International Journal of Preventive Medicine最新文献

Background: Parkinson's disease (PD) leads to a significant decrease in brain-derived neurotrophic factor (BDNF) and glial cell line-derived neurotrophic factor (GDNF). This study explores the effect of 12 weeks of multimodal exercise on the levels of BDNF and GDNF in patients with PD.

Methods: The study is a quasiexperimental study with random sampling. It was conducted in 2024 at Isfahan. Demographic data were collected using the demographic questionnaire outlined in the Methods section. Thirty patients were randomly divided into two equal groups of multimodal exercise and control, with no significant differences in age, weight, and height. The variables of BDNF and GDNF were assessed in pre- and post-tests. Multimodal exercise was performed 5 days a week for 12 weeks. Data were analyzed using covariance and t-test at a significant level of P < 0.05.

Results: The study observed significant differences in BDNF and GDNF, among two groups of PD (P < 0.01). Moreover, the levels of BDNF and GDNF were significantly higher in the PD + Training group compared to the PD group (P < 0. 01).

Conclusions: Given that multimodal exercises are effective in increasing BDNF and GDNF in individuals with PD, it is recommended to incorporate the benefits of these exercises into physical rehabilitation programs. Therefore, the combined approach of multimodal exercises (resistance, aerobic, and balance) is recommended as the most effective complementary therapeutic strategy for PD.

Background: High blood pressure is one of the most critical issues in maintaining health; it requires prevention and management methods. In traditional medicine, the combination of medicinal plants was usually used to control high blood pressure. One of these plants is Dracocephalum lindbergii. Therefore, this article examines the vasodilating effects of the flavonoid fractions of this plant and deals with this extract as a new suggestion for the prevention and control of high blood pressure.

Methods: This research evaluates the hemodynamic properties of flavonoid-rich fractions extracted from this plant in a rat model under conditions of blood pressure induction. First, the phytochemistry laboratory prepared flavonoid fractions by using a chromatography column. Then, after surgical preparation, the arterial pressure of the rats was controlled until stabilization, and it was possible to record basal systolic pressures (SYS), diastolic pressures (DBP), and mean arterial pressures (MAP). Hypertension was maintained by continuous phenylephrine infusion at 0.1 mg/kg per minute, while the vascular responses were monitored during the infusion. After the animal tests, polyamide and Sephadex columns were used to analyze the most bioactive fractions, which led to the isolation of several flavones identified by regular one- and two-dimensional NMR spectra.

Results: In this model, administration of nifedipine led to an 8% decrease in SYS and a 9% decrease in DBP. Meanwhile, treatment with flavonoid-rich fractions 3, 4, 5, and 6 reduced SYS from 15% to 42% and DBP blood pressure from 6% to 30%. Among these samples, fraction number 6, followed by fraction number 4, showed more effects. Phytochemical studies of these fractions led to the identification of their major components probably responsible for observer effects, including apigenin (1) and apigenin-7-O-β-D-glucopyranoside (2), isolated from fraction number 4, as well as luteolin-4'-O-β-D-glucopyranoside (3) and luteolin-7-O-β-D-glucopyranoside (4) isolated from fraction 6. However, other minor components in fraction 6 are still possible with blood-pressure-lowering effects.

Conclusions: Flavonoid fractions, especially fraction number 6, rich in luteolin derivatives, can provide promising results in reducing blood pressure based on traditional medicine and complementary intervention in a model of acute phenylephrine-induced blood pressure. This study highlights the importance and potency of luteolin-rich fractions of D. lindbergii to serve as a complementary intervention in essential blood pressure control.

Background: Many studies have reported the oncogenic roles of microRNA (miRNA)-629-5p and miRNA-660-5p in various cancers. This study aimed to elucidate the oncogenic roles of miRNA-629-5p and miRNA-660-5p, focusing on their potential contributions to early colorectal cancer (CRC) detection. Additionally, this research examines the efficacy of Regorafenib and 3,3'-diindolylmethane (DIM) as therapeutic agents aimed at mitigating the oncogenic activities of these miRNAs by influencing their structural and conformational dynamics, thereby offering a preventive strategy against CRC.

Methods: The study utilized quantitative real-time polymerase chain reaction (QRT-PCR) to confirm the overexpression of miR-629-5p and miR-660-5p in 40 CRC tissues compared to 40 standard samples and their association with clinicopathological factors. Molecular docking and molecular dynamics simulation were used to investigate Regorafenib and DIM binding modes to miR-629-5p and miR-660-5p.

Results: QRT-PCR showed that miR-629-5p and miR-660-5p were overexpressed in CRC tissues. In silico molecular docking and dynamic simulation strengthened our hypothesis that Regorafenib and DIM were located in the structures of the mentioned miRNAs, resulting in a slight alteration in their structures during the interaction process.

Conclusions: The study's findings suggest that miR-629-5p and miR-660-5p may have potential as predictive biomarkers and treatment targets for Preventing CRC and that Regorafenib and DIM may have miRNA binding properties. They indicated a high affinity to miRNA-629-5p compared with miRNA-660-5p created a slight change in its structure and can suppress its activity in CRC. However, extra experimental approaches are needed to approve our hypothesis.

Background: The occurrence of heat stress in healthy individuals is different from those with chronic diseases like diabetes. While exposed to heat, complications caused by diabetes may lead to problems in body temperature regulation. Due to the fact that diabetic workers are less efficient in hot environments, researchers are encouraged to evaluate this condition.

Methods: The current study incorporates 30 young males. In the first stage, individuals with the history of type 2 diabetes mellitus (T2DM), who frequently had exposure to heat at work, were selected and compared with non-diabetic workers as the control group. Indicators like deep body temperature, skin temperature, heart rate, physiological strain index (PSI), and perceptual strain index (PeSI) were measured and recorded. Eventually, data were evaluated and analyzed using repeated-measure design, independent t test, and its nonparametric equivalent, The Mann-Whitney U test.

Results: In the two groups of type 2 diabetes and control group, following one hour of heat exposure, the median heart rate was 115 (18) and 99 (21) (P = 0.008), respectively, mean deep body temperature was 37.6 (0.37) and 36.95 (0.41) (P < 0.001), mean PSI was 3.01 (0.93) and 2.08 (1.0) (P = 0.021), and mean PeSI was 7.82 (1.43) and 6.12 (2.14) (P = 0.032), which were significantly different. In addition, no significant difference was observed between the skin temperatures of the two groups after one hour of exposure to heat.

Conclusions: According to the results, workers with type 2 diabetes are exposed to more heat strain than the control group in the same hot environment.

The new managerial approach demands the profound examination of capacities, resources, and facilities in social institutions and organizations and optimum and systemic utilization of capacities such as individuals' abilities, expertise, and skills within the framework of social institutions. This approach will thus empower the community, which is the most appropriate platform for sustainable development, and improve systemic and integrated management. The study is designed systematically to identify the capacities of social institutions to empower the existing capacities and plan management and educational programs in a better manner to use these capacities within communities. This systematic review study is conducted until February 15, 2024. The PRISMA system was used to track the review process and findings. Databases were searched for relevant articles, and the STROBE checklist was used to evaluate the quality of the articles. The community-based social organizations will still face budgetary challenges and costs in their capacity-building efforts. As such, advanced management techniques such as teamwork, collaboration and coordination between departments, innovative thinking, brainstorming, or even the use of program evaluation and analytical actions can help reduce possible challenges. This calls for the availability of exact management models and planners in both government systems and people-centered systems to coordinate such capacities. This will seek to shed more light on the important role of social institutions and hence serve to give a clearer understanding of challenges, opportunities, and supportive actions for such institutions to contribute to better government system management.

Background: Understanding the seasonal and spatial patterns of COVID-19 hospitalization and deaths is crucial for effective hospital management, resource allocation, and public health interventions. The current study conducts a spatiotemporal hotspot analysis that explores the seasonal and geographical patterns of high-risk areas of COVID-19 hospitalizations and deaths in Iran.

Methods: Provincial-level data on laboratory-confirmed COVID-19 cases with acute respiratory symptoms in Iran (February 2019-March 30, 2022) were collected. Hotspot analyses mapped seasonal incidence risks, and Global Moran's spatial autocorrelation analysis identified COVID-19 clusters.

Results: Over the 2 years, 26 hotspots and 11 cold spots were identified (P < 0.05). Western and central provinces showed the highest hospitalization hotspots, while the west and north had the most death hotspots. South and southeast provinces exhibited low incidence and the highest number of cold spots. High-risk areas were prevalent in spring and autumn, mainly in the west, north, and central regions.

Conclusions: This research unveils the clustering patterns of COVID-19 hospitalizations and fatalities in Iran during the most severe pandemic. Spatial clusters and dynamic hotspots varied across regions and time. Prioritizing high-risk areas during critical epidemic waves, devising seasonal care strategies, and implementing preventive measures can significantly improve health outcomes.

Background: Urban Family Physician Program (UFPP) passed the first ten years of its age in Iran. In this study, we aimed to determine the strengths and challenges of this program from the viewpoints of family physician (FP) teams to address comprehensive evidences and solutions for its improvement.

Methods: In this qualitative study, using purposeful sampling, 58 members of FP teams from ten cities of Fars province were interviewed. In-depth semistructured phone interviews were performed. The trustworthiness of data was checked using Guba and Lincoln criteria.

Results: Interviewees' mean years of working in UFPP was 6.9 ± 3.5 years. Themes of challenges included: Inefficient governance, Challenging information system, Fragile financing system, Inefficient service provision, Inefficient Health Workforce, and Inadequate medical products and technologies. Themes of strengths included: Improving governance, Comprehensive information system, Improved quality of service delivery, Improved health workforce conditions, Curbing the costs of health systems, and Capability of application of new technologies. The bulk of views were toward challenges compared with the strengths.

Conclusions: After the first decade of running UFPP and regardless of some contradictory opinions among family physician teams, the challenges of this program outweigh its strengths. These evidences address the need for a fundamental reform in this program.

Background: The Health System Transformation Plan (HSTP) in Iran aimed to enhance universal health coverage through improved access and reduced out-of-pocket payments. However, rising healthcare expenditures have posed challenges. The Diagnosis-Related Groups (DRG) payment system has been implemented in developed countries to reduce costs, improve efficiency, and enhance service quality. This study estimates the potential cost savings in pharmaceutical and inpatient services within the HSTP framework, focusing on public hospitals affiliated with Isfahan University of Medical Sciences (MUI).

Methods: This study was conducted in three stages. First, a cross-sectional study design was used to collect current inpatient and pharmaceutical costs from public hospitals affiliated with MUI before and after the health sector reform. Second, a meta-analysis was conducted to determine the effects of implementing the DRG payment system on the costs of inpatient and pharmaceutical services. Finally, the possible costs of medication and hospitalization in 2015 were estimated by applying the annual inflation rate. The predicted costs were calculated by multiplying the impact values of the DRG payment system on the estimated expenses in 2015. The potential cost savings were calculated by subtracting the current expenses from the predicted expenses based on the DRG payment system.

Results: Based on the assumption ratio of changes following the implementation of the DRG payment system, the study estimated cost savings of $60,282,055 in both inpatient and pharmaceutical expenses.

Conclusions: Implementing the DRG payment system could have resulted in significant cost savings, equivalent to 9.2% of the total health sector expenditures of MUI.

Background: Considering the increasing prevalence of adolescent smoking in recent years, this study proposes a machine learning (ML) approach for distinguishing adolescents who are prone to start smoking and those who do not directly confess to smoking.

Methods: We used two repeated measures cross-sectional studies, including data from 7940 individuals as distinct training and test datasets. Utilizing the randomized least absolute shrinkage and selector operator (LASSO), the most influential factors were selected. We then investigated the performance of different ML approaches for the automatic classification of students into smoker/nonsmoker and low-risk/high-risk categories.

Results: Randomized LASSO feature selection prioritized 15 factors, including peer influence, risky behaviors, attitude and school policy toward smoking, family factors, depression, and sex as the most influential factors in smoking. Applying different ML approaches to the three study plans yielded an AUC of up to 0.92, sensitivity of up to 0.88, PPV of up to 0.72, specificity of up to 0.98, and NPV of up to 0.99.

Conclusions: The results showed the capability of our ML approach to distinguish between classes of smokers and nonsmokers. This model can be used as a brief screening tool for automated prediction of individuals susceptible to smoking for more precise preventive intervention plans focusing on adolescents.