Iranian Journal of Public Health

The Application of Painting in the Intervention of Children's Psychological Issues in China: A Narrative Review

Wenhui Huang — 2025-07-15

This article examines the practices, status, evolution and current challenges of painting therapy, in child psychological interventions in China. Empirical evidence shows that painting therapy significantly reduces symptoms of anxiety, anger, and schizophrenia, lowers depression scores, and enhances life satisfaction. Randomized controlled trials indicate improvements in emotional disorders, ADHD, and social adaptability. Qualitative research highlights enhanced emotional recognition and self-expression abilities in children with social disorders and ASD. Although painting therapy has made some progress in China, it faces challenges such as shortage of professional talents and lack of standardization. It is recommended to strengthen professional training, improve certification systems, interdisciplinary cooperation and the application of emerging technologies such as artificial intelligence and virtual reality. This study underscores the potential for art therapy to become a more accessible and impactful tool in child psychology, benefiting not only China but also contributing to global mental health practices.

Community Empowerment through Cadres in the Tuberculosis Program: A Scoping Review

Agung Setiyadi — 2025-07-15

Background: Tuberculosis (TB) remains a global public health problem with high morbidity and mortality rates, especially in low- and middle-income countries. Community-based approaches, including empowerment of health cadres, have been recognized as a key strategy to improve the success of TB control programs. This review systematically identifies research that has been carried out to determine the contribution of cadres in tuberculosis control programs in various countries.

Methods: This scoping review used five electronic databases, namely PubMed, Scopus, Medline-Ebscohost, ProQuest, and Cochrane, to identify the contribution of cadres in TB programs. Article selection was based on PCC (Population, Concept, Context) criteria with a limitation of 2014-2024 and only English-language articles.

Results: Out of 793 initial articles, 20 articles met the eligibility criteria. Studies show that empowering cadres is effective in detecting TB cases, improving patient adherence to treatment, and overcoming stigma through culture-based education. However, challenges such as lack of training, incentives, and access to diagnostic tools often hinder cadre performance.

Conclusion: Health cadres play an important role in bridging the gap between formal health services and the community. With the support of structured training, resource allocation, and community empowerment, cadres can maximize their impact in TB control programs.

The Efficacy and Safety of Hypoglycemic Agents in the Middle-Aged and Elderly Patients with Diabetes Mellitus: A Systematic Review and Meta-Analysis

Jiayan Huang — 2025-07-15

Background: We aimed to evaluate the efficacy and safety of combined hypoglycemic agents and insulin therapy in the middle-aged and elderly patients with diabetes through a meta-analysis.

Methods: Literature was searched in PubMed, Cochrane Library, EMbase, Web of Science, WanFang, VIP, and CNKI databases for studies on the combined use of hypoglycemic agents and insulin therapy in the middle-aged and elderly patients with diabetes, with a search time limit up to February 2023.

Results: This article includes 8 RCTs. The risk of bias assessment shows that one article had a low risk of bias, one article have an unclear risk of bias, and 6 articles have a high risk of bias. The meta-analysis results show that the combination of hypoglycemic agents and insulin has better blood glucose control (P=0.0001); fasting blood glucose reduction is more significant (P<0.00001); the 2-hour postprandial blood glucose reduction is more noticeable (P=0.002); HbA1c reduction is more pronounced (P=0.005); however, there is no difference in the incidence of adverse reactions between the two groups (P=0.09).

Conclusion: The combination of hypoglycemic agents and insulin in the treatment of middle-aged and elderly diabetic patients can reduce the fasting blood glucose, the 2-hour postprandial blood glucose, and HbA1c, and reduce adverse reactions. However, due to the limitations in the number and quality of the included studies, the conclusion still requires further verification from more high-quality RCTs.

Reliability of the Fathering Role Perception Scale in a Turkish Sample: A Meta-Analysis

Bayram Deleş — 2025-07-19

Background: The Father Role Perception Scale (FRPS) is a widely used tool to assess fathers' perceptions of their parenting roles. Understanding the consistency of its measurement across different studies is crucial for reliable interpretation of research findings.

Methods: A comprehensive literature search identified 317 studies on fathering roles. Applying inclusion criteria, 32 studies with 9,987 participants were selected for meta-analysis. Cronbach's alpha coefficients, an indicator of internal consistency reliability, were extracted from each study and analyzed to determine the overall reliability of the FRPS.

Results: The meta-analysis revealed an average Cronbach's alpha value of 0.80 for the FRPS, indicating generally acceptable reliability. However, variability in reliability was observed across studies, potentially attributable to sample characteristics, data collection methods, or cultural differences.

Conclusion: While the FRPS demonstrates acceptable reliability for assessing fathers' perceptions of their parenting roles, researchers should conduct reliability analyses within their specific study groups and consider potential influencing factors when interpreting results. This meta-analysis contributes valuable information for researchers and practitioners in family and child health, aiding in the understanding of fatherhood experiences and the development of supportive programs.

Tobacco Control Interventions in Nigeria from 2012 to 2022: A Blueprint to Reduce Smoking Prevalence: A Systematic Review

Jacob Oche Attah — 2025-07-19

Background: The results of the risk factors associated with tobacco use is a public health concern that slows global progress in the achievement of the Sustainable Development Goal 3 to ensure healthy lives. This is more pronounced in low-income countries like Nigeria where tobacco use remains prevalent leading to various types of non-communicable diseases. This study aimed to review systematically relevant literature to unravel the effects of interventions and policies geared towards tobacco control within Nigeria.

Methods: A systematic search of PubMed and ProQuest central databases, including an exploration of Google Scholar was carried out from 2012-22 for relevant studies within the last decade. The final selected studies were screened based on strict inclusion and exclusion criteria and their quality critically appraised. Six articles were included in the final review, 2 were cross-sectional studies, and 4 were experimental.

Results: Thematic and narrative synthesis of reports showed that tobacco price increase led to lower tobacco demand and use as the price elasticity of tobacco demand estimated in different target groups provided. Moreover, health education interventions positively affected tobacco control as there was a change in knowledge, attitude and practice in groups that had received interventions in Nigeria.

Conclusion: The chosen interventions and policies were effective in promoting tobacco control. There should therefore be an intentional drive to ensure enactment of policies based on the WHO Framework Convention on Tobacco Control. A global effort also must also be put to tackle prevalent health inequalities especially in developing countries like Nigeria.

Infection as a Key Determinant of Readmission in Stroke Patients: A Systematic Review and Meta-Analysis

Abbas Heydari — 2025-07-19

Background: Accurately identifying the relationship between infection and the readmission of stroke patients leads to emphasis more the corresponding strategies. We aimed to determine the relationship between infection and readmission in stroke patients.

Methods: This systematic review and meta-analysis was based on PRISMA 2020 guidelines. A comprehensive search was performed across multiple databases, including PubMed, Web of Science, CINAHL, Scopus, and Google Scholar, using keywords such as "stroke," "readmission," "recurrence," "re-hospitalization," and "infection" up to 2024. The rate of readmissions due to infection, along with the Odds Ratio (OR) for infection, was calculated using a random effects model via Comprehensive Meta-Analysis V.2 software.

Results: Based on the reviewed studies, the 30-day readmission rate of stroke patients due to infection ranged from 6.5% to 30.0% and the one-year readmission rate ranged from 5.1% to 24.5%. Also, infection is an important risk factor in the readmission of stroke patients based on cohort studies (RR 1.38, 95% CI: 1.16-1.65, P<0.001), case-control (OR 1.68, 95% CI: 1.16-2.42, P= 0.006) and descriptive-analytical (OR 1.31, 95% CI: 1.07-1.59, P= 0.008).

Conclusion: The readmission rate of stroke due to infection is high and tackling infection-related readmissions in stroke patients necessitates a holistic strategy that combines clinical care, technological advancements, and education. More studies are needed in this field.

Regenerative Medicine in the Treatment of Alzheimer's Disease: A Narrative Review

Mana Shojapour — 2025-07-19

Alzheimer’s disease (AD) is one of the progressive neurodegenerative diseases, memory impairments and multiple cognitive and behavioral deficits characterize that. We aimed to evaluate the molecular mechanisms involved in the pathogenesis of AD. It introduces the regenerative medicine approach as a novel therapeutic strategy based on the pathogenesis of AD that would be efficient. Our data was collected using databases such as the Web of Science, PubMed, Scopus, and Google Scholar. We summarized the available therapeutic strategies to induce neurodegeneration that can increase the number of neurons and their survival and improve the plasticity of synapses and synaptic activity. There is a different approach to treatment. In first-line treatment, focusing declines the amyloid beta and hypophosphorylated tau protein accumulation. It inhibits acetylcholinesterase, but in regenerative medicine focusing on treatment via gene therapy, cell therapy, and tissue engineering. As a proposed solution for AD in recent years, the use of inhibitors of the pathogenesis of AD is known as a supportive therapeutic approach, but the multi-potential treatment of regenerative medicine has been able to provide promising results in treating neurodegenerative patients.

Health Belief Model in Predicting Screening Behavior among Population at Risk of Colorectal Cancer: A Systematic Review

Fatemeh Estebsari — 2025-07-19

Background: We aimed to review systematically the role of Health Belief Model (HBM) in predicting the health behaviors of patients at risk of colorectal cancer (CRC) and to evaluate the effectiveness of HBM-based educational program on the knowledge and intention of individuals for preventive actions.

Methods: A systematic literature search was performed in PubMed, Scopus, Ovid, Science Direct, Embase, and Google Scholar from1980 up to June 2023 using CRC and HBM as the search words with all their similar terms. All available data were then extracted and described qualitatively.

Results: Overall, 37 articles with 24286 study populations were collected for data extraction. Findings showed that perceived benefit was the most important component of HBM and community-based education can play an important role in improving the awareness and intention of individuals for preventive actions such as screening behaviors. In addition, culture is an important factor in health belief of individuals, so culture-based modified HBM may help to enhance the efficiency of HBM in predicting the knowledge and intention rate among the population.

Conclusion: Preventive actions can minimize the risk of developing cancer, and consequent quality of life. HBM provides a valuable framework for understanding health behaviors by considering the perceptions of individuals about the disease.

Analyzing the Importance and Performance of Safety Education for Sports Participants with Disabilities in Korea

Seungok An — 2025-07-19

Background: We conducted an importance–performance analysis (IPA) to examine how sports instructors with disabilities perceive the effectiveness and relevance to improve safety education for sports participants with disabilities.

Methods: This study was conducted from April to July 2024 in Seoul and Gyeonggi Province, South Korea. We surveyed 395 sport instructors with disabilities and analyzed the perceived importance and performance of safety education across seven domains: life safety, traffic safety, violence and personal safety, drug and cyber addiction, disaster safety, occupational safety, and first aid. The survey included 52 sub-items, and data were analyzed using descriptive statistics, paired samples t-tests, and IPA.

Results: A significant difference in importance and performance was observed across all 7 safety education areas and 52 sub-items, with their importance exceeding their performance (P<0.05). The IPA matrix showed that the traffic and disaster safety domains required urgent improvement, while the life and occupational safety domains required long-term improvement.

Conclusion: Considering that accidents are difficult to predict and can occur in various forms, is it necessary to cultivate long-term improvement among sports participants with disabilities by incorporating safety education into their daily lives.

Empowering the Aging Workforce: The Impact of Medical Insurance on Labor Decisions in Rural China

Cheng Qin — 2025-07-19

Background: Understanding how enhanced medical insurance benefits influence labor decisions of rural elderly individuals is crucial for addressing the challenges posed by population aging on labor market. This study investigated the effects of enhanced welfare levels resulting from medical insurance integration on labor decisions of rural elderly individuals. The objective was to offer policy recommendations to the government to mitigate the decline in the working-age population and sustain the momentum and vibrancy of economic and social development.

Methods: This study conducted an empirical analysis, utilizing two waves of data from the China Health and Retirement Longitudinal Study (CHARLS) collected in 2015 and 2018. This analysis employed the Difference-in-Differences (DID) approach, treating the enhancement of medical insurance benefits for rural residents, due to China's medical insurance integration as a quasi-natural experiment.

Results: Enhancing medical insurance benefits increased the labor supply of older rural individuals, as evidenced by higher labor participation rates and increased hours of work. It also facilitates migrant work while decreasing the willingness to work indefinitely. Medical insurance benefits indirectly influence labor decisions by alleviating healthcare burdens and improving the health status. Notably, the effect is more pronounced among females, higher-income groups, and individuals with poorer health status.

Conclusion: The enhancement of medical insurance benefits resulting from China's medical insurance integration increased the social labor supply and reduced the necessity for elderly individuals to continue working indefinitely. The integration provides disadvantaged groups with improved social security, thereby allowing them to enjoy their later years more fully.

Prevalence and Risk Factors of Carbohydrate Metabolism Disorders among Pregnant Women in Kyrgyzstan

Roza Sultanalieva — 2025-07-19

Background: We aimed to determine the prevalence of carbohydrate metabolism disorders among pregnant women in Kyrgyzstan based on the 2013 WHO diagnostic criteria, to study their frequency, and to assess the influence of key risk factors on the likelihood of developing gestational diabetes mellitus (GDM) and overt diabetes.

Methods: A prospective cohort study was conducted, including 617 pregnant women between 2022 and 2024. All participants underwent an oral glucose tolerance test (OGTT) in the second half of pregnancy. Diagnosis of GDM and overt diabetes was carried out according to WHO criteria. Multivariate logistic regression was used to analyze risk factors. ROC analysis was performed to assess the diagnostic value of the number of risk factors in predicting carbohydrate metabolism disorders.

Results: The incidence of GDM was 18.8% (116/617), and overt diabetes — 6.96% (43/617). The main risk factors for GDM were: age over 35 years (P = 0.002), arterial hypertension (P = 0.001), second-degree family history of diabetes (P = 0.001), pre-pregnancy overweight or obesity (P = 0.002), and multiparity (P = 0.000). For overt diabetes, key risk factors included first-degree family history of diabetes (P = 0.034), second-degree family history (P = 0.001), and overweight or obesity (P = 0.018).

Conclusion: An increase in the number of risk factors correlates with the incidence of GDM and overt diabetes. However, for GDM, the number of risk factors is not a reliable predictor, highlighting the need for universal screening of all pregnant women. For overt diabetes, the number of risk factors showed satisfactory predictive value.

Food Choice, Eating Behaviors, and Associations with Depression Levels and Body Mass Index: A Cross-Sectional Study

Gökben Anil — 2025-07-19

Background: Depression is not only a mental health condition, but also a complex disorder that affects eating behaviors and food choices, leading to changes in body weight. This study aimed to evaluate the relationship between body mass index, eating behaviors, food choices, and depression levels in adults.

Methods: This cross-sectional study conducted in Istanbul from Apr to Jun 2022 included 208 adults aged 18 to 65 yr (mean 30.84±9.21 yr). A questionnaire consisting of sociodemographic information, Food Choice Questionnaire (FCQ), Dutch Eating Behavior Questionnaire (DEBQ) and Beck Depression Inventory (BDI) was applied. Height and body weight were measured.

Results: Of the participants were 9.6% underweight, 48.1% normal, 30.8% overweight, and 11.5% obese. Underweight individuals had significantly lower weight control scores compared to normal and overweight, and their restrictive eating scores were significantly lower than those of normal, overweight, and obese (P=0.001). Compliance scores affecting food choice were significantly lower in individuals with minimal depression than in those with mild and moderate depression (P=0.018). Emotional and external eating were higher in moderately depressed individuals than in those with minimal depression (P=0.001; P=0.018, respectively). Restrictive eating was significantly lower in individuals with minimal depression than in those with moderate and severe (P<0.001). Mood, appropriateness, natural content, weight control, and ethical concern affecting food choice were associated with eating behaviors (P<0.05).

Conclusion: Body weight and depression levels were important factors in food choice and eating behaviors in adults. Our findings emphasize the importance of considering eating behaviors and depression levels in individuals' food choice motivations.

Effect of Loneliness on Psychological Depression of Adolescent Smartphone Addicts: The Mediating Role of Interpersonal Trust

Dan Li — 2025-07-19

Background: As an important psychological antecedent of smartphone addiction, loneliness may have a far-reaching effect on the mental health of teenagers, especially their psychological depression. Interpersonal trust, which is an important psychological trait of individuals in social interaction, may play multiple mediating roles between loneliness and psychological depression.

Methods: Overall, 691 adolescent smartphone addicts in Henan Province, China were surveyed by a group questionnaire. Relevant data were collected via loneliness scale, psychological depression scale, and interpersonal trust scale (including overall trust, emotional trust, and reliableness). The effect of loneliness on the psychological depression of adolescent smartphone addicts was discussed via statistical analysis, and the multiple mediating roles played by interpersonal trust in this relationship were tested.

Results: Loneliness has a significantly positive effect on the psychological depression of adolescent smartphone addicts (P<0.01). Overall trust and emotional trust play a partial mediating role in the influence of loneliness on psychological depression, whereas reliableness plays a masking role in this influence relationship. Significant differences are observed in the influence of two factors—the length of smartphone use and the age—on the psychological depression of adolescent smartphone addicts (P<0.01).

Conclusion: This study reveals the effect of loneliness on the psychological depression of adolescent smartphone addicts and the mediating role of interpersonal trust. To reduce the risk of adolescent psychological depression, psychological health intervention measures should attach importance to the enhancement of interpersonal trust, especially overall and emotional trust.

Self-Reported Musculoskeletal Problem during Stop-Go Driving: The Combined Variables Contribution towards Knee Pain among Car Drivers

Navien Arul Raj — 2025-07-19

Background: Musculoskeletal problems among drivers sourced from severe traffic congestion have become a substantial public health issue. Prominent driving risk exposures were deemed to inflict symptoms such as discomfort and ache among drivers that subsequently contribute to fatigue. This study aimed to investigate the relationship between frequency and period of getting stuck during driving through stop-go motion towards the prevalence of musculoskeletal problems. Moreover, several combined effects of parameters were investigated towards the experience of knee pain among drivers.

Methods: This study adopted a cross-sectional questionnaire survey method. The survey conducted in 2021 was randomly sampled among 18-year-old and above Malaysian drivers with valid driving license and the survey conducted through social media via an online Google form. To analyse the association and outcomes of the survey, Chi-Square and Binary Logistic Regression tests were used respectively.

Results: Overall, 320 drivers were recruited in this study. Data of 180 drivers who frequently stuck during peak hours in congestion was analysed with chi-square test that showed no significant relationship for both the driving exposure variables with the prevalence of knee pain during stop-go motion. Nevertheless, 92 (51.11%) drivers reported commonly experiencing knee pain symptoms from prolonged repetitive driving motion. The total sample of this study tested using regression analysis for combined effects of the parameters showed a significant (P<0.05) correlation of the drivers’ experience of knee pain while driving in heavy traffic.

Conclusion: Generally, there are combined variables that contributed towards the occurrence of knee pain during stop-go driving in this study.

Promoting Stretching Engagement through Health Belief Model-Based Nudges: The Effectiveness of Threat vs. Benefit-Based Nudge Messages

Ye Hoon Lee — 2025-07-19

Background: We aimed to investigate the effectiveness of health belief model-based nudge messaging on engagement in stretching that was either threat-based or benefit-based.

Methods: A quasi-experimental design allocated the participants (N=69) into three groups: the threat nudge group, which received messages emphasizing perceived susceptibility and severity; the benefit nudge group, which received messages on the advantages of stretching; and the control group, which received no messages. The study was conducted in South Korea from October to November 2024. Participants’ engagement in stretching was measured over a six-week period using the health application, which provided the stretching exercise sessions and tracked and recorded their duration.

Results: The threat nudge group exhibited the largest increase in stretching behavior, significantly outperforming both the benefit nudge group and the control group. The benefit nudge group showed an improvement but it tended to be a generally smaller and less dramatic effect than the threat nudge group. Analysis of variance showed a significant difference in stretching time across groups (F_2,67 = 26.43, P=.000; η_p² =0.44), with post-hoc tests indicating that the threat nudge group significantly outperformed both the benefit nudge and the control group in stretching duration.

Conclusion: One implication of these findings was that, as suggested by the health belief model, perceived threat can be a strong motivator for behavior change in the short term while perceived benefits alone may not be sufficient to drive immediate action. Practically, threat-based messaging can be particularly useful in the short term for physical activity instructors and app developers to motivate clients.

Global and Cross-Country Inequalities in the Fatal and Non-Fatal Burden Attributable to Drug Use Disorders and Subtypes: Findings from the Global Burden of Disease Study 2021

Zhou Lei — 2025-07-19

Background: Drug use disorders (DUDs) pose a serious public health threat, exacerbating the worldwide disease burden and resulting in a dramatic rise in fatalities. We aimed to explore the global and cross-country disparities in the fatal and non-fatal burden attributable to DUDs and subtypes by sex and age groups from 1990 to 2021.

Methods: The Global Burden of Disease (GBD) 2021 data were analyzed to estimate the fatal [i.e. mortality and years of life lost (YLL)], non-fatal [i.e. disability-adjusted life years (DALYs), years lived with disability (YLD)] burden, trend attributable to DUDs, subtypes by sex and age groups using the joinpoint regression model across India, China, as well as world between 1990 and 2021.

Results: Between 1990 and 2021, the age-standardized fatal and non-fatal rates attributable to DUDs significantly increased in India and the world, whereas substantially declined in China. China experienced a 2-fold higher age-standardized DALYs and YLDs rate in 2021, and India observed the fastest (2-fold) upward trend in the age-standardized mortality and YLLs rate attributable to amphetamine use disorders than the world. The trend in YLD rate attributable to DUDs significantly increased in the young age group <20 years in India. The world experienced a significant increasing trend in the fatal rate attributable to DUDs in the middle age group 20-54 years. Overall, females observed remarkable improvement in the fatal and non-fatal burden attributable to DUDs across India, China and the world.

Conclusion: India and the global population experienced rising age-standardized fatal and non-fatal rates due to DUDs—while China demonstrated progress. The trend varied by DUD subtypes, age group, and gender, with amphetamine use disorders disproportionately affecting India and China and females showing improved outcomes across all regions.

The Impact of Nurses’ Psychological Well-Being on Organizational Commitment: The Mediating Role of Work Engagement and the Moderating Role of Perceived Organizational Support

Cong Hiep Duong — 2025-07-19

Background: Post-COVID-19 pandemic showed a marked increase in nurse resignations, which has exacerbated pressure on healthcare systems globally. Mental health and Perceived Organizational Support have emerged as critical factors influencing nurses' commitment to their organizations in the post-pandemic era. We aimed to explore the complex relationships between psychological well-being, work engagement, organizational commitment, and perceived organizational support within the Vietnamese healthcare context.

Methods: The research employed a cross-sectional quantitative approach. The questionnaire was distributed through Google Forms during March and April 2024, providing valuable insights into the studied phenomena within Vietnam's unique socio-cultural landscape. Convenience and snowball sampling were used to gather data. Upon completion of data collection, a total of 302 valid observations were obtained. The analysis was conducted using PLS-SEM.

Results: Work Engagement mediates the Psychological Well-being - Organizational Commitment relationship; Perceived Organizational Support moderates the Psychological Well-being - Organizational Commitment relationship; Perceived Organizational Support also moderates the mediation of Work Engagement between Psychological Well-being and Organizational Commitment. This study enhances the understanding of how Psychological Well-being and Work Engagement influence nurses’ Organizational Commitment and highlights the role of Perceived Organizational Support as a key organizational resource in shaping these mechanisms. Furthermore, Organizational Commitment is linked to demographic variables such as age and monthly income, with age being a positive predictor and monthly income a negative predictor.

Conclusion: Healthcare managers can promote Nurses’ Organizational Commitment by employing strategies to enhance their Psychological Well-being, Work Engagement, and Perceived Organizational Support.

Association of the Serpine1 with the Obesity Paradox in Ischemic Heart Failure

Xiaoqiu Zhu — 2025-07-20

Background: Extreme obesity pathology is with a risk factor for heart failure (HF), whereas the obesity paradox in HF shows that obese subjects had a good prognosis. The mechanism underlying the obesity paradox in HF prognosis is unclear till now. We aimed to provide evidence for the molecular mechanisms of the obesity paradox in HF.

Methods: Differentially expressed genes (DEGs) in ischemic HF samples were identified in the GSE57338 and GSE5406 datasets. Weighted gene co-expression network analysis (WGCNA) modules and a protein-protein interaction network (PPI) were constructed. HF-associated DEGs and pathways were screened in the Comparative Toxicogenomics Database (CTD). The expression of hub genes in adipose tissues from obese patients and LV samples from HF patients were validated in microarray datasets.

Results: Three HF-associated WGCNA modules were identified and DEGs were associated with the ‘hsa04115: p53 signaling pathway’. SERPINE1 was the only common gene between DEGs and HF-associated genes in the CTD database. The SERPINE1 gene was downregulated in the white adipose tissues compared with brown adipose tissues (P = 3.90e-03) and was upregulated in the omental adipose tissues from obese patients compared with lean subjects (P = 3.85e-02).

Conclusion: The downregulation of SERPINE1 expression might be responsible for the obesity paradox in HF via interacting with ESR1.

Epidemiological Characteristics of Road Accident Mortality and Identification of Hot Spots: Years of Life Lost in Fars Province, Iran

Mostafa Eghbalian — 2025-07-20

Background: We aimed to analyze the epidemiological characteristics of road accident mortality and identify high-risk areas, considering the years of life lost (YLL) in Fars Province, central Iran.

Methods: The present study was conducted cross-sectionally in 2019. We used Kernel Density and hot spot analysis to identify statistically significant clusters of road accidents. For the descriptive analysis, we utilized the chi-square test, considering a P-value of less than 0.05 as statistically significant. To calculate years of life lost, R 4.3.3 software and the “YLL” package were used.

Results: A total of 1,604 people died in road accidents, with the majority being male (1,304). The mean age of the subjects was 37.63+36.61 years. The axes with a greater concentration of accidents included Shiraz-Marvdasht-Abade towards Esfahan, Shiraz-Kazeroun towards Bushehr, and Kazeroun- Noorabad towards Yasouj. Head injury and multiple fractures were the most prevalent causes of death among both sexes. The number of deaths and YLL due to accidents was higher in men than in women, in all age groups. In men, the number of deaths and YLL were more between the ages of 15 and 34 years, while in women, the distribution of the number of deaths and YLL did not differ much until the age of 70 years.

Conclusion: There is significant accident hotspots along the Shiraz-Marvdasht-Abade towards Esfahan, Shiraz-Kazeroun towards Bushehr, and Kazeroun-Noorabad towards Yasouj routes. In addition, the highest number of YLL due to road accidents occurred among teenagers and young adults. Policymakers need to focus on targeted interventions in these high-risk areas and develop strategies aimed at reducing accidents, particularly among younger males, to enhance road safety and decrease mortality rates.

Synbiotic-Containing Bacillus coagulans (GBI-30) and the Effects on Glycemic Control, Androgen Hormones and Anthropometric Indices in Women with Polycystic Ovarian Syndrome

Zahra Hariri — 2025-07-20

Background: We aimed to investigate the effect of synbiotic supplement-containing spore-forming Bacillus coagulans (GBI-30) on the glycemic, hormonal and anthropometric parameters in patients with PCOS.

Methods: In this randomized, triple-blind, placebo-controlled trial, 72 patients with PCOS were randomly and equally assigned to receive a daily sachet of synbiotic (containing Bacillus coagulans (GBI-30), Lactobacillus rhamnosus, Lactobacillus helveticus, and fructooligosaccharide (FOS)) or placebo for 12 wk. Glycemic, hormonal and anthropometric parameters were measured at baseline and after the 12-week of intervention.

Results: At the end, 60 patients completed the study. After adjustment for potential confounders, significant decrease in insulin (−3.38±20.20 vs. +2.33, P=0.042), homeostatic model assessment for insulin resistance (HOMA-IR) (−0.43±3.61 vs. +0.73 ± 2.91, P=0.044) and dehydroepiandrosterone sulfate (DHEAS) (−1.47±6.62 vs. + 0.03 ± 2.06, P=0.047) was observed in the intervention group compared to the control group. Supplementation with synbiotic failed to show a significant effect on anthropometric parameters and fasting blood sugar.

Conclusion: Overall, 12 wk supplementation with synbiotic-containing Bacillus coagulans (GBI-30) can offer additional benefit to lifestyle intervention on metabolic status of women with polycystic ovarian syndrome.

Dump Fukushima Radioactive Water in the Sea Not in Our Backyard

Wenjie Sun — 2025-07-20

The Article Abstract is not available.

The Role and Differences of Primary Care and Preventive Health Services in a Potential Mpox Pandemic

Tuğba Güler Sönmez — 2025-07-20

The Article Abstract is not available.

Rapid Risk Assessment of Mpox Importation and Spread in Armenia

Ani Manukyan — 2025-07-20

The Article Abstract is not available

Digital-Related Factors Affecting Life Satisfaction among Married Immigrants

Yeo-Won Jeong — 2025-07-20

The Article Abstract is not available

Violence against Health Workers: A Global Challenge with Serious Health Consequences

Shabnam Ghasemyani — 2025-07-20

The Article Abstract is not available