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This pilot randomized controlled trial protocol aims to (1) assess the impact on the wellbeing of Syrian refugee young adults (18-24 years) of being a community mental health worker (CMHW) implementing WHO's evidence-based psychosocial intervention - Problem Management Plus (PM+) - with adults in their community, and (2) identify the mechanisms associated with the outcomes of enhanced wellbeing and coping, and reduced stress among these CMHWs. Over 108 million people have been forcibly displaced as of the end of 2022. Mental health consequences of these displacements are significant, yet human resources for health are not sufficient to meet the needs. A large proportion of refugee populations are youth and young adults (YA). Evidence indicates their engagement in supporting their communities leads to their own enhanced wellbeing and that of their community. This trial trains Syrian refugees to serve their communities as CMHW (n=19) or tutors (n=19) and compare wellbeing, stress and coping outcomes between these two groups and a control group (n = 40). We will also assess 7 mechanisms as potential pathways for the interventions to influence outcomes. Surveys will assess outcomes and mechanisms, hair samples will measure stress cortisol. The primary analysis will use a Bayesian Hierarchical Model approach to model the trajectories of the mechanisms and primary study endpoints over time for individuals in each of the arms. Our results will elucidate critical mechanisms in which engagement of young adults to support their community enhances their own wellbeing., Trial Registration: National Institutes of Mental Health, NCT05265611, Registered prospectively in 2021., Lebanon Clinical Trials Registry #: LBCTR2023015206, Registered in 2023., Competing Interests: The authors declare that they have no known competing financial interests or personal relationships that could have appeared to influence the work reported in this paper., (© 2024 The Authors.)

Purpose: Asthma control test (ACT) has been devised to assess the degree of asthma control in out-patients setting. The aim of this study is to validate the Arabic version of ACT. Materials and Methods: Patients completed the Arabic version of ACT during regular visit to one of two asthma specialists. Spirometry was obtained. The asthma specialist rated asthma control using a 5-point scale and indicated modification in management as step up, same or step down of asthma treatment. Results: 40 patients completed the study, the mean age was 32.6 + 14.0 years, mean FEV1 was 2.7 + 1.0 L (89.2% + 23.6% of predicted). The mean ACT score was 15.9 + 5.8; mean of specialist asthma control rating was 3.4 + 1.0. The internal consistency reliability of the 5-item ACT survey was alpha = 0.92. The correlation was moderate between ACT and specialists rating ( r = 0.482, P = 0.002) and between ACT and treatment modification ( r = -0.350, P = 0.027). The correlation between FEV1 and ACT was low ( r = 0.185, P = 0.259). ACT distinguished between patients with different specialist rating ( F = 3.37, P = 0.02) and the need to change therapy ( F = 3.62, P = 0.037). The areas under the curve (ROC) for ACT, FEV1, and ACT and FEV1 as independent variables were 0.720, 0.721, and 0.766 respectively. All results were comparable to the initial work for development of ACT. Conclusion: The Arabic version of the ACT is a valid tool to assess asthma control. ACT correlates better with asthma specialist rating of asthma control than with FEV1.

Lockdown measures were taken since February 2020 in Lebanon, a country already going through a socio-economic crisis, to fight the new coronavirus pandemic. The aim of this study is to evaluate the psychological impact of the lockdown in Lebanon. A cross-sectional, online survey was conducted during the lockdown period in order to punctually assess depression, anxiety symptoms as well as eating and substance use disorders using self-rating scales (the DASS-21, SCOFF and CAGE-AID respectively), while identifying factors that might affect those outcomes. Overall, 1133 participants completed the questionnaire. The DASS-21 score was positively correlated with the impact of lockdown on participants' lifestyle and lockdown duration. A highest effect on DASS-21 score was related to the intensity of other stressful life events that have happened during the last 3 months. Linear regression analysis also showed that age, monthly income, professional status, the SCOFF and CAGE-AID scores, the intensity of the lockdown's impact on lifestyle and having been through other stressful life events unrelated to the lockdown per se, were risk factors affecting significantly the DASS-21 score. Lockdown, as well as other stressful life event that have happened during the last 3 months, were therefore associated with higher depression, anxiety, and stress symptoms. These findings may guide future policy making strategies in order to prevent mental health problems in case of a pandemic concomitant with other critical stressors., Competing Interests: Conflict of interestThe authors declare that there are no conflicts of interest., (© The Author(s), under exclusive licence to Springer Science+Business Media, LLC, part of Springer Nature 2022.)

Purpose: Metastatic phyllodes tumors of the breast (MPT) are rare breast neoplasms, limiting development of standardized treatment approaches. We sought to characterize the largest group of MPT thus far reported, evaluating systemic therapy outcomes., Methods: Adult patients diagnosed with MPT between 1993 and 2015 and followed at MD Anderson Cancer Center were selected for retrospective chart review. Systemic therapy was sorted into: adriamycin/ifosfamide (AI), other anthracycline regimens, other ifosfamide regimens, gemcitabine-based regimens, and other. Given one patient may have received more than one regimen, we assumed that the effects of each regimen were independent from previous therapy. Median overall survival (OS) and progression-free survival (PFS) were estimated by the Kaplan-Meier method. Log-rank test was performed to evaluate the difference in OS between patient characteristics groups, and the differences in PFS between the five chemotherapy regimens., Results: We identified 50 MPT patients, with 31 patients receiving 61 systemic regimens. Median OS was 10.7 months (95% CI: 8.67, 16.5). AI had a PFS of 9.10 months (95% CI: 5.03, 14.2), other ifosfamide regimens had a PFS of 5.10 months (95% CI: 0.67, 12.1), other anthracycline regimens had a PFS of 3.65 months (95% CI: 1.17, 7.90), gemcitabine-based regimens had a PFS of 2.80 months (95% CI: 1.83, 4.60), and other regimens had a PFS of 1.67 months (95% CI: 1.13, 7.77)., Conclusion: MPT patients are a unique population with limited characterization to date. Our study demonstrates activity of multiple sarcoma-directed chemotherapy regimens, with ifosfamide-containing regimens having the longest PFS.

Background: There is unreliable, and negligible information on the mental health and trauma-exposure of asylum-seekers and displaced refugees in the Iraqi Kurdistan region., Objectives: To evaluate how responsible the ethno-religious origins are, for the prevalence of trauma exposure and post-traumatic stress disorder (PTSD) in displaced Iraqi asylum-seekers and refugees residing in the Iraqi Kurdistan region., Methods: Structured interviews with a cross-sectional sample of 150 individuals, comprised of three self-identified ethno-religious groups (50 participants in each): Christians, Muslims, and Yazidis., Results: 100% prevalence of trauma exposure and 48.7% of current PTSD among refugees, 70% PTSD rate of Yazidi participants, which is significantly higher (p < 0.01) compared to 44% of Muslim participants and 32% of Christian participants. These findings were corroborated using the self-rated PTSD, DSM-5 Checklist, with more severe PTSD symptom scores (p < 0.001) obtained among Yazidis (43.1; 19.7), compared to Muslims (31.3; 20.1) and Christians (29.3; 17.8). Self-rated depressive symptoms (Patient Health Questionnaire-9) were also higher (p < 0.007) among Yazidis (12.3; 8.2) and Muslims (11.7; 5.9), compared to Christians (8.1; 7)., Competing Interests: The authors have declared that no competing interests exist.

Distinguishing well-differentiated liposarcoma (WDLPS) from dedifferentiated liposarcoma (DDLPS) is essential given distinct treatment paradigms and chemosensitivity. Percutaneous biopsy has a low sensitivity for detecting DDLPS. We sought to identify the diagnostic utility of positron emission tomography/computed tomography (PET/CT) in identifying WDLPS versus DDLPS. An independent radiologist reviewed PET/CT images to identify target lesions and determine the maximum standardized uptake value (SUVmax). An independent pathologist review confirmed WDLPS or DDLPS histology. A binary cutoff point of SUVmax was identified using a classification and regression trees (CART) algorithm. We identified 20 patients with WDLPS or DDLPS with 26 PET/CTs performed for separate recurrences that were followed by surgical sampling. Of the 26 records, 12 were DDLPS (46%) and 14 were WDLPS (54%). Patients with DDLPS had significantly higher SUVmax than those with WDLPS ( p value = 0.0035). A SUVmax of 4 was identified as the cutoff point. Using this cutoff, the sensitivity of SUVmax identifying a case as DDLPS was 83.3% (95% CI: 51.6%, 97.9%) and the specificity was 85.7% (95% CI: 57.2%, 98.2%). PET/CT is a sensitive and specific diagnostic tool to identify the presence of dedifferentiation within the tumor., Competing Interests: The authors declare no conflicts of interest., (Copyright © 2020 Amanda Parkes et al.)

Malignant gastrointestinal neuroectodermal tumor (GNET) is an aggressive rare tumor, primarily occurring in young adults with frequent local-regional metastases and recurrence after local control. The tumor is characterized by the presence of EWSR1-ATF1 or EWSR1-CREB1 and immunohistochemical positivity for S-100 protein without melanocytic marker positivity. Due to poor responses to standard sarcoma regimens, GNET has a poor prognosis, and development of effective systemic therapy is desperately needed to treat these patients. Herein, we present a patient with a small bowel GNET who experienced recurrent hepatic and skeletal metastases after a primary resection. Comprehensive genomic profiling (CGP) in the course of clinical care with DNA and RNA sequencing demonstrated the presence of an exon 7 to exon 6 EWSR1-CREB1 fusion in the context of a diploid genome with no other genomic alterations. In a clinical trial, the patient received a combination of 250 mg crizotinib with 600 mg pazopanib quaque die and achieved partial response and durable clinical benefit for over 2.8 years, and with minimal toxicity from therapy. Using a CGP database of over 50,000 samples, we identified 11 additional cases that harbor EWSR1-CREB1 and report clinicopathologic characteristics, as these patients may also benefit from such a regimen., (© 2016 S. Karger AG, Basel.)

Background: One of the crises recently affecting human society is an emerging pandemic that has had a significant psychological impact on healthcare workers. Studies have shown that staff experience psychological disorders such as anxiety, depression, and insomnia when exposed to crises. Objectives: This study aimed to determine the association between health anxiety and the sleep quality of healthcare workers during crisis conditions. Methods: This cross-sectional, correlational descriptive-analytical study was conducted from late February 2019 to late March 2020. Using convenient sampling, 382 healthcare workers from medical universities in Golestan province participated in the survey. Data were collected via an internet link shared with participants through WhatsApp working groups. The instruments used in this research included demographic information, sleep quality, and health anxiety inventories. The data were analyzed using SPSS-21 with descriptive and analytical statistics. Results: Of the participants, 77.2% were women, 65.4% were single, 60.7% were nurses, and 64.4% had a bachelor's degree. The results revealed that 72.7% of the staff experienced moderate to high levels of anxiety. Regarding sleep quality, 28.3% (n = 108) of healthcare workers reported good sleep quality, while 71.7% (n = 274) reported poor sleep quality. Additionally, the results indicated a significant correlation between health anxiety scores and sleep quality scores (r = 0.129, P = 0.01). Conclusions: The results of this study showed that the critical conditions caused by emerging diseases have led to health anxiety among healthcare workers, negatively affecting their sleep quality. Therefore, medical center officials must address such psychological issues and implement preventive measures to maintain the mental health of healthcare workers. [ABSTRACT FROM AUTHOR]

Primary ovarian insufficiency (POI) is the cessation of ovarian function before the age of 40. The causes of POI are heterogeneous, but substantial evidence exists to support a genetic basis of POI, particularly in the critical involvement of genes on the X chromosome. Recent studies have revealed novel candidate genes through the identification of copy number variations associated with POI. This review summarizes the genes located on the X chromosome with variants shown to be associated with POI in humans and/or in mice. Additionally, we present evidence to support the potential involvement of these candidate genes in the etiology of POI. We conducted a literature search in PubMed to identify case studies and screenings for the genetic causes of POI. We then performed systematic searches for the proposed candidate genes to investigate their potential reproductive roles. Of the X-linked candidate genes investigated, 10 were found to have variants associated with cases of POI in humans. An additional 10 genes were found to play a supportive role in POI. Other genes were not implicated in any cases of POI but were associated with various roles in reproduction. In the majority of cases where variants were identified through whole-exome sequencing, rather than targeted screening of candidate genes, more than one genetic variant was identified. Overall, this review supports past findings that the X chromosome plays a critical role in ovarian function, as demonstrated by a link between POI and various disruptions to genes on the X chromosome. Current genetic screening for POI, which includes only FMR1, is inadequate to capture the majority of cases with a genetic origin. An expanded genetic testing may improve health outcomes for individuals with POI as it could lead to better early interventions and education about these health risks. [ABSTRACT FROM AUTHOR]

Introduction: The assessment of asthmatics' health-related quality of life (HRQOL) has become an important outcome measure of the disease's effects from the patient's perspective. This study aims to assess the asthmatics' QOL and determine the factors affecting it. Methods: A cross-sectional study was conducted among 220 adult people with asthma attending the Pneumology Department of Hassan II University Hospital in Fez from March to May 2022. Patients were questioned by a face-to-face questionnaire, an asthma control test, an observance questionnaire, a knowledge questionnaire, and a specific asthma QOL questionnaire. The influence of the variables was evaluated by bivariate analysis and multiple linear regression. Results: The mean age was 48.4 ± 15.4. 71.8% were women, half were not attending school, and 77.7% lived in urban areas. 67.7% were nonsmokers, and 72.73% were passive workers. Only 42.27% complied well with treatment, and 41.82% have well-controlled asthma. The majority of people had insufficient knowledge. The QOL was considered good for 20% of the participants, poor for 11.8%, and average for 68.2% of the patients. The mean of the global QOL score was 5.1 ± 0.9. The most significant factors associated with a higher QOL were good asthma control (ß = 0.70; P ≤ 0.001), good knowledge score (ß = 0.125; P = 0.013), insurance coverage (ß = 0.144; P = 0.005), and work activity (ß = 0.133; P = 0.007). Conclusion: Our study found multiple factors affecting asthma patients' QOL, including asthma control, knowledge, and socioeconomic status. We can take some measures to improve the situation through patient education. [ABSTRACT FROM AUTHOR]

Seismic site response is inevitably influenced by natural variability of soil properties and anticipated earthquake intensity. This study presents the influence of variability in shear wave velocity (Vs) and amplitude of input rock motion on seismic site response analysis. Monte Carlo simulations were employed to randomize the Vs profile for different scenarios. A series of 1-D equivalent linear (EQL) seismic site response analyses were conducted by combining the randomized Vs profile with different levels of rock motion intensities. The results of the analyses are presented in terms of surface spectral acceleration, amplification factors (AFs), and peak ground acceleration (PGA). The mean and standard deviation of these parameters are thoroughly discussed for a wide range of randomized Vs profile, number of Vs randomizations, and intensities of input rock motions. The results demonstrate that both the median PGA and its standard deviations across different number of Vs profile realization exhibit a slight variation. As few as twenty Vs profile realizations are sufficient to compute reliable response parameters. Both rock motion intensity and standard deviation of Vs variability cause significant variation in computed surface parameters. However, the variability in the number of records used to conduct site response has no significant impact on ground response if the records closely match the target spectrum. Incorporating the multiple sources of variabilities can reduce uncertainty when conducting ground response simulations. [ABSTRACT FROM AUTHOR]

Purpose: Recent studies imply that psychological factors may actively contribute to the development of asthma. It is generally known that people with asthma frequently suffer from psychological illnesses. This association can make it challenging to reach asthma control. This study aimed to assess the prevalence of depression and anxiety among Jordanian adults with asthma, in addition to the link between asthma control levels and these psychological disorders. Patients and Methods: This cross-sectional study included 175 adults with asthma who visited the tertiary asthma clinic in three Jordanian Governmental hospitals. Sociodemographic data was collected directly from the patients who were assessed for their level of depression and anxiety using a self-administered questionnaire, the Hospital Anxiety and Depression Scale (HADS). Also, asthma control was assessed using the Asthma Control Test (ACT). The relation between the different sociodemographic variables and clinical data, particularly depression and anxiety and asthma control level, was assessed. Results: Among 175 asthmatic patients, 60.57% had poor disease control, 8% had anxiety alone, 11.43% had depression alone, and 53.14% had anxiety plus depression. Poor asthma control was significantly associated with anxiety and depression (p= 0.044) and low levels of education (p=0.001). Further, a lower level of education was also related to higher levels of anxiety and depression. Conclusion: Most of the assessed Jordanian patients with asthma had their disease poorly controlled. Anxiety and depression are common among the studied sample of adults with asthma, and they appear to affect the level of disease control, suggesting the possibility that addressing these psychological conditions could enhance asthma control levels. [ABSTRACT FROM AUTHOR]

Purpose: The SCOFF questionnaire was designed as a simple, memorable screening tool to raise suspicion that a person might have an eating disorder. It is over 20 years since the creation of the SCOFF, during which time it has been widely used. Considering this, we wish to review the use of the SCOFF in peer-reviewed scientific journals, and to assess whether it is being used appropriately in the manner in which it was originally devised and tested. Methods: The Preferred Reporting Items for a Systematic Review and Meta-analysis (PRISMA) guidelines were followed, and all search strategies and methods were determined before the onset of the study. PubMed and Wiley Online Library were searched using the terms SCOFF and eating. Two reviewers were involved in the reviewing process. Criteria for appropriate use of the SCOFF were formalised with the tool's original authors. Results: 180 articles were included in the final review. 48 articles had used the SCOFF appropriately, 117 articles inappropriately and 15 articles had been mixed in the appropriateness of their use. Conclusion: This systematic review highlights the inappropriate use of the SCOFF in diverse languages and settings. When used correctly the SCOFF has made a significant contribution to the understanding of eating disorders and its simplicity has been applauded and led to widespread use. However in over two-thirds of studies, the use of the SCOFF was inappropriate and the paper highlights how and in what way it was misused, Guidelines for the appropriate use of the SCOFF are stated. Future validation and avenues of research are suggested. Level of evidence: Level I. [ABSTRACT FROM AUTHOR]

Background: Nonadherence to therapies and psychological disorders are associated with poor asthma control. This study aims to assess the prevalence of anxiety and depressive symptoms, asthma control, and adherence to inhalers and to investigate whether there is an association of anxiety and depressive symptoms with adherence to inhalers and asthma control. Methods: We measured anxiety and depressive symptoms using the Hospital Anxiety and Depression Scale in patients with asthma. Asthma Control Test and the 10-Item Test of Adherence to Inhalers Scale were used to assess levels of asthma control adherence to inhalers, respectively. Univariate and multivariate regression models assessed the associations of anxiety and depressive symptoms with adherence to inhalers and asthma control. Results: A total of 287 patients completed the study, of whom 72% were female. The mean ± SD age and body mass index of our study population were 44 ± 13 years and 29 ± 7.2 kg/m2, respectively. Poor adherence to inhaler use was highly prevalent (49.8%; 95% CI: 43.8 to 55.7). The prevalence of anxiety, depression and poor asthma control was 27.2% (95% CI: 22.1 to 32.7), 20.9% (95% CI: 16.3 to 26.1), and 22.7% (95% CI: 17.9 to 27.9), respectively. We found a negative relationship between asthma control and anxiety, and depressive symptoms (adjusted β: -0.25; 95% CI: -0.36 to -0.14; p < 0.001 and adjusted β: -0.29; 95% CI: -0.40 to -0.18; p < 0.001, respectively). A negative relationship was also observed between adherence to inhalers and anxiety and depressive symptoms (adjusted β: -0.34; 95% CI: -0.46 to -0.22; p < 0.001 and adjusted β: -0.36; 95% CI: − 0.48 to − 0.24; p < 0.001, respectively). Conclusions: The high prevalence of uncontrolled asthma symptoms and poor adherence to inhalers and their impact on anxiety and depression levels among patients with asthma point to the need for early screening for psychological symptoms and recognition of nonadherence as part of asthma assessment and management plan in primary care in Saudi Arabia to avoid further worsening of asthma symptoms. Further studies are needed to explore the effectiveness of specific psychoeducational interventions and investigate the long-term impact of early psychological symptom detection on asthma outcomes. [ABSTRACT FROM AUTHOR]

Fibromyalgia is a soft tissue rheumatism with significant qualitative and quantitative impact on sleep macro and micro architecture. The primary objective of this study is to analyze and identify automatically healthy individuals and those with fibromyalgia using sleep electroencephalography (EEG) signals. The study focused on the automatic detection and interpretation of EEG signals obtained from fibromyalgia patients. In this work, the sleep EEG signals are divided into 15-s and a total of 5358 (3411 healthy control and 1947 fibromyalgia) EEG segments are obtained from 16 fibromyalgia and 16 normal subjects. Our developed model has advanced multilevel feature extraction architecture and hence, we used a new feature extractor called GluPat, inspired by the glucose chemical, with a new pooling approach inspired by the D'hondt selection system. Furthermore, our proposed method incorporated feature selection techniques using iterative neighborhood component analysis and iterative Chi2 methods. These selection mechanisms enabled the identification of discriminative features for accurate classification. In the classification phase, we employed a support vector machine and k-nearest neighbor algorithms to classify the EEG signals with leave-one-record-out (LORO) and tenfold cross-validation (CV) techniques. All results are calculated channel-wise and iterative majority voting is used to obtain generalized results. The best results were determined using the greedy algorithm. The developed model achieved a detection accuracy of 100% and 91.83% with a tenfold and LORO CV strategies, respectively using sleep stage (2 + 3) EEG signals. Our generated model is simple and has linear time complexity. [ABSTRACT FROM AUTHOR]

Background: Inflammatory myofibroblastic tumors (IMTs) are rare mesenchymal soft tissue sarcomas that often present diagnostic challenges due to their wide and varied morphology. A subset of IMTs have fusions involving ALK or ROS1. The role of next‐generation sequencing (NGS) for classification of unselected sarcomas remains controversial. Methods and Results: We report a case of a metastatic sarcoma in a 34‐year‐old female originally diagnosed as an unclassified spindle cell sarcoma with myofibroblastic differentiation and later reclassified as IMT after NGS revealed a TFG‐ROS1 rearrangement. Histologically, the neoplasm had spindle cell morphology with a lobulated to focally infiltrative growth pattern with scant inflammatory cell infiltrate. Immunohistochemistry demonstrated focal desmin and variable smooth muscle actin staining but was negative for SOX10, S100, and CD34. Fluorescence in situ hybridization was negative for USP6 or ALK gene rearrangements. NGS revealed a TFG‐ROS1 rearrangement and the patient was treated with crizotinib with clinical benefit. Conclusions: We discuss the role of NGS as well as its potential benefit in patients with unresectable, ALK‐negative metastatic disease. Considering this case and previous literature, we support the use of NGS for patients requiring systemic treatment. [ABSTRACT FROM AUTHOR]

Introduction: Investigating the epidemiology of mental health disorders resulting from COVID-19 intervention measures, primary school closures, and social isolation in children and adolescents needs to be prioritized over adults at the post-pandemic stage. Most preliminary psychosocial studies conducted during the pandemic have demonstrated that younger age groups are the most vulnerable to such implications. Thus, this study aims to estimate the probable prevalence of specific anxiety disorders in children and quantify their relationships with relevant demographic risk factors. Methods: We used a cross-sectional study comprising 430 children aged between 8- and 18 years old living in Kuwait during the period of school closures as well as full and partial lockdowns. The survey included questions about participants' characteristics, children's anxiety using the Screen for Child Anxiety Related Emotional Disorders Questionnaire (SCARED) scale, and children's emotions and behaviours using the Strengths and Difficulties Questionnaire (SDQ). Univariate and multivariate logistic regression analyses were used to summarize the demographic and characteristics of the participants and their association with general, social, and generalized anxieties, as well as behavioural and emotional difficulties. Results: We inferred that 24.83% of our participants had at least one anxiety disorder, while 20.19% were classified as abnormal on the SDQ scale. Our multivariate analysis revealed that lockdown duration and sex of the child were consistently significant predictors (p-values < 0.05) of the broad spectrum of selected mental disorders. Additionally, we inferred notable increases in the likelihood of mental disorders associated with the increased duration of lockdowns. Conclusions: Our findings revealed preliminary insights into the vulnerability of young populations to the indirect negative impacts of strict public health measures during pandemic emergencies. Thus, authorities should consider such implications when planning and implementing similar interventions in future pandemics. [ABSTRACT FROM AUTHOR]

Introduction: Research from around the world shows important differences in the impact of the COVID-19 pandemic and lockdowns on mental health. This study examined the extent of mental health challenges (depressive and anxiety symptoms and daily life difficulties) and their associations with pandemic- and response-related factors during the first lockdown in Lebanon, which happened amid a severe economic crisis and socio-political turmoil. Methods: Data come from a cross-sectional internet-based survey (May-June 2020). Association of depressive (Patient Health Questionnaire (PHQ-9)) and anxiety symptoms (Generalized Anxiety Disorder (GAD-7)) with outbreak-related worries and knowledge, information sources, and confidence and satisfaction in response measures were estimated using logistic regression adjusted for sociodemographic and socioeconomic indicators. Results: Among 510 participants (mean age 36.1±11.3; 69.4% women), 32.3% had elevated depressive and 27.3% had elevated anxiety symptoms; younger age, unemployment, loss of employment, and lower income were related to more mental health symptoms. Most prevalent daily life challenges were feelings of uncertainty (74.5%) and financial (52.2%) and emotional (42.2%) difficulties; these and all other daily life difficulties (work-related, caregiving, and online learning) were significantly higher among participants with higher depressive and anxiety symptoms. Higher outbreak-related worries were associated with higher depressive (OR = 1.36, 95% CI = 1.20,1.53) and anxiety symptoms (OR = 1.47, 95% CI = 1.30,1.67). Higher pandemic-related knowledge, reliance on and trust in local health agencies and professionals' information, and satisfaction and confidence regarding governmental and health institutions' response were all related to lower mental health symptoms. Conclusion: Results show that mental health burden in Lebanon during the first lockdown (when the COVID-19 outbreak was still minimal) is among the highest reported worldwide and highlight elevated emotional and financial tolls and widespread impact on daily life. In this high-burden and multiple-challenges context, results suggest an important role for the healthcare body, knowledge, and trust in the institutions managing the response. [ABSTRACT FROM AUTHOR]

The native flora of Brazil covers a large biodiversity of plants, some of which have important pharmacological properties. Ethnobotanical studies have established that the folk use of plants for hepatobiliary disorders is very common in Brazil. This review aimed to compile, describe and discuss the main native Brazilian medicinal plants used as hepatoprotective agents listed on 25 books by authors from various regions in the country. Based on the 153 species found, a comprehensive analysis of the most relevant scientific studies is presented, including Piper umbellatum, Echinodorus macrophyllus, Fevillea trilobata and Achyrocline satureioides. Some medicinal plants share both a large number of citations and scientific evidence to corroborate their hepatoprotective effects, including Solanum paniculatum, Baccharis crispa and Phyllanthus niruri, which could be of interest to develop new phytomedicines. Additionally, some active ingredients are indicated as being responsible for the liver protective effects described, particularly phenolic compounds (flavonoids, coumestans and lignans)., (© 2022 Wiley-VHCA AG, Zurich, Switzerland.)

Renal fibrosis is increasingly recognized as a global public health problem. Acute kidney injury (AKI) and chronic kidney disease (CKD) both result in renal fibrosis. Oxidative stress and inflammation play central roles in progressive renal fibrosis. Oxidative stress and inflammation are closely linked and form a vicious cycle in which oxidative stress induces inflammation through various molecular mechanisms. Ample evidence has indicated that a hyperactive nuclear factor kappa B (NF-κB) signaling pathway plays a pivotal role in renal fibrosis. Hyperactive NF-κB causes the activation and recruitment of immune cells. Inflammation, in turn, triggers oxidative stress through the production of reactive oxygen species and nitrogen species by activating leukocytes and resident cells. These events mediate organ injury through apoptosis, necrosis, and fibrosis. Therefore, developing a strategy to target the NF-κB signaling pathway is important for the effective treatment of renal fibrosis. This Review summarizes the effect of the NF-κB signaling pathway on renal fibrosis in the context of AKI and CKD (immunoglobulin A nephropathy, membranous nephropathy, diabetic nephropathy, hypertensive nephropathy, and kidney transplantation). Therapies targeting the NF-κB signaling pathway, including natural products, are also discussed. In addition, NF-κB-dependent noncoding RNAs are involved in renal inflammation and fibrosis and are crucial targets in the development of effective treatments for kidney disease. This Review provides a clear pathophysiological rationale and specific concept-driven therapeutic strategy for the treatment of renal fibrosis by targeting the NF-κB signaling pathway. [ABSTRACT FROM AUTHOR]

Background: The mental health of healthcare workers during the coronavirus-2019 pandemic was seriously affected, and the risk of mental health problems was high. The present study sought to systematically evaluate the mental health problems of healthcare workers worldwide during the pandemic and to determine the latest global frequency of COVID-19 associated mental health problems. Methods: Data in the Cumulative Index to Nursing and Allied Health Literature (CINAHL), EMBASE, Elsevier, MEDLINE, PubMed, PsycINFO and the Web of Science before November 11, 2022, were systematically searched. Cohort, case-control and cross-sectional studies were included. The meta-analysis used a random effects model to synthesize the comprehensive prevalence rate of mental health problems. Subgroup analyses were performed based on time of data collection; whether the country was or was not developed; continent; doctors and nurses; doctors/nurses vs. other healthcare workers; and psychological evaluation scale. Results: A total of 161 studies were included, including 341,014 healthcare workers worldwide, with women accounting for 82.8%. Occupationally, 16.2% of the healthcare workers were doctors, 63.6% were nurses and 13.3% were other medical staff. During the pandemic, 47% (95% confidence interval [CI], 35–60%) of healthcare workers reported job burnout, 38% (95% CI, 35–41%) experienced anxiety, 34% (95% CI 30–38%) reported depression, 30% (95% CI, 29–31%) had acute stress disorder, and 26% (95% CI, 21–31%) had post-traumatic stress disorder. Conclusions: The study found that there were common mental health problems among health care workers during the COVID-19 pandemic. The most common was job burnout, followed by anxiety, depression, acute stress and post-traumatic stress disorder. Although the global pandemic has been brought under control, its long-term impact on the mental health of healthcare workers cannot be ignored. Additional research is required to develop measures to prevent, monitor and treat psychological disorders among healthcare workers. [ABSTRACT FROM AUTHOR]

Due to the unique soil, morphological, and subsurface topographical conditions, amplified and prolonged seismic demand traces were observed in historical strong ground motion records from Bayrakli-Izmir-Turkiye. A vivid example of this response was recorded during the Mw 7.0 Samos event on October 30, 2020. After the event, structural damage and loss of life were unexpectedly concentrated in Bayrakli-Izmir, even though the fault rupture was located 70 km away. The presence of strong ground motion stations (SGMS) located on rock (#3514) and soil (#3513) sites enabled a quantitative assessment of the amplified and prolonged seismic demand traces. The seismic response of SGMS #3513 site was assessed by using 1-D equivalent linear and analytical methods. The idealized 1-D soil profile and input parameters were calibrated and fine-tuned by using the 2020 Samos earthquake accelerograms. Then, the calibrated equivalent linear site response model was further validated by the recordings from historical events. Alternatively, an analytical wave propagation-based model was proposed, the input parameters of which were probabilistically estimated based on, again, historical recordings. Finally, the seismic responses of the site during future earthquakes were predicted based on the calibrated and validated site response models. The predicted intensity-dependent amplification spectral responses were compared with the provisions of the TEC (2018). Even though limited in number in all five future seismic scenario events, amplification ratios suggested by TEC were exceeded by a factor of 2–4 at periods falling in the range of 0.5 to 1.2 s. This clearly suggested the need to further quantify the Bayrakli seismic basin responses with basin-specific models, rather than code-based, intensity-dependent generalized amplification factors. [ABSTRACT FROM AUTHOR]

The Saudi Initiative for Asthma 2024 (SINA-2024) is the sixth version of asthma guidelines for the diagnosis and management of asthma for adults and children that was developed by the SINA group, a subsidiary of the Saudi Thoracic Society. The main objective of the SINA is to have guidelines that are up-to-date, simple to understand, and easy to use by healthcare workers dealing with asthma patients. To facilitate achieving the goals of asthma management, the SINA Panel approach is mainly based on the assessment of symptom control and risk for both adults and children. The approach to asthma management is aligned for age groups: adults, adolescents, children aged 5–12 years, and children aged <5 years. SINA guidelines have focused more on personalized approaches reflecting a better understanding of disease heterogeneity with the integration of recommendations related to biologic agents, evidence-based updates on treatment, and the role of immunotherapy in management. The medication appendix has also been updated with the addition of recent evidence, new indications for existing medication, and new medications. The guidelines are constructed based on the available evidence, local literature, and the current situation at national and regional levels. There is also an emphasis on patient–doctor partnership in the management that also includes a self-management plan. [ABSTRACT FROM AUTHOR]

Desmoid tumors (DT) represent the second high risk of tumor in familial adenomatous polyposis (FAP) patients. Although FAP-associated DTs (FAP-DT) are caused by germline mutations in the adenomatous polyposis coli (APC) gene, extracolonic manifestations, sex, family history, genotype, and the ileal pouch anal anastomosis procedure are all linked to the development of DTs in FAP patients. Multidisciplinary management has replaced aggressive surgery as the preferred treatment of DTs. There is growing evidence to support the use of active surveillance strategy as first-line treatment for FAP-DT patients. Radiotherapy for intra-abdominal desmoids is now rarely used because of severe late toxicity. Pharmacotherapy, however, represents a promising future with the improvement of traditional cytotoxic drugs and the investigation of targeted drugs. Although nonsurgery treatment has been used widely nowadays, surgery remains the mainstay when symptomatic or life-threatening DTs are present. Further research will be needed for more optimal clinical practice. [ABSTRACT FROM AUTHOR]

Diethylenetriaminepenta (methylene-phosphonic acid) pentasodium salt (DTPMPA), an ecofriendly reagent, was tried for the first time as a depressant for flotation separation of scheelite from calcite. Micro-flotation tests show that DTPMPA can selectively depress the floatability of calcite. In contrast, DTPMPA barely affects the flotation behavior of scheelite. Based on the selective depress effect, floatation separation of scheelite and calcite can be effectively achieved by using DTPMPA as depressant in artificially mixed minerals flotation tests. Based on a series of measurements, it found the surface of calcite was positively charged due to the existence of Ca ion site, which can be chelated with -PO3H-functional group on the surface of DTPMPA. In the flotation process, DTPMPA can be chemically absorbed on the surface of calcite to inhibit further collector adsorption. On contrast, little DTPMPA was adsorbed on the surface of scheelite due to the spatial site resistance and electrostatic repulsion induced by surface WO42+. All in all, these results exhibit DTPMPA has excellent selective depression ability on calcite, which can be potentially applied in the actual scheelite flotation process. [ABSTRACT FROM AUTHOR]

Intellectual disabilities (ID) and autism spectrum disorders (ASD) are characterized by extreme genetic and phenotypic heterogeneity. However, understanding this heterogeneity is difficult due to the intricate interplay among multiple interconnected genes, epigenetic factors, oxidative stress, and environmental factors. Employing next-generation sequencing (NGS), we revealed the genetic cause of ID and autistic traits in two patients from a consanguineous family followed by segregation analysis. Furthermore, in silico prediction methods and 3D modeling were conducted to predict the effect of the variants. To establish genotype–phenotype correlation, X-chromosome inactivation using Methylation-specific PCR and oxidative stress markers were also investigated. By analyzing the NGS data of the two patients, we identified a novel frameshift mutation c.2174_2177del (p.Thr725MetfsTer2) in the MAP7D3 gene inherited from their mother along with the functional BDNF Val66Met polymorphism inherited from their father. The 3D modeling demonstrated that the p.Thr725MetfsTer2 variant led to the loss of the C-terminal tail of the MAP7D3 protein. This change could destabilize its structure and impact kinesin-1's binding to microtubules via an allosteric effect. Moreover, the analysis of oxidative stress biomarkers revealed an elevated oxidative stress in the two patients compared to the controls. To the best of our knowledge, this is the first report describing severe ID and autistic traits in familial cases with novel frameshift mutation c.2174_2177del in the MAP7D3 gene co-occurring with the functional polymorphism Val66M in the BDNF gene. Besides, our study underlines the importance of investigating combined genetic variations, X-chromosome inactivation (XCI) patterns, and oxidative stress markers for a better understanding of ID and autism etiology. [ABSTRACT FROM AUTHOR]

The estimation of seismic damages and debris at the urban scale—at a building-by-building level- is challenging for several reasons. First, commonly used methodologies for seismic damage estimation rarely take into account the local site effects, precisely at the building-level. Second, the available methods for debris estimation fail to estimate at the same time the quantity of debris generated per building according to its damage level and the distribution of the debris (extent and height) around buildings. Finally, the lack of comprehensive data on the building stock and the relevant building properties and their taxonomy further increases the complexity of assessing possible earthquake consequences at an urban scale. This paper addresses these challenges and proposes improvements to the assessment of seismic damages and debris from building-level simulations, along with the development of a 3D building model based on satellite images and heterogeneous data. These developments, applied to the city of Beirut, Lebanon, highlight the control of the site effects on the seismic damage's spatial distribution throughout the city and the large volume and extent of debris to be expected in the city for a strong earthquake. [ABSTRACT FROM AUTHOR]

Asthma is a common chronic inflammatory condition with increasing global prevalence. There is some evidence highlighting the effect of asthma on brain functioning. In Saudi Arabia, limited studies have examined the relationship between asthma and mental health, including cognition and mood disorders in older adults in particular. In this study, we examine the association between asthma and mental health outcomes in middle-aged and elderly individuals in Riyadh, Saudi Arabia. In a cross-sectional study, 243 subjects were recruited from outpatient clinics between 2020–2021 (non-asthmatic: n = 159, asthmatic: n = 84). The Montreal Cognitive Assessment test, the Hospital Anxiety and Depression Scale, and the Asthma Control Test were used to assess cognition, anxiety and depression, and asthma control, respectively. Logistic regression analysis while controlling for covariates revealed an association between asthma and symptoms of anxiety and depression (OR = 2.40 [95% CI: 1.07–5.35]) and mild cognitive impairment (MCI) (OR = 1.80 [95% CI: 1.00–3.24]). Poorly controlled asthma increased the odds of anxiety cases (OR = 4.88 [95% CI: 1.09–17.2]). Stratifying analysis by age intervals revealed that asthma was associated with symptoms of anxiety and depression (OR = 2.5 [95% CI: 1.00–6.08]) in middle-aged patients only, while elderly asthmatics had increased odds of having MCI (OR = 7.4 [95% CI: 2.34–23.31]). These findings highlight the possible effects of asthma and its control on mental health among middle-aged and elderly individuals in Saudi Arabia. [ABSTRACT FROM AUTHOR]

During the October 30, 2020 Mw7.0 Samos Earthquake, the Turkiye-Izmir-Bayrakli district was affected the most due to the geometry and the deep-soft alluvial nature of the basin, although the district is approximately 70 km away from the epicenter. In this study, the seismic response of the Bayrakli basin, and the role of the soil stratigraphy and basin geometry on the recorded amplifications and prolonging of seismic shakings are investigated by using 1-, 2- and 3-D non-linear finite element-based dynamic response analyses. The assessment results are presented in the form of spectral amplification ratios, A T . The highest A (T) values were estimated at spectral periods T = 0.85 and 1 s. They exceed five in both the east–west and the north–south directions, more pronounced in the latter one. A T was decomposed into the product of two independent amplification factors, namely rock to soil amplifications, A Soil (T) , and 1-D soil column to 3-D soil basin amplifications, A Basin (T) . A Basin (T) values for T = 0.85 and 1 s are estimated as high as 1.4 and 1.6, in the east–west and the north–south directions, respectively. These values suggest that the 3-D geometry of the Bayrakli basin amplifies the spectral accelerations by 40–60% at T = 0.85 and 1 s. The unique combination of a deep-soft alluvial site with 3-D basin geometry, and overlying 7–9 story residential buildings, consistently favors and amplifies the seismic energy in the spectral period range of 0.7–1.0 s. This multi-fold increased seismic demand, combined with poor structural design and construction details, lead to localized structural damage and over 117 life losses. [ABSTRACT FROM AUTHOR]

The prediction of the behavior of vibration isolators is essential for effective and efficient design of these devices, as well as for accurately characterizing the isolator behavior. In this work, an experimental study was performed to characterize the behavior of metal-mesh isolators. Although these elements' performance is of great interest because of their usage in several applications, their characterization is complex due to their nonlinear nature, among other factors. This study's aim was to obtain the quasi-static behavior of these isolators, although dynamic tests are required for their complete characterization. These quasi-static tests allowed for the highlighting of some characteristics in a simpler and faster manner and also provided a starting point for designing future dynamic tests. The quasi-static tests performed resulted in the calculation of the hysteresis cycle under different operating conditions and manufacturing parameters. The study of different insulator characteristics, such as the energy dissipation coefficient and stiffness, led to interesting conclusions about the isolator performance. From the results, it was observed that the relative density affected most the nonlinear behavior of the insulator. Moreover, to correctly characterize their behavior, not only the Coulomb's damping but also the viscous damping had to be considered. [ABSTRACT FROM AUTHOR]