Iranian Journal of Public Health最新文献

Background: eHealth has proven effective in changing health-related behaviors and overcoming barriers to HIV care. This systematic review and meta-analysis aimed to review the effect of eHealth on HIV Pre-Exposure Prophylaxis (PrEP).

Methods: A systematic review and meta-analysis was conducted in international databases without a time limit until August 2024 to identify studies evaluating the effectiveness of eHealth interventions for PrEP among key populations. This search strategy used a combination of keywords related to "eHealth", "HIV", and "pre-exposure prophylaxis". A random effects model was used to compute the pooled measure of association (relative risk). The results were combined using a random-effects model for meta-analysis. The I² index was also used to measure heterogeneity between the studies.

Results: Twelve articles involving 3,578 participants were included in the meta-analysis. The findings showed that using websites had a positive effect on PrEP (RR=1.90, 95% CI: 1.30-2.79). Moreover, e-health interventions had the greatest effect on PrEP uptake among female sex workers (FSWs) (RR=2.27, 95% CI: 1.62-3.17). Furthermore, e-health demonstrated a notable effect on PrEP uptake (RR=1.90, 95% CI: 1.30-2.79), particularly in studies with follow-up less than six months (RR=1.85, 95% CI: 1.19-2.09). Additionally, studies conducted in the United States reported the most significant effect of e-health on PrEP (RR= 1.71, 95% CI: 1.38-2.11; I² = 0.41%).

Conclusion: eHealth interventions have the potential to improve the effectiveness of PrEP among key populations. Integrating e-health interventions with comprehensive healthcare services and providing continuous support can improve PrEP uptake, adherence, and retention in the future.

Background: Childhood intelligence is a critical developmental milestone influenced by genetic and environmental factors. The interplay between intelligence and vestibular function, which is increasingly recognized for its relevance to cognitive abilities, has not been extensively studied. This study aims to investigate the potential association between childhood intelligence and vestibular dysfunction.

Methods: Utilizing a two-sample Mendelian randomization (MR) approach, we analyzed data from publicly available genome-wide association studies (GWAS) of European ancestry. Genetic instruments were selected based on GWAS significance, independence, and F-statistics. We employed MR Egger, Weighted median, Inverse variance weighted (IVW), Simple mode, and Weighted mode methods for robustness checks.

Results: Our analysis identified a significant inverse association between childhood intelligence and the risk of vestibular dysfunction (IVW: OR= 0.907, 95% CI = 0.843 - 0.976, p= 0.009). The MR Egger intercept test did not indicate horizontal pleiotropy, and heterogeneity analysis suggested consistency in the results.

Conclusion: The study provides preliminary evidence of a negative correlation between childhood intelligence and vestibular dysfunction risk, suggesting that higher intelligence may be associated with a lower likelihood of vestibular issues. This finding underscores the importance of vestibular function in cognitive development and offers insights for early intervention strategies.

Background: Human papillomavirus (HPV) is among the most prevalent sexually transmitted infections worldwide. Understanding the psychological contributors to HPV infection is crucial for informing preventive strategies. We examined whether sexual assertiveness, body image shame, and impulsiveness predict HPV infection in women.

Methods: In this cross-sectional, predictive correlational study, 119 women aged 18 to 45 who underwent HPV testing in gynecology and oncology clinics in early 2024 were recruited via convenience sampling. Data were gathered using a demographic questionnaire and three standardized instruments: the Hurlbert Index of Sexual Assertiveness (HISA), the Body Image Shame Scale (BISS), and the Barratt Impulsiveness Scale (BIS). Logistic regression analysis was conducted using SPSS version 27.

Results: The participants had a mean age of 33.98 years, with 47.89% being single and 52.1% married. Among all participants, 40.3% tested positive for HPV. Body image shame and impulsiveness emerged as significant predictors of HPV infection risk (P < 0.001). External body image shame was identified as the most impactful subscale of body image shame, while cognitive impulsivity showed the strongest influence among the components of impulsiveness. However, the findings revealed no significant association between low sexual assertiveness and the risk of HPV infection (P > 0.05).

Conclusion: These findings highlight the role of psychological factors, especially body image shame and impulsiveness, in HPV risk. Integrating related interventions into public health measures like vaccination and screening may improve their effectiveness and enhance women's sexual health outcomes.

Background: During driving, drowsiness may happen for a few moments, but its consequences can be terrible. Drowsiness in the driver can be detected in the early stages. Each method used for detecting drowsiness has its own strengths and weaknesses or benefits and flaws. The main contribution of our research was improving Driver Drowsiness Detection (D.D.D) systems.

Methods: In accordance with the research objective, it is imperative to address the subsequent inquiries (Q) throughout the process of constructing, testing, and delivering the ultimate D.D.D software model: Q1. What is the methodology employed for constructing the initial model of drowsiness detection software? Q2. How is the initial model of drowsiness detection software tested and refined during the development phase? Q3. What is the operational mechanism of the final model of drowsiness detection software?

Results: The results were able to detect different facial conditions (with hair and glasses) with a 92.3 percentage detection rate.

Conclusion: This model could help improve D.D.D systems, and detect drowsiness in different environments and situations.

Background: Medullary thyroid cancer (MTC) is a rare neuroendocrine malignancy, accounting for 5-10% of all thyroid cancer cases. The precise molecular processes driving MTC remain largely elusive. We aimed to conduct a pilot study analyzing plasma metabolic profiles of MTC patients to uncover disruptions in metabolic pathways that may contribute to MTC tumorigenesis.

Methods: Proton nuclear magnetic resonance (1H-NMR) spectroscopy was performed to screen metabolic changes in plasma samples from MTC patients (n=16) and healthy subjects (n=12). Multivariate and univariate analyses were applied using MetaboAnalyst and SIMCA software.

Results: A total of 30 compounds were identified, of which three metabolites-glycerol, isobutyric acid, and valine-showed significant differences between MTC patients and the control group (P<0.05).

Conclusion: The findings from this study contribute to the current understanding of MTC metabolism and suggest that the NMR-based metabolomics approach can provide a metabolic pattern of MTC, potentially improving diagnostic procedures.

Background: The prevalence of obesity and overweight globally has increased to epidemic proportions, representing a substantial burden on health systems. The consumption of high-energy-density but low-nutritional-value food, known as fast food, has been linked to the obesity epidemic. This review aimed to quantify the association between fast food consumption and overweight/obesity in individuals aged ten years and above.

Methods: We followed the PRISMA-P 2020 guidelines. To identify studies, English databases, including PubMed, Web of Science, Scopus, Science Direct, and DOAJ, were searched. The search strategy focused on terms and inclusion criteria. After quality assessment, data were analyzed using SPSS software.

Results: Thirteen studies out of 665 screened indicate a significant positive association between fast food consumption and obesity or overweight (OR 2.979 [1.748-5.078]). Heterogeneity analysis revealed substantial variability across studies (Q = 119.497, P < 0.0001; I² = 92.47%), suggesting true differences beyond chance with the random-effects model showed a stronger association compared to the fixed-effects model (OR 2.979 vs. OR 1.929). Sensitivity analysis demonstrated variations based on sample size. Publication bias of the included studies was done using Egger's and Begg's tests.

Conclusion: The analysis revealed the effect of fast food consumption on weight status varied among demographic subpopulations. The review also provides further justification for interventions to encourage healthier dietary choices and reductions in consumption of fast food, both of which, in turn, are aimed at tackling the obesity epidemic.

Background: The present study addresses the development of a novel subunit vaccine (SV) to combat tuberculosis (TB).

Methods: The research used immunoinformatics to develop a subunit vaccine with 7 MHC-I, 3 MHC-II, and 7 B-cell epitopes joined by AAV, GPGPG, and KK linkers. It involved Mtb protein Rv0577 and PADRE sequence as an adjuvant. TLR2 binding affinity (Kd, nM) was determined through PRODIGY. In-silico evaluations determined allergenicity, antigenicity, and physicochemical properties. The vaccine was presented in an AAVDj/8 system, intracellular expression was verified, and the copy number was identified using qPCR and qRT-PCR.

Results: The web tools confirmed the stability, non-allergenicity, and high immunogenicity of the vaccine (0.5673 < 0.4). PRODIGY tool depicted good SV-TLR2 binding (ΔG = -8.8 kcal/mol, Kd = 330 nM) with 59 intermolecular contacts, indicating possible TLR2 activation. Indirect immunofluorescence showed the expression of intracellular proteins. Viral titers, determined by 10-fold serial dilution up to 10³, showed a detectable titer, and copy numbers (10⁹/mL-10¹¹/mL) proved productive viral replication and significant vaccine effectiveness.

Conclusion: This comprehensive methodology, from epitope selection to in-vitro testing, establishes a robust foundation for further exploring and advancing this SV.

Background: Comprehensive and updated data on the prevalence, incidence, mortality, and disability rates of musculoskeletal (MSK) and headache disorders in Asia are scarce. We aimed to analyze the trends in incidence, prevalence, mortality, and disability-adjusted life years (DALYs) related to these disorders from 1990 to 2021.

Methods: We assessed the burden of MSK and headache disorders across Asia utilizing data from the Global Burden of Disease study. We evaluated the trends in DALYs, mortality, incidence, and prevalence and their changes over time. Correlations with the sociodemographic index were examined to determine potential influencing factors.

Results: In 2021, MSK and headache disorders accounted for 120 million DALYs (95% uncertainty interval: 72.5-182.3 million), reflecting a 94% increase since 1990. Furthermore, mortality increased by 138% over the same period. Lower back pain was the leading contributor to DALYs (36.9 million), followed by migraine (25.4 million) and knee osteoarthritis (7.4 million). From 1990 to 2021, DALYs due to osteoarthritis and gout increased by 15% and 170%, respectively. DALYs due to rheumatoid arthritis (RA) remained stable, although RA-related mortality increased by 117%. Age-standardized rates exhibited minimal variation, with the highest burden observed in individuals aged 50-54 years and a higher prevalence among females.

Conclusion: MSK and headache disorders were leading causes of disability in Asia, with significant increments in both DALYs and mortality over the past three decades. These trends underscore the urgent need for targeted prevention and management strategies, particularly for high-burden conditions like lower back pain, migraine, and osteoarthritis.

Background: This scoping review aimed to identify intermediary Social Determinants of Health (SDH) affecting access to reproductive health services among Afghan migrant women, emphasizing the challenges in achieving equitable health service access for this vulnerable population.

Methods: To ensure methodological rigor, the PRISMA checklist was followed. The inclusion criteria comprised quantitative studies addressing access to reproductive health services among Afghan migrants. Articles were retrieved from SCOPUS, Web of Science, and PubMed databases, as well as through manual reference checks, covering the period from Jan 2000 to Mar 2025. Data extraction was guided by the World Health Organization's SDH framework, with a specific focus on intermediary determinants such as healthcare quality, behavioral and psychosocial factors, and social networks.

Results: From an initial pool of 628 articles, 18 met the eligibility criteria. The most frequently reported intermediary SDH was the quality and condition of healthcare services. Other common factors included behavioral aspects, social capital and cohesion, and psychological well-being. These determinants were consistently linked to disparities in access to reproductive health services.

Conclusion: Effective access to reproductive health services among Afghan migrant women hinges on addressing both structural and intermediary SDH. The influence of these factors is context-specific, and tailored interventions are needed. Notably, the supportive role of non-governmental organizations and community-based social support systems should be prioritized to enhance reproductive health outcomes in migrant population.