Iranian Journal of Public Health
Volume:51 Issue: 7, Jul 2022

Physician dual practices (PDP) is a term used to describe physicians who combine work in public and private health-care sector. This study aimed to find evidence of PDP worldwide, investigate its reasons and consequences, and compare high-income (HIC) versus low and middle-income countries (LMIC).

In this literature review, the search for PDP evidence was conducted in the English language. PubMed and Google were searched for relevant publications up to Sep 30, 2020.

Of 195 countries, PDP-reports were found in 157 countries (81%). No significant difference in prevalence of PDP was found between HIC (77%) and LMIC (82%). Most common reason for working in private sector was low government salaries in public hospitals (55%). This was more reported in LMIC (65%) than HIC (30%; P<0.001). Most common reason for working in public sector was patient recruitment for private practice (25%). This was more reported in HIC (45%) than LMIC (16%; P<0.001). PDP were described as detrimental to public health-sector in 58% of country-reports. Most common adverse consequence was lower quality-of-care in public hospitals (27%). LMIC with PDP-reports had more severe corruption (P<0.001), lower current health-expenditure (P<0.001), and higher out-of-pocket expenditure (P<0.001) than HIC. Scale of PDP was common in more LMIC (92%) than HIC (60%; P<0.001). Government policies to address PDP did not differ significantly between HIC and LMIC.

PDP were present in most HIC and LMIC. In majority of reports a detrimental effect of PDP on public health-care was described.

The policies of response to and prevention of heat waves in France in 2003 and in South Korea in 2018 were compared and reviewed to see how public health policy orientation was being expanded in connection with urban and social policies. The statistics of the patients with heat illness and resulted death in France in 2003 and South Korea in 2018 were analyzed. The results and limitations of the French and Korean responses to heat waves were compared and discussed. The heat wave in France in 2003 caused an excess death of 14,802. The 2018 heat wave in South Korea resulted in 4,526 cases of heat illness and 48 deaths. France’s National Heat wave Plan established in 2004 introduced the warning system and strengthened support for the vulnerable. The heat wave in South Korea in 2018 revealed the success and limitations of the national measures that have been gradually implemented since the mid-2000s. Both France and South Korea are making efforts in preventing heat illness and managing health risk through the warning systems, providing public and social support for the vulnerable, and expanding urban infrastructure. Paris puts priority on the long-term prevention of heat wave, in the wider context of climate change response, while Seoul shows a relatively strong point in immediate infrastructural expansion. In order to respond to the climate crisis and the following health risk, public health policies need to be contrived with deeper connection with urban social policies for sustainable development.

With growing healthcare (HC) expenditures and limited funding, policymakers need to find new ways to provide healthcare that is affordable and fair. There are many methods for paying specialists, and the three basic payment methods include fee-for-service (FFS), capitation, and salary. This review focuses on identifying published articles related to the different methods used for paying specialists for their service and further highlights their advantages and disadvantages.

The research was designed and carried out in line with the "Preferred Reporting Items for Systematic Reviews and Meta-Analysis" (PRISMA) checklist. Five databases were used in the literature search ie: Scopus, Web of Science, Ovid Medline, EBSCOhost, and PubMed in 2020. The search term used revolved around physician, payment method and specialist behavior.

Databases were searched electronically using EndNote X9.2, wherein 588 related studies of literature were included. Meanwhile, it went down to 546 related studies after the title and abstract screening was conducted in order to eliminate duplicates. In total, 24 studies were then left to be reviewed in full text; finally, 12 studies were integrated into this analysis after a description of the entire text of the studies.

Payment methods can affect physician practice behaviors and the quality of healthcare. The combination of payment methods may, however, combine the benefits of simple payment methods. Where there is not adequate mixing of methods, bonus-for-performance programs may encourage the provision of targeted services. Thus, before a new medical policy is implemented, policymakers must define and empirically examine the positive and negative impacts.

The present systematic review and meta-analysis aimed to systematically evaluate a risk prediction model for the readmission of patients with CHF.

The search was carried out in databases including PubMed, Embase, EBSCO, Web of Science, Cochrane Library and also domestic databases including Chinese Biomedical Literature Database, Chinese Academic Journal Full Text Database, Wanfang Database, and Vipu Chinese Journal Service Platform. All the original studies published by July 2021. Two researchers identified previous studies involving readmission risk prediction models that met our selection criteria. The quality of the included studies was evaluated based on the CHARMS checklist, and the prediction models were systematically evaluated.

Of the overall 4787 studies retrieved, nine studies—two prospective, seven retrospective—met our selection criteria. The area under the receiver operating characteristic curve exceeded 0.63 (0.63-0.80) for all the studies. The most common predictors in the model were B-type natriuretic peptide (BNP) or N-terminal pro-brain BNP (Odds Ratio 4.35; 95% confidence interval (CI) 2.53–7.49; P<0.001), renal insufficiency (Odds Ratio 1.60; 95%CI 1.24–2.08; P<0.001), comorbidities, and a history of hospitalization.

The use of non-parametric statistical methods and assessment of large samples of electronic data improve the predictive abilities of the risk assessment models. It is necessary to calibrate and verify such models and promote the combined use of parametric and non-parametric methods to establish precise predictive models for clinical use.

SARS-COV-2 (COVID-19) the virus that caused an epidemic of sever acute respiratory syndrome is what the world has been dealing with since Dec 2019. As the pandemic continues different variants that emerge during mutations have become the latest concern, with notable examples detected in South Africa, Brazil, and UK. Variants are complicated and each one is a collection of several mutations, all of which have the potential to change the virus in unexpected ways. Studying variants is imperative as they can lead the epidemic to the increase of population immunity. In the present study, we reviewed key mutations and concerning variants according to the WHO tracking Sars-Cov-2 program. Databases were searched through Feb to Mar 2022. Overall, 477 studies were extracted from databases, among them 165 studies included mutations, 239 included COVID-19 variants and 43 included both mutations and variants. At the final step of data screening 24 studies associated to mutations, 31 studies with the highlighted information on COVID-19 variants and 31 studies related to both mutations and variants were extracted for this review article. In conclusion, analyses of the genomic sequence of SARS-CoV-2 indicate that structural proteins are key molecules in the assembly of virus while NSPs can have different biochemical properties and possibly cellular functions.

We aimed to review the systematic economic evaluation of denosumab versus than alternative drugs and oral bisphosphonates of postmenopausal osteoporosis in women and help health system policy makers for prioritizing and optimally allocate limited health resources.

We examined the databases of PubMed, Web of Science, Embase, Scopus, Cochrane Library, ProQuest. Strategy search was designed based on keywords. Inclusion criteria were: studies that conducted economic evaluation denosumab compared to oral bisphosphonates for the treatment of osteoporosis in postmenopausal women. Cost-effectiveness studies conducted using decision analysis models based on the economic evaluation approach; studies with available full-text papers; and studies written in English and published between 2010 and 2020. After selecting articles based on inclusion and exclusion criteria, data were extracted and the results were summarized. The quality of the articles was evaluated using the CHEERS checklist.

Among 214 initial studies, 8 studies met the inclusion criteria. Most studies focused on the cost-effectiveness of denosumab compared with oral bisphosphonates for the treatment of osteoporosis. The study agreed interval ranged from 3 months to 5 years. The costs investigated in the studies were direct medical costs. In most studies, the use of denosumab significantly prevented fractures.

Denosumab is generally more cost-effective than alternative drugs and oral bisphosphonates (alendronate, risedronate, strontium ranelate, ibandronate, and untreated).

Syphilis is one of the most important sexually transmitted infections (STI) and a public health problem, but the literature describing the true burden of syphilis is limited. In Iran, there are no accurate results on the prevalence of syphilis. This study aimed to conduct a systematic review and meta-analysis of syphilis in Iran.

Following PRISMA guidelines, we conducted a systematic review and meta-analysis of studies published on the prevalence of Syphilis in Iran. We systematically reviewed the literature to identify eligible studies as of Sep 13, 2020, in international and national databases. The results are presented in the form of forest plots and tables. Pooled prevalence and 95% confidence intervals were calculated using Der Simonian and Laird method. Perform subgroup analysis through population, gender, city, and diagnostic tests to assess the source of heterogeneity.

We reviewed 1,229 papers and reports, and extracted data from 15 eligible records. The prevalence of combined syphilis in Iran is 0.1% (95% confidence interval [95% CI] 0.1-0.1%). The prevalence of syphilis was 0.4% in men (95% confidence interval [95% CI] -0.3, 1%) and 0.6% in women (95% confidence interval [95% CI] (0.1, 1%)). The cumulative meta-analysis showed a decline in the prevalence of syphilis between the years 1999 and 2015.

The prevalence of syphilis in Iran is low. In the past few decades, the prevalence of syphilis across the country has declined. Syphilis infection is a small burden that needs to be revised in the implementation of high-cost screening programs.

Application of technology in virtual or remote cardiac rehabilitation programs can resolve the challenge of accessing healthcare services and reduce access level inequalities. This study aimed to evaluate the effect of technology on different clinical outcomes in cardiac rehabilitation programs used for cardiovascular (CVD) patients.

Preferred Reporting Items for Systematic Reviews and Meta-Analyses and a comprehensive evidence map of overview was used. Two researchers searched electronic databases such as Science Direct, Medline / PubMed, Web of Science, Scopus, ProQuest, Google Scholar and Cochrane library at the time of publication until Mar 21, 2021.

Of 51 reviews published, most of them have reported that the virtual or remote cardiac rehabilitation had a positive effect on most outcomes compared to usual care, and the difference in the type of comparison group and the high heterogeneity in reviews with inconsistent results are due to different technologies used in the interventions, follow-up duration, the type of heart disease, tools, and reporting methods, the quality of the reviews, and the quality of the primary studies included in the reviews.

Two important factors before choosing the remote cardiac rehabilitation technology include the complexity of technology and the level of satisfaction and acceptability of the interventions among participants. The simplicity of the interventions increases the acceptability level, and the more complex design and advanced monitoring level during the interventions and the need for specific equipment affect cost saving, so it is important to consider the above cases while choosing the type of technology.

Y-STR, DIP-STR, and SNP-STR are useful alternatives for testing the low quantity of DNA in solving the challenges in interpreting forensic genetic profiling. In an unbalanced mixed DNA, partial DNA is often not detected due to the effect of masking by the dominant DNA. Therefore, in such cases interpretation of the results is limited. Furthermore, profiling of these specimens cannot be performed using conventional forensic genetic methods. Biomarkers including Y-STR, DIP-STR and SNP-STR perform well in detecting DNA contributes in the mixed sample. In the present research, the performance of each is evaluated separately.

We aimed to identify indicators affecting firefighters’ resilience through a systematic review.

International electronic databases, including Web of Science, Medline through PubMed, Scopus, Cochrane Library, and Google Scholar, were searched on Dec 23, 2018. The search strategy was developed using main words, including firefighter, resilience, and indicators. Then, the indicators related to firefighters’ resilience were extracted and analyzed using a qualitative synthesis method.

Overall, 7178 unique documents were identified by searching different databases. Then, by screening the title and abstract, 7104 articles were excluded, and only 74 full text papers were critically studied. Finally, 31 full text articles were selected for the analysis. Quality appraisal of included studies done by modified STROBE (Strengthening the Reporting of Observational Studies in Epidemiology) tool. Moreover, 186 indicators and criteria were extracted from the included studies and classified into 6 domains and 15 categories.

This study suggests six main domains, including physical health, physical fitness, mental health, life style, job-related competencies, and demographic status, to categorize different indicators of firefighters’ resilience. Building resilience in firefighters requires all these domains to be considered in the assessment, planning, and evaluation processes.

The purpose of this cross-sectional study was to assess the effects of health risk behaviors on the daily Internet usage of Korean high school students.

The data of 19,830 high school students who responded to the Korea Youth Risk Behavior Web-based Survey were analyzed from June to July 2018.

The mean daily Internet usage of high school students was 193.3±125.7 minutes. There were differences in daily Internet usage according to body mass index, grade level, school type, academic achievement, economic status, physical activity, number of physical education classes attended, safety accidents, and safety education (p<.05). Daily Internet usage also differed according to health risk behaviors, including smoking (t=8.32), alcohol consumption (t=9.36), drug use (t=4.51), and risky sexual behaviors (t=5.94). The daily Internet usage of students significantly increased in the absence of physical activity and with health risk behaviors such as smoking, alcohol consumption, drug use, and risky sexual behaviors.

It is necessary to develop an intervention program and provide education on increasing physical activity and reducing health risk behaviors for the proper management of health and Internet usage in adolescents.

Microscopy is a resource used in endodontics as an aid in the study of pulp and periapical pathologies; it has allowed Endodontics to become more accurate, less invasive and has enabled greater chances of success in treatment. We aimed to map the scientific production on “microscopy” and “endodontics” in the databases, the ISI Web of Knowledge/Web of Science tm.

This bibliometric survey was conducted using ISI Web of Knowledge/Web of Science database, in the time frame between the years 1945 and 2016, the first being found in 1981.

Overall, 287 articles were identified. These articles are published in 63 different journals and were written by 1145 authors who have links to 336 institutions, located in 46 countries. To achieve these articles, 5,668 references were used, with an average of approximately 20 references per article. In the national literature the number of studies on the subject is broad compared to the international literature.

The bibliometric review showed the potential of microscopy in clinical practice, the continuity of the investigation, in view of the need to expand knowledge on the topic that remains relevant.

Inferiority feeling leads to the negative reactions such as depression and anxiety among community youth, social exclusion also forms their negative emotions due to the alienation of social relations. We aimed to explore the effect of social exclusion on the inferiority feeling of community youth.

In December 2021, a total of 681 community youth from Wuhan in China were selected as the research object. They were evaluated using a social exclusion scale, inferiority scale, and rumination scale, respectively. The mediating effect of rumination on the relationship between social exclusion and inferiority of community youth was tested by using structural equation model and bootstrap test.

The scores of social exclusion, inferiority complex, and rumination were positively correlated (P<0.05). The mediation effect test showed that the mediation hypothesis model had a relatively good fitting index. Social exclusion was a positive predictor of rumination, and rumination was a positive predictor of inferiority. Ruminant thinking had a significant partial mediating effect in the relationship between social exclusion and inferiority feeling, the indirect effect was 0.078, the direct effect was 0.04, the total effect was 0.118, and the ratio of direct effect to indirect effect was approximately 1:2. Therefore, social exclusion exerted the influence on inferiority through rumination.

Social exclusion positively affects the inferiority feeling of community youth through the mediating effect of rumination thinking. The health prevention of community youth’s inferiority feeling should not only prevent the negative impact of social exclusion but also strengthen the cultivation of rumination thinking.

The increased participation in sports has led to an increased number of sports-related injuries. We aimed to identify the incidence of sports-related injuries by life course and the risk factors for sports-related extremity fractures.

We analyzed data of patients with sports-related extremity injuries from Emergency Department-based national injury surveillance systems, obtained from Jan 2013 to Dec 2016. A multiple logistic regression analysis was performed to identify risk factors of extremity fracture by life course after adjusting for sex, injury season, injury time, injury place, sports type, and mechanism of injury.

Overall, 23385 patients met our inclusion criteria. Soccer injuries were most common in the 5–14-year (32.4%), 15–24-year (43.0%), and 25–44-year groups (32.7%), and hiking injuries were most common in the 45–64-year (23.6%) and ≥65-year age groups (38.0%). The upper extremity injury and fracture rates were higher in the younger-age group; nevertheless, the injury and fracture rates of the lower extremities increased with increasing age. Moreover, the rate of hip and thigh injuries and fractures increased significantly in the ≥65-year age group.

The incidence and severity of sports injuries are affected by player factors and the sports activity itself. The age of players is a major determinant that affects their medical and physiologic conditions and the sport of choice. The strategy for preventing sports injuries should be structured based on age.

One of the important molecular pathways in breast cancer is the PTEN-PI3K-AKT pathway. Any change in the activity of the PTEN gene can alter the PI3K-AKT pathway. Moreover, there are subsets of genes and pathways their expression changes by post-transcriptional regulations. For instance, gene regulation alters by non-coding RNAs such as micro-RNAs as post-transcriptional regulators that prevent the expression of the target transcript. Therefore, it is essential to assess the related alterations in micro-RNA expression patterns to find out the possible causes of conversions in related transcripts and pathways such as the PTEN-PI3K-AKT pathway in breast cancer.

To determine the expression level of miR-181a and miR-30d in 30 breast tumor samples and 30 adjacent normal samples, the RNA extraction, and cDNA synthesis was performed by RiboEx (GeneAll, Korea). Finally, the Real-Time PCR method was used for quantitative analysis of the expression levels of these miRNAs. all the experimental part of the project in done at Islamic Azad University in 2017.

After analyzing comparisons in the expression level of miR-181a and miR-30d in tumor and normal tissues, there was a significant increase in the expression level of miR-181a in tumor samples compared with normal samples. Moreover, the expression level of miR-30d in tumor samples reported a significant decrease in comparison with normal samples (P<0.05).

Upregulation of miR-181a may affect the transcription of the PTEN gene resulting in the cell progress to cancer. The Downregulation of miR-30d may also lead to cancer cell growth, due to a reduction in the affecting on the CREB gene transcript.

We aimed to verify the effect of betting propensity as perceived by golf participants on exercise addiction, as well as the moderating effects of gender, average number of strokes, weekly exercise frequency, and monthly rounding frequency on these relationships.

The study included 377 individuals who utilized golf driving ranges and courses in Seoul and Gyeonggi Province (Korea) selected using the non-probability sampling method. The data collected thereafter were subjected to confirmatory factor analysis, reliability analysis, descriptive statistical analysis, correlation analysis, stepwise regression analysis, and moderating effect analysis using Jamovi version 2.2.2 (University of Newcastle, Sydney, Australia). When the moderating effect was statistically significant, simple linear regression analysis was used to verify the results.

Betting propensity had a positive effect on all sub-factors related to exercise addiction (withdrawal symptoms, conflict, attachment, tolerance, and obsessive–compulsive disorder) (P<0.05). Only the average number of stroke exerted a significant moderating effect on these relationships (P<0.05). Specifically, greater perceived betting propensity was associated with a greater propensity for exercise addiction, and this phenomenon was more pronounced among those with a low average number of strokes.

The current results suggest that greater perceived betting propensity is associated with an increased risk of exercise addiction among golf participants, especially those who are relatively more skilled. These results highlight the need to emphasize participating for the enjoyment of golf and psychological satisfaction without promoting practices that can lead to exercise addiction, such as betting golf.

We aimed to investigate the pathogen infection in vaginal secretions of women in Linyi area.

From October 2016 to September 2018, a total of 49,343 vaginal secretion specimens from women who attended Women and Children's Health Care Hospital of Linyi District, Shandong Province, China were used to detect the cleanliness, Candida, clue cells, Trichomonas, etc. with Ultra-high power microscopy.

Among the 49343 patients, 6377 had vaginal cleanliness of degree Ⅰ～Ⅱ, the detection rate was 37.89%; 10455 cases of Ⅲ～Ⅳ degree, the detection rate was 62.11%; 13193 cases of simple vaginal pathogen infection, the detection rate was 26.74%. Among them, 9256 cases of vaginal Candida (VVC) had a detection rate of 18.76%; 3176 cases of Bacterial vaginosis (BV) had a detection rate of 6.44%; and 761 cases of Trichomonas infection (TV) had a detection rate 1.54%; 899 cases of mixed infection. The detection rate was 1.82% and the detection rate of each pathogen in the 18-30 year old group was the highest. The detection rates of VVC, BV, TV and MVI were 10.80%, 3.25%, 0.65%, 1.00%, repsectively.

The incidence of VVC women with vaginitis in Linyi was the highest, and the incidence was mainly between 18 and 40 years old. The infection rate of VVC, BV and MVI pathogens was the highest in summer, and the infection rate of TV was the highest in autumn.

This study was conducted to examine the effectiveness of a community-based primary care program focused on hypertension and diabetes in Korea.

We selected patients and doctors who participated in the community-based primary care program as study subjects from Aug 2015 to Jan 2016. Patients and physicians completed a survey, and medical records were reviewed to obtain information regarding clinical variables. Change in the baseline recognition of diseases, motivation for changing health behavior, medical services utilization, doctor-patient relationship were assessed after participation in the program.

Both patients and physicians indicated there was improvement in recognition of disease, motivation for changing health behavior, medical services utilization, and doctor-patient relationship (All of recognition scores were above the median point). Patient health behavior such as exercise, smoking, drinking and diet and clinical variables (blood pressure and blood glucose and cholesterol level) also showed significant improvement.

The community-based primary care program was found to be helpful in improving hypertension and diabetes patients’ overall outcomes and their healthcare providers’ behavior.

We aimed to examine the quality of life of children who engage in regular physical activities.

We conducted a cross-sectional study with intersectional 301 children (182 boys and 119 girls) involved in regular sporting activities and the control group of 100 children (67 boys and 33 girls), not involved in extracurricular sports. Children in both groups were from 8 to 13 years, attending elementary school, and without any associated illnesses. The quality of life (QOL) was assessed using the Quality of Life questionnaire Kidscreen-27 version for parents. For comparison of groups, we used χ2 test, and for comparison of mean values among groups we used ANOVA test.

More boys were engaged in sport than girls and the choice of sport is gender-dependent (P<0.01). Boys preferred collective sports, while girls were more oriented towards individual sports (P<0.01). A significant statistical difference in the mean values of the socializing dimension was given to children who trained football (P=0.04) and basketball (P=0.02). In children engaged in volleyball, a statistical difference in the mean values was observed in all dimensions of the questionnaire. In children who trained water polo, a statistically significant difference in the mean values for dimensions of health (P<0.01), mood (P<0.01) and friendship (P=0.01) was seen.

KIDSCREEN scores were significantly higher in the examined group than in the control group, with a statistically significant difference between scores for different sports. Children involved in regular extra-curricular physical activities had better QOL.

We explored the methylation modification in miR-205 promoter during the pathological changes of Parkinson's disease (PD) and its regulation on Leucine-Rich Repeat Kinase 2 (LRRK2), clarified the important role of methylation in miR-205 promoter region in PD, explained the role of miR-205 methylation in the pathological changes of PD, and looked for new targets for PD.

Methylation of miR-205 promoter regions was determined by cell genomic DNA, with model bisulfite treatment, and the transcription of miR-205 and LRRK2 in PD model cells was determined by qPCR, and LRRK2 expression was determined by Western blot. The binding sites of miRNAs in the non-coding region of LRRK2 were analyzed by the targetscan database, and miR-205 expression in 293T cells was controlled. The correlation between miR-205 expression and LRRK2 was determined to clarify the regulation mode of miR-205 on LRRK2.

The level of miR-205 were reduced in the SH-SY5Y Parkinson model cells, and its promoter region was highly methylated, while LRRK2 expression decreased in the model cells after 5-Azacytidine inhibition of methylation in miR-205 promoter region. According to the target scan database analysis, LRRK2 non-coding region is a miR-205-specific binding site. After further miR-205 overexpression in 293T cells, the transcription and translation of LRRK2 decreased in cells, which increased after the treatment of miR-205 inhibitor on LRRK2.

The methylation modification of miR-205 promoter region could regulate the transcription and translation of LRRK2 in dopaminergic neurons, so miR-205 methylation regulation can serve as a new potential target for the treatment of PD.

Crohn's disease (CD) has a chronic course, which its recurrence varies widely among different patients. In this study we prospectively analyzed blood samples of 19 CD patients. Alteration in transcription of inflammatory and anti-inflammatory cytokines was analyzed compared with household members after three month follow up.

CD patients were diagnosed based on clinical symptoms, endoscopic and histopathologic characteristics. Nineteen CD patients and their households were evaluated from Jun 2019 to Feb 2021 at Tehran university hospitals. CD activity score, biological, clinical and demographic data of the patients were recorded at two time point intervals. Bacteriological tests were done using aerobic and anaerobic blood cultures. To investigate transcriptional alterations, peripheral blood mononuclear cells (PBMCs) were isolated using Ficol centrifugation method and relative quantitative real-time PCR was done to determine the expression level of IFN-γ, TNF-α, IL10, and FOXP3 cytokines.

Our results showed a correlation between fecal calprotectin level (709.8 ± 554.6), C-reactive protein concentration (18.1 ± 15.9), and erythrocyte sedimentation rate (30.4 ± 17.9) with disease activity (Flare/remission). IL10 and Foxp3 anti-inflammatory gene’s expression were significantly (P = 0.003 for IL10 and P = 0.008 Foxp3) higher during the flare and remission in patients with active disease respectively. Bacteriological examination showed infection with Streptococcus spp. and Clostridium spp. in two CD patients during flares, which was correlated with upregulation and down-regulation of IL10, TNF-α, IFN-γ and FOXP3 proteins, respectively.

Occurrence of bacteremia, and higher amount of CAP, CRP and ESR are correlated with higher level of transcription for inflammatory cytokines, which could effectively reflect the disease activity. Raise in FoxP3 transcription proposed change in Treg sub-population in PBMC or its activity during the CD remission phase.

Nogo-A, a myelin-associated inhibitor for neurite outgrowth, has important role in visual system development. Trans-differentiation ability of human amniotic fluid (HAF) on human retinal pigment epithelial cells (hRPEs) towards neural progenitor cells has been observed in several studies. We aimed to investigate the expression of NOGO-A gene and its receptors as a marker of neural differentiation in HAF-treated hRPE cells.

hRPE cells were cultivated and immune characterized via RPE65 and cytokeratin 8/18 protein markers. Also, the cytotoxicity effect of 30% HAF on hRPE cells was evaluated using ELISA cell death assay. Finally, expression of NOGO-A and its receptors, RTN4R and LINGO1 was evaluated in the cells treated with HAF in comparison with FBS-treated cells using quantitative real-time PCR.

Harvested cells showed immunoreactivity for cytokeratin 8/18 and RPE65, confirming the hRPE cell identity. Besides, HAF had no cytotoxic effect on hRPE cells compared with FBS-treated cells. Results showed that NOGO-A and its receptors were expressed in cultured hRPE cells. Besides, comparative gene expression analysis revealed significant increased expression of the investigated genes in HAF-treated hRPE cells compared to FBS-treated cells.

Augmented expression of NOGO-A and its receptors can support neural differentiation of hRPE when the cells are treated with HAF. Our outcomes provide more evidences on the trans-differentiation ability of HAF on hRPE cells into neural progenitors and retinal neural cells, but further studies are needed to elucidate the exact mechanism.

An effective strategy for primary prevention of Cardiovascular Disease (CVD) is accurate diagnosis and the subsequent evidence-based treatment for high-risk people. This study aimed to estimate the 10-year risk of CVD and its related factors.

The baseline data of 8138 participants of the Pars cohort study (PCS) in southern Iran were used. Risk scores were calculated using the updated 2019 WHO CVD risk prediction charts. The scores were determined based on age, gender, current smoking status, systolic blood pressure (SBP), diabetes status, and total serum cholesterol. Demographic and socioeconomic variables, physical activity, and anthropometric indices were measured and analyzed. Multivariable logistic regression was applied to estimate the adjusted odds ratio (aOR) and 95% confidence intervals (CI).

The mean (SD) age of the participants was 51.65 (9.06) years, and 53.44% were female. The 10-year CVD risk for 23.89% of participants was ≥10%. The prevalence of hypertension, diabetes, hypercholesterolemia, and smoking was 12.79%, 8.38%, 12.80%, and 14.41%, respectively. Having abdominal obesity, having low or moderate physical activity, being illiterate or having diplomas or lower degrees, and being in the third quartile of the wealth score group were associated with a higher 10-year risk of CVD.

About one-fourth of the participants had moderate risk and higher. Due to the relatively high prevalence of CVD risk factors in the middle-aged population, the modifiable risk factors are recommended to be adjusted. Additionally, individual- and community-based educational policies are essential to create a healthy lifestyle.