Iranian Journal of Public Health

Annual Output of “Iranian Journal of Public Health” from 2021-2024

2025-02-08T13:11:42+0330

No Abstract. Not abstract.

Assessing the Impact of Multidisciplinary Team (MDT) Care on Patients with Liver Cancer/Cirrhosis: A Systematic Review and Meta-Analysis

2025-02-08T17:48:08+0330

Background: Liver cancer and cirrhosis are significant public health challenges with a high global burden. Multidisciplinary Team (MDT) care has gained recognition as a promising approach to improve the management and outcomes of patients with liver cancer and cirrhosis. We aimed to evaluate the effectiveness of MDT care in improving the clinical outcomes, including survival rates, quality of life, and disease progression, in patients with liver cancer and cirrhosis.
Methods: The search was performed using the keywords of liver cancer and MDT and their combinations in international databases with a time limit for publishing articles from 2010 and 2023. The data were evaluated using a technique of meta-analysis as well as a model called random effects. The I2 test was used to examine the degree of heterogeneity between the studies. STATA was used to analyze the data.
Results: The analysis of 13 different papers with a total sample size of 8641 individuals revealed that the average scores of the MDT and liver cancer were identical to (0.64), with a confidence interval ranging from (95% 48.5-81.7).
Conclusion: MDT is effective in the length of treatment and reduction of risk and mortality rates. The negative prognostic factors of not following the MDT decision were not observed.

The Effect of Taekwondo on Depression: A Meta-Analysis

2025-02-08T17:48:08+0330

Background: Depression is a prevalent mental health disorder with adverse effects on both physical and psychological health. Taekwondo is posited to exert a positive influence on depression, yet its efficacy warrants further verification.
Methods: This study employed meta-analysis to quantify the intervention effect of Taekwondo on depression. Concurrently, based on subgroup analysis results, an optimal intervention program was suggested. Multiple databases were searched, including English (Web of Science, PubMed), Chinese (CNKI, WANFANG DATA), and Korean (RISS, KISS, DBPIA), to retrieve randomized controlled trials (RCTs) studying Taekwondo's impact on depression, published up to Jan 2024. The Cochrane bias risk tool version 2 (RoB 2.0) was utilized for literature bias risk assessment. Comprehensive Meta-Analysis software facilitated the meta-analysis, subgroup analysis, and publication bias evaluation.
Results: Fifteen articles, encompassing 1945 participants, were included in the study. The primary findings indicated a significant reduction in depression risk due to Taekwondo intervention (Effect Size [ES]=-0.635, P<0.001). Subgroup analysis revealed the most substantial intervention effects in elderly individuals (ES=-1.025, P=0.004) and women (ES=-1.114, P=0.009). Taekwondo exercises, when conducted over 12 wk (ES=-0.922, P<0.001), three times per week (ES=-0.729, P<0.001), for 60 min per session (ES=-0.980, P=0.003), and at low intensity (ES= -1.777, P=0.024), yielded the greatest depression mitigation effects.
Conclusion: Taekwondo is an effective means to alleviate depression, particularly in older women. The study recommends a low-intensity Taekwondo exercise regimen, consisting of 60-minute sessions, three times weekly for 12 wk, as an optimal exercise prescription for best outcomes.

The Updated Trend of Association between Dental Caries and Stunting in All Age Groups: A Systematic Review

2025-02-08T17:48:09+0330

Background: Stunting has a negative impact on the growth and development of children, which include their susceptibility to dental caries. Caries in primary teeth have been consistently related to malnutrition. Having a history of severe caries was connected with slower childhood growth. We aimed to explain the updated trend of association between stunting and dental caries among all age groups.
Methods: A review was done using PRISMA. PubMed and Science Direct was used as database from Jan 2022 to Jan 2023. Studies obtained using specific keywords was 1.748 then filtered. All of the studies that were obtained using specific keywords about stunting and DMFT and or PUFA index. There is no limited year in this systematic search. Endnote software was used to help with the inclusion process; data was extracted into a table that had been prepared.
Results: There were 10 included studies in this systematic review. Eight studies that reported higher dental caries in stunting children than the normal children. Two studies showed a connection between developing stunting malnutrition and severe dental caries. Early childhood caries may increase vulnerability to dental caries by causing odontogenesis to fail, delayed tooth eruption and changes in the salivary glands. Children's ability to eat and sleep may be negatively impacted by untreated caries pain. It might result in decreased nutrient intake and poor appetite, while sleep disturbances might prevent growth hormones from being secreted.
Conclusion: There was a correlation between dental caries and growth stunting because of a decrease in the composition of saliva and defects in tooth formation in children suffered stunting. Thus, there were oral functional limitations and a decrease in food intake since severe dental caries.

The Effect of Intermittent Fasting Combined with Ad Libitum Days on Adults’ Elevated Blood Pressure: A Systematic Review of Human Studies

2025-02-08T17:48:09+0330

Background: Diets utilizing intermittent fasting as an alternative method to promote weight loss have grown in popularity. However, the efficacy of intermittent among elevated blood pressure remains unclear. This review systematically analyses studies investigating the effects of intermittent variations among elevated blood pressure on changes in systolic blood pressure and diastolic blood pressure. Changes in body weight, body mass index, waist circumference, and energy intake were assessed as a secondary objective.
Methods: The American Search Elite, CINAHL, Cochrane, MEDLINE, ProQuest, PubMed, Scopus, and grey literature databases were searched for articles investigating intermittent fasting with ad libitum among adults with elevated blood pressure from Jan 2010 to Jun 2022.
Results: Twelve studies met the eligibility criteria. Systolic and diastolic blood pressure generally decreased, between -2.0 to -0.04 mmHg and -3 to -0.01 mmHg, respectively. The body weight and body mass index reduced significantly (-2.85 to -0.09 kg and -1.05 to -0.03 kg/m², respectively). The review found a waist circumference reduction of -0.67 to -0.21 cm and an energy intake reduction of -263.89 to -2.58 kcal.
Conclusion: Intermittent fasting reduces systolic and diastolic blood pressure in 2-24 wk while decreasing body weight, body mass index, and energy intake. However, needs 48 wk to reduce waist circumference. This implies that it is critical to perform intermittent fasting on elevated blood pressure before the development of high blood pressure as part of a program to prevent hypertension in adults.

Clinical Application Effect of Postoperative Nursing Intervention on Patients Undergoing Transurethral Prostatectomy: A Systematic Review and Meta-Analysis

2025-02-08T17:48:09+0330

Background: To study the clinical effect of postoperative nursing on patients undergoing transurethral resection of the prostate (TURP).
Methods: The relevant researches about nursing intervention effect evaluation after TURP during January 2000 to May 2024 were selected from databases. These were sorted into an intervention group (Int group) and a control group (Ctrl group) with different nursing methods. Theemotional status, length of hospital stays (LOHS), nursing satisfaction, the incidence, volume, and frequency of urinary incontinence (UI), and the incidences of urinary hemorrhage (UH), bladder spasm (BS), and catheter occlusion (CO) were compared after intervention.
Results: Eleven articles and 1,020 cases were included. The LOHS in the Int group was much shorter (mean difference (MD)=-2.91, 95% confidence interval (CI): -4.47~-1.35, Z=3.66, P=0.0002). The nursing satisfaction was significantly improved (odds ratio (OR)=5.70, 95% CI: 3.65-8.90, Z=7.64, P<0.00001). For complications, incidence of UI (OR=0.41, 95% CI: 0.26-0.66, Z=3.72, P=0.0002), the volume of UI (MD=-66.17, 95% CI: -124.74~-11.60, Z=2.36, P=0.02), and the frequency of UI (MD=-1.18, 95% CI: -1.69~-0.67, Z=4.55, P<0.00001) greatly reduced. The incidences of UH (OR=0.43, 95% CI: 0.21-0.87, Z=2.35, P=0.02), BS (OR=0.24, 95% CI: 0.14-0.42, Z=4.97, P<0.00001), and CO (OR=0.20, 95% CI: 0.11-0.36, Z=5.21, P<0.00001) were also highly reduced.
Conclusion: Postoperative nursing intervention could effectively shorten LOHS after TURP in patients with benign prostatic hyperplasia (BPH), improving the nursing satisfaction and reducing the incidence of postoperative complications.

Effect of Isolation Measures on Nosocomial Infection Rates in Nursing Practice during COVID-19: A Meta-Analysis

2025-02-08T17:48:09+0330

Background: Nosocomial infections represent a critical challenge in nursing practice, particularly during the COVID-19 pandemic. Isolation measures have been implemented widely to curb the spread of infections within healthcare settings. We aimed to evaluate the effectiveness of isolation measures in reducing nosocomial infection rates in nursing practice during the COVID-19 pandemic.
Methods: A systematic search was conducted using keywords such as "isolation measures," "nosocomial infection," and "COVID-19" and their combinations in international databases, focusing on articles published between 2020 and 2024. Data were analyzed using meta-analysis and a random effects model. Heterogeneity between studies was assessed with the I² test, and analyses were performed using STATA software.
Results: The analysis of 8 selected articles with a total sample size of 10,532 individuals showed that the implementation of isolation measures significantly reduced nosocomial infection rates, with an average effect size of 0.58 (95% CI: 42.1-74.5).
Conclusion: Isolation measures are effective in reducing nosocomial infection rates in nursing practice during the COVID-19 pandemic. The findings support the continued use of these measures to enhance patient safety and control infection spread within healthcare facilities.

Association between P53 Gene Mutations and Colorectal Cancer in the Iranian Population: A Systematic Review

2025-02-08T17:48:09+0330

Background: Colorectal cancer (CRC) is the fourth most common cancer and one of the most significant cancers affecting the Iranian population. This systematic review aimed to investigate the association between mutations in the P53 gene and CRC.
Methods: We conducted a search of six databases, including; Scopus, PubMed, Web of Science, Cochrane Library, SID, and Magiran up to Aug 10, 2024. Concepts in the search strategy were Iran, P53, and "Colorectal cancer". Original articles written in English or Persian that investigated the association between P53 gene mutations and CRC in the Iranian population were included.
Results: Out of 313 articles, 17 articles were included in the study. Six case-control studies investigated the association between the codon 72 polymorphism of the P53 gene and colorectal cancer. Three studies found a significant difference in genotype frequencies of this polymorphism between CRC patients and healthy individuals. Exon 6 was shown to be one of the most common mutated exons in colorectal cancer. Mutations in exon 7 were associated with poor prognosis. The most common type of mutation was G to A mutation from exons 5 to 8 CpG sites.
Conclusion: The present study suggests a potential association between the presence of the Arg allele at codon 72 within the P53 gene and a heightened susceptibility for developing and metastasizing CRC within the Iranian population. Furthermore, exons 5 to 8 of the P53 gene suggests that mutations localized at these sites may portend a poor prognosis.

Effects of Gestational Diabetes Mellitus on Fetal Liver Length: A Systematic Review and Meta-Analysis

2025-02-08T17:48:09+0330

Background: Gestational diabetes mellitus (GDM) is a serious pregnancy complication that can affect various organs and organ systems of the mother and fetus. In diabetic mothers, increased blood glucose delivery to the fetus leads to fetal hyperglycemia and hyperinsulinemia, which promotes the growth of insulin-dependent organs such as the liver. Therefore, this systematic review and meta-analysis was conducted to more precisely estimate the association between GDM and fetal liver length (FLL).
Methods: Six electronic databases (PubMed, Scopus, Web of Science, ProQuest, Cochrane, and Wiley) were searched up to Aug 2023. Two reviewers independently extracted data and assessed the risk of bias using the Newcastle–Ottawa Scale. The pooled weighted and standardized mean differences in FLL were calculated using random-effects models. Heterogeneity, subgroup analysis, and publication bias were also assessed using funnel plots. All statistical analyses were performed using Stata Version 16.0.
Results: Twelve articles were included in the final meta-analysis. GDM was associated with increased FLL, as assessed by ultrasound, in both the second (SMD=1.56; 95% CI: 1.04, 2.08; P<0.001) and third (SMD=0.84; 95% CI: 0.07, 1.61; P<0.001) trimesters of pregnancy. The pooled mean difference in FLL between the GDM and non-GDM groups was 4.85 mm (WMD=4.85; 95% CI: 3.26, 6.45), indicating larger liver size in fetuses from mothers with GDM.
Conclusion: GDM is a significant risk factor for increased FLL, as assessed by ultrasound, which may reflect fetal overgrowth and metabolic dysfunction.

Iran’s Leap into the Future; an Exploration of Tissue Engineering Companies: Review Article

2025-02-08T17:48:09+0330

Background: This review represents the first comprehensive compilation of data on Iranian commercial, service, and research entities in the field of tissue engineering up to 2024.
Methods: Through an extensive search of official websites, 56 companies were identified: 29 commercial enterprises, 17 service providers, and 10 research institutions. The majority (64%) of these companies are headquartered in Tehran, with many established post-2004.
Results: Biomaterials account for half of the product portfolio, with 38% of ongoing research focused on this area. Although cell-based products currently make up only 12% of offerings, they are the subject of 38% of current research, indicating significant potential for future growth.
Conclusion: This study provides a detailed overview of the development and future prospects of Iran's tissue engineering sector. The key conclusion emphasizes the need for an expanded focus on cell-based therapies and the establishment of stronger regulatory frameworks to facilitate the commercialization of innovative products. The review identifies key research gaps and proposes directions for future study, utilizing a descriptive methodology with in-depth data analysis and theoretical discussion.

A Scientometric Perspective on Stigma Research in Medicine: A Bibliometric Review

2025-02-08T17:48:10+0330

Background: Stigma is a critical social determinant of health, influencing individuals' access to resources, quality of life, and overall well-being. Despite its significant implications, bibliometric studies on stigma in the medical field remain sparse. We provide a comprehensive scientometric analysis of stigma research in medicine over the past 30 years, highlighting trends, key focus areas, and evolving challenges.
Methods: A bibliometric analysis was conducted using VOSviewer software, utilizing data from the Scopus database. The search included articles with the keyword "stigma*" in the title, published between 1992 and 2022, within the fields of Medicine, Nursing, and Professional Health. The initial search yielded 20,284 articles, narrowed down to 7,854 relevant publications for detailed analysis. Key metrics analyzed included co-authorship, co-occurrence of keywords, and co-citation patterns.
Results: The analysis revealed a significant increase in stigma-related publications in the medical field, particularly since 2010, with a peak in 2022, largely driven by the COVID-19 pandemic. The research identified nine major keyword clusters, 40 associated diseases, and 36 target groups. Persistent diseases like HIV, mental illness, addiction, and cancer continue to be strongly associated with stigma.
Conclusion: The findings underscore the evolving nature of stigma research in medicine, with an increasing focus on intersecting stigmas and their persistent impact on public health. Future research should aim to develop comprehensive models and strategies to manage and reduce stigma, particularly for diseases with enduring stigmatic associations. Collaborative efforts among policymakers, healthcare providers, and society are crucial to address the social and economic consequences of stigma and improve health outcomes.

Exploring the Association between Childhood Asthma and Abnormal Spermatozoa: An Analysis Using Mendelian Randomization

2025-02-08T17:48:08+0330

Background: Childhood asthma ranks among the prevailing chronic respiratory conditions affecting a significant number of individuals. The long-term hypoxic state and chronic inflammatory state caused by asthma could be linked with spermatozoa apoptosis. However, the correlation between childhood asthma and abnormal spermatozoa is currently unknown.
Methods: In our study, the method of two-sample Mendelian randomization (2SMR) was used by searching an appropriate European population genome-wide association studies (GWAS) database of childhood asthma and abnormal spermatozoa from the Ieu Open GWAS Project database. Sixteen related single-nucleotide polymorphisms (SNPs) were screened as instrumental variables (IV). Subsequently, we employ various statistical methods including inverse variance weighting (IVW), weighted median method (WME), MR-Egger regression, Simple mode, and Weighted mode to investigate the causal link between childhood asthma and the development of abnormal spermatozoa.
Results: Based on IVW results, childhood asthma is not an independent risk factor for abnormal sperm formation (P=0.14). Other statistical models such as WME, MR-Egger regression, Simple mode, and weighted mode also showed the same results. Leave-one-out sensitivity analysis and heterogeneity test were conducted and no horizontal pleiotropy was found.
Conclusion: There was no causal relationship between childhood asthma and abnormal spermatozoa formation at the genetic level.

Health Effects of Plant-Based Diets in University Life: A Comprehensive Study on the Constipation, Sleep and Obesity

2025-02-08T17:48:08+0330

Background: Plant-based diets have gained popularity due to their nutrient density and potential to reduce chronic disease risk. The aim of the study was to examine the relationship between diet quality and plant-based diets consumed with constipation, sleep duration and obesity in university students.
Methods: In this study conducted between September and October 2024, 676 students were recruited as participants and data on socio-demographic information, daily sleep duration, presence of constipation, 24-hour food consumption record and food consumption frequency were collected. Diet Quality Index (DQI) and Plant-Based Diet Index (PBDI) were calculated from food consumption record and frequency data.
Results: Constipation was present in 14.5% of the participants and the BMI of the participants was 21.84±3.47 kg/m². There was a significant relationship between age and constipation (P=0.013) and a weak negative relationship between age and sleep duration and PBDI (r=-0.103, P=0.007; r=-0.077, P=0.045, respectively); A weak negative correlation was found between BMI and PBDI and DQI (r=-0.092, P=0.016; r=0.173, P=0.000, respectively); a significant correlation was found between the presence of constipation and gender and income level (P=0.047; P=0.013, respectively).
Conclusion: PBDI and DQI were associated with lower BMI and emphasised the potential of alternative nutritional models in the fight against obesity. The lack of an association between PBDI, DQI and sleep duration and constipation suggests that further research is needed. This study emphasises the importance of healthy eating and lifestyle interventions, but its design limits causal conclusions and requires further research.

Factors Influencing Smartphone Screen Time among Korean Adolescents: Insights from the Korea Youth Health Behavior Survey

2025-02-08T17:48:09+0330

Background: This study is a secondary analysis aimed at identifying risk factors for smartphone overuse among adolescents, utilizing data from the 18th Korea Youth Health Behavior Survey (KYHBS) conducted in 2022.
Methods: A total of 50,071 participants were included, with schools selected through a stratified proportional allocation method that considered factors such as city/province, city size, and school type. Students were excluded from the survey if they had long-term absences, were special needs children unable to participate in the survey, or had reading disabilities. The survey encompassed students from the first year of middle school to the third year of high school across 800 schools nationwide.
Results: Several factors were significantly associated with increased smartphone screen time, including gender, education level, academic performance, economic condition, BMI, self-reported health, feelings of aloneness, insufficient sleep, breakfast consumption, fast food intake frequency, late-night meals, physical activity, current smoking, current alcohol consumption, and sexual experience.
Conclusion: These results underscore the complex interplay of various factors shaping adolescents' smartphone use patterns. Recognizing and addressing these factors is crucial for developing targeted interventions aimed at promoting healthier screen habits and mitigating the negative impacts of excessive smartphone use among adolescents. These findings underscore the complex interplay of various demographic, behavioral, and health-related factors that contribute to adolescents' smartphone use patterns.

The Relationship between Social Media Addiction and Eating Disorders among Followers of Social Media Influencers

2025-02-08T17:48:09+0330

Background: We aimed to evaluate the relationship between social media addiction and eating disorders in the followers of social media influencer.
Method: The study (n=561) was conducted with 112 men and 449 women, who follow a social media influencer and volunteered to participate in the study. Social media addiction scale for adults form (SMAS-AF) was used to evaluate the social media addiction, and ORTO-15 scale was used to determine the eating disorders.
Results: 80.9% of the participants had orthorexia nervosa and 19.1% were normal. BMI and social media addiction scale total score were significantly higher than optimal rates and ORTO-15 total score was significantly low (P<0.05). Age, anthropometric measurements, sub-scores of SMAS-AF and clinical domain sub-score of orthorexia nervosa were significantly different between the groups (P<0.05). It was significantly found that the emotional domain sub-score increased as the virtual tolerance score and virtual communication score increased (P<0.05). A relationship was found between the total score of the social media addiction scale and the emotional domain sub-score (P<0.05).
Conclusion: Social media use may negatively affect individuals’ eating behaviors and contribute to body image dissatisfaction.

Patterns of Mortality among People with Autism Spectrum Disorder in South Korea

2025-02-08T17:52:35+0330

Background: Detailed statistics on the death status of persons with autism spectrum disorder (ASD) are lacking. We aimed to identify and compare recent mortality rates in persons with ASD in Korea.
Methods: From 2012 to 2021, databases were established by linking data on persons with ASD registered in Korea with data on cause of death from the National Statistical Office.
Results: Between 2012 and 2021, the mortality rate of persons with ASD and age-standardized mortality rates fluctuated annually. The crude mortality rates in the population with ASD were 91.6, 113.8, and 74.5 in 2012, 2016, and 2021, respectively, which were lower than the rates in the general population; however, the age-standardized mortality rate was observed to be five times higher. Intentional self-harm, as a cause of death in persons with ASD, was ranked high annually. The mortality rates in persons with ASD from diseases (50.7%) and injury (49.3%) were in a ratio of 1:1. Diseases and injury were more causes of death in males with ASD. The average age of persons with ASD at death was confirmed to be approximately 50 years lower than that of the general population.
Conclusion: Deaths and causes of death in persons with ASD differ from those of the general population. Therefore, preventive measures and efforts are required to reduce avoidable deaths among persons with ASD.

Influences of Normative Medical Nutrition Management Based on Health Concepts on Weight Control and Maternal and Infant Outcomes in Women of Advanced Maternal Age

2025-02-08T17:48:09+0330

Background: We aimed to explore the effects of normative medical nutrition management based on health concepts on weight control and maternal and infant outcomes in women of advanced maternal age.
Methods: Overall, 112 women of advanced maternal age were divided into the control group and observation group by random number table method. The control group was given routine intervention, and the observation group was given normative medical nutrition management based on health concepts. The nutritional status, delivery status, weight control, and adverse pregnancy outcomes were compared, and maternal mental state during delivery was evaluated by State-Trait Anxiety Inventory Questionnaire (STAI).
Results: The nutritional status of the observation group was better than that of the control group. The weight gain during pregnancy and newborn weight of the observation group were lower than that of the control group. The second stage of labor and total labor in the observation group were shorter than those in the control group were (P < 0.05). The spontaneous delivery rate of the observation group was higher than that of the control group; while the cesarean section rate was lower (P < 0.05). The S-AI and T-AI scores of the observation group were lower than those of the control group (P < 0.05). The incidence of adverse pregnancy outcomes in the observation group was lower than that in the control group (P < 0.05).
HealthConclusion: Normative medical nutrition management based on health concepts can help to control weight, improve nutritional status, improve anxiety, and reduce cesarean section rate and the incidence of adverse pregnancy outcomes.

Bladder Cancer Mortality Trend in Montenegro: 1990-2021

2025-02-08T17:48:09+0330

Background: Bladder cancer accounts for more than 200,000 deaths annually on a global level, with an age-standardized mortality rate of 2.9 per 100,000 individuals. Despite declining global rates, it remains a substantial public health burden. We aimed to analyze the mortality trend of bladder cancer in Montenegro and identify the measures taken to combat this tumor.
Methods: Bladder cancer mortality data in Montenegro from 1990 to 2021 were collected. Mortality rates were age-standardized to the World Standard Population. The joinpoint, linear and Poisson regressions were used to assess bladder cancer mortality trend.
Results: There was a consistent increase in mortality rates due to bladder cancer, with statistical significance for both the overall population and specifically for males, with an average annual percent change (AAPC) of 1.5% (95% CI: 1.5 (0.5-2.9)) and 1.6% (AAPC (95% CI): 1.6 (0.4-3.3)) respectively. Additionally, there was a notable annual increase in the number of bladder cancer cases: average annual increase was 3.4% for the overall population, 3.5% in male and 2.9% in female, with statistical parameters (AAPC (95% CI), P-value) for join point regression: 3.4 (2.4-4.8), <0.001; 3.5 (2.3-5.1), 0.003; and 2.9 (1.2-5.1), 0.004, respectively. The majority of bladder cancer deaths occurred in the age groups of 65-74 (35.8%), 75-84 (33.6%), and 55-64 (16.8%).
Conclusion: The ongoing increase in bladder cancer mortality in Montenegro, particularly among men and elderly should encourage policymakers to take action to reverse this unfavorable trend.

The Effect of Environment Perception Preferences on Psychological Restoration of Older Adults in the Severe Cold Region

2025-02-08T17:48:09+0330

Background: Mental health issues are increasingly prevalent in older adults as the population ages. The relationship between psychological restoration and environmental perception preferences in older adults residing in the severe cold region is investigated in this study.
Methods: Six urban public areas in severe cold regions were selected as research sites, and 1093 older adults were surveyed using a questionnaire in this investigation. The questionnaire included an environmental perception preference scale and the Restorative Outcome Scale.
Results: Environmental perception preferences substantially influence psychological restoration in older adults (η² = 0.130, P < 0.001), and a notable interaction is observed between perception preferences and seasonal variations (η² = 0.065, P < 0.001). Preferences for vegetation exert the most substantial positive influence on psychological restoration during spring and summer. In winter, preferences for recreational activities are paramount; whereas in autumn, preferences for people are identified as critical for psychological restoration.
Conclusion: In severe cold regions, psychological restoration is influenced not only by environmental perception preferences but also by climate fluctuations. This study provides valuable insights, assisting designers in developing restorative environments for older adults residing in severe cold areas.

Phylogenetic and Mutational Analysis of the Tax Gene in the Human T-Lymphotropic Virus 1-Associated HAM/TSP in Comparison with Asymptomatic Careers

2025-02-08T17:48:09+0330

Background: Human T-lymphotropic virus 1 (HTLV-1) is a member of the Retroviridae family that can cause two groups of diseases: HTLV-1-associated myelopathy/tropical spastic paraparesis (HAM/TSP) and adult T-cell leukemia/lymphoma (ATLL). Despite HTLV having seven different subtypes, cosmopolitan subtype A is responsible for most HTLV-1-related disorders and is the most widely dispersed type globally, including in the Middle East, known to be an endemic area for the virus. Therefore, due to the importance of determining the subtypes of this virus, we aimed to explore the subtypes of HTLV-1 in Iran.
Methods: In this cross-sectional study, we screened 140 Blood samples for HAM/TSP infection and approximately 4,500 samples for asymptomatic carriers (ACs) from Sina Hospital, Iran between 2020 and 2021. Positive samples were used for phylogenetic and mutational analysis to compare ACs and HAM/TSP cases via the Tax segment of HTLV. To identify the genotype of positive samples, the Maximum Likelihood method was used to construct the phylogenetic tree based on the positive samples.
Results: All Iranian isolates were clustered as HTLV-1a subgroups. Moreover, all of our samples have undergone positive selection pressure. Furthermore, we detected unique mutations in Iranian HAM/TSP and ACs sequences.
Conclusion: All of the Iranian Tax proteins are under positive selection pressure with respect to Japanese isolates. Interestingly, we detect specific mutation patterns in the sequences. Positions 51, 82, 109, 172, 232, and 339 in the aa sequence have undergone mutations specific to Iranian HTLV-1; and in positions 22 and 146 aa we detected mutations unique to ACs and HAM/TSP, respectively.

Dissecting Masculinity: Transformative Strategies to Address Smoking in Indonesia

2025-02-08T17:48:08+0330

Dear Editor,

Indonesia ranks among the world’s top countries in terms of cigarette use and production (1), deeply ingrained in society and prominently featured in sports sponsorships and various forms of media such as television, print, and technological platforms. Currently, the most notable trend is the prevalence of teenagers smoking cigarettes, with individuals aged 18 and over being the target audience for cigarette advertising. However, it is crucial to address the broader impact and cultural associations of smoking (2).

Cigarettes hold significance beyond their basic function, transcending gender categorizations. Translated into semiotic jargon, cigarettes serve as references that are not inherently associated with any specific biological gender. Their cultural meaning emerges when elevated to a semiotic level, functioning as signs within a system or practice of signification. At this level, we can trace associations between smoking and masculinity, with an oppositional relationship to femininity (3).

Smoking serves as a marker influencing the dynamics of masculinity throughout men’s lives, affecting their decisions influenced by their understanding of appropriate masculine behaviour. This dynamic relationship unfolds within specific contexts, emphasizing the importance of supportive environments that enhance and promote aspects of masculinity that are not reliant on smoking. In Indonesia, there is a prevailing belief that not smoking diminishes a man’s masculinity, exacerbated by cigarette advertisements associating smoking with a macho image (4). This perpetuates a trend of toxic masculinity, complicating efforts to combat smoking in Indonesia.

Indonesia’s government aims to reduce high cigarette usage by raising prices with more taxes. As of January 1, 2024, the Ministry of Finance of the Republic of Indonesia increased the tobacco excise tax rate by an average of 10%. This strategy is outlined in Minister of Finance Regulation Number 191 of 2022, the second revision of Minister of Finance Regulation Number 191 of 2021. The rule establishes excise tax rates for different categories of tobacco products, including cigarettes, cigars, hand-rolled cigarettes (klobots), and shredded tobacco(5). This approach assumes that as cigarette prices climb from annual tax hikes, smokers will have less motivation to smoke and may eventually choose to quit. Nevertheless, in reality, this is more complex. The relationship between cigarettes and smokers is multifaceted and goes beyond only the cost. Thus, budgetary pressure may only sometimes be successful in decreasing cigarette consumption. Further socio-economic study is required to provide a more comprehensive understanding of smoking habits (6).

The 2021 Global Adult Tobacco Survey (GATS) data, published by the Ministry of Health, indicates a rise in the adult smoking population by 8.8 million individuals, from 60.3 million in 2011 to 69.1 million in 2021. Indonesian society spends almost 64 trillion rupiah annually on cigarettes. The Indonesian Tobacco Atlas data from 2020 indicates that those with lower socio-economic status tend to consume more cigarettes (7).

Research conducted by the Center for Indonesia’s Strategic Development Initiatives (CISDI) shows that cigarette usage results in significant economic losses, particularly in healthcare and family systems, totalling 27.7 trillion rupiahs. This study demonstrates greater statistics than a prior study from 2015, which reported economic losses of 13.7 trillion rupiah owing to smoking-related health issues (8).

Studies suggest that increasing cigarette taxes can lower the rate of adult smokers but may not effectively decrease smoking inequalities in younger age groups. Research indicates that raising cigarette taxes is linked to reducing cigarette usage, but substantial tax hikes are required to have a major impact (9).

To reduce the number of smokers, policies need to be more comprehensive and grounded in solid scientific research. This includes several steps, such as increasing cigarette taxes, implementing specialized rehabilitation programs for smokers, and considering social and cultural factors associated with the link between smoking and masculinity. Firstly, raising cigarette taxes has proven effective in reducing cigarette consumption, as higher prices can deter consumers, particularly among lower to middle-income groups. This policy is based on behavioural economics theory, which indicates that higher prices reduce demand for a particular product, including cigarettes. Secondly, specialized rehabilitation programs for smokers can assist individuals who want to quit smoking by providing necessary psychological, medical, and social support. These programs can be tailored to individual needs and may include nicotine replacement therapy, counselling, and other proven approaches to help smokers quit.

Additionally, it is important to consider social and cultural factors influencing smoking behaviour. One of these factors is the association of smoking with masculinity ingrained in popular culture. Changing smoking behaviour should involve altering social norms that reinforce this association. This can be achieved through educational campaigns raising awareness about the negative impacts of smoking and promoting alternative concepts of masculinity not linked to smoking. Moreover, resocialization efforts, such as those described by Obstetrics and Gynecology Specialist Budi Wiweko, who stated that smoking can reduce a man’s masculinity, should also be considered. He explained that smoking generates Reactive Oxygen Species (ROS) that produce free radicals in the body, damaging sperm genetic material. Consequently, damaged DNA sperm are unable to fertilize eggs. Smoking habits also damage blood vessels, including those in the penis, leading to erectile dysfunction. Furthermore, smoking can cause men to lose their Adam’s apple if they develop vocal cord cancer. Thus, not smoking can make men more masculine (10).

Recent Review Tuberculosis in Indonesia: Burden and the Challenge of Under-Reporting

2025-02-08T17:48:09+0330

No Abstract. Not abstract.

Effects of COVID-19 on the R&D Investment of Pharmaceutical Industry in South Korea

2025-02-08T17:48:09+0330

No Abstract. Not abstract.

The Need to Launch a Postgraduate Program in Health Tourism in Iran

2025-02-08T17:48:09+0330

No Abstract. Not abstract.

Physical Activity as a Public Health Guide to Prevent from Coronary Heart Disease

2025-02-08T17:48:09+0330

It is a letter. No Abstract.