Assessing public trust in road traffic injuries prevention policies in Iran: a cross-sectional study.

INTRODUCTION AND OBJECTIVE: Road Traffic Injuries (RTIs) represent the predominant cause of morbidity and mortality globally. Thus, impactful interventions and trustworthy authorities are imperative to mitigate traffic accidents. The present study seeks to assess public trust in traffic accident diminution policies and measures within the country of Iran. METHOD: This cross-sectional study utilized a questionnaire comprising 31 questions distributed across eight dimensions. The questionnaire's design was informed by a literature review and semi-structured interviews with experts specializing in traffic accidents. The target population consisted of Tabriz city residents, who were selected via convenience sampling. The collected data were then analyzed using SPSS-16 software, employing the T-test, One-way ANOVA, and Pearson correlation coefficient to present the study's results. structural equation modeling (SEM) was conducted using R 4-4-2 programming language. RESULTS: A total of 681 participants completed the questionnaire, yielding a commendable response rate of 88.6%. The majority of participants were male (60.8%), and 86.2% identified as drivers, with 61.8% having experienced driving accidents. The overall score for public trust in RTIs policies was calculated to be 46.9%. The individual scores for specific domains of trust in traffic safety were as follows: safer roads (43.1%), safe vehicle (43.3%), safety laws (48.8%), safe user (51.1%), safe technology (51.5%), road safety management (46.8%). All the latent variables except education are significantly effective on public trust. CONCLUSION: The study findings indicate relatively low levels of public trust in RTIs policies among the Iranian population. These results emphasize the need for targeted interventions to enhance public confidence in specific aspects of traffic safety. Policymakers can use these insights to implement effective measures, thus contributing to the RTIs and the promotion of road safety in the country.

Cerebral protection in acute type A aortic dissection surgery: a systematic review and meta-analysis.

Background: Acute type A aortic dissection (ATAAD) still challenges physicians and warrants emergent surgical management. Two main methods to reduce cerebrovascular events in ATAAD surgeries are antegrade cerebral perfusion (ACP) and retrograde cerebral perfusion (RCP). We conducted a systematic review and meta-analysis to compare the outcomes of ACP and RCP methods during the ATAAD surgery. Methods: In this study, we searched the databases until March 29th, 2023. Studies that reported the data for comparison of different types of brain perfusion protection during aortic surgery in patients with ATAAD were included. Results: Twenty-six studies met the eligibility criteria. All studies had a low risk of bias as they were evaluated by the Joanna Briggs Institute (JBI) critical appraisal tool. Eventually, we included 26 studies in the current meta-analysis, and a total of 13,039 patients were evaluated. The calculated risk ratio (RR) for permanent neurologic dysfunction (PND) in ACP and RCP comparison was RR =1.23, 95% confidence interval (CI): (0.84, 1.80) (P value =0.2662), and in unilateral ACP (uACP) and bilateral ACP (bACP) was RR =1.2786, 95% CI: (0.7931, 2.0615) (P value =0.3132). When comparing the ACP-RCP and uACP-bACP groups, significant differences were found between ACP-RCP the groups in terms of circulatory arrest time (P value =0.0017 and P value =0.1995, respectively), cardiopulmonary bypass time (P value =0.5312 and P value =0.7460, respectively), intensive care unit (ICU)-stay time (P value =0.2654 and P value =0.0099), crossclamp time (P value =0.6228 and P value =0.2625), and operative mortality (P value =0.9368 and P value =0.2398, respectively), and when comparing the u-ACP and b-ACP groups for transient neurologic deficit (TND), an RR of 1.32, 95% CI: (1.05, 1.67) (P value =0.0199). The results showed high heterogeneity and no publication bias. Conclusions: This study demonstrated that the ACP and RCP are both safe and acceptable techniques to use in emergent settings. The uACP technique is equivalent to bACP in terms of PND and mortality, however, uACP is preferred over bACP in terms of TND.

Bisphosphonates and Prevention of the Perimenopausal Breast Cancer Recurrence: A Systematic Review and Meta-Analysis.

PURPOSE: Bisphosphonates (BPs) have a powerful effect on reducing bone resorption and improving the survival of patients with breast cancer. We aimed to investigate the impact of BP treatment on the prevention of recurrence, metastasis, and death of breast cancer survivors in the perimenopausal period. METHODS: The search strategy aimed to identify both published and unpublished studies in PubMed, Web of Science, Scopus, Embase, ProQuest, and Google Scholar in March 2021. Two independent reviewers assessed quantitative papers selected for retrieval for methodological validity before being included in the review using standardized critical appraisal instruments from the Joanna Briggs Institute (JBI) Meta-Analysis of Statistics Assessment and Review Instrument (JBI-MAStARI). Statistical meta-analysis was performed using Review Manager (RevMan) 5.4 statistical software when the data were homogenous. Meta-analysis was performed by calculating the effect size (hazard ratio; HR) and 95% confidence intervals (CIs). RESULTS: Twenty-one studies were eligible for this systematic review and meta-analysis. The overall The HRs for disease-free survival (DFS) and overall survival (OS) in women who received BPs were 0.89 (95% CI, 0.83-0.97; p = 0.005), and 0.75 (95% CI, 0.63-0.89; p = 0.001), respectively. The results showed that BPs had a significant effect on the prevention of locoregional (HR, 0.64; 95% CI, 0.42-0.97; p = 0.04), bone (95% CI, 0.74-0.95; p ≤ 0.001), and distant metastases (HR, 0.77; 95% CI, 0.62-0.94; p = 0.01). In the subgroup analysis based on study design, the only insignificant HR in the included randomized controlled trials (RCTs) was that of locoregional metastasis. CONCLUSION: Although BPs have a promising effect on DFS, OS, and bone metastasis of perimenopausal women survivors of breast cancer, more RCTs are needed to evaluate their effect on other survivors' outcomes.