Background: Depressive disorder is often accompanied by physiological changes that may adversely affect the course of medical illness, including an increase in pro-inflammatory cytokines. Methods: We examine the effec...Background: Depressive disorder is often accompanied by physiological changes that may adversely affect the course of medical illness, including an increase in pro-inflammatory cytokines. Methods: We examine the effects of religious cognitive behavioral therapy (RCBT) vs. conventional CBT (CCBT) on pro-/anti-inflammatory indicators and stress hormones in 132 individuals with major depressive disorder (MDD) and chronic medical illness who were recruited into a multi-site randomized clinical trial. Biomarkers (C-reactive protein and pro-inflammatory cytokines TNF-α, IL-1β, IFN-γ, IL-6, IL-12-p70), anti-inflammatory cytokines (IL1ra, IL-4, IL-10), and stress hormones (urinary cortisol, epinephrine, norepinephrine) were assessed at baseline, 12 weeks, and 24 weeks. Differential effects of baseline religiosity on treatment response were also examined, along with effects of religiosity on changes in biomarkers over time independent of treatment group. Biomarker levels were log transformed where possible to normalize distributions. Mixed models were used to examine trajectories of change. Results: CRP increased and IL-4, IL-10, and epinephrine decreased over time, mostly in the opposite direction expected (except epinephrine). No significant difference between RCBT and CCBT was found on average trajectory of change in any biomarkers. Religiosity interacted with treatment group in effects on IL-6, such that CCBT was more effective than RCBT in lowering lL-6 in those with low religiosity whereas RCBT appeared to be more effective than CCBT in those with high religiosity. Higher baseline religiosity also tended to predict an increase in pro-inflammatory cytokines INF-γ and IL-12 (p70) and urinary cortisol over time. Conclusions: RCBT and CCBT had similar effects on stress biomarkers. CCBT was more effective in reducing IL-6 levels in those with low religiosity, whereas RCBT tended to be more effective in those with high religiosity. Unexpectedly, higher baseline religiosity was associated with an increase in several stress biomarkers.展开更多
The United States Food and Drug Administration's(FDA's)August 2024 determination that an additional phase Ⅱ study will be required to consider the approval of midomafetamine for the treatment of posttraumatic...The United States Food and Drug Administration's(FDA's)August 2024 determination that an additional phase Ⅱ study will be required to consider the approval of midomafetamine for the treatment of posttraumatic stress disorder(PTSD)could delay the potential approval of this promising treatment by several years.展开更多
BACKGROUND Burnout syndrome is a significant issue among healthcare professionals worldwide,marked by depersonalization,emotional exhaustion,and a reduced sense of personal achievement.This psychological and physical ...BACKGROUND Burnout syndrome is a significant issue among healthcare professionals worldwide,marked by depersonalization,emotional exhaustion,and a reduced sense of personal achievement.This psychological and physical burden profoundly affects healthcare professionals'quality of care and overall well-being.In Somalia,where the healthcare system faces numerous challenges,the escalating demand for medical services and inadequate resources,coupled with overwhelming workloads,long hours,and high-stress levels,make healthcare providers particularly vulnerable to burnout syndrome.This,in turn,affects both the mental health of healthcare personnel and the quality of care they provide.AIM To examine the prevalence and determinants of burnout syndrome among healthcare practitioners in Mogadishu,Somalia.METHODS This cross-sectional prospective study was performed among 246 healthcare providers employed at a tertiary care hospital in Mogadishu,Somalia,who were recruited via random sampling.Data were collected using questionnaires that covered sociodemographic,psychological,work-related characteristics,and burnout syndrome.Bivariate and multivariate logistic regression analyses were performed to identify the variables that correlated with burnout syndrome.The results were presented using adjusted odds ratios(AORs),95%CIs,and P values,with a cutoff of 0.05 for identifying significant associations.RESULTS Among the participants,24%(95%CI:18.8%–29.8%)exhibited symptoms of burnout syndrome.Factors associated with burnout included female gender(AOR=6.60;95%CI:2.29-19.04),being married(AOR=3.07;95%CI:1.14-8.28),being divorced or widowed(AOR=5.84;95%CI:1.35-25.35),working more than 7 night shifts(AOR=3.19;95%CI:1.30–7.82),having less than 5 years of job experience(AOR=5.28;95%CI:1.29-21.65),experiencing poor sleep quality(AOR=5.29;95%CI:1.88-14.89),and exhibiting depressive(AOR=4.46;95%CI:1.59-12.53)and anxiety symptoms(AOR=7.34;95%CI:2.49-21.60).CONCLUSION This study found that nearly one in four healthcare professionals suffers from burnout syndrome.Improving sleep quality,monitoring,and providing mental health support could enhance their well-being and patient care.展开更多
Background Numerous studies have consistently demonstrated that a considerable proportion of patients with major depressive disorder (MDD) frequently exhibit pronounced dyslipidaemia. However, the causal dynamics betw...Background Numerous studies have consistently demonstrated that a considerable proportion of patients with major depressive disorder (MDD) frequently exhibit pronounced dyslipidaemia. However, the causal dynamics between MDD and dyslipidaemia remain elusive.Aims To comprehensively disentangle the genetic causality between MDD and various phenotypes of blood lipids, thereby facilitating the advancement of management strategies for these conditions.Methods We conducted a two-sample univariable Mendelian randomisation (MR) analysis using different models, including the inverse variance weighted (IVW) method and causal analysis using the summary effect (CAUSE) estimates, as well as a multivariable MR analysis. This analysis used summary statistics from genome-wide association studies (GWAS) of MDD and five lipid traits: low-density lipoprotein cholesterol, high-density lipoprotein cholesterol, non-high-density lipoprotein cholesterol, total cholesterol and triglycerides (TG), encompassing 5 237 893 individuals of European and East Asian ancestries. For MDD, a total of 598 701 individuals were included, with 500 199 individuals of European ancestry (Ncase=170 756, Ncontrol=329 443) and 98 502 of East Asian ancestry (Ncase=12 588, Ncontrol=85 914). Lipid data were collected from 4 639 192 individuals through the Global Lipids Genetics Consortium (European, N=4 096 085;East Asian, N=543 107). Next, we used the two-step MR to explore the mediating factors between MDD and TG, and the risk factors affecting TG through MDD. Finally, we conducted a GWAS meta-analysis and enrichment analysis.Results In univariable MR, we observed a negative causal effect of low-density lipoprotein on MDD in both European populations (IVW: odds ratio (OR): 0.972, 95% confidence interval (CI) 0.947 to 0.998, p=0.037) and East Asian populations (IVW: OR: 0.928, 95% CI 0.864 to 0.997, p=0.042). Additionally, we identified a bidirectional causal relationship between TG and MDD, with TG having a causal effect on MDD (IVW: OR: 1.052, 95% CI 1.020 to 1.085, p=0.001) and MDD having a causal effect on TG (IVW: OR: 1.075, 95% CI 1.047 to 1.104, p<0.001). Multivariable MR analysis further supported the role of TG in MDD (OR: 1.205, 95% CI 1.034 to 1.405, p=0.017). CAUSE estimates indicated that the causal model of MDD on TG provided a better fit than the sharing model (p=0.003), while the association of TG on MDD was more likely due to horizontal correlated pleiotropy than causality. Mediation analyses revealed that waist-hip ratio (WHR) mediated 69% of the total causal effect of MDD on TG, while other identified risk factors exhibited lower mediating proportions either mediated through MDD (≤17%) or originating from MDD (≤29%). The GWAS meta-analysis highlighted potential pathways related to lipid processes and nucleosome assembling, with significant cell types identified in brain regions and liver tissues.Conclusions The findings indicate that genetic proxies of MDD are associated with elevated levels of TG, with WHR serving as a clinical indicator of the association. This suggests that interventions targeting WHR may be effective in reducing TG levels in patients with MDD.展开更多
AIM To examine sleep quality and its determinants among people with type 2 diabetes mellitus(T2DM).METHODS This is a cross-sectional study conducted among diabetic patients referring to Ardabil diabetes clinic in Nort...AIM To examine sleep quality and its determinants among people with type 2 diabetes mellitus(T2DM).METHODS This is a cross-sectional study conducted among diabetic patients referring to Ardabil diabetes clinic in Northwest of Iran. Information on sleep quality was collected using Pittsburg Sleep Quality Index(PSQI). A questionnaire was used to collect data on sociodemographic lifestyle factors and psychological distress. This questionnaire was completed through an interview, and clinical information was extracted from patient's record. Data analysis was done using SPSS software version 23 and univariate andmultivariate analyses.RESULTS Study participants consist of 256 people with T2 DM the majority of whom were women(70%), and mean age of participants was 54.06 ± 9.09. The mean of total score of PSQI was 5.56 ± 3.34. Relative to younger age group, the middle-aged people with T2 DM were twice more likely to be poor sleeper; the adjusted OR was 2.03(95%CI: 1.01-4.08); and those with longer duration of diabetes were about 1.8 times more likely to report poor quality of sleep(ORadj = 1.77, 95%CI: 0.98-3.13). Participants with cholesterol level ≥ 240 mg/dL were about twice more likely to be poor sleeper(ORadj = 1.99, 95%CI: 1.01-3.94). The odds of being poor sleeper increased as the level of distress increased(1.84-4.09).CONCLUSION As indicated by the results of the present study, some factors including age, duration of disease, psychological distress and high level of cholesterol were independently associated with poor sleep quality.展开更多
Over the past decade, there has been a substantial increase in the number of men who are treated with testosterone. Despite this increase in the use of testosterone, the risks of adverse cardiovascular events are uncl...Over the past decade, there has been a substantial increase in the number of men who are treated with testosterone. Despite this increase in the use of testosterone, the risks of adverse cardiovascular events are unclear as meta-analyses have reported conflicting findings and no clinical studies have been large enough or long enough to adequately assess for cardiovascular risks. The goal of this paper is to review large prescription database studies of testosterone treatment and adverse cardiovascular events and mortality with the aim of providing some guidance for clinicians and researchers in this controversial area.展开更多
Schizophrenia is associated with a high preva- lence of cigarette-smoking and abnormal lipid profiles. The purpose of this study was to determine whether the profiles differ between schizophrenic smokers and non-smoke...Schizophrenia is associated with a high preva- lence of cigarette-smoking and abnormal lipid profiles. The purpose of this study was to determine whether the profiles differ between schizophrenic smokers and non-smokers and whether the lipid profiles are related to psychopathological symptoms. Serum lipid profiles were measured in 130 male inpatients with DSM-IV-defined schizophrenia： 104 smokers and 26 non-smokers. Symptoms were assessed using the Positive and Negative Syndrome Scale （PANSS）. Our results showed that positive PANSS symp- toms were fewer in smokers than in non-smokers, while the negative symptoms were fewer in those who smoked more cigarettes. Total protein and globulin levels were significantly lower in the smokers than in the non-smokers. However, there was no significant difference in total cholesterol, triglycerides, high-density lipoprotein choles terol （HDL-c）, low-density lipoprotein cholesterol, apolipoprotein A1, or apolipoprotein B between the smokers and non-smokers. However, the PANSS positive subscale had a significant negative correlation with the HDL-c levels （a protective factor） in the smokers but not in the non-smokers. Our findings suggest that schizophrenic patients who smoke have fewer psychotic symptoms, but contrary to expectation, smoking does not alter lipid profile levels.展开更多
Given the interdependence of multiple factors in age-related vestibular loss (e.g., balance, vision,cognition), it is important to examine the individual contributions of these factors with ARVL. While therelationship...Given the interdependence of multiple factors in age-related vestibular loss (e.g., balance, vision,cognition), it is important to examine the individual contributions of these factors with ARVL. While therelationship between the vestibular and visual systems has been well studied (Bronstein et al., 2015),little is known about the association of the peripheral vestibular system with neurodegenerative disorders (Cronin et al., 2017). Further, emerging research developments implicate the vestibular system asan opportunity for examining brain function beyond balance, and into other areas, such as cognition andpsychological functioning. Additionally, the bidirectional impact of psychological functioning is understudied in ARVL. Recognition of ARVL as part of a multifaceted aging process will help guide thedevelopment of integrated interventions for patients who remain at risk for decline. In this review, wewill discuss a wide variety of characteristics of the peripheral vestibular system and ARVL, how it relatesto neurodegenerative diseases, and correlations between ARVL and balance, vision, cognitive, and psychological dysfunction. We also discuss clinical implications as well as future directions for research, withan emphasis on improving care for patients with ARVL.展开更多
During the development of the central nervous system(CNS),neuroepithelial cells in the ventricular zone are multipotent stem cells that can generate neurons and macroglia(astrocytes or oligodendrocytes).It is generall...During the development of the central nervous system(CNS),neuroepithelial cells in the ventricular zone are multipotent stem cells that can generate neurons and macroglia(astrocytes or oligodendrocytes).It is generally thought that these progenitor cells sequentially produce neurons followed by glia.展开更多
Antipsychotic agents are used for various indications in the treatment of psychiatric disorders.Despite their proven roles in multiple conditions,the treatment-emergent side effects of antipsychotic medications,such a...Antipsychotic agents are used for various indications in the treatment of psychiatric disorders.Despite their proven roles in multiple conditions,the treatment-emergent side effects of antipsychotic medications,such as metabolic side effects,are often the limiting factor for their long-term and short-term uses.Moreover,antipsychotic medications are often criticized for being less effective in treating different disabling symptoms such as negative symptoms of schizophrenia.As a result,the search for safer and more efficacious antipsychotic agents is ongoing.Newer antipsychotic agents are gaining attention related to emerging efficacy and tolerability data in treating neuropsychiatric conditions.In this review,we attempt to appraise the scientific data on psychopharmacology,safety profile,and efficacy of the newer additions to the list of second-generation antipsychotics,namely brexpiprazole,cariprazine,and lumateperone.We conducted a selective review utilizing PubMed,clinicaltrials.gov,and Cochrane databases to gather appropriate publications,keeping broad inclusion criteria.There were no restrictions on the age of the study population or the year of publication.We also cross-referenced articles and references to capture all existing studies.Our review of the current literature indicates that all three antipsychotic agents appear to be promising based on their short-term studies,while long-term studies remain limited.There is also a need for a head to head comparison between the newer antipsychotics with the other antipsychotic agents to ascertain if the newer agents are any better than the others.展开更多
Increasing evidence suggests that multiple genes in the human leukocyte antigen(HLA) regions play an important role in development of cancers and immunity disorders.However,the biological mechanisms of the HLA associa...Increasing evidence suggests that multiple genes in the human leukocyte antigen(HLA) regions play an important role in development of cancers and immunity disorders.However,the biological mechanisms of the HLA associations are not well understood.We recently conducted a survey of all genome-wide association studies(GWAS) with significant findings in the HLA regions and concluded that diseases such as cancer and immune disorders are more likely to be associated with genetic variants located in the HLA regions than other diseases.This finding is suggestive for testing a hypothesis of a common etiology of infectious tumors and other immunity diseases.展开更多
Background Despite the availability of evidence-based treatments for posttraumatic stress disorder(PTSD),significant heterogeneity in the effectiveness of PTSD treatment persists,especially in community settings.Clien...Background Despite the availability of evidence-based treatments for posttraumatic stress disorder(PTSD),significant heterogeneity in the effectiveness of PTSD treatment persists,especially in community settings.Client demographics used to understand this variability in treatment outcome and dropout have yielded mixed results.Despite increasing evidence for the importance of attending to treatment engagement in community settings,few studies have explored client-level predictors.Aim The purpose of this study is to explore client-level predictors of treatment outcome and dropout beyond client demographics,and to identify client-level predictors of treatment engagement in community settings.Method Secondary data analysis was conducted with data collected as part of an implementation-effectiveness hybrid study of cognitive processing therapy(CPT)for PTSD in a diverse community healthcentre.Providers(n=19)treated(n=52)clients as part of their routine clinical care.Non-demographic client-level predictors included barriers to treatment,quality of life,session-level language and employment history assessed at baseline.Treatment engagement included number of weeks in the study,number of sessions with repeated CPT content,number of unique CPT sessions attended,frequency of session attendance and consistency of session attendance.Results Results showed language as a significant predictor of treatment engagement.There were significant differences between Spanish and English-speaking clients,with the former having a tendency to repeat more session content than the latter(β=1.4 sessions,p=0.003),and also less likely to attend treatment frequently(r=0.62,p=0.009)and consistently(r=0.57,p=0.027)if high logistical and financial barriers were endorsed.Irrespective of language,clients who reported high quality of life at baseline were less likely to repeat CPT session content(β=-0.3,p=0.04),and those with increased baseline barriers to treatment had deceleration in PTSD symptom improvement over time(β=-0.62,p<0.05).In terms of treatment engagement moderators impacting treatment outcome,clients who repeated more session content were more likely to complete treatment(0R=1.84,p=0.037).Conclusion Identification of client-level predictors of treatment engagement,outcome and dropout is essential to optimise treatment,particularly in community settings.展开更多
Huntington＇s disease （HD） is an autosomal-dominant neurodegenerative disease characterized by the selec- tive loss of neurons in the striatum and cortex, leading to progressive motor dysfunction, cognitive decline ...Huntington＇s disease （HD） is an autosomal-dominant neurodegenerative disease characterized by the selec- tive loss of neurons in the striatum and cortex, leading to progressive motor dysfunction, cognitive decline and behavioral symptoms. HD is caused by a trinucleotide （CAG） repeat expansion in the gene encoding for huntingtin. Several studies have suggested that inflammation is an important feature of HD and it is already observed in the early stages of the disease. Recently, new molecules presenting anti-inflammatory and/or immunomodulatory have been investigated for HD. The objective of this review is to discuss the data obtained so far on the immune-based therapeutic strategies for HD.展开更多
Objective:To explore the effect of ethyl acetate gum resin extract of Boswellia serrata on lipopolysaccharide(LPS)induced inflammation and oxidative damage in hepatic and renal tissues of rats.Methods:The rats were di...Objective:To explore the effect of ethyl acetate gum resin extract of Boswellia serrata on lipopolysaccharide(LPS)induced inflammation and oxidative damage in hepatic and renal tissues of rats.Methods:The rats were divided into four groups:control,LPS,LPS+Boswellia serrata extracts(100 mg/kg and 200 mg/kg).LPS(1 mg/kg)and the extract(100 and 200 mg/kg,30 min before LPS)were administered intraperitoneally for 3 weeks.The levels of liver enzymes,albumin,total protein,creatinine,blood urea nitrogen(BUN),interleukin(IL)-6,malondialdehyde(MDA),and total thiol groups and superoxide dismutase(SOD)and catalase(CAT)activities were measured.Results:The levels of liver enzymes,creatinine,and BUN,IL-6,MDA in the LPS group were markedly increased(P<0.001)while albumin,total protein,and total thiol concentration,as well as SOD and CAT activities,were decreased compared with the control group(P<0.05 or 0.01).Boswellia serrata extracts diminished the levels of liver enzymes,creatinine,BUN,IL-6,and MDA(P<0.01 and P<0.001),and elevated the concentration of total protein and total thiol and SOD and CAT activities(P<0.05 or 0.01).Conclusions:The ethyl acetate gum resin extract of Boswellia serrata reduces LPS-induced inflammatory reactions and oxidative damage,thus ameliorating hepatic and renal function.展开更多
The histone methyltransferase enhancer of zeste 2 polycomb repressive complex 2 subunit(EZH2)-mediated trimethylation of histone H3 lysine 27(H3K27me3)regulates neural stem cell proliferation and fate specificity thro...The histone methyltransferase enhancer of zeste 2 polycomb repressive complex 2 subunit(EZH2)-mediated trimethylation of histone H3 lysine 27(H3K27me3)regulates neural stem cell proliferation and fate specificity through silencing different gene sets in the central nervous system.Here,we explored the function of EZH2 in early post-mitotic neurons by generating a neuron-specific Ezh2 conditional knockout mouse line.The results showed that a lack of neuronal EZH2 led to delayed neuronal migration,more complex dendritic arborization,and increased dendritic spine density.Transcriptome analysis revealed that neuronal EZH2-regulated genes are related to neuronal morphogenesis.In particular,the gene encoding p21-activated kinase 3(Pak3)was identified as a target gene suppressed by EZH2 and H3K27me3,and expression of the dominant negative Pak3 reversed Ezh2 knockout-induced higher dendritic spine density.Finally,the lack of neuronal EZH2 resulted in impaired memory behaviors in adult mice.Our results demonstrated that neuronal EZH2 acts to control multiple steps of neuronal morphogenesis during development,and has long-lasting effects on cognitive function in adult mice.展开更多
Suicide is a global public health problem with over one million people dying by suicide each year worldwide.Research efforts have focused on developing and testing novel suicide prevention strategies employing recent ...Suicide is a global public health problem with over one million people dying by suicide each year worldwide.Research efforts have focused on developing and testing novel suicide prevention strategies employing recent technological advances.In order to provide a review regarding the role of new technologies(e.g.,postcards/letters,text messages,crisis cards,telephone contacts,online interventions) in suicide prevention,we searched Pub Med,Science Direct,Research Gate,and Crisis to identify all papers in English from 1977 to 2016.Our results indicated that brief contact interventions show promise in reducing the number of episodes of repeated self-harm and/or suicide attempts following discharge from the Emergency Department or psychiatric units.Innovative methods of contact(e.g.,text messages) are easily implemented by clinicians and received by patients in the period of post discharge and have been shown to be beneficial.However,more research employing randomized clinical trials investigating the potential benefits of these novel suicide prevention methods is warranted.Future researchers should continue improving and testing new technologies in the prevention of suicide.展开更多
Previous main body of research on end-life-care in South Korea has focused on developing services quality in hospital settings or service payment system in National Health Insurance Program. The delivery system of hos...Previous main body of research on end-life-care in South Korea has focused on developing services quality in hospital settings or service payment system in National Health Insurance Program. The delivery system of hospice and palliative care services has evolved in diverse ways but there is little research on reviewing the past history of development and whole picture of them so far. So, the aim of this study is to review the old hospice and palliative care system and also to introduce the current one supported by the National Health Insurance Program in South Korea. The palliative care or hospice services in South Korea have been available in diverse settings and provided by different organizations (i.e. catholic hospitals or charity organizations). Finally, it was set up in 2004 that the hospice team or official Palliative Care Units (PCUs) was established in hospitals, in order to meet the end-of-life care for the patients with terminal cancer under the Cancer Control Act. The current hospice and palliative care services such as pain management, bereavement services, and counselling can be reimbursed by National Health Insurance program since 2008. Nevertheless hospice and palliative care services are available to dying patients, yet the utilization rate of hospice and palliative care services or the length of stay in the palliative care unit (PCU) is still relatively short compared to other country systems. South Korea is undergoing several efforts to expand the services in PCU along with the development of quality indicators for PCU. Hospice and palliative care services are still new in the health care system and unfamiliar to the public so it requires raising awareness for medical professionals and the public as well as further research.展开更多
Objective:To determine the seroprevalance of severe acute respiratory syndrome coronavirus 2(SARS-Co V-2)antibodies in the general population of Mazandaran province in Iran and to estimate the percentage of asymptomat...Objective:To determine the seroprevalance of severe acute respiratory syndrome coronavirus 2(SARS-Co V-2)antibodies in the general population of Mazandaran province in Iran and to estimate the percentage of asymptomatic,mild,and severe infections.Methods:We chose 1588 inhabitants of Mazandaran province with cluster sampling.We measured their SARS-Co V-2 immunoglobulin M(Ig M)and immunoglobulin G(Ig G)serum levels.Demographics,risk factors,and symptoms were collected.The seroprevalence of SARS-Co V-2 was calculated by age and city and the World Health Organization(WHO)protocol and further stratified by demographic variables and risk factors.Finally,we identified the symptoms and factors related to COVID-19 with logistic regression.Results:Two hundred subjects(12.59%)were tested positive for either Ig G or Ig M.Until May 23,2020,the prevalence of COVID-19 was 15.26%(95%CI:12.97%-17.79%)based on direct standardization and WHO’s standardized age groups.Based on multivariate logistic regression,the incidence of getting an infection increased by an average of 11.6%for every 10-year increase in age(OR=1.116,95%CI:1.008-1.236,P=0.035).Furthermore,those in contact with COVID-19 patients had a 66.1%higher risk of developing the disease(OR=1.661,95%CI:1.104-2.497,P=0.015).In addition,the chance of getting SARS-Co V-2 infection was almost four times higher in people who had consulted a doctor during the pandemic than those who had not(OR=3.942,95%CI:2.813-5.524,P<0.001).Conclusions:The prevalence of COVID-19 in Mazandaran province could be higher than the officially reported statistics based on diagnostic tests and clinical cases.There seems to be more asymptomatic or mild symptom cases than what was previously reported.展开更多
Resilience to psychological stress is defined as adaption to challenging life experiences and not the absence of adverse life events.Determinants of resilience include personality traits,genetic/epigenetic modificatio...Resilience to psychological stress is defined as adaption to challenging life experiences and not the absence of adverse life events.Determinants of resilience include personality traits,genetic/epigenetic modifications of genes involved in the stress response,cognitive and behavioral flexibility,secure attachment with a caregiver,social and community support systems,nutrition and exercise,and alignment of circadian rhythm to the natural light/dark cycle.Therefore,resilience is a dynamic and flexible process that continually evolves by the intersection of different domains in human’s life;biological,social,and psychological.The objective of this minireview is to summarize the existing knowledge about the multitude factors and molecular alterations that result from resilience to stress response.Given the multiple contributing factors in building resilience,we set out a goal to identify which factors were most supportive of a causal role by the current literature.We focused on resilience-related molecular alterations resulting from mind-body homeostasis in connection with psychosocial and environmental factors.We conclude that there is no one causal factor that differentiates a resilient person from a vulnerable one.Instead,building resilience requires an intricate network of positive experiences and a healthy lifestyle that contribute to a balanced mind-body connection.Therefore,a holistic approach must be adopted in future research on stress response to address the multiple elements that promote resilience and prevent illnesses and psychopathology related to stress allostatic load.展开更多
Introduction: Schizophrenia and bipolar I disorder are very common disorders in hospitalized patients. Considering that family problems are one of the factors in the appearance and persistence of schizophrenia and bip...Introduction: Schizophrenia and bipolar I disorder are very common disorders in hospitalized patients. Considering that family problems are one of the factors in the appearance and persistence of schizophrenia and bipolar I disorder, in this study, we decided to investigate and compare the family functioning between these two groups of patients. Methods: The sample consisted of 50 patients with schizophrenia and 50 patients with bipolar I disorder. The third group was the control group which consisted of 50 normal different professions such as teachers, workers, housekeepers and others. Then the Family Functioning Scale (FAD-I) was used and the final results of the three groups were compared by SPSS V21 software. Results: In the schizophrenia group, 88.9% percent of patients had family functioning scores less than 109.81 which showed that they had severe family dysfunction but in the bipolar I disorder group, 11.1% and all participants in the control group, had scores higher than 109.81.Conclusion: Family dysfunction was seen in schizophrenic patients rather than in the other two groups.展开更多
文摘Background: Depressive disorder is often accompanied by physiological changes that may adversely affect the course of medical illness, including an increase in pro-inflammatory cytokines. Methods: We examine the effects of religious cognitive behavioral therapy (RCBT) vs. conventional CBT (CCBT) on pro-/anti-inflammatory indicators and stress hormones in 132 individuals with major depressive disorder (MDD) and chronic medical illness who were recruited into a multi-site randomized clinical trial. Biomarkers (C-reactive protein and pro-inflammatory cytokines TNF-α, IL-1β, IFN-γ, IL-6, IL-12-p70), anti-inflammatory cytokines (IL1ra, IL-4, IL-10), and stress hormones (urinary cortisol, epinephrine, norepinephrine) were assessed at baseline, 12 weeks, and 24 weeks. Differential effects of baseline religiosity on treatment response were also examined, along with effects of religiosity on changes in biomarkers over time independent of treatment group. Biomarker levels were log transformed where possible to normalize distributions. Mixed models were used to examine trajectories of change. Results: CRP increased and IL-4, IL-10, and epinephrine decreased over time, mostly in the opposite direction expected (except epinephrine). No significant difference between RCBT and CCBT was found on average trajectory of change in any biomarkers. Religiosity interacted with treatment group in effects on IL-6, such that CCBT was more effective than RCBT in lowering lL-6 in those with low religiosity whereas RCBT appeared to be more effective than CCBT in those with high religiosity. Higher baseline religiosity also tended to predict an increase in pro-inflammatory cytokines INF-γ and IL-12 (p70) and urinary cortisol over time. Conclusions: RCBT and CCBT had similar effects on stress biomarkers. CCBT was more effective in reducing IL-6 levels in those with low religiosity, whereas RCBT tended to be more effective in those with high religiosity. Unexpectedly, higher baseline religiosity was associated with an increase in several stress biomarkers.
文摘The United States Food and Drug Administration's(FDA's)August 2024 determination that an additional phase Ⅱ study will be required to consider the approval of midomafetamine for the treatment of posttraumatic stress disorder(PTSD)could delay the potential approval of this promising treatment by several years.
文摘BACKGROUND Burnout syndrome is a significant issue among healthcare professionals worldwide,marked by depersonalization,emotional exhaustion,and a reduced sense of personal achievement.This psychological and physical burden profoundly affects healthcare professionals'quality of care and overall well-being.In Somalia,where the healthcare system faces numerous challenges,the escalating demand for medical services and inadequate resources,coupled with overwhelming workloads,long hours,and high-stress levels,make healthcare providers particularly vulnerable to burnout syndrome.This,in turn,affects both the mental health of healthcare personnel and the quality of care they provide.AIM To examine the prevalence and determinants of burnout syndrome among healthcare practitioners in Mogadishu,Somalia.METHODS This cross-sectional prospective study was performed among 246 healthcare providers employed at a tertiary care hospital in Mogadishu,Somalia,who were recruited via random sampling.Data were collected using questionnaires that covered sociodemographic,psychological,work-related characteristics,and burnout syndrome.Bivariate and multivariate logistic regression analyses were performed to identify the variables that correlated with burnout syndrome.The results were presented using adjusted odds ratios(AORs),95%CIs,and P values,with a cutoff of 0.05 for identifying significant associations.RESULTS Among the participants,24%(95%CI:18.8%–29.8%)exhibited symptoms of burnout syndrome.Factors associated with burnout included female gender(AOR=6.60;95%CI:2.29-19.04),being married(AOR=3.07;95%CI:1.14-8.28),being divorced or widowed(AOR=5.84;95%CI:1.35-25.35),working more than 7 night shifts(AOR=3.19;95%CI:1.30–7.82),having less than 5 years of job experience(AOR=5.28;95%CI:1.29-21.65),experiencing poor sleep quality(AOR=5.29;95%CI:1.88-14.89),and exhibiting depressive(AOR=4.46;95%CI:1.59-12.53)and anxiety symptoms(AOR=7.34;95%CI:2.49-21.60).CONCLUSION This study found that nearly one in four healthcare professionals suffers from burnout syndrome.Improving sleep quality,monitoring,and providing mental health support could enhance their well-being and patient care.
基金supported by the National Natural Science Foundation of China(82071500,82271540,32370724,82401759,81871055,32070679)Shanghai Clinical Research Center for Mental Health(19MC1911100)+11 种基金Shanghai Key Laboratory of Psychotic Disorders(13dz2260500)Shanghai Municipal Administrator of Traditional Chinese Medicine(ZY-(2021-2023)-0207-01)Shanghai Municipal Health Commission Collaborative Innovation Group(2024CXJQ03)Shanghai Science and Technology Innovation Action Program(24JS2840400,24ZR1439900,21Y11921100)Shanghai Municipal Science and Technology Major Project,the National Key R&D Program of China(2023YFA0913804,2024YFA0916603,2022FYC2503300)the Program of Shanghai Academic/Technology Research Leader(21XD1423300)Shanghai Pujiang Program(21PJD063)Shanghai Municipal Science and Technology Major Project(2017SHZDZX01)Shanghai Municipal Commission of Education(2024AIZD016)the National Key R&D Program of China(2019YFA0905400,2017YFC0908105,2021YFC2702100)National Program for Support of Top-Notch Young Professionals,Taishan Scholar Program of Shandong Province(tstp20240526)the Natural Science Foundation of Shandong Province(ZR2019YQ14,YDZX2021009,2021ZDSYS06).
文摘Background Numerous studies have consistently demonstrated that a considerable proportion of patients with major depressive disorder (MDD) frequently exhibit pronounced dyslipidaemia. However, the causal dynamics between MDD and dyslipidaemia remain elusive.Aims To comprehensively disentangle the genetic causality between MDD and various phenotypes of blood lipids, thereby facilitating the advancement of management strategies for these conditions.Methods We conducted a two-sample univariable Mendelian randomisation (MR) analysis using different models, including the inverse variance weighted (IVW) method and causal analysis using the summary effect (CAUSE) estimates, as well as a multivariable MR analysis. This analysis used summary statistics from genome-wide association studies (GWAS) of MDD and five lipid traits: low-density lipoprotein cholesterol, high-density lipoprotein cholesterol, non-high-density lipoprotein cholesterol, total cholesterol and triglycerides (TG), encompassing 5 237 893 individuals of European and East Asian ancestries. For MDD, a total of 598 701 individuals were included, with 500 199 individuals of European ancestry (Ncase=170 756, Ncontrol=329 443) and 98 502 of East Asian ancestry (Ncase=12 588, Ncontrol=85 914). Lipid data were collected from 4 639 192 individuals through the Global Lipids Genetics Consortium (European, N=4 096 085;East Asian, N=543 107). Next, we used the two-step MR to explore the mediating factors between MDD and TG, and the risk factors affecting TG through MDD. Finally, we conducted a GWAS meta-analysis and enrichment analysis.Results In univariable MR, we observed a negative causal effect of low-density lipoprotein on MDD in both European populations (IVW: odds ratio (OR): 0.972, 95% confidence interval (CI) 0.947 to 0.998, p=0.037) and East Asian populations (IVW: OR: 0.928, 95% CI 0.864 to 0.997, p=0.042). Additionally, we identified a bidirectional causal relationship between TG and MDD, with TG having a causal effect on MDD (IVW: OR: 1.052, 95% CI 1.020 to 1.085, p=0.001) and MDD having a causal effect on TG (IVW: OR: 1.075, 95% CI 1.047 to 1.104, p<0.001). Multivariable MR analysis further supported the role of TG in MDD (OR: 1.205, 95% CI 1.034 to 1.405, p=0.017). CAUSE estimates indicated that the causal model of MDD on TG provided a better fit than the sharing model (p=0.003), while the association of TG on MDD was more likely due to horizontal correlated pleiotropy than causality. Mediation analyses revealed that waist-hip ratio (WHR) mediated 69% of the total causal effect of MDD on TG, while other identified risk factors exhibited lower mediating proportions either mediated through MDD (≤17%) or originating from MDD (≤29%). The GWAS meta-analysis highlighted potential pathways related to lipid processes and nucleosome assembling, with significant cell types identified in brain regions and liver tissues.Conclusions The findings indicate that genetic proxies of MDD are associated with elevated levels of TG, with WHR serving as a clinical indicator of the association. This suggests that interventions targeting WHR may be effective in reducing TG levels in patients with MDD.
基金Supported by Research Council,Faculty of Health Sciences,Tabriz University of Medical Sciences grant,No.5.53.4452
文摘AIM To examine sleep quality and its determinants among people with type 2 diabetes mellitus(T2DM).METHODS This is a cross-sectional study conducted among diabetic patients referring to Ardabil diabetes clinic in Northwest of Iran. Information on sleep quality was collected using Pittsburg Sleep Quality Index(PSQI). A questionnaire was used to collect data on sociodemographic lifestyle factors and psychological distress. This questionnaire was completed through an interview, and clinical information was extracted from patient's record. Data analysis was done using SPSS software version 23 and univariate andmultivariate analyses.RESULTS Study participants consist of 256 people with T2 DM the majority of whom were women(70%), and mean age of participants was 54.06 ± 9.09. The mean of total score of PSQI was 5.56 ± 3.34. Relative to younger age group, the middle-aged people with T2 DM were twice more likely to be poor sleeper; the adjusted OR was 2.03(95%CI: 1.01-4.08); and those with longer duration of diabetes were about 1.8 times more likely to report poor quality of sleep(ORadj = 1.77, 95%CI: 0.98-3.13). Participants with cholesterol level ≥ 240 mg/dL were about twice more likely to be poor sleeper(ORadj = 1.99, 95%CI: 1.01-3.94). The odds of being poor sleeper increased as the level of distress increased(1.84-4.09).CONCLUSION As indicated by the results of the present study, some factors including age, duration of disease, psychological distress and high level of cholesterol were independently associated with poor sleep quality.
文摘Over the past decade, there has been a substantial increase in the number of men who are treated with testosterone. Despite this increase in the use of testosterone, the risks of adverse cardiovascular events are unclear as meta-analyses have reported conflicting findings and no clinical studies have been large enough or long enough to adequately assess for cardiovascular risks. The goal of this paper is to review large prescription database studies of testosterone treatment and adverse cardiovascular events and mortality with the aim of providing some guidance for clinicians and researchers in this controversial area.
基金supported by the National Natural Science Foundation of China(81371477)the Beijing Municipal Natural Science Foundation(7132063 and 7072035)a National Alliance for Research on Schizophrenia and Depression Independent Investigator Grant(20314)
文摘Schizophrenia is associated with a high preva- lence of cigarette-smoking and abnormal lipid profiles. The purpose of this study was to determine whether the profiles differ between schizophrenic smokers and non-smokers and whether the lipid profiles are related to psychopathological symptoms. Serum lipid profiles were measured in 130 male inpatients with DSM-IV-defined schizophrenia： 104 smokers and 26 non-smokers. Symptoms were assessed using the Positive and Negative Syndrome Scale （PANSS）. Our results showed that positive PANSS symp- toms were fewer in smokers than in non-smokers, while the negative symptoms were fewer in those who smoked more cigarettes. Total protein and globulin levels were significantly lower in the smokers than in the non-smokers. However, there was no significant difference in total cholesterol, triglycerides, high-density lipoprotein choles terol （HDL-c）, low-density lipoprotein cholesterol, apolipoprotein A1, or apolipoprotein B between the smokers and non-smokers. However, the PANSS positive subscale had a significant negative correlation with the HDL-c levels （a protective factor） in the smokers but not in the non-smokers. Our findings suggest that schizophrenic patients who smoke have fewer psychotic symptoms, but contrary to expectation, smoking does not alter lipid profile levels.
文摘Given the interdependence of multiple factors in age-related vestibular loss (e.g., balance, vision,cognition), it is important to examine the individual contributions of these factors with ARVL. While therelationship between the vestibular and visual systems has been well studied (Bronstein et al., 2015),little is known about the association of the peripheral vestibular system with neurodegenerative disorders (Cronin et al., 2017). Further, emerging research developments implicate the vestibular system asan opportunity for examining brain function beyond balance, and into other areas, such as cognition andpsychological functioning. Additionally, the bidirectional impact of psychological functioning is understudied in ARVL. Recognition of ARVL as part of a multifaceted aging process will help guide thedevelopment of integrated interventions for patients who remain at risk for decline. In this review, wewill discuss a wide variety of characteristics of the peripheral vestibular system and ARVL, how it relatesto neurodegenerative diseases, and correlations between ARVL and balance, vision, cognitive, and psychological dysfunction. We also discuss clinical implications as well as future directions for research, withan emphasis on improving care for patients with ARVL.
基金the Natural Science Foundation of Zhejiang Province(LQ19C090001)the National Natural Science Foundation of China(31900703 and 31771621).
文摘During the development of the central nervous system(CNS),neuroepithelial cells in the ventricular zone are multipotent stem cells that can generate neurons and macroglia(astrocytes or oligodendrocytes).It is generally thought that these progenitor cells sequentially produce neurons followed by glia.
文摘Antipsychotic agents are used for various indications in the treatment of psychiatric disorders.Despite their proven roles in multiple conditions,the treatment-emergent side effects of antipsychotic medications,such as metabolic side effects,are often the limiting factor for their long-term and short-term uses.Moreover,antipsychotic medications are often criticized for being less effective in treating different disabling symptoms such as negative symptoms of schizophrenia.As a result,the search for safer and more efficacious antipsychotic agents is ongoing.Newer antipsychotic agents are gaining attention related to emerging efficacy and tolerability data in treating neuropsychiatric conditions.In this review,we attempt to appraise the scientific data on psychopharmacology,safety profile,and efficacy of the newer additions to the list of second-generation antipsychotics,namely brexpiprazole,cariprazine,and lumateperone.We conducted a selective review utilizing PubMed,clinicaltrials.gov,and Cochrane databases to gather appropriate publications,keeping broad inclusion criteria.There were no restrictions on the age of the study population or the year of publication.We also cross-referenced articles and references to capture all existing studies.Our review of the current literature indicates that all three antipsychotic agents appear to be promising based on their short-term studies,while long-term studies remain limited.There is also a need for a head to head comparison between the newer antipsychotics with the other antipsychotic agents to ascertain if the newer agents are any better than the others.
文摘Increasing evidence suggests that multiple genes in the human leukocyte antigen(HLA) regions play an important role in development of cancers and immunity disorders.However,the biological mechanisms of the HLA associations are not well understood.We recently conducted a survey of all genome-wide association studies(GWAS) with significant findings in the HLA regions and concluded that diseases such as cancer and immune disorders are more likely to be associated with genetic variants located in the HLA regions than other diseases.This finding is suggestive for testing a hypothesis of a common etiology of infectious tumors and other immunity diseases.
文摘Background Despite the availability of evidence-based treatments for posttraumatic stress disorder(PTSD),significant heterogeneity in the effectiveness of PTSD treatment persists,especially in community settings.Client demographics used to understand this variability in treatment outcome and dropout have yielded mixed results.Despite increasing evidence for the importance of attending to treatment engagement in community settings,few studies have explored client-level predictors.Aim The purpose of this study is to explore client-level predictors of treatment outcome and dropout beyond client demographics,and to identify client-level predictors of treatment engagement in community settings.Method Secondary data analysis was conducted with data collected as part of an implementation-effectiveness hybrid study of cognitive processing therapy(CPT)for PTSD in a diverse community healthcentre.Providers(n=19)treated(n=52)clients as part of their routine clinical care.Non-demographic client-level predictors included barriers to treatment,quality of life,session-level language and employment history assessed at baseline.Treatment engagement included number of weeks in the study,number of sessions with repeated CPT content,number of unique CPT sessions attended,frequency of session attendance and consistency of session attendance.Results Results showed language as a significant predictor of treatment engagement.There were significant differences between Spanish and English-speaking clients,with the former having a tendency to repeat more session content than the latter(β=1.4 sessions,p=0.003),and also less likely to attend treatment frequently(r=0.62,p=0.009)and consistently(r=0.57,p=0.027)if high logistical and financial barriers were endorsed.Irrespective of language,clients who reported high quality of life at baseline were less likely to repeat CPT session content(β=-0.3,p=0.04),and those with increased baseline barriers to treatment had deceleration in PTSD symptom improvement over time(β=-0.62,p<0.05).In terms of treatment engagement moderators impacting treatment outcome,clients who repeated more session content were more likely to complete treatment(0R=1.84,p=0.037).Conclusion Identification of client-level predictors of treatment engagement,outcome and dropout is essential to optimise treatment,particularly in community settings.
文摘Huntington＇s disease （HD） is an autosomal-dominant neurodegenerative disease characterized by the selec- tive loss of neurons in the striatum and cortex, leading to progressive motor dysfunction, cognitive decline and behavioral symptoms. HD is caused by a trinucleotide （CAG） repeat expansion in the gene encoding for huntingtin. Several studies have suggested that inflammation is an important feature of HD and it is already observed in the early stages of the disease. Recently, new molecules presenting anti-inflammatory and/or immunomodulatory have been investigated for HD. The objective of this review is to discuss the data obtained so far on the immune-based therapeutic strategies for HD.
文摘Objective:To explore the effect of ethyl acetate gum resin extract of Boswellia serrata on lipopolysaccharide(LPS)induced inflammation and oxidative damage in hepatic and renal tissues of rats.Methods:The rats were divided into four groups:control,LPS,LPS+Boswellia serrata extracts(100 mg/kg and 200 mg/kg).LPS(1 mg/kg)and the extract(100 and 200 mg/kg,30 min before LPS)were administered intraperitoneally for 3 weeks.The levels of liver enzymes,albumin,total protein,creatinine,blood urea nitrogen(BUN),interleukin(IL)-6,malondialdehyde(MDA),and total thiol groups and superoxide dismutase(SOD)and catalase(CAT)activities were measured.Results:The levels of liver enzymes,creatinine,and BUN,IL-6,MDA in the LPS group were markedly increased(P<0.001)while albumin,total protein,and total thiol concentration,as well as SOD and CAT activities,were decreased compared with the control group(P<0.05 or 0.01).Boswellia serrata extracts diminished the levels of liver enzymes,creatinine,BUN,IL-6,and MDA(P<0.01 and P<0.001),and elevated the concentration of total protein and total thiol and SOD and CAT activities(P<0.05 or 0.01).Conclusions:The ethyl acetate gum resin extract of Boswellia serrata reduces LPS-induced inflammatory reactions and oxidative damage,thus ameliorating hepatic and renal function.
基金The study was supported by Grants from the NIH(R01NS064288,R01NS085176,R01GM111514,and R01EY027347)the Craig H.Neilsen Foundation(259450)the BrightFocus Foundation(G2017037).
文摘The histone methyltransferase enhancer of zeste 2 polycomb repressive complex 2 subunit(EZH2)-mediated trimethylation of histone H3 lysine 27(H3K27me3)regulates neural stem cell proliferation and fate specificity through silencing different gene sets in the central nervous system.Here,we explored the function of EZH2 in early post-mitotic neurons by generating a neuron-specific Ezh2 conditional knockout mouse line.The results showed that a lack of neuronal EZH2 led to delayed neuronal migration,more complex dendritic arborization,and increased dendritic spine density.Transcriptome analysis revealed that neuronal EZH2-regulated genes are related to neuronal morphogenesis.In particular,the gene encoding p21-activated kinase 3(Pak3)was identified as a target gene suppressed by EZH2 and H3K27me3,and expression of the dominant negative Pak3 reversed Ezh2 knockout-induced higher dendritic spine density.Finally,the lack of neuronal EZH2 resulted in impaired memory behaviors in adult mice.Our results demonstrated that neuronal EZH2 acts to control multiple steps of neuronal morphogenesis during development,and has long-lasting effects on cognitive function in adult mice.
文摘Suicide is a global public health problem with over one million people dying by suicide each year worldwide.Research efforts have focused on developing and testing novel suicide prevention strategies employing recent technological advances.In order to provide a review regarding the role of new technologies(e.g.,postcards/letters,text messages,crisis cards,telephone contacts,online interventions) in suicide prevention,we searched Pub Med,Science Direct,Research Gate,and Crisis to identify all papers in English from 1977 to 2016.Our results indicated that brief contact interventions show promise in reducing the number of episodes of repeated self-harm and/or suicide attempts following discharge from the Emergency Department or psychiatric units.Innovative methods of contact(e.g.,text messages) are easily implemented by clinicians and received by patients in the period of post discharge and have been shown to be beneficial.However,more research employing randomized clinical trials investigating the potential benefits of these novel suicide prevention methods is warranted.Future researchers should continue improving and testing new technologies in the prevention of suicide.
文摘Previous main body of research on end-life-care in South Korea has focused on developing services quality in hospital settings or service payment system in National Health Insurance Program. The delivery system of hospice and palliative care services has evolved in diverse ways but there is little research on reviewing the past history of development and whole picture of them so far. So, the aim of this study is to review the old hospice and palliative care system and also to introduce the current one supported by the National Health Insurance Program in South Korea. The palliative care or hospice services in South Korea have been available in diverse settings and provided by different organizations (i.e. catholic hospitals or charity organizations). Finally, it was set up in 2004 that the hospice team or official Palliative Care Units (PCUs) was established in hospitals, in order to meet the end-of-life care for the patients with terminal cancer under the Cancer Control Act. The current hospice and palliative care services such as pain management, bereavement services, and counselling can be reimbursed by National Health Insurance program since 2008. Nevertheless hospice and palliative care services are available to dying patients, yet the utilization rate of hospice and palliative care services or the length of stay in the palliative care unit (PCU) is still relatively short compared to other country systems. South Korea is undergoing several efforts to expand the services in PCU along with the development of quality indicators for PCU. Hospice and palliative care services are still new in the health care system and unfamiliar to the public so it requires raising awareness for medical professionals and the public as well as further research.
文摘Objective:To determine the seroprevalance of severe acute respiratory syndrome coronavirus 2(SARS-Co V-2)antibodies in the general population of Mazandaran province in Iran and to estimate the percentage of asymptomatic,mild,and severe infections.Methods:We chose 1588 inhabitants of Mazandaran province with cluster sampling.We measured their SARS-Co V-2 immunoglobulin M(Ig M)and immunoglobulin G(Ig G)serum levels.Demographics,risk factors,and symptoms were collected.The seroprevalence of SARS-Co V-2 was calculated by age and city and the World Health Organization(WHO)protocol and further stratified by demographic variables and risk factors.Finally,we identified the symptoms and factors related to COVID-19 with logistic regression.Results:Two hundred subjects(12.59%)were tested positive for either Ig G or Ig M.Until May 23,2020,the prevalence of COVID-19 was 15.26%(95%CI:12.97%-17.79%)based on direct standardization and WHO’s standardized age groups.Based on multivariate logistic regression,the incidence of getting an infection increased by an average of 11.6%for every 10-year increase in age(OR=1.116,95%CI:1.008-1.236,P=0.035).Furthermore,those in contact with COVID-19 patients had a 66.1%higher risk of developing the disease(OR=1.661,95%CI:1.104-2.497,P=0.015).In addition,the chance of getting SARS-Co V-2 infection was almost four times higher in people who had consulted a doctor during the pandemic than those who had not(OR=3.942,95%CI:2.813-5.524,P<0.001).Conclusions:The prevalence of COVID-19 in Mazandaran province could be higher than the officially reported statistics based on diagnostic tests and clinical cases.There seems to be more asymptomatic or mild symptom cases than what was previously reported.
文摘Resilience to psychological stress is defined as adaption to challenging life experiences and not the absence of adverse life events.Determinants of resilience include personality traits,genetic/epigenetic modifications of genes involved in the stress response,cognitive and behavioral flexibility,secure attachment with a caregiver,social and community support systems,nutrition and exercise,and alignment of circadian rhythm to the natural light/dark cycle.Therefore,resilience is a dynamic and flexible process that continually evolves by the intersection of different domains in human’s life;biological,social,and psychological.The objective of this minireview is to summarize the existing knowledge about the multitude factors and molecular alterations that result from resilience to stress response.Given the multiple contributing factors in building resilience,we set out a goal to identify which factors were most supportive of a causal role by the current literature.We focused on resilience-related molecular alterations resulting from mind-body homeostasis in connection with psychosocial and environmental factors.We conclude that there is no one causal factor that differentiates a resilient person from a vulnerable one.Instead,building resilience requires an intricate network of positive experiences and a healthy lifestyle that contribute to a balanced mind-body connection.Therefore,a holistic approach must be adopted in future research on stress response to address the multiple elements that promote resilience and prevent illnesses and psychopathology related to stress allostatic load.
文摘Introduction: Schizophrenia and bipolar I disorder are very common disorders in hospitalized patients. Considering that family problems are one of the factors in the appearance and persistence of schizophrenia and bipolar I disorder, in this study, we decided to investigate and compare the family functioning between these two groups of patients. Methods: The sample consisted of 50 patients with schizophrenia and 50 patients with bipolar I disorder. The third group was the control group which consisted of 50 normal different professions such as teachers, workers, housekeepers and others. Then the Family Functioning Scale (FAD-I) was used and the final results of the three groups were compared by SPSS V21 software. Results: In the schizophrenia group, 88.9% percent of patients had family functioning scores less than 109.81 which showed that they had severe family dysfunction but in the bipolar I disorder group, 11.1% and all participants in the control group, had scores higher than 109.81.Conclusion: Family dysfunction was seen in schizophrenic patients rather than in the other two groups.
