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Chemotherapy is a common treatment technique that uses chemical drugs to kill cancer cells. This technique affects normal healthy tissues being unspecific and has toxic adverse effects. Nowadays, nanotechnology applications in cancer chemotherapy have helped to solve the uncontrolled problems involving distribution of medicine particles and other side effects. Nanoparticles (NPs) can offer significant advantages over conventional drug delivery to have magnificent properties such as controlled mode of action, various methods of administration, and the ability to transport both organic/inorganic drug particles. Special ligands containing polymeric NPs preferentially hit the tumour site because of their chemical affinity to malignant tissues. This article, reviews the fabrication, characterization, and applications of NPs being used in chemotherapy. Furthermore, different forms of polymeric and especially polymeric chemotherapy were also explored and discussed to understand better the effects of NPs on cancer chemotherapy.

Background: A good quality of seating comfort requires integration of capabilities and limitations of the human body and the occupant’s preferred posture in different seating environments and tasks. This study provides a systematic and comprehensive review of past research related to the correlation between anthropometric parameter to seat pressure variables to determine the impact on comfort and safety in seat design.

Methods: This systematic review consisted of PRISMA flow diagram guidelines searched in Web of Science, Scopus, Sciencedirect and Google Scholar from 2009 till January 2020 related to keyword lists.

Results: As a result, 26 articles which addressed the correlation between anthropometric parameters and pressure variables were selected. Body mass index and weight were the most influence anthropometric parameter towards the pressure variables. In addition, almost all studies showed that there were medium to strong correlation between the lower body parts and the pressure variables, with R as above 0.5.

Conclusion: Comfort and safety depend on the design and ergonomics of the seat to maintain the body posture under complex roads, driving conditions and changing environment. In essence, seat and geometry functions help to reduce fatigue level and improve comfort, safety and health among drivers based on user, task and environment of driving activities.

Methods: This systematic review of the determinants of consanguinity among Arab populations was conducted using databases: PubMed, Medline, Direct Science, Scopus, Web of sciences, Springer, Google scholar between 2000 and 2020. Inclusion and exclusion criteria were set. The selection steps were carried out based on PRISMA guidelines. Disagreements in article selection and data extraction were resolved by discussion or recourse to a third reviewer

Results: Overall, 25 studies were selected. The synthesis of the results concerning the determinants of Arab inbreeding revealed that several economic, socio-cultural and demographic factors seem to be associated with the choice of this type of marriage, such as socioeconomic status, low level of education especially among women, early age at first marriage, place of residence especially in rural areas, and women's status in the labor market.

Conclusion: The relationship between consanguinity and economic, socio-cultural, and demographic factors may be country-specific and highly dependent on the cultural context. Public awareness of genetic risks associated with inbreeding is indispensable.

Background: Highly necessary to evaluate the effectiveness of preventive interventions to prioritize them at the community level. We aimed to systematically investigate the related studies on the effects of fluoride varnish and fissure sealant on dental caries in 6-12 children.

Methods: We searched PubMed, EMBASE, Web of Science, Cochrane Library and Scopus databases using Fluoride Varnish, Fissure Sealant, Caries, and Oral Health keywords. The timeframe selected to search for articles is from 2000 to Dec 2020. CMA software: 2 (Comprehensive Meta-Analysis) was used to perform the meta-analysis. The intervention groups in this study were fluoride varnish and fissure sealants, each of them compared to the control groups.

Results: We included nine studies. In the intervention group 84,380 and control group 11,254 individuals were studied. Eight of the studies were Randomized Clinical Trial (RCT) and Field RCT, and two was non-RCT. In the overall Fluoride Varnish efficacy study, 4 were fully effective, 1 was ineffective, and all 4 were completely effective for Fissure Sealant. There was a significant difference between decayed, missing, and filled permanent teeth (DMFT) and decayed, missing, and filled primary teeth (dmft) indices in both interventions and comparison groups. Moreover, the mean difference of DMFT for Fluoride Varnish and Fissure Sealant in the intervention and control groups were -0.55 and -0.29, respectively (P=0.00).

Conclusion: Due to the efficacy of fissure sealant and fluoride varnish in preventing dental caries in children aged 6-12 yr, these interventions can be considered as health priorities of societies and health systems interventions in countries.

Background: Vitamin D plays an essential role in the regulation of bone metabolism. The current meta-analysis aimed to assess the effectiveness of vitamin D fortification on special bone biomarkers.

Methods: Five main databases (PubMed/Medline, ISI Web of Knowledge, Science Direct, Scopus, Cochrane Library as well as Science Direct, and Scopus) were considered for this systematic review, until Jan 2020. All randomized controlled trials were included to evaluate the probable relationship between consumption of vitamin D fortification products and bone biomarkers profile in this review.

Results: Among serum bone biomarkers (osteocalcin and telopeptides of type-1 collagen) investigated, only the level of telopeptides of type-1 collagen significantly decreased after fortification of vitamin D in the intervention group. A significant increase in vitamin D was seen in those older than 18 yr old, while the increase in younger children was not statistically significant between intervention and control groups.

Conclusion: Vitamin D fortification was not associated with a significant improvement in bone mass density (BMD), while it resulted in decreased PTH levels. Vitamin D fortified foods have some benefits on bone health due to increase in the level of vitamin D and IGF-1; and decreasing PTH and CTx levels.

Background: The contamination of food products by Listeria monocytogenes as a pathogen bacterium, threatening public health and raised a global concern for a long time. Dairy and meat products and ready-to-eat foods are recognized as the most common carriers for L. monocytogenes.

Methods: The related reports of the prevalence of L. monocytogenes in dairy products in Middle East countries from 2009 to 2020 were screened through some of the international databases such as Science Direct, Web of Science, Scopus, PubMed, and Google Scholar. While a random effect model was applied to estimate pooled or overall prevalence, 95% confidence intervals (95%CI) were used.

Results: Results showed severe heterogeneity (84.2%) in studies and estimated the overall prevalence of L. monocytogenes dairy food products from the Middle East region of 3.5% (CI: 2.2-5). The highest and lowest prevalence was associated with Jordan (17.6% CI: 9.8-26.9) and Iraq (1.6% CI: 0.3-3.7), respectively. Based on the type of product, the highest and lowest prevalence of L. monocytogenes was recognized for raw cow milk (5.8% CI: 2.7-9.7) and pasteurized cow milk (1.1% CI: 0-8), respectively.

Conclusion: There is no justification for severe heterogeneity (I²) of subgroups as prevalence is heterogenic innately, but Jordan and row cow milk subgroups were found to have a considerable effect on overall pooled prevalence. Thus, they were the reason for prevalence changes.

Background: There is no comprehensive study addressing all the epidemiological aspects of Lung cancer (LC) in Iran, therefore this systematic review investigated the epidemiological aspects of lung cancer in Iran.

Methods: The search was performed until the Aug. 2020 on the in international databases based on PRISMA protocol by Pulmonary Neoplasms, Lung Neoplasm, Neoplasm, Lung, Lung Cancer, Cancer, Pulmonary Cancer, Cancer, Pulmonary, Cancers, Cancer of the Lung, Iran, incidence, death, risk factors keywords and different combinations of them. Articles that evaluated epidemiological aspects of lung cancer were included in the analysis.

Results: Of 1420 articles, 82 cases were entered the analysis. Based on studies, in Iran, lung cancer has been the most common cancer and its prevalence is increasing. Squamous cell carcinoma and adenocarcinoma is the most common type of lung cancer in men and women, respectively. Cigarette smoking, human papilloma virus (HPV) infection, mustard gas, occupational risk factors and genetic factors considered as the major reported risk factors for lung cancer and vegetarian diet as a protective factor.

Conclusion: In according to the increasing trend of incidence and mortality of lung cancer in Iran, elimination of the major risk factors can decrease this issue and national comprehensive planning should be considered in health promotion plans.

Background: We examined the Korean adults’ experience with dental implants and analyzed its association with various socioeconomic factors.

Methods: This study was based on the participants enrolled in the 2013-2015 KNHANES. Using the variables associated with dental implant treatment experience and other socioeconomic factors, we evaluated the statistical significance and potential associations between the dental implant treatment experience and its related factors. The final analysis in this study was performed on adults aged 20 yr and over. It comprised 4,893 subjects in the year 2013, 4,431 subjects in 2014, and 4,430 subjects in 2015.

Results: An increasing number of individuals had reported undergoing dental implant treatment. An older age was associated with a higher likelihood of undergoing dental implant treatment, particularly in adults aged ≥40 years. Additionally, the likelihood was higher in individuals with a greater income level, low-level of educational background, and married status. Factors that were observed to influence dental implant treatment experience included age, education level, income level, marital status.

Conclusion: Our analysis confirmed the growing accessibility to dental implants among Korean adults and an association between dental implant treatment experience and socioeconomic factors. We recommend a healthcare policy on dental implants that considers relevant socioeconomic factors, in order to provide dental implant treatment to individuals who are in absolute need of treatment.

Background: Colorectal cancer (CRC) has not only seriously affected people’s lives, but also burdened the government healthcare system. Long non-coding RNAs (lncRNA) have attracted more and more attention in the cancer study field.

Methods: Experiments were completed in the Medical Research and Innovation Center of Shanghai Pudong Hospital, China from 2019 to 2020. Cell cycle was detected by western blot analyzing and flow cytometry. Apoptosis analysis were determined using flow cytometry or western blot analysis. LncRNA CKMT2-AS1 was knocked down by shRNA transfection.

Results: We found CKMT2-AS1 was the most significant=0.0105 for SW480 and P=0.0071 for HCT116) difference lncRNA between colorectal cancer treated with autophagy inducer and colorectal cancer without any treatment. Effective shRNA-CKMT2-AS1 was also designed. Following, we found the treatment of autophagy inducer and autophagy inducer + shRNA-NC were able to suppress the proliferation of both SW480 and HCT116 cells. In addition, the treatment of autophagy inducer + shRNA-CKMT2-AS1 significantly reduced the apoptosis of SW480 and HCT116 cells induced by autophagy. Furthermore, we found the phosphorylation of mTOR, AKT was enhanced in SW480, and HCT116 cells treated with autophagy inducer + shRNA-CKMT2-AS1 compared to the cells treated with autophagy inducer of autophagy inducer + shRNA-NC.

Conclusion: Enhancing the expression of CKMT2-AS1 will become a promising strategy to prevent the progress of colorectal cancer.

Background: The purpose of this study was to verify the effects of smartphone usage mo-tives on life satisfaction in older adults, and to examine the mediating effect of digital literacy in the relationship between smartphone use motives and life satisfaction.

Methods: Data from 2004 participants of the 2018 Smartphone overdependence survey were analyzed by structural equation modeling.

Results: Smartphone use for communication had a positive impact on life satisfaction, and smartphone use for leisure negatively influenced life satisfaction. However, smartphone use for information seeking was not directly related to life satisfaction. Communication and in-formation-seeking use motives positively influenced digital literacy, but smartphone use for leisure did not affect. Digital literacy was also positively related to life satisfaction. Finally, communication use motives influenced life satisfaction partially mediating digital literacy, and smartphone use for information seeking influenced life satisfaction, fully mediating digital literacy.

Conclusion: By explaining how smartphone use motives significantly affect senior citizens’ life satisfaction, this study established the further meaningfulness of digital literacy.

Background: We aimed to explore the effect of self-efficacy intervention combined with humanistic nursing on self-care ability and quality of life in patients receiving chemotherapy for malignant tumors.

Methods: A total of 410 patients were enrolled, who received chemotherapy for malignant tumors in Fuyang People’s Hospital from June 2019 to June 2021. They were equally divided into the experimental group and the control group by a random number table. The former was given routine nursing, while self-efficacy intervention combined with humanistic nursing on the bases of routine care was introduced for the latter. Baseline information was collected from all patients. The psychological status of patients before and after intervention was assessed by self-rating anxiety scale (SAS), self-rating depression scale (SDS) and Visual analogue scale (VAS), while self-efficacy score and self-care ability scale for evaluating self-care ability of patients. Additionally, there was an evaluation of quality of life and nursing satisfaction in each group.

Results: Before intervention, no significant difference was identified in psychological status, self-care ability and quality of life between the two groups. After the intervention, the above three indexes in the experimental group were significantly better than those of the control group were. The experimental group had higher nursing satisfaction than the control group.

Conclusion: In patients with malignant tumor undergoing chemotherapy, self-efficacy intervention combined with humanistic nursing can significantly improve the self-care ability, quality of life and nursing satisfaction of patients, which is therefore worthy of promotion in clinical.

Background: We aimed to identify the factors affecting the quality of life in patients with hematologic disorders.

Methods: The sample group of 150 participants was randomly selected from among those who received hemodialysis at three public hospitals in Jeonju and Gwangju provinces and two private hospitals in Seoul, Korea. Among the 150 questionnaires retrieved, 143 were used for analysis, while 7 incomplete questionnaires were excluded. An independent t-test, one-way analysis of variance, Pearson correlation coefficient, and multiple regression analysis were performed to verify the effect on quality of life according to general characteristics such as implementing self-care, stress, and depression in patients receiving hemodialysis.

Results: General characteristics of participants accounting for differences in the quality of life were residential area (P<0.001), sex (P=0.031), monthly income (P=0.007), and frequency of dialysis (P=0.023). Moreover, quality of life was significantly and positively correlated with implementing self-care (P<0.001) and significantly and negatively correlated with stress (P<0.001) and depression (P<0.001). The variables affecting quality of life were depression (P<0.001), frequency of dialysis (two times a week) (P=0.008), monthly income (USD $2,000) (P=0.007), implementing self-care (P=0.004), and stress (P=0.010). The explanatory power (R²) of quality of life was 51.3%.

Conclusion: This study suggests providing self-nursing education to improve the quality of life of patients receiving hemodialysis. It also seeks ways to improve the patient’s self-efficacy and reduce stress and depression among hemodialysis patients.

Background: We aimed to probe carcinogenic genes associated with colon adenocarcinoma (COAD) development.

Methods: The gene expression profile of COAD were downloaded from TCGA. Differentially expressed genes (DEGs) were identified; GO and KEGG pathway enrichment were analyzed. Applying the up-mRNA-and-down-miRNA pairs and the down-mRNA-and-up-miRNA pairs, the miRNA target network was generated. The important genes were further analyzed towards the influence on overall survival and immune infiltration. In addition, essential miRNAs were selected for expression validation using real-time qPCR.

Results: Together, from 2020-2021, in Central Laboratory of the Second Affiliated Hospital of Fujian Medical University, we found 3060 up-regulated transcripts and 2254 down-regulated transcripts in mRNA expression, with 235 up-regulated and 263 down-regulated miRNAs. We discovered 98 enriched GO terms using the upregulated DEGs and 315 enriched GO terms using downregulated DEGs. There were 14 enriched KEGG pathways based on the down-regulated DEGs and only one pathway based on the up-regulated DEGs. There were 61 up-mRNA-and-down-miRNA pairs, including 7 miRNAs and 41 carcinogenic targets, among which HOXC13, FOXL2NB, ALOXE3, and ZIC2 were found related to a poorer OS. ZIC2 located at the subnet with the most targets (the miR-129-5p subnet). ZIC2 expression was correlated with immune-cell infiltration.

Conclusion: These risk genes, interaction networks, and enrichments may provide a better understanding of the complex molecular mechanisms in COAD development and potential therapeutic targets for clinical treatment of COAD.

Background: The study aimed to estimate the overall and disease-free survival rates of breast cancer patients and the factors affecting these rates.

Methods: In this retrospective study, data were obtained from 686 patients diagnosed with breast cancer in Sivas Cumhuriyet University Faculty of Medicine Research and Application Hospital Oncology Center between 1988 and 2014. Total population sampling method was used. The survival rates at certain periods were determined by creating a Life Table. By using the Kaplan-Meier Analysis, the mean survival times and rates were determined, and whether the variables had an impact on survival was examined. By applying Cox regression analysis, the effect of prognostic factors that are significant on the survival time of breast cancer patients was examined.

Results: Overall mean survival time was found as 208.4±11.8 months. According to Kaplan-Meier analysis, 1, 5, 10 and 20-years overall survival rates were 96.6 ± 0.07%, 82.3 ± 1.7%, 64.4 ± 3.4% and 49%± 7.4%, respectively. According to Cox regression analysis results, variables that influence overall survival time were found as disease stage, multicentricity status, ECOG (performance status), presence of diabetes, CA15-3 value, neutrophil/lymphocyte ratio. Moreover, variables that had an impact on the disease-free survival time were found as tumor grade, multicentricity, and ECOG.

Conclusion: Many factors other than disease can prolong survival or accelerate death. Considering the findings of this study may be useful in planning the treatment of breast cancer patients have positive affect on overall survival rates.

Background: As education develops, it proposes increasing requirements on the quality of teachers. Thus, attention on the mental health problems of teachers has also been gaining increasing attention. However, specific studies on the relationship among teachers’ perceived social support, psychache, and psychological resilience remain lacking.

Methods: Overall, 430 teachers (including teachers from universities, middle schools, and primary schools) from Zhejiang, Shanghai, Anhui, Hubei, Shanxi, Guangxi and other provinces in China were investigated in 2021 by using perceived social support scale, psychache scale, and psychological resilience scale.

Results: Teachers’ perceived social support is below the average, whereas psychache and psychological resilience are above the average. A significant gender difference exists in teachers’ psychache, and female teachers showed significantly higher teachers’ psychache than male teachers (P<0.05). Teachers’ psychache showed significantly negative correlations with perceived social support (r=−0.465, P<0.01) and psychological resilience (r=−0.526, P<0.01), but teachers psychological resilience had a significantly positive correlation with perceived social support (r=0.439, P<0.01). Teachers’ perceived social support (β=−0.465, P<0.01) could make a negative significant prediction of teachers’ psychache, and teachers’ perceived social support (β=0.435, P<0.01) could make a positive significant prediction of teachers’ psychological resilience. Moreover, psychological resilience had partial mediating effect between perceived social support and psychache, which accounts for 37.6% of the total effect.

Conclusion: Perceived social support not only is an important factor that influences teachers’ psychache directly but can also influence the psychache of teachers indirectly through psychological resilience.

Background: Similar to Indonesia, Aceh Province also showed a slight decline in neonatal mortality rate. However, the rate is still high compared to other provinces. Efforts to reduce neonatal mortality rate are essential because neonatal deaths contributed up to 71% of all under-five deaths in 2017 in Aceh. Antenatal care and low birth weight are known to be associated with neonatal mortality. The purpose of this study was to map district-level neonatal mortality rate and its determinants (antenatal care and low birth weight) in Aceh to inform policymakers in planning the interventions.

Methods: This was a cross-sectional study using publicly available secondary data obtained from Aceh Provincial Health Office. The study used the 2017 data of neonatal mortality rate, percent of 4th antenatal care visit and percent of low birth weight at district level. Thematic maps were produced using ArcMap (V.10.5). The correlation was analyzed using the Spearman rank test.

Results: The results indicated the regional variation of neonatal mortality rate across Aceh Province. Districts in the Southern region had lower neonatal mortality rates compared to others. Low birth weight was positively correlated with neonatal mortality rate at district level (Spearman’s Rho=0.545, P=0.007). However, the percent of 4th antenatal care visit at district level was not correlated with neonatal mortality rate (Spearman’s Rho= -0.35, P=0.097).

Conclusion: The study identified regional variations of neonatal mortality rate, low birth weight and ante natal care visit.

Background: Multinational comparative study of the relation of self-rated health (SRH) with health behavior and chronic disease can ease our perception of differences in health factors between countries. We aimed to compare the relation of SRH with health behavior and chronic disease.

Methods: We attempted to analyze larger data obtained from 2010 East-Asian-Social-Survey and to compare the situation of China, Japan, South Korea, and Taiwan (Special administrative region of China). As these are neighboring regions having both similarities and differences in socio-demographic aspects as well as environment and cultures. The study was composed of 10,137 participants. Univariate and multiple regression analyses were employed to estimate the Odds Ratio (OR) and 95% Confidence intervals (CI) for SRH and health-related behavior, sociodemographic, chronic disease variables.

Results: The number of individuals reporting Good SRH was 6,648, with China having the higher proportion (P=<0.05). There were 3642 (35.9%) who suffered from chronic diseases. Overall, males, age group 18-30, nonreligious, higher education levels, singles, and those living in big cities had higher percentage of good health. Those without chronic diseases had higher percentage of good health (P=<0.05). The consumption of alcohol was associated with poor SRH in all regions. While less physical activity, diabetes mellitus, and ischemic heart disease were also responsible for poor SRH in all regions (P=<0.05).

Conclusion: Several health-related behaviors and chronic diseases are associated with poor self-rated health. Effective public health strategies, in promoting healthy lifestyles, and disease prevention intervention should be encouraged.

Background: Assessing the prevalence of infections, which are preventable by vaccination, is crucial to monitor the vaccination program efficacy, and it can demonstrate the gaps in population immunity. The current study attempted to assess the specific Immunoglobulin (IgG) antibody against measles, mumps, and rubella (MMR) in Iranian children and adolescents, years after their vaccination.

Methods: This cross-sectional study was conducted in Iran. Serum samples of 2100 students, aged 7-18 years, included in a national health survey, were tested for MMR antibodies by ELISA assay. Multistage random cluster sampling was used to select subjects from 30 provinces in Iran.

Results: Overall, 1871, 1718, and 1678 serums were tested for measles, mumps, and rubella antibodies, respectively. The prevalence of positive test was 1231 (65.8%) for measles, 1327 (77.2%) for mumps and 1344 (80.1%) for rubella.

Conclusion: Despite high vaccination coverage in Iran, IgG antibody against measles, mumps, and rubella was not detected in a considerable proportion of children and adolescents aged 7-18 years. In case of contacts with residents of other countries, where measles or rubella have not yet been eliminated, it may create problems for Iranian children.

Background: Ischemic Heart Diseases (IHDs) are the main causes of deaths all over the world. Since there is no comprehensive study on IHDs mortality rate in Iran, the present study aimed to estimate age-standardized IHDs mortality rate by sex, age, geography, and time trends at both national and sub-national levels in Iran.

Methods: We used the Death Registration System (DRS) data from 1990 to 2015 collected by the Iranian Ministry of Health and Medical Education across the country, Tehran, and Isfahan main cemetery, not included in the DRS. Utilized death distribution methods to overcome the incompleteness of data. Statistical models including Spatio-temporal and Gaussian-Process Regression models were used to extrapolate all-cause and cause-specific mortality rates.

Results: Age-standardized IHDs mortality rate in Iran almost doubled from 1990 to 2015. Forty-nine deaths per 100.000 population in 1990, which increased to 91.6 deaths per 100.000 in 2015). Male to female age-standardized mortality rate increased from 1.07 to 1.32 during the studied period. Aging was associated with an increase in age-standardized IHDs mortality rate in both sexes, all provinces, and all of the years. The range of age-standardized IHDs mortality rate for both sexes was from 58 to 136.2 deaths per 100,000 across provinces in 2015.

Conclusion: Due to the increase in age-standardized IHDs mortality rate in Iran, it seems necessary to design and implement appropriate public health interventions by health authorities to prevent and control this group of diseases.

Background: Assessing the performance of hospitals in waste management requires considering several criteria of different types. The multiplicity of the criteria and how they are weighed and, ultimately, the ranking of hospitals; are among the most complex challenges faced by the environmental health authorities. This research tried to assess the capability of four commonly used multi-criteria decision-making methods, as well as a hybrid technique for performance assessment of six hospitals in Tehran City, Iran, in 2018 regarding waste management.

Methods: The effective criteria and sub-criteria were identified by reviewing the relevant literature. The data collection tool was a self-constructed checklist developed based upon the identified criteria and sub-criteria and analysis of the collected data was done in MATLAB software. The sample hospitals were ranked based on the scores given to the management performance of hospitals.

Results: The final rankings by the different techniques did not differ significantly. According to the results of the hybrid method, among six studied hospitals, the top three hospitals were Hospital C, B, and A respectively, regarding hospital waste reduction criteria. These hospitals generally had an acceptable performance in terms of waste management, especially waste disinfection and separation at the origin.

Conclusion: In assessing the performance and ranking of hospitals in terms of waste management, hybrid multi-criteria decision-making techniques can be used as a useful tool in waste management planning. By identifying the areas in need of corrective actions and choosing the appropriate strategy, they pave the way for improving the performance of hospitals in the field of waste management.

Background: We investigated the impact of cancer incidence on CHE in Iran by considering spatial variation across provinces as well as temporal trends.

Methods: Data from Household Income-Expenditure Survey were merged with cancer incidence rates during 2011-2016. We developed a Bayesian hierarchical model to explore the spatial and temporal patterns of CHE and its associated factors at provincial level. We used a Besag-York-Mollie2 prior and a random walk prior for spatial and temporal random effects respectively. All statistical analysis was carried out in R software.

Results: All-type cancer incidence (OR per SD (95% CrI) = 1.16 (1.02, 1.32)), unemployment rate (1.08 (1.01, 1.15)) and income equity (0.88 (0.81, 0.97)) have important association with CHE. Percentage of urbanization and percentage of poverty were not statistically significant.

Conclusion: The results suggest the development of new policies to protect cancer patients against financial hardship, narrow the gap in income inequality and solve the problem of high unemployment rate to reduce the level of CHE at provincial level.

Background: Mutations of the epidermal growth factor receptor (EGFR) gene, predominantly in exons 18-21, have been highlighted to function as the crucial predictors of the response rate of patients with non-small cell lung cancer (NSCLC) to EGFR tyrosine kinase inhibitors (TKIs).

Methods: This study was performed at Tehran University of Medical Sciences. Data and information were retrospectively collected from the period between Dec 2010 and Apr 2014. Exons 18 to 21 of the EGFR were analyzed for any potential mutation by PCR, accompanied by DNA sequencing on 160 with pathological confirmation of NSCLC.

Results: Demographically, the male to female ratio was approximately 2:1, and a substantial difference in age between sexes was not observed (P=0.065), but a noticeable difference was found in the smoking variable, where 77.8% of males were smokers compared to 17.3% of women (odds ratio (OR) (95% CI) = 16.72 (7.15-39.11)). We found a frequency of 10.63% (17/160) for mutations found in exons 19 and 21, nonetheless, no mutations in exon 18 and exon 20 were observed. The most frequently observed mutations were c.2235_2249, del and c.2240_2257, del in exon 19 and p. L858R in exon 21. The c.2253A>G was found as a novel mutation that was the rarest mutation detected in this work. Interestingly, a remarkable negative association was revealed between smoking and mutation rates in NSCLC patients (OR (95% CI) = 0.13 (0.04- 0.46).

Conclusion: The occurrence of EGFR mutations is largely varied among the different states of Iran, probably due to variations in ethnicity, smoking rate, and sex ratio of participants.

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 “The Effect of COVID-19 Vaccination on Reducing the Risk of Infection, Hospitalization, and Death in Isfahan Province, Iran.” by Ziba Taherian, Mostafa Rezaei, Asefeh Haddadpour, Zahra Amini, Iran J Public Health, 51(1), Jan 2022, 188-195.

The above article, published online at  https://ijph.tums.ac.ir/index.php/ijph/article/view/26539 has been retracted by agreement between the authors & the journal's Editor-in-Chief. After post-publication peer review, some concerns were raised on the terminology used in the results, discussion & related analysis. Some dates were reported incorrectly & there were some inconsistencies in reporting vaccine brand names. In addition, some unintentional errors have been found in the paper typesetting.

The retraction has been agreed by all panel of authors mentioned in the paper, so that the necessary corrections and completing the analysis are being made properly.