Tehran University of Medical Sciences Iranian Journal of Public Health 2251-6085 50 6 2021 06 10 1088 1096 EN Vita Widyasari 1. Department of Healthcare Administration, College of Medical and Health Science, Asia University, Taichung, Taiwan 2. Cluster of Public Health Science, Faculty of Medicine, Universitas Islam Indonesia, Yogyakarta, Indonesia Ferry Rahman 1. Department of Healthcare Administration, College of Medical and Health Science, Asia University, Taichung, Taiwan 2. Public Health Department, Universitas Muhammadiyah Kalimantan Timur, Samarinda, Indonesia Kuan-Han Lin Department of Healthcare Administration, College of Medical and Health Science, Asia University, Taichung, Taiwan Jiun-Yi Wang 1. Department of Healthcare Administration, College of Medical and Health Science, Asia University, Taichung, Taiwan 2. Department of Medical Research, China Medical University Hospital, China Medical University, Taichung, Taiwan 2020 10 11 2021 04 21 Background: The number of elderly and the burden of non-communicable diseases increase with time. Community involvement is expected to be an important prevention agent for their neighbors. This study aimed to determine the effectiveness of health services delivered by community health workers (CHWs) which focus on physiological indices related to non-communicable diseases among elderly people and to explain the health services or interventions carried out by CHWs. Methods: This systematic review was conducted based on the PRISMA guidelines. PubMed, ProQuest Science Database, Scopus, EBSCOhost CINAHL, and Web of Science were taken as the source of databases. Manual search was also conducted for articles published before March 2019 without time restriction. The quality of each study was assessed using Critical Checklist by Joanna Briggs Institute. Results: Of the 3,275 initial studies retrieved, 4 studies were included in qualitative synthesis analysis. Three studies arranged a face-to-face interview, while the other study was conducted over the phone. All the 4 studies were intervention studies. Three of them showed a significant improvement in mean systolic blood pressure for the intervention group compared to the control group. The other study showed a significant improvement in weight loss for the intervention group. Conclusion: Health services delivered by CHWs was beneficial to elderly people in rural areas on some physiological indices. It suggested that health services delivered CHWs could contribute toward secondary prevention programs. https://ijph.tums.ac.ir/index.php/ijph/article/view/22482 https://ijph.tums.ac.ir/index.php/ijph/article/download/22482/7244

Tehran University of Medical Sciences Iranian Journal of Public Health 2251-6085 50 6 2021 06 10 1097 1107 Wenna Li Medical Insurance Office, Jinan Central Hospital, Jinan 250013, China Qiuhong Cao Department of Anesthesiology, Jinan Central Hospital, Jinan 250013, China 2021 02 16 2021 03 06 Background: The efficacy of graded emergency nursing on acute pancreatitis (AP) patients was evaluated by the Meta-analysis system. Methods: The databases of CNKI, WanFang, VIP, PubMed, the Cochrane Library and Web of Science were searched by computer in January 2021. The references were screened according to the inclusion and exclusion criteria. The data were extracted and the quality of those references was evaluated. Meta-analysis was made by RevMan 5.4 software, publication bias was detected by funnel chart, and sensitivity analysis was carried out. Results: Thirteen papers were included, including 11 waiting time indexes, 7 disease judgment accuracy indexes, 13 rescue success rate indexes and 5 patient satisfaction rate indexes. Meta-analysis showed that compared with conventional emergency nursing methods, graded emergency nursing methods had shorter waiting time (MD=-11.97, 95%CI (-15.74, -8.21), P<0.00001), higher accuracy in judging illness (OR=6.6, 95%CI (3.13, 13,93), P<0.00001) and rescue success rate (OR=7.12，95%CI (4.16, 12.20), P<0.00001), and patients’ satisfaction was higher (OR=8.79, 95%CI (3.59, 21.56), P<0.00001). Conclusion: Graded emergency nursing can optimize the allocation of emergency resources, effectively shorten the waiting time of AP patients. It also improves the accuracy of disease judgment, the success rate of rescue and the satisfaction of patients. It is an efficient emergency nursing method and is worthy of clinical application. https://ijph.tums.ac.ir/index.php/ijph/article/view/23886 https://ijph.tums.ac.ir/index.php/ijph/article/download/23886/7245

Tehran University of Medical Sciences Iranian Journal of Public Health 2251-6085 50 6 2021 06 10 1108 1119 EN Fusheng Bai Department of Neurology, Liaoning Province Jinqiu Hospital, Shenyang 110016, China Xinming Li Key Lab of Environmental Pollution and Microecology of Liaoning Province, Shenyang Medical College, Shenyang 110034, China 2020 10 27 2021 01 19 Background: We aimed to review relevant randomized controlled trials to assess the relative clinical effects of antibiotic treatment of patients with community-acquired pneumonia (CAP). Methods: In this meta-analysis, we identified relevant studies from PubMed, Cochrane, and Embase using appropriate keywords. Key pertinent sources in the literature were also reviewed and all articles published through Oct 2019 were considered for inclusion. For each study, we assessed the risk ratios (RRs) or mean difference combined with the 95% confidence interval (CI) to assess and synthesize outcomes. Results: Overall, 36 studies were consistent with the meta-analysis, involving 17,076 patients. There was no significant difference in the mortality after subgroup analysis: individualized treatment vs. standard treatment; β-lactams plus macrolides vs. β-lactam and/or fluoroquinolone; ceftaroline fosamil vs. ceftriaxone; combination therapy vs. monotherapy or high-dose vs. low-dose. The drug-related adverse event incidence was significantly higher in the ceftriaxone group than in the other drug groups (P<0.05) and also higher in the tigecyline group than in the levofloxacin group (P<0.05). Compared with ceftriaxone, ceftaroline fosamil significantly increased the clinical cure rate at the test-of-cure (TOC) visit in the clinically evaluable population, modified intent-to-treat efficacy (MITTE) population, microbiologically evaluable (ME) population and the microbiological MITTE (mMITTE) population (all P<0.05). Compared with ceftriaxone, ceftaroline fosamil significantly increased the clinical cure rate at the TOC visit in the mMITTE population of Gram positive-Streptococcus pneumoniae (P<0.05) and multidrug-resistant S. pneumoniae (P<0.05). Conclusion: There was a limited number of included studies in the subgroup analysis, but it will still be necessary to conduct more high-quality randomized controlled trials to confirm the clinical efficacy of different antibiotics used to treat CAP. https://ijph.tums.ac.ir/index.php/ijph/article/view/22668 https://ijph.tums.ac.ir/index.php/ijph/article/download/22668/7246

Tehran University of Medical Sciences Iranian Journal of Public Health 2251-6085 50 6 2021 06 10 1120 1134 EN Maryam Selk- Ghaffari Sports Medicine Research Center, Neuroscience Institute, Tehran University of Medical Sciences, Tehran, Iran Sakineh Shab-Bidar Department of Community Nutrition, School of Nutritional Sciences and Dietetics, Tehran University of Medical Sciences, Tehran, Iran Farzin Halabchi Department of Sports and Exercise Medicine, Tehran University of Medical Sciences, Tehran, Iran 2020 01 22 2021 02 06 Background: Due to widespread abuse of anabolic-androgenic steroids among professional athletes and amateur sportsmen and their health-related problems, determining the prevalence and the pattern of anabolic-androgenic steroid misuse at the national level seems to be vital for designing efficient preventive and educational measures. Methods: This systematic review and meta-analysis was conducted via comprehensive searches of the electronic databases including PubMed, MedLine, Scopus, Google Scholar and National Persian Databases including SID, Magiran, IranDoc (between 1980 and Dec 2019 in English and Persian languages) and also from citations in the selected papers. Overall, 39 articles met the criteria and were included in qualitative and quantitative synthesis. Results: The overall prevalence rate of anabolic-androgenic steroid misuse in the Iranian athletic population was 36.2% (95% confidence interval (CI), 29-43) with significant heterogeneity between studies (I2=99.0%, P<0.001). Prevalence rate of anabolic-androgenic steroid misuse among elite, male and younger athletes was higher (P<0.05). Moreover, prevalence rate of anabolic-androgenic steroid misuse among body-building athletes (36.3%) was higher compared to other athletes (30.9%), (P<0.001). Conclusion: Due to the higher prevalence of anabolic-androgenic steroids misuse in Iran compared to global statistics and the potential for serious adverse effects, preventive strategies and policies should be regarded as a real concern for public health. https://ijph.tums.ac.ir/index.php/ijph/article/view/19510 https://ijph.tums.ac.ir/index.php/ijph/article/download/19510/7247

Tehran University of Medical Sciences Iranian Journal of Public Health 2251-6085 50 6 2021 06 10 1135 1142 Arshid Yousefi Avarvand Department of Medical Laboratory Sciences, Faculty of Para Medicine, Ahvaz Jundishapur University of Medical Sciences, Ahvaz, Iran Mehrdad Halaji Department of Microbiology, School of Medicine, Babol University of Medical Sciences, Babol, Iran Donya Zare Department of Microbiology, School of Medicine, Isfahan University of Medical Sciences, Isfahan, Iran Meysam Hasannejad-Bibalan Department of Microbiology, School of Medicine, Guilan University of Medical Sciences, Rasht, Iran Hadi Sedigh Ebrahim-Saraie Razi Clinical Research Development Unit, Razi Hospital, Guilan University of Medical Sciences, Rasht, Iran 2019 05 01 2019 10 20 Background: Streptococcus pneumoniae is an important pathogen of children, mostly in developing countries. We aimed to investigate the prevalence of invasive S. pneumoniae among Iranian children using a systematic review and meta-analysis. Methods: A systematic search was carried out to identify papers published by Iranian authors in the Web of Science, PubMed, Scopus, and Google Scholar electronic databases from January of 2010 to December of 2017. Then, seven publications that met our inclusion criteria were selected for data extraction and analysis. Results: Totally, one study was multicenter, and six were single-center based studies. Meanwhile, all of the included studied performed among hospitalized patients. Seven studies reported the prevalence of invasive S. pneumoniae isolated from children, of these the pooled prevalence of S. pneumoniae was 2.5% (95% CI: 0.7%-9.1%). Conclusion: The overall prevalence of invasive S. pneumoniae infections among Iranian children is low (2.5%). However, further clinical studies are required to elucidate the burden of infections among Iranian children, especially in eastern regions. https://ijph.tums.ac.ir/index.php/ijph/article/view/17011 https://ijph.tums.ac.ir/index.php/ijph/article/download/17011/7248

Tehran University of Medical Sciences Iranian Journal of Public Health 2251-6085 50 6 2021 06 10 1143 1155 Elham Ghazanchaei Social Determinants of Health Research Center, Urmia University of Medical Sciences, Urmia, Iran Davoud Khorasani-Zavareh 2. Skull Base Research Center, Loghman Hakim Hospital, Shahid Beheshti University of Medical Sciences, Tehran, Iran 3. Workplace Health Promotion Research Center, Department of Health in Emergencies and Disasters, School of Public Health and Safety, Shahid Beheshti University of Medical Sciences, Tehran, Iran Javad Aghazadeh-Attari Social Determinants of Health Research Center, Urmia University of Medical Sciences, Urmia, Iran Iraj Mohebbi Social Determinants of Health Research Center, Urmia University of Medical Sciences, Urmia, Iran 2020 05 26 2020 11 08 Background: Patients with non-communicable diseases are vulnerable to disasters. This is a systematic review describing the impact of disasters on non-communicable diseases. Methods: A systematic review was conducted using PRISMA standards. Relevant articles published from 1997 to 2019 collected by searching the Scopus, PubMed, Science Direct, databases. We specifically examined reports describing NCDs and including the key words “non-communicable disease and Disasters”. NCDs included cardiovascular, respiratory, diabetes, cancer and mental health diseases. Results: Of the 663 studies identified, only 48 articles met all the eligibility criteria. Most studies have shown the impact of all natural disasters on non-communicable diseases (39.8% n=19). The largest study was the effect of earthquakes on non-communicable diseases (29.2% n=14). For the NCDs targeted by this research, most of the included studies were a combination of four diseases: cardiovascular disease, respiratory disease, diabetes and cancer (44% n=21). Followed by cardiovascular disease (14.6% n=7), chronic respiratory disease (12.5% n=6), diabetes and cancer (6.2% n=3) and mental health (12.5% n=6). Conclusion: The incidence of disasters affects the management of treatment and care for patients with NCDs. Specific measures include a multi-part approach to ensuring that patients with non-communicable diseases have access to life-saving services during and after disasters. The approach of the health system should be expanded from traditional approaches to disasters and requires comprehensive planning of health care by policy makers and health professionals to develop effective strategies to enable patients to access medical, therapeutic and diagnostic services in natural disasters. https://ijph.tums.ac.ir/index.php/ijph/article/view/20917 https://ijph.tums.ac.ir/index.php/ijph/article/download/20917/7249

Tehran University of Medical Sciences Iranian Journal of Public Health 2251-6085 50 6 2021 06 10 1156 1166 Farzaneh Valizadeh Student Research Committee, School of Nursing and Midwifery, Shahroud University of Medical Sciences, Shahroud, Iran Reza Chaman Center for Health Related Social and Behavioral Sciences Research, Shahroud University of Medical Sciences, Shahroud, Iran Zahra Motaghi Department of Reproductive Health, Shahroud University of Medical Sciences, Shahroud, Iran Ali Mohammad Nazari Department of Reproductive Health, Shahroud University of Medical Sciences, Shahroud, Iran 2020 09 10 2020 12 28 Background: Temporary marriage (TM) is legitimate sexual relations without social, moral approval, which can be a threat to individuals’ health, it is a risk factor for spread of Sexual Transmitted Infections (STIs). Therefore, it is necessary to identify and control STIs in TM-individuals and subsequent save of "society health". In this meat-analysis, we examined the prevalence of STIs in TM in Iran. We further examined un-protected sex among TM-individuals. Method: Up to Feb 2020, we searched international and national electronic databases identify to published studies on the prevalence of STIs in TM. We estimated the prevalence of STIs in TM using a random-effect pooled estimate analysis approach. Results: Totally, we retrieved 1616 studies from the previously mentioned databases, of which, 18 met the eligibility criteria, published from 1995 to 2020 in different provinces. The total sample size of the included studied contained 2056 TM-individuals, of which 368 were found with STIs and 955 with unprotected sex. The pooled prevalence of STIs and unprotected sex among TM women was 39% (95%CI: 24% to 54%), 55% (95%CI: 40% to 70%) Conclusion: STI and unprotected sex are high among TM-individuals which call an urgent need for community and health care providers to provide especially designed medical and psycho-social supportive care services in a safe and unprejudiced environment for TM-individuals. Furthermore, untrained health care providers for TM-individuals, under reporting, social stigma should be taken in to account. Denying the presence of such realities, does not eradicate the facts but results in catastrophic public health problems. https://ijph.tums.ac.ir/index.php/ijph/article/view/22141 https://ijph.tums.ac.ir/index.php/ijph/article/download/22141/7250

Tehran University of Medical Sciences Iranian Journal of Public Health 2251-6085 50 6 2021 06 10 1167 1176 Hyunwoo Kang College of Sport Science, Sungkyunkwan University, Seobu-ro 2066, Suwon, Korea Seyong Jang Department of Taekwondo, College of Arts and Physical Education, Gachon University, Seongnam 13120, Korea 2021 04 08 2021 06 10 Abstract Background: The present study aimed to provide an empirical theoretical basis for the psychological phenomena that occur among competing athletes. To this end, we utilized the actor and partner interdependence model (APIM) to analyze the self- and relative effects of competitive state anxiety on perceived performance in middle and high school Taekwondo athletes. Methods: Data were analyzed for 372 middle and high school athletes (red group=186, blue group=186) who participated in the first round of the 2020 Korea Taekwondo Association National Taekwondo Competition. Analysis based on the APIM was applied to the collected data, and a path analysis was conducted to verify the self- and relative effects of competitive state anxiety on perceived performance. Results: Cognitive (red: P<0.01, blue: P<0.001) and physical state anxiety (red: P<0.01, blue: P<0.01) exerted a significant negative self-effect on perceived performance in both groups. In contrast, state confidence (red: P<0.001, blue: P<0.001) exerted a significant positive self-effect on perceived performance. Furthermore, cognitive (red: P<0.001, blue: P<0.01) and physical state anxiety (red: P<0.001, blue: P<0.001) exerted a significant positive relative effect on the opponent’s perceived performance in both groups, while state confidence (red: P<0.01, blue: P<0.001) exerted a significant negative relative effect on the opponent’s perceived performance. Conclusion: Sports psychologists should focus on developing a psychological training program that provides practical psychological support as well as self-regulatory and relative strategies for improving athletic performance in competitive scenarios. https://ijph.tums.ac.ir/index.php/ijph/article/view/24505 https://ijph.tums.ac.ir/index.php/ijph/article/download/24505/7251

Tehran University of Medical Sciences Iranian Journal of Public Health 2251-6085 50 6 2021 06 10 1177 1187 Yawen Shao Gansu Provincial Maternity and Child Care Hospital, Lanzhou, Gansu, China Baohong Mao Gansu Provincial Maternity and Child Care Hospital, Lanzhou, Gansu, China Jie Qiu Gansu Provincial Maternity and Child Care Hospital, Lanzhou, Gansu, China Yan Bai Gansu Provincial Maternity and Child Care Hospital, Lanzhou, Gansu, China Ru Lin Gansu Provincial Maternity and Child Care Hospital, Lanzhou, Gansu, China Xiaochun He Gansu Provincial Maternity and Child Care Hospital, Lanzhou, Gansu, China Xiaojuan Lin Gansu Provincial Maternity and Child Care Hospital, Lanzhou, Gansu, China Ling Lv Gansu Provincial Maternity and Child Care Hospital, Lanzhou, Gansu, China Zhongfeng Tang Gansu Provincial Maternity and Child Care Hospital, Lanzhou, Gansu, China Min Zhou Xiaoying Xu Gansu Provincial Maternity and Child Care Hospital, Lanzhou, Gansu, China Bin Yi Gansu Provincial Maternity and Child Care Hospital, Lanzhou, Gansu, China Qing Liu Gansu Provincial Maternity and Child Care Hospital, Lanzhou, Gansu, China 2019 07 14 2019 12 08 Abstract Background: To evaluate the independent and collective effects of maternal iron supplementation and dietary iron intake upon the risk of moderate preterm birth and its subtypes. Methods: In this birth cohort study, 1019 pregnant women with moderate preterm birth and 9160 women with term birth were recruited at Gansu Provincial Maternity and Child Care Hospital from 2010-2012 in China. Unconditional logistic regression models were utilized to evaluate the association between maternal iron supplementation, dietary iron intake, and the risk of moderate preterm birth and its subtypes. Results: Compared with non-users, iron supplement users exerted a protective effect upon the overall (OR=0.54, 95%CI=0.40-0.72) and spontaneous moderate preterm birth (OR=0.39, 95%CI=0.33-0.83). Compared with the 25th quartiles of dietary iron intake, either before or during pregnancy, it exerted a significantly protective effect upon those who had the highest quartiles of dietary iron intake (OR=0.87, 95%CI=0.82-0.95 for the highest quartiles of dietary iron intake before pregnancy OR=0.85, 95%CI=0.79-0.91). Positive association was observed between the additive scale and multiplicative scale for preterm birth, spontaneous preterm rather than medically indicated preterm. Conclusion: Iron supplements (60 mg/day) and high-iron intake (>25.86 mg/day before pregnancy, >30.46 mg/day during pregnancy) reduced the risk of moderate preterm birth. Positive correlation is found between the additive scale and multiplicative scale for preterm birth, spontaneous preterm birth.       https://ijph.tums.ac.ir/index.php/ijph/article/view/17765 https://ijph.tums.ac.ir/index.php/ijph/article/download/17765/7252

Tehran University of Medical Sciences Iranian Journal of Public Health 2251-6085 50 6 2021 06 10 1188 1196 Basri Furkan Dagcioglu Department of Family Medicine, Faculty of Medicine, Ankara Yildirim Beyazit University, Ankara, Turkey Erhan Simsek Department of Family Medicine, Faculty of Medicine, Ankara Yildirim Beyazit University, Ankara, Turkey Ramazan Tepeli Department of Family Medicine, Faculty of Medicine, Ankara Yildirim Beyazit University, Ankara, Turkey Dilek Oztas Department of Public Health, Faculty of Medicine, Ankara Yildirim Beyazit University, Ankara, Turkey 2019 11 13 2019 12 24 Background: Considering the gap between organ donors and receivers, it can be assumed that family physicians may play an important role in organ donation. Thus, we aimed to investigate the family physicians’ approaches to organ donation in Turkey. Methods: In this cross-sectional study, an online survey was sent to all family physicians working in Family Health Centers in Turkey Between Jul – Sep 2018. The survey questioned the knowledge, approaches, and opinions about organ donation issues, besides the socio-demographic characteristics. Results: Most physicians stated that they had given information to their patients on this subject at least occasionally (59.19%, n=998). Among participants, the most common reason for refusing consent for organ donation was the fear of commercial abuse (19.66%, n=244). Most participants (52.61%, n=887) stated that they had been positively affected by the media about organ donation. Some physicians were uncertain about the reliability of the brain death diagnosis (18.39%, n=310). A minor group stated that organ donation might be religiously inappropriate (10.50%, n=177). Conclusion: Although most of the family physicians had a positive manner about organ donation, there was still some wrong knowledge of the participants about legal and medical aspects of organ donation, as well as some other concerns like organ trafficking and reliability of brain death diagnoses, whereas religious concerns were not significant. https://ijph.tums.ac.ir/index.php/ijph/article/view/18937 https://ijph.tums.ac.ir/index.php/ijph/article/download/18937/7253

Tehran University of Medical Sciences Iranian Journal of Public Health 2251-6085 50 6 2021 06 10 1197 1205 Qiuhua Wan Department of Clinical Laboratory, Jining Maternal and Child Health and Family Planning Service Center, Jining, 272100, China Yiping Liu Prenatal Diagnosis Center, Jining Maternal and Child Health and Family Planning Service Center, Jining, 272100, China Bo Lv Department of Clinical Laboratory, Jining Maternal and Child Health and Family Planning Service Center, Jining, 272100, China Xiaofang Chen Department of Obstetrics and Gynecology, Jining Maternal and Child Health and Family Planning Service Center, Jining, 272100, China 2020 11 18 2021 02 06 Abstract Background: This study was designed to explore the levels of serum moleculartumor markers carbohydrate antigen 125 (CA125), human epididymis protein 4 (HE4), and carcinoembryonic antigen (CEA) in patients with primary epithelial ovarian cancer, and their correlation with the progression of the cancer. Methods: A total of 222 people were enrolled in this study admitted to Jining Maternal and Child Health and Family Planning Service Center from January 2016 to December 2017. There were 122 patients with primary epithelial ovarian cancer (ovarian cancer group), 50 patients with benign ovarian diseases (benign control group), and 50 healthy individuals (normal control group). The levels of serum CA125, CEA, and HE4 were detected by the electrochemical luminescence method and ELISA. Results: The levels of serum CA125, HE4, and CEA in the ovarian cancer group were significantly higher than those in patients with the benign control group and the normal control group (P<0.01). The levels of serum CA125, HE4, and CEA in the high clinical staging group (stage III and stage II), low differentiation group, comorbid ascites group, metastasis group, and recurrence group were significantly higher than those in the low clinical staging group (stage I and stage II), high + moderate differentiation group, non-ascites group, non-metastasis group, and non-recurrence group, respectively (all P<0.05), and the levels of serum CA125, HE4, and CEA decreased significantly after treatment (P<0.01). Conclusion: The levels of serum CA125, HE4, and CEA are closely related to the development and progression of epithelial ovarian cancer, and combined detection of CA125, HE4 and CEA is of great significance for early diagnosis, disease development monitoring, and prognosis evaluation of epithelial ovarian cancer. https://ijph.tums.ac.ir/index.php/ijph/article/view/22915 https://ijph.tums.ac.ir/index.php/ijph/article/download/22915/7254

Tehran University of Medical Sciences Iranian Journal of Public Health 2251-6085 50 6 2021 06 10 1206 1212 Zelal Adibelli Division of Nephrology, Department of Internal Medicine, Usak University, School of Medicine, Usak, Turkey Cevdet Duran Division of Endocrinology and Metabolism, Department of Internal Medicine, Usak University, School of Med-icine, Usak, Turkey 2019 03 05 2019 04 24 Background: Diabetes mellitus (DM) and chronic kidney disease (CKD) are global growing health problems. Since DM is the major cause for CKD etiology, its development can be prevented with simple measures, like achievements of glycemic, lipid and blood pressure targets. This study aimed to evaluate whether the treatment goals for CKD patients with DM are achieved under the Kidney Disease Outcomes Quality Initiative (KDOQI) guideline. Methods: Overall, 160 CKD patients with DM were enrolled in the study performed in Usak, Turkey from Jan 2016 to Jan 2018. Compatibility with treatment goals defined in KDOQI 2012 guideline for HbA1c levels, hypertension and dyslipidemia were evaluated retrospectively. Results: Of 160 CKD patients [15 (9.4%) in stage 3a, 53 (33.1%) stage 3b, 51 (31.9%) stage 4 and 41 (25.6%) stage 5], 23 patients in stage 5 were on hemodialysis. Total compliance rate to hyperglycemia treatment was 94 of 160 patients (58.8%). Compatibility rates between different stages of CKD were similar. Hypertension was detected only in 134 patients. Sixty-six (49.3%) patients were compatible with the treatment goals, and as the CKD stages progressed, the rate of patients achieving hypertension treatment goals was declined (P=0.001). One-hundred and thirty-seven patients were not on hemodialysis and fifty-four (39.9%) of 137 patients achieved dyslipidemia goal. There was no difference between different stages of CKD. Conclusion: Under KDOQI 2012 guideline, treatment goal for hyperglycemia was better achieved than the treatment goals for hypertension and dyslipidemia. In CKD patients with DM the physicians should be also focused on the treatment of hypertension and dyslipidemia. https://ijph.tums.ac.ir/index.php/ijph/article/view/16441 https://ijph.tums.ac.ir/index.php/ijph/article/download/16441/7255

Tehran University of Medical Sciences Iranian Journal of Public Health 2251-6085 50 6 2021 06 10 1213 1223 Li Jing Department of Physical Education, Xianyang Normal University, China Seung-Yong Kim Major in Physical Education, Graduate School of Education, Kyonggi University, Republic of Korea 2021 04 11 2021 06 10 Background: We aimed to investigate the relationships among self-management, self-resilience, and adaptability to college life in Chinese and Korean students majoring in physical education. In addition, we explored the mediating role of self-resilience in the relationship between self-management and adaptability to college life. Methods: Random sampling was used to identify participants majoring in physical education at five colleges and universities in Shaanxi (China) and four universities in Kyonggi-do Province (Republic of Korea) in June 2020. We analyzed data for 700 students via exploratory factor analysis, confirmatory factor analysis, correlation analysis, structural equation model analysis, and path analysis. Results: Self-management had a significant impact on self-resilience (P<0.001), while self-resilience had a significant impact on adaptability to college life (P<0.001). Among self-management variables, body management had a significant negative impact on adaptability to college life (P<0.001). Self-resilience had a mediating effect on the relationship between self-management and adaptability to college life (P=0.024). Conclusion: Our findings highlight the need to develop systems that cultivate students’ abilities to integrate into university life, including their abilities to face unsatisfactory studies, manage spare time, make physical adjustments, adapt to new living environments, and maintain interpersonal relationships. Strengthening self-management abilities will lead to improvements in self-resilience, adaptability, and satisfaction with university life among physical education majors. https://ijph.tums.ac.ir/index.php/ijph/article/view/24541 https://ijph.tums.ac.ir/index.php/ijph/article/download/24541/7256

Tehran University of Medical Sciences Iranian Journal of Public Health 2251-6085 50 6 2021 06 10 1224 1232 Bin Li Department of Physical Education, Yantai University, Yantai, China 2021 05 11 2021 06 10 Background: Shoulder, neck, and back discomforts and abdominal obesity caused by sedentariness are increasingly prominent in young and middle-aged population groups. Health Qigong improves physical functions and strengthens the disease resistance of exercisers. This study aims to explore health Qigong intervention’s effects on the cervical vertebra, lumbar vertebra, and mental status. Methods: A total of 108 sedentary young and middle-aged faculties from Yantai University in China were recruited from July to December 2020 and randomly classified into the experimental and control groups. The former received health Qigong exercises for 12 weeks, and the latter was not intervened. The total general skeletal muscle mass, range of neck joint motion, mental health, and range of waist joint motion of all respondents before and after the intervention were tested and calculated. Results: The body fat rate of the experimental group after intervention was significantly lower than that before intervention (P<0.05). The skeletal muscle mass (SMM) value was significantly higher than that before intervention. The experimental group had lower body fat rate but higher SMM value than the control group after the intervention. In addition, the range of motion (ROM) of the cervical vertebra was significantly higher in the experimental group than in the control group after intervention. Somatization, obsessive/compulsive disorder, interpersonal sensitivity, depression, anxiety, hostility, paranoia, and SCL-90 total score of the experimental group after intervention decreased significantly compared with that before intervention (P<0.05). Conclusion: Health Qigong improves the ROM of cervical and lumbar vertebrae and the mental health status of sedentary young and middle-aged groups. https://ijph.tums.ac.ir/index.php/ijph/article/view/24893 https://ijph.tums.ac.ir/index.php/ijph/article/download/24893/7257

Tehran University of Medical Sciences Iranian Journal of Public Health 2251-6085 50 6 2021 06 10 1233 1240 Jinfu Liu 1. School of Physical Education and Sport Sciences, Fujian Normal University, Fuzhou, China 2. Department of Physical Education and Military Training, Jiaxing University, Jiaxing, China Feng Gao Department of Physical Education and Military Training, Jiaxing University, Jiaxing, China Lugang Yuan Department of Physical Education and Military Training, Jiaxing University, Jiaxing, China 2021 04 11 2021 06 10 Background: Chinese children are poorer in sports activity as compared to foreign children and their prospects as to physical fitness are not optimistic. This study aimed to discuss the effects of diversified sports activity modules on physical fitness and mental health of preschoolers ages 4–5 years. Methods: Sixty preschoolers aged 4–5-yr-old from two kindergartens in Jiaxing of China were selected randomly during Mar-Oct 2019. These respondents were divided into the experimental group (n=30) and the control group (n=30). The experimental group implemented the diversified sports activity module for 16 wk successively, 5 d per week, and 30-45 min per day. The control group adopted conventional sports activity. The body shape, physical fitness, and mental health of the two groups were measured and compared. Results: For body shape, the height of the experimental group increased is significantly higher than that of the control group. The experimental and control groups show no significant differences in body weight. For physical fitness, the experimental group is significantly superior to the control group in testing results of standing long jump, double-feet continuous jump, balancing on one foot, tennis shot, sit-and-reach, and 10 m repeated run. For mental health, the testing results of action development, language development, and social development of the experimental group are significantly better than those of the control group. Conclusion: The diversified sports activity module is not only conducive to strengthening the physical fitness of 4–5-year-old preschoolers but also improves their mental health. https://ijph.tums.ac.ir/index.php/ijph/article/view/24540 https://ijph.tums.ac.ir/index.php/ijph/article/download/24540/7258

Tehran University of Medical Sciences Iranian Journal of Public Health 2251-6085 50 6 2021 2019 02 23 Background: In recent years, Facebook has increasingly become an essential part of the lives of people, particularly youths, thus many research efforts have been focused on investigating the potential connection between social networking and mental health issues. This study aimed to examine the relationship between Facebook use, emotional state of depression, and family satisfaction. Methods: This study used the online survey created in Google Docs on the Facebook ‘wall’, as research method. The survey was available during Jun-Jul 2015 in Romania. In our cross-sectional study on a sample of 708 young Facebook users (aged 13-35), we divided the sample into 3 groups: ordinary, middle, and intense Facebook users. Materials and instruments: the survey comprised a series of basic demographic as well as some measures of Facebook addiction, depression, and family satisfaction. We used two methods connected with extensive Facebook usage, the first one measuring only the intensity of use, and the second one measuring not only the intensity but also the consequences of this use. Results: Facebook engagement is negatively related to family satisfaction. Moreover, Facebook engagement is positively related to depression symptoms. The Pearson correlations showed that higher Facebook intensity is positively associated with Facebook addiction. Conclusion: The study confirm previously published findings of other authors in the fields of social networking psychology. The study examined the relationship between Facebook use, depression, and life satisfaction and the hypotheses were supported. https://ijph.tums.ac.ir/index.php/ijph/article/view/15830 https://ijph.tums.ac.ir/index.php/ijph/article/download/15830/7038

Tehran University of Medical Sciences Iranian Journal of Public Health 2251-6085 49 11 2020 10 28 2230 2231 EN Mojtaba NOUHI Health Equity Research Center, Tehran University of Medical Sciences, Tehran, Iran AND Health Technology Assessment Office, Deputy of Treatment Affairs, Ministry of Health and Medical Education, Tehran, Iran Alireza OLYAEEMANESH Health Equity Research Center, Tehran University of Medical Sciences, Tehran, Iran AND National Institute for Health Research, Tehran University of Medical Sciences, Tehran, Iran Reza JAHANGIRI Department of Management and Information Sciences, Iran University of Medical Education, Tehran, Iran Mahdi NADERI Physician Payment System and Tariffs Office, Deputy of Treatment Affairs, Ministry of Health and Medical Educations, Tehran, Iran 2018 10 11 2018 10 31 No Abstract https://ijph.tums.ac.ir/index.php/ijph/article/view/14951 https://ijph.tums.ac.ir/index.php/ijph/article/download/14951/7056

Tehran University of Medical Sciences Iranian Journal of Public Health 2251-6085 49 11 2020 10 27 2120 2127 EN Seyed Tayeb MORADIAN Atherosclerosis Research Center, Faculty of Nursing, Baqiyatallah University of Medical Sciences, Tehran, Iran Akram PARANDEH Medicine, Quran and Hadith Research Center, Faculty of Nursing, Baqiyatallah University of Medical Sciences, Tehran, Iran Robabe KHALILI Behavioral Sciences Research Center, Life Style Institute, Faculty of Nursing, Baqiyatallah University of Medical Sciences, Tehran, Iran Leila KARIMI Behavioral Sciences Research Center, Life Style Institute, Faculty of Nursing, Baqiyatallah University of Medical Sciences, Tehran, Iran 2020 08 15 2020 09 10 Background: COVID-19 is a new disease, so we don’t know what comes next. Since information on delayed symptoms is limited, this study was conducted to assess the frequency of delayed symptoms in patients with COVID-19. Methods: This follow-up cross-sectional study was conducted in a referral general hospital in Tehran, Iran from Feb to Apr 2020. Two hundred patients hospitalized for COVID-19 and were discharged were assessed for delayed symptoms 6 wk after discharge. Results: The mean age of the participants was 55.58±13.52, and 160 (80%) Of them were male. On admission to hospital, patients reported a mean of 5.63±2.88 symptoms per patient, range from 1 to 14 symptoms. Dyspnea was seen in 119 (59.5%) 0f them as the most frequent symptom. Then weakness, myalgia, and shivering were reported with a frequency of 111 (55.5%), 107 (53.5%), and 103 (51.5%), respectively. Six weeks after discharge reassessment was done. None of the patients was readmitted to the hospital. Ninety-four (42%) of them were symptom-free. Fatigue was the most frequent delayed symptom with a frequency of 39 (19.5%), and then dyspnea, weakness, and activity intolerance with a frequency of 37 (18.5%), 36 (18%), and 29 (14.5%) were reported, respectively. Conclusion: Fatigue, dyspnea, weakness, anxiety, and activity intolerance were most frequent delayed symptoms, respectively. Majority of patient was symptoms free and those with symptom, had mild to moderate symptoms. The importance of symptoms is not fully recognized. Follow up clinics and in some cases rehabilitation programs may be helpful. https://ijph.tums.ac.ir/index.php/ijph/article/view/21834 https://ijph.tums.ac.ir/index.php/ijph/article/download/21834/7039

Tehran University of Medical Sciences Iranian Journal of Public Health 2251-6085 49 11 2020 10 28 2232 2234 EN Saeed KHALEGHI Department of Nursing, School of Nursing & Midwifery, Alborz University of Medical Sciences, Karaj, Iran Ali SADEGHI MOGHADDAM Department of Nursing, School of Nursing & Midwifery, Dezful University of Medical Sciences, Dezful, Iran Anna ABDOLSHAHI Food Safety Research Center (Salt), Semnan University of Medical Scienses, Semnan, Iran Akbar SHOKRI Network of Health Parsabad, Ardabil University of Medical Sciences, Ardabil, Iran Mohammad KHANDAN Department of Occupational Health, Shool of Health, Qom University of Medical Sciences, Qom, Iran Mohsen POURSADEQIYAN Health Sciences Research Center, Torbat Heydariyeh University of Medical Sciences, Torbat Heydariyeh, Iran AND Student Research Committee, Ilam University of Medical Sciences, Ilam, Iran 2018 10 11 2018 12 02 No Abstract https://ijph.tums.ac.ir/index.php/ijph/article/view/14971 https://ijph.tums.ac.ir/index.php/ijph/article/download/14971/7057

Tehran University of Medical Sciences Iranian Journal of Public Health 2251-6085 49 11 2020 10 27 2128 2135 Farnoush ALIAZAMI Department of Genetics, Tehran Medical Branch, Islamic Azad University, Tehran, Iran AND Applied Biotechnology Research Center, Tehran Medical Branch, Islamic Azad University, Tehran, Iran Dariush D. FARHUD School of Public Health, Tehran University of Medical Sciences, Tehran, Iran AND Department of Basic Sciences, Iranian Academy of Medical Sciences, Tehran, Iran Marjan ZARIF-YEGANEH Cellular and Molecular Endocrine Research Center, Research Institute for Endocrine Sciences, Shahid Beheshti University of Medical Sciences, Tehran, Iran Siamak SALEHI Institute of Liver Studies, King's College Hospital, London, United Kingdom Azam HOSSEINIPOUR Department of Exceptional Children, Ministry of Education and Training of the Islamic Republic of Iran, Tehran, Iran Roxana SASANFAR Psychiatric and Neurodevelopmental Genetic Unit, Massachusetts General Hospital, Harvard Medical School, Boston, USA Maryam Eslami Department of Genetics, Tehran Medical Branch, Islamic Azad University, Tehran, Iran AND Applied Biotechnology Research Center, Tehran Medical Branch, Islamic Azad University, Tehran, Iran 2019 12 02 2020 06 24 Background: Hearing loss (HL) is one of the most common heterogeneous congenital disabilities worldwide. Gap junction protein β-3 (GJB3) gene encodes Connexin31 protein (Cx31). The hereditary type of hearing impairment in this gene are known to cause both autosomal recessive and autosomal dominant form. In addition, GJB3 mutations have been involved in sensorineural deafness, erythrokeratodermia variabilis (EKV), and neuropathy diseases. We aimed to investigate GJB3 mutations in people suffering from HL among three different ethnicities of Iranian population (Baloch, Kurd, and Turkmen). Methods: In this descriptive study, 50 GJB2-negative non-syndromic hearing loss (NSHL) Iranian individuals from 3 ethnic groups of Baloch (n=17), Kurd (n =15) and Turkmen (n=18) were enrolled.  DNA extractions, PCR, and mutation detection was carried out for the two large deletions of the GJB6, del (GJB6 -D13S1830,) and del (GJB6 -D13S1854) followed by direct DNA sequencing method for the GJB3. Results: DNA sequencing of GJB3 was shown a missense heterozygous mutation rs199689484 (NM_024009.3) GJB3: c.340G>A (p.Ala114Thr) in a Baloch patient, and a polymorphism rs35983826 (NM_024009.3) GJB3: c.798C>T (p.Asn266=) in a Turkman patient, in coding region of the GJB3. We did not detect del (GJB6 -D13S1830) and del (GJB6 -D13S1854) among these three ethnicities in Iran. Conclusion: Deafness is a heterogeneous disorder. Specific genes and mutations contribute to hearing loss that varies from locus to locus as well as from population to population. https://ijph.tums.ac.ir/index.php/ijph/article/view/19049 https://ijph.tums.ac.ir/index.php/ijph/article/download/19049/7040

Tehran University of Medical Sciences Iranian Journal of Public Health 2251-6085 49 11 2020 10 27 2136 2143 EN Fatemeh HATATIAN Inflammation and Inflammatory Disease Research Center, Faculty of Medicine, Mashhad University of Medical Sciences, Mashhad, Iran Farzad BABAKHANI Department of Virology, School of Public Health, Tehran University of Medical Sciences, Tehran, Iran Hoda GUDARZI Department of Virology, School of Public Health, Tehran University of Medical Sciences, Tehran, Iran Navid MOMENIFAR Human and Animal Cell Bank, Iranian Biological Resource Center, Academic Center of Education, Culture and Research, Tehran, Iran Mehdi NOROUZI Department of Virology, School of Public Health, Tehran University of Medical Sciences, Tehran, Iran AND Research Center for Clinical Virology, Tehran University of Medical Sciences, Tehran, Iran Mina SHAFIEIFAR Department of Virology, School of Public Health, Tehran University of Medical Sciences, Tehran, Iran Ehsan KAKAVANDI Department of Virology, School of Public Health, Tehran University of Medical Sciences, Tehran, Iran Ahmadreza SADEGHI Iranian Tissue Bank and Research Center, Tehran University of Medical Sciences, Tehran, Iran Hedyeh SHARBATDAR-ALAEI Department of Microbial Biotechnology, Faculty of Basic Sciences and Advanced Technologies in Biology, University of Science and Culture, Tehran, Iran Mohammad FARAHMAND Department of Virology, School of Public Health, Tehran University of Medical Sciences, Tehran, Iran Maedeh AMIRI-ROUDY Department of Virology, School of Public Health, Tehran University of Medical Sciences, Tehran, Iran Hamid Reza JAHANTIGH Department of Virology, School of Public Health, Tehran University of Medical Sciences, Tehran, Iran Mobina MADIHI Department of Virology, School of Public Health, Tehran University of Medical Sciences, Tehran, Iran Kiandokht BORHANI Department of Virology, School of Medical Sciences, Tarbiat Modares University, Tehran, Iran Mehdi AJORLOO Hepatitis Research Center, Lorestan University of Medical Sciences, Khorramabad, Iran AND Department of Clinical Laboratory Sciences, School of Allied Medicine, Lorestan University of Medical Sciences, Khorramabad, Iran Mojtaba HEDAYAT YAGHOOBI Department of Infectious Disease, School of Medicine, Alborz University of Medical Sciences, Karaj, Iran 2018 08 01 2019 01 09 Background: Hemodialysis (HD) patients and kidney transplant (KT) recipients are exposed to be infected by blood-borne viruses (BBVs). Current study was conducted to evaluate the prevalence of BBVs in HD and KT patients in the whole Iranian population. Methods: From Jan 2016 to Dec 2017, 174 hemodialysis and 139 kidney transplant recipients enrolled in this survey. After blood sampling, serum samples were detected for HBV, HCV, HCMV, HIV and HTLV antibodies. Seropositive samples confirmed by Polymerase chain reaction (PCR) method. Results: Overall, 6 (3.44%) and 3 (2.15%) of hemodialysis-dependent and transplantation patients had evidence of HCV infection, whereas no patients were HIV and HBV positive, two cases (1.14%) of hemodialysis and one case (0.71%) of transplantation patients demonstrated the HTLV-1 infection. 52 (37.4%) of patients received graft were positive for HCMV antibody. In addition, our study showed a co-infection of HCMV with HCV (3 patients, 2.15%) in transplantation patients. Conclusion: Prevalence of BBVs infection was lower in comparison to the previous studies. The current strict infection control practices in Iran appear to be effective in limiting dialysis and related infections after transplantation. Because BBVs infections constantly occur especially in dialysis and after transplantation units, our data will be useful to build a new strategic plan for the elimination of BBVs infection in kidney therapycenters. https://ijph.tums.ac.ir/index.php/ijph/article/view/14301 https://ijph.tums.ac.ir/index.php/ijph/article/download/14301/7041

Tehran University of Medical Sciences Iranian Journal of Public Health 2251-6085 49 11 2020 10 27 2144 2151 EN Farshad TAVAKOLI Department of Health Services Management, School of Medical Sciences, Science and Research Branch, Islamic Azad University, Tehran, Iran Amir Ashkan NASIRIPOUR Department of Health Services Management, School of Medical Sciences, Science and Research Branch, Islamic Azad University, Tehran, Iran Leila RIAHI Department of Health Services Management, School of Medical Sciences, Science and Research Branch, Islamic Azad University, Tehran, Iran Mahmoud MAHMOUDI Department of Health Services Management, School of Medical Sciences, Science and Research Branch, Islamic Azad University, Tehran, Iran 2018 06 24 2018 10 31 Background: The purpose of this research was to identify the main dimensions of management of referral systems in family physician program and then introduce them to policymakers of the country primary health care. Methods: This descriptive-correlation study was designed in Mazandaran Province, northern Iran (2017). The participants were employees of health centers of Mazandaran and Fars Provinces, Iran. The dimensions influencing on the referral system were identified systematically in the selected countries by using researcher-made questionnaire according to a statistical method called Factor Analysis. The data sufficiency was evaluated by the Bartlett's and Kaiser-Meyer-Olkin’s tests. Reliability of test was calculated and confirmed according to Cronbach's Alpha and Combined Reliability tests. Validity of the test was calculated and confirmed based on the average variance extracted (AVE). Results: In confirmatory factor analysis, coefficient of effect of Electronic Health Record on referral system (as the most important dimension), coefficient of Family Physician, coefficient of structure of insurance, coefficient of policymaking in health care system, coefficient of proper stewardship of health system, and basic health care services, were 0.887, 0.877, 0.860, 0.804, 0.568, and 0.522, respectively. Conclusion: Six effective dimensions including Electronic Health Record (as the most important dimension), family physician, structure of insurance, policymaking in health care system, proper stewardship of health system, and basic health care services were identified. According to six effective dimensions on management model of the referral system in the Iranian urban family physician program, the health system authorities pay serious attention to the six identified dimensions of the current study to improve the health of the urban community. https://ijph.tums.ac.ir/index.php/ijph/article/view/13813 https://ijph.tums.ac.ir/index.php/ijph/article/download/13813/7042

Tehran University of Medical Sciences Iranian Journal of Public Health 2251-6085 49 11 2020 10 27 2152 2160 EN Ali Asghar POURI Liver and Gastrointestinal Diseases Research Center, Tabriz University of Medical Sciences, Tabriz, Iran Morteza GHOJAZADEH Liver and Gastrointestinal Diseases Research Center, Tabriz University of Medical Sciences, Tabriz, Iran Masoud SHIRMOHAMMADI Liver and Gastrointestinal Diseases Research Center, Tabriz University of Medical Sciences, Tabriz, Iran Amir-Taher EFTEKHAR-SADAT Department of Pathology, Imam Reza Hospital, Tabriz University of Medical Sciences, Tabriz, Iran Mohammad Hossein SOMI Liver and Gastrointestinal Diseases Research Center, Tabriz University of Medical Sciences, Tabriz, Iran 2018 07 05 2019 02 02 Background: Hepatitis B is a major global health problem. It can cause chronic infections and put people at high risk of death from cirrhosis and hepatocellular carcinoma. The aim of this study was to report the epidemiological features of hepatitis B virus (HBV) infection and risk factors based on the data from Azar Cohort. Methods: The population of this study comprised the people in the age range of 35-70 yr from Azar cohort, East Azerbaijan Province, Iran between 2015 and 2016. Based on cluster sampling, 4,949 people were selected and invited to complete the questionnaire and perform the tests. Blood samples were analyzed for serum HBV markers (HBsAg, HBsAb and HBcAb) by ELFA method. The data were analyzed using SPSS statistical software. Results: The mean (SD) age of the participants was 49.15 ± 9.02 years. The frequency rates of HBsAg, HBsAb and HBcAb were estimated as 1.03%, 16.9% and 24.95%, respectively. There was statistically significant association between family history of hepatitis (P<0.001) and jaundice history (P<0.001) with the presence of HBsAg. There was also a positive correlation between marital status (P=0.002), history of hospitalization (P<0.001), smoking (P=0.001), dental procedures (P<0.001), foreign travels (P=0.005), occupation status (P=0.002) and the presence of HBcAb. Conclusion: The frequency of hepatitis B in Azar Cohort was 1.03% which is a lower rate compared with other reports from Iran. The association of the population studied and the increase of public awareness in this area can probably prevent this disease. https://ijph.tums.ac.ir/index.php/ijph/article/view/13938 https://ijph.tums.ac.ir/index.php/ijph/article/download/13938/7043

Tehran University of Medical Sciences Iranian Journal of Public Health 2251-6085 49 11 2020 10 27 2161 2169 Ahad ALIZADEH Department of Epidemiology and Biostatistics, School of Public Health, Tehran University of Medical Sciences, Tehran, Iran Reza OMANI-SAMANI Department of Medical Ethics and Law, Reproductive Biomedicine Research Center, Royan Institute for Reproductive Biomedicine, ACECR, Tehran, Iran Mohammad Ali MANSOURNIA Department of Epidemiology and Biostatistics, School of Public Health, Tehran University of Medical Sciences, Tehran, Iran Azadeh AKBARI SENE Shahid Akbarabadi Clinical Research Development Unit, Iran University of Medical Sciences, Tehran, Iran Abbas RAHIMI FOROUSHANI Department of Epidemiology and Biostatistics, School of Public Health, Tehran University of Medical Sciences, Tehran, Iran 2019 01 19 2019 02 27 Background: Body Mass Index (BMI) and maternal age are related to various disorders of the female reproductive system. This study aimed to estimate the causal effects of BMI and maternal age on the rate of metaphase II oocytes (MII) using a new statistical method based on Bayesian LASSO and model averaging. Methods: This investigation was a historical cohort study and data were collected from women who underwent assisted reproductive treatments in Tehran, Iran during 2015 to 2018. Exclusion criteria were gestational surrogacy and donor oocyte. We used a new method based on Bayesian LASSO and model average to capture important confounders. Results: Overall, 536 cycles of 398 women were evaluated. BMI and Age had inverse relationships with the number of MII based on univariate analysis, but after adjusting the effects of other variables, there was just a significant association between age and the number of MII (adjusted incidence rate ratio (aIRR) of age =0.989, 95% CI: [0.979, 0.998], P=0.02). The results of causal inference based on the new presented method showed that the overall effects of age and BMI of all patients were significantly and inversely associated with the number of MII (both P<0.001). Therefore the expected number of MII decreased by 0.99 for an increase of 1 year (95% CI: [-1.00,-0.97]) and decreased by 0.99 for each 1-unit increase in BMI (95% CI: [-1.01,-0.98]). Conclusion: Maternal age and BMI have significant adverse casual effects on the rate of MII in patients undergoing ART when the effects of important confounders were adjusted. https://ijph.tums.ac.ir/index.php/ijph/article/view/15985 https://ijph.tums.ac.ir/index.php/ijph/article/download/15985/7044

Tehran University of Medical Sciences Iranian Journal of Public Health 2251-6085 49 11 2020 10 27 2170 2178 EN Fatemeh SHAHBAZI Department of Epidemiology, School of Public Health, Hamadan University of Medical Sciences, Hamadan, Iran Davood MIRTORABI Department of Neurosciences and Addiction Studies, School of Advanced Technologies in Medicine, Tehran University of Medical Sciences, Tehran, Iran Mohammad Reza GHADIRZADEH Legal Medicine Research Center, Legal Medicine Organization, Tehran, Iran Ahmad SHOJAEI Legal Medicine Research Center, Legal Medicine Organization, Tehran, Iran Seyed Saeed HASHEMI NAZARI Safety Promotion and Injury Prevention Research Center, Department of Epidemiology, School of Public Health and Safety, Shahid Beheshti University of Medical Sciences, Tehran, Iran 2018 12 01 2019 02 13 Background: Using dexmedetomidine (Dex) as a sedative agent may benefit the clinical outcomes of post-surgery patients. We reviewed randomized controlled trials (RCTs) to assess whether use of a Dex could improve the outcomes in post-surgery critically ill adults. Methods: We searched Medline, Embase, PubMed, and the Cochrane databases for RCTs comparing Dex with propofol or a placebo in post-operative patients, all included RCTs should be publ