Background: Salivary compounds can be used as diagnostic markers for changes in the oral cavity that cause oral problems in type 2 diabetes mellitus (T2DM).
Methods: This meta-analysis searched PubMed/Medline, EMBASE, Scopus and Cochrane Library, and the Web of Science until Nov 2023. The observational studies included patients with T2DM and healthy controls aged > 18 yr with no oral health problems or systematic or periodontal diseases. The Quality in Prognostic Studies (QUIPS) tool was used to evaluate the risk of bias. The random-effects model was constructed using standardized mean differences (SMD).
Results: The meta-analysis analyzed 13 observational studies that included 519 patients with T2DM and 356 healthy controls. Non-fasting periods of 30 min to 8 h were used to measure salivary profiles. Overall, salivary proinflammatory mediators favored patients with T2DM (SMD: 1.66; CI_95%: 0.42, 2.91, P<0.01) compared with healthy subjects. Subgroup analysis revealed that interleukin-6 (SMD: 1.33; CI_95%: -0.04, 2.69, P<0.05), followed by interleukin-8 (SMD: 0.92; CI_95%: -0.71, 2.55, P<0.13), was greater in patients with T2DM than in healthy subjects. Among patients with T2DM, network analysis identified salivary factors most closely associated with male sex (i.e., tumor necrosis factor), female sex (i.e., interleukin-8), fasting plasma glucose (i.e., C-reactive protein), HbA1c (i.e., IL-8), and age (i.e., C-reactive protein).
Conclusion: Overall, salivary IL-6 levels were greater in patients with T2DM and might be considered for monitoring oral changes. Moreover, network analysis could identify different salivary components that were most closely associated with patient characteristics.

Background: The unmet need for family planning is an indicator in monitoring and evaluating family planning programs in the decentralization era. Spatial analysis is an analytical tool that can understand the existence of family planning disparities among regions. This study aimed to conduct a systematic review of the application of spatial analysis in research related to the unmet need for family planning and to review its results.
Methods: The databases used in the literature search are PubMed, Scopus, and SpringerLink. The keywords used in the search were: “unmet need for family planning” OR “unmet need for contraception” AND (spatial OR geographic). Full-text articles from 2013 to 2022 were included.
Results: Of the 334 identified articles, 3 (three) articles were reviewed. The three studies used spatial analysis at the level of spatial data exploration by using global and local Moran Index tests, Getis-Ord Gi* local statistics, and natural break spatial techniques.
Conclusion: The use of advanced spatial analysis such as GWR and other regression analyzes is needed to investigate factors associated with regionally specific unmet need for family planning so that policy makers can allocate resources effectively.

Background: The global maternal mortality rate has increased annually. This study aimed to examine the role of emotional support and the social support theraphy on the experience of emergency caesarean deliveries.
Methods: The narrative study was conducted using scientific journal database sources from PubMed, Proquest, Ebsco, Science Direct, and Google Scholar from 2016 to 2023. After the articles were obtained, they were tabulated using an Excel table. Overall, 184 articles were identified based on the search titles. Ten articles focused on the influence of emotional support on patient experiences, and five articles focused on the influence of sociocultural atmosphere on patient experiences.
Results: The influence of emotional support and the socio-cultural atmosphere on emergency caesarean section patients is one strategy for reducing maternal mortality rates. The poor sociocultural atmosphere regarding cesarean delivery is still a hot issue in the community, and the lack of emotional support from health service providers can cause patient and family approval to be late in agreeing to informed consent for emergency cesarean care, which should be provided immediately.
Conclusion: There is a need for adequate emotional support in the form of empathy, interactive communication, presence and availability, motivation and hope, nonverbal communication, sense of humor, and ambient environment.

Background: We aimed to identify and classify barriers and facilitators of implementation of research finding in healthcare.
Methods: A scoping review was conducted using Preferred Reporting Items for Systematic Reviews and Meta-analyses Extension for Scoping Reviews (PRISMA-ScR). Articles were extracted from online databases. The initial search was implemented on Jun, 2022, and updated until end of 2023. Two independent reviewers screened, selected, and extracted the data. Data were synthesized using thematic analysis.
Results: Overall, 32 studies from 3,435 documents met the inclusion criteria. From which 60 barriers and 45 facilitators were identified. The main barriers and facilitators extracted were grouped into eight components: Organization, Collaboration to knowledge utilization, Researcher role, Methodology and technical aspect of research, Management, Cultural and social determinants, Training, and Government and community. Organizational barriers and facilitators were the most concerning with insufficient attention, methodology and technical aspects of research were salient barriers, and the other components had similar roles.
Conclusion: This study directly addresses a gap in implementing the research findings in organizations. The government would benefit from knowledge implementation with respect to evidence utilization. Additionally, implementation knowledge was not transferred to healthcare practice to a sufficient extent, thus restricting the systematic use of implementation knowledge in practice.

Background: This systematic scoping review aimed to investigate and delineate the dimensions of the Community First Responder (CFR) model implemented in emergency medical services (EMS) across different countries. The primary focus was on identifying key components and characteristics associated with CFR programs.
Methods: This study conducted an extensive search across multiple databases (PubMed, Scopus, and Web of Science) and grey literature sources (Google Scholar, official sites) until Mar 2023 using keywords related to community first responders. Initially, 14,135 articles were found. After removing duplicates and similar titles, 37 articles were reviewed. The analysis covered training, motivation, public awareness, emotional support for responders, coordination with ambulance staff, program development, and the impact on patient outcomes.
Results: This review revealed key dimensions and components common to CFR models worldwide. Notable findings included insights into the significance of training, the motivating factors for individuals joining CFR groups, public awareness regarding the role of CFRs, the importance of emotional support for CFRs, effective coordination with ambulance staff, development requirements of CFR programs, and the consequential effects of plan implementation on patient outcomes.
Conclusion: This systematic scoping review offers valuable insights into CFR models worldwide, enhancing understanding of their effectiveness, challenges, and capabilities. Its recommendations can influence policy, guide future research, and strengthen CFRs' contributions to emergency medical services.

Cervical Intraepithelial Neoplasia grade III (CIN III) represents a critical precursor to invasive cervical cancer, necessitating a comprehensive understanding of its etiology, progression, diagnosis, and preventive strategies. This review integrates an approach to synthesize current literature, conducted through a meticulous search of databases (Scopus, Web of Science, and Google Scholar) for relevant articles discussing CIN III and its association with Human Papillomavirus (HPV). The review delineates the multifaceted landscape of CIN III, elucidating the pathogenesis involving high-risk HPV types, demographic factors (age and sexual behavior), behavioral determinants (smoking and contraceptive use), and environmental influences impacting disease epidemiology. Diagnostic modalities, including Pap smears, HPV testing, and colposcopy, were assessed for their role in early detection and intervention. The results highlight the significance of HPV vaccination, screening programs, and robust public health policies in mitigating the burden of CIN III. Effective interventions, particularly excisional procedures, demonstrate efficacy in reducing the risk of progression to invasive cancer, emphasizing the importance of vigilant follow-up. A comprehensive approach integrating vaccination initiatives, early detection through screening, and equitable healthcare policies stands pivotal in combating CIN III. The review underscores the imperative of evidence-based interventions for disease prevention, reducing disparities, and enhancing public health outcomes for individuals affected by or at risk of CIN III.

Background: Phlebotomy has been used as a non-pharmacological treatment for different types of diseases, regarding the philosophy of humors in traditional medicines, such as Persian Medicine. However, according to the narrow-approved indications for phlebotomy in Western Medicine, we aimed to systematically summarize high-level of evidence on safety and efficacy of phlebotomy in treatment of human diseases.
Methods: In this umbrella review, to identify meta-analysis studies of clinical trials on phlebotomy, four electronic databases, including PubMed, web of science, Scopus, and Cochran library were searched until Jun 18, 2022 with relevant keywords for ‘phlebotomy’ and ‘meta-analysis’ according to PRISMA guidelines and PICO questions. After excluding irrelevant studies, data on subject characteristics, method of intervention, and adverse events were extracted. To evaluate the quality of the methodology of the systematic reviews, AMSTAR2 scale was utilized.
Results: From 327 identified studies, 7 full texts met the inclusion criteria, consisting of 56 clinical trials on 5648 subjects. These meta-analysis studies reported effects of phlebotomy on hypertension, acute gouty arthritis, skin disease (chronic urticaria and porphyria), and liver diseases (non-alcoholic fatty liver disease, chronic hepatitis C, and liver surgery). Our results showed significant improvements in different outcomes, while the most common adverse event was hematoma.
Conclusion: The level of evidence on the efficacy and safety of phlebotomy in some specific health conditions was substantial; however, to investigate the efficacy and safety of phlebotomy in management of other health problems more clinical studies with high sample sizes are needed.

Male breast cancer (MBC) is a rare type of cancer that affects men, accounting for only 1% of all cancers in men and all breast cancer cases worldwide. Its rarity is due to the differences in male endocrine function and the smaller amount of mammary tissue in males. Due to its infrequency, there is limited knowledge about the disease, and treatment recommendations are often based on extrapolation from clinical trial data involving female breast cancer patients. Men with MBC typically present in their 50s or older and may mistake a suspicious breast mass for a benign condition called gynecomastia. Various known risk factors contribute to breast cancer in men. Currently, there are no international randomized control trials (RCTs) specifically focused on MBC, and management guidelines are primarily derived from studies conducted among female patients. Localized and resectable cases of breast cancer typically require surgical intervention, followed by radiotherapy, chemotherapy, hormonal therapy, or potentially utilizing recent advancements in immune-oncology agents. A comprehensive approach that involves a multidisciplinary team ensures appropriate treatment and can lead to favorable outcomes. However, screening for MBC is limited due to the lack of large-scale international RCTs demonstrating its effectiveness in reducing MBC-related mortality.

Background: Truancy is correlated with variety of unfavorable outcomes that can negatively impact adolescents’ development and well-being. We investigated the prevalence of truancy and its associated factors among school-going adolescents in Malaysia in 2022.
Methods: We used secondary data from the National Health and Morbidity Survey 2022. It is a cross-sectional study with a multistage stratified cluster sampling study design including 32,290 students aged 13 to 17 years old. It utilized the self-administered questionnaire from the validated Malaysian Global School-based Health Survey (GSHS). The associations between the truancy and its associated factors were examined using multivariate logistic regression, a complex sample analysis with sampling weightage.
Results: The prevalence of truancy was 25.6% (95% CI=24.25, 26.98). In the multivariate analysis, truancy was significantly associated with older age groups (P<0.001), adolescents with separated/ divorced/ widowed parents (P<0.001), those with current any tobacco product use (P<0.001), those with ever drug use (P<0.001), those who have been physically attacked (P<0.001) and being bullied (P<0.001).
Conclusion: Gender, age, parent marital status, and adolescents with risk behavior were associated with truancy. This information may provide evidence for the implementation of effective prevention and intervention strategies to reduce truancy among these school-going adolescents.

Background: We aimed to determine the differences in physical fitness between older adults with and without indicators of possible sarcopenia and the associations between possible sarcopenia and fear of falling.
Methods: Individuals aged >75 years living in Harbin City, China in 2023 were recruited through a local community center. The presence of possible sarcopenia was defined using the Asian Working Group for Sarcopenia 2 criteria via grip strength measurement, with cut-off points of >28 kg for men and >18 kg for women. Physical fitness, gait ability tests, and a fear of falling questionnaire were administered. An independent t-test was used to compare differences in physical fitness and gait between individuals with and without possible sarcopenia. Multivariate logistic regression was used to investigate the association between possible sarcopenia and fear of falling.
Results: The possible sarcopenia group had lower extremity strength, flexibility, and aerobic endurance than the group without possible sarcopenia (P<0.001). Regarding dynamic balance, the time taken was longer in the possible sarcopenia group (P<0.001). There was also a difference in gait ability and fear of falling between the two groups (P<0.001). Compared to individuals without possible sarcopenia, those with possible sarcopenia had significantly increased odds ratios for fear of falling (odds ratio, 9.66; 95% confidence interval, 4.06–22.98).
FallingConclusion: Possible sarcopenia based on the grip strength criterion was associated with decreased physical fitness and gait performance in Chinese community-dwelling older adults.

Background: According to World Health Organisation data, on the top ten causes of death in the world in 2019, ischemic heart diseases ranked first, followed by stroke and chronic respiratory diseases. This study aimed to make cross-section of the current mortality rates of indicators of circulatory diseases, ischemic heart diseases and cerebrovascular diseases, access the trends of indicators in Serbia more than two decades and to find the correlation of these observed indicators between males and females.
Methods: Medical indicators were taken from the publicly available Health for all databases that deals with long-term evaluation and monitoring of indicators obtained from national authorities. In this epidemiological study, following indicators were analysed: indicator of standardized circulatory diseases, ischemic heart disease, and cerebrovascular diseases. SPSS was used for statistical analysis.
Results: Between 1998 and 2021 all of the mortality indicators were decreasing in Serbia. Between 2002 and 2005 observed indicators had almost constant decreasing trend. The standardized mortality for circulatory disease along with indicators for mortality from ischemic diseases and cerebrovascular disease was more prevalent among males than females,
Conclusion: Continuing the follow of indicators is of the great importance for public health and macroeconomic of countries. This decreasing trend in Serbia must remain constant and that can be effectively done through continuous improvement of health systems, focusing on the primary health care and conducting pharmacoeconomic studies and epidemiological studies. 

Background: Countries that are becoming aging societies are struggling to establish financial support policies due to their increasing numbers of retired people. In particular, the increase in middle-aged retirees has been reported as unusual and influenced by various factors. This study aimed to identify the subjective health conditions of middle-aged retirees and explore the factors that help provide basic data for developing health-related programs for them.
Methods: This cross-sectional study was conducted among 7,893 people who participated in the 6^th Korean Longitudinal Study of Aging in 2016. Among them, the data of 315 participants were analyzed. A theoretical framework guided the use of multiple regression analysis to examine the factors related to the subjective health status of middle-aged retirees.
Results: The significant factors influencing the subjective health status were socioeconomic status (middle/high: β=.14, P=.005), number of chronic diseases (β=-.11, P=.035; above 2: β=-.38, P<.001), depression (β = -.17, P<.001), and retirement satisfaction (β=.32, P<.001).
Conclusion: This study can help policymakers create effective retirement programs for middle-aged individuals and re-socialize them by enhancing physical and psychological support.

Background: We aimed to identify the factors affecting sleep quality in community-dwelling older adults.
Methods: This cross-sectional descriptive study was conducted from 6 to 13 October 2021. A hypothetical model based on Spielman’s 3P model of insomnia was constructed using the multiple factors that influence sleep quality in older adults. Data were collected from 114 elderly adults at two welfare centers located in, South Korea and analyzed using IBM SPSS 21.0.
Results: The hierarchical regression model showing the predictors of sleep quality was significant, and it explained 23.9% of the variance (F=9.879, P<.001). Pre-sleep arousal (β=0.283, P=.005) and sleep hygiene (β=0.269, P=.014) were associated with sleep quality.
Conclusion: Sleep improvement interventions which consider pre-sleep arousal and sleep hygiene for older adults may improve sleep quality.

Background: Sensory impairments, notably hearing loss (68% in those aged 70+) and vision loss (24%-50%), are prevalent in older individuals. We investigated the correlation between visual and hearing impairments in older adults, considering sociodemographic factors, mental health, and social support.
Methods: The study is part of The Serbian 2019 National Health Survey, conducted in 2019. Questionnaires were used as the research tool, following the methodology of the European Health Survey. Multivariable logistic regression was used to assess predictors of visual and hearing impairments.
Results: Findings revealed a higher prevalence of vision difficulties among women (P< 0.001) and a significant reduction in reported vision issues with increased social support (P< 0.001). Higher education, particularly at the doctoral level, demonstrated a strong protective effect against hearing difficulties (P< 0.001).
Conclusion: Education at the doctoral level provides significant protection against sensory difficulties, especially in the case of hearing loss, while a high level of social support positively influences the reduction of vision-related problems. Further research is necessary for a better understanding of relationships and the development of effective support strategies for the elderly population with vision and hearing impairments.

Background: Disabled college students are facing special life pressures and social challenges due to physical and psychological obstacles. Given such difficulties, they may experience a high level of negative emotion (NE) that aggravates their risk of suicidal ideation. As a positive psychological trait, self-acceptance is very important to promote the mental health of disabled college students and reduce their risk of committing suicide. A state of high-intensity hopelessness easily mediates the influence of the NE and self-acceptance of disabled college students.
Methods: A group questionnaire survey was conducted among 663 college students with disabilities across 16 universities from Zhejiang Province. These surveys involved the use of a self-acceptance questionnaire, NE questionnaire, suicidal ideation questionnaire, and the Beck hopelessness scale, and the mediating role of hopelessness in the influence of NE and self-acceptance on the suicidal ideation of disabled college students was tested.
Results: Self-acceptance had a significantly negative influence on suicidal ideation (P<0.01), while NE exerted a significantly positive influence (P<0.01). Hopelessness partially mediated the influence of NE on the suicidal ideation of disabled college students and exerted a masking effect on the influence of self-acceptance on suicidal ideation. Hopelessness was a key psychological mechanism that bonds NE and self-acceptance with suicidal ideation.
Conclusion: The mental health intervention measures for disabled college students should include self-acceptance strategies and skills for reducing these students’ NE to relieve their hopelessness and further reduce their risk of committing suicide.

Background: Community Health Volunteers (CHVs) are crucial in achieving universal health coverage and vital in public health activities, including the COMBI (Communication for Behavioral Impact) approach for dengue prevention and control and assessing the performance of COMBI CHVs are essential in evaluating the program effectiveness. We aimed to measure the level of performance and determine predictors of high-performance among COMBI CHVs in Kuala Lumpur and Putrajaya.
Methods: A cross-sectional study was conducted in 2023 among 285 COMBI CHVs from 5 health operational zones in Kuala Lumpur and Putrajaya. The CHVs were stratified proportionately, with 45.5% of respondents randomly selected from each stratum based on their zones. Self-administered questionnaires assessed their performance level and associated factors, including training, supervision, knowledge, motivation, and job satisfaction. Chi-square and Multiple Logistic Regression tests were used to determine the factors and predictors of high-performance COMBI CHVs.
Results: The prevalence of high-performance COMBI CHVs was 59.3%, significantly associated with training factors (experience, duration, and adequacy of training), supervision factors (being supervised, supervision frequency, and encouragement from supervision), motivation and job satisfaction level. As for significant predictors, having at least one day of training (AOR=14.557), being supervised by medical personnel (AOR=4.997), having a high motivation level (AOR=5.538) and having a high job satisfaction level (AOR=4.562) were more likely to have a high-performance level.
Conclusion: Training duration, supervisor background, motivation and job satisfaction can contribute to high-performance levels among COMBI CHVs, which can applied in evidence-based policies and strategies for performance improvement and more effective community healthcare delivery.

Background: The aim was to explore the relationships among employment pressure, ego depletion, negotiable fate, and recent graduates’ suicidal ideation during the COVID-19 pandemic.
Methods: A total of 2703 recent graduates completed two times questionnaires that measured employment pressure, ego depletion, negotiable fate and suicidal ideation in the current study.
Results: 1) employment pressure positively predicts suicidal ideation among recent graduates; 2) ego depletion mediates the association between employment pressure and recent graduates’ suicidal ideation; and 3) negotiable fate moderates the associations of employment pressure with ego depletion and suicidal ideation, while the relationships of employment pressure with ego depletion and suicidal ideation are stronger for recent graduates with a strong belief in negotiable fate.
Conclusion: Ego depletion and negotiable fate play a significant role between employment pressure and recent graduates’ suicidal ideation during the COVID-19 pandemic. This still needs to be noted in the post-epidemic era.

Background: Nipah virus is a pathogenic virus of ruinous zoonotic potential with inflated rate of mortality in humans.
Methods: Considering the emerging threat of this pandemic virus, the present investigation amid to design vaccine by using the bioinformatics tools such as host and virus codon usage analysis, CD8+ peptide prediction, immunogenicity/allergenicity/toxicity, MHC-I allele binding prediction and subsequent population coverage and MHC-I-peptide docking analysis.
Results: In this study (conducted in 2022 at School of Biotechnology, Katra, India), a set of 11 peptides of the structural proteins of Nipah Virus were predicted and recognized by the set of MHC-I alleles that are expressed in 92% of the global human population.
Conclusion: The strong interactions between these peptides and the MHC-I protein suggest them as strong peptide candidates for the development of vaccine against Nipah Virus.

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Background: We aimed to elucidate the potential correlation between single-nucleotide polymorphisms (SNPs) in miRNA machinery genes and colorectal cancer (CRC) risk in an Iranian cohort.
Methods: We conducted a robust case‒control study involving 507 participants, which included 213 patients diagnosed with CRC and 294 healthy controls at Research Institute for Gastroenterology and Liver Diseases in Tehran Province, Iran in 2018. The study focused on genotyping four specific SNPs, RAN (rs14035), GEMIN3 (rs197412), GEMIN4 (rs2740348), and Dicer (rs3742330), using advanced ARMS-PCR and Tetra-primer ARMS-PCR techniques.
Results: Notably, our investigation revealed the significant inverse association between the C/C genotype of rs197412 in the GEMIN3 gene and CRC risk (OR=0.54, 95% CI=0.33-0.87; P=0.0087). In stark contrast, the T/T genotype of rs14035 in the RAN gene was strongly associated with a heightened risk of developing CRC (OR=4.44, 95% CI=2.60-7.57, P<0.0001). Furthermore, we found that the G/G genotype of rs2740348 in GEMIN4 posed an increased risk for CRC (OR=2.9, 95% CI=1.44-5.85, P=0.0041) and it has a major effect on CRC risk in our population. The alleles and genotypes of rs3742330 in Dicer, however, did not exhibit a significant correlation with CRC.
Conclusion: Our study provides compelling evidence that SNPs within miRNA processing genes significantly contribute to susceptibility to CRC among the Iranian population. Our research not only contributes to the growing body of miRNA-related genetic studies but also opens avenues for population-specific risk assessment and personalized medicine approaches in cancer therapy.

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