Tehran University of Medical Sciences Iranian Journal of Public Health 2251-6085 44 7 2015 10 11 892 901 EN Mohammad KHANAHMADI Dept. of Clinical Psychology, Allame Tabataba’i University, Tehran, Iran. Dariush D.FARHUD D.FARHUD School of Public Health, Tehran University of Medical Sciences, Tehran, Iran AND Dept. of Basic Sciences, Iranian Academy of Medical Sciences, Tehran, Iran. Maryam MALMIR Dept. of Exceptional Children Psychology, Science & Research Branch, Islamic Azad University, Tehran, Iran. 2015 10 11 2015 10 11 Background: Alzheimer's disease (AD) is one of the most common problems for old peoples. Etiology of AD is not clear, but genetic factors play a major role in determining a person's risk to develop AD. Twin and family studies con-firm that AD has a genetic basis.AD genetics has been split into two broad categories: early-onset and late-onset. EO-AD cases are inherited in an autosomal dominant pattern. In this form, dominant mutations in genes like APP, PSEN-1 and PSEN-2 associated with AD. This study aimed to consider the role of genetic in AD. Method: At the first, most of the references in relation with genetic basis of AD searched from the following web-sites: PubMed, Science direct, Wiley & Sons (1995-2014). Then, the most common genes and their affects described briefly. Results: Aging is the most obvious risk factor for developing AD. There is a genetic basis for AD, of course this rela-tion is not complete but it is significant. Conclusion: More than thousand genes studied in relation with Alzheimer's disease. Against the improvements in understanding different aspects of AD, the accurate genetic foundation of AD remain unclear. https://ijph.tums.ac.ir/index.php/ijph/article/view/3324 https://ijph.tums.ac.ir/index.php/ijph/article/download/3324/3046

Tehran University of Medical Sciences Iranian Journal of Public Health 2251-6085 44 7 2015 10 11 902 912 EN Mohammad MOHSENI Health Management and Economics Research Center, Iran University of Medical Sciences, Tehran, Iran. Mahtab ALIKHANI School of Health Management and Information Sciences, Iran University of Medical Sciences, Tehran, Iran. Sogand TOURANI School of Health Management and Information Sciences, Iran University of Medical Sciences, Tehran, Iran. Saber AZAMI-AGHDASH Iranian Center of Excellence in Health Management, Tabriz University of Medical Sciences, Tabriz, Iran. Sanaz ROYANI School of Health Management and Information Sciences, Iran University of Medical Sciences, Tehran, Iran. Mohammad MORADI-JOO Cancer Research Center, Shahid Beheshti University of Medical Sciences, Tehran, Iran. 2015 10 11 2015 10 11 Background: Discharge against Medical Advice (DAMA) is a problem for hospitals which may result in increasing readmissions, morbidities, inabilities, deaths and health care costs. This study, aimed to investigate the rate and causes of DAMA in Iranian hospitals. Methods: A systematic review and meta-analysis study was conducted in 2014. Required data were collected through searching for key words included: "Discharge Against Medical Advice", "Leaving against medical advice", "causes*", "hospital" and their Persian equivalents, over databases including PubMed, OVID, Google Scholar, Embase, Scopus, Magiran, scientific information database (SID). The reference lists of the articles, certain relevant journals and web sites in this field were also searched. Results: Out of 913 articles initially retrieved, finally 17 articles were incorporated into the study. There were 244858 individuals studied in the articles. Using a random effects model, the rate of DAMA in Iranian hospitals was estimated at 7.9% (6.3%-9.8%). While the highest rate of DAMA was associated with patients in departments of psychiatry (12%), the lowest rate was related to patients in departments of pediatrics (3.7). DAMA was in men more than women (P<0.05) Patient's perception of feeling of wellbeing, financial problems, family problems, the lack of attention from physicians and nurses, inappropriate behavior with patients by hospital team and the lack of timely care were men-tioned as main causes for DAMA. Conclusion: The rate of DAMA in Iranian hospitals is relatively high. Thus effective initiatives in this area are re-quired. https://ijph.tums.ac.ir/index.php/ijph/article/view/3325 https://ijph.tums.ac.ir/index.php/ijph/article/download/3325/3047

Tehran University of Medical Sciences Iranian Journal of Public Health 2251-6085 44 7 2015 10 11 913 919 EN Yongbing LIU Dept. of Clinical Nursing, School of Nursing, Xinjiang Medical University, Xinjiang China. Yanru WANG Dept. of Clinical Nursing, School of Nursing, Xinjiang Medical University, Xinjiang China. Fang LIANG Dept. of Clinical Nursing, School of Nursing, Xinjiang Medical University, Xinjiang China. Yanli CHEN Dept. of Clinical Nursing, School of Nursing, Xinjiang Medical University, Xinjiang China. Liu LIU Dept. of Clinical Nursing, School of Nursing, Xinjiang Medical University, Xinjiang China. Yanfei LI Dept. of Clinical Nursing, School of Nursing, Xinjiang Medical University, Xinjiang China. Hua YAO First Affiliated Hospital of Xinjiang Medical University, Xinjiang China. Qingquan CHU Social Welfare and Social Affairs Office, Urumchi Civil Affairs Bureau, Xinjiang China. 2015 10 11 2015 10 11 Background: This study was to investigate the health literacy and influencing factors of older population in pension institution of Xinjiang, China. Methods: Elderly people were selected from 44 pension institutions in Urumqi, Changji, Karamay and Shihezi and from September 2011 to June 2012 using random layer sampling method. The investigation was carried out by Chi-nese citizen health literacy questionnaire prepared by the China Health Education Center. Data were analyzed by One-way ANOVA, multiple linear regression and Pearson correlation analysis. Results: A total of 1396 elderly people met the inclusion criteria and their average age was (77.37 ± 8.48) years. Their average health literacy score was (77.37 ± 8.48) points, which was at a low level. There was significant difference in health literacy score among the factors of age, gender, race, education, household income, marital status and occupa-tion (P<0.05). The independent influencing factors of health literacy were education, race, occupation, household in-come, age and marital status (P < 0.05). Correlation analysis was conducted between the scores of health knowledge, health belief, health behavior, health skill and total scores of health literacy. Health knowledge scores and total scores had highest correlation (r=0.95), followed by health belief scores and total scores (r=0.81). Conclusion: The correlation between health behavior scores and health skill scores was the lowest (r=0.33). The ma-jor factors that lead to low health literacy in elderly people are femininity, minority and low levels of education. https://ijph.tums.ac.ir/index.php/ijph/article/view/3326 https://ijph.tums.ac.ir/index.php/ijph/article/download/3326/3048

Tehran University of Medical Sciences Iranian Journal of Public Health 2251-6085 44 7 2015 10 11 920 930 EN Aristide Romaric BADO Dept. of Statistics and Population Studies, Faculty of Natural Sciences, University of the Western Cape, Cape Town, South Africa. Sathiya Susuman APPUNNI Dept. of Statistics and Population Studies, Faculty of Natural Sciences, University of the Western Cape, Cape Town, South Africa. 2015 10 11 2015 10 11 Background: This study aimed to analysis the inequalities of mortality of children under 5 years in West Africa by examining the determinants and contributing factors to the overall inequality concentration in these countries. Method: Data used came from the DHS surveys conducted in the six countries in West Africa: Burkina Faso (2010), Benin (2006), Cote d'Ivoire 2011), Ghana (2008), Mali (2006), Nigeria (2008) and Niger (2012). The concentration index (CI) and Generalized Linear Model (GLM) with logit link were used to access inequality. Results: The results show that in all countries, the poorest Q1 have the highest proportions of deaths: Nigeria (31.4%), Cote d'Ivoire (30.4%) and Ghana (36.4%), over 30% of deaths of children under 5 years are among the chil-dren of the poorest (Q1) and the absolute differences of proportions Q1-Q5 are more than 20 points (25.8 in Ghana and 23.6 in Nigeria). The contributing factors of inequalities of child mortality were birth order, maternal age, parity and household size. Our findings also showed that the intensity of inequality varies from one country to another. Conclusion: The most important conclusion of this study is to reduce mortality in children under 5 years, it is needed to reduce economic and social inequalities and improve the country's economic and social condition. There is a need for monitoring and assessment inequalities by leading causes of death and morbidity among children in the region in order to advance in understanding the gaps and finding a way to reduce them in West Africa countries. https://ijph.tums.ac.ir/index.php/ijph/article/view/3327 https://ijph.tums.ac.ir/index.php/ijph/article/download/3327/3049

Tehran University of Medical Sciences Iranian Journal of Public Health 2251-6085 44 7 2015 10 11 931 938 EN Chonticha KAEWANUCHIT Dept. of Applied Sciences, Faculty of Science and Technology, Phranakhon Si Ayutthaya Rajabhat University, Phranakhon Si Ayutthaya Province, Thailand 13000. Carles MUNTANER Bloomberg Faculty of Nursing, Dalla Lana School of Public Health and Department of Psychiatry, School of Medicine, University of Toronto, Toronto K51P8, Canada. Nizam ISHA Dept. of Management and Humanities, University Teknologi PETRONAS, Bandar Seri Iskandar Tronoh, Perak, Malaysia 32610. 2015 10 11 2015 10 11 Background: Occupational stress is a psychosocial dimension of occupational health concept on social determinants of health, especially, job & environmental condition. Recently, staff network of different government universities of Thailand have called higher education commission, and Ministry of Education, Thailand to resolve the issue of gov-ernment education policy (e.g. wage inequity, poor welfare, law, and job & environment condition) that leads to their job insecurity, physical and mental health problems from occupational stress. The aim of this study was to investigate a causal relationship of occupational stress among the academic university employees. Methods: This cross sectional research was conducted in 2014 among 2,000 academic university employees at Thai government universities using stratified random sampling. Independent variables were wage, family support, periods of duty, and job & environmental condition. Dependent variable was stress. Results: Job & environmental condition, as social and environmental factor, and periods of duty as individual factor had direct effect to stress (P< 0.05). Family support, as family factor, and wage, as individual factor had direct effect to stress (P < 0.05). Both family support and wage were the causal endogenous variables. Conclusion: Job & environmental condition and periods of duty were increased so that it associated with occupation-al stress among academic university employees at moderate level. https://ijph.tums.ac.ir/index.php/ijph/article/view/3328 https://ijph.tums.ac.ir/index.php/ijph/article/download/3328/3050

Tehran University of Medical Sciences Iranian Journal of Public Health 2251-6085 44 7 2015 10 11 939 952 EN Kamila SOBAS Dept. of Human Nutrition, University of Warmia and Mazury, Olsztyn, Poland. Lidia WADOLOWSKA Dept. of Human Nutrition, University of Warmia and Mazury, Olsztyn, Poland. MalgorzataAnna SLOWINSKA Dept. of Human Nutrition, University of Warmia and Mazury, Olsztyn, Poland. Magdalena CZLAPKA-MATYASIK Dept. of Human Nutrition and Hygiene, University of Life Sciences in Poznan, Poland. Justyna WUENSTEL Dept. of Human Nutrition, University of Warmia and Mazury, Olsztyn, Poland. Ewa NIEDZWIEDZKA Dept. of Human Nutrition, University of Warmia and Mazury, Olsztyn, Poland. 2015 10 11 2015 10 11 Background: The aim of this study was to demonstrate similarities and differences between mothers and daughters regarding dietary and non-dietary risk factors for bone fractures and osteoporosis. Methods: The study was carried out in 2007-2010 on 712 mothers (29-59 years) and daughters (12-21 years) family pairs. In the sub-sample (170 family pairs) bone mineral density (BMD) was measured for the forearm by dual-energy x-ray absorptiometry (DXA). The consumption of dairy products was determined with a semi-quantitative food fre-quency questionnaire (ADOS-Ca) and calcium intake from the daily diet was calculated. Results: The presence of risk factors for bone fractures in mothers and daughters was significantly correlated. The Spearman rank coefficient for dietary factors of fracture risk was 0.87 (P<0.05) in whole sub-sample, 0.94 (P<0.05) in bottom tercile of BMD, 0.82 (P<0.05) in middle tercile of BMD, 0.54 (P>0.05) in upper tercile of BMD and for non-dietary factors of fracture risk was 0.83 (P<0.05) in whole sub-sample, 0.86 (P<0.05) in bottom tercile of BMD, 0.93 (P<0.05) in middle tercile of BMD, 0.65 (P<0.05) in upper tercile of BMD. Conclusions: Our results confirm the role of the family environment for bone health and document the stronger ef-fect of negative factors of the family environment as compared to other positive factors on bone fracture risk. https://ijph.tums.ac.ir/index.php/ijph/article/view/3329 https://ijph.tums.ac.ir/index.php/ijph/article/download/3329/3051

Tehran University of Medical Sciences Iranian Journal of Public Health 2251-6085 44 7 2015 10 11 953 961 EN Xin LIU Blood Sampling Room, Second Affiliated Hospital of Harbin Medical University, Harbin 150086, China. Xu HE Dept. of Hepatopancreatobiliary Surgery, First Affiliated Hospital of Harbin Medical University, Harbin 150001, China. Ling LI Disaster Preparedness and Relief Center of Red Cross Society of Heilongjiang, Harbin 150008, China. Lili HUANG https://ijph.tums.ac.ir/index.php/ijph/article/view/41196 https://ijph.tums.ac.ir/index.php/ijph/article/download/41196/8722

Tehran University of Medical Sciences Iranian Journal of Public Health 2251-6085 54 12 2025 12 31 2623 2633 Motahhareh Yekehbash Health Policy Research Center, Institute of Health, Shiraz University of Medical Sciences, Shiraz, Iran Reyhaneh Zarei Health Policy Research Center, Institute of Health, Shiraz University of Medical Sciences, Shiraz, Iran Hassan Joulaei Health Policy Research Center, Institute of Health, Shiraz University of Medical Sciences, Shiraz, Iran 2025 01 12 2025 09 25 Background: Public-private partnerships (PPPs) address issues of access, quality, and innovation in health care. This paper assesses the impact of various PPP models on health care delivery and explores factors influencing their success. We aimed to deepen policymakers’ and practitioners’ understanding of PPP dynamics, challenges, and opportunities. Methods: A scoping review was conducted using a systematic approach to identify relevant literature on PPPs in health care from 2000 to 2024. Searches were performed in PubMed, Scopus, and Web of Science using specific search terms and inclusion criteria. Data from selected articles were analyzed to identify key themes, drivers, and outcomes related to PPP implementation and impact. Results: The review covered 37 PPP studies from multiple countries, revealing mixed results and challenges. Successful PPPs in China, Iran, and Kenya improved health care delivery, efficiency, and patient satisfaction. However, challenges such as regulatory barriers, financial constraints, and integration issues persist. In Spain and Portugal, PPPs often face public rejection due to perceived financial unsustainability. Legal and regulatory frameworks in Iran and Tanzania hinder effective PPP implementation. Conclusion: PPPs have significant potential to transform health systems, especially in resource-limited settings. Their success relies on careful planning, strong governance, and adapting to local contexts. For PPPs to be effective, they must prioritize equity and sustainability in their design and execution. https://ijph.tums.ac.ir/index.php/ijph/article/view/37797 https://ijph.tums.ac.ir/index.php/ijph/article/download/37797/8723

Tehran University of Medical Sciences Iranian Journal of Public Health 2251-6085 54 12 2025 12 31 2634 2646 Zakieh Ostadahmadi Social Determinants of Health Research Center, Mashhad University of Medical Sciences, Mashhad, Iran Sara Boccalini Department of Health Sciences, University of Florence, Florence, Italy Mohammad-Reza Modabberi Department of Management Sciences and Health Economics, School of Health, Mashhad University of Medical Sciences, Mashhad, Iran Anahita Behzadi Social Determinants of Health Research Center, Institute for Futures Studies in Health, Kerman University of Medical Sciences, Kerman, Iran 2025 04 09 2025 09 18 Background: Maternal influenza immunization is a primary strategy for protecting mothers and infants under six months, though its comprehensive efficacy and safety profiles undergo continuous evaluation. However, the reliability of current evidence is moderated by varying degrees of primary study overlap across existing reviews. Methods: Five electronic databases—PubMed, Embase, Web of Science, ProQuest, and Scopus—were systematically searched up to August 2024. Study eligibility and quality were assessed using the ROBIS tool. To ensure the integrity of the findings and address potential primary study overlap, the Corrected Covered Area (CCA) formula was applied. Results: Eleven systematic reviews and meta-analyses were evaluated. Maternal influenza vaccination may reduce the risk of laboratory-confirmed influenza (LCI) in both mothers and infants; however, no clear effect was observed on influenza-like illness (ILI). Vaccination is generally associated with a reduced risk of fetal mortality and no consistent evidence suggests a significant increase in congenital anomalies or spontaneous abortion. Maternal influenza vaccination may modestly reduce preterm birth risk, shows no clear effect on small for gestational age, and is associated with reduced low birth weight (LBW). The studies on influenza vaccination in pregnant women showed high overlap for LCI (0.66), infant LCI (0.50), and varying overlap for stillbirth (0.38), congenital anomalies (0.28), spontaneous abortion (0.23), premature birth (0.13), SGA (0.27), and LBW (0.14). Conclusion: Influenza vaccination during pregnancy effectively reduces LCI in mothers and infants without increasing adverse neonatal outcomes, though its impact on ILI remains inconsistent. Due to high study overlap and variable quality, further large-scale research is required to confirm effects on preterm birth and congenital anomalies. https://ijph.tums.ac.ir/index.php/ijph/article/view/38792 https://ijph.tums.ac.ir/index.php/ijph/article/download/38792/8724

Tehran University of Medical Sciences Iranian Journal of Public Health 2251-6085 54 12 2025 12 31 2647 2659 Hamid Pourasghari Hospital Management Research Center, Health Management Research Institute, Iran University of Medical Sciences, Tehran, Iran Mohammad Ali Rezaei Hospital Management Research Center, Health Management Research Institute, Iran University of Medical Sciences, Tehran, Iran 2025 05 01 2025 09 18 Background: Leptospirosis is a widespread zoonotic disease causing over one million cases and 60,000 deaths annually. This review aimed to identify and assess policy options for leptospirosis prevention using the One Health approach and One Health Governance Index (OHGI) framework. Methods: PubMed, Web of Science, Scopus, and Cochrane Library were searched for full-text academic articles, along with Google Scholar and reference lists from Jan 2008 to Dec 2023. A scoping review was conducted following Arksey and O’Malley’s framework and PRISMA-ScR guidelines. Articles were retrieved from major databases using defined keywords. Eligible studies focused on community-based policies for human leptospirosis prevention. Two reviewers independently assessed quality, and data were categorized by One Health domains and analyzed using the OHGI framework. Results: Forty-two studies were included. Common policy strategies involved sanitation education, medical training, surveillance of humans, animals, and environments, legal controls on exposure sources, infrastructure upgrades, and vaccination. Tools like GIS and climate data supported preparedness. Policy options most addressed rule of law, effectiveness, and equity. Conclusion: Preventing leptospirosis epidemics demands coordinated, context-specific One Health policies that address implementation gaps and promote equity across vulnerable settings. https://ijph.tums.ac.ir/index.php/ijph/article/view/38968 https://ijph.tums.ac.ir/index.php/ijph/article/download/38968/8725

Tehran University of Medical Sciences Iranian Journal of Public Health 2251-6085 54 12 2025 12 31 2660 2669 Şeyma Kara Pursaklar District Health Directorate, Ministry of Health, Ankara, Turkey Banu Cakir Division of Epidemiology, Department of Public Health, Hacettepe University Faculty of Medicine, Ankara, Turkey 2025 05 01 2025 09 30 Background: Measles, a highly contagious, yet vaccine-preventable disease, is currently experiencing a notable resurge in numbers, in developing countries. With limited reading time, physicians often rely on structured summaries, and well-prepared abstracts can encourage them to read the full article, facilitating patient care. We aimed to examine the reporting quality of article abstracts about measles. Methods: Indirectly/directly address measles and its vaccine, scrutinizing on systematic reviews and meta-analyses published from 2009 to the present, and indexed in the open-access PubMed article database. With the widespread use of abstract checklists like PRISMA-A in reading systematic reviews and meta-analyses, the message intended to be conveyed can be adequately delivered to the reader by abstracts only, respecting standard rules and requirements for reporting. We used a scoring system for compliance with PRISMA-A checklist in reading measles-related reviews published over the last 15 years. Results: On average, the abstracts were “very highly” compliant with the expected reporting criteria: The year of publication (with 2020 as the timepoint) did not make any difference in reporting quality, but structured abstract were significantly more likely to convey their message in an “expected” manner, based on PRISMA-A criteria. Conclusion: Using standard guidelines in evaluating reporting quality of different publications and emphasizing its importance for the writers and readers, alike, will be encouraging for improved presentation of original/filtered research results, with the goal of conveying valid and reliable health-related information, in a time-efficient way. https://ijph.tums.ac.ir/index.php/ijph/article/view/38967 https://ijph.tums.ac.ir/index.php/ijph/article/download/38967/8726

Tehran University of Medical Sciences Iranian Journal of Public Health 2251-6085 54 12 2025 12 31 2670 2679 NamGi Lee Department of Physical Therapy, Kwangju Women’s University, Gwangju, Republic of Korea Sam-Ho Park Department of Physical Therapy, Kwangju Women’s University, Gwangju, Republic of Korea 2025 02 04 2025 09 30 Background: We compared abdominal muscle and subcutaneous fat thicknesses, and core stability among young Korean women with normal weight non-obesity (NWNO), normal weight obesity (NWO), and obesity (OB). Methods: Between May and September 2024, fifty-seven female university students from K University in Gwangju, Republic of Korea, were classified into three groups (NWNO: n = 15, NWO: n = 20, and OB: n = 22) based on body mass index and body fat percentage. The thicknesses of the abdominal muscles, including the transverse abdominis (TrA), internal abdominal oblique (IO), and external abdominal oblique (EO) muscles, and of the subcutaneous fat were measured using real-time ultrasound imaging. Core stability was assessed using trunk extensor, trunk flexor, and side-bridge endurance tests. Data were analyzed using one-way ANOVA with a significance level of 0.05. Results: Significant differences were observed in the thicknesses of the TrA (P = 0.002), EO (P = 0.001), and subcutaneous fat (P < 0.05) between groups. The OB group had the greatest TrA and subcutaneous fat thicknesses. The side-bridge endurance test revealed a significant difference in core stability (P = 0.002), with the OB group demonstrating the lowest core stability. Conclusion: Although the OB group had the largest muscle thickness, it demonstrated lower core stability than the NWNO group. These results suggest that obesity might impair neuromuscular activation and muscle fiber recruitment, leading to functional limitations despite increased muscle mass. These findings emphasize the importance of preventing and managing normal-weight obesity in women in their 20s. https://ijph.tums.ac.ir/index.php/ijph/article/view/38054 https://ijph.tums.ac.ir/index.php/ijph/article/download/38054/8727

Tehran University of Medical Sciences Iranian Journal of Public Health 2251-6085 54 12 2025 12 31 2680 2689 Elif Nur Yıldırım Öztürk Konya Provincial Health Directorate, Public Health Service, Selcuklu, Konya, Türkiye Mustafa Ozturk Konya Meram State Hospital, Emergency Service, Meram, Konya, Türkiye 2025 04 28 2025 07 17 Background: This study aimed to analyze trends in the population attributable fraction (PAF) for mortality attributable to dietary risks over a 22-year period between 2000 and 2021 and to determine which type of dietary risk has a significant effect on mortality from which NCDs. Methods: In this descriptive and ecological study, data were obtained from the Global Burden of Disease Study, 2021. Age-standardized and sex-specific PAFs for mortality attributable to dietary risks and PAFs for mortality attributable to selected and specific dietary risks were calculated for six noncommunicable diseases worldwide for the 22-year period. The trend of PAFs over time was assessed by joinpoint regression analysis. Results: The two diseases with the highest mean PAF for mortality attributable to dietary risks were hypertensive heart disease followed by ischemic heart disease (0.63±0.01 and 0.45±0.01, respectively). The mean PAF for mortality attributable to dietary risks differed between sexes for four diseases. All six diseases had dietary risk-attributable mortality starting at a young age. Over a 22-year period, PAF for mortality attributable to dietary risks followed a significant decreasing trend for all six diseases. When the PAFs for mortality attributable to selected and specific dietary risks were examined, the majority showed a decreasing trend. Conclusion: It is essential to clarify the relationship between NCDs and dietary risks. This is because the human body is exposed to nutritional and dietary risks every day, both as individuals and as a community. https://ijph.tums.ac.ir/index.php/ijph/article/view/38935 https://ijph.tums.ac.ir/index.php/ijph/article/download/38935/8728

Tehran University of Medical Sciences Iranian Journal of Public Health 2251-6085 54 12 2025 12 31 2690 2700 Changgyun Kim Department of Electronic and AI System Engineering, Kangwon National University, Kangwon, Samcheok, 25913, Republic of Korea Ji-Yong Lee Center for Sports and Performance Analysis, Korea National Sports University, Seoul, Songpa-gu, 05541, Republic of Korea 2025 04 30 2025 06 21 Background: Childhood obesity poses serious long-term health risks and is a growing global concern. In South Korea, national health surveys collect behavioral and physical data from elementary students, but the large number of questionnaire items can burden young respondents and reduce accuracy. Thus, simplified models with high predictive power are needed. Methods: We analyzed data from over 250,000 elementary students collected by the Korean Ministry of Education (2015–2022). Using the Rohrer Index as the outcome variable, key predictors were selected via Lasso and Elastic Net regression. Categorical variables were reduced using Multiple Correspondence Analysis (MCA), and a deep learning model (NECTOR) combining MLP and self-attention was developed. Results: NECTOR achieved high predictive performance with R² scores of 0.994 (boys) and 0.996 (girls), and low mean squared errors of 3.072 and 1.841, respectively. It outperformed baseline models using the same inputs. Conclusion: A small set of core health indicators can effectively predict the Rohrer Index. The proposed model enables efficient and reliable obesity screening in school settings, supporting early intervention efforts. https://ijph.tums.ac.ir/index.php/ijph/article/view/38957 https://ijph.tums.ac.ir/index.php/ijph/article/download/38957/8729

Tehran University of Medical Sciences Iranian Journal of Public Health 2251-6085 54 12 2025 12 31 2701 2711 Ola Monther Amaireh 1. Department of Medical Laboratory Sciences, Faculty of Allied Medical Sciences, Al-Ahliyya Amman University, Amman, Jordan 2. Cytopathology Laboratory in Pathology Department, Princess Iman Research and Laboratory Sciences Center, KHMC, Jordan Manal Abbas Department of Medical Laboratory Sciences, Faculty of Allied Medical Sciences, Al-Ahliyya Amman University, Amman, Jordan Manal Abbas Department of Medical Laboratory Sciences, Faculty of Allied Medical Sciences, Al-Ahliyya Amman University, Amman, Jordan 2025 05 09 2025 09 30 Background: IQOS (I Quit Ordinary Smoking) has been introduced as a “safer” alternative to traditional tobacco smoking. We aimed to determine how heated tobacco products influence iron metabolism by examining the impact of IQOS use and conventional cigarette smoking on hepcidin and iron-related parameters. Methods: In this cross-sectional study, an iron panel and hepcidin levels were measured in participants who were using IQOS for at least six months and compared with those of conventional smokers or non-smokers.   Results: A total of 185 adults (18-40 years) of both sexes participated in the study, including 80 IQOS users, 49 cigarette smokers and 56 non-smokers. No significant differences were found in hemoglobin level, red blood cell count, mean corpuscular volume, white blood cell count, platelet count or total iron level between IQOS users and non-smokers in both sexes. However, ferritin levels were significantly higher in male IQOS users compared to non-smokers (P=0.022). Hepcidin levels were markedly higher in IQOS users (375.77 ± 98.59 pg/mL) compared with cigarette smokers (26.35 ± 8.81 pg/mL; P = 0.0001) and non-smokers (31.27 ± 7.78 pg/mL; P = 0.0001). No significant difference in unsaturated iron-binding capacity, total iron-binding capacity or transferrin saturation was found between IQOS users compared to non-smokers. Conclusion: IQOS use was associated with significantly elevated hepcidin levels and higher ferritin in males, suggesting a potential disruption of iron regulation compared to conventional smokers and non-smokers. https://ijph.tums.ac.ir/index.php/ijph/article/view/39042 https://ijph.tums.ac.ir/index.php/ijph/article/download/39042/8730

Tehran University of Medical Sciences Iranian Journal of Public Health 2251-6085 54 12 2025 12 31 2712 2723 Xin Gong Department of Otolaryngology, Wushan County People’s Hospital of Chongqing, Chongqing, 404700, China Yongqi Dong Department of Gastroenterology, Wushan County People’s Hospital of Chongqing, Chongqing, 404700, China Yinxia Xu Children Health Care Center, Wushan County People’s Hospital of Chongqing, Chongqing, 404700, China Chao Yuan Department of Otolaryngology, Wushan County People’s Hospital of Chongqing, Chongqing, 404700, China Xiaoling Zhang Department of Otolaryngology, Wushan County People’s Hospital of Chongqing, Chongqing, 404700, China Shiyong Xiao Department of Clinical Nutrition, Wushan County People’s Hospital of Chongqing, Chongqing, 404700, China Dan Wu Department of Dermatology, Wushan County People’s Hospital of Chongqing, Chongqing, 404700, China Deping Wang Department of Otolaryngology, The Second Affiliated Hospital of Chongqing Medical University, Chongqing, 400010, China 2025 05 04 2025 06 21 Background: Hearing loss (HL) constitutes a significant hazard to the health and social welfare, yet there is a lack of data on its burden in young adults (YAs) aged 15-39 yr. This study aimed to delineate the global temporal trends and predict the future burden of HL in YAs. Methods: Using data from the Global Burden of Disease study 2021, we analyzed the prevalent cases and age-standardized prevalence rates (ASPR) of HL in YAs by age, sex, and Socio-demographic Index(SDI). The age-period-cohort (APC) model was used to assess trends, while the Bayesian Age-Period-Cohort (BAPC) model projected future epidemiological trajectories. Results: Globally, HL prevalent cases in YAs increased from 171.77 million (95% CI: 145.95–200.16) in 1992 to 256.16 million (95% CI: 222.49–293.87) in 2021. The ASPR rose from 7862.80 to 8474.66 per 100,000 over this period, with males consistently showing higher rates than females. APC analysis revealed age-dependent increases in hearing loss risk, adverse period effects in recent years (2012–2021), and a peak relative risk in the 1997–2006 birth cohort. The BAPC model projects 291.37 million (95% CI: 182.25–400.49) prevalent cases by 2040. Conclusion: The global burden of HL in YAs is rising, particularly since the relative risk of HL has continued to grow during the last 10 years, highlighting the need for further research and intervention. https://ijph.tums.ac.ir/index.php/ijph/article/view/38998 https://ijph.tums.ac.ir/index.php/ijph/article/download/38998/8731

Tehran University of Medical Sciences Iranian Journal of Public Health 2251-6085 54 12 2025 12 31 2724 2734 İzzet Fidancı Department of Family Medicine, Faculty of Medicine, Hacettepe University, Ankara, Türkiye Hilal Aksoy Department of Family Medicine, Faculty of Medicine, Hacettepe University, Ankara, Türkiye Duygu Ayhan Başer Department of Family Medicine, Faculty of Medicine, Hacettepe University, Ankara, Türkiye 2025 04 29 2025 09 18 Background: We aimed to examine the association between occupational burnout and food disgust among professional chefs working in restaurants, hotels, and catering services in Turkey. Methods: This cross-sectional study was conducted between December 1, 2024, and April 1, 2025, using a convenience sampling method. Participants included 279 professional chefs working in restaurants, hotels, and catering services across Turkey, as well as those presenting to outpatient clinics affiliated with our institution. Eligible participants were aged 18 years or older, had at least one year of professional culinary experience, and were currently employed in a food service setting. Results: The average burnout score was 3.88 ± 1.69, measured on a 7-point scale (1 = no burnout, 7 = severe burnout). The mean food disgust score was 119.9 ± 45.54 on a 32–192 scale, with higher scores indicating greater food disgust sensitivity. Participants with critical burnout reported significantly elevated food disgust compared to those in lower burnout categories (P=0.001). Robust regression confirmed burnout as an independent predictor of food disgust (β=4.263, P=0.008), whereas demographic and occupational variables were not significantly associated with either outcome. Conclusion: This study provides evidence of an association between occupational burnout and food disgust among professional chefs. However, due to the cross-sectional design, no causal inferences can be made. Findings should therefore be interpreted with caution, and future longitudinal studies are needed to clarify temporal relationships. https://ijph.tums.ac.ir/index.php/ijph/article/view/38952 https://ijph.tums.ac.ir/index.php/ijph/article/download/38952/8732

Tehran University of Medical Sciences Iranian Journal of Public Health 2251-6085 54 12 2025 12 31 2735 2744 Maryam Chegeni 1. Department of Public Health, Khomein University of Medical Sciences, Khomein, Iran 2. Molecular and Medicine Research Center, Khomein University of Medical Sciences, Khomein, Iran Nouzar Nakhaee Neuroscience Research Center, Institute of Neuropharmacology, Kerman University of Medical Sciences, Kerman, Iran Negar Sangsefidi Department of Biostatistics, Faculty of Health, Mashhad University of Medical Sciences, Mashhad, Iran Shakila Zarrinnegar Department of Clinical Psychology, School of Behavioral Sciences and Mental Health, Iran University of Medical Sciences and Health Services, Tehran, Iran Zahra Khorrami Ophthalmic Epidemiology Research Center, Research Institute for Ophthalmology and Vision Science, Shahid Beheshti University of Medical Sciences, Tehran, Iran Parvin Mangolian Shahrbabaki Nursing Research Center, Depart, Kerman University of Medical Sciences, Kerman, Iran Mahin Eslami Shahrbabaki Neuroscience Research Center, Institute of Neuropharmacology, Department of Psychiatry, Kerman University of Medical Sciences, Kerman, Iran Ali-Akbar Haghdoost Modeling in Health Research Center, Institute for Futures Studies in Health, Kerman University of Medical Sciences, Kerman, Iran 2025 02 05 2025 10 24 Background: Adverse childhood experiences (ACEs) are linked to various behavioral and psychological issues. This study explored the relationship between ACEs and social media addiction (SMA), examining the mediating role of quality of life (QoL) and the moderating effect of occupational status. Methods: Overall, 1,247 adults (55.4% females), aged 19 to 65 yr, were recruited through convenience sampling in Kerman, southeast Iran. Validated Persian versions of the ACE-ASF, WHOQOL-BREF, and Bergen Social Media Addiction Scale were used. Structural equation modeling (PLS-SEM) assessed direct, indirect, and moderated pathways. Results: ACEs were significantly associated with higher SMA (β=0.088, P=0.002) and lower QoL (β = –0.234, P<0.001). QoL was inversely related to SMA (β = –0.225, P<0.001), and partially mediated the ACE–SMA relationship (β=0.053, P < 0.001). Occupational status moderated the effects of ACEs on both QoL (β=0.066, P=0.021) and SMA (β= –0.055, P=0.046), Higher job levels reduced adverse effects. However, no significant moderation was found in the QoL–SMA path. Conclusion: ACEs significantly increase the risk of SMA, partly through reduced QoL. Improving occupational status and QoL can reduce the long-term behavioral effects of childhood adversity. https://ijph.tums.ac.ir/index.php/ijph/article/view/38059 https://ijph.tums.ac.ir/index.php/ijph/article/download/38059/8733

Tehran University of Medical Sciences Iranian Journal of Public Health 2251-6085 54 12 2025 12 31 2745 2753 Mina Nosrati 1. International UNESCO Center for Health-Related Basic Sciences and Human Nutrition, Mashhad University of Medical Sciences, Mashhad, Iran 2. Department of Nutrition, Faculty of Medicine, Mashhad University of Medical Sciences, Mashhad, Iran Hossein Hatamzadeh Department of Nutrition, Faculty of Medicine, Mashhad University of Medical Sciences, Mashhad, Iran Amin Mansoori 1. Department of Applied Mathematics, Ferdowsi University of Mashhad, Iran 2. Social Determinants of Health Research Center, Mashhad University of Medical Sciences, Mashhad, Iran 3. Mathematical Biology Research Laboratory (MBRL), Faculty of Mathematical Sciences, Ferdowsi University of Mashhad, Mashhad, Iran Mahsa Tousi Department of Nutrition, Faculty of Medicine, Mashhad University of Medical Sciences, Mashhad, Iran Shakiba Najjar Khalilabad Student Research Committee, Faculty of Medicine, Mashhad University of Medical Sciences, Mashhad, Iran Fatemeh Rojoee Student Research Committee, Faculty of Medicine, Mashhad University of Medical Sciences, Mashhad, Iran Fatemeh Mohammadyari School of Medicine, Guilan University of Medical Sciences, Rasht, Iran Gordon A Ferns Department of Medical Education, Brighton and Sussex Medical School, Brighton, United Kingdom Habibollah Esmaily 1. Social Determinants of Health Research Center, Mashhad University of Medical Sciences, Mashhad, Iran 2. Department of Biostatistics, School of Health, Mashhad University of Medical Sciences, Mashhad, Iran Majid Ghayour-Mobarhan 1. International UNESCO Center for Health-Related Basic Sciences and Human Nutrition, Mashhad University of Medical Sciences, Mashhad, Iran 2. Department of Nutrition, Faculty of Medicine, Mashhad University of Medical Sciences, Mashhad, Iran 2025 04 23 2025 10 19 Background: Inflammatory indices have been linked to mood disorders. We aimed to examine whether these inflammatory indices are associated with the severity of depression and anxiety as measured by Beck scores. Methods: This cross-sectional analysis included 9,704 participants aged 35–65 years from the Mashhad Stroke and Heart Atherosclerotic Disorder (MASHAD) cohort study. Depression and anxiety were assessed using the Beck Depression Inventory (BDI) and Beck Anxiety Inventory (BAI). Inflammatory indices were calculated based on hematological and biochemical parameters. Multinomial logistic regression was applied to evaluate the associations between inflammatory markers and mood disorder severity. Results: In cases of severe depression, the neutrophil-to-lymphocyte ratio (NLR), white blood cell (WBC) count, and serum high-sensitivity C-reactive protein (hs-CRP) levels were significantly higher (OR = 1.29, 1.08, and 1.01, respectively; P < 0.05) than in individuals with minimal depression. Serum hs-CRP levels were also significantly higher (OR = 0.98; 95% CI: 0.95–0.99) in participants with moderate anxiety compared with those with minimal anxiety. Conclusion: Higher levels of depression were associated with increased inflammatory hematological indices, and that the severity of depression was related to elevated levels of NLR, WBC, and hs-CRP. https://ijph.tums.ac.ir/index.php/ijph/article/view/38880 https://ijph.tums.ac.ir/index.php/ijph/article/download/38880/8734

Tehran University of Medical Sciences Iranian Journal of Public Health 2251-6085 54 12 2025 12 31 2754 2763 Akram Gholipour Cardiogenetic Research Center, Rajaie Cardiovascular Institute, Tehran, Iran Molood Farsi Department of Molecular Genetics, Faculty of Biological Sciences, Tarbiat Modares University, Tehran, Iran Faezeh Sari Department of Molecular Genetics, Faculty of Biological Sciences, Tarbiat Modares University, Tehran, Iran Zahra Khajali 1. Cardiogenetic Research Center, Rajaie Cardiovascular Institute, Tehran, Iran 2. Congenital Heart Diseases Research Center, Rajaie Cardiovascular Institute, Tehran, Iran Majid Maleki Cardiogenetic Research Center, Rajaie Cardiovascular Institute, Tehran, Iran Mahshid Malakootian 1. Cardiogenetic Research Center, Rajaie Cardiovascular Institute, Tehran, Iran 2. Vascular Disease and Thrombosis Research Center, Rajaie Cardiovascular Institute, Tehran, Iran 2025 05 02 2025 10 19 Background: Pulmonary arterial hypertension (PAH) is characterized by high blood pressure in the lungs due to obstruction of small pulmonary arteries. Its exact cause is unknown. We aimed to identify specific genes, signaling pathways, and microRNAs (miRNAs) as novel diagnostic biomarkers for PAH progression. Methods: We analyzed differentially expressed genes (DEGs) from PAH and control samples in the GSE144932 and GSE131793 datasets using GEO2R. We performed GO enrichment and KEGG pathway analyses. miRNAs targeting common DEGs were identified using miRDB and TargetScan. Results: MYLK and CLU were upregulated in both datasets, implicating calcium signaling and coagulation pathways, respectively. In silico analysis showed that miR-9-5p, miR-3179, and miR-580-3p potentially target MYLK; miR-369-3p potentially targets CLU; and miR-499a-5p potentially targets both. Conclusion: This study identifies MYLK and CLU, and their associated miRNAs (miR-9-5p, miR-3179, miR-580-3p, miR-499a-5p, and miR-369-3p), as potential noninvasive diagnostic biomarkers for PAH, requiring experimental validation.  https://ijph.tums.ac.ir/index.php/ijph/article/view/38971 https://ijph.tums.ac.ir/index.php/ijph/article/download/38971/8735

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