Factors affecting subsequent dose of COVID-19 vaccine uptake based on BASNEF model among older adults.

BACKGROUND: Vaccination is a primary prevention approach to preventing disease by disconnecting the transmission chain. The current study utilized a BASNEF model framework to identify factors influencing subsequent doses of COVID-19 vaccination among older adults. METHODS: This cross-sectional study was performed in the west of Iran in May 2022. The participants were selected via multi-stage sampling. Finally, 1120 participants contributed to the present study. The questionnaire consisted of three sections: a) Socio-demographic characteristics, b) cognitive impairments tests, and c) Questionnaire about the subsequent dose of COVID-19 vaccine uptake based on the BASNEF model. Data were analyzed using the software IBM AMOS-20 and SPSS-23 via one-way analysis of variance (ANOVA) and independent sample T-tests were used, too. The significance level of statistical tests was regarded as less than 0.05. RESULTS: The presented results of analyzing 50% of the variance of vaccination intention as the dependent variable (R square = 0.497) and 10% of the behavior variance as the dependent variable (R square = 0.104) can be explained based on the BASNEF model. The enabling factors (ß = 0.636, p < 0.001) and the intention (ß = 0.322, p < 0.001) were important factors for subsequent doses of COVID-19 vaccine uptake in older adults. CONCLUSION: So, planning and implementing promotional intervention programs for older people (over 65; 80), females, illiterate, widows and divorced, good economic status, and urban areas is essential. It seems that enabling factors such as free vaccinations, vaccination inaccessible places such as public social security agencies, social supports such as involvement of the government and physicians, and improving information by the medium or knowledge-sharing experience, which can be further used to enhance the acceptance of subsequent doses of COVID-19 uptake in older adults.

Understanding the features and effectiveness of randomized controlled trials in reducing COVID-19 misinformation: a systematic review.

This systematic review aimed to assess the features and effectiveness of individual-level randomized controlled trials targeting COVID-19 misinformation. The selection process included rigorous criteria, resulting in the inclusion of 24 individual studies from 21 papers. The majority of studies were conducted in high-income countries, with the accuracy/credibility of information as the primary outcome. Debunking and boosting interventions were the most common interventions while nudging and content labeling interventions were examined in a few studies. This study highlights that further research is needed to enhance the effectiveness of boosting strategies and to explore the impact of combined interventions. Addressing bias concerns and standardizing intervention assessment measures will contribute to the development of evidence-based approaches in this critical area.

Cultural appropriateness of interventions to prevent and reduce musculoskeletal disorders among students: a systematic review.

This systematic review was conducted to identify the types of interventions and cultural appropriateness of intervention studies for preventing and reducing musculoskeletal disorders (MSDs) in students. In this systematic review, articles were retrieved from scientific databases including PubMed, Sciencedirect, Web of Science, Scopus, SAGE journals, and Cochrane library using a search strategy. The types of interventions for preventing and reducing MSDs among students published in English up to 2022 were examined, with a comparison of studies in terms of the cultural appropriateness of strategies. Also, studies were categorised based on six intervention types: physical exercise, education, ergonomics, participatory ergonomics, stress management, and multicomponent. Out of the 29 studies included in this review, ten were randomised controlled trials, fifteen were controlled pre-test/post-test studies, and four were pre-test/post-test studies. The articles measured students' knowledge, beliefs, behaviour, good posture/performance, pain intensity decrease, and back care as outcomes. Only two articles were categorised as having moderate cultural adaptation. The results showed that any type of intervention was successful, and two studies were evaluated as having high quality. Our review found evidence of efficacy for interventions aimed at preventing and reducing MSDs in students.Practitioner summary: Musculoskeletal disorders are common problems that affect students of all ages. To prevent these problems from getting worse or affecting students' future health, it is important to find effective ways to prevent and reduce musculoskeletal disorders in students.

Cultural appropriateness in randomized controlled trials (RCTs) aimed at reducing pesticide exposure among farmers and farmworkers: a systematic review.

OBJECTIVE: The widespread use of pesticides poses serious health hazards to farmers and their families. Some evidence shows that culturally sensitive interventions could be associated with improved outcomes; however, little is known about the effectiveness of cultural adaptations in interventions among farmers and farmworkers. Therefore, the purpose of this study was to summarize strategies used in the cultural adaptation interventions addressing the reduction of pesticide exposure in farmers and farmworkers, as well as assessing the effects of these strategies. METHODS: A comprehensive systematic literature search was conducted on PubMed, Embase, Clarivate Web of Science, Scopus, NIOSHTIC, Agricola, Agris, as well as reference lists to identify randomized controlled trials (RCTs) published in English from January 2000 until March 2022. Data were extracted to examine the characteristics of interventions in terms of the cultural adaptation strategies and their effectiveness by two independent reviewers. RESULTS: Eleven articles from ten trials met the inclusion criteria. The majority of studies were conducted in the USA (n = 7) and were ranked as poor quality (n = 5). Four of the ten studies were rated moderate, and six were rated weak. The socio-cultural and constituent-involving strategies were the most commonly reported across the included studies, followed by linguistic strategy. Six studies (seven articles) were tailored for subgroups or individuals. Overall, 8 of 10 studies reported significant changes in whole and some outcomes in the intervention groups over controls. Seven studies received moderate cultural adaptation scores which may reflect the moderate effectiveness of the interventions. CONCLUSION: Our review underscored the paucity and low quality of existing studies investigating the culturally adapted interventions in reducing farmers' and farmworkers' pesticide exposure. Future high-quality culturally sensitive studies could increase our knowledge regarding the culture's role in reducing pesticide exposure in farmers and farmworkers.

Factors Influencing Brucellosis Preventive Behaviors among Marginalized Iranian Women: An Application of the Health Belief Model.

Background: Brucellosis is still a serious public health threat in developing countries, especially in Iran. Brucellosis is an endemic disease in Iran and risk factors increasing its broadcast are prevalent. This study investigated factors influencing brucellosis preventive behaviors amongst marginalized women in Hamadan city, Iran, using the health belief model (HBM). Methods: In this cross-sectional study, 289 women living in marginal areas were considered from April until May 2018. Via cluster random sampling methods, comprehensive health services where women get health care were selected. Each woman in the selected comprehensive health services was then enrolled by the simple random sampling method. Data were gathered from a face-to-face interview via a questionnaire. Results: Most women had a history of using nonpasteurized dairy products (86.2%). Most women (64.7%) boiled the milk for 3-5 minutes. 61.2% of women put the cheese in a salt-water solution. The results showed that one unit rise in the scores of knowledge, self-efficacy, and cues to action resulted in an increase in the mean score of the protective behavior by 0.189, 209, and 0.150, respectively. Conclusion: The HBM was a helpful model in predicting the influential elements in brucellosis preventive behaviors. Also, recognized effective factors should be taken into account when designing interventions.

Activation of PLAG1 and HMGA2 by gene fusions involving the transcriptional regulator gene NFIB.

The pleomorphic adenoma (PA), which is the most common salivary gland neoplasm, is a benign tumor characterized by recurrent chromosome rearrangements involving 8q12 and 12q14-15. We have previously shown that the PLAG1 and HMGA2 oncogenes are the targets of these rearrangements. Here, we have identified previously unrecognized subsets of PAs with ins(9;8)/t(8;9) (n = 5) and ins(9;12)/t(9;12) (n = 8) and breakpoints located in the vicinity of the PLAG1 and HMGA2 loci. RNA-sequencing and reverse transcriptase (RT)-PCR analyses of a case with an ins(9;8) revealed a novel NFIB-PLAG1 fusion in which NFIB exon 4 is linked to PLAG1 exon 3. In contrast to the developmentally regulated PLAG1 gene, NFIB was highly expressed in normal salivary gland, indicating that PLAG1 in this case, as in other variant fusions, is activated by promoter swapping. RT-PCR analysis of three PAs with t(9;12) revealed two tumors with chimeric transcripts consisting of HMGA2 exon 4 linked to NFIB exons 9 or 3 and one case with a fusion linking HMGA2 exon 3 to NFIB exon 9. The NFIB fusion events resulted in potent activation of PLAG1 and HMGA2. Analysis of the chromatin landscape surrounding NFIB revealed several super-enhancers in the 5'- and 3'-parts of the NFIB locus and its flanking sequences. These findings indicate that PLAG1 and HMGA2, similar to MYB in adenoid cystic carcinoma, may be activated by enhancer-hijacking events, in which super-enhancers in NFIB are translocated upstream of PLAG1 or downstream of HMGA2. Our results further emphasize the role of NFIB as a fusion partner to multiple oncogenes in histopathologically different types of salivary gland tumors.

Ups and downs of drug rehab among women: a qualitative study.

BACKGROUND: According to recent studies, the number of women drug users is dramatically increasing. However, the information on the issue of drug rehab in women is not sufficient, and there are numerous traditional, organizational, political and cultural barriers to the provision of relevant information in this regard in Iran. This study, thus, aimed to explain the factors influencing the decision of these women to stop drug use. METHODS: This qualitative study was conducted in two rehab camps of Isfahan (in Iran) on July to October 2017. Thirty participants (women drug users) were selected through purposive and theoretical sampling until data saturation was reached. Data collection was conducted through semi-structured interviews. The transcribed interviews were analyzed using conventional content analysis. RESULTS: Based on the analysis of the obtained results, the women's experience of the ups and downs of stopping drug use yielded two themes and nine sub-themes. The themes were "the need for emancipation (the deviated path, being abused, compulsive drug use, acquaintance with God, a supportive family)" and "Sinking factors (non-assisting mates, pro-addictive family, unawareness of assisting official organization and non-government organization, woman's lack of authority, ineffective opportunities)". CONCLUSIONS: It was concluded that addiction rehab strategies can lead to a brighter life for women drug users only when they are coupled with open-hearted assistance of the families and women specific rehab centers are established to help them meet their specific needs.

Cultural adaptation for country diversity: A systematic review of injury prevention interventions caused by domestic accidents in children under five years old.

Background: Children under five years old are the most vulnerable in home-injuries. More than half of the accident happens at home. Intervention programs are effective ways to reduce the risk of injuries. The use of cultural strategies has been recommended for effective interventions. The aim of this study was to evaluate cultural adaptability in interventional studies which were performed to prevent injuries caused by domestic accidents in children under five years old in all countries. Methods: This systematic review has been conducted from June to July 2016. Iran Medex, Magiran, SID from Persian databases and Scopus, Web of Science, Science direct, Pub Med, Biomed central from English databases were employed. Available cultural adaptation guidelines were used to compare the cultural adaptation strategies. A search of studies had been conducted from the creation of databases until July 2016. Results: Overall, 15 studies were entered into the analyses. The interventional approach in 11 studies was an educational approach. Consequently, 8 studies from 11 reported that they had significantly achieved all expected outcomes. Three studies had used behavioral change models or theories to achieve the desired changes. Seven studies had considered socio-cultural strategy in their interventions, and six studies had reported achieving outcomes. Only seven studies acquired a minimum score of cultural adaptation. Conclusion: In this systematic review, an educational intervention was effective in preventing child injuries. If cultural strategies are taken into consideration in interventions, they will have a change in behavior in this regard. Also, theoretical frameworks and models can be effective.

Acute pesticide poisoning and related factors among farmers in rural Western Iran.

Although acute pesticide poisoning (APP) is known to be a major health concern among farmers in developing countries, knowledge of its prevalence and risk factors is limited. The purpose of this study was to investigate the prevalence and a broad range of potential work-related risk factors of APP among Iranian farmers and farm workers. This cross-sectional study was conducted in rural areas of the Twiserkan County in Iran. In this study, there were 474 farmers and farm workers who had used pesticide 1 week before data collection. Participants were selected from 104 villages. Data were gathered using a questionnaire and analyzed using STATA (version 14.2 SE). Binary logistic regression and multinomial logistic regression were employed. The results of this study showed that 286 (60.3%) farmers and farm workers who applied pesticides suffered from work-related APP. Most frequent APP symptoms were runny nose (29.8%) and headache (25.1%). Five risk factors were identified, including annual income ( p < 0.05), number of farming years (odds ratio (OR) = 0.31), number of spraying years (OR = 2.40), place of pesticide storage (OR = 2.69), and type of sprayer ( p < 0.05). The results of this study indicated that APP is prevalent among the studied farmers. Some work-related factors play an important role in APP among Iranian rural farmers. In addition, the magnitude of these risk factors differed significantly by severity of acute and somatic pesticide poisoning.

The role of nutritional interventions in increasing fruit and vegetable intake in the elderlies: a systematic review.

BACKGROUND: The consumption of fruit and vegetables in old ages is particularly important, so that the appropriate consumption amount leads to reduction in the risk of chronic diseases. To increase consumption of fruit and vegetables and modify consumption pattern in the elderlies, training programs and appropriate intervention can be designed and implemented. AIMS: The study was done to assess and compare nutritional intervention-based training methods and education using theories and health education models for the consumption of fruits and vegetables in the elderlies. METHODS: Electronic search using keywords of Country Review Information Bank (Magiran), Scientific Information Database, Pub Med, Science direct, Science, Biomed central from the beginning of March 2014 to end of April 2015 was performed. RESULTS: Ten interventional studies were assessed in this systematic study. The interventions were divided into two groups of studies, a total of five studies, theories and health education models were the basis of training intervention and the other five studies that include their interventions without the use of theories and health education models was carried out. Of ten interventional studies, three studies as before and after and seven studies as the intervention and control was performed. DISCUSSION: The results showed that education-based theory and health education models have a greater impact on the consumption of fruit and vegetables in the elderlies. CONCLUSIONS: The duration and interventions performing method, environmental factors and educational programs using appropriate models and theories are important on the effectiveness of interventions to increase consumption of fruit and vegetables in the elderliness.

Determinants of medication adherence among elderly with high blood pressure living in deprived areas.

INTRODUCTION: The current study was conducted to determine the impact of health literacy and factors related to adherence to drug treatment, using the model proposed by the World Health Organization, in older adults with hypertension residing in informal settlements in Hamadan. METHODS: This cross-sectional study was conducted on 405 patients in Hamadan city, located in the western part of Iran. Data were collected using an interviewer-administered questionnaire that included the 5-dimensional model proposed by the World Health Organization, Health Literacy for Iranian Adults, and Morisky Medication Adherence Scale-8. A two-stage sampling procedure was used to select patients from 14 comprehensive health service centers and health bases. The data were analyzed using SPSS v.24. RESULTS: The study found that medication adherence was suboptimal in 63% of the participants. Additionally, 87.5% of patients had inadequate or insufficient health literacy. Factors related to medication adherence included age (odds ratio (OR) = 1.07), annual income (OR = 0.17), duration of hypertension (OR = 7.33), health literacy (OR = 1.03), self-reported health status (P < 0.05), and regular medication use (P < 0.008). CONCLUSION: The results of this study indicate that more than half of the older adults in the study had suboptimal medication adherence and insufficient health literacy. The study also found that various factors, such as socioeconomic status, disease and treatment-related factors, and patient-related factors, influence medication adherence among older adults.

Understanding determinants related to farmers' protective measures towards pesticide exposure: A systematic review.

OBJECTIVE: Pesticide poisoning is the main cause of adverse effects and mortality worldwide. Protective measures can reduce the intensity of the effects of pesticides on the health of farmers. Numerous cross-sectional studies have been conducted on the determinants of performing protective measures to reduce exposure to pesticides, but there is no systematic study that comprehensively examines the impact of these factors. Therefore, the aim of this study is to identify existing studies on the determinants of effective protective measures to reduce exposure to pesticides among farmers. METHODS: In this systematic review, studies were obtained from PubMed, Web of Science and Scopus databases using a search strategy that covered articles from the first years of database design to April 20, 2023. The inclusion and exclusion criteria were based on the PICOs criteria. The study included cross-sectional studies that measured the implementation of protective measures using objective or valid subjective tools. The data were extracted and analyzed based on several criteria and ecological levels. The Ecological Model of Health Behavior was used to classify the determinants that affect the performance of protective behaviors. The National Heart, Lung and Blood Institute (NHLBI) has developed a quality assessment tool for studies. RESULTS: A total of 39 studies were ultimately selected for inclusion in this analysis. Many of these studies were conducted in developing countries. The most important factors that have an impact on protective measures include a variety of socio-demographic characteristics (age, gender, level of education, income, farming experience, experience of using pesticides), individual level (knowledge, attitude, risk perception, intention), interpersonal level (subjective norms), organizational level (education), and public policy level (government attention, health costs, governmental extension services). The quality of most studies was fair. CONCLUSIONS: Research indicates that several factors influence the use of personal protective equipment and safe behaviors when handling pesticides. These include farmers' education level, knowledge, and attitudes towards safety measures. Environmental factors such as access to information, extension services, training programs, and media coverage can also help minimize exposure to pesticides.

Correlates of malnutrition in patients with heart failure: the role of social support.

AIMS: Heart failure (HF) is a major public health challenge. Malnutrition has a significant effect on HF prognosis. Understanding the impact of social and clinical factors on the risk of malnutrition is necessary because it may aid in improving the health status of HF patients. METHODS AND RESULTS: Three hundred twenty patients with HF who were hospitalized in a heart centre in Shiraz, Iran, from March to November 2022 were studied. Two validated questionnaires were used to evaluate malnutrition and social support: (1) Mini-Nutritional Assessment Short Form and (2) Medical Outcomes Study Social Support Survey. The participants were then divided into three groups: those with normal nutritional status (scores 12-14), those at risk of malnutrition (scores 7-11), and those who were malnourished (scores 0-6). The potential correlates of malnutrition (including socio-demographic, clinical, comorbidities, and laboratory factors) were included in the study. Then, ordinal logistic regression was used to investigate the correlates of malnutrition. The mean age of the participants was 64.2 ± 11.2 years, and more than half were male and married. Normal nutritional status was seen in 110 (34.4%) participants, 151 (47.2%) were at risk of malnutrition, and 58 (18.1%) were malnourished. The mean social support score of the participants was 61.65 ± 12.91. According to the adjusted odds ratios (95% confidence intervals) obtained from multivariate analysis, increased risk of malnutrition was associated with having a lower social support score [0.95 (0.93-0.97), P-value ≤ 0.001], lower body mass index [0.91 (0.86-0.97), P-value = 0.004], higher New York Heart Association classification [1.26 (1.02-1.56), P-value = 0.03], longer duration of disease [1.006 (1.001-1.01), P-value = 0.006], and lower serum albumin level [0.25 (0.08-0.75), P-value = 0.01]. CONCLUSIONS: Besides the clinical conditions affecting the risk of malnutrition in patients with HF, social support may play an important role. Including this factor in HF guidelines and developing educational programmes may help improve HF patients' health.

Association Between Preoperative Hyponatremia and Survival After Liver Transplant: A Systematic Review and Meta-Analysis.

OBJECTIVES: Numerous studies have been conducted to investigate the effects of preoperative hyponatremia on survival after liver transplantation. The variable findings underscore the necessity for performing a systematic review to elucidate the potential effects of preoperative hyponatremia. MATERIALS AND METHODS: We searched PubMed, Scopus, Web of Science, Science Direct, Cochrane Library, and reference lists of articles for observational cohort studies that reported association between preopera-tive hyponatremia and survival after liver transplant in adults regardless of publication year. We used the random-effect model to pool the extracted data for meta-analysis. RESULTS: Meta-analyses of mean difference in serum sodium levels showed that nonsurviving recipients had 2.58 mEq/L lower preoperative serum sodium levels than surviving recipients (0.02; 95% CI, .33-4.83). Two observational methods were used to assess survival after liver transplant of patients with preoperative hyponatremia. According to meta-analyses, no dif-ference in survival was shown between recipients with and without preoperative hyponatremia (sodium> 130 mEq/L) (≤1 month : 0.69 [95% CI, 0.9-1.07], 3-month survival: 0.54 [95% CI, 0.95-1.02]). Second, when we compared posttransplant survival of recipients with preoperative hypo-natremia versus those with normal serum sodium levels (sodium = 130-145 mEq/L), we found that recipients with preoperative hyponatremia had lower survival after liver transplant than those with normal preoperative serum sodium levels. CONCLUSIONS: Liver transplant recipients with preop-erative hyponatremia probably have shorter survival posttransplant than those with normal preoperative serum sodium level.

Diagnostic Accuracy of ChatGPT for Patients' Triage; a Systematic Review and Meta-Analysis.

Introduction: Artificial intelligence (AI), particularly ChatGPT developed by OpenAI, has shown the potential to improve diagnostic accuracy and efficiency in emergency department (ED) triage. This study aims to evaluate the diagnostic performance and safety of ChatGPT in prioritizing patients based on urgency in ED settings. Methods: A systematic review and meta-analysis were conducted following PRISMA guidelines. Comprehensive literature searches were performed in Scopus, Web of Science, PubMed, and Embase. Studies evaluating ChatGPT's diagnostic performance in ED triage were included. Quality assessment was conducted using the QUADAS-2 tool. Pooled accuracy estimates were calculated using a random-effects model, and heterogeneity was assessed with the I² statistic. Results: Fourteen studies with a total of 1,412 patients or scenarios were included. ChatGPT 4.0 demonstrated a pooled accuracy of 0.86 (95% CI: 0.64-0.98) with substantial heterogeneity (I² = 93%). ChatGPT 3.5 showed a pooled accuracy of 0.63 (95% CI: 0.43-0.81) with significant heterogeneity (I² = 84%). Funnel plots indicated potential publication bias, particularly for ChatGPT 3.5. Quality assessments revealed varying levels of risk of bias and applicability concerns. Conclusion: ChatGPT, especially version 4.0, shows promise in improving ED triage accuracy. However, significant variability and potential biases highlight the need for further evaluation and enhancement.

Factors related to medication adherence in patients with hypertension in Iran: a systematic review study.

OBJECTIVES: This study aimed to review the available studies of the factors in Iranian hypertensive patients' adherence to drug treatment. METHODS: Four Persian databases and seven English databases were searched. The articles, which were published from 2000 to 2022 in Persian and English and examined the adherence to drug treatment in the Iranian population of adults with high blood pressure, were reviewed. Based on the primary examination, 31 of the initial 1062 articles met the inclusion criteria and were included in the analysis. The evidence, which was provided by the examined articles, was summarized and discussed using the 5-dimensional framework of adherence to long-term treatments, which was developed by WHO. RESULTS: The factors that significantly correlated with adherence to drug treatment in the examined studies were: (1) factors that were related to the health team or the health system: patients' satisfaction with their doctor-patient relationship; (2) factors that were related to the conditions: the number of concomitant diseases, high quality of life and the implementation of effective interventions; (3) factors which were related to the treatment: long duration of illness, short intervals between the visits, duration of treatment, lower numbers of drugs, and the patient's blood pressure control; and (4) factors that were related to the patient: self-efficacy, health literacy, social support, locus of control, illness perception, beliefs, attitude, knowledge, and cues to action. CONCLUSION: It is possible to draw definite conclusions about the factors which affect adherence to drug treatment in patients with high blood pressure because most of the relevant studies have been cross-sectional. Therefore, in the future, valuable results can be obtained by conducting more studies that preferably use objective instruments for assessing adherence to drug treatment.

The effect of intervention programs on road traffic injury prevention among adolescents and young people: a systematic review.

Road traffic injuries (RTIs) are a significant cause of death and disability among young people worldwide. Programs that use injury prevention strategies have been shown to effectively reduce the number of injuries. This systematic review aims to present the available evidence on the effectiveness of intervention programs in preventing RTIs among adolescents and young adults. Articles were identified and retrieved from databases including PubMed, Embase, Web of Science, Scopus, Science Direct, Magiran, SID, and Iran Medex. Two reviewers independently screened the articles. Articles published from the first year of publication until January 2018 that met the eligibility criteria were included in the review. These articles covered randomized controlled trials, pretest/post-test interventions, and controlled pretest/post-test interventions aimed at reducing RTIs among adolescents and young people aged 12-26 years. The framework, provided by Murphy and Haddon, were used to categorize the interventions. According to this framework, the interventions were categorized into five groups including education/behavior change, incentive, engineering/technology, legislation/enforcement, and multifaceted programs. The methodological quality of the studies was assessed using the Effective Public Health Practice Project. Of the initial 3165 findings, 13 studies met the inclusion criteria. Eleven of these studies used educational/behavioral approaches, while two employed multifaceted programs. In the educational/behavioral approach, participants' behaviors were considered as outcome variables. Only one of these studies was not successful. Multifaceted interventions were successful in changing behaviors. No studies were found on the effectiveness of other interventions. Eight studies were assessed as having moderate quality. The systematic review shows that educational/behavioral strategies and multifaceted programs are effective in reducing RTIs among young adults and adolescents. However, there is a lack of studies on other potential interventions. The quality of the included studies was moderate, suggesting a need for more rigorous research.

Long non-coding RNAs and melanoma: From diagnosis to therapy.

Although extremely rare, malignant melanoma is the deadliest type of skin malignancy with the inherent capability to invade other organs and metastasize to distant tissues. In 2021, it was estimated that approximately 106,110 patients may have received the diagnosis of melanoma, with a mortality rate of 7180. Surgery remains the common choice for treatment in patients with melanoma. Despite many advances in the treatment of melanoma, some patients, such as those who have received cytotoxic chemotherapeutic and immunotherapic agents, a significant number of patients may show inadequate treatment response following initiating these treatments. Non-coding RNAs, including lncRNAs, have become recently popular and attracted the attention of many researchers to make new insights into the pathogenesis of many diseases, particularly malignancies. LncRNAs have been thoroughly investigated in multiple cancers such as melanoma and have been shown to play a major role in regulating various physiological and pathological cellular processes. Considering their core regulatory function, these non-coding RNAs may be appropriate candidates for melanoma patients' diagnosis, prognosis, and treatment. In this review, we will cover all the current literature available for lncRNAs in melanoma and will discuss their potential benefits as diagnostic and/or prognostic markers or potent therapeutic targets in the treatment of melanoma patients.

Development and validation of assessment tool of knowledge, attitude, and practice of outdoor workers regarding heat stress.

BACKGROUND: Improving the level of knowledge, attitude and practices of workers exposed to heat stress using a suitable tool can be a cheap and effective method. This requires the consideration of personal, environmental and social factors, which, the PRECEDE model is highly applicable for. Thus, the aim of the present study is the development of a tool assessment for measuring the knowledge, attitude and practices of workers in outdoor occupations regarding heat stress exposure using the PRECEDE model. METHODS: In the present study, a tool was designed and constructed using the PRECEDE model by analyzing the relevant literature and expert opinion. The face validity of the tool was determined based on the opinion of ten experts with experience in the field of occupational weather conditions. The content validity of the tool was determined using the Content Validity Ratio (CVR) and the Content Validity Index (CVI). Cronbach's alpha reliability coefficient was used to determine the reliability of the tool's internal consistency. SPSS version 23 was used for statistical analysis. RESULTS: A PRECEDE based questionnaire was designed with a total of 55 questions consisting of predisposing factors (28 questions for knowledge and 14 questions for attitude), enabling factors (5 questions), reinforcing factors (3 questions) and preventive behaviors (5 questions). The Content Validity Index (CVI) of all questions was above 0.79. The Content Validity Ratio (CVR) of all questions was above 0.62 (Lawshe method). The Cronbach's alpha reliability coefficient of all PRECEDE domains were above the 0.7 acceptable value. Based on the results obtained, all 55 questions were approved and thus the content validity and reliability of this tool was deemed acceptable. CONCLUSION: Considering the reliability and validity of this tool, its application is recommended in all health and safety inspections within various industries for measuring the heat stress knowledge, attitude and practices of workers engaged in outdoor occupations and also for presenting suitable solutions or preventive measures.