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"n Normal 0 false false false EN-US X-NONE AR-SA MicrosoftInternetExplorer4 /* Style Definitions */ table.MsoNormalTable {mso-style-name:"Table Normal"; mso-tstyle-rowband-size:0; mso-tstyle-colband-size:0; mso-style-noshow:yes; mso-style-priority:99; mso-style-qformat:yes; mso-style-parent:""; mso-padding-alt:0in 5.4pt 0in 5.4pt; mso-para-margin:0in; mso-para-margin-bottom:.0001pt; mso-pagination:widow-orphan; font-size:11.0pt; font-family:"Calibri","sans-serif"; mso-ascii-font-family:Calibri; mso-ascii-theme-font:minor-latin; mso-fareast-font-family:"Times New Roman"; mso-fareast-theme-font:minor-fareast; mso-hansi-font-family:Calibri; mso-hansi-theme-font:minor-latin; mso-bidi-font-family:Arial; mso-bidi-theme-font:minor-bidi;} Background: Osteoarthritis is the most common form of arthritis in the world. This study presents the evidence on the prevalence of symptomatic hand osteoarthritis in urban community. To add to the evidence on the prevalence of symptomatic hand osteoarthritis in urban community."n"nMethods: Inhabitants (age≥15 yrs) in 22 randomly selected districts (Tehran) participated in a Community-Oriented Program for Control of Rheumatic Diseases (COPCORD) evaluating major rheumatic disorders, including osteoarthritis. Eventually, 10, 291 inhabitants completed a Questionnaire (75% response-rate). Trained interviewers asked participants whether they had had any pain, swelling, tenderness, or morning stiffness in the right/ left hand during previous seven days. Participants underwent a complete physical examination if they had any musculoskeletal complaint or extra-articular manifestation of rheumatic disease. Osteoarthritis was defined as presence of palpable nodules (Heberden's/ Bouchard's nodes, CMC1's squaring), pain, tenderness, swelling, or a combination of them on that joint (DIP-PIP-MCP-CMC1). Clinical hand osteoarthritis was positive if at least one joint showed osteoarthritis. "n"nResults: Symptomatic hand osteoarthritis was present in 2.8%(CI; 2.3-3.4) (52.6% female, mean age; 37.1±16.3). Prevalence was higher in females (4.3% vs. 1.3%, p=0.000) and increased with age (0.1% in people 70, p=0.000). The most common signs in the DIP, PIP and CMC1 joints were bony enlargement, followed by tenderness and pain on movement. "n"nConclusions: our study confirms the evidence of high prevalence of symptomatic hand osteoarthritis in an urban community. The prevalence, pattern of hand joints involvement and relationship with age and sex in this study performed in an Eastern community resemble those in Westerners, which calls for further attention by appropriate services.

"nBackground: To evaluate the association between age, sex, BMI, waist/hip ratio, smoking, religion, ethnicity, education and knee osteoarthritis. "nMethods: Eligible subjects were randomly included from participants of Tehran COPCORD study, of whom 480 subjects with knee osteoarthritis were compared to 490 subjects without (case-control study). Using a questionnaire developed by COPCORD group (Asia & Oceania), we enquired about the risk factors of knee osteoarthritis i.e. age, sex, BMI, Waist/Hip ratio, religion, ethnicity, education and smoking. Knee osteoarthritis was defined using ACR criteria. Each knee was unit of analysis using GEE technique to evaluate these associations. "nResults: Age (OR; 1.096; CI95%: 1.091-1.1; P: 0.00) and sex (OR; 2.85; CI95%: 2.49-3.28; P: 0.00) showed significant association with knee osteoarthritis. Overweight (OR; 1.81; CI95%: 1.28-2.55; P: 0.00) and obesity (OR; 3.3; CI95%: 2.34-4.66; P: 0.00) both showed higher risk for knee osteoarthritis. The association between waist/hip ratio and knee osteoarthritis showed an OR of 5.28, CI95%: 0.89-31.44; P: 0.07. However, this association was only borderline significant. People with different religion or ethnicity and smokers had no extra risks for knee osteoarthritis. Higher education is a protective factor for knee osteoarthritis as people who had university education compared to people with no/primary education showed a lower risk for knee osteoarthritis (OR; 0.54; CI95%: 0.38-0.78; P: 0.00). "nConclusions: Our study confirmed that elderly, females, overweight and obese people are at higher risk to develop knee osteoarthritis as found in western societies. Higher education is a protective factor against knee osteoarthritis. Ethnicity, religion and smoking showed no extra risk of knee osteoarthritis.

Objective(s): The main purpose of the study was the development of a self-assessment tool for research organizations to enable them to assess knowledge translation in their own settings.Methods: The development of this self-assessment tool is done based on a narrative review and subsequent focus group discussions, to design a knowledge translation model that would provide a conceptual framework for linking the different components of a knowledge translation cycle, which reported previously.Repeatability of the self-assessment domains was assessed in the 21 participants using intraclass correlation coefficient (ICC). Each participant filled the form twice within a two-week interval. The internal consistency for each domain was estimated in the 45 study subjects using Cronbach’s alpha.Results: This self-assessment tool is an instrument that allows stakeholders in a research organization to review their own knowledge translation activities. This tool consists of 50 statements in four domains; 1- The research question, 2- Knowledge production, 3- Knowledge transfer and 4- Promoting the use of evidence. The respective ICCs and Cronbach’s alpha for the four domains were 0.94 and 0.79 for the research question, 0.87 and 0.70 for knowledge production, 0.90 and 0.86 for knowledge transfer, 0.48 and 0.27 for promoting the use of evidence.Conclusion: This self-assessment tool is a way of listing the wide range of variables that affect knowledge translation at organizational level. Although the tool is intended for use by a group of people and not by individuals, it is not a survey instrument and its results should not be interpreted quantitatively. Therefore, this self-assessment tool can be useful for assessing the knowledge translation activities of each research organization, thereby identifying its shortcomings and seeking ways to improve them.

Today land-use change is one of the most important challenges facing the agricultural sector, and the conservation of agricultural lands is an important goal worldwide. So, this study aimed to design a model for the protection of agricultural lands in Hamedan province using structural equation modeling (SEM). The statistical population was composed of all farmers in the province (N = 117,571) out of whom 384 people were sampled based on Krejcie and Morgan's table with a multi-stage sampling method. The main research instrument was a researcher-made questionnaire for collecting and analyzing the required data. The reliability of the questionnaire was confirmed by Cronbach's alpha and its validity by a group of experts in the fields of agricultural extension and sustainable development. Results revealed that six strategies including social, economic, access, regional, policy, and technical-agricultural strategies should be considered for the conservation of agricultural lands. The result of the Friedman test showed that technical-agricultural strategies are the top priority for the conservation of agricultural lands. The use of SEM showed that the model has a good fit and there is a good correlation between the six factors and the related indicators. Increasing the economic efficiency of the agricultural sector prepares agriculture for competing with other economic sectors, and increasing the economic power of farmers is the most important factor in protecting agricultural lands. [ABSTRACT FROM AUTHOR]

Integrated writing tasks require the writers to juxtapose the concepts and ideas presented in the given reading and/or listening based prompts in their essays. The issue of integrated writing has received considerable attention in recent years. This study explores the essential strategies employed and preferred by EFL learners in dealing with integrated writing tasks. This study relied on Yang and Plakans' (2012) framework on the use of and relationship among discourse synthesis, self-regulatory and test-wiseness strategies. The Strategy Inventory for Integrated Writing (SIIW), adopted from Yang and Plakans (2012), was the major instrument of data collection in the study. A total of 101 EFL learners undertaking a TOEFL iBT preparation course completed the questionnaire in the last session of the course to ensure their familiarity with integrated writing tasks and explore the strategies used by the participants in doing the tasks. Based on Friedman rank test results, it was found that discourse synthesis was the most preferred strategy, while self-regulatory and test-wiseness strategies were favoured less by the participants. The Pearson Correlation Coefficient demonstrated a significant relationship between self-regulatory and testwiseness strategies, but discourse synthesis strategy showed no significant relationship with the other two strategies. This study calls for accommodating the processes underlying integrated writing construct and raising further awareness on the use of integrated strategies in teaching and testing EFL/ESL writing skill. [ABSTRACT FROM AUTHOR]

Equal-channel angular pressing (ECAP) combined with the Conform process provides a solution for the continuous production of ultrafine-grained materials. In the present study finite element method was executed to investigate the effects of die channel angle and friction on the strain homogeneity and the required torque in ECAPConform process. Deformation behavior of Al 6061 wires was analyzed using the ABAQUS/Explicit software. A number of Finite element simulations considering different channel angles (90°, 100° and 110°) and various friction conditions of 0.2, 0.3 and 0.4 were surveyed. The results revealed two distinct trends in which by increasing the channel angle among 90° to 110°, the amount of induced plastic strain into the initial wire is reduced about 40% and required processing torque is decreased about 50%. In addition, more homogeneity was observed in higher angle values. The results regarding to equivalent strain, obtained from FE analyses, show a good agreement with previous studies. Eventually, the FE results indicate that plastic strains and required torque for a successful processing increased about 8% and 12% when the friction coefficient raises between (0.2-0.4). [ABSTRACT FROM AUTHOR]

Background and Aim: In the past few years publications in the field of medicine have increased considerably in Iran and knowledge production in this country shows the greatest growth rate in the entire Middle East region. Considering the fact that 12% of all faculty members in the health and medical sector in Iran are employed by Tehran University of Medical Sciences, this university is regarded as the country's leading research institution. This study is focused on the behavior of the researchers in this university in terms of collaboration in research and factors that affect such behavior. Materials and Methods: Our samples included all research projects in Tehran University of Medical Sciences that had obtained grants from inside and outside the university in 2004, had registered their contracts, had been finished by the time of this study (October 2006- March 2007) and whose final reports had been submitted (315 projects). The data collecting forms were filled for 301 files. The researcher's questionnaire was sent to the principal investigators of the projects and eventually 208 questionnaires were collected. We used the SPSS software package and the usual statistical tests (frequency ratio, chi square, analysis of variance and multiple linear regression with the Enter method) to assess the factors affecting the participation scores of individuals. Based on the data gathered from the forms, we used the UNICET software to analyze the 'cooperation network' between project directors and their principal co-workers and the relationship between different sections of the university. Results: Only in 2.2 percent of the projects whose contracts were arranged in 1383 there has been some cooperation between the project director/principal coworkers and non-academic organizations. This ratio reaches 2.5% for collaboration with other universities. Among all projects, health system research programs show a better status of collaboration. Linear regression analysis showed that another important factor affecting the participation score is the "method for choosing the research topic". University-affiliated research centers only collaborate with the Schools of Medicine and Public Health, while in the School of Rehabilitation and Physical Medicine all projects are defined within the School's own structure, with virtually no collaboration with any other sections of the university. Conclusion: The present study showed that research programs in this university include little collaboration with organizations outside the university or with other universities. Part of this is related to the current structure of the research sector in the country, which is largely financed by the government with hardly any participation by the private sector. Current potentials within the University make it possible to embark upon joint research initiatives with other academic institutions. As the possible effect of intervention on health system research has been shown, policies can be implemented to promote effective collaborative research at university and national level. [ABSTRACT FROM AUTHOR]

Abstract Background Mass media play an important role in keeping people up-to-date with the latest health news. This study aims at investigating the quality of health news disseminated in the print media, its course of production and factors affecting its quality. Methods In the quantitative section of the study, 410 health-related news items, published during a six-month span in the Iranian public press, underwent content analysis. In the qualitative section, focus group discussions were held with journalists, editors-in-chief and news gatekeepers. Results The quantitative phase showed that 18% of the news articles were not fit for dissemination in public. The qualitative phase illustrated that multiple factors at various levels affect the quality of news, namely poor knowledge, inadequate motivations and context-related barriers. Conclusions The quality of health news reporting is not desirable. Educational interventions need to be carried out to raise awareness among researchers and journalists. Also, certain steps should be taken to increase motivations and strengthen infrastructures, including designing guidelines and monitoring news.

Abstract Background The knowledge translation self-assessment tool for research institutes (SATORI) was designed to assess the status of knowledge translation in research institutes. The objective was, to identify the weaknesses and strengths of knowledge translation in research centres and faculties associated with Tehran University of Medical Sciences (TUMS). Methods The tool, consisting of 50 statements in four main domains, was used in 20 TUMS-affiliated research centres and departments after its reliability was established. It was completed in a group discussion by the members of the research council, researchers and research users' representatives from each centre and/or department. Results The mean score obtained in the four domains of 'The question of research', 'Knowledge production', 'Knowledge transfer' and 'Promoting the use of evidence' were 2.26, 2.92, 2 and 1.89 (out of 5) respectively. Nine out of 12 interventional priorities with the lowest quartile score were related to knowledge transfer resources and strategies, whereas eight of them were in the highest quartile and related to 'The question of research' and 'Knowledge production'. Conclusions The self-assessment tool identifies the gaps in capacity and infrastructure of knowledge translation support within research organizations. Assessment of research institutes using SATORI pointed out that strengthening knowledge translation through provision of financial support for knowledge translation activities, creating supportive and facilitating infrastructures, and facilitating interactions between researchers and target audiences to exchange questions and research findings are among the priorities of research centres and/or departments.

Abstract Background In 1985 medical schools were integrated into the Ministry of Health, and the Ministry of Health and Medical Education was created in Iran. Under this infrastructure education, research and service provision are unified, and it is expected that collaboration between researchers and decision makers become easier in such an integrated context. The question here is how the researchers behavior in the biggest medical university of the country towards collaboration is, i.e. how much do decision makers participate in different stages of research? Which factors affect it? Methodology The samples under study were all Tehran University of Medical Sciences (TUMS) completed research projects that had gotten grants in 2004 and were over by the time this study was done. Two questionnaires were designed for this study: i) the research checklist which was filled for 301 projects, ii) the researcher's questionnaire, which was sent to principle investigators, 208 of which were collected. Multiple linear regression analysis was used for evaluating the potential factors affecting individuals 'collaboration score'. Results Only 2.2 percent of TUMS' projects initiated in 2004 have had collaboration as a joint PI or co-investigator from non-academic organizations. The principle investigators mean collaboration score was 2.09, where 6 was the total score. So the collaboration score obtained was 35%. The 'type of research' had significant association with the collaboration score which is shown in the linear regression; collaboration was seen more in clinical (p = 0.007) and health system researches (p = 0.001) as compared to basic research. Conclusion The present study shows that not many individuals collaborated as co-investigators from outside the university. This finding shows that research policy makers need to introduce interventions in this field. And assessment of barriers to collaboration and its facilitating factors should be considered in order to make it actually happen.

Abstract Background In the past two decades, scientific publications in Iran have considerably increased their medical science content, and the number of articles published in ISI journals has doubled between 1997 and 2001. The aim of the present study was to determine how frequently knowledge transfer strategies were applied in Tehran University of Medical Sciences (TUMS). We were also interested in studying the determining factors leading to the type of strategy selected. Methodology All TUMS research projects that had received grants from inside and outside the university in 2004, and were completed by the end of 2006, were included in the study. In total, 301 projects were examined, and data on each of the projects were collected by the research team using a standardized questionnaire. The projects' principle investigators filled out a second questionnaire. In all, 208 questionnaires were collected. Results Researchers stated being more engaged in the passive strategies of knowledge transfer, especially those publishing in peer-reviewed journals. The mean score for the researchers' performance in passive and active strategies were 22% and 9% of the total score, respectively. Linear regression analysis showed that the passive strategy score decreased with the increase in the number of years working as a professional (p = 0.01) and personal interest as the only reason for choosing the research topic (p = 0.01). Regarding the active strategies of knowledge transfer, health system research studies significantly raised the score (p = 0.02) and 'executive responsibility' significantly lowered it (p = 0.03). Conclusion As a study carried out in a Middle Eastern developing country, we see that, like many other universities in the world, many academicians still do not give priority to active strategies of knowledge transfer. Therefore, if 'linking knowledge to action' is necessary, it may also be necessary to introduce considerable changes in academic procedures and encouragement policies (e.g., employment and promotion criteria of academic members).

Background and Ams: Despite the evident public health impact, the extent and patterns of alcohol use in the Eastern Mediterranean countries remain understudied. The latest estimation for the last 12-month use of alcohol in the region was 2.9% in 2016 by the World Health Organization. We reviewed the main indicators for alcohol consumption in the region since 2010., Methods: We systematically searched on-line databases until September 2023, together with other global and regional sources for studies on the adult general population (aged ≥ 15 years) and young general populations (aged < 18 years) and studies on the treatment-seeking individuals with substance use in Eastern Mediterranean countries. Studies were included from 22 countries: Afghanistan, Bahrain, Djibouti, Egypt, Iran, Iraq, Jordan, Kuwait, Lebanon, Libya, Morocco, Oman, Pakistan, Palestine, Qatar, Saudi Arabia, Somalia, Sudan, Syria, Tunisia, United Arab Emirates and Yemen., Results: A total of 148 were included (n = 95 on the prevalence of alcohol use, n = 46 on the prevalence of alcohol use disorder, regular use and heavy episodic drinking, n = 35 on alcohol use pattern among people who use substances and one report on alcohol per capita consumption, n = 29 had data for more than one category). The pooled prevalence of the last 12-month alcohol use in the adult general population was 9.5% [95% confidence interval (CI) = 6.4-13.7] among males, 2.8% (95% CI = 1.3-5.5\) among females and 6.2% (95% CI = 3.9-9.6) in both sexes in the region, with notable subregional variations. Data on the prevalence of alcohol use disorder and heavy drinking were limited to several countries, with heterogeneous indicators. The pooled estimate of alcohol as the primary substance of use among treatment-seeking people who used substances was 16.9% (95% CI = 8.8-26.9)., Conclusions: More than 30 million adults in the Eastern Mediterranean region used alcohol in the last 12 months, with a prevalence of 6.2%. This is far fewer than the global estimate of 43% of the population aged 15 years and above, but is approximately two times more than the previous estimate (2.9%), reported by the World Health Organization in 2016, which might show an increasing trend., (© 2024 Society for the Study of Addiction.)

Background: The most recent formulation of buprenorphine treatment is extended-release depot injections (BUP-XR) that are administered subcutaneously by health care professionals. This study aimed to observe treatment outcomes of BUP-XR delivered in standard practice during a 96-week follow-up period in a community setting., Methods: This study is an extension of the CoLAB study, a prospective single-arm, multicentre, open label trial (N=100, 7 sites in Australia) among people with opioid dependence who received monthly injections of BUP-XR to evaluate the retention in treatment. Participants were followed for 96 weeks, comprising 48 weeks of the CoLAB study followed by a 48-week extension., Results: Of 100 participants at baseline, 47 were retained on BUP-XR at 96 weeks. The median time retained on monthly depot was 90 weeks. Heroin use (adjusted OR=0.19, P=0.012) in the month prior to baseline was associated with lower odds of retention on BUP-XR. Older age at first opioid use (adjusted OR= 1.08, P=0.009) and longer duration in OAT at baseline (adjusted OR= 1.12, P=0.001) were associated with increased retention. Prevalence of past four-weeks opioid use was estimated at 4% at 96 weeks of treatment (prevalence 0.04, 95%CI: 0.00-0.11) compared to 15% at baseline. Quality of life and medication treatment satisfaction improved over time for those retained in treatment., Conclusion: This is one of the few studies to describe long term (96 week) retention in treatment with BUP-XR in a community setting. It displayed retention rates with 47% of participants completing 96 weeks of treatment with BUP-XR. Patient reported outcomes suggest improvements in client wellbeing., Funding: Indivior., Competing Interests: Declaration of competing interest This study was supported by an Externally Sponsored Collaborative Research grant from Indivior PLC (MF, BL, LD, NL, AD, RA, SN, GD, J Grebely). In the past three years, MF and LD have received funding from Indivior for studies of new opioid medications in Australia. J Grebely reports grants and personal fees from Abbvie, bioLytical, Camurus, Cepheid, Hologic, Indivior, and Gilead Sciences. NL has received reimbursement for participation in Advisory Boards for Mundipharma, Indivior and Chiesi Pharmaceuticals; he received funding from Camurus for a company-sponsored trial of BUP-XR. RA has received untied educational grants from Reckitt Benckiser and an untied educational grant from Mundipharma. AJD reports grants from Braeburn/Camurus AB, to conduct clinical studies with buprenorphine products and travel support to Hunter New England Local Health District, which employs AJD. GJD has received research grant funding from Gilead and Abbvie. MM has served as an honorary on advisory boards for Pfizer and AbbVie. MC, JS, MB, JG, and EZ have no conflicts to declare. SN has received untied research funding from Seqirus to conduct research on prescription opioid related harms., (Crown Copyright © 2024. Published by Elsevier B.V. All rights reserved.)

This study aims to investigate the wellbeing of Iranian English as Foreign Language (EFL) teachers across their career stages in terms of teaching experience. In this regard, the study categorized teachers into three groups based on their experience: novice, experienced, and highly experienced. Using a quantitative and cross-sectional survey design, this study employed a validated scale to measure psychological wellbeing, positive perception about self and life, goal setting and time management, and positive relationships among teachers. Using a convenience sampling procedure, 182 teachers participated in the study, representing varying age ranges, teaching experience, and employment status. The data was collected through an online survey within a month and underwent descriptive and inferential statistical analyses using SPSS software. The results revealed significant differences in the wellbeing of language teachers across experience groups. More specifically, novice teachers scored lower in various wellbeing dimensions than experienced and highly experienced teachers. These findings emphasize the importance of considering career stages when investigating teachers' professional wellbeing. The findings also contribute to a deeper understanding of the relationship between teaching experience and wellbeing, with implications for supporting the EFL teachers' wellbeing and informing educational policies and practices. The study results are discussed, and the related implications are provided for running professional development courses to enhance teachers' wellbeing., Competing Interests: The authors declare that the research was conducted in the absence of any commercial or financial relationships that could be construed as a potential conflict of interest., (Copyright © 2024 Ashegh Navaie, Gholami and Mohammadnia.)

Background: The extent of illicit drug use among university students necessitates effective preventive programs. To identify and assess the effectiveness of university-based interventions in preventing or reducing illicit drug use., Methods: The MEDLINE (PubMed), SCOPUS, ISI (Web of Science), and other sources were searched according to the Cochrane Collaboration method. RCTs, CRTs and non- RCTs evaluating university-based interventions designed to prevent illicit drug use were reviewed. Data were extracted independently by two reviewers. The quality of the publications was assessed. Interventions were classified by type, provider, duration, and theoretical background., Results: Of 6652 papers, 11 studies met the eligibility criteria that were conducted between 1987 and 2020. The effectiveness of interventions was different. Substantial heterogeneity among the studies prevented the integration of results for estimating summaries., Conclusion: Despite the importance of the subject, there is a paucity of studies about specific educational programs for illicit drug use, indicating the necessity of further research in other countries., (Copyright© 2024 Ghani et al. Published by Tehran University of Medical Sciences.)

Background: Considerable disease burden is attributed to injecting drug use (IDU). This regional systematic review and meta-analysis aimed to assess the prevalence of IDU and the characteristics of people who inject drugs in the 22 countries of the WHO Eastern Mediterranean region., Methods: We conducted a systematic review and meta-analysis on the prevalence of IDU, estimation of the population size of people who inject drugs, the characteristics of people who inject drugs, commonly injected drugs, the prevalence of HIV, hepatitis C virus, and hepatitis B virus in people who inject drugs, and opioid agonist treatment and needle and syringe programme services. We searched PubMed, Web of Science, Scopus, Embase, and the Index Medicus for the Eastern Mediterranean Region for documents published between Jan 1, 2010, and April 17, 2022, with no language restrictions. We also searched government reports, civil society information, and UN websites and databases for grey literature published between Jan 1, 2010, and April 17, 2022. Documents were eligible if they reported or estimated an indicator of interest, or reported enough data to permit calculation of the indicator. We extracted data from the eligible documents and calculated national and regional estimates., Findings: We identified 38 283 documents and included 201 documents in the systematic review. A total of 115 documents were included for the four outcomes for which meta-analyses were performed. The number of people who inject drugs was estimated as 864 597 (95% CI 641 909-1 205 255), amounting to a prevalence of 20·0 per 10 000 adults (95% CI 14·9-27·9) in the region. Among people who inject drugs, the prevalence of HIV was estimated as 19·22% (95% CI 12·86-26·36), hepatitis C virus as 44·82% (29·32-61·16), and hepatitis B virus as 2·66% (0·84-7·26). Countries varied greatly regarding the variables of interest and the availability of relevant data. Nine countries provided needle and syringe programme services and seven countries provided opioid agonist treatment services, mostly with very low, low, or unclear coverage., Interpretation: The prevalence of IDU in the Eastern Mediterranean region is lower than the global mean, particularly among women. The HIV infection rate is higher than the global mean, and the hepatitis C virus infection rate is lower than the global mean. Harm-reduction services are underdeveloped. Data collection on IDU and provision of services need improvement in the region., Funding: World Health Organization., Translations: For the Arabic, Farsi and French translations of the abstract see Supplementary Materials section., Competing Interests: Declaration of interests We declare no competing interests., (Copyright © 2023 The Author(s). Published by Elsevier Ltd. This is an Open Access article under the CC BY 4.0 license. Published by Elsevier Ltd.. All rights reserved.)

Background: Drug use, especially injecting drug use, is associated with a higher risk of tuberculosis (TB). This study aimed to systematically review the prevalence of TB among people who use drugs (PWUD) in Iran., Methods: A systematic search was conducted in international and national databases. All studies that provided data on the prevalence of TB among PWUD based on screening tests and diagnosis from 1990 up to August 2019 were assessed. Meta-analysis was performed on the prevalence of active TB among people who inject drugs (PWID)., Findings: Overall, nine studies were included. The studies were carried out from 1994 to 2012 in seven out of the 31 provinces of Iran. Seven studies provided data on the prevalence of TB diagnosis among 1087 PWID. The pooled prevalence of TB diagnosis was 10.1% (95% CI: 4.5, 15.8) in studies carried out in hospitals and 0.54% (95% CI: 0.04, 1.04) in other settings., Conclusion: The present review suggests an approximately 40 times higher prevalence of TB among PWID compared to the general population. However, most of the included studies were conducted on a subpopulation of drug users, and caution should be exercised when generalizing the findings., Competing Interests: Competing Interests None., (© 2023 Kerman University of Medical Sciences.)

Drug use is an increasing global public health concern. We reviewed the prevalence and patterns of drug use, drug use disorders, and the extent of treatment services in 21 countries and one territory in the Eastern Mediterranean region from 2010 to 2022. Online databases were systematically searched on April 17, 2022, along with other sources for grey literature. The extracted data were analysed and used for synthesis at the country, subregional, and regional levels. The prevalence of drug use is higher in the Eastern Mediterranean region than global estimates, with cannabis, opium, khat, and tramadol among the main drugs used in the region. Data on the prevalence of drug use disorders were scarce and heterogeneous. Treatment facilities for drug use disorders are available in most countries, but opioid agonist treatment exists in only seven countries. There is a need to expand evidence-based and cost-effective care. Limited data exist, especially regarding drug use disorders, treatment coverage, and drug use among women and young people., Competing Interests: Declaration of interests We declare no competing interests., (Copyright © 2023 Elsevier Ltd. All rights reserved.)

Background: Frequent cannabis use is associated with adverse health-related outcomes. This study followed up individuals who used cannabis to assess their use and adverse event status., Methods: The eligible individuals, recruited in the Iranian Mental Health Survey (IranMHS), were contacted via telephone calls six years after the index interview. The frequency of cannabis use and the occurrence of selected adverse events were recorded. The baseline status was extracted from the index survey. If any individual was inaccessible, his/her vital status was assessed., Findings: Of the 50 eligible individuals (all male), two had died. Moreover, from among 25 reached participants, 19 reported abstinence from cannabis in the past year, and 18 reported at least one adverse event in the past six years. Violence and imprisonment were the most common events reported., Conclusion: Six years after the index interview, most of the participants abstained from cannabis. Besides, adverse events were common, emphasizing the need for further investigations on larger samples of cannabis users., Competing Interests: Competing Interests The authors have no conflict of interest., (© 2023 Kerman University of Medical Sciences.)

Background: There is a high prevalence of substance use disorders, especially among men, in Iran and is associated with a high burden on families. We aimed to systematically review the association between illicit drug use and spouse and child abuse in Iran., Method: Comprehensive terms were used to search three international databases (ISI, Medline, and Scopus) and a national database of Scientific Information Database up to September 2019. The retrieved citations were screened based on the eligibility criteria and then data were extracted, and the risk of bias was assessed by two independent investigators. Data were analyzed using random-effects model to estimate pooled odds ratios ( OR s) and the heterogeneity of studies., Results: The search yielded 18 articles that met the inclusion criteria. Illicit substance use in husbands was associated with increased odds of current violence ( OR = 3.50; 95% CI [2.09, 5.86]), current physical violence ( OR = 5.41; 95% CI [3.50, 8.35]), current psychological violence ( OR = 6.20; 95% CI [3.74, 10.30]), and current sexual violence ( OR = 7.23; 95% CI [4.06, 12.87]) against spouse. In studies on child abuse, the odds of current physical child abuse by parents who used an illicit substance was 3.88 times (95% CI [1.50, 10.01]) higher than parents who did not use any illicit substance., Conclusion: The results of the current study showed that illicit substance use is associated with an increased risk of spouse and child abuse. This is an important social and health consequence of drug use and should be addressed in all drug control plans.

Alzheimer's disease (AD) is progressive neurodegeneration known as the most common cause of dementia, and it is the sixth leading cause of death in older people. Given the promising data on the additive effect of combination therapy with donepezil (Aricept), an acetylcholinesterase inhibitor (AChEI), and regarding the similar neuronal mechanisms through which donepezil (DON) and environmental enrichment (EE) exert their enhancing effects on cognition; we asked whether simultaneous treatment with two paradigms in amyloid-beta-induced AD rats may lead to greater protection against the cognitive impairments than either treatment individually. The experimental groups consisted of Alz, sham-operated, Alz + DON, Alz + EE, and Alz + DON + EE. AD was induced by intrahippocampal injection of amyloid-beta (1-42, 6 μg), and DON was orally administrated (4 mg/kg) for 21 days. Environmental enrichment consisted of housing animals in large cages (50 × 50 × 50 cm) containing a running wheel and differently shaped objects for 21 days. Spatial learning and memory were assessed in the Morris water maze (MWM) and Real-time PCR was performed to assess the expression of brain-derived neurotrophic factor (BDNF) and M1 muscarinic acetylcholine receptor (AchM1R) within the hippocampus. Spatial memory was impaired in Alz animals, and while neither pretreatment with DON nor EE alone could significantly restore spatial memory scores in Alz rats, combination therapy was effective. BDNF expression was suppressed in Alz rats and pretreatment with DON plus EE could increase it to the saline levels. The data suggest that a cholinesterase inhibitor and cognitive stimulation can be used effectively in combination to protect cognitive loss in an AD rat model. This additive protective effect may be in part due to the augmented influence of this combination on BDNF levels and cholinergic neuronal system within the hippocampus., Competing Interests: The authors declare that they have no known competing financial interests or personal relationships that could have appeared to influence the work reported in this paper., (© 2022 The Authors.)

The present study aimed to assess the influence of ciprofloxacin (CIP) against the doxorubicin (DOX)-resistant androgen-independent prostate cancer DU145 cells. The DOX-resistant DU145 (DU145/DOX20) cells were established by exposing DU145 cells to the increasing concentrations of DOX. The antiproliferative effect of CIP was examined through employing MTT, colony formation, and 3D culture assays. DU145/DOX20 cells exhibited a twofold higher IC 50 value for DOX, an increased ABCB1 transporter activity, and some morphological changes accompanied by a decrease in spheroid size, adhesive and migration potential compared to DU145 cells. CIP (5 and 25 µg mL -1 ) resulted in a higher reduction in the viability of DU145/DOX20 cells than in DU145 cells. DU145/DOX20 cells were more resistant to CIP in 3D culture compared to the 2D one. No spheroid formation was observed for DU145/DOX20 cells treated with DOX and CIP combination. CIP and DOX, alone or in combination, significantly reduced the growth of DU145 spheroids. CIP in combination with 20 nM DOX prevented the colony formation of DU145 cells. The clonogenicity of DU145/DOX20 cells could not be estimated due to their low adhesive potential. CIP alone caused a significant reduction in the migration of DU145 cells and resulted in a more severe decrease in the wound closure ability of DOX-exposed ones. We identified that CIP enhanced DOX sensitivity in DU145 and DU145/DOX20 cells. This study suggested the co-delivery of low concentrations of CIP and DOX may be a promising strategy in treating the DOX-resistant and -sensitive hormone-refractory prostate cancer., (© 2022. The Author(s), under exclusive licence to Springer Science+Business Media, LLC, part of Springer Nature.)

Background and Aims: There is a paucity of data on outcomes of opioid use disorder (OUD) from low- and middle-income countries. We aimed to investigate the mortality as well as negative social and health outcomes in a 6-year follow-up study of a cohort of individuals with opioid use, including those with OUD, in Iran., Design and Setting: Participants with opioid use initially interviewed in late 2011 in the Iranian National Mental Health Survey (IranMHS)-a household survey of 15-64-year-old population-were followed-up in early 2018., Participants: All respondents (n = 236) who had reported use of any opioids at least five times during the 12-month period prior to the index interview were included in the study., Measurements: Composite International Diagnostic Interview (CIDI) version 2.1 was used for assessment of opioid use and OUD at baseline. Vital status in the follow-up was ascertained through contact with participants/informants, primarily via telephone calls and also through the death registration systems. Weighted incidence rates of negative consequences of opioid use (e.g. incarceration, suicide attempts, violent behavior) were estimated for those who were interviewed., Findings: Seven (3.3%) of the 236 participants with opioid use including four (3.1%) of the 136 with OUD had died by the time of the follow-up interview, resulting in death rates of 0.49 [95% confidence interval (CI) = 0.21-1.38] and 0.53 (95% CI = 0.16-2.62) per 100 person-years, respectively. Overall, 35.0% of participants with opioid use and 44.0% of those with OUD among the 145 individuals interviewed at follow-up experienced non-fatal serious adverse outcomes., Conclusions: In Iran, opioid use and opioid use disorder are associated with increased mortality and other adverse outcomes., (© 2022 Society for the Study of Addiction.)

Issues: This systematic review aimed to provide an updated estimate on the prevalence of human immunodeficiency virus (HIV) infection among non-injecting people who use drugs (PWUD) and the various subgroups and the odds of HIV infection in the injecting compared to non-injecting PWUD., Approach: A comprehensive search of international, regional and national databases was performed from January 2005 to May 2020. We conducted backward citation tracking of the included studies and contacted experts for unpublished studies. Studies providing HIV prevalence among non-injecting PWUD were included. Data were also drawn from a previous systematic review, covering 10 years from 1998 to 2007, and was added to the new database. The HIV prevalence was pooled for non-injecting PWUD and other subgroups using the random-effects model., Key Findings: Seventeen studies with a total sample of 9912 non-injecting PWUD were found. The prevalence of HIV infection was 1.9% (95% confidence interval 0.9, 3.1) for 2007 and afterward (nine studies). It was not significantly different from the estimate for the years before 2007 (0.5%; 95% confidence interval 0.0, 2.0; eight studies). No significant difference was found among gender subgroups. The overall estimate of odds of HIV infection among injecting PWUD was 5.7 (95% confidence interval 3.2, 10.0) times higher than non-injecting PWUD., Implications and Conclusions: The HIV prevalence among the non-injecting PWUD was higher than the general population in Iran. Targeting non-injection PWUD by preventive measures such as harm reduction, drug and psychoeducation, and surveillance seem to be crucial in reducing HIV prevalence in this group., (© 2021 Australasian Professional Society on Alcohol and other Drugs.)

Background: Several factors may influence the validity of self-report. In this study, we aimed to assess the validity of self-reported drug use compared to urine testing among treatment-seeking patients with opioid use disorder (OUD)., Methods: This cross-sectional study recruited 293 patients with OUD, referred to the Iranian National Center for Addiction Studies (INCAS) clinic, from November 2015 to June 2017. The study compared self-reported opioid use in the past 72 h with the results of urinalysis, using immunoassay technique. We estimated sensitivity, negative predictive value, percent agreement, positive percent agreement, and Cohen's kappa statistics for those with OUD., Results: The sensitivity of self-reported opioid use was 85.9%. Percent agreement, positive percent agreement, and Cohen's Kappa statistics between self-reported opioid use and urine testing for morphine in the first month were 88.5%, 78.1%, and 77.0, respectively. Multilevel logistic regression showed that longer treatment duration (OR = 1.21, 95%CI: 1.07-1.37, p-value = 0.002) was significantly associated with the agreement of self-reported opioid use with urine testing., Conclusion: Self-report can be used as a reliable method for monitoring treatment adherence combined with random urine tests., (Copyright © 2021 Elsevier Inc. All rights reserved.)

Background: There has been a marked growth in methadone maintenance treatment (MMT) in Iran in the past two decades with positive health outcomes. We conducted a systematic review of studies on the prevalence of non-prescribed methadone use, methadone use disorder, and methadone-related poisoning and mortality in Iran., Methods: We searched International and Iranian databases up to May 2020 and contacted relevant experts. The pooled proportions were estimated through random-effects model. Methadone-related adverse outcomes were evaluated over time., Results: Sixty-five studies were included. The pooled estimates of non-prescribed methadone use in the last 12-month were 2.7% (95%CI: 0.9-5.4) and 0.1% (95%CI: 0.03-0.2) in the male and female general population, respectively. Among people who use drugs, 8.4% reported daily non-prescribed use in 2018. Four heterogeneous studies in drug treatment centers reported the existence of treatment-seeking for methadone use disorder. Methadone was responsible for 10.4% (95%CI: 4.5-18.3) of cases of acute poisoning in adults and 16.0% (95%CI: 9.3-24.1) in children. Methadone was reported as a cause of death in 53.5% of substance-related deaths referred to the Legal Medicine Organization while being the only cause in 35.8% of all cases., Conclusion: Non-prescribed use of methadone in the general population is much less than opiates and some other available prescription opioids, like tramadol. However, notwithstanding the large and successful MMT program in Iran, increasing trends in methadone-related poisoning and deaths pose serious public health concerns. There is an urgent need to explore these fatal and non-fatal poisoning cases and implement policies to curb the harms associated with methadone use., Competing Interests: Declarations of Interest None., (Copyright © 2021 Elsevier B.V. All rights reserved.)

Background: The weight of evidence suggests that sleep is essential for the processes of memory consolidation and sleep deprivation (SD) impairs the retention of long-term memory in both humans and experimental animals, which is associated with oxidative stress damage within the brain. Green tea polyphenols have revealed carcinogenic, antioxidant, anti-, and anti-mutagenic properties. We aimed to investigate the possible protective effect of green tea extract (GTE) and its main active catechin, epigallocatechin-3-gallate (EGCG), on post-training total sleep deprivation (TSD) -induced spatial memory deficits and oxidative stress profile in the hippocampus of the rat., Methods: Male rats were treated with saline, GTE (100 and 200 mg/kg/day), and EGCG (50 mg/kg/day) intraperitoneally for 21 days and then trained in Morris water maze (MWM) in a single day protocol. Immediately after the end of MWM training, animals were sleep deprived for 6 h by the gentle handling method, and then evaluated for spatial memory. Hippocampal levels of malondialdehyde, (MDA), and thiol was assessed as oxidant and antioxidant markers., Results: Spatial memory was impaired in the TSD group and GTE at the dose of 200 mg/kg/day as well as EGCG at the dose of 50 mg/kg/day could reverse the impairment to the saline-treated levels. Despite the unchanged MDA levels, hippocampal total thiol was significantly decreased after TSD and EGCG increased it to the basal levels., Conclusion: In conclusion, green tea and its main catechin, EGCG, could prevent memory impairments during 6 h of TSD; probably through normalizing the antioxidant thiol defense system which was impaired during TSD., Competing Interests: The authors declare no conflict of interest., (© 2021 The Author(s).)

Objectives: Cognitive decline is one of the most prevalent health problems and is associated with increased healthcare utilization and economic burden. Physical and cognitive training both have positive effects on cognition but have been less applied in combination. We hypothesized that simultaneous cognitive-physical components would yield greater cognitive benefits than single-domain interventions in rats., Methods: A total of 40 male Wistar rats were divided into four treatment groups: the control, enriched environment (EE), exercise (EX), and EE + EX. Animals in EE groups housed in the large cages (50 × 50 × 50 cm) contained differently shaped objects for 3 weeks. EX animals were forced to run on a treadmill once daily for 3 consecutive weeks. Morris water maze test was used for the assessment of spatial learning and memory. Real-time PCR was performed to assess the expression of nestin, and Sox2 in the hippocampus., Results: EX and EE animals separately did not show a significantly enhanced function in spatial memory in comparison with the control group. When animals were treated with EE and EX simultaneously, they exhibited significantly superior performance in spatial memory than control, EX, or EE groups separately. The hippocampal expression of Sox2 was significantly higher in EE + EX group than in the control, EX, and EE alone., Conclusions: These results may have clinical implications for behavioral interventions in conditions with cognitive deficiencies., (Copyright © 2021 Wolters Kluwer Health, Inc. All rights reserved.)

Introduction: Buprenorphine maintenance treatment (BMT) is widely used in Iran, and its use is growing continuously. We reviewed studies on buprenorphine use, non-prescribed use, use disorder and treatment-seeking for it, buprenorphine-associated poisoning, and mortality in Iran in the current systematic review., Methods: An Iranian database (Scientific Information Database; SID) and three International electronic databases (PubMed, Scopus, and Web of Science) were searched for publications up to August 2020 for the relevant data. Opportunistic methods (Contact with experts and backward citation tracking) were also used for this purpose. Identified records were screened for eligibility criteria, and data of included studies were extracted. For context, the trend of BMT in the country was also examined., Results: Ten studies were found on the prevalence of non-prescribed buprenorphine use, seven were on the regular use and use disorder, and two studies on buprenorphine poisoning. The last 12-month prevalence of non-prescribed use was lower than 0.5 % in the general population, university, and high school students. The indicator was 2.5 % among persons who use drugs in a 2018 national study. The proportion of buprenorphine poisoning was 4.9 % among all illicit substance poisoning cases admitted to a hospital. The proportion of buprenorphine poisoning cases among all acute pediatric drug poisoning cases increased from 1.2 % to 2.5 % in a 3-year study., Conclusion: Despite the expansion of BMT in Iran in the last decade, the adverse health consequences associated with buprenorphine are infrequent, when compared to other opioids used in Iran, suggesting the safety of BMT for future expansion., (Copyright © 2021 Elsevier B.V. All rights reserved.)

Background and Aims: Cannabis is the most widely used illicit substance globally. In this systematic review, we examined the prevalence and trends of cannabis use and cannabis use disorder in Iran., Methods: We searched International and Iranian databases up to March 2021. Pooled prevalence of use among sex subgroups of the general population, university and high school students, combined youth groups, and high-risk groups was estimated through random-effects model. Trends of various use indicators and national seizures were examined., Results: Ninety studies were included. The prevalence estimates of last 12-month cannabis use were 1.3% (95%CI: 0.1-3.6) and 0.2% (95%CI: 0.1-0.3) among the male and female Iranian general population, respectively. The prevalence of cannabis use disorder among general population in national studies rose from 0% in 2001 to 0.5% in 2011. In the 2016-2020 period, the pooled prevalence estimates of last 12-month cannabis use were 4.9% (95% CI: 3.4-6.7) and 0.3% (95% CI: 0.0-1.3) among males and females of "combined youth groups", respectively. The linear trend of last 12-month cannabis use among males of "combined youth groups" and among female university students increased significantly from 2000 to 2020., Conclusions: Prevalence of cannabis use in Iran is low compared to many countries. However, there is strong evidence of an increase in cannabis use among the youth and some evidence for an increase in cannabis use disorder., Competing Interests: The authors have declared that no competing interests exist.