this case, which is slightly larger.

The effect of psychological first-aid virtual education on the communication skills of nurses in disasters: a randomized controlled trial.

BACKGROUND: Disasters have affected the physical and mental health of people around the world. Since nurses are frontlines in disasters, it seems necessary to prepare for this responsibility. This study investigates the effect of psychological first-aid virtual education on the communication skills of nurses in disasters such as COVID pandemic. METHODS: In a randomized controlled trial, 55 nurses were selected by purposive sampling method from two hospitals in Isfahan and Tehran, Iran in December-November 2022 and randomly replaced in the intervention group who participated in psychological first aid virtual training and control group. The data were collected through the personal information form and Communication Skills -Test-Revised (CSTR). RESULTS: Two groups were homogeneous in terms of communication skills (p = 0.177), the total score of communication skills was significant between the two groups after the intervention (p < 0.0001). Regarding communication skills, in the pre-intervention phase, the subscale of "the ability to receive and send messages" and "insight into the communication process" the difference before the intervention was not significant between the two groups (p > 0.05). However, it was significant between the two groups after the intervention (p < 0.05), and regarding "emotional control", "listening skills", and "communication along with assertiveness" the difference before and after the intervention was not significant between the two groups (p > 0.05). CONCLUSION: Pre-disaster training and virtual education can increase nurses' communication skills in their ability to handle a disaster such as COVID pandemic. Virtual education of post-disaster psychological interventions is suggested. TRIAL REGISTRATION: IRCT20220923056023N1; date: 2023-01-31.

A concept analysis of transitional care for people with cancer.

AIM: Transitional care as the journey between different caregivers in multiple healthcare centres is crucial for the provision of care to people with cancer, but it is often complex and poorly coordinated. This study aimed to analyse the concept of transitional care for people with cancer. DESIGN: Rodgers' evolutionary concept analysis. METHODS: A systematic literature search was conducted on the databases of PubMed (including MEDLINE), EMBASE, Scopus and Web of Science to retrieve articles published between 2000 and 2022. RESULTS: Twenty-nine eligible articles were selected and their findings were classified in terms of related concepts and alternative terms, antecedents, attributes and consequences. Attributes included three main categories, namely 'nurse-related attributes', 'organisation-related attributes' and 'patient-related attributes'. Antecedents of transitional care for people with cancer were categorized into two main categories: 'patient-related antecedents' and 'caregiver-related antecedents'. Consequences were categorized into 'psychological consequences' and 'objective consequences'.

Renal synovial sarcoma: Considerations for radical nephrectomy- a case report and literature review.

Synovial sarcoma, a rare soft tissue malignancy typically arising from synovial tissue, primarily manifests in the extremities but it may uncommonly present in other locations such as kidneys. Primary renal synovial sarcoma is an uncommon sarcoma with high mortality and recurrence rates. Here, we present a teenage boy with primary renal synovial sarcoma who was referred to our institution.

Plant-Derived Antioxidants for Management of COVID-19: A Comprehensive Review of Molecular Mechanisms.

We aimed to review the literature to introduce some effective plant-derived antioxidants to prevent and treat COVID-19. Natural products from plants are excellent sources to be used for such discoveries. Among different plant-derived bioactive substances, components including luteolin, quercetin, glycyrrhizin, andrographolide, patchouli alcohol, baicalin, and baicalein were investigated for several viral infections as well as SARS-COV-2. The mechanisms of effects detected for these agents were related to their antiviral activity through inhibition of viral entry and/or suppuration of virus function. Also, the majority of components exert anti-inflammatory effects and reduce the cytokine storm induced by virus infection. The data from different studies confirmed that these agents may play a critical role against SARS-COVID-2 via direct (antiviral activity) and indirect (antioxidant and anti-inflammatory) mechanisms, suggesting that natural products are a potential option for management of patients with COVID-19 due to the lower side effects and high efficiency.

Vanishing bile duct syndrome-related jaundice as the first presentation of Hodgkin lymphoma.

Vanishing bile duct syndrome is a rare, acquired disease that has been described in different pathologic conditions' including adverse drug reactions, autoimmune diseases, graft vs host disease, and neoplasms. It is a condition characterized by progressive loss of intrahepatic bile ducts leading to ductopenia and cholestasis. Here we report a 27-year-old female who presented with jaundice and cholestatic hepatitis and was finally diagnosed with vanishing Bile duct syndrome secondary to Hodgkin lymphoma. Physicians need to consider a range of differential diagnoses, especially malignancies, in suspected cases of vanishing bile duct syndrome.

Electronic Properties of Zn2V(1-x)NbxN3 Alloys to Model Novel Materials for Light-Emitting Diodes.

We propose the Zn2V(1-x)NbxN3 alloy as a new promising material for optoelectronic applications, in particular for light-emitting diodes (LEDs). We perform accurate electronic-structure calculations of the alloy for several concentrations x using density-functional theory with meta-GGA exchange-correlation functional TB09. The band gap is found to vary between 2.2 and 2.9 eV with varying V/Nb concentration. This range is suitable for developing bright LEDs with tunable band gap as potential replacements for the more expensive Ga(1-x)In(x)N systems. Effects of configurational disorder are taken into account by explicitly considering all possible distributions of the metal ions within the metal sublattice for the chosen supercells. We have evaluated the band gap's nonlinear behavior (bowing) with variation of V/Nb concentration for two possible scenarios: (i) only the structure with the lowest total energy is present at each concentration and (ii) the structure with minimum band gap is present at each concentration, which corresponds to experimental conditions when also metastable structures are presents. We found that the bowing is about twice larger in the latter case. However, in both cases, the bowing parameter is found to be lower than 1 eV, which is about twice smaller than that in the widely used Ga(1-x)In(x)N alloy. Furthermore, we found that both crystal volume changes due to alloying and local effects (atomic relaxation and the V-N/Nb-N bonding difference) have important contributions to the band gap bowing in Zn2V(1-x)NbxN3.

Psychological impacts of the COVID-19 on health care providers.

BACKGROUND: Psychological distress, functional impairment, reduced quality of life, and subjective well-being were the most common negative psychological effects during the COVID-19 outbreak. The present study was to investigate the impact of job stress, hospital resources, and fear of infection on job burnout of medical staff in Iran during the Covid-19 pandemic. MATERIALS AND METHODS: In this cross-sectional study, 223 hospital staff from several public and private hospitals in Tehran and Mazandaran provinces, selected through convenience sampling. The questionnaire included the validated "Maslach Burnout Inventory (MBI)", "job stress scale (Parker and DeCotiis, 1983)", and the questions about "hospital resources", and "fear of infection" developed by the researcher wereused to collect data. Data were analyzed by correlation and regression methods using SPSS software. RESULTS: The results revealed that there was a significant difference in the scores on the burnout scale, in the dimension of emotional exhaustion, but the differences were not significant in the dimensions of depersonalization and self-accomplishment. Also, job stress and fear of infection significantly correlated with job burnout in the dimensions of emotional exhaustion and personal-accomplishment. However, the correlation between the adequacy of hospital resources and job burnout in these two dimensions was not significant. None of the three variables of the study showed a significant correlation with the dimension of depersonalization. CONCLUSION: It is essential to consider the package of psychological interventions which, primarily includes finding the sources of stress to resolve them through stress management programs, based on education and training in stress coping and management strategies.

Effectiveness of Psychological First Aid E-learning on the Competence and Empathy of Nurses in Disasters: A Randomized Controlled Trial.

OBJECTIVE: This study aimed to determine the effect of psychological first-aid (PFA) E-learning on the competence and empathy of nurses in disasters. METHODS: In a randomized controlled trial, 50 nurses were randomly assigned to 2 intervention and control groups, and psychological first-aid training sessions were implemented for the intervention group. The data were collected using the personal information form, a researcher-made questionnaire to measure competence, and the Davis Empathy Questionnaire. RESULTS: Two groups were homogeneous in terms of competency (P = 0.691) and empathy (P = 0.363) in the preintervention phase. The intervention group had more competence in the next stage than before the intervention (P < 0.0001). In the post-intervention phase, the intervention group had more competence compared with the control group (P < 0.0001). The overall effect size of PFA E-learning training on the nurses' competency was 1.9. Regarding empathy, in the post-intervention phase, the subscale of personal distress (P = 0.014) was significantly lower in the intervention group and the perspective-taking subscale was higher than in the control group (P < 0.0001). However, there was no significant difference between the groups in terms of all scores of empathy and the subscale of empathic concern (P > 0.05). The overall effect size of PFA E-learning training on the nurses' empathy was 0.44. CONCLUSIONS: It is suggested to provide training, including a PFA E-learning model, for nurses and other therapists in disaster situations.

Electronic Properties of Functionalized Diamanes for Field-Emission Displays.

Ultrathin diamond films, or diamanes, are promising quasi-2D materials that are characterized by high stiffness, extreme wear resistance, high thermal conductivity, and chemical stability. Surface functionalization of multilayer graphene with different stackings of layers could be an interesting opportunity to induce proper electronic properties into diamanes. Combination of these electronic properties together with extraordinary mechanical ones will lead to their applications as field-emission displays substituting original devices with light-emitting diodes or organic light-emitting diodes. In the present study, we focus on the electronic properties of fluorinated and hydrogenated diamanes with (111), (110), (0001), (101̅0), and (2̅110) crystallographic orientations of surfaces of various thicknesses by using first-principles calculations and Bader analysis of electron density. We see that fluorine induces an occupied surface electronic state, while hydrogen modifies the occupied bulk state and also induces unoccupied surface states. Furthermore, a lower number of layers is necessary for hydrogenated diamanes to achieve the convergence of the work function in comparison with fluorinated diamanes, with the exception of fluorinated (110) and (2̅110) films that achieve rapid convergence and have the same behavior as other hydrogenated surfaces. This induces a modification of the work function with an increase of the number of layers that makes hydrogenated (2̅110) diamanes the most suitable surface for field-emission displays, better than the fluorinated counterparts. In addition, a quasi-quantitative descriptor of surface dipole moment based on the Tantardini-Oganov electronegativity scale is introduced as the average of bond dipole moments between the surface atoms. This new fundamental descriptor is capable of predicting a priori the bond dipole moment and may be considered as a new useful feature for crystal structure prediction based on artificial intelligence.

Industrial Manufacture of Enteric Hard Capsules Using Novel Formulations Based on Hypromellose Phthalate/Gelatin and Investigation of Pantoprazole Release.

Capsules are popular oral dosage forms because of their ease of production. They are widespread pharmaceutical products. Hard capsules are preferred dosage forms for new medicines undergoing clinical tests because they do not require expansive formulation development. Functional capsules with built-in gastroresistance, aside from the traditional hard-gelatin or cellulose-based vegetarian capsules, would be beneficial. In this research, the effect of polyethylene glycol-4000 (PEG-4000) was investigated on the formulation of uncoated enteric hard capsules based on hypromellose phthalate (HPMCPh) and gelatin. Three different formulations based on HPMCPh, gelatin, and PEG-4000 were tested to achieve the optimal formulation for the industrial production of hard enteric capsules with desired physicochemical and enteric properties. The results reveal that the capsules containing HPMCPh, gelatin, and PEG-4000 (F1) are stable in the stomach environment (pH = 1.2) for 120 min, and during this time, no release happens. The outcomes also demonstrate that PEG-4000 blocks the pores and improves enteric hard capsule formulation. In this research, we present a specific procedure for manufacturing uncoated enteric hard capsules on an industrial scale that does not require an extra coating step for the first time. The industrial-scale validated process can considerably reduce the cost of manufacturing standard enteric-coated dosage forms.

Psychological Distress Model Among Iranian Pre-Hospital Personnel in Disasters: A Grounded Theory Study.

Objective: Pre-hospital personnels (PHPs) who work in disasters under extreme pressure, uncertainty, and complex situations are victims of disasters themselves, and there is a link between experiencing such incidents and mental health problems. Because most studies focus on the injured and less on the psychological issues of PHPs, the present study aimed to develop a model to provide relief for PHPs in disasters from a psychological perspective. Methods: A grounded theory methodology recommended by Corbin and Strauss (2015) was employed. PHPs (n = 24) participated in a semi-structured interview between July 2018 to May 2020. Results: In the analysis of the pre-hospital staff interviews, three main themes were extracted, namely, providing relief with struggle (complexity of incident scenes, command-organizational and occupational challenges), psychological distress (psychological regression and psychological empowerment), and consequences (resilience and job burnout). Seven categories and 22 subcategories were explored from our data via the grounded theory approach Conclusions: The PHPs managed psychological distress with two approaches: psychological self-empowerment and regression, which resulted in resilience and burnout, respectively. Due to the lack of enough support, the resilience of the PHPs was short-term, turned into burnout over time, and affected the structural factors again as a cycle.

Psychological distress Management in Iranian emergency prehospital providers: A Qualitative study.

INTRODUCTION: Emergency prehospital providers (EPHP) who are constantly providing medical care in threatening conditions are more at risk of displaying psychological distress presentations in disaster situations. Problem-solving strategies are essential for effective and efficient management of event position. Therefore, the present study aimed to explore psychological distress promotion in Iranian EPHP. MATERIALS AND METHODS: A qualitative content analysis study was conducted based on 24 semi-structured interviews. A purposeful sampling method was applied until reaching data saturation. Interviews were transcribed verbatim, and then, data condensing, labeling, coding, and defining categories were performed by the qualitative content analysis recommended by the Landman and Graneheim approach. RESULTS: Based on the experience of study participants, two main themes with six categories developed. The main themes included emotion-based management and problem-based management when confronting with incidence scene. CONCLUSION: The main problems of EPHP in confronting with incidence and disasters scenes are psychological distress which some rescuers have emotional reactions while some others who are more resilience and experience manage this problem in the form of problem-based approach. It is recommended these practical strategies to be taught to less experienced rescuers for avoiding emotional-based reactions and better management of disaster scene.

Copper halide diselenium: predicted two-dimensional materials with ultrahigh anisotropic carrier mobilities.

On the basis of first-principles calculations, we discuss a new class of two-dimensional materials-CuXSe2 (X = Cl, Br) nanocomposite monolayers and bilayers-whose bulk parent was experimentally reported in 1969. We show the monolayers are dynamically, mechanically and thermodynamically stable and have very small cleavage energies of ∼0.26 J m-2, suggesting their exfoliation is experimentally feasible. The monolayers are indirect-gap semiconductors with practically the same moderate band gaps of 1.74 eV and possess extremely anisotropic and very high carrier mobilities (e.g., their electron mobilities are 21 263.45 and 10 274.83 cm2 V-1 s-1 along the Y direction for CuClSe2 and CuBrSe2, respectively, while hole mobilities reach 2054.21 and 892.61 cm2 V-1 s-1 along the X direction). CuXSe2 bilayers are also indirect band gap semiconductors with slightly smaller band gaps of 1.54 and 1.59 eV, suggesting weak interlayer quantum confinement effects. Moreover, the monolayers exhibit high absorption coefficients (>105 cm-1) over a wide range of the visible light spectra. Their moderate band gaps, very high unidirectional electron and hole mobilities, and pronounced absorption coefficients indicate the proposed CuXSe2 (X = Cl, Br) nanocomposite monolayers hold significant promise for application in optoelectronic devices.

Health-related quality of life of parents of children with phenylketonuria in Tehran Province, Islamic Republic of Iran.

BACKGROUND: Parents of children with phenylketonuria are at risk of reduced quality of life. AIMS: This study determined the quality of life of parents of children with phenylketonuria in Tehran Province. METHODS: The study was conducted in 2015 and included parents of children with phenylketonuria referred to three government children's hospitals in Tehran Province that provide phenylketonuria services. Data were collected using the Farsi version of the World Health Organization Quality of Life-Bref questionnaire. Analysis of variance, t-test, Pearson correlation coefficient and multiple linear regression were used to assess the relationship between quality of life domains and sociodemographic characteristics of the parent and child. RESULTS: The study included 240 parents; 55% were mothers. Quality of life of parents in psychological, social relationships and environment domains was low. Significant relationships were found between: physical domain and age of child at phenylketonuria diagnosis (P = 0.044); psychological domain and parent's age (P = 0.019), child's age (P = 0.007) and parent's education (P = 0.015); social relationships domain and parent's age (P = 0.003), and education (P = 0.002), household income (P = 0.025) and child's age (P = 0.004; and environmental domain and residence (P = 0.034), parent's education (P = 0.007), household income (P = 0.002) and child's age (P = 0.049). In the multivariable analysis, parent's age and education, child's age, and household income were significantly associated with parent's quality of life. CONCLUSION: Given the low levels of quality of life in the parents, education and more financial support are recommended.