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Mistreatment of women during childbirth is a global health challenge. Maternity healthcare providers play a key role in influencing women's birth experience. This study aimed to assess the knowledge, attitudes, and practices of healthcare providers regarding mistreatment of women during labour and childbirth in public hospitals in Tehran, Iran. This cross-sectional study was part of an implementation research project that was conducted from October to December 2021 at five public teaching hospitals in Tehran. All eligible maternity healthcare providers (obstetricians and midwives) and students were invited to participate in this study. Data were collected using a questionnaire consisting of four sections: socio-demographic characteristics (11 items), knowledge (11 items), attitudes (13 items), and practices (14 items) about mistreatment. Knowledge, attitude, and practice scores were determined using Bloom's cut-off points. Logistic regression analyses were used to identify the socio-demographic characteristics associated with knowledge and attitudes. A p-value of <0.05 was considered statistically significant. Of the 270 participants, 255 (94.5%) participated in the study. Majority of the participants (82.7%) had poor knowledge regarding mistreatment of women during labour and childbirth. Poor knowledge was more apparent in the categories of physical abuse, verbal abuse, poor rapport between women and providers, and failure to meet professional standards of care. Most participants (69.4%) had poor attitudes towards mistreatment; they were alright with physical abuse, verbal abuse, and discrimination. Only 3.1% of the participants reported moderate mistreatment practices towards birthing women. Verbal and physical abuse were the most prevalent categories used by the participants. The number of night shifts was associated with attitudes regarding mistreatment (AOR = 0.45, 95% CI = 0.22-0.89, p = 0.02). The knowledge and attitude of our participants regarding maternity mistreatment were poor. A small percentage of the participants reported mistreatment practices. The findings of our study have important implications for program planners and decision-makers in developing effective interventions to reduce mistreatment of women during labour and childbirth in Iran.

Background Infertility can cause psychological distress and has a negative impact on quality of life (QoL). There have been no studies investigating the effect of depression on QoL in infertile couples at the dyadic level. This study aimed to investigate the effects of actors’ and partners’ depression on QoL in male-female dyads experiencing infertility using an innovative dyadic analysis approach, the Actor–Partner Interdependence Model (APIM). Methods We conducted this cross-sectional study on 180 infertile couples in Tehran, Iran, during August-September 2017. Quality of life and depression were assessed using Fertility Quality of Life and Patient Health Questionnaire-9, respectively. Dyadic data were analyzed by the APIM approach. In this method, actor effect is the impact of a person’s depression on his/her own QoL. Partner effect is the impact of a person’s depression on his/her partner’s QoL. Results Results from APIM revealed that both males and females’ depression exuded an actor effect on their own QoL (β = − 0.589, p  < 0.001; β = − 0.588, p  < 0.001, respectively). Furthermore, males’ depression exuded a significant partner effect on their wives’ QoL (β = − 0.128, p  = 0.030). Although the partner effect of females’ depression on males’ QoL was not statistically significant (β = − 0.108, P  = 0.070), males whose wives had higher depression were more to indicate their own QoL was poorer. Based on equality constraint test, both actor and partner effects of depression on QoL were similar between males and females. Conclusions The findings suggest that QoL in infertile patients was influenced by not only their own depression but also their spouses’ depression; therefore, interventions to improve QoL should include both males and females.

Background Much evidence consistent with the Marital Discord Model of Depression (MDMD) suggests that marital discord is associated with depression, but no studies examine the relationship between marital satisfaction and depression at the dyadic level in infertile couples. This study examined the effect of actors’ and partners’ marital satisfaction on depressive symptoms in husband-wife dyads with infertility using an innovative dyadic analysis approach, the Actor–Partner Interdependence Model (APIM). Methods In this cross-sectional study, the sample comprised of 141 infertile couples in the evaluation phase of treatment. We collected data in a referral infertility center in Tehran, Iran between February and May 2017. Marital satisfaction and depression were measured using ENRICH marital satisfaction scale and Hospital Anxiety and Depression Scale, respectively, before starting the treatment. Dyadic analysis applying the APIM was used. In this study, actor effect is the impact of a person’s marital satisfaction on his/her own depression. Partner effect is the impact of a person’s marital satisfaction on his/her partner’s depression. Results The APIM analysis revealed that both men and women’s marital satisfaction excreted an actor effect on their own depression (β = − 0.412, P  < 0.001; β = − 0.263, P  = 0.002, respectively). Furthermore, men’s marital satisfaction exerted a significant partner effect on their wives’ depression symptoms (β = − 0.170, p  = 0.047). However, the wives’ marital satisfaction was not related to their husbands’ depressive symptoms (β = − 0.028, P  = 0.735). Conclusions The findings support that the MDMD is a valid theoretical model for the conceptualization of marital satisfaction and depressive symptoms among infertile couples and suggest that interventions to reduce depressive symptoms should include both men and women.

This study used Targeted Maximum Likelihood Estimation (TMLE) as a double robust method to estimate the causal effect of previous tuberculosis treatment history on the occurrence of multidrug-resistant tuberculosis (MDR-TB). TMLE is a method to estimate the marginal statistical parameters in case-control study design. The aim of this study was to estimate the causal effect of the previous tuberculosis treatment on the occurrence of MDR-TB using TMLE in Sudan. A case-control study design combined with TMLE was used to estimate parameters. Cases were MDR-TB patients and controls were and patients who cured from tuberculosis. The history of previous TB treatment was considered the main exposure, and MDR-TB as an outcome. A designed questionnaire was used to collect a set of covariates including age, time to reach a health facility, number of times stopping treatment, gender, education level, and contact with MDR-TB cases. TMLE method was used to estimate the causal association of parameters. Statistical analysis was carried out with ltmle package in R-software. Result presented in graph and tables. A total number of 430 cases and 860 controls were included in this study. The estimated risk difference of the previous tuberculosis treatment was (0.189, 95% CI; 0.161, 0.218) with SE 0.014, and p-value (<0.001). In addition, the estimated risk ratio was (16.1, 95% CI; 12.932, 20.001) with SE = 0.014 and p-value (<0.001). Our findings indicated that previous tuberculosis treatment history was determine as a risk factor for MDR-TB in Sudan. Also, TMLE method can be used to estimate the risk difference and the risk ratio in a case-control study design.

Background Dyadic data analysis (DDA) is increasingly being used to better understand, analyze and model intra- and inter-personal mechanisms of health in various types of dyads such as husband-wife, caregiver-patient, doctor-patient, and parent-child. A key strength of the DDA is its flexibility to take the nonindependence available in the dyads into account. In this article, we illustrate the value of using DDA to examine how anxiety is associated with marital satisfaction in infertile couples. Methods This cross-sectional study included 141 infertile couples from a referral infertility clinic in Tehran, Iran between February and May 2017. Anxiety and marital satisfaction were measured by the anxiety subscale of the Hospital Anxiety and Depression Scale and 10-Item ENRICH Marital Satisfaction Scale, respectively. We apply and compare tree different dyadic models to explore the effect of anxiety on marital satisfaction, including the Actor-Partner Interdependence Model (APIM), Mutual Influence Model (MIM), and Common Fate Model (CFM). Results This study demonstrated a practical application of the dyadic models. These dyadic models provide results that appear to give different interpretations of the data. The APIM analysis revealed that both men’s and women’s anxiety excreted an actor effect on their own marital satisfaction. In addition, women’s anxiety exerted a significant partner effect on their husbands’ marital satisfaction. In MIM analysis, in addition to significant actor effects of anxiety on marital satisfaction, women’s reports of marital satisfaction significantly predicted men’s marital satisfaction. The CFM analysis revealed that higher couple anxiety scores predicted lower couple marital satisfaction scores. Conclusion In sum, the study highlights the usefulness of DDA to explore and test the phenomena with inherently dyadic nature. With regard to our empirical data, the findings confirmed that marital satisfaction was influenced by anxiety in infertile couples at both individual and dyadic level; thus, interventions to improve marital satisfaction should include both men and women. In addition, future studies should consider using DDA when dyadic data are available.

Cutaneous leishmaniasis (CL) represents a significant vector‐borne disease in Iran. Our study examined the status of zoonotic CL (ZCL) in the country and forecasted the influence of global climate change on the monthly activity of Phlebotomus papatasi , the main vector of ZCL in the country. To predict the impact of climate change on the monthly activity of Ph. papatasi , we obtained the monthly average minimum and maximum temperatures for both the reference and future periods, using the MIROC6 model and two different shared socioeconomic pathway (SSP) scenarios. Based on our analysis, we found that Ph. papatasi can be active in Iran from March to November, although this may vary depending on the region. Our predictions suggest that the duration of Ph. papatasi ’s activity may change following future changes in weather patterns. In different scenarios, the duration of the active season in various regions of the country extends by at least 1–2 months. This extension is likely more pronounced in the southern provinces. Additionally, our findings indicate a notable correlation between ZCL incidence, the presence of Ph. papatasi , and environmental factors in Ardestan, Esfahan Province. This study focuses on the impact of temperature on the activity and distribution of Ph. papatasi in Iran, which is a significant vector for transmitting ZCL. The study predicts that with future climate scenarios, especially SSP5‐8.5, the activity of this vector will start earlier, last longer, and might even occur throughout the year by the 2050s, thereby increasing the risk of ZCL transmission. Although temperature plays a dominant role in shaping the activity of Ph. papatasi , its influence is not consistent across Iran. The variation in different regions emphasizes the importance of implementing targeted public health approaches to address the changing risks of ZCL transmission due to evolving climate conditions. However, it acknowledges that certain factors such as land use and humidity have not been taken into account and requests additional research in these areas. It also calls for enhanced environmental monitoring and public health interventions.

Older adults are more vulnerable to health risks than younger people and may get exposed to various dangers, including elder abuse. This study aimed to design and implement an empowerment educational intervention to prevent elder abuse. This parallel randomized controlled trial was conducted in 2014-2016 for 18 months on 464 older adults aged above 60 years who visited health houses of 22 municipalities in Tehran. Data were collected using standard questionnaires, including the Elder Abuse-Knowledge Questionnaire, Health-Promoting Behavior Questionnaire, Health-Promoting Lifestyle Profile II, Barriers to Healthy Lifestyle, Perceived Social Support, Perceived Self-Efficacy, Loneliness Scale, Geriatric Depression Scale, Multidimensional Health Locus of Control Scale, and the SCARED (stress, coping, argument, resources, events, and dependence) tool. The intervention was done in twenty 45- to 60-minute training sessions over 6 months. Data analysis were performed using tests, multiple linear and logistic regression, and structural equation modeling (SEM). The frequency of knowledge of elder abuse, self-efficacy, social support and health promoting lifestyle before the intervention was similar in the two groups. However, the frequency of high knowledge of elder abuse (94.8% in the intervention group and 46.6% in the control group), high self-efficacy (82.8% and 7.8%, respectively), high social support (97.0% and 10.3%, respectively) and high health promoting lifestyle (97.0% and 10.3%, respectively) was significantly higher ( <0.001) and the frequency of elder abuse risk (28.0% and 49.6%, respectively) was significantly less in the intervention group after the intervention. SEM standardized beta (Sβ) showed that the intervention had the highest impact on increase social support (Sβ=0.80, β=48.64, SE=1.70, <0.05), self-efficacy (Sβ=0.76, β=13.32, SE=0.52, <0.05) and health promoting behaviors (Sβ=0.48, β=33.08, SE=2.26, <0.05), respectively. The effect of the intervention on decrease of elder abuse risk was indirect and significant (Sβ=-0.406, β=-0.340, SE=0.03, <0.05), and through social support, self-efficacy, and health promoting behaviors. Educational interventions can be effective in preventing elder abuse.

Introduction: Helicobacter pylori could colonize the gastric mucosa and cause gastritis, ulcers and cancer. Numerous virulence factors have been identified in this bacterium that play important roles in promoting gastric disorders. Although the interaction of long noncoding RNAs (lncRNAs) with transcription, processing, and translation of genes associated with different diseases are described, their interaction with the inflammatory genes and H. pylori infection in the gastric tissue is not well known. This study compared changes in common NF-κB-regulatory lncRNAs in the gastric tissue of H. pylori-infected and non-infected patients with gastritis. Moreover, a link between the virulence entity of the strains and the transcriptional changes was analyzed. Methodology: Two groups of infected and non-infected patients with chronic gastritis were included in the study. Genotyping of the H. pylori strains was done by PCR and relative changes in the expression of NF-κB and regulatory lncRNAs, lincRNA-p21, MALAT1, NKILA, were measured by relative quantitative real time-PCR. Results: Transcriptional levels of MALAT1, lincRNA-p21, and NKILA genes decreased in the infected patients compared with the non-infected patients, which was significantly linked with increased NF-κB gene expression. Our results showed that a hypervirulent strain of H. pylori with oipA“on”/HP-NAP+/iceA1+/iceA2+/vacA s1m1/s1m2+/cagA+ genotype can promote a higher level of NF-κB transcription in the inflamed tissue. Conclusions: H. pylori infection could promote down-regulation of lincRNA-p21, MALAT1 and NKILA in the infected gastric tissue in correlation with NF-κB upregulation. More detailed studies are needed to show a link between the virulence genes and their impact on the regulation of lncRNAs in the stomach.

The growing demand for high food quality has been encouraging researchers in the food industry to apply biodegradable nanocomposites, which provide new opportunities and challenges for the advance of nanomaterials in the food industry. The objective of this study was to estimate the antibacterial activity and cytotoxicity effects of zinc oxide nanocomposite/zeolite (c/Zeo) with Aloe vera gel (AG) and its effect on the shelf life of chicken meat. The ZnONPs/Zeo was assessed using X‐ray fluorescence (XRF) and field emission scanning electron microscopy (FE‐SEM) analyses. The cytotoxicity effect of ZnONPs/Zeo was assessed by MTT assay. Then, the minimum inhibitory concentrations (MIC) and minimum bactericidal concentration (MBC) of ZnONPs/Zeo and ZnONPs/Zeo‐AG against Salmonella typhi and Salmonella para typhi A were investigated. Also, the preservative effect of nanocomposites on chicken fillets was evaluated. The results showed that these nanocomposites have the least cytotoxicity effect, resulting in good biocompatibility with the host. The MIC and MBC values of ZnONPs/Zeo‐AG were lower than the ZnONPs/Zeo against S. typhi and S. paratyphi A. Both ZnONPs/Zeo‐AG and ZnONPs/Zeo caused a significant decrease in the bacterial count of the chicken fillets. So, by spraying on meat, the number of bacteria presented a sharper decline as compared with the control group, resulting in an approximately 3.3 and 3‐log 10 reduction over 48 h in the ZnONPs/Zeo‐AG and ZnONPs/Zeo treatment samples, respectively. In conclusion, antimicrobial packaging with ZnONPs containing A. vera is a beneficial solution for preserving and improving the quality, safety, and shelf life of fresh meat products.

Background Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) is a highly contagious virus that uses angiotensin converting enzyme 2 (ACE2), a pivotal member of the renin–angiotensin system (RAS), as its cell-entry receptor. Another member of the RAS, angiotensin II (Ang II), is the major biologically active component in this system. There is growing evidence suggesting that serum miRNAs could serve as prognostic biomarkers for SARS-CoV-2 infection and regulate ACE2 expression. Therefore, the aim of this study is to evaluate the changes in the serum levels of sACE2 and Ang II, as well as the expression level of miR-141-3p and miR-421 in SARS-CoV-2 positive and negative subjects. Methods In the present study, the serum levels of sACE2 and Ang II were measured in 94 SARS-CoV-2 positive patients and 94 SARS-CoV-2 negative subjects with some symptoms similar to those of SARS-CoV-2 positive patients using the ELISA method. In addition, the expression level of miR-141-3p and miR-421 as ACE2 regulators and biomarkers was evaluated using quantitative real-time PCR (qRT-PCR) method. Results The mean serum sACE2 concentration in the SARS-CoV-2-positive group was 3.268 ± 0.410 ng/ml, whereas in the SARS-CoV-2 negative group, it was 3.564 ± 0.437 ng/ml. Additionally, the mean serum Ang II level in the SARS-CoV-2 positive and negative groups were 60.67 ± 6.192 ng/L and 67.97 ± 6.837 ng/L, respectively. However, there was no significant difference in the serum levels of sACE2 ( P value: 0.516) and Ang II ( P value: 0.134) between the SARS-CoV-2 positive and negative groups. Meanwhile, our findings indicated that the expression levels of miR-141-3p and miR-421 in SARS-CoV-2 positive group were significantly lower and higher than SARS-CoV-2 negative group, respectively ( P value < 0.001). Conclusions Taken together, the results of this study showed that the serum levels of sACE2 and Ang II in SARS-CoV-2 positive and negative subjects were not significantly different, but the expression levels of miR-141-3p and miR-421 were altered in SARS-CoV-2 positive patients which need more investigation to be used as biomarkers for COVID-19 diagnosis.