COVID-19 related stigma among the general population in Iran.

BACKGROUND: COVID-19 related stigma has been identified as a critical issue since the beginning of the pandemic. We developed a valid and reliable questionnaire to measure COVID-19 related enacted stigma, inflicted by the non-infected general population. We applied the questionnaire to measure COVID-19 related enacted stigma among Tehran citizens from 27 to 30 September 2020. METHODS: A preliminary questionnaire with 18 items was developed. The total score ranged from 18 to 54; a higher score indicated a higher level of COVID-19 related stigma. An expert panel assessed the face and content validity. Of 1637 randomly recruited Tehran citizens without a history of COVID-19 infection, 1064 participants consented and were interviewed by trained interviewers by phone. RESULTS: Item content validity index (I-CVI), Item content validity ratio (I-CVR), and Item face validity index (I-FVI) were higher than 0.78 for all 18 items. The content and face validity were established with a scale content validity index (S-CVI) of 0.90 and a scale face validity index (S-CVI) of 93.9%, respectively. Internal consistency of the questionnaire with 18 items was confirmed with Cronbach's alpha of 0.625. Exploratory factor analysis revealed five latent variables, including "blaming", "social discrimination", "dishonor label", "interpersonal contact", and "retribution and requital attitude". The median of the stigma score was 24 [25th percentile: 22, 75the percentile: 28]. A large majority (86.8%) of participants reported a low level of stigma with a score below 31. None of the participants showed a high level of stigma with a score above 43. We found that the higher the educational level the lower the participant's stigma score. CONCLUSION: We found a low level of stigmatizing thoughts and behavior among the non-infected general population in Tehran, which may be due to the social desirability effect, to the widespread nature of COVID-19, or to the adaptation to sociocultural diversity of the large city.

Physiological State and Learning Ability of Students in Normal and Virtual Reality Conditions: Complexity-Based Analysis.

BACKGROUND: Education and learning are the most important goals of all universities. For this purpose, lecturers use various tools to grab the attention of students and improve their learning ability. Virtual reality refers to the subjective sensory experience of being immersed in a computer-mediated world, and has recently been implemented in learning environments. OBJECTIVE: The aim of this study was to analyze the effect of a virtual reality condition on students' learning ability and physiological state. METHODS: Students were shown 6 sets of videos (3 videos in a two-dimensional condition and 3 videos in a three-dimensional condition), and their learning ability was analyzed based on a subsequent questionnaire. In addition, we analyzed the reaction of the brain and facial muscles of the students during both the two-dimensional and three-dimensional viewing conditions and used fractal theory to investigate their attention to the videos. RESULTS: The learning ability of students was increased in the three-dimensional condition compared to that in the two-dimensional condition. In addition, analysis of physiological signals showed that students paid more attention to the three-dimensional videos. CONCLUSIONS: A virtual reality condition has a greater effect on enhancing the learning ability of students. The analytical approach of this study can be further extended to evaluate other physiological signals of subjects in a virtual reality condition.

The medicalization of ethics or ethicalization of neuroscience: Toward a conceptual re-examination.

Thinking With a growing body of brain science, the research and technological interventions in neuroscience have led to the rise of some ethical, moral, legal, conceptual, and socioeconomic problems. These problems and the need to establish an intellectual framework to approach them framed the base of Neuroethics. Most conveniently, the normative definition of Neuroethics is declared as ethics of neuroscience and neuroscience of ethics. However, there are more critical issues to define and frame the conceptual structure of the field. The current naturalist-positivist vision in neuroscience will extend the concept that human behavior, such as decision-making, consciousness, character, and moral intuitions, are mechanical features of a machine. Arguments from philosophical and anthropological views arose around this definition, focusing on the reductionist nature of merely a positive view of the human mind and behavior. Thinking through the pearls of such an approach and what would be at stake if we fail to recognize the importance of the philosophical-anthropological aspect of neuroscience, we first review different definitions and critics of the field, then proceed to discuss two concepts of Ethicalization and Medicalization. These concepts clearly show the established positivist-naturalist view in bioethics and the issues it caused. To better understand these two concepts, we use existing discussions and literature around them in bioethics. By reviewing the existing literature and adding a philosophical view of the field, we aim to add a new approach to the field of Neuroethics. We focus on adopting an interdisciplinary approach to Neuroethics to provide the needed background vision and theory to discuss interdisciplinary issues and enable scholars and theorists to reframe the fundamental issues of the field, such as the nature and scope of Neuroethics.

A Bridge Between East and West: Dr. Johan Louis Schlimmer's Medical Contributions in Qajar Iran (1819-1881).

Dr. Johan Louis Schlimmer (1819-1881), a Dutch physician, played a transformative role in the development of modern medicine in Qajar-era Iran. Arriving in Iran driven by a deep passion for Eastern culture, Schlimmer's contributions extended far beyond the confines of traditional medical practice. His work in medical education, particularly at the prestigious Dar al-Fonun, laid the foundation for the modernization of Iranian healthcare. Schlimmer's efforts to bridge the gap between Western and Iranian medical knowledge are epitomized by his collaboration on the Persian medical dictionary, commonly known as Schlimmer's Dictionary, and his seminal work, Terminologie Médico-Pharmaceutique et Anthropologique Française-Persane. These texts not only expanded the Persian medical lexicon but also integrated contemporary Western medical concepts with traditional Iranian practices. Schlimmer's approach, which emphasized the indigenization of medical knowledge, made complex medical phenomena accessible to Iranian practitioners and laid the groundwork for the advancement of public health in Iran. His legacy, marked by a commitment to cultural and scientific exchange, continues to resonate in the field of Iranian medical history. This article explores the multifaceted contributions of Dr. Schlimmer, highlighting his enduring impact on the evolution of healthcare in 19th-century Iran.

Ultra-overt therapy: a novel medical approach centered on patient consciousness.

Within the realms of human and artificial intelligence, the concepts of consciousness and comprehension are fundamental distinctions. In the clinical sphere, patient awareness regarding medication and its physiological processes plays a crucial role in determining drug efficacy and outcomes. This article introduces a novel perspective on prescription practices termed "Ultra-Overt Therapy" (UOT). A review of current supporting evidence was conducted through a non-systematic search in PubMed and Google Scholar, focusing on concepts such as the "mind-body relationship," "placebo response," "neuroscience," and "complementary medicine." Our findings, rooted in the mechanisms of the "placebo effect," the intricacies of "intersubjective therapy," the potency of "interoceptive awareness," and other domains of medical science, suggest that UOT holds theoretical promise. Future research endeavors focusing on these areas may elucidate the global impact of this method on medical treatment and patient care.

Code of ethics for the national pharmaceutical system: Codifying and compilation.

Pharmacists as one of health-care providers face ethical issues in terms of pharmaceutical care, relationship with patients and cooperation with the health-care team. Other than pharmacy, there are pharmaceutical companies in various fields of manufacturing, importing or distributing that have their own ethical issues. Therefore, pharmacy practice is vulnerable to ethical challenges and needs special code of conducts. On feeling the need, based on a shared project between experts of the ethics from relevant research centers, all the needs were fully recognized and then specified code of conduct for each was written. The code of conduct was subject to comments of all experts involved in the pharmaceutical sector and thus criticized in several meetings. The prepared code of conduct is comprised of professional code of ethics for pharmacists, ethics guideline for pharmaceutical manufacturers, ethics guideline for pharmaceutical importers, ethics guideline for pharmaceutical distributors, and ethics guideline for policy makers. The document was compiled based on the principles of bioethics and professionalism. The compiling the code of ethics for the national pharmaceutical system is the first step in implementing ethics in pharmacy practice and further attempts into teaching the professionalism and the ethical code as the necessary and complementary effort are highly recommended.

COVID-19 anti-vaccine attitude and hesitancy.

High vaccination rates are required around the world to create herd immunity and terminate the current COVID-19 pandemic growth. With the steady rise in COVID-19 vaccine supplies, hesitancy and rejection to be vaccinated has become a problem worldwide for large vaccine coverage. Understanding the causes of vaccine avoidance or hesitancy can help to increase vaccination intentions in the general population. A number of factors contributed to increasing hesitancy. Some causes of COVID-19 vaccine hesitancy include anti-vaccine myths and confusing messages about some severe side effects of few vaccines, confusion over protection levels, poor health literacy (lack of accurate knowledge about vaccines and virus), deficient legal liability from the vaccine manufacturers, political and economic intentions, mistrust and suspicion of medical companies, concern of efficacy against to severe acute respiratory syndrome coronavirus-2 (SARS-CoV-2) variants, safety concerns (elderly, people with preexisting comorbidities) and some socio-demographic factors. Urgent interventions and policies targeting the corresponding factors are needed. Recognizing obstacles to vaccine uptake helps in the development of effective solutions to solve them. Evidence-based and behaviorally guided approaches should be used to achieve high acceptance and uptake. Supplementary Information: The online version contains supplementary material available at 10.1007/s40200-022-01018-y.

Decoding the correlation between heart activation and walking path by information-based analysis.

BACKGROND: One of the important areas of heart research is to analyze heart rate variability during (HRV) walking. OBJECTIVE: In this research, we investigated the correction between heart activation and the variations of walking paths. METHOD: We employed Shannon entropy to analyze how the information content of walking paths affects the information content of HRV. Eight healthy students walked on three designed walking paths with different information contents while we recorded their ECG signals. We computed and analyzed the Shannon entropy of the R-R interval time series (as an indicator of HRV) versus the Shannon entropy of different walking paths and accordingly evaluated their relation. RESULTS: According to the obtained results, walking on the path that contains more information leads to less information in the R-R time series. CONCLUSION: The analysis method employed in this research can be extended to analyze the relation between other physiological signals (such as brain or muscle reactions) and the walking path.

Dynamic analysis of the discrete fractional-order Rulkov neuron map.

Human evolution is carried out by two genetic systems based on DNA and another based on the transmission of information through the functions of the nervous system. In computational neuroscience, mathematical neural models are used to describe the biological function of the brain. Discrete-time neural models have received particular attention due to their simple analysis and low computational costs. From the concept of neuroscience, discrete fractional order neuron models incorporate the memory in a dynamic model. This paper introduces the fractional order discrete Rulkov neuron map. The presented model is analyzed dynamically and also in terms of synchronization ability. First, the Rulkov neuron map is examined in terms of phase plane, bifurcation diagram, and Lyapunov exponent. The biological behaviors of the Rulkov neuron map, such as silence, bursting, and chaotic firing, also exist in its discrete fractional-order version. The bifurcation diagrams of the proposed model are investigated under the effect of the neuron model's parameters and the fractional order. The stability regions of the system are theoretically and numerically obtained, and it is shown that increasing the order of the fractional order decreases the stable areas. Finally, the synchronization behavior of two fractional-order models is investigated. The results represent that the fractional-order systems cannot reach complete synchronization.

Decoding the coupling between the brain and skin reactions in auditory stimulation by information-based analysis of EEG and GSR signals.

BACKGROUND: The analysis of brain activity in different conditions is an important research area in neuroscience. OBJECTIVE: This paper analyzed the correlation between the brain and skin activities in rest and stimulations by information-based analysis of electroencephalogram (EEG) and galvanic skin resistance (GSR) signals. METHODS: We recorded EEG and GSR signals of eleven subjects during rest and auditory stimulations using three pieces of music that were differentiated based on their complexity. Then, we calculated the Shannon entropy of these signals to quantify their information contents. RESULTS: The results showed that music with greater complexity has a more significant effect on altering the information contents of EEG and GSR signals. We also found a strong correlation (r= 0.9682) among the variations of the information contents of EEG and GSR signals. Therefore, the activities of the skin and brain are correlated in different conditions. CONCLUSION: This analysis technique can be utilized to evaluate the correlation among the activities of various organs versus brain activity in different conditions.

Media codes of ethics for health professionals and media professionals: a qualitative study.

Media is an opportunity for health professionals; however, it is not free of threats. Fixing the threats requires professional systematization through developing practical guidelines, which brings us to the goal this study was designed to achieve. The study was conducted qualitatively through literature review, semi-structured interviews, and a focus group discussion with health and media experts, as a result of which 486 codes were extracted and classified into 4 groups. The first group was addressed to media professionals and contained 126 codes in 5 categories: seeking and reporting the truth, harm minimization, integrity, independence, and respect for the rights of others. The second and third groups were addressed to health professionals, the former (150 codes) dealing with formal media, and the latter (190 codes) dealing with cyberspace. These groups were both categorized into 6 categories: scientific demeanor, beneficence, harm minimization, integrity, maintaining the dignity of the profession and professionals, and respect for the rights of others. The fourth group was addressed to the public audience and contained 20 codes categorized into 2 categories: ethics of belief, and ethics of (re-)publishing. Since the study was conducted during the pandemic/infodemic, the proposed codes can help reduce possible conflicts in similar future situations.

Decoding of the coupling between the brain and facial muscle reactions in auditory stimulation.

BACKGROUND: Analysis of the reactions of different organs to external stimuli is an important area of research in physiological science. OBJECTIVE: In this paper, we investigated the correlation between the brain and facial muscle activities by information-based analysis of electroencephalogram (EEG) signals and electromyogram (EMG) signals using Shannon entropy. METHOD: The EEG and EMG signals of thirteen subjects were recorded during rest and auditory stimulations using relaxing, pop, and rock music. Accordingly, we calculated the Shannon entropy of these signals. RESULTS: The results showed that rock music has a greater effect on the information of EEG and EMG signals than pop music, which itself has a greater effect than relaxing music. Furthermore, a strong correlation (r= 0.9980) was found between the variations of the information of EEG and EMG signals. CONCLUSION: The activities of the facial muscle and brain are correlated in different conditions. This technique can be utilized to investigate the correlation between the activities of different organs versus brain activity in different situations.

Synchronization of the neurons coupled with sequential developing electrical and chemical synapses.

There is some evidence representing the sequential formation and elimination of electrical and chemical synapses in particular brain regions. Relying on this feature, this paper presents a purely mathematical modeling study on the synchronization among neurons connected by transient electrical synapses transformed to chemical synapses over time. This deletion and development of synapses are considered consecutive. The results represent that the transient synapses lead to burst synchronization of the neurons while the neurons are resting when both synapses exist constantly. The period of the transitions and also the time of presence of electrical synapses to chemical ones are effective on the synchronization. The larger synchronization error is obtained by increasing the transition period and the time of chemical synapses' existence.

Information-based analysis of the coupling between brain and heart reactions to olfactory stimulation.

BACKGROUND: Analysis of the heart activity is one of the important areas of research in biomedical science and engineering. For this purpose, scientists analyze the activity of the heart in various conditions. Since the brain controls the heart's activity, a relationship should exist among their activities. OBJECTIVE: In this research, for the first time the coupling between heart and brain activities was analyzed by information-based analysis. METHODS: Considering Shannon entropy as the indicator of the information of a system, we recorded electroencephalogram (EEG) and electrocardiogram (ECG) signals of 13 participants (7 M, 6 F, 18-22 years old) in different external stimulations (using pineapple, banana, vanilla, and lemon flavors as olfactory stimuli) and evaluated how the information of EEG signals and R-R time series (as heart rate variability (HRV)) are linked. RESULTS: The results indicate that the changes in the information of the R-R time series and EEG signals are strongly correlated (ρ=-0.9566). CONCLUSION: We conclude that heart and brain activities are related.

Outstanding qualities of a successful role model in medical education: Students and professors' points of view.

Introduction: Role models play a crucial role in determining the professional development of medical trainees. The purpose of this study was to gain in-depth understanding of the outstanding qualities of successful role models. Material and methods: In this qualitative-descriptive study, data were collected through conducting interviews, and the inductive content analysis was performed. The study was done at the school of medicine of Tehran University of Medical Sciences in Iran. Twenty-five medical students, medical graduates, and faculty members participated in 25 interviews from April to December 2019. The participants were recruited via purposive sampling. Results: five categories and 13 subcategories were extracted from the data. The results of this study illustrated five crucial qualities of a good clinical role model including an excellent character, effective coach and mentor, inspiring medical leader, expert clinical teacher, and a professional physician. Our results also highlighted the lasting effects of positive role modeling of clinical teachers on medical trainees' professional careers. Another category in the present study was connected to future consequences of being a role model in a clinical setting. Conclusion: The result of this study illustrated crucial qualities of a good medical role model. This result can assist the leaders to engage with medical educators to better understand the process of role modeling and design the best plan for development of role modeling in medical education.

Complexity-Based Analysis of the Variations of Brain and Muscle Reactions in Walking and Standing Balance While Receiving Different Perturbations.

In this article, we evaluated the variations of the brain and muscle activations while subjects are exposed to different perturbations to walking and standing balance. Since EEG and EMG signals have complex structures, we utilized the complexity-based analysis. Specifically, we analyzed the fractal dimension and sample entropy of Electroencephalogram (EEG) and Electromyogram (EMG) signals while subjects walked and stood, and received different perturbations in the form of pulling and rotation (via virtual reality). The results showed that the complexity of EEG signals was higher in walking than standing as the result of different perturbations. However, the complexity of EMG signals was higher in standing than walking as the result of different perturbations. Therefore, the alterations in the complexity of EEG and EMG signals are inversely correlated. This analysis could be extended to investigate simultaneous variations of rhythmic patterns of other physiological signals while subjects perform different activities.

Information-based decoding of the coupling among human brain activity and movement paths.

BACKGROUND: Walking like many other actions of a human is controlled by the brain through the nervous system. In fact, if a problem occurs in our brain, we cannot walk correctly. Therefore, the analysis of the coupling of brain activity and walking is very important especially in rehabilitation science. The complexity of movement paths is one of the factors that affect human walking. For instance, if we walk on a path that is more complex, our brain activity increases to adjust our movements. OBJECTIVE: This study for the first time analyzed the coupling of walking paths and brain reaction from the information point of view. METHODS: We analyzed the Shannon entropy for electroencephalography (EEG) signals versus the walking paths in order to relate their information contents. RESULTS: According to the results, walking on a path that contains more information causes more information in EEG signals. A strong correlation (p= 0.9999) was observed between the information contents of EEG signals and walking paths. Our method of analysis can also be used to investigate the relation among other physiological signals of a human and walking paths, which has great benefits in rehabilitation science.

Predictors of COVID-19 Preventive Behavior Adoption Intention in Malaysia.

Preventive behavior adoption is the key to reduce the possibility of getting COVID-19 infection. This paper aims to examine the determinants of intention to adopt preventive behavior by incorporating perception of e-government information and services and perception of social media into the theory of reasoned action. A cross-sectional online survey was carried out among Malaysian residents. Four hundred four valid responses were obtained and used for data analysis. A partial least-square-based path analysis revealed direct effects of attitude and subjective norm in predicting intention to adopt preventive behavior. In addition, perception of e-government information and services and perception of social media were found to be significant predictors of attitude toward preventive behavior. The findings highlight the importance of digital platforms in improving people's attitudes toward preventive behavior and in turn contain the spread of the infectious disease.

Analysis of the information transfer between brains during a conversation.

BACKGROUND: The interaction between people is one of the usual daily activities. For this purpose, people mainly connect with others, using their voice. Voices act as the auditory stimuli on the brain during a conversation. OBJECTIVE: In this research, we analyze the relationship between the brains' activities of subjects during a conversation. METHODS: Since human voice transfers information from one subject to another, we used information theory for our analysis. We investigated the alterations of Shannon entropy of electroencephalography (EEG) signals for subjects during a conversation. RESULTS: The results demonstrated that the alterations in the information contents of the EEG signals for the listeners and speakers are correlated. Therefore, we concluded that the brains' activities of both subjects are linked. CONCLUSION: Our results can be expanded to analyze the coupling among other physiological signals of subjects (such as heart rate) during the conversation.