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Background: Opioid agonist treatment, as the most effective treatment for opioid dependency, requires patient adherence for its effectiveness over the long run. Previous studies on psychiatric and non- psychiatric patients indicated that the patient`s temperament has had effect on their treatment compliance. Some studies on different types of addiction have attributed special temperament and character traits to these patients. Introduction: This study aims to investigate the impact of temperament and characteristics on opioid treatment compliance. In this study, the relationship between demographic variables, type of medication therapy, and temperament and characteristics scales of patients against opioid agonists therapy compliance was examined Methods: In this cross-sectional study, 150 patients who had initiated the course of opioid agonist maintenance therapy underwent TCI 125-item test and were followed-up for 2 months regarding compliance. The data were inputted into SPSS 24. K-S and Mann-Whitney U tests were employed to explore the relationship between quantitative and qualitative variables, while for examining the relationship between qualitative variables with each other, Chi-square test was utilized. The significance level in the tests was considered p Result: The treatment compliance in this study was 67.2%. In patients who did not have treatment compliance, scores of novelty-seeking (16.7±7versus11.7±4, p Conclusion: The results of this study can help to identify high-risk individuals for withdrawing opioid addiction. These people can be a target for pharmacological and non-pharmacological interventions to have their personality traits modified. Investigation of the effect of performing these interventions on treatment compliance can be a subject of future study in this area. Also while there are differences in personality characteristics among cultures, this study investigated Iranian culture more precisely.

Background: Today, prioritizing the spiritual well-being of medical students holds significant importance in numerous countries worldwide. An educational curriculum serves as a comprehensive written document that delineates educational objectives, content, as well as teaching and assessment methods. Objectives: This study aims to formulate and construct a curriculum for a master's degree program in spiritual health. Methods: The initial phase of this study aims to ascertain the existing state of spiritual health education programs by conducting a thorough literature review. In the subsequent phase, a focus group discussion was conducted with eight experts and scholars to deliberate on the spiritual health curriculum, utilizing Tyler's curriculum development model as a framework. Finally, the nominal group process was employed to reach a consensus among the experts, ensuring the formulation of the final draft. Results: The spiritual health education curriculum was developed following Tyler's curriculum planning framework, encompassing four distinct components. Part one outlines the goals of the spiritual health curriculum, while part two focuses on defining the content of the curriculum. Part three addresses the learning opportunities and strategies for teaching spiritual health within the curriculum. Lastly, part four involves the evaluation process to assess the effectiveness and impact of the spiritual health curriculum. Conclusions: Spiritual health education has been recommended in various references. Recognizing discipline as spiritual health has fostered the growth of spiritual concepts in the healthcare environment, bringing attention to the needs of patients.

Diabetes mellitus may cause tau protein hyperphosphorylation and neurodegeneration, but the exact mechanism by which diabetic conditions induce tau pathology remains unclear. Tau protein hyperphosphorylation is considered a major pathological hallmark of neurodegeneration and can be triggered by diabetes. Various tau-directed kinases, including P38, can be activated upon diabetic stress and induce tau hyperphosphorylation. Despite extensive research efforts, the exact tau specie(s) and kinases driving neurodegeneration in diabetes mellitus have not been clearly elucidated. We herein employed different techniques to determine the exact molecular mechanism of tau pathology triggered by diabetes in in vivo and in vitro models. We showed that diabetes-related stresses and glucose metabolism deficiency could induce cis P-tau (an early driver of the tau pathology) accumulation in the midbrain and corpus callosum of the diabetic mice models and cells treated with 2-deoxy-D-glucose, respectively. We found that the active phosphorylated level of P38 was increased in the treated cells and diabetic mice models. We observed that oxidative stress activated P38, which directly and indirectly drove tau pathology in the GABAergic and glutamatergic neurons of the midbrain of the diabetic mice after 96 h, which accumulated in the other neighboring brain areas after 2 months. Notably, P38 inhibition suppressed tau pathogenicity and risk-taking behaviors in the animal models after 96 h. The data establish P38 as a central mediator of diabetes mellitus-induced tau pathology. Our findings provide mechanistic insight into the consequences of this metabolic disorder on the nervous system.

This study aims to compare the positive and negative symptoms of schizophrenia in patients who had psychotic symptoms more than one month after discontinuation of methamphetamine abuse. These factors were analyzed by the positive and negative syndrome scale (PANSS) questionnaire.Sixty participants were selected from patients referred to Iran Psychiatric Hospital with psychotic symptoms (delusions or hallucinations, disorganized behavior, and speech). The control group was 30 patients with schizophrenia based on a semi-structured interview according to DSMIV-TR (SCID). Thirty patients with a prolonged methamphetamine-induced psychotic disorder were also placed in the case group. For both groups of patients, questionnaires of PANSS, Brief Psychiatric Rating Scale (BPRS), and Global Assessment Of Functioning (GAF) were filled out after obtaining the companions' consent. The scale scores were compared between groups. We used the Mann-Whitney and the Chi-square test to evaluate the mean values of PANSS, BPRS, and GAF scores between the two groups.here was an insignificant difference in positive and general pathology scores between the two groups, but the total score of negative symptoms in the schizophrenia group was significantly higher than in the group of prolonged methamphetamine psychotic disorders (P=0.034). Average scores of uncooperativeness (0.008), difficulty in abstract thinking (0.004), motor retardation (0.002), unusual thought content (0.001), and hostility (0.011) in the schizophrenia group were significantly higher than those in the prolonged methamphetamine psychosis.The results showed that most of the disturbances in patients with schizophrenia might be more influenced by the expression of cognitive disabilities than those with methamphetamine psychosis. The difference in negative symptom scores suggests that schizophrenia and prolonged methamphetamine psychotic disorder can be two different disorders.General and positive symptoms scores don't have significant differences.Negative symptoms are much more in schizophrenia.Uncooperativeness, unusual thought content and, motor retardation have more scores in schizophrenia.In clinical practice, Schizophrenia and prolonged methamphetamine-induced psychotic disorder have some similar mental presentations. Additionally, in scientific literature, there is scarce evidence about these similarities. In this regard, this research was designed to investigate the aforementioned obscurity. Determination of similarities and differences between them helps us to address these disorders in terms of treatment and follow-up and awareness of their prognosis of them. This research is a case-control study in which we examine positive and negative psychotic symptoms in schizophrenia and prolonged methamphetamine-induced psychotic disorder. Researchers investigated psychotic symptoms with positive and negative syndrome scale (PANSS), brief psychiatric rating scale (BPRS), and global assessment of functioning (GAF) questionnaires. Moreover, results demonstrate general and positive symptoms scores don't have many differences but negative symptoms are much more in patients with schizophrenia than in patients with a prolonged methamphetamine-induced psychotic disorder. Also, other features like uncooperativeness, unusual thought content, motor retardation, difficulty in abstract thinking, and hostility have higher scores in schizophrenia than the others. In conclusion, this research showed that these disorders are two distinct disorders with some similarities in positive symptoms but not in all features. So, some studies can be designed about why there are similarities between them?

Objective: This review aimed to measure the degree of placebo response in panic disorder. Data Sources: We searched major databases up to 31 January 2021, for randomized pharmacotherapy trials published in English. Study Selection: A total of 43 studies met inclusion criteria to be in the analysis (with 174 separate outcome measurements). Data Extraction: Changes in outcome measures from baseline in the placebo group were used to estimate modified Cohen’s d effect size. Results: A total of 43 trials (2392 subjects, 174 outcomes using 27 rating scales) were included in the meta-analysis. Overall placebo effect size was 0.57 (95% confidence interval = [0.50, 0.64]), heterogeneity ( I2: 96.3%). Higher placebo effect size was observed among clinician-rated scales compared to patient reports (0.75 vs 0.35) and among general symptom and anxiety scales compared to panic symptoms and depression scales (0.92 and 0.64 vs 0.56 and 0.54, respectively). There was an upward trend in effect size over the publication period ( r = 0.02, p = 0.002) that was only significant among clinician-rated scales ( r = 0.02, p = 0.011). There was no significant publication bias, Egger’s test ( p = 0.08). Conclusion: We observed a substantial placebo effect size in panic disorder. This effect was more prominent for some aspects of panic disorder psychopathology than for others and was correlated with the source of the assessment and publication year. This finding has implications both for research design, to address the heterogeneity and diversity in placebo responses, and for clinical practice to ensure optimal quality of care. Systematic review registration number: PROSPERO, CRD42019125979.

Background: Gestational trophoblastic disease (GTD) is a general term that includes several types of pathologically different diseases, which range from hydatidiform mole to choriocarcinoma. Early differentiation of these types is important to determine treatment strategy and prognosis. Objectives: Genetic markers such as TP53 and HER-2/neu expression are recently shown to have diagnostic and prognostic values. The aim of this study was to evaluate its significance. Methods: We enrolled 62 patients diagnosed with GTD referred to Imam Hossein Hospital in Tehran, Iran between 2012 and 2017. Endometrial pathologic specimens were stained, using the immunohistochemistry (IHC) method for the expression of TP53 and HER-2/neu genes. Expression levels determined by IHC were compared between final pathologic diagnoses, using one-way ANOVA test (analysis of variances), which detects significant differences between the means of 3 or more independent groups. Results: Out of 62 participants, 32 and 24 cases were diagnosed as partial and complete hydatidiform mole, respectively. Four cases had invasive hydatidiform mole and only 2 cases were diagnosed as choriocarcinoma. Analysis using ANOVA demonstrated that expression levels of both TP53 and HER-2/neu genes are significantly higher among patients with invasive form and choriocarcinoma compared with non-invasive hydatidiform mole (P < 0.05 for both genes). The receiver operating characteristic (ROC) curve for each gene showed that more than 55% positive staining for the TP53 gene can differentiate non-invasive hydatidiform mole from invasive form and choriocarcinoma with 100% sensitivity, and 92.9% specificity. Conclusions: TP53 expression might serve as a potential diagnostic aid to differentiate benign and malignant GTDs and a future target for adjusting treatment based on the expression levels.

Baseline biomarkers including glomerular filtration rate (GFR) guide the management of patients with ST-segment elevation myocardial infarction (STEMI). GFR is a tool for prediction of adverse outcomes in these patients.We aimed to determine the prognostic utility of estimated GFR using Chronic Kidney Disease Epidemiology Collaboration in a cohort of STEMI patients.A retrospective cohort was designed among 5953 patients with STEMI. Primary endpoint of the study was major adverse cardiovascular events. GFR was classified into 3 categories delineated as C1 (60 mL/min), C2 (60-90), and C3 (≥ 90).Mean age of the patients was 60.38 ± 5.54 years and men constituted 78.8% of the study participants. After a median of 22 months, Multivariate Cox-regression demonstrated that hazards of major averse cardiovascular event, all-cause mortality, cardiovascular mortality, and nonfatal myocardial infarction were significantly lower for subjects in C3 as compared with those in C1. Corresponding hazard ratios (HRs) for mentioned outcomes regarding C3 versus C1 were (95% confidence interval) were (HR = 0.852 [0.656-0.975]; P = 0.035), (HR = 0.425 [0.250-0.725]; P = 0.002), (HR = 0.425 [0.242-0.749]; P = 0.003), and (0.885 [0.742-0.949]; P = 0.003), respectively. Normal GFR was also associated with declined in-hospital mortality with HR of C3 versus C1: 0.299 (0.178-0.504; P0.0001).Baseline GFR via Chronic Kidney Disease Epidemiology Collaboration is associated with long-term cardiovascular outcomes following STEMI.

Background: Nowadays, the attention to the combination of Substance Use Disorders (SUD) and anxiety disorders in women is increasing; therefore, the aim of this study was to investigate the prevalence of anxiety disorders in women substance users and epidemiological features of this population. Methods: In a cross-sectional study, 48 female outpatients with SUD referred to the Iran psychiatric hospital substance use clinic with a range of 18 to 65 years, were involved in the study. All participants referred to the substance use clinic of Iran psychiatric center to follow up on the comorbidities and psychiatric disorders, were involved in the study. The Structured Clinical Interview for DSM-5 (SCID) was used to anxiety disorders and SUD diagnoses. The SCID is a semi-structured interview guide for making the major DSM-5 diagnoses. It is administered by a clinician who is familiar with the DSM-5 classification and diagnostic criteria. Finally, gathered data were analyzed by SPSS-22. Results: Totally, 48 patients enrolled to this study. The mean age of patients was 34.2±9.4. Crystal (60.4%) and alcohol (50%) were the most commonly used substances. Of the 48 substance users, 47.9% had at least one type of anxiety disorders. The most common anxiety disorders in substance users were generalized anxiety disorder (37.5%), social anxiety disorder (18.8%), and agoraphobia and panic disorder (12.5%). A statistically significant correlation was found between agoraphobia and opium (p=0.04), generalized anxiety disorders and benzodiazepines (p=0.02). Conclusion: In the present study, it was shown that anxiety disorders co-occur with SUD at a high rate. Generalized anxiety disorders and social anxiety disorder were the two most prevalent conditions among substance users. Analysis showed a statistically significant correlation between agoraphobia and opium, general anxiety disorders and benzodiazepines.

Background: Child maltreatment or abuse has been a worldwide major problem and has remained a persistent public health challenge in all countries. Physicians have a significant role in the prevention and intervention of child maltreatment. An educated physician that can effectively identify and report child maltreatment, can fill one of the largest gaps in reducing child abuse.This study was performed to examine the efficacy of clinical medical training regarding child maltreatment among Iranian medical students and outcome of knowledge, attitude, and practice in regards to child maltreatment.Method: All the medical students (235 students) of the Iran University of Medical Sciences who passed the internship entrance exam in 2019-2020 academic year participated in this study. The participants completed the questionnaire about their attitude, knowledge and practice skills in the first month of their internship course and then completed the same questionnaire 18 months later, at the end-point of the internship period.Results: 139 (59.1%) participants were female and 96 (40.9%) were male. The mean age of the subjects was 24.35±0.76. Only 7 (3%) of them formerly received any education about child maltreatment.There was a significant difference in scores of the knowledge of diagnosis (p-value< 0.001), the practice of prevention (p-value< 0.002) and the general subscale of the practice section (p-value< 0.001) during the internship course. However, the performance of participants decreased with a significant difference in the subscales of the attitude towards diagnosis (p-value< 0.001) and the attitude towards reporting (p-value< 0.001).At the end of the study, the result of graduated physicians was: The total knowledge and attitude of participants were satisfactory and the majority of the participants were at good levels. Although, in the practice subscale, 70.6% of the participants didn’t identify, 84.7% didn’t refer, and 86.4% didn’t report a case of child abuse in the past year.Conclusion: The knowledge and attitude of Iranian recently graduated physicians regarding child maltreatment are at a satisfactory level. Although, the practice level has deficiencies and needs more education. In addition, Iranian medical training regarding child maltreatment is not sufficient and there are multiple obstacles that need to be solved.

The Wnt pathway is the most important cascade in the nervous system; evidence has indicated that deregulation of the Wnt pathway induced pathogenic hallmarks of neurodegenerative diseases. Glycogen synthase kinase-3β (GSK-3β) as the main member of the Wnt pathway increases tau inclusions, the main marker in the neurodegenerative diseases. Phosphorylated tau is observed in the pre-tangle of the neurons in the early stage of neurodegenerative diseases. The researchers always try to improve pharmacological approaches of new therapeutic strategies to the treatment of neurodegenerative diseases that are required to represent a significant entry point by understanding the theoretical interactions of the molecular pathways. In this review, we have discussed the recent knowledge about the canonical and non-canonical Wnt signalling pathway, GSK-3β, Wnt/β-catenin antagonists, tau phosphorylation, and their important roles in the neurodegenerative diseases.

Sleep disturbances are common non-motor symptoms of Parkinson's disease (PD). We aimed to compare the safety and efficacy of trazodone with melatonin and clonazepam in patients with PD and sleep complaints.This single-center, double-blind, randomized clinical trial was conducted on PD patients with subjective sleep complaints. Eligible patients were randomized 1:1:1 to receive melatonin 3 mg/day, clonazepam 1 mg/day, or trazodone 50 mg/day for 4 weeks. The primary outcome measure was the changes in Pittsburgh Sleep Quality Index (PSQI) scores. The mean change in Epworth Sleepiness Scale (ESS) and RBD screening questionnaire (RBDSQ) was considered as the secondary outcome measures.A total of 112 eligible patients were randomized and 93 participants, melatonin (n = 31), trazodone (n = 31), and clonazepam (n = 31), completed the study. There was a significant decrease in PSQI scores after 4 weeks of treatment in all groups. The mean changes of PSQI from baseline were similar among the treatment arms (P = 0.325). Mean changes of RBDSQ and ESS from baseline were significantly different between study arms (P 0.05). Melatonin intake was associated with a higher decrease in RBDSQ score compared to trazodone (P = 0.011) and clonazepam (P = 0.004). Trazodone intake was associated with a higher decrease in ESS score compared to clonazepam (P = 0.010). Mild adverse events were reported in three patients in the clonazepam, two patients in the trazodone group, and none in the melatonin group.Trazodone 50 mg/day, clonazepam 1 mg/day, and melatonin 3 mg/day were all tolerable and effective in improving sleep quality in patients with PD.Iranian Registry of Clinical Trials (registration number; IRCT20170821035819N2).

Developing an effective model for non-equilibrium states is of great importance for a variety of problems related to chemical synthesis and combustion. Rate-Controlled Constrained-Equilibrium (RCCE), a model order reduction method that originated from the second law of thermodynamics, assumes that the non-equilibrium states of a system can be described by a sequence of constrained-equilibrium states kinetically controlled by a relatively small number of constraints within acceptable accuracy. The full chemical composition at each constrained-equilibrium state is obtained by maximizing (or minimizing) the appropriate thermodynamic quantities, e. g., entropy (or Gibbs functions), subject to the instantaneous values of RCCE constraints. Regardless of the nature of the kinetic constraints, RCCE always guarantees a correct final equilibrium state. This paper reviews the fundamentals of the RCCE method, its constraints, constraint potential formulations, and major constraint selection techniques, as well as the application of the RCCE method to combustion of different fuels using a variety of combustion models. The RCCE method has been proven to be accurate and to reduce computational time in these simulations.

The scalar filtered density function (FDF) methodology is extended and employed for large eddy simulation (LES) of turbulent flows under supercritical condition. To describe real fluid behavior, the extended methodology incorporates the generalized heat and mass diffusion models along with real fluid thermodynamic relations which are derived using the cubic Peng–Robinson equation of state. These models are implemented within the stochastic differential equations comprising the scalar FDF transport. Simulations are conducted of a temporally developing mixing layer under supercritical condition and the results are assessed by comparing with data generated by direct numerical simulation (DNS) of the same layer. The consistency of the proposed FDF methodology is assessed. The LES-FDF predictions are shown to agree favorably with the DNS data and exhibit several key features pertaining to supercritical turbulent flows.

The rate-controlled constrained equilibrium (RCCE) is a model reduction scheme for chemical kinetics. It describes the evolution of a complex chemical system with acceptable accuracy with a number of rate controlling constraints on the associated constrained-equilibrium states of the system, much lower than the number of species in the underlying detailed kinetic model (DKM). Successful approximation of the constrained-equilibrium states requires accurate identification of the constraints. One promising procedure is the fully automatable Approximate Singular Value Decomposition of the Actual Degrees of Disequilibrium (ASVDADD) method that is capable of identifying the best constraints for a given range of thermodynamic conditions and a required level of approximation. ASVDADD is based on simple algebraic analysis of the results of the underlying DKM simulation and is focused on the behavior of the degrees of disequilibrium (DoD) of the individual chemical reactions. In this paper, we introduce an alternative ASVDADD algorithm. Unlike the original ASVDADD algorithm that require the direct computation of the DKM-derived DoDs and the identification of the set of linearly independent reactions, in the alternative algorithm, the components of the overall degree of disequilibrium vector can be computed directly by casting the DKM as an RCCE simulation considering a set of linearly independent constraints equaling the number of chemical species in size. The effectiveness and robustness of the derived constraints from the alternative procedure is examined in hydrogen/oxygen and methane/oxygen ignition delay simulations and the results are compared with those obtained from DKM.

This article composes a systematic design methodology to obtain optimal parameters of the Tesla turbine, which is applicable in water distribution systems, faced with the need to supply power for wireless sensors and other components used in smart water networks and the challenges associated with the feasibility of Tesla turbine in a small scale. The optimal geometric model is sought by using a theoretical model relating turbine physical properties and flow conditions to power output by solving Navier–Stokes equations for steady laminar incompressible flow between adjacent disks. The model shows that the proposed design with dimensions and flow conditions relevant to water pipe networks can achieve a power output of 1.55 mW using a 2.5-cm diameter turbine given a pressure difference of 140 Pa. At 70 Pa using a 1-cm diameter turbine, a power output of 0.17 mW can be obtained. This study shows a great potential in application of Tesla turbine for energy harvesting in water distribution systems.

Parkinson disease (PD) is the second most common neurodegenerative disorder, whose prevalence is 2~3% in the population over 65. α-Synuclein aggregation is the major pathological hallmark of PD. However, recent studies have demonstrated enhancing evidence of tau pathology in PD. Despite extensive considerations, thus far, the actual spreading mechanism of neurodegeneration has remained elusive in a PD brain. This study aimed to further investigate the development of α-synuclein and tau pathology. We employed various PD models, including cultured neurons treated with either 1-methyl-4-phenyl-1,2,3,6-tetrahydropyridine (MPTP) or with recombinant α-synuclein. Also, we studied dopaminergic neurons of cytokine Interferon-β knock-out. Moreover, we examined rats treated with 6-hydroxydopamine, Rhesus monkeys administrated with MPTP neurotoxin, and finally, human post-mortem brains. We found the α-synuclein phosphorylation triggers tau pathogenicity. Also, we observed more widespread phosphorylated tau than α-synuclein with prion-like nature in various brain areas. We optionally removed P-tau or P-α-synuclein from cytokine interferon-β knock out with respective monoclonal antibodies. We found that tau immunotherapy suppressed neurodegeneration more than α-synuclein elimination. Our findings indicate that the pathogenic tau could be one of the leading causes of comprehensive neurodegeneration triggered by PD. Thus, we can propose an efficient therapeutic target to fight the devastating disorder.

Background: Diabetes mellitus may cause neurodegeneration, but the exact mechanism by which diabetic conditions induce neuronal cell death remains unclear. Tau protein hyperphosphorylation is considered to be a major pathological hallmark of neurodegeneration and can be triggered by diabetes. Various tau-directed kinases, including P38, can be activated upon diabetic stress and induce tau hyperphosphorylation. Despite extensive research efforts and the known importance of tau pathology in neurodegeneration, the exact tau specie(s) and kinases driving neurodegeneration in diabetes mellitus have not been clearly elucidated. Methods: We herein employed protein expression data analysis as well as immunofluorescence and immunoblotting techniques to determine the exact molecular mechanism of tau pathology triggered by diabetes in both in vitro and in vivo systems.Results: We found that P38, a major tau kinase, was increased in Glutamatergic & GABAergic neuron subtypes under diabetic conditions. This rendered them more responsive to oxidative stress caused by diabetes. We observed that oxidative stress activated P38, which in turn directly and indirectly drove tau pathology in the brainstem (enriched by Glutamatergic & GABAergic neurons), which gradually spread to neighboring brain areas. Notably, P38 inhibition suppressed tau pathogenicity and neurodegeneration in diabetic mouse models. Conclusion: The data establish P38 as a central mediator of diabetes mellitus induced tau pathology. Furthermore, the inhibition of P38 at early stages of diabetes-induced stress can inhibit tau pathology. Our findings provide mechanistic insight on the consequences of this metabolic disorder on the nervous system.

Aim: Parkinson's disease (PD) is a neurological disorder resulting from decreased dopamine (DA) secretion in the brain, which reflects impaired motor function. Thus, a drug-delivery system for releasing DA into the brain would be of crucial importance. Materials & methods: We herein examined the in vivo drug efficiency of novel poly-butyl-cyanoacrylate nanoparticles loaded with DA (DA-PBCA NPs). Results & conclusion: The NPs were able to pass through the blood–brain barrier and improve brain structure and function in the PD animal models. Moreover, we found a reduced α-synucleinopathy in the animal model brains after the NPs administration. Thus, the NPs seem to be a reliable DA delivery system for treating PD patients.

Introduction This article is a report of designing a rapid and effective guide for paramedics who take care of patients in a pre-hospital setting to answer developing demands. Methods The relevant literature was reviewed, and the topics were extracted. Then, the extracted items were discussed in an expert panel. Finally, items were discussed in a meeting including emergency technicians and emergency technical assistants to identify implementation problems. Results Important topics for managing psychiatric patients were categorized at three levels: 1) Patient safety and security issues, 2) Patient status assessment and diagnosis, and 3) Patient management (medical, behavioral management, and referral to a treatment center). Discussion This protocol can be a solution to improve emergency technician training. Such summarized protocols can be used for rapid review immediately before exposing a patient with an acute psychiatric condition. Due to specific cultural and different access to medicines in Iran, some issues are different.

Background: Discharge from the hospital against the doctor’s advice and refusal of receiving treatment is one of the significant issues at the time of hospitalization, which is especially crucial in relation to psychiatric patients. It can exacerbate the disorder and the subsequent complications and increase further hospital admissions. The present study was designed to evaluate the causes of discharge from the hospital and the refusal of receiving treatment against medical advice in hospitalized patients in Iran Psychiatric Hospital. Methods: The present study was a descriptive cross-sectional study. One hundred patients hospitalized in Iran Psychiatric Hospital discharged with personal consent against medical advice from July to December 2018 were studied. Two methods were used for assessment; the fulfillment of a routine ministry-approved checklist by the dischargers themselves and the face-to-face interview with both the patient and discharger based on a researcher-made checklist. Cohen’s Kappa coefficient was used to assess the agreement of the answers of patients to both routine ministry-approved and researcher-made checklists by SPSS software version 16.0 with an overall accuracy of 95%. Results: Based on the results extracted from the researcher-made checklist, 43 (43%) of the discharges were generally based on patient-related factors. The personal insistence to discharge by the patient was cited as the main reason for discharge. Cohen’s Kappa coefficient showed no significant agreement between the patient’s answers to the interview and what they have previously filled in the routine ministry-approved checklist. More specifically, the measure of agreement for answers of patients to questions in the standard checklist and the questions asked by the interviewer was 0.078 (p=0.167). Conclusion: From the results of this study, it can be concluded that the face-to-face interview based on the researcher-made checklist can more effectively determine the reasons for discharge of patients due to the accuracy of the interview.

In this study, the fully automatable Approximate Singular Value Decomposition of the Actual Degrees of Disequilibrium (ASVDADD) method is used for combustion modeling of ethanol. Due to the importance of ethanol as one of the most common type of biofuels, modeling its reaction kinetics and chemical composition evolution during combustion is necessary. The detailed kinetic mechanism (DKM) considered here is generated by authors using reaction mechanism generator (RMG) technique and it consists of 66 species and 1031 reactions. Tracking this number of species and chemical reactions in computational fluid dynamic (CFD) analysis of engineering problems is prohibitive. To alleviate this issue, Rate-Controlled Constrained-Equilibrium (RCCE) model reduction scheme for chemical kinetics is employed. It describes the evolution of a complex chemical system with acceptable accuracy with a number of rates controlling constraints on the associated constrained-equilibrium states of the system, much lower than the number of species in the underlying DKM. Successful approximation of the constrained equilibrium states requires accurate identification of the constraints. One promising procedure is the ASVDADD method that is capable of identifying the best constraints for a given range of thermodynamic conditions and a required level of approximation. ASVDADD is based on simple algebraic analysis of the results of the underlying DKM simulation and is focused on the behavior of the degrees of disequilibrium (DoD) of the individual chemical reactions. In this paper, ASVDADD is used to derive the RCCE constraints and ethanol combustion is modeled using both DKM and RCCE. Comparison of RCCE results with those of DKM shows the effectiveness of the ASVDADD derived constraints which demonstrates the potential of the RCCE method for combustion modeling of heavy and complex fuels.

Significance of ethanol as an alternative source of renewable energy is increasing every day. In this study a chemical mechanism has been developed to predict the characteristic of ethanol oxidation in a wide range of temperature and pressure of 300–2500 K and 1–50 atm, respectively. The mechanism is generated using reaction mechanism generator (RMG). Sensitivity analysis on the mechanism is done to find the reactions responsible in the deviation of numerical results with experimental data. Rate coefficient of important reactions is corrected with well-accepted data from literature which helps to improve the mechanism against experiment. The validation is done with laminar burning speed and ignition delay time results at various operating conditions. The results show a reasonable agreement in both high pressure and low temperature cases. A good prediction of major species concentration is found in flame structure measurement. A comparison of the current mechanism with other available chemical mechanisms is also presented at different operating conditions. Compared to other mechanisms, this improved mechanism has an advantage of handling the high pressure and low temperature operating conditions within a reasonable time and accuracy.

Injury to podocytes is a principle cause of initiation and progression of both immune and non-immune mediated glomerular diseases that result in proteinuria and decreased function of the kidney. Current advances in regenerative medicine shed light on the therapeutic potential of cell-based strategies for treatment of such disorders. Thus, there is hope that generation and transplantation of podocytes from induced pluripotent stem cells (iPSCs), could potentially be used as a curative treatment for glomerulonephritis caused by podocytes injury and loss. Despite several reports on the generation of iPSC-derived podocytes, there are rare reports about successful use of these cells in animal models. In this study, we first generated a model of anti-podocyte antibody-induced heavy proteinuria that resembled human membranous nephropathy and was characterized by the presence of sub-epithelial immune deposits and podocytes loss. Thereafter, we showed that transplantation of functional iPSC-derived podocytes following podocytes depletion results in recruitment of iPSC-derived podocytes within the damaged glomerulus, and leads to attenuation of proteinuria and histological alterations. These results provided evidence that application of iPSCs-derived renal cells could be a possible therapeutic strategy to favorably influence glomerular diseases outcomes.

The development of chemotherapies against eukaryotic pathogens is especially challenging because of both the evolutionary conservation of drug targets between host and parasite, and the evolution of strain-dependent drug resistance. There is a strong need for new nontoxic drugs with broad-spectrum activity against trypanosome parasites such as Leishmania and Trypanosoma. A relatively untested approach is to target macromolecular interactions in parasites rather than small molecular interactions, under the hypothesis that the features specifying macromolecular interactions diverge more rapidly through coevolution. We computed tRNA Class-Informative Features in humans and independently in eight distinct clades of trypanosomes, identifying parasite-specific informative features, including base pairs and base mis-pairs, that are broadly conserved over approximately 250 million years of trypanosome evolution. Validating these observations, we demonstrated biochemically that tRNA:aminoacyl-tRNA synthetase (aaRS) interactions are a promising target for anti-trypanosomal drug discovery. From a marine natural products extract library, we identified several fractions with inhibitory activity toward Leishmania major alanyl-tRNA synthetase (AlaRS) but no activity against the human homolog. These marine natural products extracts showed cross-reactivity towards Trypanosoma cruzi AlaRS indicating the broad-spectrum potential of our network predictions. We also identified Leishmania major threonyl-tRNA synthetase (ThrRS) inhibitors from the same library. We discuss why chemotherapies targeting multiple aaRSs should be less prone to the evolution of resistance than monotherapeutic or synergistic combination chemotherapies targeting only one aaRS., Author summary Trypanosome parasites pose a significant health risk worldwide. Conventional drug development strategies have proven challenging given the high conservation between humans and pathogens, with off-target toxicity being a common problem. Protein synthesis inhibitors have historically been an attractive target for antimicrobial discovery against bacteria, and more recently for eukaryotic pathogens. Here we propose that exploiting pathogen-specific tRNA-synthetase interactions offers the potential for highly targeted drug discovery. To this end, we improved tRNA gene annotations in trypanosome genomes, identified functionally informative trypanosome-specific tRNA features, and showed that these features are highly conserved over approximately 250 million years of trypanosome evolution. Highlighting the species-specific and broad-spectrum potential of our approach, we identified natural product inhibitors against the parasite translational machinery that have no effect on the homologous human enzyme.

The main objective of the present study was to compare the distribution of underlying factors such as neurological soft signs, obstetric complications, and family history of psychiatric disorders between two groups of schizophrenic patients and patients with prolonged methamphetamine-induced psychosis. In a case-control study, 30 patients with prolonged methamphetamine-induced psychosis and 30 patients with schizophrenia were selected. Data were collected through a demographic questionnaire, the Buchanan and Heinrichs’ Neurological Evaluation Scale (NES), the Lewis-Murray’s Obstetric Complications Scale (LMOCS), and the Weissman’s Family History Screen (FHS). Mean scores of the neurological soft signs (±SD) in the two groups of schizophrenic patients and patients with prolonged methamphetamine-induced psychosis were 15.7±8.7 and 11.7±6.2, respectively (P=0.040), and a significant difference was observed in the sensory integration between the two groups (P=0.022). Obstetric complications revealed similar distributions in the two groups. Patients with prolonged methamphetamine-induced psychosis reported higher prevalence of alcohol and other substances use disorders (P=0.003 and P=0.001, respectively) in their close relatives; however, the distributions of other disorders were not statistically different between the two groups’ close relatives. Similarities and differences in certain aspects were observed between the two groups, suggesting susceptibility for psychosis in patients with prolonged methamphetamine-induced psychosis; yet we found diversities that distinguish the two disorders. © 2019 Tehran University of Medical Sciences. All rights reserved. Acta Med Iran 2019;57(4):235-243

Injury to podocytes is a principle cause of initiation and progression of both immune and non-immune mediated glomerular diseases that result in proteinuria and decreased function of the kidney. Current advances in regenerative medicine shed light on the therapeutic potential of cell-based strategies for treatment of such disorders. Thus, there is hope that generation and transplantation of podocytes from induced pluripotent stem cells (iPSCs), could potentially be used as a curative treatment for glomerulonephritis caused by podocytes injury and loss. Despite several reports on the generation of iPSC-derived podocytes, there are rare reports about successful use of these cells in animal models. In this study, we first generated a model of anti-podocyte antibody-induced heavy proteinuria that resembled human membranous nephropathy and was characterized by the presence of sub-epithelial immune deposits and podocytes loss. Thereafter, we showed that transplantation of functional iPSC-derived podocytes following podocytes depletion results in recruitment of iPSC-derived podocytes within the damaged glomerulus, and leads to attenuation of proteinuria and histological alterations. These results provided evidence that application of iPSCs-derived renal cells could be a possible therapeutic strategy to favorably influence glomerular diseases outcomes.

The Rate-Controlled Constrained-Equilibrium (RCCE) is a model reduction scheme for chemical kinetics. It describes the evolution of a complex chemical system with acceptable accuracy with a number of rate controlling constraints on the associated constrained-equilibrium states of the system, much lower than the number of species in the underlying Detailed Kinetic Model (DKM). Successful approximation of the constrained-equilibrium states requires accurate identification of the constraints. One promising procedure is the fully automatable Approximate Singular Value Decomposition of the Actual Degrees of Disequilibrium (ASVDADD) method that is capable of identifying the best constraints for a given range of thermodynamic conditions and a required level of approximation. ASVDADD is based on simple algebraic analysis of the results of the underlying DKM simulation and is focused on the behavior of the degrees of disequilibrium (DoD) of the individual chemical reactions. In this paper, we propose a method, as part of our work-in-progress efforts, that could expand the applicability of the derived constraints. This method involves running DKM calculations for a wider range of initial conditions, appending the results of all these cases one after the other after normalizing, and finally running the ASVDADD method to get a set of ‘universal’ constraints applicable within that range of conditions. The effectiveness and robustness of the derived constraints is examined in hydrogen/oxygen ignition delay simulations and the results are compared with those obtained from DKM. The proof-of-concept results demonstrate the potential of the method for finding ‘universal’ constraints.