Effect of Modafinil on functional connectivity in healthy young people using resting-state fMRI data.

BACKGROUND: Examining the differences in the Functional Connectivity (FC) network while using Functional Magnetic Resonance Imaging (fMRI) between two groups can expand the understanding of neural processes and help diagnose and prevent neurological progression disorders. The present study evaluated the Modafinil effect on the FC of brain Regions of Interest (ROI) among healthy young individuals between the Modafinil and placebo groups. METHOD: The data used in this study were downloaded from the open fMRI site and analyzed after preprocessing. Data included brain scan images of 26 healthy young men with no history of neurological disorders. These people are divided into two groups of drugs and a placebo. The drug group was given 100 mg of Modafinil, and the placebo group was assigned the same dose. Data were analyzed using a longitudinal variance component model. RESULT: After taking the drug and placebo by the two groups, the study of the difference between FC in the drug and placebo group and the baseline effect showed a statistically significant difference in one pair of ROIs. Also, in examining the difference between FC in the drug and placebo groups of the longitudinal trend, there was a statistically significant difference between 5 pairs of ROIs. CONCLUSION: After taking Modafinil and placebo, it was observed that FC in most areas in the drug group increased compared to the placebo group, indicating Modafinil has cognitive enhancement properties and has a role in visual, auditory, memory learning, and self-awareness functions and enhances these functions.

Worldwide trend analysis of primary and secondary infertility rates over past decades: A cross-sectional study.

Background: Infertility is a global health issue and is reported differently worldwide. Objective: To assess the longitudinal trends of primary and secondary infertility prevalence rate (PSIPR) per 100,000 across all countries during past decades. Materials and Methods: The PSIPR was extracted from the Global Burden of Disease database for 195 countries during 1993-2017. The longitudinal trends of PSIPR were explored across the seven epidemiological regions designated by the Global Burden of Disease. Results: Globally, the PSIPR was lower among men than women. Over time, the prevalence of primary infertility in men and women had a decreasing trend of -9.3 and -11.6 in high-income countries. Other regions have seen an increase, the highest being in South Asian women, and men of the Middle East and North Africa, with rates of change of 40.9 and 19.0, respectively. Over time, the secondary infertility prevalence in women of Central Asia, Central Europe and Eastern Europe, as well as of high-income countries, has been declining (rates of change of -16.9 and -11.7, respectively). Other regions have been on the rise, with the highest increase among women of the Middle East, North Africa, and South Asia (trend of 119.9 and 83.4, respectively), and in South Asian men (trend of 48.4). Conclusion: The overall trend of infertility prevalence shows a downward trajectory in high-income and developed countries and an upward trend in others. These findings might be explained by missed cases of infertility due to a low tendency for reproduction and the presence of more infertility treatment facilities in these regions.

Functional Brain Response to Emotional Musical Stimuli in Depression, Using INLA Approach for Approximate Bayesian Inference.

INTRODUCTION: One of the vital skills which has an impact on emotional health and well-being is the regulation of emotions. In recent years, the neural basis of this process has been considered widely. One of the powerful tools for eliciting and regulating emotion is music. The Anterior Cingulate Cortex (ACC) is part of the emotional neural circuitry involved in Major Depressive Disorder (MDD). The current study uses functional Magnetic Resonance Imaging (fMRI) to examine how neural processing of emotional musical auditory stimuli is changed within the ACC in depression. Statistical inference is conducted using a Bayesian Generalized Linear Model (GLM) approach with an Integrated Nested Laplace Approximation (INLA) algorithm. METHODS: A new proposed Bayesian approach was applied for assessing functional response to emotional musical auditory stimuli in a block design fMRI data with 105 scans of two healthy and depressed women. In this Bayesian approach, Unweighted Graph-Laplacian (UGL) prior was chosen for spatial dependency, and autoregressive (AR) (1) process was used for temporal correlation via pre-weighting residuals. Finally, the inference was conducted using the Integrated Nested Laplace Approximation (INLA) algorithm in the R-INLA package. RESULTS: The results revealed that positive music, as compared to negative music, elicits stronger activation within the ACC area in both healthy and depressed subjects. In comparing MDD and Never-Depressed (ND) individuals, a significant difference was found between MDD and ND groups in response to positive music vs negative music stimuli. The activations increase from baseline to positive stimuli and decrease from baseline to negative stimuli in ND subjects. Also, a significant decrease from baseline to positive stimuli was observed in MDD subjects, but there was no significant difference between baseline and negative stimuli. CONCLUSION: Assessing the pattern of activations within ACC in a depressed individual may be useful in retraining the ACC and improving its function, and lead to more effective therapeutic interventions.

The prevalence rate of sexual violence worldwide: a trend analysis.

BACKGROUND: The purpose of the present study is to showcase the image of Sexual Violence (SV) temporal trends through exploring differences in its prevalence rates during 1990-2017 across 195 countries and territories. METHODS: The SV prevalence rates were derived from the Global Burden of Disease (GBD) database during 1990-2017, worldwide. First, the Latent Growth Model (LGM) was employed for assessing the change in SV prevalence rate over time in Asia, Africa, Europe, North America, South America, Australia & Oceania, for men and women separately. Then, the change in SV prevalence rate over time was determined within countries with high and low Human Development Index (HDI). Finally, the Latent Growth Mixture Models (LGMM) were applied for identifying classes where countries within each class have similar trend of SV prevalence rate over time. RESULTS: The SV prevalence was higher among women than men and decreased in both genders over time across the world. The declining trend in SV prevalence against men is visible in both countries with high and low HDI, but SV prevalence against women in countries with low HDI shows an increase. The findings of LGMM identified six classes of SV prevalence trajectories. LGMM allocated Bermuda into the class with the highest decrease in SV prevalence against men, and Equatorial Guinea and Luxembourg into the class with the highest increase. Other countries had very slow declining trends. In terms of SV prevalence against women, LGMM allocated China, North Korea, and Taiwan into the class with the most increase among the countries in the world. Bermuda, Guyana, Mexico, Nigeria, and Saint Lucia were placed into the class which witnessed the largest decline and Angola, Congo, and Equatorial Guinea were ranked next. The trend in other countries was mostly decreasing. CONCLUSION: Given the high economic and social burden that SV has on victims and societies, the rate of SV in most countries does not seem to have dropped remarkably and requires special attention by relevant policymakers. The SV prevalence rate is highly heterogeneous among world countries which may be due to the definitions and tools used, and more importantly, the culture norms.

How to improve the human brucellosis surveillance system in Kurdistan Province, Iran: reduce the delay in the diagnosis time.

OBJECTIVES: Spatial information makes a crucial contribution to enhancing and monitoring the brucellosis surveillance system by facilitating the timely diagnosis and treatment of brucellosis. METHODS: An exponential scan statistic model was used to formalize the spatial distribution of the adjusted delay in the diagnosis time of brucellosis (time between onset and diagnosis of the disease) in Kurdistan Province, Iran. Logistic regression analysis was used to compare variables of interest between the clustered and non-clustered areas. RESULTS: The spatial distribution of clusters of human brucellosis cases with delayed diagnoses was not random in Kurdistan Province. The mean survival time (i.e., time between symptom onset and diagnosis) was 4.02 months for the short spatial cluster, which was centered around the city of Baneh, and was 4.21 months for spatiotemporal clusters centered around the cities of Baneh and Qorveh. Similarly, the mean survival time for the long spatial and spatiotemporal clusters was 6.56 months and 15.69 months, respectively. The spatial distribution of the cases inside and outside of clusters differed in terms of livestock vaccination, residence, sex, and occupational variables. CONCLUSIONS: The cluster pattern of brucellosis cases with delayed diagnoses indicated poor performance of the surveillance system in Kurdistan Province. Accordingly, targeted and multi-faceted approaches should be implemented to improve the brucellosis surveillance system and to reduce the number of lost days caused by delays in the diagnosis of brucellosis, which can lead to long-term and serious complications in patients.

Clustering of the Deadliest Diseases among Iranian Men from 1990 to 2016: A Growth Mixture Model Approach.

BACKGROUND: Paying attention to men's health seems quite important for a variety of reasons. We evaluated the change of mortality rates due to various causes in Iranian men over the past decades. STUDY DESIGN: A cross-sectional study. METHODS: The mortality rates for deadliest causes of diseases among Iranian men during 1990-2016 were extracted from the Global Burden of Disease (GBD) study. Latent Growth Mixture Models (LGMM) were applied to determine subgroups' cause of death. In this way, the causes within each group showed similar trends of mortality rates over time. RESULTS: The LGMM clustered causes into 4 classes. Diabetes mellitus, hypertensive heart disease and neurological disorders have had increasing trend. Causes in class 2, including diarrhea, lower respiratory and other common infectious diseases, ischemic heart disease, ischemic stroke, neonatal disorders, and other non-communicable diseases manifested a slow decreasing trend. Most causes were allocated to 3rd class with a slow increase in mortality rates over time. Finally, within the last class, transport injuries and unintentional injuries revealed a decreasing trend. CONCLUSION: Most factors have rising trend, despite the fact that some have shown a very slight downward trend. Consequently, according to the four distinguished clusters resulting from LGMM, it is essential to provide programs to attain the goal of access to prevention, treatment, and support for high-risk mortality factors.

Fitting Cure Rate Model to Breast Cancer Data of Cancer Research Center.

BACKGROUND: The Cox PH model is one of the most significant statistical models in studying survival of patients. But, in the case of patients with long-term survival, it may not be the most appropriate. In such cases, a cure rate model seems more suitable. The purpose of this study was to determine clinical factors associated with cure rate of patients with breast cancer. MATERIALS AND METHODS: In order to find factors affecting cure rate (response), a non-mixed cure rate model with negative binomial distribution for latent variable was used. Variables selected were recurrence cancer, status for HER2, estrogen receptor (ER) and progesterone receptor (PR), size of tumor, grade of cancer, stage of cancer, type of surgery, age at the diagnosis time and number of removed positive lymph nodes. All analyses were performed using PROC MCMC processes in the SAS 9.2 program. RESULTS: The mean (SD) age of patients was equal to 48.9 (11.1) months. For these patients, 1, 5 and 10-year survival rates were 95, 79 and 50 percent respectively. All of the mentioned variables were effective in cure fraction. Kaplan-Meier curve showed cure model's use competence. CONCLUSIONS: Unlike other variables, existence of ER and PR positivity will increase probability of cure in patients. In the present study, Weibull distribution was used for the purpose of analysing survival times. Model fitness with other distributions such as log-N and log-logistic and other distributions for latent variable is recommended.

The effect of in-service English education on medical professionals' language proficiency.

BACKGROUND: Despite its inevitable significance, the effect of in-service English education on medical professionals has rarely been studied longitudinally. The reason can be issues such as physicians' heavy workload, commuting problems, inappropriate class times, and inexperienced teaching staff. MATERIALS AND METHODS: A needs assessment worksheet was administered to faculty members of Shahid Beheshti University of Medical Sciences in Tehran and the responses were analyzed. A project for the promotion of faculty members' English proficiency was formulated. Then, following a placement test, 235 applicants from the university colleges and hospitals were classified into 28 homogeneous groups. After four terms of instruction, the participants' scores on the pre- and post- assessments were analyzed. RESULTS: There was significant improvement in participants' total scores on different communicative skills (P<0.001). Regarding individual skills also, they achieved meaningful gains on listening (P<0.001), writing (P = 0.038), and grammar (P<0.001), but failed to progress significantly on reading comprehension (P = 0.523). CONCLUSION: The administration of in-service education for skill-oriented courses, over a long period, can be quite encouraging and should be further strengthened. Regular instructions on each individual skill on the one hand and on their combination on the other are essential for success in such education.