Lifetime prevalence, comorbidities, and Sociodemographic predictors of post-traumatic stress disorder (PTSD): the National Epidemiology of Iranian Children and adolescents Psychiatric disorders (IRCAP).

OBJECTIVE: The aims of this study were to (a) evaluate the lifetime prevalence of post-traumatic stress disorder (PTSD) according to sociodemographic characteristics, (b) determine sociodemographic factors associated with PTSD, (c) estimate the lifetime prevalence rates of comorbidities by age and gender, and (d) assess the proportion of traumatic events in the non-PTSD sample and the PTSD sample, according to gender. METHODS: The data used for the present study were obtained from the IRCAP study which was a cross-sectional, community-based study on 29,250 children and adolescents aged 6-18 years from all provinces of Iran, which was done using multistage cluster sampling. Trained psychologists conducted diagnostic interviews with parents, children, and adolescents using the Persian version of the Kiddie Schedule for Affective Disorders and Schizophrenia for School-Age Children-Present and Lifetime Version (K-SADS-PL). RESULTS: In this study, the prevalence of PTSD across the sample population was 0.6% (95% CI, 0.5-0.7%). Higher rates of PTSD were observed among girls (0.7%, CI 0.5-0.8%), adolescents aged 15-18 years (0.8%, CI 0.6-1.0%), and participants who had unemployed (1.5%, CI 0.8-2.8%), or farmer fathers (1.1%, CI 0.5-2.5%). Of the participants with PTSD, 65.1% met the criteria for at least one other psychiatric disorder. PTSD had a high rate of comorbidity with oppositional defiant disorder (22.9%, CI 17.5-29.4%), generalized anxiety disorder (20.8%, CI 15.7-27.1%), separation anxiety disorder (20.3%, CI 15.2-26.6%), and major depressive disorder (19.8%, CI 14.8-26.0%). We found 9.5% of non-PTSD sample experienced at least one traumatic event. Witness to domestic violence was the most common traumatic event experienced by 32.8% of PTSD sample. CONCLUSION: Our results in the prevalence, comorbidities, and sociodemographic factors associated with PTSD supported findings of previous studies that used a structured diagnostic interview. It is recommended to use purposive sampling and to investigate comorbidities of PTSD and type of traumatic events in a large clinical population.

The global prevalence of myocardial infarction: a systematic review and meta-analysis.

BACKGROUND: Myocardial infarction (MI) is one of the life-threatening coronary-associated pathologies characterized by sudden cardiac death. The provision of complete insight into MI complications along with designing a preventive program against MI seems necessary. METHODS: Various databases (PubMed, Web of Science, ScienceDirect, Scopus, Embase, and Google scholar search engine) were hired for comprehensive searching. The keywords of "Prevalence", "Outbreak", "Burden", "Myocardial Infarction", "Myocardial Infarct", and "Heart Attack" were hired with no time/language restrictions. Collected data were imported into the information management software (EndNote v.8x). Also, citations of all relevant articles were screened manually. The search was updated on 2022.9.13 prior to the publication. RESULTS: Twenty-two eligible studies with a sample size of 2,982,6717 individuals (< 60 years) were included for data analysis. The global prevalence of MI in individuals < 60 years was found 3.8%. Also, following the assessment of 20 eligible investigations with a sample size of 5,071,185 individuals (> 60 years), this value was detected at 9.5%. CONCLUSION: Due to the accelerated rate of MI prevalence in older ages, precise attention by patients regarding the complications of MI seems critical. Thus, determination of preventive planning along with the application of safe treatment methods is critical.

Changes in psychological and cognitive variables as well as cortisol levels in recovered Covid-19 patients: a longitudinal study.

BACKGROUND: Decreased psychological and cognitive functioning is one of the complications of Covid-19 disease. We aimed to evaluate mental health, cognitive functioning, and salivary cortisol levels in Covid-19 patients with different disease severities in three 45-day intervals after recovery. METHODS: 258 Covid-19 patients were assigned into three groups based on their disease severity: 112 patients in mild group, 67 patients in moderate group and 79 patients in severe group. The participants underwent psychological evaluations (including Depression, Anxiety and Stress Scale questionnaire, Beck Depression Inventory, SpeilBerger State-Trait Anxiety Inventory, Pittsburgh Sleep Quality Inventory), cognitive assessments (The Paced Auditory Serial Addition Test) and salivary cortisol level evaluation in three 45-day periods. Non-parametric statistical methods were applied for psychological and cognitive indicators, while two-way mixed model ANOVA was used to evaluate the cortisol concentration in three replications. RESULTS: The group of mild patients became more anxious and the group of moderate patients became more anxious and depressed. But all three groups of patients developed severe sleep disorders over time. For cognitive functioning, although the results showed a decrease in the correct response rate, a significant increase in the correct response rate was observed in all three groups in all three measurements. However, the response speed not only did not increase, but also decreased in severe group. Cortisol level had a markedly increasing trend in all three groups. CONCLUSION: Improvement of cognitive functioning was in line with the increase in cortisol. Besides, the decrease in mental health had no effect on the cognitive functioning.

Social Capital of Parents of Children and Adolescents and Its Relation to Psychiatric Disorders; A Population-Based Study.

Social capital is a complex concept that is considered an effective factor in the development of societies. Considering the importance of burdens of psychiatric disorders in Iran, we studied the relationship between various dimensions of social capital of parents of children and adolescents and psychiatric disorders among them. In this cross-sectional study, 18,940 parents of children and adolescents aged 6 to 18 years old were randomly selected from all provinces of Iran and were evaluated by the Millon clinical multiaxial inventory-III (MCMI-III) and a modified version of Nahapiet and Ghoshal questionnaire. MCMI-III was designed as a self-report tool for investigating psychiatric clinical disorders and personality traits in the general population. Modified Nahapiet and ghoshal questionnaire has 20 items and measures four components of social capital included trust, values, communication, and collaboration. Validity and reliability of both questionnaires have been approved in Iran. In the regression model, the relationship between social capital components and clinical and sever clinical syndromes, in the form of regression weight and standard weight for trust was - 0.558 and - 0.062 with p value less than 0.0001, and for values was - 0.466 and - 0.057, respectively, with p value less than 0.0001. There was a reverse correlation between social capital components of parents of children and adolescents and psychiatric disorders in Iran. In regression statistical models, the two components of values and trust were negative predictors of psychiatric disorders. Considering the high prevalence of psychiatric disorders in Iran, it seems that the strengthening of cognitive and structural aspects of social capital of parents of children and adolescents is one of the effective factors in reducing the prevalence of these disorders among them.

The Relationship of Parental Personality Disorders with Offspring Eating Disorders at Childhood and Adolescence Age.

This study aimed to investigate parents' PDs that could be associated with children and adolescents' EDs. We studied association of parental PDs with offspring EDs in age group 6-18 years in a nationally representative sample of Iranians with 27,111 children and adolescents and their parents. We used a multistage random cluster sampling method. We used Millon Clinical Multiaxial Inventory-Third Edition and Persian present and lifetime version of Kiddie Schedule for Affective Disorders and Schizophrenia to measure parental PDs and children and adolescents' EDs, respectively. We used descriptive statistics and binary logistic regression analysis methods to analyze the data. Maternal but not paternal PDs were significantly associated with EDs in offspring. Maternal antisocial, borderline, schizoid, histrionic, and compulsive PDs were significantly associated with EDs in offspring by 32.06, 4.66, 4.32, 3.15, and 1.71 odd ratios, respectively. Of EDs in offspring, anorexia nervosa and binge ED were significantly associated with maternal PDs.

Lifetime Prevalence, Predictors and Comorbidities of Tic Disorders: A Population-Based Survey of Children and Adolescents in Iran.

In this population-based survey, we have evaluated the lifetime prevalence of tic disorders and related sociodemographic factors and comorbidities of them. The data obtained from face-to-face interviews with 29,885 children and adolescents aged 6-18 years. We used the multistage cluster sampling method and a cross-sectional design. Tic disorders and other psychiatric disorders were assessed using the Persian version of the Kiddie Schedule for Affective Disorders and Schizophrenia-Present and Lifetime Version (K-SADS-PL). The lifetime prevalence of tic disorders was 1.5% (95% CI (1.3-1.7%)). The highest prevalence was in the age range of 15-18 years old with 1.9% (95% CI (1.6-2.3%)).57.7% (95% CI 51.8-63.3%) of patients with tic disorders had comorbidity with other psychiatric disorders. Increasing the prevalence of tic disorder with increasing age among Iranian children and adolescents, emphasizes the need to pay more attention to use of pharmacological and non-pharmacological treatments and increase education to families in this regard.

Management of COVID-19-related challenges faced by EMS personnel: a qualitative study.

BACKGROUND: As the first link in the chain of providing healthcare services in the frontline of the battle against COVID-19, emergency medical services (EMS) personnel are faced with various challenges, which affect their professional performance. The present study aimed to identify some strategies to manage the COVID-19-related challenges faced by the pre-hospital emergency care personnel in the south of Iran. METHODS: In this qualitative descriptive study, 27 pre-hospital emergency care personnel who were selected through the purposeful sampling method. Data were collected through 27 semi-structured, in-depth, individual interviews. The collected data were then analyzed based on the Granheim and Lundman's method. RESULTS: Analysis of the data resulted in the identification of 3 main themes and eight sub-themes. These three main themes were as follows: comprehensive and systematic planning, provision of medical equipment, and reduction of professional challenges. CONCLUSION: The findings of the present study showed that, during the COVID-19 crisis, emergency medical services personnel should be provided with a comprehensive and systematic protocol to provide pre-hospital care and their performance should be assessed in terms of a set of scientific standards. Due to lack of equipment and work overload in the current crisis, emergency medical services personnel are faced with many psychological challenges, which adversely affect their quality of pre-hospital emergency care. Furthermore, emergency care senior managers should develop comprehensive protocols, provide more equipment, and eliminate professional challenges to pave the ground for improving the quality and safety of the healthcare services in pre-hospital emergency care during the current COVID-19 crisis.

Prevalence, correlates and comorbidities of feeding and eating disorders in a nationally representative sample of Iranian children and adolescents.

OBJECTIVE: This study investigated the prevalence of feeding and eating disorders, and identified their correlates and comorbidities among children and adolescents. METHOD: We used the nationally representative sample of the Iranian Children and Adolescents' Psychiatric disorders (IRCAP) survey, with 30,532 participants randomly selected by a multistage cluster sampling method. We employed the kiddie schedule for affective disorders and schizophrenia-present and lifetime version (K-SADS-PL) semi-structured face-to-face interview to screen for any psychiatric disorders, including feeding and eating disorders, and associated factors. We used multivariate binary logistic regression to analyze the data. RESULTS: Valid data from 27,111 participants were analyzed. The total prevalence of feeding and eating disorders among children and adolescents was 0.89 (0.81-1.10). In all types of feeding and eating disorders, the adjusted odds ratio was higher among girls (except binge-eating disorder) and older adolescents but was lower among rural residents. The most common psychiatric comorbidities observed in children and adolescents with feeding and eating disorders were obsessive-compulsive disorder (20.2%), agoraphobia (20.2%), depressive disorder (16.4%), social phobia (10.1%), oppositional defiant disorder (10.1%), generalized anxiety disorder (9.4%), attention deficit hyperactivity disorder (7.5%), and conduct disorder (5.7%), which were significantly more common compared to their peers without feeding and eating disorders. DISCUSSION: Older age, female gender and living in an urban area are predisposing factors in feeding and eating disorders (in binge-eating disorder, the male gender is a positive correlate). We suggest that future works pay attention to the role of gender, comorbidities and predisposing factors.

Is transcranial direct current stimulation an effective modality in reducing food craving? A systematic review and meta-analysis.

Non-invasive electrical stimulation of the brain has recently been extensively investigated to regulate food craving. However, the existing literature is controversial and there are some important questions which need to be addressed about clinical and technical factors contributing to efficacy of this method. A systematic search was performed in reliable scientific databases, and 15 eligible studies were identified. The pooled standardized mean differences for the effects of transcranial direct current stimulation (tDCS) on Visual Analogue Scale, energy intake and food craving questionnaire were -0.78 [-1.12, -0.44], -0.91 [-1.38, -0.44], -0.54 [-0.85, -0.24], respectively. Subgroup analysis showed that the most important factors associated with the impact of tDCS on food craving were the population under study, current intensity of stimulation, and number of stimulation sessions. The findings of this study support a significant impact of neuromodulation of dorsolateral prefrontal cortex (DLPFC) on energy intake and food craving using tDCS. It is recommended that multisession bilateral stimulation of the DLPFC with the current intensity of 2 mA be used to reduce food craving.

Effects of transcranial direct current stimulation of prefrontal cortex on risk-taking behavior.

AIM: Recent cognitive neuroscience research shows that noninvasive brain stimulation can modify a wide range of behaviors in healthy people. Such regulation effects on human behaviors provide new insights into the neurobiology of cognitive processes and establish causal brain-behavior relations. Here, we aimed to examine the effects of transcranial electrical stimulation (TES) of the prefrontal cortex on risk-taking. METHODS: We performed a systematic search on the PubMed, Web of Science, and Cochrane databases with appropriate keywords for original studies reporting the use of TES to modulate risk-taking behavior in healthy individuals. Then, in the meta-analysis phase, a random-effects model was used to measure the pooled effect size (ES). RESULTS: Twenty articles were evaluated as eligible studies, including 16 articles on transcranial direct current stimulation (tDCS), two on transcranial alternating current stimulation, one on transcranial pulsed current stimulation, and one on high-definition tDCS. A meta-analysis showed a pooled estimated standardized ES of -0.20 (95% confidence interval [CI], -0.39 to -0.01), which indicates a small ES for active tDCS over the dorsolateral prefrontal cortex (DLPFC) in comparison to sham stimulation (z = 2.31, P = 0.03) in terms of less risky behaviors. Subgroup analysis showed that there is no significant ES for bilateral DLPFC stimulation (d = -0.01; 95%CI, -0.28 to 0.26), but a significant near-medium ES for unilateral DLPFC stimulation (d = -0.41; 95%CI, -0.71 to -0.10). CONCLUSION: Our findings support a significant impact of neuroregulation of the DLPFC on risk-taking behavior in healthy individuals. Unilateral noninvasive electrical stimulation of the DLPFC can result in a conservative risk-averse response style, probably through modulating plasticity of the relevant brain networks, including cortical and subcortical structures, as well as increasing subcortical dopaminergic activity.

Prevalence, comorbidities, and sociodemographic predictors of conduct disorder: the national epidemiology of Iranian children and adolescents psychiatric disorders (IRCAP).

The aim was to evaluate the lifetime prevalence of conduct disorder according to sociodemographic characteristics, determine the sociodemographic predictors of conduct disorder, and estimate the rates of comorbidities of psychiatric disorders in children and adolescents with conduct disorder by age and gender. The National Epidemiology of Iranian Children and Adolescents Psychiatric Disorders was a cross-sectional, general population-based study on 30,532 children and adolescents aged 6-18 years from all provinces of Iran, which was done using multistage cluster sampling. Iranian citizens aged 6-18 years who resided at least 1 year in each province were included, and children and adolescents with severe physical illnesses that prevented them to participate in the study were excluded. The sample weighting adjustment was used, since we had randomly selected the equal number of 1000 participants of each province from the urban and rural areas. Trained psychologists conducted diagnostic interviews with the adolescents and the children's parents using the Persian version of the Kiddie Schedule for Affective Disorders and Schizophrenia for School-Age Children-Present and Lifetime Version (K-SADS-PL). In this study, 54 children aged 6-9 years (0.58%, CI 0.47-0.77), 64 adolescents aged 10-14 years (0.57%, CI 0.47-0.77), and 117 adolescents aged 15-18 years (1.22%, CI 0.96-1.44) met the criteria of the lifetime conduct disorder. Conduct disorder was significantly more common in boys than in girls, and was significantly less prevalent among those participants whose fathers had no history of psychiatric hospitalization. Of the participants with conduct disorder, 83.4% met the criteria for at least one other psychiatric disorder. Conduct disorder had a high rate of comorbidity with oppositional defiant disorder (54.89%, CI 48.50-61.12), attention-deficit/hyperactivity disorder (32.34%, CI 26.68-38.56), tobacco use (20.43%, CI 15.77-26.04), and depressive disorders (18.30%, CI 13.88-23.74). Because of using the diagnostic instrument, we found a low total rate of prevalence for conduct disorder; however, higher rates of it were observed among boys and adolescents. Further studies are needed to explore the nature of comorbidities of conduct disorder and to consider them in a large clinical population.

Prevalence, Comorbidity and Predictor of Separation Anxiety Disorder in Children and Adolescents.

Separation Anxiety Disorder(SAD) is one of the earliest anxiety disorders. The effect of this disorder on the performance of children and adolescents reveals the need for awareness of the prevalence and comorbidity of this disorder in each region. This study is a cross-sectional analytical study implemented in all provinces of Iran. The instrument used in this study is the Persian version of the Kiddie Schedule for Affective Disorders and Schizophrenia-Present and Lifetime Version(K-SADA-PL) questionnaire. The total number of participants was 29,699. The overall prevalence of SAD was 5.3%. The comorbidity rate of 65.3% was found between SAD and other psychiatric disorders. Specific phobia and oppositional defiant disorder had the highest comorbidity with this disorder in the studied population. The more prevalence of separation anxiety disorder in the age range of 6-9 years old highlights the need for early detection of this disorder and targeting screening programs in childhood and adolescence.

Visual and auditory steady-state responses in attention-deficit/hyperactivity disorder.

We designed a study to investigate the patterns of the steady-state visual evoked potential (SSVEP) and auditory steady-state response (ASSR) in adolescents with attention-deficit/hyperactivity disorder (ADHD) when performing a motor response inhibition task. Thirty 12- to 18-year-old adolescents with ADHD and 30 healthy control adolescents underwent an electroencephalogram (EEG) examination during steady-state stimuli when performing a stop-signal task. Then, we calculated the amplitude and phase of the steady-state responses in both visual and auditory modalities. Results showed that adolescents with ADHD had a significantly poorer performance in the stop-signal task during both visual and auditory stimuli. The SSVEP amplitude of the ADHD group was larger than that of the healthy control group in most regions of the brain, whereas the ASSR amplitude of the ADHD group was smaller than that of the healthy control group in some brain regions (e.g., right hemisphere). In conclusion, poorer task performance (especially inattention) and neurophysiological results in ADHD demonstrate a possible impairment in the interconnection of the association cortices in the parietal and temporal lobes and the prefrontal cortex. Also, the motor control problems in ADHD may arise from neural deficits in the frontoparietal and occipitoparietal systems and other brain structures such as cerebellum.

Multiphysics simulation of magnetoelectric micro core-shells for wireless cellular stimulation therapy via magnetic temporal interference.

This paper presents an innovative approach to wireless cellular stimulation therapy through the design of a magnetoelectric (ME) microdevice. Traditional electrophysiological stimulation techniques for neural and deep brain stimulation face limitations due to their reliance on electronics, electrode arrays, or the complexity of magnetic induction. In contrast, the proposed ME microdevice offers a self-contained, controllable, battery-free, and electronics-free alternative, holding promise for targeted precise stimulation of biological cells and tissues. The designed microdevice integrates core shell ME materials with remote coils which applies magnetic temporal interference (MTI) signals, leading to the generation of a bipolar local electric stimulation current operating at low frequencies which is suitable for precise stimulation. The nonlinear property of the magnetostrictive core enables the demodulation of remotely applied high-frequency electromagnetic fields, resulting in a localized, tunable, and manipulatable electric potential on the piezoelectric shell surface. This potential, triggers electrical spikes in neural cells, facilitating stimulation. Rigorous computational simulations support this concept, highlighting a significantly high ME coupling factor generation of 550 V/m·Oe. The high ME coupling is primarily attributed to the operation of the device in its mechanical resonance modes. This achievement is the result of a carefully designed core shell structure operating at the MTI resonance frequencies, coupled with an optimal magnetic bias, and predetermined piezo shell thickness. These findings underscore the potential of the engineered ME core shell as a candidate for wireless and minimally invasive cellular stimulation therapy, characterized by high resolution and precision. These results open new avenues for injectable material structures capable of delivering effective cellular stimulation therapy, carrying implications across neuroscience medical devices, and regenerative medicine.

A Smartphone-Gamified Virtual Reality Exposure Therapy Augmented With Biofeedback for Ailurophobia: Development and Evaluation Study.

BACKGROUND: To the best of our knowledge, no specialized research has been conducted to address ailurophobia (fear of cats) in Iran or globally. This has driven our project, along with the prevalence of ailurophobia and the absence of a gamified virtual reality exposure therapy (VRET) that incorporates affordable and easily accessible biofeedback (BF) tools. We hypothesize that a gamified VRET augmented with BF will yield more positive effects than a similar device lacking BF. OBJECTIVE: This study primarily focuses on the development and preliminary evaluation of a smartphone-gamified VRET integrated with BF, targeting animal phobia, with a specific case study on ailurophobia. The secondary objectives are using affordable and readily available BF found in devices such as smart bands and smartwatches and creating a mobile virtual reality gamified app to improve patients' adherence to treatments while simultaneously enhancing the app's accessibility, scalability, and outreach. METHODS: Evaluations encompassed 3 methods. First, we identified the tool's potential positive effects on phobia interventions, exploring 4 effects: intrinsic motivation, simulation of fearful situations, management of stressful circumstances without therapists' presence and mitigation of catastrophic thoughts, and preliminary effects on ailurophobia treatment. Participants were divided into BF and non-BF groups. Second, we gathered user preferences and opinions about the treatment. Third, we conducted heuristic evaluations using 44 heuristics from existing system usability scales assessing user interfaces, virtual reality platforms, and video games' playability. To interpret the data, mean scores; ANOVA, single factor; and ANOVA, 2-factor with replication were used. A total of 29 individuals were identified, of which 10 met the eligibility criteria or were accessible. RESULTS: The smartphone-gamified VRET augmented with BF exhibited better results on the identified effects compared with the non-BF version and contributed to normalizing encounters with cats. Moreover, 41 of the 44 heuristics achieved a percentage above 62%, indicating its potential as a therapeutic product and its ability to enhance patient adherence to treatments. Patient preferences on the treatment and its strengths and weaknesses were provided for further improvement. CONCLUSIONS: The tool has the potential to evolve into a comprehensive solution by incorporating various types of cats and their behaviors, simulating environments in which they are commonly found, and enhancing its appeal through an increased sense of adventure without inducing unrealistic fears. By adapting fear elements, the game can be tailored to treat various animal phobias. Phobia-focused games should avoid action and combat scenarios to prevent reinforcement of fear responses. After rigorous evaluation, further exploration is required to provide remote use beyond clinical settings.

The Effectiveness of Transcranial Direct Current Stimulation (tDCS) and Omega-3 on Food Craving, Executive Functions, Weight, and Depressive Symptoms in Patients with Depression and Overweight: A Randomized Controlled Trial.

Objective: The most important hypothesis of this research was based on the fact that the mechanism of the effect of omega-3 on depression and obesity is formed through its accumulation in the dorsolateral prefrontal cortex (DLPFC), especially in women. Accordingly, we investigated the omega-3 intake and the concurrent stimulation of the DLPFC by tDCS and hypothesized that the synergy of these two treatments can increase the obtained effect size in patients with depression and overweight. Method : This research was a double-blind randomized controlled trial (RCT) with a factorial design consisting of four treatment and control groups. The participants were females with depression and overweight on an outpatient basis. They received 5 ml/day omega-3 syrup (545 mg DHA, 620 mg EPA) or placebo adjunct with 12 sessions sham/tDCS stimulation administered for 3 weeks with anode-left/cathode-right protocol in the prefrontal cortex (1.5 mA, 15 minutes' stimulation / 15-20 minutes' rest intervals/one visit per week, 4 stimulations per visit). Results: tDCS or omega-3 alone did not significantly improve the executive functions, depression, food cravings, and weight in the experimental groups compared to the control group (P > 0.05). However, tDCS adjunct with the omega-3 had a significant and positive effect on improving weight change (P = 0.011; df = 1; F = 1.27; Eta = 0.108) with a power of 0.73 compared to the control group. Furthermore, their interaction led to an improving trend in executive functions and a decreasing trend in food cravings which are clinically important. Conclusion: tDCS could strengthen the omega-3 mechanisms of effect through stimulating its accumulation site in the brain (i.e., the DLPFC) and the synergistic effects of these two treatments result in weight control as well as an improvement trend in the executive functions and food craving in women.

Auditory Steady-State Evoked Potentials in Post Traumatic Stress Disorder: Introduction of a Potential Biomarker.

Objective: The lack of steady-state evoked potential (SSEP) studies on post-traumatic stress disorder (PTSD) has led to undiscovered useful information about the pathophysiology of the disorder. Thus, we explored SSEP patterns in PTSD patients during a stop-signal task to disclose possible impairments in these informative brain potentials. Method : 25 adult patients with PTSD and 25 healthy adults participated in this research. Subjects were assessed with electroencephalography while the tone signal stimuli at 40 Hz were used to evoke SSEPs and subjects performed a stop-signal task. The amplitude and phase of SSEPs were then computed in different brain regions. The subjects were also evaluated using the Mississippi PTSD questionnaire. Appropriate statistical methods such as repeated measure ANOVA were used to compare the two groups, and the correlation between SSEPs and clinical symptoms was assessed using Pearson correlation analysis. Results: Patients showed considerably poorer performance in the cognitive task (P < 0.01), accompanied by raised SSEP phase and amplitude in the anterior and midline regions compared to healthy controls (P < 0.05). The Mississippi total score was positively correlated with the SSEP amplitude in the midline region (r = 0.62, P < 0.05). Furthermore, based on ROC analysis, the SSEP amplitude in the midline region provided an excellent AUC value (AUC = 0.850) for distinguishing patients with PTSD from normal subjects. Conclusion: Current findings suggest that abnormalities in the anterior and midline cortical neural networks are involved in the pathophysiology of PTSD. Importantly, midline abnormalities may provide a clinically-relevant measure for researchers wishing to assess the use of biomarkers for early diagnosis of PTSD as well as to evaluate new therapeutic and management approaches in the treatment of PTSD.

The Global Prevalence of Vitamin D Deficiency in the Elderly: A Meta-analysis.

Background: Vitamin D deficiency is widely prevalent among the elderly, posing significant health risks. This study aims to determine the global prevalence of vitamin D deficiency in the elderly. Methods: A systematic review and meta-analysis was conducted, examining databases including Scientific Information Database (SID), Medline (PubMed), ScienceDirect, Scopus, Embase, and Google Scholar until January 2023. The publication bias of the studies was assessed using the I2 test of heterogeneity and the Egger test. Results: The prevalence of vitamin D deficiency, defined as levels below 20 ng or 50 nmol was found to be 59.7% (95% CI 45.9-72.1). Furthermore, a review of six studies involving 6748 elderly individuals showed a prevalence of 27.5% (95% CI 21.8-34.1) for deficiency defined between 20 and 30 ng or 50-75 nmol. Additionally, a meta-analysis of seven studies with a sample size of 6918 elderly individuals reported a prevalence of 16% (95% CI 10.2-24.1) for deficiency defined above 30 nmol or 75 nmol. Conclusion: The results of the present study reveal that the prevalence of vitamin D deficiency among the elderly is high and requires the attention of health policymakers at the World Health Organization to prioritize extensive information dissemination and screening to mitigate the adverse effects on their quality of life. Supplementary Information: The online version contains supplementary material available at 10.1007/s43465-023-01089-w.

The effect of zinc supplementation on improving sperm parameters in infertile diabetic men.

Background and aims: Diabetes mellitus (DM) may have different adverse effects on the male reproductive system. Zinc (Zn) is one of the necessary elements in the human and mammalian diet that plays an important role in scavenging reactive oxygen species (ROS) by providing antioxidant and anti-apoptotic properties. The aim of this study was to determine the protective effects of zinc supplements on sperm chromatin and the evaluation of sperm deoxyribonucleic acid (DNA) integrity in diabetic men. Methods: In this interventional study, 43 infertile Iranian men in diabetic and non-diabetic groups were included. They were then randomly divided into two subgroups: normal saline intake and zinc sulfate intake (25 mg orally for 64 days each). Different indices of sperm analysis (number, morphology and motility) and testosterone levels were evaluated in four groups. Protamine deficiency and DNA fragmentation were assessed using chromomycin A3 (CMA3) and sperm chromatin dispersion (SCD) methods, respectively. Results: Zinc supplementation reduced the deformity of neck and head of sperms (p < 0.05), as well as deformity of sperm tail in infertile diabetic men. Zinc administration ameliorated sperm motility types A, B and C (p < 0.05). Moreover, zinc administration reduced abnormal morphology and DNA fragmentation of sperms, which increased the SCD1 and SCD2 and reduced the SCD3 and SCD4 in both treated groups. Conclusion: Zinc supplementation, as a powerful complement, is able to balance the effect of diabetes on sperm parameters, sperm chromatin and DNA integrity. Consequently, zinc supplementation can probably be considered a supportive compound in the diet of diabetic infertile men.

Possible Neuropathological Mechanisms Underlying the Increased Complexity of Brain Electrical Activity in Schizophrenia: A Computational Study.

Objective: Schizophrenia is a complex neurodevelopmental illness that is associated with different deficits in the cerebral cortex and neural networks, resulting in irregularity of brain waves. Various neuropathological hypotheses have been proposed for this irregularity that we intend to examine in this computational study. Method : We used a mathematical model of a neuronal population based on cellular automata to examine two hypotheses about the neuropathology of schizophrenia: first, reducing neuronal stimulation thresholds to increase neuronal excitability; and second, increasing the percentage of excitatory neurons and decreasing the percentage of inhibitory neurons to increase the excitation to inhibition ratio in the neuronal population. Then, we compare the complexity of the output signals produced by the model in both cases with real healthy resting-state electroencephalogram (EEG) signals using the Lempel-Ziv complexity measure and see if these changes alter (increase or decrease) the complexity of the neuronal population dynamics. Results: By lowering the neuronal stimulation threshold (i.e., the first hypothesis), no significant change in the pattern and amplitude of the network complexity was observed, and the model complexity was very similar to the complexity of real EEG signals (P > 0.05). However, increasing the excitation to inhibition ratio (i.e., the second hypothesis) led to significant changes in the complexity pattern of the designed network (P < 0.05). More interestingly, in this case, the complexity of the output signals of the model increased significantly compared to real healthy EEGs (P = 0.002) and the model output of the unchanged condition (P = 0.028) and the first hypothesis (P = 0.001). Conclusion: Our computational model suggests that imbalances in the excitation to inhibition ratio in the neural network are probably the source of abnormal neuronal firing patterns and thus the cause of increased complexity of brain electrical activity in schizophrenia.