Background: Cubital tunnel release (CuTR) relieves ulnar nerve compression; however, about 35% of patients who undergo this procedure develop persistent neuropathy and about 7% require revision. Type 2 diabetes mellitus (T2DM) worsens ulnar neuropathy, whereas glucagon-like peptide-1 receptor agonists (GLP-1 RAs) may be neuroprotective. We compared short- (90-day) and mid-term (2-year) CuTR outcomes in diabetic patients who did or did not receive perioperative GLP-1 RA treatment. Methods: TriNetX identified adults (≥18 years) with T2DM who underwent primary CuTR during the period 2015–2023, and who underwent at least 2 years of follow-up. The experimental cohort had received an active GLP-1 RA prescription at surgery, while the controls had not. Exclusion criteria were T1DM, pancreatitis, multiple endocrine neoplasia 2, systemic steroids, end-stage renal disease, or prior major CuTR. Propensity-score matching (1:1) balanced demographics, body mass index, glycated hemoglobin (HbA1c), creatinine, and comorbidities. Outcomes were captured using International Classification of Diseases, 10th Revision, Clinical Modification (ICD-10-CM) and Current Procedural Terminology (CPT) codes. Results: After matching, 1,766 pairs of patients (mean age, 58 years; 46% female) were analyzed. At 90 days, fewer GLP-1 RA users had emergency-department visits than non-users (8.9% vs. 10.7%, P=0.048). Despite higher HbA1c at each timepoint, GLP-1 RA users showed a larger decline. At 2 years, GLP-1 RA exposure was associated with fewer reoperations (5.2% vs. 6.9%, P=0.028), less frequent neuropathy (23.4% vs. 30.4%, P<0.001), and fewer inpatient admissions (14.6% vs. 17.2%, P=0.030). Major medical complications did not differ in occurrence between the groups. Conclusions Perioperative GLP-1 RA therapy in diabetic patients undergoing CuTR correlated with fewer 90-day emergency visits and lower 2-year risks of revisional surgery and ICD-coded ulnar neuropathy (all-cause, non-adjudicated).. These findings support a potential protective role of GLP-1 RAs in this surgical population. Evidence: III.

Purpose::Road traffic accidents pose a global challenge with substantial human and economic costs. Iran experiences a high incidence of road traffic injuries, leading to a significant burden on society. This study aims to predict the future burden of road traffic injuries in Iran until 2030, providing valuable insights for policy-making and interventions to improve road safety and reduce the associated human and economic costs.Methods::This analytical study utilized time series models, specifically autoregressive integrated moving average (ARIMA) and artificial neural networks (ANNs), to predict the burden of road traffic accidents by analyzing past data to identify patterns and trends in Iran until 2030. The required data related to prevalence, death, and disability-adjusted life years (DALYs) rates were collected from the Institute for Health Metrics and Evaluation database and analyzed using R software and relevant modeling and statistical analysis packages.Results::Both prediction models, ARIMA and ANNs indicate that the prevalence rates (per 100,000) of all road traffic injuries, except for motorcyclist road injuries which have an almost flat trend, remaining at around 430, increase by 2030. Based on estimations of both models, the rates of death and DALYs due to motor vehicle and pedestrian road traffic injuries decrease. For motor vehicle road injuries, estimated trends decrease to approximately 520 DALYs and 10 deaths. Also, for pedestrian road injuries these rates reached approximately 300 DALYs and 6 deaths, according to the models. For cyclists and other road traffic injuries, the predicted DALY rates by the ANN model increase to almost 50 and 8, while predictions conducted by the ARIMA model show a static trend, remaining at 40 and approximately 6.5. Moreover, these rates for the prediction of death rate by the ANN model increased to 0.6 and 0.1, while predictions conducted by the ARIMA model show a static trend, remaining at 0.43 and 0.07. According to the ANN model, the predicted rates of DALY and death for motorcyclists decrease to 100 and approximately 2.7, respectively. On the other hand, predictions made by the ARIMA model show a static trend, with rates remaining at 200 and approximately 3.2, respectively.Conclusion::The prevalence of road traffic injuries is predicted to increase, while the death and DALY rates of road traffic injuries show different patterns. Effective intervention programs and safety measures are necessary to prevent and reduce road traffic accidents. Different interventions should be designed and implemented specifically for different groups of pedestrians, cyclists, motorcyclists, and motor vehicle drivers.

SITUATIONAL ANALYSIS OF GENERAL PRACTITIONERS USING A FORECASTING APPROACH UNTIL 2025 AND A MULTI-STATE MARKOV MODEL: A RETROSPECTIVE LONGITUDINAL STUDY ntroduction: Undesirable working conditions, insufficient professional development and other labour market pressures have significantly impacted the status of general practitioners (GPs). This study aimed to conduct a situational analysis of GPs in Iran using a forecasting approach until 2025. Methods: Data were collected concurrently through direct contact, data matching among databases and tracking among graduates from four clusters of medical science universities over the past decade. This retrospective longitudinal study determined the status of GPs over consecutive years. Multi-state Markov and binary logistic regression analyses were performed using R and Stata 14. Results: Of 430 graduates over the past decade, 94% were successfully identified. Only 20% of the graduates remained active as GPs. The greatest fluctuations in transfer occurred in the third year after graduation, with the remaining proportion of GPs dropping to less than 50%. The probability of remaining as GPs was 0.76 per year, while the highest transition was observed towards specialisation (0.12). Additionally, 2% of the GPs chose not to work, and less than 1% transitioned to a different specialty. Based on the transfer matrix for 2025, only 19% of the GPs were projected to remain, with the majority (59%) transitioning to specialisation. Conclusion: The transfer probability varies across different years, indicating higher flow rates among GPs. However, only a limited number of GPs are projected to remain until 2025. A comprehensive set of interventions should be considered, spanning the pre-medical stage, during education and after graduation, to mitigate the factors contributing to GPs leaving their profession.

Organoids ; Biomedical Research

MONITORING, VIDEO AND AUDIO RECORDING CLASSROOMS BY CCTV CAMERAS: IRANIAN EFL STUDENTS’ PERCEPTIONS Abstract Nowadays our way of working and studying are becoming more and more cyber. So, we can’t turn a blind to the fact that technology is already affecting our educational system. Abundant gadgets and equipment are being applied to schools, universities, and institutes for many specific reasons. One of which is installing cameras in classrooms. In Iran, some of the English language teaching institutes have installed cameras in their classrooms to monitor (and evaluate) teachers’ and students’ actions and performances. Some issues such as: whether both teachers and students are informed about the presence of cameras, the purposes behind installing cameras in classes, recording and monitoring classroom activities, and other aspects of equipping a classroom with cameras are not known clearly. The present study aimed to explore the perceptions and feedbacks of Iranian EFL students on video-recording and monitoring English language classrooms via CCTV cameras. In this study an attempt was made to find more about EFL students’ beliefs and feedbacks on monitoring, video and audio recording classrooms by CCTV cameras in language institutes in Iran. The researcher himself designed a questionnaire having four different sections to gather students’ feedbacks. The student participants (N=57) were supposed to answer the questionnaire via online google forms. The findings of the study revealed that students believed and claimed that there exist differences between camera-equipped classrooms and those that are not camera-equipped. ASEAN Journal of Psychiatry, Vol. 24 S(Advancements in psychology and mental health), July-August 2023; 1-5.

Anxiety problems are common disorders in children and later ages. People with anxiety disorders need to be treated by psychological methods. The aim of the present study was to determine the effectivness of Mindfulness-Based Cognitive Therapy (MBCT) on self-esteem, self-concept, and social anxiety of people with social anxiety disorder. The participants in this study were 30 individuals with social anxiety disorder who referred to counseling and psychotherapy centers in Shiraz during April to July 2021 (experimental group: 15, control group: 15). The experimental group received 8 sessions of MBCT training, once a week for 120 minutes over 56 days and the control group received no interventions. Results of covariance analysis for the effect of MBCT treatment on self-esteem (F=32, P=0.001), self-concept (F=38, P=0.001), and social anxiety (F=48, P=0.001) showed a significant difference between the experimental and control groups. Results of the present study showed that MBSR therapy could be useful in patients by increasing their self-esteem and self-concept and also reducing social anxiety.

Anxiety problems are common disorders in children that reported as a risk factor for depression and substance abuse in later ages. Children with anxiety disorders in adolescence need to be treated by psychological methods. Therefore, the purpose of the present study was to investigate the role of the narrative therapy on the cognitive avoidance and meta-cognitive beliefs among the female adolescent students in Kazerun, Iran. Research method was quasi experimental with pre-test and post-test with experimental and control groups. The present research was performed on 36 adolescent, who were referred to psychological centres and were selected by cluster sampling method. The research tools included cognitive avoidance questionnaire and meta-cognitive beliefs questionnaire. The narrative therapy program was performed for the experimental group in eight sessions. The results showed a significant difference between treated and untreated groups for the cognitive avoidance (F=7.1, P=0.04), but this difference for meta-cognitive beliefs variable was insignificant (F=0.58, P=0.45). According to this finding, we conclude that narrative therapy could be an appropriate method for reducing treatment of social anxiety according to cognitive avoidance.

OBJECTIVE: This study aimed to investigate the effects of Montanide ISA-720 and Naloxone (NLX) in Hepatitis B surface antigen (HBsAg) vaccine formulation on cytokine and long-lasting antibody responses. METHODS: First, the HBsAg was formulated in Montanide ISA-720 adjuvant and Naloxone at 5 and 10 mg/kg. The experimental mice were immunized three times at a 2-week interval, and then IL-4, IL-2, TNF-α, and IFN-γ cytokines; long-lasting IgG antibody responses 220 days after the last shot; and IgG1/IgG2a isotypes were assessed by ELISA. RESULTS: The HBsAg-Alum group exhibited the highest IL-4 cytokine response among the experimental groups, whereas NLX in HBsAg-MON720 vaccine formulation did not affect cytokine responses. In addition, NLX in Alum-based vaccine suppressed IL-4 cytokine response and increased the IL-2/IL-4 cytokine ratio. Moreover, HBsAg-MON720 was more potent than HBsAg-Alum in the induction of antibody responses, and NLX in Alum- and MON720-based vaccines induced long-lasting antibody responses. CONCLUSION NLX in Alum-based vaccine decreased IL-4 cytokine response, increased IL-2/IL-4 cytokine ratio, and improved long-lasting humoral immune responses in both vaccine formulations. Therefore, the adjuvant activity of NLX in the vaccine formulation depends on the type of adjuvant and the nature of the antigen in the vaccine formulation.
Adjuvants, Immunologic/pharmacology* ; Alum Compounds ; Animals ; Cytokines ; Hepatitis B Surface Antigens ; Hepatitis B Vaccines ; Immunity, Humoral ; Immunoglobulin G ; Interleukin-2 ; Interleukin-4 ; Mice ; Mice, Inbred BALB C ; Mineral Oil ; Naloxone/pharmacology* ; Tumor Necrosis Factor-alpha

Objectives: Household overcrowding (HC) can contribute to both physical and mental disorders among the members of overcrowded households. This study aimed to measure the status of HC and its main determinants across the provinces of Iran. Methods: Data from 39 864 households from the 2016 Iranian Household Income and Expenditures Survey were used in this study. The Equivalized Crowding Index (ECI) and HC index were applied to measure the overcrowding of households. Regression models were estimated to show the relationships between different variables and the ECI. Results: The overall, urban, and rural prevalence of HC was 8.2%, 6.3%, and 10.1%, respectively. The highest prevalence of HC was found in Sistan and Baluchestan Province (28.7%), while the lowest was found in Guilan Province (1.8%). The number of men in the household, rural residency, the average age of household members, yearly income, and the household wealth index were identified as the main determinants of the ECI and HC. Conclusions The study demonstrated that the ECI and HC were higher in regions near the borders of Iran than in other regions. Therefore, health promotion and empowerment strategies are required to avoid the negative consequences of HC, and screening programs are needed to identify at-risk families.

Mycobacterium tuberculosis has infected more than two billion individuals worldwide, of whom 5%–10% have clinically active disease and 90%–95% remain in the latent stage with a reservoir of viable bacteria in the macrophages for extended periods of time. The tubercle bacilli at this stage are usually called dormant, non-viable, and/or non-culturable microorganisms. The patients with latent bacilli will not have clinical pictures and are not infectious. The infections in about 2%–23% of the patients with latent status become reactivated for various reasons such as cancer, human immunodeficiency virus infection, diabetes, and/or aging. Many studies have examined the mechanisms involved in the latent state of Mycobacterium and showed that latency modified the expression of many genes. Therefore, several mechanisms will change in this bacterium. Hence, this study aimed to briefly examine the genes involved in the latent state as well as the changes that are caused by Mycobacterium tuberculosis. The study also evaluated the relationship between the functions of these genes.