Health literacy and mental health: a national cross-sectional inquiry.

Health literacy and mental health are among the most important issues in the modern health and era of public health. This study aimed to investigate the association between health literacy and mental health status. This was a national cross-sectional study that was conducted in Iran. A sample of literate individuals aged 18-65 was entered into the study using multistage sampling. The data were collected by the Health Literacy Instrument for Adults (HELIA) and the 12-item General Health Questionnaire (GHQ-12). Logistic regression and path analysis were used for data analysis. A total of 20,571 individuals completed the questionnaires. The mean(± SD) age of participants was 34.9(± 11.8) years old, 51% were female, and 38.1% had higher education. The mean(± SD) health literacy score was 68.3(± 15.2), and 29.8% of the respondents reported some mental health problems. Logistic regression analysis showed that limited health literacy was associated with poor mental health status (OR 2.560, 95% CI 2.396-2.735, P = 0.001). The path analysis showed that an increase in health literacy could reduce psychological and social dysfunction (the effect of health literacy on reducing psychological distress is more profound). It is recommended to carry out interventions that strengthen adult's cognitive and communication skills to improve their ability to access and use health information to make healthy choices.

Preliminary guideline for reporting bibliometric reviews of the biomedical literature (BIBLIO): a minimum requirements.

BACKGROUND: A bibliometric review of the biomedical literature could be essential in synthesizing evidence if thoroughly conducted and documented. Although very similar to review papers in nature, it slightly differs in synthesizing the data when it comes to providing a pile of evidence from different studies into a single document. This paper provides a preliminary guideline for reporting bibliometric reviews of the biomedical literature (BIBLIO). METHODS: The BIBLIO was developed through two major processes: literature review and the consensus process. The BIBLIO started with a comprehensive review of publications on the conduct and reporting of bibliometric studies. The databases searched included PubMed, Scopus, Web of Sciences, and Cochrane Library. The process followed the general recommendations of the EQUATOR Network on how to develop a reporting guideline, of which one fundamental part is a consensus process. A panel of experts was invited to identify additional items and was asked to choose preferred options or suggest another item that should be included in the checklist. Finally, the checklist was completed based on the comments and responses of the panel members in four rounds. RESULTS: The BIBLIO includes 20 items as follows: title (2 items), abstract (1 item), introduction/background (2 items), methods (7 items), results (4 items), discussion (4 items). These should be described as a minimum requirements in reporting a bibliometric review. CONCLUSIONS: The BIBLIO for the first time provides a preliminary guideline of its own kind. It is hoped that it could contribute to the transparent reporting of bibliometric reviews. The quality and utility of BIBILO remain to be investigated further.

An experimental and computational study of graphene oxide functionalized with tris(hydroxymethyl)aminomethane as an electrode material for supercapacitors.

In this research, graphene oxide (GO) functionalized with tris(hydroxymethyl)aminomethane (T) was synthesized with a simple one-pot method, and applied as an electrode material for supercapacitors. Electrochemical measurements on the synthesized tris(hydroxymethyl)aminomethane-functionalized graphene oxide (GO@T) indicated a specific capacitance of 549.8 F g- 1 at a specific current of 2.5 A g- 1 and a specific capacitance of 358 F g-1 at a specific current of 7 A g- 1 in the potential range of - 0.5-0.5 V versus Ag/AgCl. It also showed a high cyclic stability. According to the results, 80 and 68% of the initial capacitance was retained after 5500 and 9300 cycles, respectively. Density functional theory calculations were used to investigate the quantum capacitance, free energy change during functionalization reaction, and the layer distance of GO and GO@T.

Assessment of risk factors for suicidal behavior: results from the Tehran University of Medical Sciences Employees' Cohort study.

Introduction: Suicide is a major issue of concern for public health. It is estimated that suicide accounts for 700,000 deaths every year. A personal history of one or more suicide attempts is the most important determinant of suicide among the general population. This study aimed to assess the major risk factors associated with suicidal behaviors among Iranian employees in a medical setting. Methods: In this study, 3,913 employees of Tehran University of Medical Sciences who participated in the employees' cohort study conducted by the university were recruited. Suicidal behaviors (SBs) and their associated risk factors were evaluated using the World Mental Health Composite International Diagnostic Interview (CIDI) Version 3.0. Univariate and multivariate logistic regressions were performed to identify the determinants of SBs among the participants, and crude and adjusted odds ratios (ORs) with corresponding 95% confidence intervals (95% CIs) were calculated. Results: Overall, 49.6% of respondents (n = 1,939) reported that they were tired of life and thinking about death. The lifetime prevalence rate of suicidal ideation (SI) was 8.1% (n = 317), that of suicide planning (SP) was 7.3% (n = 287), and that of suicide attempts (SA) was 3.1% (n = 122). Being female (OR: 1.87, CI: 1.64-2.12), being divorced (OR: 3.13, CI: 1.88-5.22), having a low level of education (OR: 1.57, CI: 1.15-2.14), and working in clinical and medical services (OR: 1.25, CI: 1.09-1.43) were associated with being tired of life and thinking about death. These factors were also associated with SI, SP, and SA. Discussion: These findings highlight the need to prioritize mental health for suicide prevention, especially for high-risk groups, in workplace mental health promotion programs and policies.

Exposure to the COVID-19 news on social media and consequent psychological distress and potential behavioral change.

Exposure to coronavirus disease 2019 (COVID-19) news pandemic is inevitable. This study aimed to explore the association between exposure to COVID-19 news on social media and feeling of anxiety, fear, and potential opportunities for behavioral change among Iranians. A telephone-based survey was carried out in 2020. Adults aged 18 years and above were randomly selected. A self-designed questionnaire was administered to collect information on demographic variables and questions to address exposure to news and psychological and behavioral responses regarding COVID-19. A multivariate logistic regression analysis was performed to assess the relationship between anxiety, fear, behavioral responses, and independent variables, including exposure to news. In all, 1563 adults participated in the study. The mean age of respondents was 39.17 ± 13.5 years. Almost 55% of participants reported moderate to high-level anxiety, while fear of being affected by COVID-19 was reported 54.1%. Overall 88% reported that they had changed their behaviors to some extent. Exposure to the COVID-19 news on social media was the most influencing variable on anxiety (OR 2.21, 95% CI 1.62-3.04; P < 0.0001), fear (OR 1.95, 95% CI 1.49-2.56; P < 0.0001), and change in health behaviors (OR 2.02, 95% CI 1.28-3.19; P = 0.003) in the regression model. The fear of being infected by the COVID19 was associated with the female gender and some socioeconomic characteristics. Although exposure to the COVID-19 news on social media seemed to be associated with excess anxiety and fear, it also, to some extent, had positively changed people's health behaviors towards preventive measures.

Differentiating Engineered Tissue Images and Experimental Factors to Classify Cardiomyocyte Content.

In this study, we used machine learning (ML) to classify the cardiomyocyte (CM) content on day 10 of the differentiation of human-induced pluripotent stem cell (hiPSC)-laden microspheroids using easily acquirable nondestructive phase-contrast images taken in the middle of differentiation and tunable experimental parameters. Scale-up suspension culture, use of engineered tissues to support stem cell differentiation, and CM production for improved control over cellular microenvironment in the suspension system need nondestructive methods to track engineered tissue development. The ability to couple images that capture experimenter perceived "good" or "bad" batches based on visualization at early differentiation time points with actual experimental outcomes in an unbiased way is a step toward building these methods. In recent years, ML techniques have been successfully applied to identify critical process parameters and use this information to build models that describe process outcomes in cell production and hiPSC differentiation. Building upon these successes, here, we utilize convolutional neural networks (CNNs) to build a binary classifier model for CM content on differentiation day 10 (dd10) for hiPSC-CMs. We consider two separate data sets as potential input features for the classification models. The first set includes phase-contrast images of microspheroid tissues taken on days 3 and 5 of the differentiation batches at different experimental conditions. The second set supplements the images with tunable experimental differentiation parameters, such as cell concentration and microspheroids' size. The CM content classes were sufficient and insufficient. The accuracy of the CNN classifier using images only was 63%. The addition of experimental features increased the accuracy to 85%, indicating the importance of tunable parameters in predicting CM content. Impact statement Machine learning approaches were used to predict the final cardiomyocyte (CM) content class (sufficient vs. insufficient) of engineered cardiac tissue microspheroids produced through suspension-based cardiac differentiation of human-induced pluripotent stem cell-laden engineered tissue microspheroids. The models used specified experimental features and data collected using nondestructive inexpensive methods, specifically phase-contrast images taken during the initial days of differentiation as inputs. The best model was a convolutional neural network trained using experimental features and differentiation day 5 images. It classified the CM content with 85% accuracy and replicated and formalized experimenter's visual intuition about differentiation outcomes by incorporating images from early time points.

Effect of Helicobacter pylori eradication on metabolic profile: an international, multicenter, case-control study.

BACKGROUND: As a gram-negative and microaerophilic bacterium, Helicobacter pylori (HP) is the main cause of chronic gastritis. Therefore, considering the high prevalence of HP infection worldwide, as well as the increasing prevalence of metabolic disorders, the present study aimed to investigate the relationship between HP infection eradication and metabolic profile. METHODS: This prospective case-control study was performed on patients with HP infection whom referred to 7 medical centers in 3 countries (Iran, Egypt, and Vietnam) in 2020-2021. The metabolic profile of all of the participants evaluated before starting of treatment for HP eradication and 3 months after the treatment. Then changes of metabolic profile compared between those with successful HP eradication (group A) and subjects who failed to eradicate (group B). RESULTS: Overall, 199 patients, including 93 male (46.7%) with the mean age of 44.5 years (18-93 years) included. Based on response to treatment, the participants allocate into group A (those who respond to HP eradication): 164 cases (82.42%); or group B as those who failed to achieve eradication (35 cases, 17.58%). Racially 86.9% of participants were Caucasian and 89% diagnosed as non-ulcer dyspepsia (NUD). The most prevalent comorbidity include hypertension (11.5%) and hyperlipidemia (10%) which were more prevalent in group B (P = 0.002). Three months after therapy, average weight of participants among those who achieved eradication (group A) decreased from 73.1 to 71.4 kg (P = 0.01), but in comparison with group B, was non-significant (P = 0.171). The BMI of patients before and after treatment did not show any significant differences. The biochemical parameters of patients before and after treatment were not significantly different regardless of treatment success (P > 0.05). The levels of total cholesterol and VLDL cholesterol after treatment were not significantly different from baseline values in two groups. HDL and LDL cholesterol levels before and after treatment in the resistant group were significantly higher than the responding group. Average serum TG level decreased significantly after treatment in the group A (P < 0.0001), in contrast to the resistant group (P = 0.356). The liver transaminases (AST and ALT) before and after treatment were not significantly different between the two groups (P > 0.05). The results of logistic regression showed that the eradication of infection has no significant affect any of the metabolic profile parameters. CONCLUSION: HP infection treatment in individuals without significant metabolic disorders does not affect metabolic parameters up to 3 months after eradication. HP eradication among subjects with several comorbidities mandates eradication protocol intensification to avoid treatment failure.

Development of a new version of the Bristol Stool Form Scale: translation, content validity, face validity, and reliability of the Persian version.

OBJECTIVES: The Bristol Stool Form Scale (BSFS) is the most widely used scale for stool form assessment. This study aimed to translate the BSFS into the Persian version and determine its content validity, face validity, and reliability. DESIGN: Following permission, a forward-backward translation procedure was applied to translate the scale from English into Persian. A cross-sectional study was conducted on a sample of 210 participants from the general and gastrointestinal clinics of a teaching hospital affiliated with the Tehran University of Medical Sciences, Tehran, Iran, from January 2020 to August 2020. The samples were selected using convenience sampling. A group of 10 experts and 10 adults assessed content and face validity, respectively. The kappa index evaluated the reliability of the instruments. RESULTS: Participants' mean (±SD) age was 37.62 (±8.87) years. Most of the participants (65.7%) were women. The highest percentage of concordance was 100% for stool type 7, and stool type 5 had the lowest concordance percentage (78.1%). The overall kappa index was 0.79. CONCLUSION: The Persian version of the BSFS is a valid and reliable measure for assessing stool form, and now it can be used in research and clinical practice.

Measuring health literacy: A systematic review and bibliometric analysis of instruments from 1993 to 2021.

BACKGROUND: It has been about 30 years since the first health literacy instrument was developed. This study aimed to review all existing instruments to summarize the current knowledge on the development of existing measurement instruments and their possible translation and validation in other languages different from the original languages. METHODS: The review was conducted using PubMed, Web of Science, Scopus, and Google Scholar on all published papers on health literacy instrument development and psychometric properties in English biomedical journals from 1993 to the end of 2021. RESULTS: The findings were summarized and synthesized on several headings, including general instruments, condition specific health literacy instruments (disease & content), population- specific instruments, and electronic health. Overall, 4848 citations were retrieved. After removing duplicates (n = 2336) and non-related papers (n = 2175), 361 studies (162 papers introducing an instrument and 199 papers reporting translation and psychometric properties of an original instrument) were selected for the final review. The original instruments included 39 general health literacy instruments, 90 condition specific (disease or content) health literacy instruments, 22 population- specific instruments, and 11 electronic health literacy instruments. Almost all papers reported reliability and validity, and the findings indicated that most existing health literacy instruments benefit from some relatively good psychometric properties. CONCLUSION: This review highlighted that there were more than enough instruments for measuring health literacy. In addition, we found that a number of instruments did not report psychometric properties sufficiently. However, evidence suggest that well developed instruments and those reported adequate measures of validation could be helpful if appropriately selected based on objectives of a given study. Perhaps an authorized institution such as World Health Organization should take responsibility and provide a clear guideline for measuring health literacy as appropriate.

The efficacy of the VUV/O3 process run in a continuous-flow fluidized bed reactor for simultaneous elimination of favipiravir and bacteria in aqueous matrices.

The efficacy of the Vacuum UV/Ozonation (VUV/O3) process was evaluated for the degradation of favipiravir (FAV). It was found that coupling O3 and VUV resulted in a considerable synergistic catalytic effect on FAV removal. The VUV/O3 process performed better in moderately alkaline conditions than in acidic ones; complete FAV degradation and 99.4% TOC removal were achieved within 10 and 60 min, respectively. HO• played the dominant role in FAV degradation, with a second-order reaction rate constant with HO• at 1.05 × 1010 M-1 s-1. The VUV/O3 process could effectively treat tap water spiked with FAV. Efficient FAV and TOC removal, as well as total bacterial inactivation, was attained when treating municipal secondary effluent by the VUV/O3 process. Finally, the VUV/O3 process was operated in a continuous-flow mode in a fluidized-bed (FBR) reactor for treating FAV-spiked tap water. Complete degradation and 75.1% mineralization of 10 mg/L FAV were obtained at a hydraulic retention time of 1 and 8 min, respectively. The findings clearly suggest that the VUV/O3 process operated in a continuous-flow FBR is a promising, efficient technology for the removal of novel and emerging contaminants, such as the antiviral FAV.

The relationship between happiness and self-rated health: A population-based study of 19499 Iranian adults.

BACKGROUND: Health is one of the most important factors that affect happiness. This study aimed to assess the association between happiness and self-rated health among the Iranian adult population. METHODS: This cross-sectional study was conducted on a sample of adults aged 18-65 In Iran in 2020. Demographic information, the Oxford Happiness Questionnaire, and a single item on self-rated health were used to collect the data. The relationship between happiness with demographic variables and self-rated health was examined by performing logistic regression analyses. RESULTS: In all, 19499 were studied (9845 males and 9654 females). The mean age of participants was 36.38± 8.17 years. The mean happiness score was 4.1± 0.57 (out of 6) and this for self-rated health was 3.66±1.2 (out of 5). The results obtained from logistic regression analysis showed that very poor health status (OR: 5.114, 95% CI, P = 4.490-5.824, p <0.001), poor or very poor income status (OR: 1.553, 95% CI, P = 1.406-1.716, p <0.001), unemployment (OR: 1.704, 95% CI, P = 1.432-2.029, p <0.001), being aged 25-34 years (OR: 1.190, 95% CI, P = 1.088-1.302, p <0.001), and years of education (OR for 10-12 years of education: 1.271, 95% CI = 1.174-1.377, p< 0.001) were significant contributing factors to a lower happiness. CONCLUSION: The results showed that self-rated health was the most significant factor that affected happiness even after adjustment for socioeconomic variables, including age, income, employment, and education. Indeed, improving population health might be an effective measure to improve happiness among Iranians.

Vacuum UV pre-treatment coupled with self-generated peroxide stimulation of biomass: An innovative hybrid system for detoxification and mineralization of toxic compounds.

The degradation of p-nitrophenol (pNP) was investigated in the chemical-less UVC/VUV process (Advanced Oxidation/Reduction Process, AORP), the packed bed bioreactor (PBR), and the hybrid of AORP/PBR system. The control UVC/VUV process degraded and mineralized pNP with rate constants of 0.098 and 0.032 min-1, respectively, at neutral initial pH. Operating the UVC/VUV process in a fluidized bed reactor improved the rate of pNP degradation by 21 % at a packing ratio of 0.5 %. The fluidized bed AORP was operated under continuous-flow mode, where 79 % degradation and 28 % mineralization of pNP were obtained along a significant improvement in the biodegradability (41 %) at a hydraulic retention time of 20 min. The oxidation with HO and reduction with eaq- simultaneously contributed to the degradation of pNP in the UVC/VUV process. In comparison, degradation and mineralization of pNP in a single PBR process (without pretreatment) was found to be 84.7 % and 47.2 %, respectively, during 30 h biotreatment. Coupling the fluidized bed UVC/VUV with the PBR attained complete biodegradation of the residual pNP within 1 h and over 89 % of TOC reduction during 3 h post treatment in the PBR. Accordingly, the hybrid, fluidized bed UVC/VUV reactor coupled with the PBR is an efficient and promising technology for treating toxic environmental contaminants.

Astaxanthin engages the l-arginine/NO/cGMP/KATP channel signaling pathway toward antinociceptive effects.

One of the main functions of the sensory system in our body is to maintain somatosensory homeostasis. Recent reports have led to a significant advance in our understanding of pain signaling mechanisms; however, the exact mechanisms of pain transmission have remained unclear. There is an urgent need to reveal the precise signaling mediators of pain to provide alternative therapeutic agents with more efficacy and fewer side effects. Accordingly, although the anti-inflammatory, antioxidative and anti-neuropathic effects of astaxanthin (AST) have been previously highlighted, its peripheral antinociceptive mechanisms are not fully understood. In this line, considering the engagement of l-arginine/nitric oxide (NO)/cyclic GMP (cGMP)/potassium channel (KATP) signaling pathway in the antinociceptive responses, the present study evaluated its associated role in the antinociceptive activity of AST. Male mice were intraperitoneally (i.p.) injected with l-arginine (100 mg/kg), SNAP (1 mg/kg), L-NAME (30 mg/kg), sildenafil (5 mg/kg), and glibenclamide (10 mg/kg) alone and prior to the most effective dose of AST. Following AST administration, intraplantarly (i.pl) injection of formalin was done, and pain responses were evaluated in mice during the primary (acute) and secondary (inflammatory) phases of formalin test. The results highlighted that 10 mg/kg i.p. dose of AST showed the greatest antinociceptive effect. Besides, while L-NAME and glibenclamide reduced the antinociceptive effect of AST, it was significantly increased by l-arginine, SNAP and sildenafil during both the primary and secondary phases of formalin test. These data suggest that the antinociceptive activity of AST is passing through the l-arginine/NO/cGMP/KATP pathway.

Photocatalytic activation of peroxymonosulfate (PMS) by novel mesoporous Ag/ZnO@NiFe2O4 nanorods, inducing radical-mediated acetaminophen degradation under UVA irradiation.

A new mesoporous Ag/ZnO@NiFe2O4 nanorod was prepared by a facile, low-cost, and environmentally friendly strategy from a bimetallic Fe2Ni-MIL-88 metal organic framework (MOF), as an effective catalyst and peroxymonosulfate (PMS) photo-activator. The structural, morphological, optical, and magnetic properties, as well as the material composition were investigated by XRD, FE-SEM, EDX, HR-TEM, XPS, DRS, PL, EIS, VSM, N2 adsorption-desorption and ICP-AES analysis. 1.0% w/w loading of Ag nanoparticles on ZnO0.04@NiFe2O4 led to the best catalytic activity for PMS activation under UVA in acetaminophen (ACT) degradation. The maximum degradation efficiency for ACT was 100% within 15 min (at pH = 7.0), with a first-order rate constant of 0.368 min-1. The calculated quantum yield (1.3 × 10-3 molecule/photon) of the optimum catalyst was 2.05, and 5.63 times higher than its simple constituents, ZnO0.04@NiFe2O4 and NiFe2O4, respectively. Among the various inorganic ions, Cl- and HCO3- showed significant inhibition effect in 1.0%w/w Ag/ZnO0.04@NiFe2O4/PMS/UVA system, due to radical quenching effects. Based on scavenger experiments, HO• and SO4•- were the dominant reactive species in photocatalytic process coupled with PMS. Due to presence of the Fe3+/Fe2+, and Ni2+/Ni3+ reaction cycles in the as-made catalyst, the reaction rate of PMS activation was greatly enhanced. Moreover, the formation of a hetero-junction structure with NiFe2O4 and ZnO promoted the charge separation of the photo-generated electron/hole pairs. Finally, the major intermediates produced during the reaction were detected by LC-MS analysis, and a plausible mechanism for the photocatalytic degradation of ACT was proposed and discussed in detail.

Development of a VUV-UVC/peroxymonosulfate, continuous-flow Advanced Oxidation Process for surface water disinfection and Natural Organic Matter elimination: Application and mechanistic aspects.

Surface waters are often charged with high amounts of natural organic matter (NOM), organic contaminants and pathogens. In this work, a Vacuum UV/PMS process (VUV-UVC/PMS) was employed for treating river water, assessing the simultaneous NOM mineralization and bacterial disinfection. The VUV-UVC process (without PMS) decreased TOC concentration from 3.83 to 0.15 mg/L within 20 min, achieving complete disinfection. Adding 5 mg/L PMS increased the rate of TOC removal by 80%; complete removal of TOC was achieved in 15 min and disinfection was attained twice as fast. The mechanism of NOM mineralization was scrutinized; aeration played a considerable role due to oxygen supply, mixing, and inducing in-situ H2O2 production. HO• and SO4•- were the main radical species involved, alongside an important contribution of the matrix; sulfate enhanced TOC removal, due to the formation of additional radicals, underlining its importance. Furthermore, over 99% TOC reduction and complete disinfection was achieved in the VUV-UVC/PMS process operated under continuous-flow mode with a 2-min hydraulic retention time. Finally, the use of Atrazine (ATZ) as a probe compound and a series of scavenging tests led to an integrated proposal for the mineralization of NOM. Accordingly, the VUV-UVC/PMS process is evaluated as an efficient and promising technology for surface water treatment.

Prediction of Human Induced Pluripotent Stem Cell Cardiac Differentiation Outcome by Multifactorial Process Modeling.

Human cardiomyocytes (CMs) have potential for use in therapeutic cell therapy and high-throughput drug screening. Because of the inability to expand adult CMs, their large-scale production from human pluripotent stem cells (hPSC) has been suggested. Significant improvements have been made in understanding directed differentiation processes of CMs from hPSCs and their suspension culture-based production at chemically defined conditions. However, optimization experiments are costly, time-consuming, and highly variable, leading to challenges in developing reliable and consistent protocols for the generation of large CM numbers at high purity. This study examined the ability of data-driven modeling with machine learning for identifying key experimental conditions and predicting final CM content using data collected during hPSC-cardiac differentiation in advanced stirred tank bioreactors (STBRs). Through feature selection, we identified process conditions, features, and patterns that are the most influential on and predictive of the CM content at the process endpoint, on differentiation day 10 (dd10). Process-related features were extracted from experimental data collected from 58 differentiation experiments by feature engineering. These features included data continuously collected online by the bioreactor system, such as dissolved oxygen concentration and pH patterns, as well as offline determined data, including the cell density, cell aggregate size, and nutrient concentrations. The selected features were used as inputs to construct models to classify the resulting CM content as being "sufficient" or "insufficient" regarding pre-defined thresholds. The models built using random forests and Gaussian process modeling predicted insufficient CM content for a differentiation process with 90% accuracy and precision on dd7 of the protocol and with 85% accuracy and 82% precision at a substantially earlier stage: dd5. These models provide insight into potential key factors affecting hPSC cardiac differentiation to aid in selecting future experimental conditions and can predict the final CM content at earlier process timepoints, providing cost and time savings. This study suggests that data-driven models and machine learning techniques can be employed using existing data for understanding and improving production of a specific cell type, which is potentially applicable to other lineages and critical for realization of their therapeutic applications.

The effect of prepregnancy body mass index on the risk of gestational diabetes mellitus: A systematic review and dose-response meta-analysis.

This study was conducted to investigate the effect of the prepregnancy BMI on the risk of gestational diabetes mellitus (GDM). Five electronic databases, including PubMed, Scopus, Embase, Web of Science, and Google Scholar, were searched for literature published until 1 January 2018. The two-stage, random effect meta-analysis was performed to compare the dose-response relationship between BMI and GDM. As well as studies with categorized BMI, studies that treat BMI as a continuous variable were analysed. A total of 33 observational studies with an overall sample size of 962 966 women and 42 211 patients with GDM were included in analysis. The pooled estimate of GDM risk in the underweight, overweight, and obese pregnant women was 0.68, 2.01, and 3.98 using the adjusted OR and 0.34, 1.52, and 2.24 using the adjusted RR. The GDM risk increased 4% per unit of increase in BMI with both the crude and adjusted OR/RR models. Also, the risk of GDM increased 19% with the crude model and 14% with the adjusted model. The existence of dose-response relationship between the pre-pregnancy BMI and GDM can strengthen the scientific background for vigorous public health interventions for the control of pre-pregnancy BMI as well as the weight gain during pregnancy.

Effect of an Intervention on the Breast Cancer Screening Behavior in Women: Application of Integrated Behavioral Model.

BACKGROUND: Screening is the most important action in the early diagnosis of breast cancer. This study investigates the impact of educational intervention based on the integrated behavioral model on breast cancer screening behavior in women in Karaj City, 2016. METHODS: This semi-experimental study was conducted on 138 women who were attended to health centers in Mohammad Shahr city. The samples were selected using cluster sampling and were randomly divided into two groups, experimental and control group. Data gathering tool was a four-part questionnaire (demographic characteristics, knowledge, Champion's Health Belief Scale, subjective norms). Two 50-min sessions were held for educational intervention in the experimental group. Training was presented through lecture, questioning and answering and group discussion. The data were completed in three steps (before, immediately after and 2 months after the intervention) and were analyzed using SPSS 16 software. RESULTS: The results showed that the mean score of all structures except the perceived benefits of mammography and mammography behavior have a significant difference in the intervention group than the control group in 2 months after intervention (P < 0.001). In all the studied structures, except the perceived benefits of mammography (P = 0.083) and mammographic behavior (P = 0.156), there was a significant difference between the two groups before and immediately after the intervention (P < 0.001). CONCLUSIONS: The finding of this study showed that the efficiency and effectiveness of an educational intervention based on health belief model along with subjective norms that emphasize the opinions of others about the behaviors of individuals also has a very dramatic effect on the promotion of breast cancer screening behaviors.

Prevalence of HIV-1 pre-treatment drug resistance in a southern province of Iran, 2016-2017.

HIV-1 transmitted drug resistance (TDR) occurs when primary viruses bear drug resistance mutations (DRMs). TDR causes first-line antiretroviral (ARV) therapy (ART) failure and is becoming more pronounced due to the widespread use of ART. With the absence of routine individual-level drug resistance testing, the World Health Organization (WHO) recommends the tracking of TDR mutations and optimizing the first-line ART following pre-treatment drug resistance (PDR) surveys. Here, we report the PDR frequency for the first time in Hormozgan, a southern province of Iran. In this study, 41 blood samples from HIV-1-positive ART-candidate volunteers were collected across the province between April 2016 and March 2017. Phylogenetic analysis of the sequenced protease (PR) and reverse transcriptase (RT) regions showed that 39 out of 41 samples (95%) were CRF35_AD and the two remaining cases were subtype B (2.5%) and C (2.5%). D67G (2.4%), a mutation that reduces susceptibility to nucleoside reverse transcriptase inhibitors (NRTIs) was the only detectable TDR mutation in this population. Two other DRMs, including E138A (9.7%) and V179T (4.9%), which confer resistance to non-nucleoside reverse transcriptase inhibitors (NNRTIs), were also identified. Although no major protease inhibitor (PI) resistance mutations were detected, the minor mutations L10F and L33F (2.5% each) as well as several highly frequent polymorphic mutations were identified. Our results show a PDR frequency of 17% in infected individuals from Hormozgan, classified further as 2.4% NRTIs and 14.6% NNRTIs. These results suggest that first-line ART should be practiced carefully in Hormozgan province, and alternative regimens may become necessary for all starters.

Optimal DNA Isolation Method for Detection of Nontuberculous Mycobacteria by Polymerase Chain Reaction.

BACKGROUND: Nontuberculous mycobacteria (NTM) are a group of opportunistic pathogens and these are widely dispersed in water and soil resources. Identification of mycobacteria isolates by conventional methods including biochemical tests, growth rates, colony pigmentation, and presence of acid-fast bacilli is widely used, but these methods are time-consuming, labor-intensive, and may sometimes remain inconclusive. MATERIALS AND METHODS: The DNA was extracted from NTM cultures using CTAB, Chelex, Chelex + Nonidet P-40, FTA® Elute card, and boiling The quantity and quality of the DNA extracted via these methods were determined using UV-photometer at 260 and 280 nm, and polymerase chain reaction (PCR) amplification of the heat-shock protein 65 gene with serially diluted DNA samples. RESULTS: The CTAB method showed more positive results at 1:10-1:100,000 at which the DNA amount was substantial. With the Chelex method of DNA extraction, PCR amplification was detected at 1:10 and 1:1000 dilutions. CONCLUSIONS: According to the electrophoresis results, the CTAB and Chelex DNA extraction methods were more successful in comparison with the others as regard producing suitable concentrations of DNA with the minimum use of PCR inhibitor.