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Background Asthma-COPD overlap (ACO) is a term that encompasses patients with features of both asthma and COPD. To date, the global prevalence of ACO in the general population remains unknown. The objective of this study was to estimate the prevalence of ACO in the general population using a systematic review and meta-analysis. Methods A systematic search of ISI Web of Knowledge, MEDLINE/PubMed, and Scopus was performed up to May 2019 to identify studies reporting the prevalence of ACO. Reference lists from identified studies and relevant review articles were also searched. Eligibility criteria were studies reporting the prevalence of ACO, performed in general population, and published in English language. Pooled prevalence of ACO with 95% confidence interval (CI) was calculated using random effects Meta-analysis. Results A total of 27 studies were included in this meta-analysis. The Cochran Q test and I 2 statistics revealed substantial heterogeneity among studies. Based on the random-effects model, the pooled prevalence of ACO was 2.0% (95% CI: 1.4–2.6%) in the general population, 26.5% (95% CI: 19.5–33.6%) among patients with asthma, and 29.6% (95% CI: 19.3–39.9%) among patients with COPD. In addition, for included studies, the global prevalence of asthma-only was 6.2% (95% CI: 5.0–7.4%) and COPD-only was 4.9% (95% CI: 4.3–5.5%). Conclusion We estimated the global prevalence of ACO based on population-based studies and found that 2.0% of the general population is affected. However, the prevalence of ACO depends on its diagnostic criteria. Therefore, there is a vital need to better define the ACO diagnostic criteria, management and treatment. It is worth noting that the limitations of the present study include lack of studies in some region of the world and small number of studies included in the subgroup analyses.

Background Depression in patients with infertility often goes undiagnosed and untreated. The Patient Health Questionnaire-9 (PHQ-9) and its ultra-brief version (i.e. PHQ-2) are widely used measures of depressive symptoms. These scales have not been validated in patients with infertility. The aim of the present study was to examine the reliability and validity of the PHQ-9 and PHQ-2 in patients with infertility. Methods In this cross-sectional study, a total of 539 patients with infertility from a referral infertility clinic in Tehran, Iran completed the PHQ-9, along with other relevant scales: the WHO-five Well-being Index (WHO-5), the Hospital Anxiety and Depression Scale (HADS), and the Generalized Anxiety Disorder-7 (GAD-7). Factor structure and internal consistency of PHQ-9 were examined via confirmatory factor analysis (CFA) and Cronbach’s alpha, respectively. Convergent validity was evaluated by relationship with WHO-5, HADS and GAD-7. Results The mean total PHQ-9 and PHQ-2 scores were 8.47 ± 6.17 and 2.42 ± 1.86, respectively, and using a cut-off value of 10 (for PHQ-9) and 3 (for PHQ-2), the prevalence of depressive symptoms was 38.6 and 43.6%, respectively. The Cronbach’s alphas for PHQ-9 and PHQ-2 were, respectively, 0.851 and 0.767, indicating good internal consistency. The CFA results confirmed the one-factor model of the PHQ-9 (χ 2 /df = 4.29; CFI = 0.98; RMSEA = 0.078 and SRMR = 0.044). Both PHQ-9 and PHQ-2 showed moderate to strong correlation with the measures of WHO-5, HADS-depression, HADS-anxiety, and the GAD-7, confirming convergent validity. In univariate analysis, female sex, long infertility duration, and unsuccessful treatment were significantly associated with depression symptoms. Conclusion Both PHQ-9 and PHQ-2 are brief and easy to use measures of depressive symptoms with good psychometric properties that appear suitable for routine use in patients with infertility.

BackgroundCurrent evidence supports the association between the high sperm DNA fragmentation (SDF) and the poor fertilization rate following either natural conception or assisted reproductive techniques (ART). On the other hand, there are conflicting results regarding the decreased sperm DNA integrity in men with high body mass index (BMI).ObjectiveWe aimed at the present systematic review and meta-analysis at evaluating the association between BMI and SDF.MethodsWe searched databases of Medline, Embase, Scopus, and Web of Science up to May 2019, to identify observational studies that assessed the associations between BMI and SDF. BMI was classified, according to the standard BMI classifications, into six categories including underweight (<18.5), normal weight (18.5–24.99), overweight (25–29.99), class I obesity (30–34.99), class II obesity (35–39.99), and class III obesity (≥40). Standardized mean differences (SMDs) and 95% confidence intervals (CIs) of SDF were calculated by using a random-effects model for BMI categories.ResultsThe initial extensive literature search yielded 33,739 potentially relevant articles (3,917 from Medline, 781 from Embase, 12,685 from Scopus, and 9,348 from Web of Science). Fourteen studies (nine cross-sectional, four cohort, and one case–control studies), with a total number of 8,255 participants, were included in the meta-analysis. Finally, three studies reported higher SDF levels in obese men (BMI = 30–34.99) compared with normal-weight men (BMI < 25) (SMD: 0.23, 95% CI: 0.01, 0.46, P = 0.05, I2 = 0%), but there was no difference between other categories.ConclusionsThere is insufficient data to demonstrate a positive association between BMI and SDF. Our findings provide a rationale for conducting further cohort studies for evaluation of the association between BMI and SDF, considering potential confounders.

Background The worldwide rise in life expectancy has resulted in an expanding elderly population, particularly in developing nations, amplifying the demand for social support to manage the challenges associated with aging. Therefore, this study aimed to investigate social support and its associated factors among older adults in the Prospective Epidemiological Research Studies in Iran (PERSIAN) Guilan Cohort study (PGCS) population. Methods The present cross-sectional study was conducted on 389 participants of the PGCS population. The social support was measured using 10-item Duke Social Support Index (DSSI-10). Data analysis was performed in SPSS v16 with a significance level of < 0.05. Results The mean age of the elderly people was 69.88 (SD = 2.62) and 51.4% were female. The mean total DSSI-10 score was 20.05 (SD = 4.61). Based on the multiple linear regression analysis, lower age ( P  = 0.001), residency in rural area ( P  = 0.002) and being in the third tertile of wealth score index ( P  = 0.011) was statistically associated with lower total DSSI-10 scores. The coefficient of determination (R 2 ) was 9.2%, indicating that 9.2% of the variation in the total DSSI-10 scores was explained by the demographic characteristics. Conclusion Based on the results, it can be concluded that younger elderly individuals, those living in rural areas, and those with lower socioeconomic status experience significantly lower levels of overall social support. These findings highlight the need for focused strategies and interventions to improve social support among these vulnerable subgroups to promote better health and well-being in aging populations.

Background The intensive care unit (ICU) is crucial in treating severely ill patients, particularly those requiring mechanical ventilation. Nurses are essential for coordinating care and addressing any gaps within the ICU team. This study aimed to evaluate the care coordination competency of nurses in Iranian ICUs, specifically about mechanically ventilated patients. Methods A descriptive cross-sectional study was conducted at Guilan University of Medical Science from September to December 2022, involving 211 ICU nurses selected through convenience sampling. The Nurses’ Coordination Competency Scale (NCCCS) and a demographic information form were used. Statistical analyses were conducted using SPSS version 16, including Pearson correlation, independent t-tests, one-way ANOVA, and multiple linear regression analysis, with a significance level set at 0.05. Results The mean score on the NCCCS for nurses was 3.41 out of 5. The multivariable analysis identified key factors influencing coordination competency, including a Master of Science in Nursing (MSN) degree (b = 0.891, P  < 0.001), prior ICU experience (b = 0.080, P  < 0.001), and fixed shift employment (b = 0.500, P  = 0.011) scored higher on the NCCCS. Conversely, those in commitment-type positions had lower scores than those in standard roles (b=-0.690, P  < 0.001). Conclusion The study found that Iranian ICU nurses demonstrated high competency in coordinating care for mechanically ventilated patients. However, they must improve teamwork, align their understanding of patient care needs, and enhance team cohesion through training and advanced technologies.

Background The rapid growth of technology forced enormous changes in the provision of healthcare services. Different strategies are used to keep nurses up to date with rapid changes in health systems. Microlearning is one of the new methods of teaching professional skills to health workers. This method is effective in care settings that have many limitations in terms of time and place. However, it is very important to test the acceptability of this method among nurses before practical measures are taken for its widespread use. This study aimed to determine nurses’ acceptance rate of quick response code as a microlearning tool in workplace. Method This is a cross-sectional study was conducted in medical and surgical wards in hospitals affiliated to Guilan University of Medical Sciences. 185 nurses participated in the study. A number of selected medical devices were labeled with quick response codes containing educational content. The eligible nurses were instructed how to use the QR codes. After two months, they were asked to complete a questionnaire adapted from the technology acceptance model 3. SPSS 21 software was used to analyze the data. Results 166 nurses and 19 head nurses with mean age of 34.26 ± 8.17 years and mean work experience of 10.46 ± 7.64 years completed the questionnaires. Most participants were female, married, with a bachelor’s degree, worked on rotating shifts, in medical wards. The findings showed that the acceptance of the quick response code as a learning tool was at a moderate level (M = 66.1, SD = 16.6). Statistically, there was no significant relationship between nurses’ demographic characteristics and the total acceptance rate ( P  > 0.05). However, the analyses at the multivariate level, using multiple linear regression, showed a significant superiority of the total acceptance score in head nurses compared to nurses ( b  = 7.97, P  = 0.047) and in nurses who had previous experience of using quick response codes, compared to colleagues without such experience ( b  = 5.18, P  = 0.036). Based on the coefficient of determination, only 6.1% of the changes in the total acceptance score of quick response codes of nurses are explained by their personal-occupational characteristics ( R 2  = 0.061). Conclusions The provision of QR code requirements such as necessary infrastructure and training by the health authorities could increase the acceptance of this tool as a microlearning measure.

Background Generalized anxiety disorder (GAD) is one of the most prevalent anxiety disorders among infertile patients. This study aimed to determine the prevalence of GAD and its associated factors among infertile patients in Tehran, Iran. Methods This cross-sectional study included 1146 infertile patients in a referral fertility center in Tehran, Iran between May and October 2017. GAD was measured using the Generalized Anxiety Disorder-7 (GAD-7) scale. The associations between GAD and demographic/fertility characteristics were estimated using simple and multiple logistic regression with odds ratio (OR) and 95% confidence interval (CI). Results The mean total GAD-7 score was 6.61 (SD = 5.32). Using a cut-off value of 10, the prevalence of GAD was 28.3%. In adjusted analysis, female sex (OR = 2.54, 95% CI = 1.88–3.42, P  < 0.001), low educational level (OR = 1.45, 95% CI = 1.08–1.94, P  = 0.012), high infertility duration (OR = 1.05, 95% CI = 1.01–1.09, P  = 0.013), and treatment failure (OR = 1.52, 95% CI = 1.13–2.04, P  = 0.006) were associated with GAD. Conclusions The prevalence of GAD is relatively high in infertile patients. We conclude that all infertile patients should be screened for symptoms of GAD and treated for this disorder as need arises.

Objective Women undergoing assisted reproductive technology treatment, are often anxious and depressed because of their fertility problem and the uncertainties of the treatment with which they have to deal. On the other hand, recent studies have shown that the effects of psychological distress on the IVF treatment outcome is unclear. This study aimed to examine the effects of anxiety, depression, and stress symptoms before IVF treatment on the clinical pregnancy rate, controlling for known confounders. Results In total, 142 women undergoing IVF treatment participated in this prospective study. The clinical pregnancy rate was 26.8% in this study. Controlling for age, infertility duration, and cause of infertility, there were no relationship between IVF outcome and anxiety (relative risk (RR) = 1.00; 95% CI 0.91–1.09), depression (RR = 0.96; 95% CI 0.88–1.05), and stress (RR = 1.01; 95% CI 0.96–1.07) symptoms. High woman’s age and women with both cause of infertility were independent predictors of IVF clinical pregnancy rate. In sum, we found that anxiety, depression, and stress symptoms were not associated with the IVF clinical pregnancy rate.

Background The objective of this systematic review and meta-analyses was to assess the risk of preeclampsia among women who conceived with assisted reproductive technology (ART). Methods We searched the ISI Web of Knowledge, Medline/PubMed, Scopus, and Embase (from inception to May 2017) for English language articles using a list of key words. In addition, reference lists from identified studies and relevant review articles were also searched. Data extraction was performed by two authors, and the study quality was assessed using the Newcastle–Ottawa Scale. Random-effects model meta-analysis was applied to pool the relative risks (RR) across studies. Results A total of 48 studies (5 case-control studies and 43 cohort studies) were included in this meta-analysis. The Cochran Q test and I 2 statistics revealed substantial heterogeneity (Q = 26,313.92, d.f. = 47, p  < 0.001 and I 2  = 99.8%). Meta-analysis showed a significant increase in preeclampsia in women who conceived by ART compared with those who conceived spontaneously (RR = 1.71, 95% CI = 1.11–2.62, p  = 0.015). Conclusions The findings of this systematic review indicate that the use of ART treatment is associated with a 1.71-fold increase in preeclampsia.

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.