Iranian Journal of Public Health

Impact of Fast Food Consumption on Obesity and Overweight among Individuals Aged Ten Years and Above: A Systematic Review and Meta-Analysis

Seif Said Khalfan — 2025-10-13

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.

Intermediary Determinants of Health and Access to Reproductive Health Services among Afghan Migrant Women: A Scoping Review

Zahra Bayat Jozani — 2025-10-13

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.

Challenges of the Referral System in Family Medicine Program in Iran: A Scoping Review

Javad Barzegari — 2025-10-13

Background: Since its inception in 2005, Iran’s Family Medicine Program has faced persistent challenges in implementing an effective referral system, limiting its potential to optimize healthcare delivery and reduce hospital overcrowding. This scoping review synthesized evidence from 31 studies (2005–2022) to identify and categorize systemic challenges within Iran’s referral system.

Methods: In 2023, a systematic search of English and Persian databases (e.g., PubMed, SID, Magiran) identified studies on referral system challenges. Data were thematically analyzed and mapped to six WHO domains: governance, financing, human resources, equipment, information systems, and service delivery.

Results: Key challenges include: Governance: Fragmented policies, weak oversight and lack of enforceable referral protocols. Financing: Delayed payments to physicians and restrictive insurance tariffs disincentivize compliance. Service Delivery: Public distrust in family physicians, low reverse referral rates, and poor specialist feedback. Technology: Reliance on paper-based referrals and fragmented electronic records. Human Resources: Rural specialist shortages (0.5 per 10,000 in Iran vs. 4.2 in urban areas) drive bypassing of primary care.

Conclusion: Iran’s referral system struggles reflect systemic deficiencies in governance, financing, and infrastructure. Successful reforms require multi-level interventions: digitizing referrals, incentivizing compliance through blended payment models, and rebuilding public trust via awareness campaigns. Lessons from countries like South Korea (differential copayments) and the UK (Shared Care models) highlight pathways for integration. Without urgent action, the Family Medicine Program risks perpetuating inefficiencies and inequities in Iran’s healthcare system.

Sleep Quality in Heart Failure Patients: A Systematic Review of Risk Factors and Assessment Tools

Akram Gazerani — 2025-10-13

Background: Poorly sleeping is a common problem for heart failure patients and can significantly decrease their quality of life. Among heart failure patients, the widespread issue of poor sleep quality can lead to a diminished quality of life. The present study aimed to review systematically the evidence focused on the determinants of sleep quality factors in heart failure patients.

Methods: We conducted a comprehensive search for observational studies in both English- and Persian-language databases from Feb 1991 to Jan 2023. The search strategy included keywords such as "sleep quality" and "heart failure" and risk factors. All screening and extraction steps were carried out by two researchers.

Results: The initial search yielded 10,357 articles. After screening, 37 studies (30 cross-sectional studies, 1 longitudinal study, 2 correlational studies, 1 prospective observational study, 2 case‒control studies and 1 descriptive-analytical study) were included. We categorized the identified factors as demographic, habits and lifestyle, medication use, and psychological. The Pittsburgh Sleep Quality Index (PSQI) is the most commonly used sleep quality assessment tool.

Conclusion: Mental health-related and lifestyle factors such as depression, fatigue, female sex, and high BMI play important roles in disrupting sleep quality. In addition, it is necessary to develop new assessment tools for sleep quality specified for HF patients.

Effectiveness of eHealth on Human Immunodeficiency Viruses Pre-Exposure Prophylaxis among Key Population: A Systematic Review and Meta-Analysis

Hossein Moameri — 2025-10-13

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.

Identifying Dimensions of Organizational Health Literacy in Hospitals: A Scoping Review

Meghdad Rahati — 2025-10-13

Background: Organizational health literacy (OHL) plays a crucial role in improving patients’ understanding and engagement in hospital care. Despite its importance, little is known about the comprehensive dimensions of OHL from a managerial perspective. This study aimed to identify key dimensions that can influence OHL in hospital settings to enhance patient care.

Methods: A scoping review was conducted to examine studies published from 2012-2024 regarding OHL in hospitals. Relevant studies were identified using a structured search strategy across multiple databases, including PubMed, Scopus, and Web of Science. Overall, 39 articles were selected after screening, and content analysis was performed using MAXQDA-10. The review adhered to the PRISMA guidelines for scoping reviews.

Results: The analysis identified six core dimensions of OHL: (i) leadership and management, (ii) policy and strategy formulation, (iii) human resources, (iv) organizational resources (including financial, physical, and informational), (v) processes, products, and services, and (vi) results. These dimensions were further categorized into 21 subcategories. Each dimension outlines essential components for improving hospital OHL, such as leadership support, staff training, communication strategies, and resource allocation. Additionally, the study highlights the role of technology, including electronic health literacy, in improving organizational performance.

Conclusion: By addressing the key dimensions that influence organizational health literacy in hospitals, hospital administrators can enhance patient understanding of healthcare services, improve safety and satisfaction levels, and foster a culture of health literacy. The provided framework offers a valuable management approach for integrating OHL into hospital operations, potentially leading to more informed and health-literate patient communities.

Burden of Musculoskeletal and Headache Disorders in Asian Countries, 1990–2021: A Cross-Sectional Analysis of the Global Burden of Disease Study 2021

Youngoh Bae — 2025-10-13

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.

Interaction between Overweight, Obesity and Smoking on the Risk of Pre-Diabetes and Type 2 Diabetes in Guangdong, China

Zhuanping Zeng — 2025-10-13

Background: Pre-diabetes mellitus (PDM) is considered a precursor stage of type 2 diabetes mellitus (T2DM) and serves as an early warning sign for the disease. However, most studies only analyze the risk factors of T2DM, ignore the exploration of PDM.

Methods: Here 28,208 patients with T2DM were selected from 5 cities in the Pearl River Delta, Guangdong Province, China in 2017. Then a 1:1 matched case-control study was conducted according to the matching conditions. Finally, 28208 patients with PDM and 28208 patients with normal glucose tolerance (NGT) were matched, and when multiple subjects were matched, the same subjects in the region were preferredOrdered multiple logistic regression was used to analyze the influencing factors of T2DM and PDM. When analyzing the relationship between overweight, obesity, smoking, and T2DM, factors such as age, education level, exercise were adjusted.

Results: Overweight, obesity (OR=1.427, 95%CI:1.388~1.468; OR=1.829,95%CI:1.753~1.908) and smoking (OR=1.161,95%CI:1.113~1.212) were risk factors for the onset of T2DM by ordered multiple logistic regression. There was an additive interaction between overweight obesity and smoking in the developing of T2DM. Moreover, there were 0.196(0.051~0.341) relative excess risk due to the additive interaction, 9.1% (2.0%-16.1%) of T2DM exposed to both risk factors was attributable to the additive interaction, and the risk of T2DM in overweight and obese smokers was 1.203(1.004-1.402) times as high as the sum of risks in the participants exposed to a single risk factor too.

Conclusion: Overweight obesity and smoking are the risk factors for the onset of T2DM.

Prostate Cancer Mortality Trend in Montenegro 1990-2018

Mirjana Nedovic Vukovic — 2025-10-13

Background: Prostate cancer is the fifth leading cause of cancer-related death among men worldwide, with an estimated 375,304 deaths in 2020 and a mortality rate of 7.7 deaths per 100,000. It stands as the leading cause of cancer mortality in 48 countries. We aimed to analyze the prostate cancer mortality trend in Montenegro for the period 1990-2018 using regression techniques.

Methods: The data concerning prostate cancer mortality in Montenegro from 1990 to 2018 was collected. Mortality rates were age-standardized to the World Standard Population for estimating both overall and gender-specific trends. The joinpoint, linear and Poason regression were applied for trend assessment.

Results: In Montenegro, during the period from 1990 to 2018, 1,184 individuals died from prostate cancer. The average annual number of deaths was 40.8, with an average age-standardized rate of 8.3. For the period 1990-2018, rates statistically significantly increased on average by 2.4% annually [AAPC (95%CI)=2.4% (1.4-3.4); P<0.001]. An increase in mortality rates was observed among individuals aged 65-74 by 1.1%, which was not statistically significant (P=0.452), and among those aged 75-84 by 2.7%, which was statistically significant [AAPC (95%CI)=2.7% (1.3-4.1); P<0.001]. Almost 50% of all deaths occurred in men aged 75-84, and nearly a third in the age group 65-74.

Conclusion: The rising trend in prostate cancer mortality indicates the need for more effective prevention, screening, early diagnosis, and treatment measures for prostate cancer in Montenegro with special focus on older men.

Risk Factors for Hand, Foot and Mouth Disease Reinfection in Qingdao, China, from 2014 to 2022

Xueling Xin — 2025-10-13

Background: Hand, foot and mouth disease (HFMD) is a common infection disease among children, which is caused by human enterovirus (EV) family. The absence of cross-protection against different EV sub-types, makes HFMD reinfection common. Thus, we aimed to explore the epidemiological characteristics and influencing factors of HFMD reinfection in Qingdao City.

Methods: Data on HFMD cases from 2014 to 2022 were obtained from National Infectious Surveillance System. Logistic regression analysis was used to assess the independent risk factors of HFMD reinfection.

Results: Overall, 78422 HFMD cases were enrolled. Of these, 2041 cases were classified as reinfection, corresponding to the reinfection rate of 2.60%. The median time interval between the primary infection and secondary infection was 12.75 (IQR=12.24) months. The seasonal peak of reinfection occurred from June to August each year. Multivarite logistic analysis showed that male, younger age, scattered children, severe cases, hospitalization, and EV71 infection were risk factors for HFMD reinfection. The proportion of patients infected with EV71 in the primary infection cases was higher than that in non-reinfection cases (OR=1.83, 95%CI=1.29-2.60).

Conclusion: Boys aged 5 years and below, especially those with severe cases and first infected with EV71 are more prone to reinfection. Therefore, authorities should implement targeted health education and intervention strategies to reduce the reinfection rate among vulnerable population.

The Effects of Different Intervention Protocols on Anthropometric Measures, Lipid Profile, and Quality of Life: Insights from a Pandemic-Era Randomized Controlled Trial

Dilara Canbay Ozdemir — 2025-10-13

Background: To assess the effect of different treatment protocols on anthropometric measures, lipid profile, and weight-related quality of life amid the pandemic.

Methods: A single-blind randomized controlled trial was conducted at Hacettepe University's Family Medicine outpatient clinics in Ankara, Turkey, in 2022. Participants were stratified into three groups: intervention, control-1, and control-2. The intervention group received a calorie-restricted diet, exercise program, and follow-up calls every 15 days. Control-1 received the same plan with a single follow-up at week 4. Control-2 received general dietary and exercise advice and regular follow-up calls every 15 days. Outcomes were measured at baseline and 12 weeks, including quality of life assessed with the Turkish IWQOL-Lite scale.

Results: We 153 participants, with 51 individuals per group. At the 12th week, all groups exhibited significant improvements in weight, BMI, waist circumference, fat mass, and quality of life scores. The intervention group demonstrated improvements in physical function, self-esteem, work, and total quality of life score compared to baseline (P<0.001).

Conclusion: Developing and adhering to a personalized exercise and diet plan is crucial for maintaining a healthy lifestyle, even during a pandemic

Optimizing a Subunit Vaccine of Mycobacterium tuberculosis Using In-Silico and In-Vitro Approaches

Zaiqin Ling — 2025-10-13

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.

Diet Quality as a Determinant of Physical Activity, Sleep Patterns, and Quality of Life in Young Adults

Pınar Hamurcu — 2025-10-13

Background: This study aimed to examine the relationship between nutritional status assessed by the diet quality index with physical activity, sleep, and quality of life among young adults.

Methods: This descriptive, cross-sectional research utilized a sample of 700 university students enrolled in the 2021–2022 academic year at a private university's Faculty of Health Sciences in Istanbul, Türkiye. Data were collected using face-to-face interviews with Information Form, Pittsburgh Sleep Quality Index (PSQI), International Physical Activity Questionnaire (IPAQ), World Health Organization Quality of Life-Short Form-Turkish Version (WHOQOL-BREF-TR) and 24-Hour Food Consumption Record. The dietary quality of the participants assessed via Diet Quality Index-International (DQI-I).

Results: The study revealed inadequate diet quality among young adults, with a mean DQI-I score of 33.08±7.03. According to PSQI assessment, 85.3% of them had impoverished sleep quality, and according to IPAQ assessment, 23.3% of them were physically inactive. In comparing participants' characteristics with DQI-I, a positive correlation observed between age and both DQI-I-Total (P=0.017) and Variety sub-dimension (P=0.027). Furthermore, statistically significant differences identified between Moderation sub-dimension and economic situation (P=0.032), as well as between Variety sub-dimension and sleep duration (P=0.044). No statistically significant association found between diet quality and either sleep quality or physical activity levels (P>0.05). However, a significant relationship observed solely between Variety sub-dimension and social relationship sub-dimension of WHOQOL-BREF-TR (P=0.033).

Conclusion:This study observed a significant correlation between dietary diversity and quality of life, whereas no significant correlation observed between diet quality and sleep quality, physical activity level, or quality of life.

Factors that Affect the Quality of Life of Caregiving Nursing Technicians of Psychiatric Patients

Mihael Djacic — 2025-10-13

Background: The importance of the role of nurse technicians lies in the fact that they are becoming the main providers of health care for psychiatric patients, in addition to providing them with appropriate care. We aimed to examine predictors of quality of life of nurse technicians caring for psychiatric patients.

Methods: The sample consisted of 260 nurse technicians caring for psychiatric patients at the Special Hospital for Psychiatric Diseases "Dr Slavoljub Bakalović" in Vršac and the Special Hospital for Psychiatric Diseases in Kovin, Serbia. The following instruments were used in the study: a questionnaire to collect sociodemographic characteristics, the World Health Organization Quality of Life Self-Assessment Questionnaire – Short Version, the Depression Anxiety Stress Scales, the Brief Resilience Scale, and the Fatigue Assessment Scale – FAS Serbian and the Zarit Stress Interview.

Results: On the physical and mental aspects of the quality of life of medical technicians, the greatest negative impact is the physical aspect of fatigue (P=0.036) and anxiety (P=0.017), and the positive impact is the number of household members (P=0.001). On the environmental aspect of the quality of life, the greatest negative impact is the burden of caregivers (P=0.000).

Conclusion: Due to unique working environment of care-giving medical nurses, the quality of life has become very considering aspect. Fatigue, stress, anxiety can have a cumulative effect of those individuals, and lead to the burnout syndrome.

Physical Exercise and Behavioral Addiction: How Self-Control and Subjective Emptiness Jointly Mediate the Reduction of Short-Video Addiction in Adolescents

Zhen Su — 2025-10-13

Background: Short-video addiction is prevalent among adolescents and threatens their development. This study aimed to examine the relationships among physical exercise, self-control, subjective emptiness, and short-video addiction in adolescents and the underlying mechanisms.

Methods: A total of 889 adolescents were recruited from 3 middle schools in Zhejiang Province, China. Data collection was conducted from April to June 2025 using a questionnaire.

Results: The mean score of short-video addiction in adolescents was 3.01; physical exercise was negatively correlated with short-video addiction (r=−0.626, P<0.001); self-control (effect=−0.106, 95% CI [−0.175, −0.047]) and subjective emptiness (effect=−0.360, 95% CI [−0.492, −0.260]) mediated the relationship between physical exercise and short-video addiction; and the chain mediation model shaped by self-control and subjective emptiness had a statistically significant effect (effect=−0.064, 95% CI [−0.115, −0.025]).

Conclusion: Physical exercise contributes to mitigating short-video addiction in adolescents by enhancing self-control and alleviating psychological emptiness. Relevant interventions should integrate physical activities to improve adolescents’ self-management abilities, satisfy their psychological needs, and lay a foundation for the prevention and treatment of this addictive behavior.

Investigation of the Relationship between Somatotypes and Hand Types in Healthy Young Individuals

Rukiye Sumeyye Bakici — 2025-10-13

Background: This study aimed to examine the relationship between hand types and somatotypes of healthy young individuals.

Materials: A total of 312 volunteering individuals (152 F, 160 M) from Karabük University (Karabük, Türkiye), between the ages of 17 and 35 years were included in this prospective study. The somatotypes of the individuals were measured using a previously formed Excel template based on the Heath-Carter method. Factor analysis and clustering analysis were conducted with the 17 parameters measured.

Results: The mean body mass index of female participants was 21.23±3.30 kg/m², while that of males was 23.48±3.52 kg/m². When the somatotypes of individuals were examined, 5 different groups were found to be balanced: ectomorph, endomorphic mesomorph, mesomorph endomorph, mesomorphic endomorph, and central. As a result of these factors, it was concluded that there were 4 hand types: short palm short finger, long palm long finger, wide hand long finger, narrow hand short finger. The distribution of hand types between somatotype groups, the result that endomorphic mesomorph group had long palm long finger and wide hand long finger, while balanced ectomorph group had narrow hand short finger was found to be statistically significant (x²=55.817;df=12, P<0.05).

Conclusion: The difference between somatotypes was not only in body types, but also in hand anthropometry. We believe that the fact that these results can be used as anatomical data in product design, ergonomics, and preliminary design of interfaces for young individuals in the Turkish population will contribute to experts interested in this field.

Exploring the Association between Childhood Intelligence and Vestibular Function: A Mendelian Randomization Study

Anqi Zhong — 2025-10-13

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.

Metabolomics-Based Diagnosis of Medullary Thyroid Cancer: A Plasma 1H NMR Approach

Khadijeh Saeidi — 2025-10-13

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.

Predicting Human Papillomavirus Infection in Women Based on Sexual Assertiveness, Body Image Shame, and Impulsiveness

Niloofar Harati — 2025-10-13

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.

Development of a Software to Drowsiness Detection for Drivers Using Image Processing and Neural Networks

Ali Askari — 2025-10-13

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.

Public Health Insights from Social Media Analysis during the COVID-19 Pandemic in South Korea

Seungeun Park — 2025-10-13