Tehran University of Medical Sciences Iranian Journal of Public Health 2251-6085 54 8 2025 09 02 1712 1720 Yizhen Chen Department of Pharmacy, Women and Children's Hospital, School of Medicine, Xiamen University, Xiamen, China Shaoxing Guan School of Pharmaceutical Sciences, Sun Yat-sen University, Guangzhou, China Xiaorong Su Department of Pharmacy, Women and Children's Hospital, School of Medicine, Xiamen University, Xiamen, China Wei Zhuang Department of Pharmacy, Women and Children's Hospital, School of Medicine, Xiamen University, Xiamen, China 2024 07 20 2025 01 15 Background: Insulin resistance and abnormal glucose metabolism are the main characteristics of thyrotoxicosis and gestational diabetes mellitus (GDM). However, it remains unclear whether thyrotoxicosis increases the risk of GDM. Therefore, this research aimed to explore the causality between thyrotoxicosis and GDM by using a Mendelian randomization (MR) analysis. Methods: A MR analysis was conducted to explore the causal effects of thyrotoxicosis on GDM. Summary statistics data of thyrotoxicosis (3115 thyrotoxicosis cases and 187684 controls) and GDM (13039 cases and 197831 controls) were derived from genome-wide association study. We selected MR Egger, Weighted median, Inverse-variance weighted, Simple mode and Weighted mode to evaluate the causal effect between thyrotoxicosis and GDM. Results: By using a two-sample MR analysis, we found a strong causal relationship between thyrotoxicosis and GDM as indicated by Inverse-variance weighted (OR=1.069; beta=0.067; 95%CI=1.023-1.118; P=0.003), Weighted median (OR=1.087; beta=0.084; 95%CI=1.040-1.137; P=0.0002), Simple mode (OR=1.102; beta=0.097; 95%CI= 1.038-1.170; P=0.013) and Weighted mode (OR=1.089; beta=0.085; 95%CI=1.033-1.147; P=0.013). No significant pleiotropy, heterogeneity, genetic correlations or bi-directional causal relationship was existed in this study. Bayesian colocalization suggested that thyrotoxicosis colocalized with GDM on rs10830963 (PP.H4 = 1.000), where rs10830963 was located on MTNR1B gene locus. Conclusion: Thyrotoxicosis had a causal effect on the risk of developing GDM, and the exposure of thyrotoxicosis increased the risk of GDM. https://ijph.tums.ac.ir/index.php/ijph/article/view/36129 https://ijph.tums.ac.ir/index.php/ijph/article/download/36129/8626

Tehran University of Medical Sciences Iranian Journal of Public Health 2251-6085 54 8 2025 09 02 1563 1576 EN Fengyu Xue 1. Department of Epidemiology and Biostatistics, School of Public Health, Jilin University, Changchun 130021, China 2. Department of Immunization and Prevention, Fangshan District Center for Disease Prevention and Control, Beijing 102488, China Zhijun Li Department of Epidemiology and Biostatistics, School of Public Health, Jilin University, Changchun 130021, China Lijuan Yan Department of Psychology, Changchun Sixth Hospital, Changchun 130000, China Qiong YU Department of Epidemiology and Biostatistics, School of Public Health, Jilin University, Changchun 130021, China Yanchi Zhang Department of Psychology, Changchun Sixth Hospital, Changchun 130000, China 2024 08 14 2025 03 09 Background: We have included literature on changes in immune cells in patients with schizophrenia and have systematically and quantitatively reviewed these studies through meta-analysis, with a view to understanding the potential effects of immune system dysfunction on the pathophysiology of schizophrenia. Methods: We conducted a systematic search in PubMed, Embase, Web of Science, and the Cochrane Library, covering publications from inception to Sep 25, 2023. The systematic review followed the PRISMA guidelines, and a random-effects meta-analysis was performed. Heterogeneity was evaluated using the I² index, and sensitivity analyses were conducted to assess the stability of the findings. Results: The systematic review includes 42 studies on schizophrenia. Meta-analysis revealed that compared to the control group, schizophrenia patients had significantly higher white blood cell counts (WBC, P<0.01), CD4 absolute values (P=0.02), CD4 percentage (CD4%, P=0.05), CD4/CD8 ratio (P<0.01), monocyte-to-lymphocyte ratio (MLR, P<0.01), neutrophil-to-lymphocyte ratio (NLR, P<0.01), and platelet-to-lymphocyte ratio (PLR, P<0.01). No significant differences were observed for other immune markers in the meta-analysis. Conclusion: The number of immune cells in the blood of patients with schizophrenia increased. Therefore, more research on immune system abnormalities in schizophrenia patients is needed to better understand the underlying mechanisms between schizophrenia and immune cell parameters. https://ijph.tums.ac.ir/index.php/ijph/article/view/36350 https://ijph.tums.ac.ir/index.php/ijph/article/download/36350/8614

Tehran University of Medical Sciences Iranian Journal of Public Health 2251-6085 54 8 2025 09 02 1796 1797 Seung-Taek Lim 1. General Education, Kookmin University, Seoul 02707, Republic of Korea 2. Waseda Institute for Sport Sciences, Waseda University, Saitama 341-0018, Japan 2024 09 09 2024 10 29 No Abstract. https://ijph.tums.ac.ir/index.php/ijph/article/view/36580 https://ijph.tums.ac.ir/index.php/ijph/article/download/36580/8634

Tehran University of Medical Sciences Iranian Journal of Public Health 2251-6085 54 8 2025 09 02 1721 1730 JinShil Kim Gachon University, College of Nursing, Incheon, South Korea Jisun Yang Gachon University Gil Hospital, Incheon, South Korea KyungAh Cho Gachon University, College of Nursing, Incheon, South Korea Sang Baek Gachon University, College of Nursing, Incheon, South Korea Seongkum Heo 3. Mercer University, Georgia Baptist College of Nursing, 3001 Mercer University Drive, Atlanta, GA 30341, USA 2024 10 12 2025 02 18 Background: Periodic symptom assessment in outpatient settings may enhance self-care in heart failure (HF) patients, though its effects are not fully studied. This study examined the impact of periodic HF and depressive symptom assessments on self-care (maintenance, symptom perception, and management) over nine months. Methods: In this randomized controlled trial, symptom assessments were conducted in the intervention group at baseline and at three, six, and nine months in South Korea between Sep 2022 and Nov 2023. Data on self-care were collected at baseline and at nine-month follow-up. A series of two-way repeated measures analysis of variance were used to address the purpose. Results: The only variable that showed a significant difference between the intervention group (n=17, age=64.8 yr) and the control group (n=21, age=64.6 yr) from baseline to nine-month follow-up was self-care maintenance. The main effect of time on self-care maintenance was statistically significant, improving from baseline to follow-up regardless of group (F[1,36])=26.53, P<0.001). A significant group-by-time interaction (F[1,36] = 26.53, P=0.015) indicated the changes in self-care maintenance varied over time by group membership. Conclusion: A periodic assessment of HF symptoms and depressive symptoms increased self-care maintenance, but did not affect other self-care behaviors, in outpatients with HF. Clinicians may consider regular outpatient symptom assessment as a tool for educational support to enhance self-care maintenance in patients with HF. https://ijph.tums.ac.ir/index.php/ijph/article/view/36893 https://ijph.tums.ac.ir/index.php/ijph/article/download/36893/8627

Tehran University of Medical Sciences Iranian Journal of Public Health 2251-6085 54 8 2025 09 02 1577 1590 Kangtai Zheng The Jockey Club School of Public Health and Primary Care, The Chinese University of Hong Kong, Hong Kong Special Adminis-trative Region, Hong Kong SAR, China 2024 10 09 2025 08 09 Background: Task-sharing in diabetes management may be useful for health systems in staff- and resource-poor middle-income countries. The study evaluated the effectiveness of a task-sharing intervention for diabetes led by non-professional health workers in improving glycaemic indicators and blood pressure among adults in middle-income countries. Methods: Embase, PubMed, MEDLINE and Cochrane Central Registry of Controlled Trials were searched for studies published from 2010-2022. Intervention studies involving task-sharing strategies for managing diabetes and other cardiovascular risk factors were included. Extracts were made on populations, interventions, and lay health worker training and supervision. The quality of studies was assessed using the Cochrane Risk of Bias tool. Performed a meta-analysis of randomised controlled trials. A random-effects model was used due to significant heterogeneity among the studies (I² ≥ 50%), otherwise, a fixed-effect model was used. Results: Thirteen randomised controlled trials with 8183 patients were included in the meta-analysis. The population average pooled mean difference in HbA1c was -0.17% (95% CI -0.34 to -0.01) and in fasting blood glucose was -0.75 mmol/L (95% CI -1.14 to -0.35). The population average pooled mean difference in systolic blood pressure was -5.90 mmHg (95% CI -8.11 to -3.68) and in diastolic blood pressure was -2.25 mmHg (95% CI -3.10 to -1.40). Conclusion: Task-sharing interventions for diabetes led by lay health workers in middle-income countries have shown potential for lowering blood glucose levels and reducing blood pressure. https://ijph.tums.ac.ir/index.php/ijph/article/view/36860 https://ijph.tums.ac.ir/index.php/ijph/article/download/36860/8615

Tehran University of Medical Sciences Iranian Journal of Public Health 2251-6085 54 8 2025 09 02 1798 1799 Nader Aghakhani Food and Beverages Safety Research Center, Urmia University of Medical Sciences, Urmia, Iran Béatrice Marianne Ewalds‑Kvist 1. Department of Psychology, Stockholm University, Stockholm, Sweden 2. Division of Psychology, University of Turku, Turku, Finland Sina Aghakhani Department of Law, Faculty of Humanities Sciences, Islamic Azad University of Tehran, West Branch, Tehran, Iran Babak Alishahihesar Department of Nursing, University of Vienna, Vienna, Austria Pedram Abolfathpour Department of Medical Surgical Nursing, School of Nursing and Midwifery, Urmia University of Medical Sciences, Urmia, Iran 2024 11 28 2024 12 15 No Abstract. https://ijph.tums.ac.ir/index.php/ijph/article/view/37345 https://ijph.tums.ac.ir/index.php/ijph/article/download/37345/8635

Tehran University of Medical Sciences Iranian Journal of Public Health 2251-6085 54 8 2025 09 02 1731 1741 Jae-Yo Kim Sport and Healthcare, Namseoul University, Cheonan-si, Korea Sangmin Jeon Department of Media & Communication, Jeonbuk National University, Jeonju-si, Korea Ho-Hyun Song Department of Physical Education, Korea National University of Education, Cheongju-si, Korea 2025 07 08 2025 09 02 Background: In elite Korean wrestling, a sport marked by cultural hierarchy and limited athlete participation, the coach–athlete relationship plays a critical role in shaping an athlete’s development and wellbeing. However, the psychological mechanisms linking the coach–athlete relationship to burnout remain underexplored. This study investigated the mediating role of athletic identity in the relationship between the coach–athlete relationship and athlete burnout among Korean male wrestlers. Methods: We conducted a cross-sectional survey with 369 officially registered Korean male wrestlers (20.37±4.01 years old) from high school, collegiate, and professional levels from whole Republic of Korea via online survey using Google Forms. Participants completed validated measures of the coach–athlete relationship, athletic identity, and athlete burnout. Structural equation modeling with bootstrapping procedures was used to assess direct and indirect effects. Results: The coach–athlete relationship significantly predicted athletic identity (β=0.705, P<0.001) but did not directly affect athlete burnout (β=–0.101, P=0.212). Athletic identity negatively predicted burnout (β=–0.635, P<0.001) and fully mediated the relationship between the coach–athlete relationship and burnout (indirect effect: β=–0.448, P=0.010). These results suggest that athletic identity serves as a protective psychological factor, mitigating burnout even when relational quality is high. Conclusion: While a positive coach–athlete relationship alone does not directly reduce burnout; it exerts an indirect protective effect by enhancing athletic identity. Strengthening athletic identity through supportive coaching may be key to reducing psychological exhaustion among male wrestlers in culturally hierarchical sports environments. https://ijph.tums.ac.ir/index.php/ijph/article/view/39804 https://ijph.tums.ac.ir/index.php/ijph/article/download/39804/8628

Tehran University of Medical Sciences Iranian Journal of Public Health 2251-6085 54 8 2025 09 02 1591 1607 Haiping Li College of Acupuncture-Moxibustion and Massage, Hebei University of Chinese Medicine, Shijiazhuang, Hebei, China Yuanbo Gao College of Acupuncture-Moxibustion and Massage, Hebei University of Chinese Medicine, Shijiazhuang, Hebei, China Guang Zuo College of Acupuncture-Moxibustion and Massage, Hebei University of Chinese Medicine, Shijiazhuang, Hebei, China Hao Chen College of Acupuncture-Moxibustion and Massage, Hebei University of Chinese Medicine, Shijiazhuang, Hebei, China Xiaojun Zheng College of Acupuncture-Moxibustion and Massage, Hebei University of Chinese Medicine, Shijiazhuang, Hebei, China Xuxin Li College of Acupuncture-Moxibustion and Massage, Hebei University of Chinese Medicine, Shijiazhuang, Hebei, China Xifen Zhang College of Acupuncture-Moxibustion and Massage, Hebei University of Chinese Medicine, Shijiazhuang, Hebei, China Yu Wang College of Acupuncture-Moxibustion and Massage, Hebei University of Chinese Medicine, Shijiazhuang, Hebei, China Xihui Zheng College of Acupuncture-Moxibustion and Massage, Hebei University of Chinese Medicine, Shijiazhuang, Hebei, China Xisheng Fan 1. College of Acupuncture-Moxibustion and Massage, Hebei University of Chinese Medicine, Shijiazhuang, Hebei, China 2. Hebei International Joint Research Center for Dominant Diseases in Chinese Medicine and Acupuncture, Hebei University of Chinese Medicine, Shijiazhuang, Hebei, China Yanfen She 1. College of Acupuncture-Moxibustion and Massage, Hebei University of Chinese Medicine, Shijiazhuang, Hebei, China 2. Hebei International Joint Research Center for Dominant Diseases in Chinese Medicine and Acupuncture, Hebei University of Chinese Medicine, Shijiazhuang, Hebei, China 2025 01 13 2025 03 09 Background: We aimed to comprehensively summarise and classify the rules for selecting acupoints for acupuncture for functional gastrointestinal disorders (FGIDs). Methods: We searched relevant literature in PubMed, Embase, Web of Science, the Cochrane Library, China Biology Medicine, China National Knowledge Infrastructure, Wanfang Data, and Chinese Scientific Journal Database from the inception of the database to 18 Aug 2023. Following literature screening, data extraction, standardised processing, frequency analysis, association rules analysis, and correlation analyses were conducted using Microsoft Excel, IBM SPSS Modeller, Cytoscape, and R software. Results: Zusanli (ST36), Tianshu (ST25), and Shangjuxu (ST37) were the most used acupoints. The stomach meridian, conception vessel, and bladder meridian were the more commonly used. The Five-shu points were the most used acupoints. The Shangjuxu-Tianshu (ST37-ST25) combination was the most common acupuncture combination in clinical settings. Furthermore, the acupoints ST36, ST25, Zhongwan (CV12), and Guanyuan (CV4) constituted the core groups of acupoints. Conclusion: We summarized the current characteristics of acupuncture treatment for FGIDs, including the selection of acupoints, meridians, and specific acupoints. The stomach meridian of foot-yangming is frequently utilised, as it aligns with the core meridian theory of "Where the meridian passes through, that's the key point of healing" and "The relationship between meridians and internal Zangfu (脏腑)". The treatment of FGIDs focuses on specific acupoints, with the most effective option being the combination of the Front Mu and Lower-he(sea) points. These findings provide novel insights for the clinical management of FGIDs. https://ijph.tums.ac.ir/index.php/ijph/article/view/37811 https://ijph.tums.ac.ir/index.php/ijph/article/download/37811/8616

Tehran University of Medical Sciences Iranian Journal of Public Health 2251-6085 54 8 2025 09 02 1800 1802 EN Zeinab Khaledian 1. Department of Health Management, Policy and Economics, School of Public Health, Tehran University of Medical Sciences, Tehran, Iran 2. Department of Health Service Management, Se.C., Islamic Azad University, Semnan, Iran Maryam Tajvar Department of Health Management, Policy and Economics, School of Public Health, Tehran University of Medical Sciences, Tehran, Iran Elham Ehsani-Chimeh National Institute for Health Research, Tehran University of Medical Sciences, Tehran, Iran 2025 02 20 2025 04 07 No Abstract. https://ijph.tums.ac.ir/index.php/ijph/article/view/38239 https://ijph.tums.ac.ir/index.php/ijph/article/download/38239/8636

Tehran University of Medical Sciences Iranian Journal of Public Health 2251-6085 54 8 2025 09 02 1742 1753 Franko Shehaj Department of Orthopedics, Renmin Hospital of Wuhan University, Wuhan, China Ahmed Jasim Mahmood Al-Mashhadani Department of Ophthalmology, Renmin Hospital of Wuhan University, Wuhan, China Haohuan Li Department of Orthopedics, Renmin Hospital of Wuhan University, Wuhan, China 2024 10 10 2025 03 09 Background: We aimed to identify biomarkers associated with Osteoarthritis (OA) and evaluate their predictive capabilities. Methods: Four synovial tissue datasets (GSE1919, GSE12021, GSE55235, GSE55457) and one peripheral blood mononuclear rcells (PBMC) dataset (GSE48556) were obtained. GSE55235 and GSE55457 were merged to conduct differential expression analysis and train machine learning algorithms. Predictive models were trained using a subset of genes and then validated on the other datasets. In addition, PBMC dataset was used to train predictive models using the same subset of genes, with the synovial tissue datasets serving as validation datasets. Finally, immune infiltration analysis was performed in the merged synovial tissue dataset using CIBERSORT. Results: RPA3, LAMA5, SAT1, and UCP2 were used to train machine learning algorithms. Predictive models performed well in synovial tissue datasets but faced challenges in the PBMC dataset, as models achieved high sensitivity but moderate specificity. However, models trained on the PBMC dataset exhibited high sensitivity and specificity in the four external validation datasets. SAT1 exhibited the highest impact on the model performance. Immune infiltration analysis revealed significant differences in the expression of several immune cells, such as mast cells, between OA and control groups. In general, the four genes showed moderate to strong correlations with mast cells. Conclusion: While promising, our findings point to the need for further studies to validate biomarkers and improve the models' predictive power across diverse sample types. https://ijph.tums.ac.ir/index.php/ijph/article/view/36874 https://ijph.tums.ac.ir/index.php/ijph/article/download/36874/8629

Tehran University of Medical Sciences Iranian Journal of Public Health 2251-6085 54 8 2025 09 02 1608 1619 EN Aqilah Hazizi Nutrition Programme, School of Health Sciences, Universiti Sains Malaysia, Kelantan, Malaysia NurZetty Zainuddin Dietetic Programme, School of Health Sciences, Universiti Sains Malaysia, Kelantan, Malaysia Divya Vanoh Dietetic Programme, School of Health Sciences, Universiti Sains Malaysia, Kelantan, Malaysia Affizal Ahmad Speech Pathology Programme, School of Health Sciences, Universiti Sains Malaysia, Kelantan, Malaysia Nani Draman Department of Family Medicine, School of Health Sciences, Universiti Sains Malaysia, Kelantan, Malaysia Hana Fauziyyah Nutrition Programme, School of Health Sciences, Universiti Sains Malaysia, Kelantan, Malaysia 2025 01 09 2025 03 01 Background: Unhealthy eating habits and behaviours among educators contribute to mental health issues, which profoundly affect both physical health and work-related wellness. The objectives of the review were to identify the prevalence of psychological distress and dietary habits among teachers and the tools used to assess psychological distress and dietary intake or behaviour in this population. Methods: Three databases which are SCOPUS, PubMed and Web of Science were extensively searched to identify primary articles. Full articles were screened independently based on predefined inclusion and exclusion criteria. Fifteen studies published between 2016 and 2024 were included, following PRISMA-ScR guidelines. Results: The prevalence of psychological distress ranged from 15% to 50%, with the most commonly used tools being the Patient Health Questionnaire (PHQ-9) and Job Content Questionnaire (JCQ). Regarding dietary behaviour, studies revealed that teachers tend to skip meals and reported moderate to high scores of Healthy Eating Index. The Food Frequency Questionnaire (FFQ) was the most commonly used tool for assessing nutritional intake. Conclusion: Addressing these issues, interventions that incorporate emotional skills development, coping strategies and social support are required to explore this relationship in greater detail. https://ijph.tums.ac.ir/index.php/ijph/article/view/37769 https://ijph.tums.ac.ir/index.php/ijph/article/download/37769/8617

Tehran University of Medical Sciences Iranian Journal of Public Health 2251-6085 54 8 2025 09 02 1803 1804 Hamid Jomehpour Psychiatry and Behavioral Sciences Research Center, Mashhad University of Medical Sciences, Mashhad, Iran Mohammad Niroumand Sarvandani Social Determinants of Health Research Center, Gonabad University of Medical Sciences, Gonabad, Iran Raheleh Rafaiee Psychiatry and Behavioral Sciences Research Center, Addiction Institute, Mazandaran University of Medical Sciences, Sari, Iran 2024 09 27 2024 11 18 No Abstract. https://ijph.tums.ac.ir/index.php/ijph/article/view/36732 https://ijph.tums.ac.ir/index.php/ijph/article/download/36732/8637

Tehran University of Medical Sciences Iranian Journal of Public Health 2251-6085 54 8 2025 09 02 1754 1764 Seyed Hadi Hosseini 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 adjustity of Technology, Xi'an, China 2. Center for Youth Development Research, Shaoxing University, Shaoxing, China Ling Zhang Center for Youth Development Research, Shaoxing University, Shaoxing, China 2023 07 05 2023 08 06 Background: Competition among countries becomes fiercer with progress in globalization. As the future and hope of national development, the youth are undertaking intensifying competitive pressures. More youths suffer psychological health issues, such as non-suicidal self-injury (NSSI), depression, and aggressive behaviors. What are the relationships among suicidal self-injury, aggression, and depression? There’s few systematic study on these two aspects yet. Thus, we examined the relationship between aggression and NSSI in youths, as well as the mediating effects of depression in such a relationship. Methods: A total of 770 youths (comprising university students, community youths and rural migrant workers) in Zhejiang, Anhui and Henan in China were investigated from August to December 2022 by using the aggression scale, NSSI scale, and depression scale. The relationship among aggression, NSSI and depression in youths was discussed through a t-test, correlation analysis, and multivariate regression analysis. Results: With respect to abuse experiences during childhood, parental emotional status and family conditions, the total scores in aggression, NSSI, and depression of youths differed significantly (P<0.05). A significantly positive correlation existed between aggression and NSSI of youths (r=0.41, P<0.01), a significantly positive correlation existed between aggression and depression (r=0.42, P<0.01), and a significantly positive correlation exists between NSSI and depression (r=0.42, P<0.01). Aggression of youths had not only direct and positive prediction effects on NSSI (B=0.41, P<0.001) but also indirect effects on NSSI through depression. Conclusion: Aggression, NSSI and depression of youths were influenced significantly by abuse experiences during childhood, parental emotional status and family conditions. Depression has partial mediating effects between aggression and NSSI in youths. https://ijph.tums.ac.ir/index.php/ijph/article/view/32562 https://ijph.tums.ac.ir/index.php/ijph/article/download/32562/8014

Tehran University of Medical Sciences Iranian Journal of Public Health 2251-6085 52 8 2023 08 06 1613 1625 EN Mirghani Seyed Someah Department of Natural Resources and Environment, Science and Research Branch, Islamic Azad University, Tehran, Iran Farideh Golbabaei 1. Department of Natural Resources and Environment, Science and Research Branch, Islamic Azad University, Tehran, Iran 2. Department of Occupational Health Engineering, School of Public Health, Tehran University of Medical Sciences, Tehran, Iran Reza Arjomandi Department of Natural Resources and Environment, Science and Research Branch, Islamic Azad University, Tehran, Iran Farzam Babaei Semiromi Department of Natural Resources and Environment, Science and Research Branch, Islamic Azad University, Tehran, Iran Ali Mohammadi Department of Natural Resources and Environment, Science and Research Branch, Islamic Azad University, Tehran, Iran 2022 04 13 2022 12 21 Background: Asbestos is one of the most important environmental and occupational carcinogens. Nevertheless, the mechanisms by which asbestos fiber exposure causes chronic diseases are not fully understood. We performed the first systematic review on the epidemiological evidence to examine the association between occupational exposure to asbestos and oxidative stress and DNA damage. Methods: In this systematic review study, the PubMed and Scopus databases were searched for English-language publications. Eleven cross-sectional studies were included in the systematic review. A literature search was conducted by the main keywords including "Asbestos", "crocidolite", "chrysotile", "amphibole", "amosite", "Oxidative Stress", "DNA Damage", and "DNA injury". To evaluate the quality of studies, the "Newcastle-Ottawa Quality Assessment Scale" (NOS) was used. Results: Overall, 1235 articles were achieved by searching in databases. Finally, by considering the inclusion, and exclusion criteria, 11 articles were conducted for this study. These studies were published between 1986 and 2020. Oxidative stress and DNA damage can occur in exposure to asbestos. Among various biomarkers, 8-OHdG is the best. The analysis of 8-oxodG in asbestos workers can help identify subjects with a higher level of genotoxic damage. Conclusion: This systematic review suggests that oxidative stress and DNA damage are two main outputs of asbestos exposure. Therefore, oxidative stress and DNA damage biomarkers can be used for identifying subjects at higher risk of cancer. These findings support policy initiatives aimed at detecting and eliminating asbestos fiber exposure and preventing potential health hazards in occupational settings. https://ijph.tums.ac.ir/index.php/ijph/article/view/28441 https://ijph.tums.ac.ir/index.php/ijph/article/download/28441/8005

Tehran University of Medical Sciences Iranian Journal of Public Health 2251-6085 52 8 2023 08 06 1720 1729 Zhicheng Pan General Surgery Department, Nanjing Red Cross Hospital, Nanjing City, Jiangsu Province, 210000, China Huazhong Yun General Surgery Department, Nanjing Red Cross Hospital, Nanjing City, Jiangsu Province, 210000, China Yun Xiao General Surgery Department, Nanjing Red Cross Hospital, Nanjing City, Jiangsu Province, 210000, China Fei Tong General Surgery Department, Nanjing Red Cross Hospital, Nanjing City, Jiangsu Province, 210000, China Guodong Liu General Surgery Department, Nanjing Red Cross Hospital, Nanjing City, Jiangsu Province, 210000, China Ge Zhang General Surgery Department, Nanjing Red Cross Hospital, Nanjing City, Jiangsu Province, 210000, China Jianbo Han General Surgery Department, Nanjing Red Cross Hospital, Nanjing City, Jiangsu Province, 210000, China 2023 01 26 2023 04 07 Background: In order to explore new targets for the treatment of gastric cancer (GC), we investigated the regulatory mechanism of miR-934 in the malignant phenotype of gastric cancer. Results: GC tissues and cell lines showed notably higher levels of miR-934. Overexpression of miR-934 promoted cell viability, migration and invasion, while inhibited cell apoptosis of GC cells. ZFP36 was predicted and verified to be the target of miR-934 and low protein levels of ZFP36 were observed in GC tissues. The ZFP36 protein expressions were suppressed by miR-934 overexpression, while were facilitated by miR-934 inhibition. Furthermore, the carcinogenic functions of miR-934 were partially reversed after ZFP36 overexpression. The results of in vivo experiments further demonstrated that miR-934 promoted tumor growth and repressed the protein expression of ZFP36. Conclusion: miR-934 served as a tumor promoter in GC via targeting ZFP36, and ZFP36 overexpression could efficiently relieve malignant phenotypes caused by miR-934, which prompted an exploitable molecular target for GC treatment. https://ijph.tums.ac.ir/index.php/ijph/article/view/30977 https://ijph.tums.ac.ir/index.php/ijph/article/download/30977/8015

Tehran University of Medical Sciences Iranian Journal of Public Health 2251-6085 52 8 2023 08 06 1626 1641 EN Ehsan Jamshidian University of social welfare and rehabilitation sciences Elahe Hojati Abed PhD in Occupational Therapy, Department of Occupational Therapy, School of Rehabilitation Sciences, Iran University of Medical Sciences, Tehran, Iran Elahe Fathi Azar MSc in Occupational Therapy, University of Social Welfare and Rehabilitation Sciences, Tehran, Iran Mozhdeh Hashemzadeh PhD Candidate in Medical Librarianship and Information Science, Department of Medical Library and Information Science, School of Management and Medical Information Sciences, Clinical Informationist Research Group, Isfahan University of Medical Sciences, Isfahan, Iran. Hooshang Mirzaie PhD in Occupational Therapy, University of Social Welfare and Rehabilitation Sciences, Tehran, Iran Hossein Sourtiji Assistant professor, School of Rehabilitation Sciences, Isfahan University of Medical Sciences, Isfahan, Iran 2022 06 28 2022 12 21 Background: Autism is a lifelong condition that seriously affects many aspects of children's and families' lives. The experience attained by living with a child with autism can be a valuable source of information to provide support and satisfactory services to children with autism and their families. We aimed to investigate the lived experiences of Iranian parents of children with autism. Methods: The search was conducted in PubMed, Web of Science, Embase, Google Scholar, CINAHL, PsychInfo, SID, and Magiran until Nov 2021. Two reviewers screened the articles, applied inclusion criteria, critically evaluated articles using the Critical Appraisal Skills Program (CASP), and extracted study details according to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) checklist. Thematic synthesis was used to analyze included studies.  Results: From 2772 articles in the initial search, sixteen studies entered the final analysis. Four themes emerged, including treatment-related lived experience, individual lived experience, social lived experience, and occupational lived experience. Iranian parents of children with autism are confronted with negative experiences, including inaccurate diagnostic processes, lack of adequate support at the diagnosis time, low-quality treatment, psychological problems, and concern about the child's future. Also, Parent's experiences showed family problems, stigma, and problems with doing occupations. Conclusion: Practitioners, policy-makers, and regulatory organizations should urgently consider issues mentioned in the parents' experiences to provide proper healthcare services for children with autism and their families.  https://ijph.tums.ac.ir/index.php/ijph/article/view/29128 https://ijph.tums.ac.ir/index.php/ijph/article/download/29128/8006

Tehran University of Medical Sciences Iranian Journal of Public Health 2251-6085 52 8 2023 08 06 1730 1738 Raziyeh Zareh-Khoshchehreh 1. Department of Virology, School of Public Health, Tehran University of Medical Sciences, Tehran, Iran 2. Department of Virology, School of Medical Sciences, Tarbiat Modares University, Tehran, Iran Vahid Salimi 1. Department of Virology, School of Public Health, Tehran University of Medical Sciences, Tehran, Iran 2. National Reference Laboratory for Measles and Rubella, School of Public Health, Tehran University of Medical Sciences, Tehran, Iran Ghazal Sadat Fatemi Nasab 1. Department of Virology, School of Public Health, Tehran University of Medical Sciences, Tehran, Iran 2. National Reference Laboratory for Measles and Rubella, School of Public Health, Tehran University of Medical Sciences, Tehran, Iran Maryam Naseri Department of Virology, School of Public Health, Tehran University of Medical Sciences, Tehran, Iran Fatemeh Adjami Nezhad Fard 1. Department of Virology, School of Public Health, Tehran University of Medical Sciences, Tehran, Iran 2. National Reference Laboratory for Measles and Rubella, School of Public Health, Tehran University of Medical Sciences, Tehran, Iran Talat Mokhtari Azad 1. Department of Virology, School of Public Health, Tehran University of Medical Sciences, Tehran, Iran 2. National Reference Laboratory for Measles and Rubella, School of Public Health, Tehran University of Medical Sciences, Tehran, Iran 2020 06 20 2023 01 22 Background: Despite decreasing the global burden of measles disease after the introduction of vaccination, measles remains one of the most devastating childhood diseases. Since genotype B3 is reported as a predominant Measles Virus (MeV) genotype recently, the current study aimed to better understand MeV genetic variation by analyzing the complete sequence of Hemagglutinin (H) gene associated with outbreaks of circulated genotypes in Iran. Methods: Nine positive measles specimens were selected from three circulated different genotypes H1, B3, and D4. Two different regions of MeV RNA were detected by RT-PCR assay. Sequence data and phylogenetic trees were analyzed and constructed by MEGA X software program. Moreover, missense and silent mutations in critical positions of the MeV-H protein were investigated. Results: The result of phylogenetic analysis from the C-terminus of the Nucleoprotein gene (NP-450) and the complete H gene revealed that the mean sequence diversity was 0.06%-0.08% and 0.04%, respectively. Genotype H1 had the highest mutation in this study; however, the substitutions in genotype B3 fundamentally occurred in critical epitopes. Moreover, genotype D4 was more stable than genotypes B3 and H1. Conclusion: Mutations were investigated in the whole sequence of H protein. Moreover, the mutations that occur in the critical sites of the protein have an important effect on the pathogenicity of the virus. In this way, we were able to illustrate why genotype B3 is more transmissible than other measles genotypes and is the most important circulating genotype around the world. https://ijph.tums.ac.ir/index.php/ijph/article/view/21197 https://ijph.tums.ac.ir/index.php/ijph/article/download/21197/8016

Tehran University of Medical Sciences Iranian Journal of Public Health 2251-6085 52 8 2023 08 06 1642 1655 Farzaneh Kermani Health Information Technology Department, School of Allied Medical Sciences, Semnan University of Medical Sciences, Semnan, Iran Mehdi Kahouei 1. Health Information Technology Department, School of Allied Medical Sciences, Semnan University of Medical Sciences, Semnan, Iran 2. Social Determinants of Health Research Center, Semnan University of Medical Sciences, Semnan, Iran Ali Valinejadi 1. Health Information Technology Department, School of Allied Medical Sciences, Semnan University of Medical Sciences, Semnan, Iran 2. Social Determinants of Health Research Center, Semnan University of Medical Sciences, Semnan, Iran Malihe Sadeghi Health Information Technology Department, School of Allied Medical Sciences, Semnan University of Medical Sciences, Semnan, Iran Marjan Momeni School of Rehabilitation, Semnan University of Medical Sciences, Semnan, Iran Shahrbanoo Pahlevanynejad Health Information Technology Department, School of Allied Medical Sciences, Semnan University of Medical Sciences, Semnan, Iran 2022 03 13 2022 12 09 Background: Integration of healthcare services for preterm neonates at home and hospital by mobile technology is an economical and convenient intervention, which is being increasingly applied worldwide. We aimed to classify the outcomes of mobile applications tailored to parents of premature infants. Methods: This systematic review was conducted by searching the six main databases until May 2021. Mobile applications tailored to parents of premature infants and the reported outcomes of this technology were identified and classified. Quality of screened articles checked by MMAT tool. Results: Overall, 10703 articles were retrieved, and after eliminating the duplicated articles, 9 articles were reviewed ultimately. Identified outcomes were categorized into three groups parental, application, and neonatal outcomes. In the parental outcomes, maternal stress/stress coping, parenting self-efficacy, satisfaction, anxiety, partnership advocacy/improved parent-infant relationship, feeling of being safe, reassurance and confidence, increase awareness, as well as discharge preparedness, were identified. In the application outcomes, application usage, ease of use/user-friendly, and usability of the designed application were placed. Finally, the neonatal outcomes include health and clinical items. Conclusion: Mobile applications can be useful in prematurity for educating pregnant mothers, managing stress and anxiety, supporting families, and preparing for discharge. Moreover, due to the coronavirus condition, providing remote services for parents is an appropriate solution to reduce the in-person visits to neonatal care centers. Development of tailored apps can promote the neonates' health and reduce their parents’ stress. https://ijph.tums.ac.ir/index.php/ijph/article/view/28135 https://ijph.tums.ac.ir/index.php/ijph/article/download/28135/8007

Tehran University of Medical Sciences Iranian Journal of Public Health 2251-6085 52 8 2023 08 06 1739 1748 EN Majid Babaie Social Determinants of Health Research Center, Clinical Research Institute, Urmia University of Medical Sciences, Urmia, Iran Habibollah Pirnejad 1. Patient Safety Research Center, Clinical Research Institute, Urmia University of Medical Sciences, Urmia, Iran 2. Erasmus School of Health Policy & Management (ESHPM), Erasmus University Rotterdam, Rotterdam, Netherlands Jafar Rezaie Solid Tumor Research Center, Cellular and Molecular Medicine Research Institute, Urmia University of Medical Sciences, Ur-mia, Iran Gholamreza Roshandel Research Center of Gastroenterology and Hepatology, Golestan University of Medical Sciences, Gorgan, Iran Rana Hoseini Social Determinants of Health Research Center, Clinical Research Institute, Urmia University of Medical Sciences, Urmia, Iran 2021 12 29 2022 08 09 Background: Gastric cancer (GC), one of the most common cancer worldwide, remains the third leading cause of cancer-related mortality. The etiology of GC may arise from genetic and environmental factors. This study aimed to determine the association between GC incidence and socioeconomic status in Iran. Methods: An ecological study was designed to investigate the relationship between socioeconomic factors and the risk of GC incidence. The data of socioeconomic variables such as income changes, unemployment rate, urbanization ratio, inflation rate, and air pollution changes in 31 provinces were collected from the Statistical Center of Iran, and the data of GC of 31 provinces were provided from the Iranian National Population-based Cancer Registry (INPCR). Data from 2014 to 2017 was analyzed using panel data analysis, the fixed effects model by EViews software. Results: Panel data model was suitable for the present study. Results showed that there was a positive and significant relationship between GC incidence and socioeconomic factors including income changes (P≤ 0.001), unemployment rate (P≤0.01), inflation rate (P≤ 0.05), and air pollution changes (P≤ 0.001). The urbanization ratio showed a negative relationship and was not statistically associated with GC incidence (P> 0.05). Conclusion: Our findings suggest a positive and significant association between socioeconomic status and GC incidence, proposing a GC risk factor. The key public health policies and welfare policies' priority should therefore be to schedule for the GC management.   https://ijph.tums.ac.ir/index.php/ijph/article/view/27332 https://ijph.tums.ac.ir/index.php/ijph/article/download/27332/8017

Tehran University of Medical Sciences Iranian Journal of Public Health 2251-6085 52 8 2023 08 07 1749 1757 Ebrahim Alijani Clinical Immunology Research Center, Zahedan University of Medical Sciences, Zahedan, Iran Farhad Riazi Rad Department of Immunology, Pasteur Institute of Iran, Tehran, Iran Asal Katebi Department of Immunology, Pasteur Institute of Iran, Tehran, Iran Soheila Ajdary Department of Immunology, Pasteur Institute of Iran, Tehran, Iran 2022<