Tehran University of Medical Sciences Iranian Journal of Public Health 2251-6085 52 6 2023 06 12 1099 1107 Seonjae Been Department of Digital Anti-Aging Healthcare (BK21), Inje University, Gimhae 50834, Republic of Korea Haewon Byeon Department of Digital Anti-Aging Healthcare (BK21), Inje University, Gimhae 50834, Republic of Korea 2022 12 15 2023 02 19 Background: We systematically reviewed (evaluated methodological quality) meta-analysis studies on the suicidal ideation of South Koreans using a measurement tool to assess systematic reviews version 2 (AMSTAR-2) to present the ways for improving the quality of follow-up meta-analysis studies and suggest the direction of future studies. Methods: We analyzed 11 meta-analysis studies based on AMSTAR-2 criteria by collecting documents related to suicidal thoughts using seven electronic databases (DBPia, Scholar, KISS, KCI, RISS, KoreaEmbase, and National Assembly Electronic Library) from Jan 1, 2000 to Dec 3, 2022. Results: Among the 142 papers searched, we analyzed the final 11 selected studies. Not all analyzed meta-analysis studies conducted quality assessment and these studies omitted the list of excluded references and the adequacy of the literature search. Moreover, 54.5% of the analyzed studies (six out of eleven studies) did not present the effect of publication bias. Consequently, SOMETHING was critically low due to omissions in critical domains. Conclusion: In all 11 studies analyzed, 2 or more of 7 critical domains were omitted, and the quality level was confirmed to be critically low. Therefore, future meta-analysis studies on suicidal ideation will have to include quality assessment and improve the quality of meta-analysis, such as testing bias effects.   https://ijph.tums.ac.ir/index.php/ijph/article/view/30681 https://ijph.tums.ac.ir/index.php/ijph/article/download/30681/7948

Tehran University of Medical Sciences Iranian Journal of Public Health 2251-6085 52 6 2023 06 12 1108 1120 Siti Maisara Amir 1. Department of Public Health Medicine, Faculty of Medicine, Universiti Kebangsaan Malaysia, Kuala Lumpur 56000, Malaysia 2. Ministry of Health Malaysia, Kompleks E, Pusat Pentadbiran Kerajaan Persekutuan, 62590 Putrajaya, Wilayah Persekutuan Putrajaya, Malaysia Idayu Idris Department of Public Health Medicine, Faculty of Medicine, Universiti Kebangsaan Malaysia, Kuala Lumpur 56000, Malaysia Zakiah Mohd Said 1. Department of Public Health Medicine, Faculty of Medicine, Universiti Kebangsaan Malaysia, Kuala Lumpur 56000, Malaysia 2. Ministry of Health Malaysia, Kompleks E, Pusat Pentadbiran Kerajaan Persekutuan, 62590 Putrajaya, Wilayah Persekutuan Putrajaya, Malaysia Hanizah Mohd Yusoff Department of Public Health Medicine, Faculty of Medicine, Universiti Kebangsaan Malaysia, Kuala Lumpur 56000, Malaysia Mohd Rizal Abdul Manaf Department of Public Health Medicine, Faculty of Medicine, Universiti Kebangsaan Malaysia, Kuala Lumpur 56000, Malaysia 2022 08 09 2023 02 02 Background: This study reviewed cervical cancer policies implemented in developing countries that adhered to WHO standards. Despite long being known as a preventable disease, cervical cancer is still one of the leading causes of mortality among women. Nine out of ten cervical cancer deaths occurred in less-developed countries, suggesting that the preventive and control approaches in these countries might differ from those in developed nations. Methods: Cervical cancer policies in six developing countries from each WHO region were selected while related data from the Cervical Cancer Country Profiles 2021 by WHO were retrieved for comparison. Results: The cervical cancer policies that were included in this review were from Malaysia, Thailand, Iran, Kenya, Argentina, and Ukraine. According to the latest guidelines on the management of cervical cancers, WHO recommendations have been elaborated on primary, secondary, and tertiary prevention. A comparison of policies among these selected countries showed variation in each level of prevention. The cancer burden in each country was also found to determine the progression of cervical cancer prevention and policy controls in these countries. Conclusion: This review emphasizes the dissimilarities of cervical cancer policies in six developing countries compared to recommendations by the WHO. Identifying these discrepancies could help policymakers in developing nations to recognize the pressing issues surrounding cervical cancer prevention and establish more effective prevention and control approaches. https://ijph.tums.ac.ir/index.php/ijph/article/view/29514 https://ijph.tums.ac.ir/index.php/ijph/article/download/29514/7949

Tehran University of Medical Sciences Iranian Journal of Public Health 2251-6085 52 6 2023 06 12 1121 1128 EN Rishi Bharti Department of Family and Community Medicine, College of Medicine, King Khalid University, Abha, Saudi Arabia 2022 06 07 2023 04 15 Background: Didactic lecture is most commonly used method to teach medical students in Family and Community Medicine. However, considering its demerits and the need to integrate theoretical knowledge into practice, the objective of this paper is to review the contribution of role play in medical education and to propose it’s applications to deliver healthcare services in community more effectively. Methods: Research studies on role play were searched in PubMed, Google scholar, Google using terms role play, medical education, community medicine, family medicine, health promotion, awareness during the period between January 2000 up to December 2021 to evaluate the potential and contribution of role play in medical education and health promotion. Results: Review of role play and related researches were included to analyze the outcome. The outcomes of different studies analyzed were showing several teaching methodologies used in medical field. Several studies have tested role play in other medical specialities and have found it to be a powerful educational tool. However, not many studies have tested its effectiveness to educate students in Family and Community Medicine although it could have immense practical applications like demonstrating and creating awareness in the community about the importance of cancer screening, breast feeding, immunisation, food fortification, genetic screening, premarital counselling, ante natal checkups, danger signs in pregnancy. Conclusion: Role play simulates real scenarios enabling students to apply their skills and knowledge into practice in real time. It can integrate theory concepts into practice. Hence, it must be introduced in medical curriculum to achieve the objectives of teaching and learning more effectively.   https://ijph.tums.ac.ir/index.php/ijph/article/view/28959 https://ijph.tums.ac.ir/index.php/ijph/article/download/28959/7950

Tehran University of Medical Sciences Iranian Journal of Public Health 2251-6085 52 6 2023 06 12 1129 1139 Sona Beyrami Student Research Committee, Department of Occupational Health and Safety, School of Public Health and Safety, Shahid Be-heshti University of Medical Sciences, Tehran, Iran Soleiman Ramezanifar Student Research Committee, Department of Occupational Health and Safety, School of Public Health and Safety, Shahid Be-heshti University of Medical Sciences, Tehran, Iran Heidar Golmohammadi Department of Environmental Education, Payam Noor University, Central Branch, Tehran, Iran Rasoul Nasiri Department of Environmental Health Engineering, School of Public Health and Safety, Shahid Beheshti University of Medical Sciences, Tehran, Iran Saeed Mahmoudi Department of Occupational Health and Safety, School of Public Health, Tabriz University of Medical Sciences, Tabriz, Iran Ehsan Ramezanifar Department of Occupational Health and Safety, School of Public Health and Safety, Hamadan University of Medical Sciences, Hamadan, Iran Zahra Soltanpour Department of Occupational Health and Safety, School of Public Health, Tabriz University of Medical Sciences, Tabriz, Iran Noradin Gharari Department of Occupational Health and Safety, School of Public Health and Safety, Shahid Beheshti University of Medical Sciences, Tehran, Iran 2022 08 07 2022 11 29 Background: Physical and chemical factors of workplace, either alone or in combination, contribute to oxidative stress that is harmful to the body. The combined impact of physical and chemical components of the work environment on oxidative stress was examined in this research. Methods: Research articles published from 2000 to 2021 on this topic in reliable national and international databases were collected and analyzed. Based on the preliminary screening, 120 articles were selected for the first stage. The relevance and quality of 85 suitable papers were found appropriate and evaluated by examining the purpose of the study in the next phase. Results: The data collected and presented from the articles cover simultaneous exposure to physical risk factors such as noise, radiation, and chemicals such as metal solvents, as well as different types of oxidative stress parameters like MDA, GHS, LOP, 8-OHdG, SOD, CAT, ROS, and other parameters such as research site, co-exposure effects, and target organ. Investigating the combined effect of physical and chemical variables on oxidative stress in the target organs, as well as the interaction of multiple effects on each other, was one of the key goals of the articles (synergistic, reinforcing, additive or antagonistic). Conclusion: Most of the findings of theses researches generally highlight the synergistic impact of concurrent exposure to chemical and physical risk factors on oxidative stress.   https://ijph.tums.ac.ir/index.php/ijph/article/view/29498 https://ijph.tums.ac.ir/index.php/ijph/article/download/29498/7951

Tehran University of Medical Sciences Iranian Journal of Public Health 2251-6085 52 6 2023 06 13 1140 1149 Yon Hee Seo Department of Nursing Science, Andong National University, 1375 Gyeongdong-ro, Andong-si, Gyeongsangbuk-do, 36729, Korea Kyeongmin Jang Department of Nursing, Bucheon University, 56 Sosa-ro, Bucheon-si, Gyeonggi-do 14774, Korea Jung-Won Ahn Department of Nursing, Gangneung-Wonju National University, 150 Namwon-ro, Heungeop-myeon, Wonju-si, Gangwon-do 26403, Korea 2023 03 20 2023 06 13 Background: Since most of nursing students lack clinical reasoning competency, for effective handover education, it is necessary to include a strategy to improve the clinical reasoning competency in the practical training course of the nursing department. Methods: This study used a quasi-experimental research design using a non-equivalent control group pretest-posttest design to verify the effectiveness of the practice education program using the OPT model and SBAR. The subjects were 73 third-year students participating in clinical practice or clinical alternative practice in Korea. Results: The experimental group showed significantly better communication clarity (t=-12.262, P<.001), communication confidence (t=-12.486, P<.001), problem-solving processes (t=-13.100, P<.001), and team efficacy (t=-6.197, P<.001) compared to before the intervention. However, there was no significant difference between the pre- and post-intervention scores of the control group. Conclusion: In a situation where clinical practice is difficult for nursing students, the handover education program using the OPT model and SBAR can helps improve their communication clarity, communication confidence, problem- solving process, and team efficacy.   https://ijph.tums.ac.ir/index.php/ijph/article/view/31522 https://ijph.tums.ac.ir/index.php/ijph/article/download/31522/7952

Tehran University of Medical Sciences Iranian Journal of Public Health 2251-6085 52 6 2023 06 13 1150 1160 Zhongwu An Clinical Laboratory, The Affiliated Lianyungang Oriental Hospital, Xuzhou Medical University, Jiang Su, China Weibo Bo Clinical Laboratory, The Affiliated Lianyungang Oriental Hospital, Xuzhou Medical University, Jiang Su, China Jibao Qin Clinical Laboratory, The Affiliated Lianyungang Oriental Hospital, Xuzhou Medical University, Jiang Su, China Ling Jiang Clinical Laboratory, The Affiliated Lianyungang Oriental Hospital, Xuzhou Medical University, Jiang Su, China Jie Jiang Department of Pharmacy, The Affiliated Lianyungang Oriental Hospital, Xuzhou Medical University, Jiang Su, China 2022 09 06 2023 04 07 Background: As the most convenient and commonly used for clinical diagnosis, cancer biomarker has been widely used in the auxiliary diagnosis of tumors, the observation of curative effect, the judgment of prognosis, and the monitoring of the disease. Methods: Pan-cancer analysis was used to validate the value of Dehydrogenase/Reductase 2 (DHRS2) as a tumor prognostic marker in various tumors. The relationship of DHRS2 to TMB and MSI was used to explain the effect of DHRS2 on genomic instability. Online cbioportal was used to analyze DHRS2 mutations in tumors. Finally, 33 clinical tumor samples were collected in 2021 who were enrolled into the Affiliated Lianyungang Oriental Hospital of Xuzhou Medical University, to verify the expression and diagnostic prognostic value of DHRS2. Results: The expression of DHRS2 was up-regulated in a variety of tumors and had adverse effects on the overall survival, disease-free interval, and progression-free interval of tumor patients. DHRS2 was associated with tumor genome instability, confirming that DHRS2 was correlated with tumorigenesis. In addition, DHRS2 had different mutation sites in various tumors. DHRS2 was up-regulated and was a poor prognosis biomarker in clinical tumor samples. Conclusion: DHRS2 was aberrantly expressed in tumors and has diagnostic prognostic value. https://ijph.tums.ac.ir/index.php/ijph/article/view/29734 https://ijph.tums.ac.ir/index.php/ijph/article/download/29734/7953

Tehran University of Medical Sciences Iranian Journal of Public Health 2251-6085 52 6 2023 06 13 1161 1169 EN Hee Wook Weon Department of Brain and Cognitive Sciences, Seoul University of Buddhism, Seoul, Republic of Korea Hae Kyoung Son Department of Nursing, Eulji University, Seongnam-shi, Republic of Korea 2022 11 09 2023 02 19 Background: Women undergo an array of menstrual symptoms, depending on the menstrual cycle period. This study aimed to gain a more objective understanding of the impact of menstruation by examining differences in menstrual symptoms, menstrual attitude, physical stress, and psychological stress across the menstrual cycle. Methods: This study was conducted from Apr to Jun 2021 in the Gyeonggi Province of Korea. Women aged ≥20 yr were divided into premenstrual (n=17), menstrual (n=8), and postmenstrual periods (n=23). Menstrual symptoms and menstrual attitudes were assessed using questionnaires. Quantitative electroencephalography was used to assess the physical stress indices (left and right), and the psychological stress indices (left and right), with brainwave parameters quantified by frequency series power spectrum analysis. Data were compared using the non-parametric tests. Results: More menstrual symptoms were experienced in the menstrual period than in the premenstrual period (Z=2.16, P=.031). Menstrual attitudes did not significantly differ among menstrual periods (Z=1.20, P=.231). Physical stress indices were high (≥10 μV) throughout the menstrual cycle and there were significant differences among the three periods (left: χ2=4.00, P=.035, right: χ2=5.78, P=.046). Psychological stress indices were >1 μV during the premenstrual and menstrual periods. Conclusion: Women experience more severe and diverse menstrual symptoms in the menstrual period than in other periods. Objective investigations are needed to inform an effective approach for addressing negative menstruation-related experiences.  https://ijph.tums.ac.ir/index.php/ijph/article/view/30335 https://ijph.tums.ac.ir/index.php/ijph/article/download/30335/7954

Tehran University of Medical Sciences Iranian Journal of Public Health 2251-6085 52 6 2023 06 13 1170 1180 Wei Wei Department of Cardiothoracic Surgery, Zhuhai People's Hospital, Zhuhai Hospital Affiliated with Jinan University, Zhuhai 519000, China Xuan Wei Department of Radiation Oncology, The First Affiliated Hospital of Guangzhou Medical University, Guangzhou 510520, China Xin Xie Department of Cardiothoracic Surgery, Zhuhai People's Hospital, Zhuhai Hospital Affiliated with Jinan University, Zhuhai 519000, China 2022 12 02 2023 04 07 Background: Esophageal squamous cell carcinoma (ESCC), a widely known esophageal disease, severely affects people's health. Numerous investigations demonstrated that long non-coding RNAs (lncRNAs) performed key jobs inside a wide scope of organic cycles and stand out in malignant growth. Our study planned to investigate the roles and mechanisms of linc01614 in ESCC. Methods: A Total of 60 ESCC tissue samples including 30 patients with cisplatin sensitivity and 30 patients with cisplatin resistance, who received DDP-based treatment, were obtained from Zhuhai People's Hospital, Zhuhai City during 2021. These tissues were frozen and saved in a -80 ℃ ultra-low temperature freezer. We performed CCK-8, clone formation, flow cytometry assays to determine the effect of linc01614 on ESCC progression, and explored the specific mechanism of linc01614 in ESCC cell proliferation, apoptosis, and chemotherapy resistance. Results: linc01614 expression was upregulated in ESCC tissues and cells compared with non-tumor tissues and human normal esophageal epithelial cells (Het-1A). Knockdown of linc01614 repressed cell expansion, chemotherapy opposition, and advanced cell apoptosis in ESCC. Besides, linc01614 regulated the expression of miR-4775 as a competitive endogenous RNA (ceRNA). Conclusion: The linc01614/miR-4775 axis played an important role in ESCC progression and drug resistance, revealing that linc01614 is a promising target in ESCC treatment. https://ijph.tums.ac.ir/index.php/ijph/article/view/30529 https://ijph.tums.ac.ir/index.php/ijph/article/download/30529/7955

Tehran University of Medical Sciences Iranian Journal of Public Health 2251-6085 52 6 2023 06 13 1181 1189 Aleksandra Nikolic Clinic for Rheumatology, Allergology and Clinical Immunology, Clinical Centre Kragujevac, Kragujevac, Serbia Sonja Djuric Gentext Research group, University of Valencia, Valencia, Spain Vladimir Biocanin Faculty of Dentistry, University of Bussines Academy, Novi Sad, Serbia Katarina Djordjevic Department of Pharmacy, Faculty of Medical Sciences, University of Kragujevac, Kragujevac, Serbia Marko Ravic Department of Pharmacy, Faculty of Medical Sciences, University of Kragujevac, Kragujevac, Serbia Aleksandra Stojanovic Department of Pharmacy, Faculty of Medical Sciences, University of Kragujevac, Kragujevac, Serbia Olivera Milovanovic Department of Pharmacy, Faculty of Medical Sciences, University of Kragujevac, Kragujevac, Serbia Jasmina Skerlic Faculty of Technical Sciences, University of Pristina, Kosovska Mitrovica, Serbia Radisa Pavlovic Department of Pharmacy, Faculty of Medical Sciences, University of Kragujevac, Kragujevac, Serbia Tamara Nikolic Turnic 1. Department of Pharmacy, Faculty of Medical Sciences, University of Kragujevac, Kragujevac, Serbia 2. N.A. Semashko Public Health and Healthcare Department, F.F. Erismann Institute of Public Health, I.M. Sechenov First Moscow State Medical University, Sechenov University, Moscow, Russian Federation 2021 12 27 2022 05 07 Background: Elevated blood pressure (BP) is one of the leading causes for developing major cardiovascular events and still represents a major public health challenge worldwide. We aimed to provide data on predictors of poor adherence to medication in hypertensive patients in Serbia. Methods: Observational, analytical study was undertaken at a group of 388 patients who refilled their medications in the Pharmacy Institution, “Apoteka Kragujevac”, Kragujevac, Serbia between Jan and Mar 2019. Afterward, we conducted a case-control study to evaluate the influence of the variables associated with the adherence. We used a self-developed questionnaire and SF-36 to assess the influence of the quality of life on medication adherence. Results: Results revealed four independent predictors of non-adherence: increased number of medications, living in a city, forgetfulness of the dosing regimen and low energy. The odds of non-adherence were the highest among the participants living in the city and the low energy was the only factor inversely associated with the level of non-adherence. Conclusion: Many factors were associated with the non-adherence to medication. Further studies are needed to find the most appropriate protocol to promote adherence. The four risk factors (increased number of medications, living in a city, forgetfulness of the dosing regimen and low energy) are associated with non-adherence in adult hypertensive patients.   https://ijph.tums.ac.ir/index.php/ijph/article/view/27311 https://ijph.tums.ac.ir/index.php/ijph/article/download/27311/7956

Tehran University of Medical Sciences Iranian Journal of Public Health 2251-6085 52 6 2023 06 13 1190 1198 EN Chunjing Tu School of Teacher Education, Taizhou University, Taizhou, China Yuxuan Tu Department of Polymer Science and Engineering, Zhejiang University, Hangzhou, China Chongmin Jiang China Institute of Sport Science, Beijing, China Sanhua Zhang College of Education, Hangzhou Normal University, Hangzhou, China 2022 12 22 2023 04 25 Background: We aimed to establish the cut-off value of weight-for-height for preschool children in China, and to explore the influence of overweight and obesity on the physical performance of preschool children. Methods: Data from 31 provinces in China monitored in 2010 and 2014, the standard deviation unit curves of WFH were established by using GAMLSS (generalized additive model for location, scale, and shape) method preschool children in China, and then the cut-off values of normal weight, overweight and obesity were divided. The research group tested 5 physical performance indicators of 5154 preschool children from April 2018 to June 2019 in Beijing and Zhejiang in China. We then compared physical performance differences between the normal-weight group and the overweight-obesity group. Results: A smooth and effective standard deviation unit curve of WFH was established. The overweight and obesity of Chinese preschool children were at a high level. Being overweight and obese reduced preschool children's relative strength, speed, sensitivity, coordination, and balance ability, but did not reduce preschool children's flexibility. In general, the physical performance of preschool children in the normal weight group was better than that in the overweight and obesity group. Conclusion: It is suggested to use the WFH criteria in this study to evaluate overweight and obesity in Chinese preschool children, and strengthen physical activity and take in energy substances properly of preschool children, to control the spread of overweight and obesity， to improve physical performance level.   https://ijph.tums.ac.ir/index.php/ijph/article/view/30742 https://ijph.tums.ac.ir/index.php/ijph/article/download/30742/7957

Tehran University of Medical Sciences Iranian Journal of Public Health 2251-6085 52 6 2023 06 13 1199 1206 EN Aasma Munawwar Department of Zoology, Government College, University Faisalabad, Faisalabad, Pakistan Amna Sajjad Department of Zoology, Government College, University Faisalabad, Faisalabad, Pakistan Shahla Faisal Department of Statistics, Government College University, Faisalabad, Pakistan Azhar Rasul Department of Zoology, Government College, University Faisalabad, Faisalabad, Pakistan Aneeqa Zarbab Department of Zoology, Government College, University Faisalabad, Faisalabad, Pakistan Afshan Ashraf Government College University Faisalabad Afshan Bibi Department of ZooS">1. Department of Healthcare Services Management, School of Health, Alborz University of Medical Sciences, Karaj, Iran 2. Social Determinants of Health Research Center, Alborz University of Medical Sciences, Karaj, Iran Amirhossein Takian 1. Centre of Excellence for Global Health (CEGH), Department of Global Health and Public Policy, School of Public Health, Tehran University of Medical Sciences, Tehran, Iran 2. Health Equity Research Center (HERC), Tehran University of Medical Sciences, Tehran, Iran 3. Department of Health Management, Policy & Economics, School of Public Health, Tehran University of Medical Sciences, Tehran, Iran 4. National Center for Health Insurance Research, Iranian Health Insurance Organization, Tehran, Iran Mohammad Amerzadeh Non-communicable Diseases Research Center, Research Institute for Prevention of ‎Non-Communicable Diseases, Qazvin Uni-versity of Medical Sciences, Qazvin, Iran Yasaman Poormoosa Department of Health Management, Policy & Economics, School of Public Health, Tehran University of Medical Sciences, Tehran, Iran 2023 07 15 2025 07 08 Background: Enhancing the performance of healthcare provider units, such as Health Houses (HHs) and Health Posts (HPs), is vital for improving service delivery. We aimed to develop simulation-based scenarios to optimize performance and minimize risks associated with decision-making. Methods: Conducted in 2021, this empirical study utilized operational research methods at one HH and one HP in southern Tehran. The operational characteristics of these units were modeled using Arena 20 simulation software. Additional performance scenarios were iteratively developed based on expert recommendations. Key performance metrics from the simulations were evaluated and ranked using the nominal group technique and Expert Choice software. Results: Four distinct scenarios were developed for both units. The fourth scenario emerged as the optimal model, receiving the highest expert scores for both the HH (score: 349) and HP (score: 418). This scenario demonstrated significant improvements in key indicators, including the number of patients admitted (HH: 24; HP: 31), patients served (HH: 23; HP: 33), health worker productivity (HH: 95%; HP: 47%), and reduced patient waiting times (HH: 4.45 min; HP: 0 min). Conclusion: The study recommends adopting the fourth scenario as a benchmark for HHs and HPs in suburban areas of major Iranian cities. The employed simulation methodology and evidence-based scenarios can be applied to other healthcare units, aiding in performance forecasting and system optimization.  https://ijph.tums.ac.ir/index.php/ijph/article/view/32567 https://ijph.tums.ac.ir/index.php/ijph/article/download/32567/8630

Tehran University of Medical Sciences Iranian Journal of Public Health 2251-6085 54 8 2025 09 02 1620 1630 Sedat Kahya Ministry of Education, Physical Education Teaching, Sivas, Turkey 2024 04 01 2025 05 09 Background: Sporting performance is a multifactorial phenomenon that is affected by many factors. Several polymorphisms have recently been associated with sports performance. ACE I/D and ACTN3 R577X gene polymorphisms are some of these. This study aimed to investigate the relationship between ACTN3 R577X and ACE I/D polymorphisms and sports performance together with the results of studies conducted in the literature. Methods: The review included studies on the relationship between ACTN3 R577X and ACE I/D polymorphisms and sports performance from Feb 2014 to Feb 2024. The studies registered in PubMed, PubMed Central and Google Scholar search engines were scanned. The present review included 756 cases, 2,191 controls, and 178 individuals from the cross-sectional and longitudinal studies. The PRISMA checklist and flow diagram were used to include data in the review. Results: The review started with 224 studies, and the number of studies was reduced by 9. Then, a risk analysis was performed to determine whether 9 articles had a risk of bias. In the risk analysis conducted using the ROBINS-I tool, 3 articles were moderate, 3 articles were serious, and 3 articles were critical. Additionally, in the review, significant differences were found in 5 of the 9 studies (P<0.05). Conclusion: ACTN3 R577X and ACE I/D polymorphisms may be evaluated together with many parameters related to performance. To our knowledge, ACTN3 R577X and ACE I/D polymorphisms may be important regulators for sports performance. https://ijph.tums.ac.ir/index.php/ijph/article/view/35048 https://ijph.tums.ac.ir/index.php/ijph/article/download/35048/8618

Tehran University of Medical Sciences Iranian Journal of Public Health 2251-6085 54 8 2025 09 02 1805 1807 Rostam Menati Psychosocial Injuries Research Center, Ilam University of Medical Sciences, Ilam, Iran Aziz Kassani Department of Community Medicine, School of Medicine, Dezful University of Medical Sciences, Dezful, Iran 2024 06 06 2024 12 15 No Abstract. Not abstract. https://ijph.tums.ac.ir/index.php/ijph/article/view/35735 https://ijph.tums.ac.ir/index.php/ijph/article/download/35735/8638

Tehran University of Medical Sciences Iranian Journal of Public Health 2251-6085 54 8 2025 09 02 1765 1775 Reza Maddah National Institute of Genetic Engineering and Biotechnology (NIGEB), Tehran, Iran Marjan Talebi Department of Pharmacognosy, School of Pharmacy, Shahid Beheshti University of Medical Sciences, Tehran, Iran Rouzbeh Almasi Ghale Department of Energy and Environmental Biotechnology, National Institute of Genetic Engineering and Biotechnology (NI-GEB), Tehran, Iran Fatemeh Saadati National Institute of Genetic Engineering and Biotechnology (NIGEB), Tehran, Iran Saghi Noorayi National Institute of Genetic Engineering and Biotechnology (NIGEB), Tehran, Iran Mahnaz Karimi National Institute of Genetic Engineering and Biotechnology (NIGEB), Tehran, Iran Amir Shafie Kafraj National Institute of Genetic Engineering and Biotechnology (NIGEB), Tehran, Iran Farkhondeh Pouresmaeili 1. Men’s Health and Reproductive Health Research Center, Shahid Beheshti University of Medical Sciences Tehran, Iran 2. Department of Medical Genetics, Faculty of Medicine, Shahid Beheshti University of Medical Sciences, Tehran, Iran 2024 02 13 2025 04 07 Background: Gastric cancer (GC) ranks among the most prevalent malignancies globally, contributing significantly to both morbidity and mortality. Ferroptosis, a unique iron-dependent form of cell death, has been implicated in various cancers, including GC. This study investigated the association between ferroptosis-related genes (FRGs) and GC using bioinformatics analyses. Methods: Differentially expressed genes (DEGs) were identified using a publicly available microarray dataset. Genes associated with ferroptosis were then extracted, and their overlap with the DEGs was assessed. To gain further insights, functional enrichment analysis was performed, followed by the prediction of microRNA (miRNA) and transcription factor (TF) interactions. Additionally, a protein-protein interaction (PPI) network was constructed. Key genes were identified using the CytoHubba extension in Cytoscape, and their prognostic value was analyzed through receiver operating characteristic (ROC) curve evaluation. Results: Overall, 3242 DEGs were identified, of which 78 were ferroptosis-related (DEFRGs). These DEFRGs were enriched in pathways such as ferroptosis and pathways in cancer. Among them, hsa-miR-106a-5p and SP1 were identified as key miRNA and TF, respectively. The PPI network revealed five hub genes: TP53, MDM2, KRAS, IL6, and PTGS2. ROC curve analysis demonstrated that all hub genes have excellent prognostic value for GC. Conclusion: This study highlights the critical association between GC and ferroptosis-related genes using bioinformatics tools. These findings provide insights for future investigations and the development of targeted therapies against GC. https://ijph.tums.ac.ir/index.php/ijph/article/view/34625 https://ijph.tums.ac.ir/index.php/ijph/article/download/34625/8631

Tehran University of Medical Sciences Iranian Journal of Public Health 2251-6085 54 8 2025 09 02 1631 1642 Chenxi Li Neurological Department, Yan'an People's Hospital, Yan'an, Shaanxi, 716000, China Chao Qi Department of Emergency & Critical Care Medicine I, Affiliated Hospital of Shandong, University of Traditional Chinese Medicine, Jinan, Shandong, 250000, China Yalong He Neurological Department, Yan'an People's Hospital, Yan'an, Shaanxi, 716000, China Baiya Fan Neurological Department, Yan'an People's Hospital, Yan'an, Shaanxi, 716000, China Ruyu Bai Neurological Department, Yan'an People's Hospital, Yan'an, Shaanxi, 716000, China 2024 08 21 2024 12 14 Background: Ethylene oxide (EO) is widely used in various industries and has been associated with multiple health risks. However, its impact on stroke risk and all-cause mortality in the general population remains has not been definitively established. This study aimed to investigate the association between EO exposure, stroke risk, and all-cause mortality in a population-based sample. Methods: Data were obtained from the National Health and Nutrition Examination Survey (NHANES) from 2013 to 2018, involving 29,350 participants. After applying inclusion and exclusion criteria, 4,908 participants with detectable EO levels and complete stroke and mortality data were included in the analysis. Hemoglobin adducts of EO (HbEO) were used as a marker of exposure. Logistic regression models were used to examine the association between EO levels and stroke risk, while Cox proportional hazards models assessed the relationship between EO levels and all-cause mortality, adjusting for covariates such as age, high blood pressure, diabetes, and smoking history. Results: Higher EO exposure levels were significantly associated with an increased risk of stroke, particularly after adjusting for covariates such as age (OR: 1.002, 95% CI: 1.001-1.003, P<0.0001) and additional covariates (OR: 1.001, 95% CI: 1.000-1.003, P=0.023). Higher EO levels were also associated with increased all-cause mortality when adjusted for age and additional covariates (HR: 1.333, 95% CI: 1.003-1.770, P=0.047). Conclusion: This study provides evidence of a significant association between EO exposure and increased risks of stroke and all-cause mortality in the general population. Further research is necessary to confirm these findings using direct EO exposure measurements. https://ijph.tums.ac.ir/index.php/ijph/article/view/36403 https://ijph.tums.ac.ir/index.php/ijph/article/download/36403/8619

Tehran University of Medical Sciences Iranian Journal of Public Health 2251-6085 54 8 2025 09 02 1776 1785 Sepideh Valipour Department of Hematology, School of Para Medicine, Bushehr University of Medical Sciences, Bushehr, Iran Narges Obeidi 1. Department of Hematology, School of Para Medicine, Bushehr University of Medical Sciences, Bushehr, Iran 2. The Persian Gulf Marine Biotechnology Research Center, Bushehr, Iran Gholamreza Khamisipour Department of Hematology, School of Para Medicine, Bushehr University of Medical Sciences, Bushehr, Iran Seyed Amin Mohammadi Department of Hematology, School of Para Medicine, Bushehr University of Medical Sciences, Bushehr, Iran Maryam Ghaemi Iranian National Institute for Oceanography and Atmospheric Science, Bushehr, Iran Farzad Farhangdoost Department of Hematology, School of Para Medicine, Bushehr University of Medical Sciences, Bushehr, Iran Hamideh Malekhayaty Department of Hematology, School of Para Medicine, Bushehr University of Medical Sciences, Bushehr, Iran Maedeh Darzipour Department of Hematology, School of Para Medicine, Bushehr University of Medical Sciences, Bushehr, Iran 2024 03 08 2025 04 07 Background: One of the treatments of acute lymphoblastic leukemia (ALL) is chemotherapy but it can destroy other normal cells as well as cancer cells, which can lead to infection and bleeding. The widespread consumption of nanoparticles synthesized biogenically by seaweed is because of their easy accessibility and usefulness. We aimed to investigate silver nanoparticles synthesised using Sargassum on the expression of miR-25 and 143 in Jurkat cell line. Methods: In an interventional study in 2019, Bushehr, Iran, following culture of the Jurkat cell line with 95% survival rate, we applied different drug concentrations to 20,000 cell lines and control cells separately to determine maximum cell growth inhibition and IC50. After treatment for 48 h, RNA extraction was performed, and Real Time PCR was used to evaluate miR-25 and 143 expressions. Results: MiR-25 expression in the groups that treated with the maximum dose and IC50 of silver nanoparticles and algae extract was decline but did not differ significantly from that of the control group. Conversely, miR-143 showed a remarkable decline in both treatment groups (P<0.0001). After treating PBMC with nanoparticles the expression level of miR-25 and miR-143were not significantly different. Conclusion: The level of miR-25 and 143 expressions were decrease in the IC50 dosage of silver nanoparticles and algae extract produced. The level of miR-25 expression decreased more in the treated Jurkat cell line than the level of miR-143 expression in normal lymphocytes. Given the oncogenicity of miR-25 in the Jurkat cell line, it is suggested that decreasing level of this microRNA can help to apoptosis of leukemic cells. https://ijph.tums.ac.ir/index.php/ijph/article/view/34855 https://ijph.tums.ac.ir/index.php/ijph/article/download/34855/8632

Tehran University of Medical Sciences Iranian Journal of Public Health 2251-6085 54 8 2025 09 02 1643 1655 Ling Shen Intensive Care Unit, The First People’s Hospital of Pinghu, Jiaxing, China Haijie Li Cardiac Rehabilitation Center, Beijing Rehabilitation Hospital, Beijing, China 2024 12 03 2025 01 25 Background: Ventilator-associated pneumonia (VAP) remains a significant challenge in intensive care units, especially among mechanically ventilated patients. Sedation protocols, particularly nurse-led interventions, have been suggested to improve patient outcomes by reducing the incidence of VAP. This study evaluated the effectiveness of such protocols on VAP incidence, mechanical ventilation duration and ICU length of stay. Methods: A comprehensive search of electronic databases, including MEDLINE, EMBASE and Cochrane CENTRAL from inception to 30 August 2024 was conducted following PRISMA guidelines. Nurse-led sedation protocols and their impact on VAP outcomes were selected for meta-analysis. Data extraction included sample size, interventions, control measures and primary outcomes. Statistical analysis was performed using a fixed-effects model to calculate risk differences and odds ratios with heterogeneity assessed using the I² statistic. Results: The systematic review comprised 15 studies, with 7 studies meeting the criteria for meta-analysis. Nurse-led sedation protocols were associated with a significant reduction in the duration of mechanical ventilation (Risk Difference: -0.21; 95% CI: -0.37 to -0.04, P=0.01). However, analyzing VAP-related mortality, the odds ratio (OR: 0.80; 95% CI: 0.60 to 1.07) indicated no statistically significant difference between intervention and control groups (P=0.14). Conclusion: Nurse-led sedation protocols show promise in reducing the duration of mechanical ventilation, impact on VAP-related mortality remains inconclusive. Future research should focus on refining these protocols and further evaluating their long-term effects on VAP prevention and patient outcomes. https://ijph.tums.ac.ir/index.php/ijph/article/view/37406 https://ijph.tums.ac.ir/index.php/ijph/article/download/37406/8620

Tehran University of Medical Sciences Iranian Journal of Public Health 2251-6085 54 8 2025 09 02 1786 1795 EN Maryam Mokhtari Department of Sociology, School of Human Sciences, Yasouj University, Yasouj, Iran Siroos Ahmadi Department of Sociology, School of Human Sciences, Yasouj University, Yasouj, Iran 2024 10 16 2025 02 06 Background: Although suicide is ultimately committed by individuals, it is influenced by a wide range of factors, from micro to macro levels. Methods: This time-series research examines the relationship between macro socioeconomic variables and the suicide rate from 1991 to 2023. The data were collected from the Statistical Center of Iran (SCI), the Central Bank of Iran (CBI), and the World Bank (WB). Time series charts were used to describe the data, and an autoregressive distributed lag (ARDL) model was employed for examining the relationship among variables using the Microfit 5 software. Results: The results indicate a significant negative relationship between inflation, urban population, and women's participation in the labor force with suicide, but a significant positive relationship between mobile phone penetration and labor force participation with suicide rate. Furthermore, literacy and GDP per capita were not associated with the suicide rate. Conclusion: Macro socioeconomic indicators impact on suicide rates. By better understanding the mechanism of this impact and appropriate planning, suicide rates can be reduced. https://ijph.tums.ac.ir/index.php/ijph/article/view/36937 https://ijph.tums.ac.ir/index.php/ijph/article/download/36937/8633

Tehran University of Medical Sciences Iranian Journal of Public Health 2251-6085 54 8 2025 09 02 1656 1666 Lu Che 1. Zhejiang Chinese Medical University, Hangzhou 310000, Zhejiang, China 2. Hangzhou First People’s Hospital, Hangzhou 310000, Zhejiang, China Haonan Zhang Hangzhou First People’s Hospital, Hangzhou 310000, Zhejiang, China Kaili Xing Hangzhou First People’s Hospital, Hangzhou 310000, Zhejiang, China 2024 11 06 2025 01 14 Background: To systematically evaluate the risk factors of ventilator-associated pneumonia (VAP) in critically ill elderly patients in intensive care unit (ICU). Methods: The China National Knowledge Infrastructure (CNKI), Wanfang Database, PubMed and Web of science databases were searched to collect the literature published at home and abroad on the risk factors of ventilator-associated pneumonia in critically ill elderly patients in ICU. The publication date of the literature was up to Oct 24, 2024. Meta-analysis was performed using Stata SE14.0 software to calculate the Odds ratio (OR) and 95% Confidence intervals (CIs) of each risk factor. Results: Thirteen articles were included, all of which were case-control studies. Age, glucocorticoids, mechanical ventilation ≥7 d, tracheotomy, gastrointestinal feeding nutrition, and acute physiological and acute physiology and chronic health evaluation ⅱ(APACHEII) score ≥15 were the risk factor for VAP in ICU patients (OR (95%CI) were 1.044 (1.004, 1.086), 4.663 (2.098, 10.363), 2.749 (1.912, 3.952), 7.405 (2.040, 26.884), 2.676 (1.888, 3.794), 1.822 (1.198, 2.771). Conclusion: Clinical interventions targeting age, glucocorticoid use, mechanical ventilation ≥7 days, tracheotomy, gastrointestinal feeding nutrition, and APACHEII ≥15 should be prioritized to reduce VAP incidence in critically ill elderly ICU patients.Elderly https://ijph.tums.ac.ir/index.php/ijph/article/view/37128 https://ijph.tums.ac.ir/index.php/ijph/article/download/37128/8621

Tehran University of Medical Sciences Iranian Journal of Public Health 2251-6085 54 8 2025 09 02 1667 1677 Chuanze Hu Pediatric Department Ward 1, Jinhua Maternal & Child Health Care Hospital, Jinhua, 321000, China Yaping Xu Neonatal Ward, Jinhua Maternal & Child Health Care Hospital, Jinhua, 321000, China Fang Sheng Pediatric Department Ward 1, Jinhua Maternal & Child Health Care Hospital, Jinhua, 321000, China Buqing Chen Pediatric Department Ward 1, Jinhua Maternal; Child Health Care Hospital, Jinhua, 321000,China Limei Cao Pediatric Department Ward 1, Jinhua Maternal & Child Health Care Hospital, Jinhua, 321000, China 2024 09 28 2024 12 15 Background: This study aimed to investigate the differential diagnostic value of CRP and PCT in distinguishing viral and Mycoplasma pneumonia infections in children with respiratory tract infections. Methods: A total of 13 relevant articles (12 of relatively high quality) were included after quality evaluation, through a literature search. Meta-analysis and SROC curve evaluation were performed. Results: The pooled sensitivity and specificity of CRP diagnosis were 0.91 (95% CI: 0.893-0.937) and 0.4815 (95% CI: 0.440-0.523), respectively, and the area under the SROC curve was 0.699. The pooled sensitivity and specificity of PCT were 68.92% (95% CI: 64.9%-72.7%) and 50.00% (95% CI: 45.6%-54.4%), respectively, and the area under the curve was 0.595. Conclusion: CRP demonstrated higher sensitivity, while PCT showed relatively better specificity. Using both together could improve diagnostic performance. https://ijph.tums.ac.ir/index.php/ijph/article/view/36754 https://ijph.tums.ac.ir/index.php/ijph/article/download/36754/8622

Tehran University of Medical Sciences Iranian Journal of Public Health 2251-6085 54 8 2025 09 02 1678 1688 Mandana Pouladzadeh Emergency Medicine Department, Faculty of Medicine, Ahvaz Jundishapur University of Medical Sciences, Ahvaz, Iran Masoud Danjeh Department of Cardiology, Shahid Beheshti University of Medical Sciences, Tehran, Iran Negin Yousefi Chermehini Emergency Medicine Department, Faculty of Medicine, Ahvaz Jundishapur University of Medical Sciences, Ahvaz, Iran Somayeh Zamanifard Department of Cardiology, School of Medicine, Hajar Hospital, Shahrekord University of Medical Sciences, Shahrekord, Iran Ali Abesi Student Research Committee, School of Medicine, Isfahan University of Medical Sciences, Isfahan, Iran Parisa Molaee Department of Cardiology, School of Medicine, Tehran University of Medical Sciences, Tehran, Iran Hadi Rezaeeyan Asadabad School of Medical Sciences, Asadabad, Iran 2024 06 24 2025 04 23 We investigated the mechanisms of cadmium-induced cardiotoxicity, focusing on its pathophysiological effects, potential preventive strategies, and therapeutic interventions. We further explored approaches to mitigate long-term cardiovascular risks associated with cadmium exposure. This research analyzed the molecular and cellular pathways involved in cadmium toxicity, emphasizing oxidative stress, inflammation, endothelial dysfunction, platelet-leukocyte interactions, and cardiomyocyte damage. Experimental findings and existing literature were examined to uncover the mechanisms driving cadmium-induced cardiotoxicity and to identify potential therapeutic targets. Cadmium exposure leads to oxidative stress and inflammation, resulting in endothelial dysfunction, platelet-leukocyte activation, and thromboinflammation. It disrupts calcium signaling, elevates reactive oxygen species (ROS) production, and causes cardiomyocyte loss, ultimately impairing cardiac function. Cadmium also remodels ion channels and suppresses cardiomyocyte proliferation, intensifying its cardiotoxic effects. While current therapies focus on removing circulating cadmium, they do not address the residual cardiovascular damage caused by prior exposure. Cadmium exerts significant cardiotoxic effects through oxidative stress, inflammation, and cellular activation. Future therapeutic strategies should target these pathways, particularly the activation of platelets, leukocytes, and endothelial cells, to reduce cadmium-induced cardiovascular damage and improve long-term outcomes. https://ijph.tums.ac.ir/index.php/ijph/article/view/35885 https://ijph.tums.ac.ir/index.php/ijph/article/download/35885/8623

Tehran University of Medical Sciences Iranian Journal of Public Health 2251-6085 54 8 2025 09 02 1689 1700 Tayebeh Mokhtari Sorkhani Social Determinants of Health Research Center, Non-Communicable Diseases Research Institute, Department of Health Edu-cation and Promotion, School of Public Health, Shahid Sadoughi University of Medical Sciences, Yazd, Iran Mahshid Bokaie Research Center for Nursing and Midwifery Care, Department of Midwifery, School of Nursing and Midwifery, Shahid Sadoughi University of Medical Sciences, Yazd, Iran Farzan Madadizadeh Center for Healthcare Data Modeling, Departments of Biostatistics and Epidemiology, School of Public Health, Shahid Sadoughi University of Medical Sciences, Yazd, Iran Manoj Sharma 1. Department of Social and Behavioral Health, School of Public Health, University of Nevada (UNLV), Las Vegas, United States 2. Department of Internal Medicine, Kirk Kerkorian School of Medicine at UNLV, Las Vegas, United States Bendaoud Nadif ESEF, Sultan Moulay Slimane University, Beni Mellal, Morocco Seyed Saeed Mazloomy Mahmoodabad Social Determinants of Health Research Center, Non-Communicable Diseases Research Institute, Department of Health Edu-cation and Promotion, School of Public Health, Shahid Sadoughi University of Medical Sciences, Yazd, Iran 2024 10 27 2025 03 19 The decline in total fertility rate (TFR) below replacement levels has significant implications for public health. This comprehensive narrative review aimed to examine behavioral change models and theories pertinent to childbearing decisions. Articles published between 1977 and 2024 were retrieved from from domestic databases (Magiran, SID) and international databases (Web of Science, Scopus, ProQuest, PubMed, MEDLINE), as well as Google Scholar using relevant keywords. Out of 90 articles initially identified, 36 met the inclusion criteria and were selected for analysis. Existing behavioral change models in health education have limitations in motivating couples to increase childbearing. These models do not fully address complex and multifaceted factors such as socio-economic and cultural influences. Furthermore, there is a need for more rigorous and comprehensive evaluations of the effectiveness of interventions based on these models. Evidence-based educational programs, tailored incentive policies, and rigorous model evaluation are essential to promote positive attitudes towards parenthood. Future interventions should assess the applicability of novel theories to optimize fertility program outcomes, with a particular focus on the role of public health. Further research is needed to investigate innovative models for explaining and changing childbearing behaviors. https://ijph.tums.ac.ir/index.php/ijph/article/view/37038 https://ijph.tums.ac.ir/index.php/ijph/article/download/37038/8624

Tehran University of Medical Sciences Iranian Journal of Public Health 2251-6085 54 8 2025 09 02 1701 1711 Marziyeh Ghalamkari Hematologist and Medical Oncologist, School of Medicine, Iran University of Medical Sciences, Tehran, Iran Leyla Sahebi Maternal, Fetal and Neonatal Research Center, Family Health Research Institute, Tehran University of Medical Sciences, Teh-ran, Iran Sara Toogeh Thrombosis Hemostasis Research Center, Tehran University of Medical Sciences, Tehran, Iran Gholamreza Toogeh 1. Thrombosis Hemostasis Research Center, Tehran University of Medical Sciences, Tehran, Iran 2. Division of Clinical Hematology Oncology and Bone Marrow Transplantation, Vali-e-Asr Hospital, Imam Khomeini Hospital Complex, Tehran University of Medical Sciences, Tehran, Iran 2025 01 29 2025 04 23 Background: We evaluated the effects of fasting on cancer treatment outcomes, gathering evidence separately from human clinical trials and in vitro (animal) studies. Methods: A comprehensive search was conducted using the PubMed, Scopus, and Web of Science databases. Studies were included if they examined the effects of fasting on cancer treatment outcomes in vitro or in human subjects, regardless of study design, sample size, or country of origin. Results: A total of 16 studies were included, consisting