The psychological toll of the COVID-19 pandemic on dental care providers in Iran: A multicenter cross-sectional study.

Background/Purpose: The COVID-19 pandemic affects social and psychological resources. Healthcare workers, especially dental personnel, are more at risk for mental issues due to anxiety, pressure, and frustration. This study assessed mental health outcomes during the COVID-19 epidemic among Iranian dental care providers, focusing on insomnia, anxiety, depression, and posttraumatic stress disorder (PTSD). Methods: In this multicenter cross-sectional survey, the Insomnia Severity Index, the Hospital Anxiety and Depression Scale, and the Global Psychotrauma Screening were masured. Six hundred thirty-eight dental care providers (dental specialists, general dentists, dental hygienists, dental assistants, and dental students) from different parts of Iran (Tehran, Shiraz, Tabriz, and Mashhad) were investigated by the stratified sampling method. The univariate analysis was incorporated as independent in binary logistic regression models to analyze the data. In this study, the significance level was set at 0.05. Results: Among all the participants, 42.8% were dental students or residents, 21.9% were general or specialist dentists, 18.7% were dental assistants, and 16.6% were nonclinicians. The prevalence of insomnia, anxiety, and depression was 31.3%, 40.8%, and 54.9%, respectively. The frequency of participants in the low, moderate, and high levels of PTSD resulting from LCA 56.6%, 33.7%, and 9.7%, respectively. Conclusions: This study found a significant frequency of mental health issues among Iranian dentists. Females, participants whose relatives have COVID-19, and those with a higher workload were more likely to develop mental health symptoms. As mental problems among dental professionals might affect the quality of patient care, diagnostic, supportive, and therapeutic interventions should be taken.

Predicting the effect of a combination drug therapy on the prostate tumor growth via an improvement of a direct radial basis function partition of unity technique for a diffuse-interface model.

Chemotherapy is usually applied to treat advanced prostate cancer that cancer cells spread outside the prostate gland. The treatment uses cytotoxic drugs to target cells that grow and divide quickly. On the other hand, the growth of such cancerous tumors depends on angiogenesis. In this paper, we numerically study a diffuse-interface model in a two-dimensional space related to the therapies of prostate cancer. The proposed model describes the tumor growth driven by a generic nutrient and producing the prostate-specific antigen. More precisely, the effect of cytotoxic chemotherapy in the model is evaluated by considering a time-dependent function in the tumor dynamics. Also, another function related to the antiangiogenic therapy is considered to show the reducing intratumoral nutrient supply in the nutrient dynamics. Here, a meshless approximation, i.e., a generalized form of the direct radial basis function partition of unity (D-RBF-PU) method is presented for finding the numerical simulations of this model utilizing in medical oncology. The method uses the lower number of trial points in each patch than the original D-RBF-PU scheme for approximating the trial function per test point. Hence, the time complexity of the method is less than the D-RBF-PU technique. Besides, a semi-implicit time discretization of order 1 has been used to deal with the time variable. Consequently, a linear system of algebraic equations could be solved iteratively per time step by the use of the biconjugate gradient stabilized method with zero-fill incomplete lower-upper preconditioner. Finally, the obtained results without using any adaptive algorithm demonstrate the response of the prostate tumor growth to the chemotherapy, antiangiogenic therapy and a combined therapy.

The numerical solution of a mathematical model of the Covid-19 pandemic utilizing a meshless local discrete Galerkin method.

It was in early December 2019 that the terrible news of the outbreak of new coronavirus disease (Covid-19) was reported by the world media, which appeared in Wuhan, China, and is rapidly spreading to other parts of China and several overseas countries. In the field of infectious diseases, modeling, evaluating, and predicting the rate of disease transmission are very important for epidemic prevention and control. Several preliminary mathematical models for Covid-19 are formulated by various international study groups. In this article, the SEIHR(D) compartmental model is proposed to study this epidemic and the factors affecting it, including vaccination. The proposed model can be used to compute the trajectory of the spread of the disease in different countries. Most importantly, it can be used to predict the impact of different inhibition strategies on the development of Covid-19. A computational approach is applied to solve the offered model utilizing the Galerkin method based on the moving least squares approximation constructed on a set of scattered points as a locally weighted least square polynomial fitting. As the method does not need any background meshes, its algorithm can be easily implemented on computers. Finally, illustrative examples clearly show the reliability and efficiency of the new technique and the obtained results are in good agreement with the known facts about the Covid-19 pandemic.

Verbal and oral apraxia in patients with acute stroke: Frequency, relationship, and some risk factors.

Verbal and oral apraxia are two possible consequences of stroke. It seems that there are not sufficient studies regarding the frequency of these disorders. This study aimed to evaluate the frequency of Verbal and oral apraxia. In addition, the relationship between apraxia and some variables such as age, gender, and education, as well as the relationship between types of apraxia with each other, and damaged areas of the brain in apraxia of the oral system in Persian-speaking patients with stroke were studied. In this descriptive-analytical study, 42 patients participated using the convenient sampling method. Verbal and oral apraxia were assessed using the oral and verbal apraxia tasks for adults test. Data were analyzed using independent t-test, Chi-square, and Fisher's exact test. The frequency of patients with oral apraxia was 35.7%, those with verbal apraxia was 2.3%, and the combination of both verbal and oral apraxia was 4.7%. People with apraxia were significantly older than those without apraxia. There was not any significant relationship between apraxia and gender, apraxia and education, and oral apraxia with verbal apraxia (p < 0.05). The present study's findings showed the high frequency of post-stroke apraxia and the high rate of its incidence with age.

Translation, Validity, and Reliability of the Persian Version of the Aging Voice Index.

OBJECTIVES: The Aging Voice Index (AVI) was developed to study quality of life in older adults with voice disorders. The purpose of this study was to translate the original English version of the AVI to Persian version of Aging Voice Index (P-AVI) and validate the P-AVI for the Persian-speaking older adults with voice disorders. METHODS: A cross-sectional, descriptive, and methodological study was performed to translate and validate the Persian version of the AVI. The translation was performed in accordance with recommendations from the World Health Organization. Eighty-five treatment-seeking patients with voice disorders and 20 older adults without voice complaints were recruited for this study. Psychometric properties were investigated, including: different types of validity (content validity, construct validity, and criterion-related validity), reliability (test-retest and internal consistency), and item analysis of the Persian version of AVI. The relationship between total score of P-AVI and age, sex, and voice pathology were determined using multiple linear regression. RESULTS: A panel of three speech pathologists performed the content validity of the P-AVI and reached agreement on all of the items. Construct validity was confirmed by a significant difference in the mean of total score of the P-AVI was identified between the particiapnts with voice disorders and those with no voice complaints (P < 0.001). There was high correlation between the total scores of the participants in the Persian version of the AVI and the Persian version of the voice-related quality of life (r = 0.86, P < 0.001). All reliability measures were found to be good with scores higher than 0.8. To assess the need for item reduction, a Cronbach's alpha coefficient remained constant with the elimination of each item; therefore, all no items were removed. Age and voice pathology were not predictive for the total P-AVI score, but a weak effect was identified for sex and the total score of P-AVI (F = 18.75, P < 0.001) with an R2 of 0.21. CONCLUSIONS: The Persian version of AVI is a valid and reliable questionnaire designed specifically for older adults that speech-language pathologists and otolaryngologists can use to objectively assess the impact of voice disorders in aging Persian-speaking patients.

Generalized moving least squares approximation for the solution of local and non-local models of cancer cell invasion of tissue under the effect of adhesion in one- and two-dimensional spaces.

The main aim of this study is to solve numerically the mathematical models showing cancer cell invasion of tissue with/without considering the effect of cell-cell and cell-matrix adhesion. The mathematical models studied here are the systems of time-dependent reaction-diffusion-taxis equations in one- and two-dimensional spaces, which are formulated in the local and non-local forms. There are some difficulties in finding their solutions via numerical methods. The main difficulty is to compute the non-local term appearing in one of the studied models, which causes more CPU time during simulations. The current paper aims to overcome this problem, where a new meshless method, namely generalized moving least squares (GMLS) approximation in space and a semi-implicit backward differential formula of first-order (SBDF1) in time have been applied. Based on GMLS theory, the non-local term is approximated without any difficulties. Moreover, a simple method based on the GMLS technique is presented to implement the boundary conditions. The obtained discrete scheme for both mathematical models is a linear system of algebraic equations per time step. The biconjugate gradient stabilized (BiCGSTAB) algorithm with zero-fill incomplete lower-upper (ILU) preconditioner is used to solve the obtained linear system at each time step. At the end of this paper, some simulation results are reported to show the behavior of cancer cell invasion in the local model, and the non-local model due to reduction of cell-cell adhesion and increasing cell-matrix adhesion in one- and two-dimensional spaces, where two different types of distribution points have been considered in the square domain. The computational algorithms of the GMLS approximation and the developed numerical method for solving the non-local (local) model are included in the Appendix.

Radial basis function-generated finite difference scheme for simulating the brain cancer growth model under radiotherapy in various types of computational domains.

BACKGROUND AND OBJECTIVES: We extend the original mathematical model, i.e., Swanson's reaction-diffusion equation to the surfaces with no boundary, and we find a new numerical method based on a meshless approach for solving numerically Swanson's reaction-diffusion model in the square and on the sphere. METHODS: To solve numerically the Swanson's reaction-diffusion model and its extension version, a collocation meshless technique, namely radial basis function-generated finite difference (RBF-FD) scheme is employed for approximating the spatial variables in the square domain and on the sphere, respectively. Also, to approximate the time variable of the studied models, a first-order semi-implicit backward Euler scheme is used. The resulting fully discrete scheme is a linear system of algebraic equations per time step that is solved via the biconjugate gradient stabilized (BiCGSTAB) iterative algorithm with a zero-fill incomplete lower-upper (ILU) preconditioner. RESULTS: The numerical simulations show the growth of untreated and treated brain tumors with radiotherapy using estimated and clinical data (given from magnetic resonance imaging (MRI) scans of patients). Moreover, the results reported here can be used for improving the treatment strategies of the invasive brain tumor. CONCLUSIONS: Using the developed numerical scheme in this paper, we can simulate the behavior of the invasive form of brain tumor response to radiotherapy. Also, we can see the effects of radiation response on the brain tumor cell concentration of individual patients. The proposed meshless technique, which is applied for solving numerically the studied model, does not depend on any background mesh or triangulation for approximation in comparison with mesh-dependent methods. Moreover, we apply this technique to the sphere via any set of distributed points easily.

Effects of Rheumatoid Arthritis on the Larynx.

INTRODUCTION: The aim of the present study was to compare the videolaryngostroboscopic findings between patients with rheumatoid arthritis and vocally healthy controls. MATERIALS AND METHODS: This case-control descriptive study was performed on 113 people, including 50 patients with rheumatoid arthritis and 63 controls. The participants were subjected to videolaryngostroboscopic examinations in order to evaluate fundamental frequency, different structural vocal lesions, patterns of glottal closure, subglottal changes, supraglottis appearance, and movement patterns of the arytenoid cartilage. The obtained results were compared between the two research groups. Data analysis was performed in the Statistical Package for the Social Sciences, version 24.0. A p-value less than 0.05 was considered statistically significant. RESULTS: The results revealed a statistically significant difference between the two groups in terms of the complete pattern (P=0.00) and strained state of glottal closure (P=0.00), pattern of subglottal changes (χ2=25.98, df=2; P<0.001), and movement patterns of the arytenoid (χ2=21.16, df=1; P<0.001). Additionally, based on the obtained frequencies, the two groups showed significant differences regarding the normal state of the larynx (P=0.00), hypertrophy of vocal fold (P=0.007), epithelial change (P=0.007), and Reinke's edema (P=0.001). However, the videolaryngostroboscopic examination results revealed no significant difference between the two groups in terms of polyp (P=0.20), nodule (P=0.57), sulcus vocalis (P=0.08), cyst (P=0.45), and atrophy of vocal folds (P=0.45). CONCLUSION: It seems that rheumatoid arthritis affects the patterns of arytenoids movement, some kinds of glottal closure patterns, and subglottal changes. As the results indicated, the occurrence of some laryngeal structural changes was higher in patients with rheumatoid arthritis than in individuals without this disorder.

Speech and language development of children born following assisted reproductive technologies.

OBJECTIVES: Studies which targeted communication skills of children born following assisted reproductive technologies have reported contradictory results. Concerning the increasing rates of children born in these technologies and the importance of some factors as risk factors like birth weight, gestational age, and the number of children per birth in these procedures, studying speech and language skills is critical. So, the current study aimed to investigate the speech and language capabilities of Persian speaking children born following these procedures. METHODS: A descriptive and cross-sectional study was carried out in Babol city in 2016-2017 to investigate the receptive and expressive language and speech of Persian speaking children born in assisted reproductive technologies in the age range of 6-72 months. Parents of 78 children completed the Newsha Developmental Scale to assess language and speech skills. Then, the language and speech performance of the participants were compared in terms of gestational age, birth weight, number of children per birth, and sex in the current research and they are categorized as normal or having delay in language and speech development. RESULTS: The participants had statistically significant difference for the receptive language in terms of gestational age (χ2 (1) = 5.76, p = 0.01) and birth weight (χ2 (1) = 8.22, p = 0.004) but in terms of the number of children per birth (χ2 (1) = 7.11, p = 0.009) and sex (χ2 (1) = 0.037, p = 0.84) did not have statistically significant difference. The children did not show significant difference for the expressive language in terms of gestational age (χ2 (1) = 1.09, p = 0.29), birth weight (χ2 (1) = 0.34, p = 0.55), the number of children per birth (χ2 (1) = 1.58, p = 0.2), and sex (χ2 (1) = 0.037, p = 0.84). The participants of the present study did not have statistically significant difference in speech in terms of gestational age (χ2 (1) = 2.82, p = 0.09), the number of children per birth (χ2 (1) = 3.57, p = 0.06), and sex (χ2 (1) = 0.06, p = 0.79). They had significant difference in speech only in terms of birth weight (χ2 (1) = 4.13, p = 0.04). CONCLUSION: Based on the results of the administration of the Newsha Developmental Scale as a screening tool, it seems that some factors like sex and number of children per birth do not affect speech and language performance of children born following ART. Another factor including gestational age and birth weight had effects on some domains. It is essential to design longitudinal studies to follow the speech and language performance of this population.

A multilevel Monte Carlo finite element method for the stochastic Cahn-Hilliard-Cook equation.

In this paper, we employ the multilevel Monte Carlo finite element method to solve the stochastic Cahn-Hilliard-Cook equation. The Ciarlet-Raviart mixed finite element method is applied to solve the fourth-order equation. In order to estimate the mild solution, we use finite elements for space discretization and the semi-implicit Euler-Maruyama method in time. For the stochastic scheme, we use the multilevel method to decrease the computational cost (compared to the Monte Carlo method). We implement the method to solve three specific numerical examples (both two- and three dimensional) and study the effect of different noise measures.

A comprehensive survey of energy-aware routing protocols in wireless body area sensor networks.

Wireless body area sensor network is a special purpose wireless sensor network that, employing wireless sensor nodes in, on, or around the human body, makes it possible to measure biological parameters of a person for specific applications. One of the most fundamental concerns in wireless body sensor networks is accurate routing in order to send data promptly and properly, and therefore overcome some of the challenges. Routing protocols for such networks are affected by a large number of factors including energy, topology, temperature, posture, the radio range of sensors, and appropriate quality of service in sensor nodes. Since energy is highly important in wireless body area sensor networks, and increasing the network lifetime results in benefiting greatly from sensor capabilities, improving routing performance with reduced energy consumption presents a major challenge. This paper aims to study wireless body area sensor networks and the related routing methods. It also presents a thorough, comprehensive review of routing methods in wireless body area sensor networks from the perspective of energy. Furthermore, different routing methods affecting the parameter of energy will be classified and compared according to their advantages and disadvantages. In this paper, fundamental concepts of wireless body area sensor networks are provided, and then the advantages and disadvantages of these networks are investigated. Since one of the most fundamental issues in wireless body sensor networks is to perform routing so as to transmit data precisely and promptly, we discuss the same issue. As a result, we propose a classification of the available relevant literature with respect to the key challenge of energy in the routing process. With this end in view, all important papers published between 2000 and 2015 are classified under eight categories including 'Mobility-Aware', 'Thermal-Aware', 'Restriction of Location and Number of Relays', 'Link-aware', 'Cluster- and Tree-Based', 'Cross-Layer', 'Opportunistic', and 'Medium Access Control'. We, then, provide a full description of the statistical analysis of each category in relation to all papers, current hybrid protocols, and the type of simulators used in each paper. Next, we analyze the distribution of papers in each category during various years. Moreover, for each category, the advantages and disadvantages as well as the number of issued papers in different years are given. We also analyze the type of layer and deployment of mathematical models or algorithmic techniques in each category. Finally, after introducing certain important protocols for each category, the goals, advantages, and disadvantages of the protocols are discussed and compared with each other.

Learning Stationary Correlated Equilibria in Constrained General-Sum Stochastic Games.

We study constrained general-sum stochastic games with unknown Markovian dynamics. A distributed constrained no-regret Q -learning scheme (CNR Q ) is presented to guarantee convergence to the set of stationary correlated equilibria of the game. Prior art addresses the unconstrained case only, is structured with nested control loops, and has no convergence result. CNR Q is cast as a single-loop three-timescale asynchronous stochastic approximation algorithm with set-valued update increments. A rigorous convergence analysis with differential inclusion arguments is given which draws on recent extensions of the theory of stochastic approximation to the case of asynchronous recursive inclusions with set-valued mean fields. Numerical results are given for the exemplary application of CNR Q to decentralized resource control in heterogeneous wireless networks.

Candida laryngitis appearing as carcinoma.

BACKGROUND: Focal laryngeal candidiasis is not reported widely and is very infrequently recognized clinically. This disease is rare and may occur after pulmonary, pharyngeal and esophageal candidiasis or as part of disseminated disease. It is also secondary to inhaled steroid therapy which is usually mild and has been reported in 10-15 percent of patients taking these medications. CASE PRESENTATION: In this study, we introduced a rare case of laryngeal candidiasis in a 79-year-old immunocompromised male presented with 17 months of progressive hoarseness. In video laryngoscopy a white, vegetative mass on anterior one-third of right vocal cord mimicking laryngeal carcinoma. The histopathological examination showed laryngeal mucosal with keratosis, degenerating necrotic epithelial cell aggregates containing hyphea and candida albicans. CONCLUSION: In immunocompromised patients, the diagnosis of laryngeal candidiasis should be considered in any patients with laryngeal symptoms.

Etiologies of Dysphonia in Patients Referred to ENT Clinics Based on Videolaryngoscopy.

INTRODUCTION: Laryngeal dysfunction may be divided into three categories; organic, neurologic and functional disorders. Dysphonia and hoarseness are the most common symptoms and, in some cases, the only signs of laryngeal dysfunction. In differential diagnosis of any type of chronic hoarseness, a neoplastic process must be considered and, thus continuous light video laryngoscopy can provide important information on the presence of neoplastic lesions in order to prevent disease progression via early detection and action. MATERIALS AND METHODS: This cross-sectional, descriptive-analytical study was carried out on 197 patients with voice disorders admitted to Ayatollah Rouhani Hospital for video laryngoscopy. Available sampling was used and the results achieved were analyzed using SPSS17 statistical software. RESULTS: A total of 197 patients (mean age, 40.72 ±15.17 years) participated in this study, 56.9% of whom were male. From analysis of video laryngoscopy, organic dysphonia was found to be the most common cause of voice disorders, while functional and neurologic dysphonia were observed in 8.6% and 5.6% of patients, respectively. Vocal nodules and Reinke's edema were among the most common causes of organic dysphonia, with a frequency of 24.4% and 23.4%, respectively; while laryngeal carcinoma accounted for 2.5% of all diagnosed cases with organic causes. CONCLUSION: Since the presence of voice disorders for more than 3 weeks can be a sign of laryngeal dysfunction, early diagnosis using noninvasive methods such as video laryngoscopy and appropriate medical measures can help prevent the disease progression and eliminate the need for actions such as laryngectomy.

Monitoring of cytomegalovirus reactivation in bone marrow transplant recipients by real-time PCR.

Cytomegalovirus (CMV) has been recognized as the most important viral pathogen in persons undergoing bone marrow transplantation (BMT). The aim was to develop a quantitative PCR assay to quantify CMV DNA in peripheral blood leukocytes (PBLs) of bone marrow transplantation (BMT) patients. An in-house real-time PCR assay based on TaqMan technology was developed to monitor the quantity of CMV DNA in PBLs of the BMT recipients. Sequential blood samples (415 specimens) were collected from 43 patients as weekly intervals until day 100 after transplantation. The CMV DNA was quantified in parallel with the pp65 antigenemia assay in PBL samples. Viral reactivation occurred in 51% and 41.8% of the recipients as detected by RQ-PCR and antigenemia assays respectively. There was a significant correlation between both assays (P < 0.0001); however, the RQ-PCR was more sensitive than the antigenemia. CMV DNA was detected by the RQ-PCR by a median of 14 days earlier than the antigenemia. Preemptive therapy was implemented in the antigenemia positive cases. The administration of ganciclovir led to a rapid decrease in the viral load. After preemptive therapy, the antigenemia achieved a negative result earlier than the RQ-PCR assay (a median of 17.5 days). An increase of viral load in both quantitative assays and of cyclosporine serum level were identified as the most significant risk factors for CMV reactivation. The quantitative CMV PCR might be a useful tool for monitoring the CMV reactivation and guiding the efficacy of the CMV preemptive therapy in BMT recipients.