The mediating role of psychological well-being in the relationship between the light triad of personality and sense of concordance with treatment adherence in patients with type 2 diabetes: A network analysis and structural equation modeling study.

BACKGROUND: This study aimed to investigate the intricate relationship among treatment adherence, the light triad of personality, self-coherence, and psychological well-being in individuals diagnosed with Type 2 Diabetes Mellitus (T2DM). Structural equation modeling (SEM) was employed to elucidate the direct and mediated pathways linking these variables, while network analysis sought to identify and characterize the underlying factors of the light triad of personality within the context of T2DM management. METHOD: A path analysis-network analysis study using convenience sampling was conducted, recruiting 412 T2DM patients from ten private practices and general hospitals in Gilan province, Iran. Data collection utilized Antonovsky's Self of Coherence scale (SOC), The Light Triad Rating Scale, and The Reef's Psychological Well-being Questionnaire. Structural equation modeling assessed model fitness and determined direct and indirect links between variables. Analysis was conducted using R-Studio software (Version 4.2.1), SPSS (V.26), and AMOS software (V.24). RESULTS: Confirmatory factor analysis and network analysis confirmed the three-factor structure of the Light Triad of Personality scale. Direct impacts of Light Triad of Personality (ß = 0.34, p < .001) and self-coherence (ß = 0.32, p < .001) on treatment adherence were observed. Psychological well-being played an indirect role in this relationship, with significant effects from Light Triad of Personality (ß = 0.25, p < .001) and self-coherence (ß = 0.08, p < .001) on treatment adherence. Bootstrapped exploratory graph analysis revealed an average of 3 dimensions within the network, indicating community structures. CONCLUSION: SEM analysis demonstrated good model fit, suggesting the importance of designing interventional programs incorporating self-coherence and psychological well-being frameworks to enhance treatment adherence in T2DM patients.

Takotsubo Cardiomyopathy and Autoimmune Disorders: A Systematic Scoping Review of Published Cases.

Introduction: Takotsubo cardiomyopathy (TCM) features transient left ventricular apical dysfunction or ballooning. The underlying mechanism remains elusive; however, evidence suggests the role of different physical and psychological stressors. We systematically reviewed patients presenting with TCM and autoimmunity to explore the link between the two conditions. Methods: We applied the Preferred Reporting Items for Systematic reviews and Meta-Analyses extension for Scoping Reviews (PRISMA-ScR) to report this review. Using keywords related to autoimmune/immune-mediated diseases and TCM, we searched PubMed, Scopus, and WOS in March 2022. The final results were added to a data extraction sheet. Data were analyzed by SPSS version 26.0. Results: Our search yielded 121 studies, including 155 patients. Females were considerably predominant. Most patients had a history of autoimmune disease, and almost a third had a history of cardiovascular disease. Dyspnea and chest pain were the most common chief complaints. More than 70% of patients had experienced physical stress. Myasthenia gravis, systemic lupus erythematosus, and multiple sclerosis were the most frequently reported autoimmune diseases. Conclusion: There were similarities in age and sex compared to classic TCM. TCM should be considered as a differential diagnosis for ACS, especially in patients with a positive background of autoimmunity. A precise reporting system is required for further studies.

Structural equation modeling to estimate treatment adherence based on the light triad of personality and sense of coherence in patients with type-2 diabetes: examining the mediating role of psychological well-being.

Background: The current study investigated the relationship between the light triad of personality and self-coherence with treatment adherence in patients with Type 2 Diabetes Mellitus (T2DM) using Structural Equation Modeling (SEM). Psychological well-being was considered a mediator variable in this SEM assessment. Method: A cross-sectional study by convenience sampling was conducted, and 368 patients with T2DM were recruited from 10 private practice and general hospitals from May to November 2021 in Gilan province, Iran. The Reef's Psychological Well-being Questionnaire, the Light Triad Rating Scale, and Antonovsky's Sense of Coherence Scale were used for data collection. Structural equation modeling was used to examine the model fitness and identify direct/indirect relationships among variables. Data were analyzed by the SPSS (Version 26) and AMOS software (Version 24). Results: The average score of light triads, sense of coherence, psychological well-being, and treatment adherence were 70.36 ± 25.55, 108.25 ± 37.68, 57.03 ± 23.84, and 106.81 ± 39.61, respectively. Model fit statistics suggest that the measurement model fits the data well: χ2 (146, N = 368) = 314.011 (p < 0.001). The SEM results showed that the light triad of personality (ß = 0.12) and self-coherence (ß = 0.14) were positively associated with treatment adherence. Anxiety, the light triad of personality (ß = 0.12), and self-coherence (ß = 0.14) affect treatment adherence indirectly through psychological well-being. Conclusion: The analysis of the SEM revealed that the suggested model had a suitable goodness of fit. So, using self-coherence and psychological well-being structures in designing interventional programs is recommended to optimize treatment adherence in patients with T2DM.

Incidence and exposure to microplastics in table salt present in the Iran market.

Plastics and microplastics (MPs) are toxic, pervasive and threatening the biotic and abiotic components of the earth, and they threaten food safety and food security by moving in the food chain. In this study, the amounts and characteristics of 40 table salt samples with different brands, including sea salt (No = 13), rock (No = 13), bulk (No = 8) and non-standard (No = 6), were investigated with a combination of sieving, filtration, observation and FTIR, Micro-Raman and SEM techniques. The results showed that all the salts were contaminated with MPs. In general, the abundance range of detected particles was 700-5470 MPs/kg. The abundance of MPs was higher in counterfeit and non-standard salts (1825 ± 1808 MPs/kg). Investigating the relationship between the effect of the purification process (Kruskal-Wallis Test, P = 0.841), the type of packaging (Kruskal-Wallis Test, P = 0.609), and the type of salt (Kruskal-Wallis Test, P = 0.942), on the abundance of MPs using a comparison test Kruskal-Wallis was not significant. However, the numerical difference was recognizable. The most identified polymer in the salts was cellulose acetate, which probably causes by unmanaged plastic litter in the environment (especially cigarette butts). The dominant form of particles was fragment-shaped, which is the most abundant form of identified MPs in the environment. Both environmental pollution and secondary pollution (during production and packaging), respectively, contribute to the contamination of salts with MPs. The estimated human dietary intake (EDI) and the amount of estimated annual intake (EAI) for different ages in Iran were obtained EDI = 5-59 MPs/capita/day and EAI = 1967-21563 MPs/capita/year. The surface morphology of the particles showed that the MPs were affected by continuous weathering, mechanical fracture and oxidation. MPs are a threat to human health due to the absorption and transmission of dangerous pollutants and their inherent toxicity. Therefore, a solution must be thought of to prevent the contamination of the food chain through salts by MPs, (with protective measures at the salt source, and by improving its production processes.

From Hair to the Brain: The Short-Term Therapeutic Potential of Human Hair Follicle-Derived Stem Cells and Their Conditioned Medium in a Rat Model of Stroke.

The short-term therapeutic impacts of stem cells and their derivatives were frequently reported in preclinical investigations of ischemic stroke (IS); however, several drawbacks including accessibility, abundancy, and ethical concerns limited their clinical application. We describe here for the first time the therapeutic potential of human hair follicle-derived stem cells (hHFSCs) and their conditioned medium (CM) in a rat model of IS. Furthermore, we hypothesized that a combination of cell therapy with repeated CM administration might enhance the restorative efficiency of this approach compared to each treatment alone. Middle cerebral artery occlusion was performed for 30 min to induce IS. Immediately after reperfusion, hHFSCs were transplanted through the intra-arterial route and/or hHFSC-CM administered intranasally. The neurological outcomes, short-term spatial working memory, and infarct size were evaluated. Furthermore, relative expression of seven target genes in three categories of neuronal markers, synaptic markers, and angiogenic markers was assessed. The hHFSCs and hHFSC-CM treatments improved neurological impairments and reduced infarct size in the IS rats. Moreover, molecular data elucidated that IS was accompanied by attenuation in the expression of neuronal and synaptic markers in the evaluated brain regions and the interventions rescued these expression changes. Although there was no considerable difference between hHFSCs and hHFSC-CM treatments in the improvement of neurological function and decrement of infarct size, combination therapy was more effective to reduce infarction and elevation of target gene expression especially in the hippocampus. These findings highlight the curative potential of hHFSCs and their CM in a rat model of IS.

The impacts of anesthetic regimens on the middle cerebral artery occlusion outcomes in male rats.

The middle cerebral artery occlusion (MCAO) model was introduced more than 3 decades ago to simulate human stroke. Till now, it is the most common platform to investigate stroke-induced pathological changes as well as to discover new drugs and treatments. Induction of general anesthesia is mandatory to induce this model, and different laboratories are using various anesthetic drugs, which might affect MCAO results. Therefore, the present study was designed to compare the impacts of several widely used anesthetic regimens on the MCAO outcomes. Here, adult male rats were anesthetized by isoflurane inhalation, intraperitoneal injection of chloral hydrate (CH), intraperitoneal injection of ketamine-xylazine, or subcutaneous administration of ketamine-xylazine, then subjected to 30 min MCAO. Survival rate, body weight change, infarct size, as well as cognitive and neurological performance were evaluated up to 3 days after the surgery. Our findings revealed CH caused the highest, whereas subcutaneous ketamine-xylazine led to the lowest mortality. Meanwhile, there were no significant differences in the body weight loss, infarct size, cognitive impairments, and neurological deficits among the experimental groups. Based on the current results, we proposed that subcutaneous injection of ketamine-xylazine could be an effective anesthetic regimen in the rat model of MCAO with several advantages such as low mortality, cost-effectiveness, safety, ease of administration, and not requiring specialized equipment.

Assessment of inequity in bicyclist crashes using bivariate Bayesian copulas.

INTRODUCTION: Physical activity associated with active transport modes such as bicycling has major health benefits and can help to reduce health concerns related to sedentary lifestyles, such as cardiovascular disease, Type II diabetes, and obesity, as well as risks of colon and breast cancer, high blood pressure, lipid disorders, osteoporosis, depression, and anxiety. However, as a vulnerable user group, bicyclists experience negative health impacts of transportation policies and infrastructure, such as traffic crashes and exposure to air and noise pollution that is disproportionately distributed within low-income and underserved areas. METHOD: This study used aggregated (block-group) bicyclist crash data from Harris County, Texas, to analyze how various equity measures are associated with both fatal and injury (FI) and no injury (property damage only) bicyclist crashes that occurred from 2010 to 2017. We used Bayesian bivariate copula-based random effects regression analysis to evaluate these associations. In contrast to more traditional univariate analysis, this novel methodology can consider the effects of factors of interest across different severity levels or crash types to fully understand their effects and how they may differ across categories. RESULTS: The analysis results indicate that the bicyclist exposure, vehicle exposure, population demographics, population density, the percentage of African-Americans, and households below the poverty level are associated with both FI and PDO bicyclist crashes. CONCLUSIONS: Although more location and context-specific analyses are required, this study's overall results once again conform with the findings and assumptions in bicycling safety literature that the low-income and racially diverse communities are prone to experience more bicyclist crashes. PRACTICAL APPLICATIONS: The findings of this study may have implications for future transportation and planning policies. These findings can be used to guide the policies and strategies targeting the elimination of inequity in transportation-related health concerns.

Therapeutic potential of hair follicle-derived stem cell intranasal transplantation in a rat model of ischemic stroke.

BACKGROUND: Stem cell-based therapy has received considerable attention as a potential candidate in the treatment of ischemic stroke; however, employing an appropriate type of stem cells and an effective delivery route are still challenging. In the present study, we investigated the therapeutic effect of safe, noninvasive, and brain-targeted intranasal administration of hair follicle-derived stem cells (HFSCs) in a rat model of ischemic stroke. METHODS: Stem cells were obtained from the adult rat hair follicles. In experiment 1, stroke was induced by 30 min middle cerebral artery occlusion (MCAO) and stem cells were intranasally transplanted immediately after ischemia. In experiment 2, stroke was induced by 120 min MCAO and stem cells were administered 24 h after cerebral ischemia. In all experimental groups, neurological performance, short-term spatial working memory and infarct volume were assessed. Moreover, relative expression of major trophic factors in the striatum and cortex was evaluated by the quantitative PCR technique. The end point of experiment 1 was day 3 and the end point of experiment 2 was day 15. RESULTS: In both experiments, intranasal administration of HFSCs improved functional performance and decreased infarct volume compared to the MCAO rats. Furthermore, NeuN and VEGF expression were higher in the transplanted group and stem cell therapy partially prevented BDNF and neurotrophin-3 over-expression induced by cerebral ischemia. CONCLUSIONS: These findings highlight the curative potential of HFSCs following intranasal transplantation in a rat model of ischemic stroke.

Intranasal application of stem cells and their derivatives as a new hope in the treatment of cerebral hypoxia/ischemia: a review.

Intranasal delivery of stem cells and conditioned medium to target the brain has attracted major interest in the field of regenerative medicine. In pre-clinical investigations during the last ten years, several research groups focused on this strategy to treat cerebral hypoxia/ischemia in neonates as well as adults. In this review, we discuss the curative potential of stem cells, stem cell derivatives, and their delivery route via intranasal application to the hypoxic/ischemic brain. After intranasal application, stem cells migrate from the nasal cavity to the injured area and exert therapeutic effects by reducing brain tissue loss, enhancing endogenous neurogenesis, and modulating cerebral inflammation that leads to functional improvements. However, application of this administration route for delivering stem cells and/or therapeutic substances to the damaged sites requires further optimization to translate the findings of animal experiments to clinical trials.

Toward a crowdsourcing solution to identify high-risk highway segments through mining driving jerks.

Traffic crashes have become a leading cause of preventable deaths globally. Identifying high-risk segments not only benefits safety specialists to better understand crash patterns but also reminds road users to be aware of driving risks. This study reports on a new crowdsourcing solution to identify high-risk highway segments by analyzing driving jerks. Driving jerks represent the abrupt changes of acceleration, which have been shown to be closely related to traffic risks. In this study, we first calculate driving jerks from each participant's naturalistic driving data and identify "unsafe" drivers based on their jerk-ratio. Then, we innovatively propose an improved line-constrained clustering method to identify each participant's jerk clusters on each road. These individual-specific jerk clusters are overlapped with road networks to identify potential risky segments. By synthesizing these potential risky segments reported by different participants, we obtain the final detection results for high-risk highway segments. In this study, we compare the jerk-cluster-determined risky segments with crash-rate-determined risky segments to evaluate the proposed solution's effectiveness. The study results demonstrate that our crowdsourcing solution can effectively identify high-risk road segments with an estimated 75 % accuracy. More importantly, by analyzing this valued surrogate measure, safety specialists can identify hazardous road segments before crashes occur.

Quantifying the automated vehicle safety performance: A scoping review of the literature, evaluation of methods, and directions for future research.

Vehicle automation safety must be evaluated not only for market success but also for more informed decision-making about Automated Vehicles' (AVs) deployment and supporting policies and regulations to govern AVs' unintended consequences. This study is designed to identify the AV safety quantification studies, evaluate the quantification approaches used in the literature, and uncover the gaps and challenges in AV safety evaluation. We employed a scoping review methodology to identify the approaches used in the literature to quantify AV safety. After screening and reviewing the literature, six approaches were identified: target crash population, traffic simulation, driving simulator, road test data analysis, system failure risk assessment, and safety effectiveness estimation. We ran two evaluations on the identified approaches. First, we investigated each approach in terms of its input (required data, assumptions, etc.), output (safety evaluation metrics), and application (to estimate AVs' safety implications at the vehicle, transportation system, and society levels). Second, we qualitatively compared them in terms of three criteria: availability of input data, suitability for evaluating different automation levels, and reliability of estimations. This review identifies four challenges in AV safety evaluation: (a) shortcomings in AV safety evaluation approaches, (b) uncertainties in AV implementations and their impacts on AV safety, (c) potential riskier behavior of AV passengers as well as other road users, and (d) emerging safety issues related to AV implementations. This review is expected to help researchers and rulemakers to choose the most appropriate quantification method based on their goals and study limitations. Future research is required to address the identified challenges in AV safety evaluation.

Investigating the safety and operational benefits of mixed traffic environments with different automated vehicle market penetration rates in the proximity of a driveway on an urban arterial.

Traffic congestion is monotonically increasing, especially in large cities, due to rapid urbanization. Traffic congestion not only deteriorates traffic operation and degrades traffic safety, but also imposes costs to the road users. The concerns associated with traffic congestion increase when considering more complicated situations such as unsignalized intersections and driveways at which maneuvers are entirely dependent upon drivers' judgment. Urban arterials are characterized by closely spaced signalized and unsignalized intersections and high traffic volumes, which make them a priority while analyzing traffic safety and operation. Autonomous Vehicles (AV) provide ample opportunities to overcome the aforementioned challenges. In essence, this study evaluates the impact of various AV Market Penetration Rates (MPR) on the safety and operation of urban arterials in proximity of a driveway under different traffic levels of service (LOS). Twenty-four separate scenarios were developed using VISSIM, considering six AV MPRs of 0 %, 10 %, 25 %, 50 %, 75 %, and 100 %, and four LOS including A, B, C, and D. Various operational and safety measures were analyzed including traffic density, traffic speed, traffic conflict (rear-end and lane-changing), and driving volatility. The trajectory and lane-based analysis of the traffic density indicates that MPR significantly improves the overall traffic density for all the scenarios, especially under high traffic LOS. Additionally, by increasing the MPR and decreasing the traffic volume of the network, the mean speed increases significantly by up to 6 %. Exploring the safety of the scenarios indicates that by increasing the MPR from 0% to 100 % for all the LOS, the number of rear-end conflicts and lane-changing conflicts decreases 84 %-100 % and 42 %-100 %, respectively. Moreover, assessing the longitudinal driving volatility measures, which represent risky driving behaviors, showed that higher MPRs significantly reduce some of the driving volatility measures and enhance safety.

The Effectiveness of Group Training of CBT-Based Stress Management on Anxiety, Psychological Hardiness and General Self-Efficacy Among University Students.

BACKGROUND: Admission to university is a very sensitive period of life for efficient, active, and young workforces in any country, and it is mostly associated with many changes in social and human relationships. These changes lead to anxiety in students. Moreover, humans need certain functions in order to adaptively deal with different life situations and challenges. By training stress management, these functions can help human acquire the required abilities. OBJECTIVE: The present study was aimed at investigating the effectiveness of stress management training in anxiety, psychological hardiness, and general self-efficacy among university students. METHOD: The study was a quasi-experimental intervention (pretest-posttest-follow-up) including a control group, it was a fundamental applied study. The statistical population consisted of all students of Islamic Azad University, Karaj, Iran. Convenient sampling was employed to select 30 students who were divided into an experimental group (n=15) and a control group (n=15). Before stress management training, both groups filled out Beck Anxiety Inventory, Long and Goulet scale of psychological hardiness, and General Self-efficacy Scale (GSE-10). Afterwards, the experimental group was provided with stress management training. And after the experiment, the abovementioned questionnaires and scales were responded by the two groups. Finally the collected data were analyzed and compared using one-way MANOVA. RESULTS: The results of MANOVA indicated that there was a significant difference between the two groups in terms of anxiety, hardiness, and general self-efficacy (p<0.001). CONCLUSION: According to the results of the present study and those of previous investigations that are in agreement with those of the present study, it can be concluded that stress management among university students cause anxiety to drop; moreover, it enhances their psychological hardiness and self-efficacy. In regard with the role and importance of stress management, training this skill should be included in educational plans of university.

Cavitary pulmonary lesions in systemic lupus erythematosus: an unusual manifestation.

Systemic lupus erythematosus (SLE) is an autoimmune disease of unknown pathogenesis. The frequency of SLE with cavitary lesion manifestation is very rare and is thought to be due to infection or pulmonary embolism. A 19-year-old female diagnosed with SLE complicated by lupus nephritis and cavitary pulmonary lesion is presented in this case report. Other diseases that can lead to such lesions were ruled out in the patient. The patient improved briefly after the initiation of immunosuppressive therapy, but was unresponsive to supportive treatment due to pneumothorax. Pneumothorax is caused by cavitary lesions and possibly bronchopleural fistulas - these later caused respiratory distress and death. The patient did not show any improvement in the lesions after the initiation of immunosuppressive therapy. This case report suggests that the differential diagnosis of cavitary lung lesions should include SLE.

Radioprotective effects of hawthorn fruit extract against gamma irradiation in mouse bone marrow cells.

The radioprotective effect of hawthorn (Crataegus microphylla) fruit extract against genotoxicity induced by gamma irradiation has been investigated in mouse bone marrow cells. A single intraperitoneal (ip) administration of hawthorn extract at doses of 25, 50, 100 and 200 mg/kg 1h prior to gamma irradiation (2 Gy) reduced the frequencies of micronucleated polychromatic erythrocytes (MnPCEs). All four doses of hawthorn extract significantly reduced the frequencies of MnPCEs and increased the PCE/PCE+NCE ratio (polychromatic erythrocyte/ polychromatic erythrocyte + normochromatic erythrocyte) in mice bone marrow compared with the non drug-treated irradiated control (p < 0.02-0.00001). The maximum reduction in MnPCEs was observed in mice treated with extract at a dose of 200 mg/kg. Administration of amifostine at dose 100 mg/kg and hawthorn at dose 200 mg/kg reduced the frequency of MnPCE almost 4.8 and 5.7 fold; respectively, after being exposed to 2 Gy of gamma rays, compare with the irradiated control group. Crataegus extract exhibited concentration-dependent activity on 1,1-diphenyl 2-picrylhydrazyl free radical showing that Crataegus contained high amounts of phenolic compounds and the HPLC analysis determined that it contained chlorogenic acid, epicatechin and hyperoside. It appeared that hawthorn extract with antioxidant activity reduced the genotoxicity induced by gamma irradiation in bone marrow cells.