Loss of free will in the Iranian criminal justice system: Interdisciplinary analysis of law and neuroscience

Today, with the development of neuroscience and the discovery of new secrets of the brain, the social sciences, including law, have made significant progress with the help of new findings in this science. One of the significant applications of neuroscience in modern criminal law is the explanation of the neurological dimensions of human free will, which in addition to creating a profound and scientific approach to the definition of this important element of criminal responsibility, can help ascertain the loss of free will causes. To this end, the present study is an attempt to answer this question in the context of the Iranian criminal justice system: What are the core causes of the loss of free will from the perspective of neurolaw? The paper strives to take an appropriate step toward the development of criminal justice. In this study, we found that mental disorders, coercion, drunkenness, somnambulism, and error are the core causes that can be assessed in particular ways using EEG and fMRI techniques, however, each with limitations.

Predictors of international Muslim medical tourists' expectations on halal-friendly healthcare services: A hospital-based study

BACKGROUND

Halal-friendly healthcare services have emerged as an important sector of the overall healthcare service delivery system. This study aimed to examine levels and determinants of expectations on halal-friendly healthcare services from the Muslim medical tourists' perspective.

METHODS

A cross-sectional survey was conducted in four cities, seventeen hospitals, across Iran, with a sample of 365 international Muslim medical tourists.

RESULTS

Mean expectation score of the respondents was 3.95 ± 1.43. Being in the 25-34 age group (aOR = 2.65; CI 95%: 2.14-3.16), being married (aOR = 2.09; CI 95%: 1.46-2.72), having completed secondary education (aOR = 2.14; CI 95%: 1.26-3.02), belonging to a high-income socioeconomic background (aOR = 1.69; CI 95%: 1.06-2.33), coming from Iraq (aOR = 3.08; CI 95%: 2.12-4.04), being Shia (aOR = 2.83; CI 95%: 2.00-3.67), receiving information by recommendation as a source for travel decision (aOR = 3.02; CI 95%: 1.82-4.22), traveling with family or relatives (aOR=2.16; CI 95%: 1.42-2.90), receiving medical service of cosmetic surgery (aOR = 1.57; CI 95%: 1.22-1.92) and cardiovascular therapy (aOR = 2.33; CI 95%: 1.23-3.43), and traveling one or two times in the past (aOR = 2.33; CI 95%: 1.00-3.66) significantly increased the expectations on halal-friendly healthcare services.

CONCLUSION

This study will represent an important contribution to the literature concerned with the levels and drivers of expectations on halal-friendly healthcare services.

A nanoscale electrochemical guanine DNA-biosensor based on a flower-like nanocomposite of Tb-doped ZnO for the sensitive determination of pemetrexed

Pemetrexed is an antineoplastic drug used in chemotherapeutic treatments, especially in malignant mesothelioma and non-small cell lung carcinoma, but can also cause a variety of complications, like stomach pain, nausea, burning, vomiting, numbness, and tingling, emphasizing the need for an approach to quantify the drug in biological matrices. Herein, a DNA-based biosensor was introduced for pemetrexed determination. A hydrothermal approach was used for synthesizing flower-like nanoparticles (NPs) of zinc oxide (ZnO) doped with Tb (FL-NP Tb3+/ZnO). Moreover, energy dispersive X-ray (EDX), field-emission scanning electron microscopy (FESEM), zeta potential, Brunauer-Emmett-Teller (BET), and X-ray diffraction (XRD) analyses were used for characterizing the as-prepared nanocomposite. According to the impedance analysis, FL-NP Tb3+/ZnO was accompanied by very good electrochemical functions for a simple transfer of electrons. In the case of the immobilization of double-stranded deoxyribonucleic acid (ds-DNA) on the FL-NP Tb3+/ZnO and polypyrrole (PP)-modified pencil graphite electrode (ds-DNA/PP/FL-NP Tb3+/ZnO/PGE), a considerable enhancement was found in the electrochemical oxidation of guanine in ds-DNA residue bases. Since there was an interaction between ds-DNA and pemetrexed, the voltammetric current of guanine over the ds-DNA/PP/FL-NP Tb3+/ZnO/PGE declined in the presence of pemetrexed in the electrolytic solution. Moreover, under optimum conditions (25 mg L-1 of ds-DNA and 10 min incubation time, in acetate buffer at 25 °C), a linear decrease in the guanine signal was observed on the ds-DNA/PP/FL-NP Tb3+/ZnO/PGE as the pemetrexed concentration increased in the range from 0.001 μM to 175.0 μM with a limit of detection of 0.17 nM. Finally, the new DNA-based biosensor was successfully used for determining pemetrexed in real samples, indicating its application potential.

Impact of teaching, learning, and assessment of medical law on cognitive, affective and psychomotor skills of medical students: a systematic review

BACKGROUND

It is necessary to improve medical students' legal cognitive, affective, and psychomotor skills to prevent further legal issues in the medical profession. Choosing the proper teaching and assessment methods is crucial in this matter. This study aimed to investigate the impact of teaching, learning, and assessment of medical law on the cognitive, affective, and psychomotor skills of medical students.

METHODS

A systematic review was conducted in PubMed, Embass, and Web of Science databases, and Google Scholar search engine using MECIR and PRISMA, AMEE Guide 94 for 1980 to 2022.12.30. Nineteen articles met the inclusion criteria. MERSQI checklist was used to assess the quality of the articles, and URSEC (theoretical underpinning of the development, resources required, setting, educational methods employed, and content) used to assess the risk of educational bias.

RESULTS

Internship courses called Medical Education Humanities and Society (MESH), clinical scenario design, seminars and small group discussions, web-based interactive training, legal training courses, PBL, and mind maps have been used to improve the medico-legal knowledge of medical students. MESH clerkship, simulation of a legal event, medico-legal advocacy program based on interdisciplinary education, group discussion, integration, and court-based learning used to improve student attitudes. Multidisciplinary training, small group discussions after the seminar, mock trial competition, and interdisciplinary education are used to teach psychomotor skills. All studies, except one on knowledge, reported positive effects of legal education on students' knowledge, attitudes, and legal performance. Written assessments were used for cognitive and affective domains, while performance was assessed by OSCE, simulated court, and evaluation of patient referrals.

CONCLUSION

There are few studies to examine the cognitive, affective, and legal psychomotor skills of medical students. The texts have not yet fully explored the high level of affective and psychomotor domains, which is evidence of a gap in this sector. Recognizing that medico-legal problems are prevented through proper education and assessment, it is recommended that this area be considered a research priority and that effective educational policies are adopted.

Gender and Physical Activity: What We Can Learn from The Ottawa Charter for Health Promotion?

Physical activity is a modifiable risk factor for non-communicable disease. This study used the Ottawa Charter as a framework to explore responses for low physical activity caused by gender inequity. The researchers examined factors related to physical activity in women based on Ottawa Charter strategies. Promote the knowledge, beliefs, and attitudes of women about health issues, as well as work in socio-demographic factors as social support. The community level corresponds to the physical settings that affect physical activity. Lack of suitable places and facilities, absence of walking paths, neighborhood hazards, insufficient sports campaigns for women, shortage of government financial support for female athletes, and religious legislation in Islamic countries are the barriers to ensure physical activity in women. This review provides a comprehensive understanding of the relevant advantages of physical activity in women across the Ottawa Charter declaration.

Effect of Monovalent Copper Oxide and Potentiated Zinc Oxide on Growth Performance and Gut Morphology of Broiler Chickens Challenged with Coccidiosis

An experiment was conducted to evaluate the effect of copper oxide (Cu₂O) and potentiated zinc oxide (ZnO) on performance, intestinal morphology, oocyst excretion, coccidial lesion scores, and antioxidant properties in broilers during an Eimeria spp. challenge. A total of 288 1-day-old male broiler chickens (Ross 308) were divided into 18 treatments. Treatments included three levels of Cu (0, 15, or 150 mg/kg) from Cu₂O and three levels of Zn (0, 80, or 160 mg/kg) from potentiated ZnO which were added to the basal diet and fed to broilers with or without challenge, using a completely randomized design in a factorial arrangement for 42 days. Live body weight, feed intake, mortality, and the cause of death were recorded weekly and histomorphology of jejunum was measured at the end of the experiment. Results showed that birds fed Cu and Zn linearly decreased (P < 0.0001) oocyst shedding. The number of excreted oocysts was reduced eight times in broilers fed a diet containing 150 mg/kg copper from Cu₂O and 160 mg/kg zinc from potentiated ZnO, compared to the infected group without Cu and Zn supplementation (P < 0.0001). Microscopic features of both non-challenged and challenged broiler jejunum revealed significant improvement along with increased Cu₂O and potentiated ZnO doses. Supplementation of Cu₂O and potentiated ZnO decreased the jejunum structure damages and intestinal lesion score (P < 0.002). Eimeria caused a decrease (P < 0.006) in total antioxidant capacity. Superoxide dismutase increased by dietary zinc supplementation (P < 0.05). Results suggested that a combination of Cu₂O and potentiated ZnO could exhibit efficient anticoccidial activity.

Mental Health Disorders in Circumcised Reproductive-age Women, Legal Dimensions and Prevention Strategies: A Narrative Review

OBJECTIVE

 Female genital mutilation/cutting (FGM/C) can affect women's lives through various physical, psychological, social and even sexual mechanisms. According to the World Health Organization guidelines for managing the health effects of FGM/C, further research into its psychological effects and preventative measures is required. In this study, a comprehensive review of the mental health consequences of circumcised women of reproductive age has been conducted with a special focus on providing preventive solutions.

METHODS

 A comprehensive search of the Web of Science, PubMed(MEDLINE), Proquest, Scopus and Google scholar was carried outfrom 2000 to 2022. The second stage of search was conducted in grey literature. To facilitate a systematic approach to search the literature, the PECO framework, was adopted.

RESULTS

 The result of this narrative review study showed that, the most common mental health disorder in reproductive age circumcised women were depression, anxiety and post-traumatic stress disorder. Some studies found a significant relationship between parents' education level and circumcised girls, so that parents of the circumcised women had a low level of education. Two studies considered religious beliefs, tradition, cleanness, sexual desire control and virginity as the reasons for FGM/C.

CONCLUSION

 All forms of FGM/C may be harmful to one's health. Women, who have undergone widespread forms of circumcision, are more likely to develop mental disorders. As the psychosocial effects of circumcision can affect the sexual experience of circumcised women, addressing this issue, emphasizing its legal aspects, and providing preventative solutions can improve physical, mental, social, and even sexual health in circumcised women.

Ph3P-mediated decarboxylative ring-opening of maleic anhydride by thiolic compounds: formation of two carbon-sulfur bonds

In this study, a simple and efficient method for the formation of carbon-sulfur bonds is described. In this process, ring opening of maleic anhydride by thiols or disulfides and triphenylphosphine led to the formation of sulfide products via formation of two carbon-sulfur bonds.

Development of the DNA-based voltammetric biosensor for detection of vincristine as anticancer drug

In the article presented herein, a deoxyribonucleic acid (DNA) biosensor is introduced for Vincristine determination in pharmaceutical preparations based on the modification of screen printed electrode (SPE) with double-stranded DNA (ds-DNA), polypyrrole (PP), peony-like CuO:Tb³⁺ nanostructure (P-L CuO:Tb³⁺ NS). The developed sensor indicated a wide linear response to Vincristine concentration ranged from 1.0 nM to 400.0 μM with a limit of detection as low as .21 nM. The intercalation of Vincristine with DNA guanine led to the response. The optimized parameters for the biosensor performance were ds-DNA/Vincristine interaction time, DNA concentration and type of buffer solution. The docking investigation confirm the minor groove interaction between guanine base at surface of or ds-DNA/PP/P-L CuO:Tb³⁺ NS/SPE and Vincristine. The proposed sensor could successfully determine Vincristine in Vincristine injections and biological fluids, with acceptable obtains.

Design of an all-optical insulator-metal-insulator and metal-insulator-metal Feynman logic gates

In this paper, two Feynman logic gates based on insulator-metal-insulator (IMI) and metal-insulator-metal (MIM) waveguides are proposed. The gates are modeled using the finite-difference time-domain method. The IMI-based Feynman gate shows high extinction ratio (ER) values of 11.06 dB and 7.61 dB for the output bits P and Q, respectively. The ER values of the MIM-based Feynman gate are also 12.83 dB and 7.29 dB for the output bits P and Q, respectively. The footprint of the gates is less than 2µm². The proposed gates benefit from high ERs in the wavelength range of 1.5-1.6 µm (band C), ultra-compact footprints, and CMOS-compatible structures, which make them potential candidates for use in integrated photonic circuits.

POS0198 COVID-19 OUTCOMES IN PATIENTS WITH DERMATOMYOSITIS: A REGISTRY-BASED COHORT ANALYSIS

Background

Dermatomyositis (DM) patients have fewer risks of COVID-19 infection compared to the general population, however, certain subgroups with DM have worse outcomes. Men. African Americans, those with interstitial lung disease, exhibited higher risks of severe COVID-19. DMARD and glucocorticoid use was associated with frequent hospitalisations and severe sepsis.

Objectives

Rheumatic diseases (RDs) like DM, are previously known to be vulnerable towards various types of infections due to its aggressive activity mandating high dose immunosuppressive therapy. The severity of COVID-19 in RDs is limited in literature due to the heterogeneous nature of the condition. Therefore, specific details on mortality is essential to navigate any precautions required in the treatment.

Methods

Retrospective data of individuals with DM and COVID-19 and the general population with COVID-19 between January 2020 to August 2020 was retrieved from the TriNetX database. A one-to-one matched COVID-19 positive control was selected using propensity score (PS) matching. We assessed COVID-19 outcomes such as mortality, hospitalisation, ICU admission, severe COVID-19, mechanical ventilation (MV), acute kidney injury (AKI), venous thromboembolism (VTE), ischemic stroke, acute respiratory distress syndrome (ARDS), renal replacement therapy (RRT) and sepsis. Subgroup analyses included gender, race, ILD, cancer patients, disease-modifying rheumatic drugs (DMARDs) use, and glucocorticoids (GC) use (Figure 1).

Figure 1.

Overview of study

Results

We identified 5,574 DM patients with COVID-19, and 5,574 general population with COVID-19 (controls). DM with COVID-19 had a lower risk of mortality in comparison to controls [RR 0.76], hospitalisation [RR 0.8], severe COVID-19 [RR 0.76], AKI [RR 0.83], and sepsis [RR 0.73]. Males and African Americans were more likely to develop AKI [RR 1.35, 1.65], while African Americans had higher odds for severe COVID-19 [RR 1.62] and VTE [RR 1.54]. DM with ILD group also experienced higher odds for severe COVID-19 infection [RR 1.64], and VTE [RR 2.06] (Figure 1).

DM patients receiving DMARDs and glucocorticoids had higher odds for hospitalisation [RR 1.46, 2.12], and sepsis [RR 3.25] Subgroup analysis of neoplasms amongst DM patients with COVID-19 was inadequate for meaningful comparison (Figure 1).

Conclusion

DM patients are protected for certain aspects of COVID-19 disease, including severe COVID-19, hospitalization, and mortality. The African American race, male gender, ILD, DMARDS and glucocorticoid users, are associated with poor outcomes.

Disclosure of Interests

Latika Gupta: None declared, Haig Pakhchanian: None declared, Hiba Khan: None declared, Rahul Raiker: None declared, Maryam Abbasi: None declared, Charles DeYoung: None declared, Sinan Kardes Grant/research support from: SK has received congress travel, accommodation, and participation fee support (12th Anatolian Rheumatology Days) from Abbvie, Sakir Ahmed Speakers bureau: SA has received honorarium as speaker for Pfizer, Chengappa Kavadichanda: None declared, Parikshit Sen: None declared, Rohit Aggarwal Consultant of: RA has/had a consultancy relationship with and/or has received research funding from the following companies-Bristol Myers-Squibb, Pfizer, Genentech, Octapharma, CSL Behring, Mallinckrodt, AstraZeneca, Corbus, Kezar, and Abbvie, Janssen, Alexion, Argenx, Q32, EMD-Serono, Boehringer Ingelheim, Roivant., Grant/research support from: RA has/had a consultancy relationship with and/or has received research funding from the following companies-Bristol Myers-Squibb, Pfizer, Genentech, Octapharma, CSL Behring, Mallinckrodt, AstraZeneca, Corbus, Kezar, and Abbvie, Janssen, Alexion, Argenx, Q32, EMD-Serono, Boehringer Ingelheim, Roivant.

The Effects of Nano and Micro Particle Size of Zinc Oxide on Performance, Fertility, Hatchability, and Egg Quality Characteristics in Laying Japanese Quail

The current trial was conducted by using the 288 Japanese quails to evaluate the effects of a zinc-deficient diet supplemented with nano and micro zinc oxide on performance, fertility, hatchability, and egg quality characteristics. In this experiment, birds were randomly allocated to 9 dietary treatments includes diets supplemented with nano or micro particles of zinc oxide (amount of ZnO supplement for each treatment) to supply 49, 74, 99, and 124 mg zinc per kilogram of diet in a factorial arrangement (2 × 4) and a control non supplemented diet (24 mg/kg) with four replicates of eight birds (six females and two males) in each pen. Birds were fed the experimental diets from 47 to 75 days of age and had free access to water and feed during the experimental period. Results showed that Zn supplementation, regardless of particle size, improved the eggshell thickness (P < 0.01). A significant (P < 0.05) interaction was observed between zinc level and ZnO particle size for Shell breaking strength. Quails fed diets supplement with ZnO showed significantly higher egg weight and eggshell surface (P < 0.05) as compared with birds fed a non-supplemented control diet. Results obtained here showed that supplementation of nano ZnO enhanced fertility considerably. Application of non-linear quadratic models showed that the maximum egg production percentage was achieved when 67 or 72 mg/kg of dietary zinc was supplied from nano and micro ZnO, respectively. This result indicated that nano ZnO could reduce the zinc requirement in laying Japanese quail.

COVID-19 Vaccine Triggered Rejection in Lung Transplant Recipients: A Case Series

Purpose

Methods

Results

Conclusion

The United States Experience of Lung Transplantation in Recipients with COVID-19 Fibrosis: A UNOS/OPTN Analysis

Purpose

Coronavirus Disease 19 (COVID-19) is a novel cause of end-stage fibrotic lung disease. Data has been limited to case series and single center reports with regards to outcomes in this unique cohort of patients. We sought to investigate the largest experience to date in patients with COVID-19 fibrosis (CVF) who underwent lung transplantation.

Methods

The United Network for Organ Sharing (UNOS) database was queried for all adult patients (≥18 years old) who underwent isolated lung transplantation between 2018 and July 2021. Recipients diagnosed with CVF were identified and compared to those with idiopathic pulmonary fibrosis (IPF). The IPF cohort included recipients from 2018, in the pre-COVID era. Baseline demographics, perioperative factors, and 30-day outcomes were examined.

Results

A total of 931 recipients were included in this study, 868 (93.2%) and 63 (6.8%) were IPF and CVF, respectively. IPF recipients were on average older (65 vs. 56 years, p<0.001), white race (83% vs. 51%, p<0.001), and less likely to be male (73% vs. 86%, p=0.04). BMI was similar between the IPF and CVF, 27.6 and 27.2 kg/m², as was the mean PAP 24 and 21 mmHg. The CVF cohort had lower predicted FVC (32% vs. 47%, p=0.01), and had less tobacco use (36% vs 61%, p<0.001). Mean creatinine level was clinically similar, though statistically higher in the IPF cohort, (0.83 vs 0.64, p<0.001). CVF recipients were on the waitlist for a shorter median duration (10 vs 32 days, p<0.001) with a higher LAS (85 vs 41, p<0.001). Notably, more CVF recipient were be on ECMO at time of listing (29% vs 2%, p<0.001) and require ventilatory support (27% vs. 2%, p<0.001). CVF recipients were more likely to receive a double lung transplantation compared to IPF (83% vs 64%, p=0.002), with similar ischemia times, 5.5 vs 5.1 hrs (p=0.17). Mortality at 30 days was comparable between CVF and IPF (7.0% vs. 2.3%, p=0.09), though 20 patients in the CVF cohort had missing data.

Conclusion

Patients with end-stage lung disease secondary to CVF are higher acuity, and more likely to require ECMO and ventilatory support as a bridge to lung transplantation. Early mortality, while comparable to non-COVID related fibrotic lung disease, remains almost 3 times higher with CVF. In the era of publicly reported survival outcomes, the transplant community may need to reconsider how we approach this new and devastating diagnosis of CVF.

Entanglement of the Rights of the Child, Well-being, and Justice: A Conceptual Framework for Child Protection and Well-being

Background: Human Rights (HRs) framework supports improving human health status and the reduction of health inequalities through action on Social Determinants of Health (SDH). Given the shortcoming of HRs to protect the children, the question is, how can we ensure child protection and well-being rather than just child health? Methods: In this conceptual analysis study, first, we explain the fundamental rights of the child and the steering role of them in moving towards health equity through action on SDH; second, meanwhile argue the shortcoming of rights-based protection, provide a list of the core capabilities and corresponding rights of the child; and third, we represent a conceptual framework for child protection and well-being using both HRs norms and moral entitlements based on recent ethical theories of justice, with a preventive approach. Results: According to the framework, HRs instruments should lead to the protection of the child and the development of core capabilities through addressing social determinants and providing equal opportunities, of which the ability to live a healthy life is just one. In addition, actualizing these capabilities depends on the context. Since achieving well-being rather than just the health, in addition to acquiring the core capabilities as states of beings, implies their function as doings, that requires considering the socioecological context to provide means necessary to meet the essential dimensions of well-being at the level of adequacy. Conclusion: Implementing the suggested framework requires that each country create a national action framework and determine the role and duties of the responsible organizations.

Toward children's cognitive development from the perspective of neurolaw: implications of Roper v Simmons

After reaching the age of criminal responsibility, children are deemed capable of having committed criminal offenses. In this regard, the level of criminal responsibility depends on cognitive development and the type of offense committed. Cognitive development is a process of the growth of perception, thinking and reasoning in children. This concept is frequently referred to in cognitive neuroscience literature. Recently, the U.S. Supreme Court's decision in Roper v Simmons has substantially changed attitudes toward juvenile delinquency, considering the fact that cognitive development continues until early adulthood. The present study attempts to scrutinize this case and explain cognitive development by its factors from an interdisciplinary perspective, combining methods and theories from neuroscience and criminal law.

Postprocedural Thrombosis following Endovascular Treatment of Intracranial Aneurysm with Flow Diverters or Coiling: A Histologic Study

Endovascular treatment of aneurysms with flow diverters or coiling is sometimes complicated by intraprocedural or postprocedural thrombosis along or within the devices. Thrombus composition and structure associated with such complications may provide insights into mechanisms of thrombus formation and clinical strategies to remove the thrombus. We present a retrospective histopathologic study of 4 patients who underwent mechanical thrombectomy due to acute occlusion of either implanted flow diverter devices or along coils during the treatment of intracranial aneurysm.

Arterial Collapse during Thrombectomy for Stroke: Clinical Evidence and Experimental Findings in Human Brains and In Vivo Models

BACKGROUND AND PURPOSE

Aspiration thrombectomy has become a preferred approach to recanalize large-vessel occlusion in stroke with a growing trend toward using larger-bore catheters and stronger vacuum pumps. However, the mechanical response of the delicate cerebral arteries to aspiration force has not been evaluated. Here, we provide preclinical and clinical evidence of intracranial arterial collapse in aspiration thrombectomy.

MATERIALS AND METHODS

We presented a clinical case of arterial collapse with previously implanted flow diverters. We then evaluated the effect of vacuum with conventional aspiration catheters (with and without stent retrievers) in a rabbit model (n = 3) using fluoroscopy and intravascular optical coherence tomography. Then, in a validated human cadaveric brain model, we conducted 168 tests of direct aspiration thrombectomy following an experimental design modifying the catheter inner diameter (0.064 inch, 0.068 inch, and 0.070 inch), cerebral perfusion pressures (mean around 60 and 90 mm Hg), and anterior-versus-posterior circulation. Arterial wall response was recorded and graded via direct transluminal observation.

RESULTS

Arterial collapse was observed in both the patient and preclinical experimental models. In the human brain model, arterial collapse was observed in 98% of cases in the M2 and in all the cases with complete proximal flow arrest. A larger bore size of the aspiration catheter, a lower cerebral perfusion pressure, and the posterior circulation in comparison with the anterior circulation were associated with a higher probability of arterial collapse.

CONCLUSIONS

Arterial collapse does occur during aspiration thrombectomy and is more likely to happen with larger catheters, lower perfusion pressure, and smaller arteries.

C(sp2)–H bond sulfenylation of aminouracils and enaminones from aryl halides

Direct thioarylation of aminouracils and enaminones from aryl iodides and bromides using potassium cyanodithioformate as an odorless and stable source of sulfur.

An experimental approach to the influence of partial rebar corrosion and concrete degradation on behavior of FRP-strengthened RC beams

Human factors are one of the main reasons for structural damage as they decrease the bearing capacity and also lead to an inaccurate estimation of the structure. Previous studies show that the use of CFRP in the damaged structures can significantly increase their bending and shear capacity. This study examines the capacity and cracks distribution in eight RC (reinforced concrete) beams (210 × 250 × 250 cm), each of which was rehabilitated with seven CFRP (carbon fiber-reinforced polymer) strips using the strip method. Each beam, except for the control specimen, experiences different types of concrete and rebar damages, which are finally compared with those of the control specimen. The results indicated that rebar damage in all the beams was significant and the effects of concrete damage were minimized by CFRP strips. Moreover, the force–displacement diagrams indicate the greatest force for the control specimen. Other specimens reached up to 80% of the force experienced by the control specimen. Finally, the parametric study showed that the influence of the crack width on decreasing the bearing capacity was more significant compared with the other parameters.

Iatrogenic Foreign Materials Associated with Retrieved Clot Tissue via Mechanical Thrombectomy

BACKGROUND AND PURPOSE

Hydrophilic polymers and polytetrafluoroethylene liners, commonly used in the construction of endovascular devices, occasionally separate from devices with subsequent embolization. We determined the frequency of such materials in thrombus specimens retrieved by mechanical thrombectomy in patients with stroke.

MATERIALS AND METHODS

We retrospectively reviewed H&E-stained thrombus sections for presence and types of foreign materials. We identified 4 types of foreign materials-Type I: material was light green with refraction and had a homogeneous texture; type II: material was light gray and/or dark gray, thin, and loose or attenuated in texture; type III: material was light green with refraction, solitary in texture, irregular in shape, and was often associated with round or oval bubblelike particles and/or diffuse black particles; and type IV: material had homogeneous texture and was light pink or red. In addition, polymer materials from different layers of used mechanical thrombectomy catheters were compared with the foreign materials found in thrombus specimens.

RESULTS

A total of 101 thrombi were evaluated. Foreign materials were found in 53 (52.5%) thrombus samples. The most common type was type I (92%), followed by type II (30%). The histopathologic features of the polymer materials from mechanical thrombectomy catheters were similar to the foreign materials found in thrombus specimens. The inner polytetrafluoroethylene liner and coating layer of catheters resembled type I and type II of the foreign materials, respectively.

CONCLUSIONS

Foreign polymer materials are present in approximately half of retrieved thrombi, most commonly polytetrafluoroethylene from catheter liners and less from hydrophilic coatings.

Novel Human Acute Ischemic Stroke Blood Clot Analogs for In Vitro Thrombectomy Testing

BACKGROUND AND PURPOSE

Previous studies have successfully created blood clot analogs for in vitro endovascular device testing using animal blood of various species. Blood components vary greatly among species; therefore, creating clot analogs from human blood is likely a more accurate representation of thrombi formed in the human vasculature.

MATERIALS AND METHODS

Following approval from the Mayo Clinic institutional review board, human whole-blood and platelet donations were obtained from the blood transfusion service. Twelve clot analogs were created by combining different ratios of red blood cells + buffy coat, plasma, and platelets. Thrombin and calcium chloride were added to stimulate coagulation. Clot composition was assessed using histologic and immunohistochemical staining. To assess the similarities of mechanical properties to patient clots, 3 types of clot analogs (soft, elastic, and stiff) were selected for in vitro thrombectomy testing.

RESULTS

The range of histopathologic compositions produced is representative of clots removed during thrombectomy procedures. The red blood cell composition ranged from 8.9% to 91.4%, and fibrin composition ranged from 3.1% to 53.4%. Platelets (CD42b) and von Willebrand Factor ranged from 0.5% to 47.1% and 1.0% to 63.4%, respectively. The soft clots had the highest first-pass effect and successful revascularization rates followed by the elastic and stiff clots. Distal embolization events were observed when clot ingestion could not be achieved, requiring device pullback. The incidence rate of distal embolization was the highest for the stiff clots due to the weak clot/device integration.

CONCLUSIONS

Red blood cell-rich, fibrin-rich, and platelet-rich clot analogs that mimic clots retrieved from patients with acute ischemic stroke were created in vitro. Differing retrieval outcomes were confirmed using in vitro thrombectomy testing in a subset of clots.

Posthumous reproduction in Iranian law

Posthumous reproduction (PHR) is the process by which assisted reproductive technology is used to establish pregnancy and produce genetic offspring following the death of a parent. There are different ethical and legal approaches towards this method of reproduction around the world. This paper will study the legality of PHR and its legal consequences for the family status of a child born by this technology according to Iranian law. This research uses the descriptive-analytical method to study Iranian legislation, the opinion of jurists and jurisconsults, and case law in the area of PHR. The only statute regarding assisted reproductive technology in Iranian law - the Embryo Donation Act 2003 - and the associated regulation contain no explicit provision on PHR. The subject is therefore very controversial among Iranian jurists and jurisconsults. This issue has also been the subject of divergent court decisions. This study shows that the current legislation is insufficient to address various issues raised by PHR, and there is a need for the legislature to provide legislative clarity. Although advocates of this technique use the approval of some jurisconsults (fuqahâ) as justification for the legal recognition of PHR during the idda period in Iranian law, some concerns regarding the practice, especially the child's best interests, support prohibition or at least restriction to specific, limited cases.

The Most Prevalent Intimate Partner Violence; Physical, Sexual, Verbal, or Emotional in Early Marriage: A Narrative Review

Context: Early marriage is relatively common in the world and has become a public concern. One of the problems seen in early marriage is the high prevalence of partner violence against women, which, along with other harmful effects of early marriage, can hurt a woman’s mental and physical health. This research is the first narrative review investigating the most prevalent type of intimate partner violence and the risk factors for violence against women who marry as a child. Evidence Acquisition: A skim and scan review related to the correlation between child marriage and any type of intimate partner violence was done. Also a comprehensive search of the Web of Science, PsycINFO, PubMed (MEDLINE), Scopus, and Google Scholar was carried out from 2000 to 2019. A comprehensive search of the Web of Science, PsycINFO, PubMed (MEDLINE), Scopus, and Google Scholar was carried out from 2000 to 2019. The second stage of the search was conducted in grey literature. To facilitate a systematic approach, we adopted the PECO framework. Results: The database search yielded 756 articles relevant to child marriage and different types of intimate partner violence, with other articles added in a manual review of reference lists. In the final review, a total of 12 articles were included as they contained the eligibility criteria. The result of this narrative review study showed the relationship between child marriage and intimate partner violence. Conclusions: ince the present study considers physical and sexual violence the most common type of violence against women and other studies have explicitly pointed to the adverse consequences of such violence, it seems necessary to make efforts to reduce early marriage by providing economic opportunities and promoting education and as a result to avoid adverse effects, including partner violence.

Fractal signatures of the COVID-19 spread

Recent quantitative approaches for studying several aspects of urban life and infrastructure have shown that scale properties allow the understanding of many features of urban infrastructure and of human activity in cities. In this paper, we show that COVID-19 virus contamination follows a similar pattern in different regions of the world. The superlinear power-law behavior for the number of contamination cases as a function of the city population, with exponent β of the order of 1.15 is always obtained. Due to the strong indication that scaling is a determinant feature of covid-19 spread, we propose an epidemiological model that embodies a fractal structure, allowing a more detailed description of the observed data about the virus spread in different countries and regions. The hypothesis that fractal structures can be formed in cities as well as in larger networks is tested, indicating that indeed self-similarity may be found in networks connecting several cities.

Analyzing Toxic Chemical Components in Illegal Alcoholic Beverages

Background: The illegal production of alcoholic beverages, due to the non-standard conditions, increases the risk of producing counterfeit and toxic products. The chemical analysis of toxic components in illegally-produced alcoholic beverages is necessary for each country. The present study aimed to identify the existence of methanol and other potentially toxic compounds in the seized illegally-produced alcoholic beverages. Methods: In this descriptive laboratory-based study, we analyzed the toxic chemical components in sized illegally-produced alcoholic beverages, submitted to the Forensic Toxicology Laboratory of the Legal Medicine Center of Markazi Province, Arak City, Iran, in a year. A total of 100 seized illegally-produced alcohol beverage samples were collected. The qualitative and quantitative analysis of ethanol, methanol, 1-propanol, 2-propanol, and acetone was performed by the Gas Chromatography-Flame Ionization Detection (GC–FID) method. Results: Methanol was detected in 6% of the evaluated samples (concentration range:1.2%-12%v/v). Acetone was detected in two of the studied samples (mean concentration: 0.7%v/v), and 2-propanol with a concentration of 0.5%v/v was found in one sample. Besides, ethanol was detected in all explored samples (mean concentration: 24%v/v). Conclusion: Methanol was the main toxic chemical component in illegal alcoholic beverages; thus, it should be considered in public health policy and prevention programs in the country.

Ethical challenges in the relationship between the pharmacist and patient in Iran

Purpose

Based on the developmental process of pharmacy in medical relationships, it is essential to pay attention to ethical issues in this field and develop a good pharmacist–patient relationship. The present study aimed to mention the frequency of ethical challenges of pharmacy in Iran as a fundamental step towards designing a practical ethical guideline for professionals.

Design/methodology/approach

In this observational study, data were collected using a two-part questionnaire with 64 items developed after examining relevant texts and conducting unstructured interviews with pharmacy specialists. The first part determined the frequency of ethical challenges that the pharmacist confronts, using 43 short scenarios, whereas the second part comprised 21 questions with short answers. For validation, the questionnaire was sent to 20 medical ethics specialists who were familiar with issues in pharmacy ethics.

Findings

Data were collected from 48 members of the Iranian Association of Pharmacists (Working Group of Hospital Pharmacists). and the frequency of ethical challenges was determined. The most frequent issues were patient's request for over-the-counter drugs, asking about their lab results, asking drug for another person and returning the drug.

Research limitations/implications

One of the limitation of our study is its population, there were hospital pharmacist, other pharmacist such as community pharmacist may face different challenges.

Practical implications

The finding of this study could lead the policymakers to develop ethical guidelines for pharmacy practices.

Social implications

The pharmacist–patient relationship is one of the important aspects of health system, and therefore regulating this relationship based on the professional ethics guidelines could have a positive impact on therapeutic relationships.

Originality/value

Results showed that designing codes of ethics and practical guidelines based on the frequency of the noted challenges enhances the quality of treatment, improves the pharmacist–patient relationship, increases the level of cooperation and decreases patient complaints.

Relationship Between Attitude Toward Spirituality and Attitude and Performance of Spiritual Care Among Nurse

Introduction

Although spiritual care is commonly regarded as a nursing task, in practice, it is often provided inadequately.

Objective

The purpose of this study was to examine relationship between attitude toward spirituality and the attitude and performance of spiritual care among nurses who working in hospitals of Iran university of medical sciences.

Methods

This was a correlative-descriptive study. Spiritual Perspective Scale (SPS) and Nursing Spiritual Care Perspective Scale (NSCPS) were used to gather the data. A number of 166 nurses participated in this study.

Results

Findings showed that of nurses’ spirituality attitude score was 4.98 ± 1.1 which indicated high attitude toward spirituality. The total average of nurses’ attitude about spiritual practices was 3.67 ± 0.51, which signified the positive attitude of nurses about spiritual practices. Findings revealed that positive spiritual attitude had a significant correlation with 6 out of 12 expressed spiritual interventions. In addition, spiritual attitude generally had a significant positive correlation with spiritual interventions. The positive spiritual attitude had a significant correlation with only 3 items out of 11 for the attitude toward spiritual practices. There was no correlation between spiritual attitude and the attitude toward spiritual practices.

Conclusion

In spite of the positive attitude, nurses did not perform half of the spiritual interventions which most of them were in line with fulfilling the patients’ religious needs. Establishment of in-service education program regarding spiritual care practice by role play and modeling methods are recommended.

Disclosure of interest

The authors have not supplied their declaration of competing interest.

Decomposing Socioeconomic Inequality in Health Literacy in Iran: A Concentration Index Approach

Background

Health literacy is a major factor for health promotion and well-being. In spite of several researches on health literacy, information on the subject of the status of health literacy in Asian countries such as Iran is inadequate. Therefore, this study aimed to assess the inequality of health literacy in an Iranian population and its influencing factors.

Methods

In this cross-sectional study, 736 families were selected by cluster random sampling. A validated questionnaire was used to measure the health literacy of participants. Socioeconomic status (SES) was calculated by asset-based approach, and principal component analysis (PCA) was performed to estimate the families' SES. Concentration index and curve were used to measure SES inequality in health literacy, and after that decomposed into its determinants. The data were analyzed by Stata software.

Results

The mean age of the participants was 34.81 years (standard deviation = 5.98 years). The value of concentration index for health literacy equals 0.2292 (95% confidence interval = 0.168-0.283), and this value indicates that there is inequality in distribution of health literacy in Iran and the inequality disfavors the poor.

Conclusions

The results of this study revealed that there is inequality in distribution of health literacy in Iran, and people of higher economic status in Iran enjoy from better health literacy levels.

Socioeconomic inequalities in metastasis, recurrence, stage and grade of breast cancer: a hospital-based retrospective cohort study

Introduction

This study aims to estimate the Socio-Economic Status (SES) inequality on the metastasis, recurrence, stage and grade in Breast Cancer (BC).

Methods

This retrospective cohort study conducted on 411 BC patients in Arak, Iran. Asset-based questionnaire used to estimate the household SES. For calculate of SES inequality was used from Concentration Index (C). Moreover for investigate the association between recurrence and metastasis with other variables were used from multilevel logistic regression and analysis of variance were used to investigate the relationship between SES and other variables. The data were analyzed with Stata (v.13) software.

Results

Results of analysis of variance showed statistical significant relationship between SES with, insurance, surgery, grade, stage, recurrence and metastasis (p-value < 0.05). Moreover the Odds Ratio (OR) were significant of recurrence with age, academic level of education, supplementary insurance history of BC in first-degree relatives, stage and grade, also, metastasis with age of > 80 years, insurance, supplementary insurance, history of BC in first-degree relatives, chemotherapy, radiotherapy, stage and grade four. The total C index obtained 0.015 (0.002, 0.026), 0.011 (0.003, 0.031), – 0.014 (– 0.034, – 0.001) and – 0.042 (– 0.061, – 0.002) for metastasis, recurrence, stage and grade of BC respectively.

Conclusions

Our results showed evidence of inequality in the metastasis, recurrence, stage and grade in BC patients.

Improved diagnostic accuracy for myocardial perfusion imaging using artificial neural networks on different input variables including clinical and quantification data

OBJECTIVE

Diagnostic accuracy of myocardial perfusion imaging (MPI) is not optimal to predict the result of angiography. The current study aimed at investigating the application of artificial neural network (ANN) to integrate the clinical data with the result and quantification of MPI.

METHODS

Out of 923 patients with MPI, 93 who underwent angiography were recruited. The clinical data including the cardiac risk factors were collected and the results of MPI and coronary angiography were recorded. The quantification of MPI polar plots (i.e. the counts of 20 segments of each stress and rest polar plots) and the Gensini score of angiographies were calculated. Feed-forward ANN was designed integrating clinical and quantification data to predict the result of angiography (normal vs. abnormal), non-obstructive or obstructive coronary artery disease (CAD), and Gensini score (≥10 and <10). The ANNs were designed to predict the results of angiography using different combinations of data as follows: reports of MPI, the counts of 40 segments of stress and rest polar plots, and the count of these 40 segments in addition to age, gender, and the number of risk factors. The diagnostic performance of MPI with different ANNs was compared.

RESULTS

The accuracy of MPI to predict the result of angiography, obstructive CAD, and Gensini score increased from 81.7% to 92.9%, 65.0% to 85.7%, and 50.5% to 92.9%, respectively by ANN using counts and clinical risk factors.

CONCLUSION

The diagnostic accuracy of MPI could be improved by ANN, using clinical and quantification data.

Adoption of Iran’s code of ethics for blood donation and transfusion as a public health policy

Blood is a public resource of human origin and its transfusion process is essential to individual and public health. This study aimed to develop a national code of ethics for blood donation and transfusion (BDT). This was a qualitative research with a multi methods approach in which a combination of methods including situational analysis, focus group discussion and expert panels were used. After situational analysis and orientation, the code of ethics for BDT was developed based on the findings of a content analysis within the framework of the four principles of biomedical ethics. The results were categorized into two sections: situational analysis and underpinnings measures, and the clauses of the code. The Iranian Blood Transfusion Organization has carried out three essential supportive measures over the past decades: approval of insurance coverage of blood recipients against communicable diseases; inclusion of 14 blood services in the book of “Relative Value Units of Health Services”; and formation of the National Ethics Committee of Transfusion Medicine. After recognition and orientation, the national code of ethics for BDT was adopted and imparted to blood donation centers. The code consists of two sections: “Blood Transfusion Centers: Donors and Donation” in 19 clauses, and “Hospitals: Patients” in 8 clauses. The national code of ethics for BDT establishes moral norms in order to protect the rights of blood donors and recipients. It could also serve as a basis for addressing the related ethical challenges and right decision-making in the area of BDT.

Changes in ethical attitudes of clinical laboratory professionals after teaching them ethics using three different methods

Background: Ethical attitudes and personal values play a significant role in clinical decision-making; however, they have been given limited attention by professionals in laboratory medicine. Studies suggest that individual attitudes are not static and that professionals learn ethical attitudes through a variety of formal and informal learning methods. This study was conducted to investigate changes in the attitudes of clinical laboratory professionals after teaching them ethics and to compare the results among the 3 groups. Methods: Four topics were selected in the field of medical laboratory ethics as teaching materials. A questionnaire including 22 items was designed and validated. Teaching sessions for the 3 study groups were held. All 65 clinical laboratory participants completed the questionnaire before and after the classes. Paired t test and ANOVA were used to assess differences among groups. Results: Significant differences were found in the mean scores of ethical attitudes before and after the educational intervention among the lecture-based teaching group (p=0.016), problem-based learning group (p=0.001), and all participants (p=0.004). However, no significant difference was found between the mean scores before and after the intervention in role-playing group (p=0.623). Conclusion: Teaching by lecturing and problem-based learning was more effective to change ethical attitude of the laboratory professionals than the role-playing method. Thus, we suggest the implementation of teaching ethics using these methods to improve the ethical attitude of clinical laboratory professionals.

Associations of demographic, socioeconomic, self-rated health, and metastasis in colorectal cancer in Iran

Background: Metastasis in Colorectal Cancer (CRC) is important because of the costs imposed on the individual. Self-Rated Health (SRH) can be useful for preventing cancer. Considering the role of Socio-Economic Status (SES) in CRC, our study was conducted to evaluate the relationship between demographic, SES, SRH, and metastasis of this type of cancer in Markazi province, Iran. Methods: This cross-sectional, descriptive study (April to July 2018) was conducted on 411 patients suffering from CRC. These patients were hospitalized in one of the medical centers affiliated to Arak University of Medical Sciences (Arak, Iran), and with non-random sampling (available sampling) they were imported to the study. A reliable and valid questionnaire about levels of SES and SRH was filled by patients. For analyzing the data, Binomial logistic regression and chi-square tests were executed using Stata 11 software. Results: The mean age was 60.01 years. According to the results of this study, as compared with poorest SES patients, the OR estimate of metastasis was 0.80 (95% CI: 0.36, 1.78) among the richest SES patients, in patients with age of >60 years was 9.92 (95% CI: 1.53, 64.39) in comparison with patients with age of <40 years, in male patients was 3.26 (95% CI: 1.76, 6.04) compared with female ones; in divorced/widowed patients was 0.52 (95% CI: 0.11, 2.51) in comparison with single ones; among those with academic level of education was 4.28 (95% CI: 1.49, 12.26) compared with illiterate patients; and compared with poor SRH-age of patients, was 3.78 (95% CI: 2.09, 6.85) among those with good SRH-age. Conclusion: Patient's education and SES are important variables in metastasis and SRH of CRC in Iranian patients. All diagnostic tests and medical possibilities should be available for all individuals with adequate interventions. Patient's education and awareness should also be increased.

Ethical Considerations from the Viewpoint of Headquarters Experts on HIV/AIDS Prevention and Control Strategic Program

Background

The HIV control and prevention program is one of the Public Health programs that confronts with many ethical challenges. This study aimed to explore ethical considerations from the viewpoint of headquarters experts on HIV and AIDS prevention and control strategic plan.

Methods

In this qualitative study with content analysis design, focus group discussion method was utilized. After purposeful introduction of the experts and previous coordination about subject and time, two discussion sessions were held with the participation of six ministry and university headquarters experts of HIV control program. After frequent reviews of the data and using deductive content analysis, main themes and subthemes were categorized. In order to transformability of the findings to similar situations, the data were checked by three external reviewers.

Results

The participants agreed that HIV/AIDS control requires focusing on prevention, treatment, and support services, and considering the general population and all vulnerable groups. In this study, five main themes were emerged: informing and empowering to make autonomous decisions, observing confidentiality, prohibiting stigma and discrimination, and being accountable.

Conclusions

The viewpoint of participants indicates on the more need to pay attention the mentioned ethical considerations when compiling and finalizing the program. Moreover, in addition to instructing moral norms in PH programs with a special look to HIV/AIDS and how to apply them in the formulation and implementation of program, systematic evaluation of the program by an ethical framework is recommended to ensure the achievement to the goals of program.