فهرست مطالب roya kelishadi

This study aims to determine the concentrations of urinary Cadmium (Cd) in a group of pregnant women and its association with neonatal anthropometric Indices.

This cross‑sectional study was conducted, involving 136 pregnant women in the first trimester, as a sub‑study of the PERSIAN Birth Cohort in Isfahan in 2020. Cadmium exposure was assessed by urinary concentrations using atomic absorption spectrometry. The socioeconomic information and neonatal anthropometric indices were documented. Data were analyzed using the SPSS statistical package. P < 0.05 was considered statistically significant.

The results of the study revealed the mean (standard deviation) concentration of urinary Cd (U‑Cd) was 0.16 (0.11) µg/L. The U‑Cd by Creatinine ranged from 0.06 to 1.24 with a median (interquartile range) of 0.18 (0.12–0.26) (µg/g creatinine). The mean age of participants was 30.26 (4.92) years. Although the association between birth height and birth head circumference was inverse, it was not significant after using the adjusted model for confounder variables, including maternal anthropometric measurements, maternal body mass index, passive smoking status, and socioeconomic demographic.

The current findings show that maternal Cd exposure was reversely associated with physical growth at birth. Hence, reduction of maternal Cd exposure is essential to improve infant health. Further research is required to investigate the effect of maternal exposure to Cd on adverse health outcomes in long‑term periods considering other cofounders and metal pollutants.

Postpartum depression (PPD) can exert both short‑term and long‑term effects on a child’s health. Offspring born to mothers who suffer from PPD face an elevated susceptibility to encountering psychological disturbances and developmental delays. Moreover, there has been conjecture surrounding a plausible connection between maternal magnesium (Mg) levels and psychiatric manifestations. This study aims to investigate the relationship between maternal Mg levels and PPD and the correlation between PPD and an infant’s growth and neurodevelopment at 6 and 12 months.

This longitudinal study is a sub‑study derived from the “PERSIAN Birth Cohort Study,” encompassing 224 mother–infant pairs randomly enlisted during 2019–2020 in Isfahan. Maternal serum magnesium (Mg) levels were measured at 38 weeks of gestation. PPD was evaluated employing the Edinburgh Postpartum Depression Scale (EPDS) four weeks postpartum. Measurements of birth size were undertaken, adhering to standardized protocols at birth, 6 months, and 12 months. Anthropometric parameters and the Persian version of the validated Ages and Stages Questionnaires (ASQ) were employed to assess infant neurodevelopmental status at 6 and 12 months.

Overall, 22.3% of mothers grappled with PPD. The mean (standard deviation) maternal magnesium levels (Mg) were 1.95 ± 0.23 mg/dL. No statistically significant association was detected between maternal serum magnesium (Mg) levels and the incidence of PPD. Correspondingly, no significant association emerged between PPD and indices of growth. However, a noteworthy distinction materialized in the communication scores of offspring born to depressed and non‑depressed mothers following adjustments for confounding variables at 12 months (β = 1.81; 95% confidence interval: 0.32‑3.30). Furthermore, a substantial regression in communication skills became apparent between 6 and 12 months.

This study failed to establish a significant association between maternal serum magnesium (Mg) levels and PPD. Nevertheless, research lends credence to an inverse correlation between maternal depression and subsequent behavioral difficulties in offspring, such as communication skills. Thus, the imperative nature of screening for PPD should be underscored to facilitate its early detection and intervention, thereby enhancing infant well‑being.

The extensive use of various electronic games and communication devices, particularly among children and adolescents, has raised concerns, particularly during the COVID‑19 pandemic. This study investigated the link between screen time and internalizing disorders, such as anxiety and depression, among individuals aged ≤18 during the global COVID‑19 pandemic.

This systematic review aims to summarize scientific publications from 2019 to early 2022 by searching databases, including the Cochrane Library, PubMed, Web of Science, Scopus, and PsycINFO, to identify suitable studies. In each paper, we searched the following keywords and their synonyms: screen, child, high school, middle school, and psychiatric disorders. The quality of the selected papers was evaluated using a checklist recommended by the National Institutes of Health (NIH) for observational cohort studies.

Out of 986 reports identified, we included 12 papers with 14,483 participants. The study revealed a negative correlation between screen time (TV, computer, video games, and mobile phones) and behavioral outcomes. Smartphones were the most frequently used devices, with video games being more prevalent among older participants for education, communication, and entertainment purposes. The prevalence of depression ranged between 10% and 25%. Furthermore, anxiety and depression were identified as predictors of increased screen usage. Some results displayed variation based on the type of screen exposure, the questionnaires used, and the age of the participants.

The findings imply an indirect association between increased screen time and depression and anxiety. It is crucial to consider limitations on screen time exposure and parental supervision as measures to prevent certain mental disorders.

Previous evidence suggests that exposure to organochlorine pesticides (OCPs) may contribute to the development of type 2 diabetes.

The relationship between OCPs and type 1 diabetes (T1D) in children and adolescents is not well understood. We aimed to explore the association between organochlorine pesticide levels and T1D in this population.

In this case-control study, we included 147 newly diagnosed T1D cases and 147 healthy controls. Spot urine samples were collected from children under 15 years old in both groups to measure organochlorine pesticide levels. We analyzed six OCPs: β-HCH, heptachlor, aldrin, heptachloro epoxy, α-endosulfan, and p,p'-DDD, categorizing them into tertiles. We examined the relationship between urinary OCP levels and T1D, adjusting for age, sex, duration of breastfeeding, Body mass index (BMI), family history of diabetes, and five dietary patterns.

The average urinary concentration of p,p'-DDD was significantly higher in cases than in controls (0.15 (0.07 - 0.3) vs. 0.09 (0.04 - 0.2) μg/g creatinine, P < 0.001). After adjustments for age, sex, breastfeeding duration, BMI, family history of diabetes, and dietary patterns, a significantly positive association was observed between the highest levels of p,p'-DDD, and T1D (odds ratio (OR) = 4.9; 95% confidence interval (CI): 2 - 12.3). Additionally, participants in the middle tertile of urinary β-BHC had a higher OR for diabetes compared to those in the lowest tertile (OR = 2.9; 95% CI: 1.2 - 6.8). No association was found between other OCPs and T1D.

These findings highlight a potential role for p,p'-DDD, and β-BHC in the development of T1D, urging further investigation into the mechanisms of this association and potential preventive strategies in this area.

Obesity is a major public health concern. Since the prevalence of obesity is increasing, exploring the impacts of obesity on the developing musculoskeletal system is important. The aim of this study was to compare postural balance, muscle force, and spinal posture between children and adolescents with and without obesity.

This is a case-control study on 90 children and adolescents with and without obesity (N=45 in each group). Outcome measures will be postural balance, muscle force, and spinal posture. These outcome measures will be compared between groups.

Evaluation of HbA1c level based on the presence or absence of anemia showed that in diabetic group with anemia significantly had a lower level 8.4 (± 1.5) than people without anemia 8.6 (± 1.5) (P= 0.045).

The findings can determine the importance of assessing musculoskeletal health in children and adolescents with obesity.

The present research was conducted to predict mental health based on three factors: nutrition, activity, and leisure time, among students in the adolescent age group, using data mining techniques.

The present analytical study was conducted on 14274 data available in the Caspian 5 database. According to the CRISP-DM method, data mining was done in 6 steps using decision trees, k nearest neighbors, simple Bayesian and random forest techniques in Rapidminer software.

Among the four data mining techniques used to predict the mental health of adolescents based on nutrition, physical activity and leisure time, the random forest technique has the highest accuracy (91.72) and specificity (82.73) and the k-nearest neighbors technique has the highest sensitivity (96.30). In addition, based on random forest techniques, the rule with the highest level of support showed that an adolescent who is in high school, eats breakfast, lunch, and dinner every day, drinks tea and coffee weekly, exercises 2 hours a week at school,also, he has 4 days of physical activity for 30 minutes in the last week, and he goes to school with the service, with 100% confidence has good mental health.

Based on the random forest technique, which has showen the best performance, nutrition has the greatest impact on the mental health of Iranian adolescents. So, it is necessary to think about providing a suitable platform for training parents and adolescents regarding proper nutrition and increasing awareness in the field of adolescent mental health.

Ganoderma lucidum (G. lucidum) is one of the most popular edible mushrooms in the world which has various pharmacological components. Recently, some animal studies have investigated the lipid?lowering effects of G. lucidum and have shown contradictory results. This study aims to systematically review the effects of G. lucidum on lipid parameters in animal studies.

A systematic search was conducted in the Medline database (PubMed), Scopus, Web of Science, Cochrane Library, and Google Scholar up to the end of January 2022. Only animal studies and all eligible randomized controlled trials (RCTs), including cluster RCTs and randomized crossover trials were included. The English language studies that assessed the effects ofG. lucidum on lipid profiles including total cholesterol (TC), triglycerides (TG), low?density lipoprotein cholesterol (LDL?C), high?density lipoprotein cholesterol (HDL?C), and very low?density lipoproteins (VLDL) were selected.

Among 358 studies, 49 articles were included in the systematic review and meta?analysis. G. lucidum consumption was associated with decreased levels of TG (standardized mean difference [SMD] = ?1.52, 95% CI: ?1.79, ?1.24), TC (SMD = ?1.51, 95% CI: ?1.75, ?1.27), LDL?C (SMD = ?2.03, 95% CI: ?2.37, ?1.69) and VLDL (SMD =?1.06, 95% CI: ?1.638, ?0.482). Furthermore, G. lucidum consumption was associated with increased levels of HDL?C (SMD = 1.03, 95% CI: 0.73, 1.33).

G. lucidum has favorable effects on TG, TC, LDL?C,HDL?C, and VLDL. Different doses of G. lucidum have various degrees of effectiveness on lipid profiles.

Acute leukemia is the most common type of malignancy in children, and no major environmental risk factors have been identified relating to its pathogenesis. This study has been conducted with the aim for identifying risk factors associated with this disease.

This study was conducted in 2016–2020 among children aged <15 years residing in Isfahan Province, Iran. Children with newly diagnosed Acute lymphoblastic leukemia, including Acute myeloid leukemia (ALL and AML) were considered a case group. The control group was selected among children hospitalized in orthopedic and surgery wards in the same region. Demographic data, parental occupational exposures and educational level, maternal obstetric history, type of feeding during infancy and parental smoking habits, exposure to pesticides, and hydrocarbons besides dietary habits (using a food frequency questionnaire) were evaluated.

Overall, 497 children (195 cases and 302 controls) completed the survey. In the initial analysis, there was no significant difference between case and control groups about type of milk feeding (P = 0.34) or parental age (P = 0.56); however, an association between mothers’ education and increased risk for ALL was observed (P = 0.02).

The results of this study can be helpful in better understanding the environmental risk factors involved in the incidence of acute leukemia. Future publications based on the analysis of the database created in the present study can lead to recognizing these factors. In addition, evaluating the effect of these factors on treatment outcomes is an important step in reducing the burden of the disease.

There are 2 measures of anogenital distance (AGD) in men and women. AGD has been used as an indicator of fetal androgen dysfunction and an adverse outcome in adulthood. Some studies have shown the association of AGD as a predictor in the diagnosis and prognosis of diseases and disorders.

To systematically summarize the latest evidence for presenting AGD as a new approach for prognosis and early diagnosis of diseases.

A systematic review of the available literature was performed using Medline via PubMed, Scopus, and ISI Web of Knowledge up to July 2021, using search terms "anogenital distance" OR "anogenital index" OR "ano genital distance" OR "ano genital index". Language restrictions were not imposed.

After reviewing the retrieved articles, 47 unique studies were included in this systematic review. Different outcomes, including endometriosis, prostate cancer, polycystic ovary syndrome, pelvic organ prolapse, hypospadias, cryptorchidism, fertility and semen parameters, maternal and birth development, and ovarian and gynecological-related disorders, have been studied in the included evidence. A negative association was observed between AGD and endometriosis and hypospadias and a positive association between AGD and prostate cancer, polycystic ovary syndrome, male fetal gender, and fertility parameters.

Using quantitative indicators such as AGD may be a useful clinical tool for the diagnosis of diseases. Although many studies have shown an association between AGD and diseases, some factors, including different measurement methods, different measurement tools, age, and different definitions of AGD, can be involved in the variation of AGD.

This study aims to assess the zinc deficiency prevalence in Iran during the past two decades and compare it with other countries.

We searched PubMed, Google Scholar, Web of Sciences, Scientific Information Database (SID), and Magiran for English and Persian reports on zinc deficiency prevalence in Iran. The search terms were “zinc”, zinc deficiency”, “low zinc level”, “low zinc concentration”, “prevalence”, “epidemiology”, “status”, “Iran”, “Iranian”, and “Persian”, using Boolean operators ‘AND’ or ‘OR.’ The preferred reporting items for systematic reviews and meta-analysis (PRISMA) checklist were applied during the review. Two authors reviewed the articles independently. We included all articles published from 2001 to 2021 that reported zinc deficiency prevalence based on serum zinc levels (μg/dL) in the Iranian population. We excluded clinical intervention studies and studies on pregnant women, children with stunting or malnutrition, and patients with a particular disease. The effect sizes of prevalence rates were extracted from original studies. Meta-analysis with the random-effects model was used to estimate the pooled prevalence of zinc deficiency. Publication bias was evaluated by Egger’s test and the Funnel plot.

This systematic review and meta-analysis included 20 studies (12 for males, 13 for females, and 18 for both that involved 16138 participants; 8424 males and 9053 females). Using the random effect model, the overall prevalence of zinc deficiency in the general population was 16% (95% CI, 11%-20%), and in males and females, 18.4% (95% CI, 0.12%-0.24%) and 15% (95% CI, 10%-20%), respectively. In subgroup analysis, the prevalence rates of zinc deficiency for 6 years old children and adolescents were 29% and 12%, respectively. 

The overall prevalence of zinc deficiency in the Iranian population was 16%, lower than the 20% set by IZiNCG (the International Zinc Nutrition Consultative Group) to indicate the need for national intervention programs. However, the COVID-19 pandemic and climate changes threaten this fragile margin. Dietary diversification/modifications, supplementation programs, fortification, and bio-fortification can be used to minimize the problem in high-risk populations. Since this study evaluates the adult healthy population of Iran, we should be cautious about generalizing its results on other population groups like children.

Considering the students’ importance in the construction and development of society, analyzing data on students' mental health is essential. However, the growing volume of data requires analysis and management, and at a higher level, the discovery of knowledge, and the use of techniques such as data mining in the health field becomes more apparent.

The research conducted in 1399 is based on the data cleansing of the Caspian 5 questionnaire conducted in Iran from 1393 to 1394. Using purposive sampling, the authors extracted 23 characteristics affecting the mental health of students aged 13 to 18 years in 4 regions: North, South, West, and East Central.  A set of characteristics affecting mental health were extracted for the provined included in each region.

In the southern regions, the consumption of sweets and in the northern regions, the consumption of sausages, hot dogs, pizzas, and hamburgers had the greatest impact on students’ mental health. In the western regions, tea, and coffee, and in the central regions, the average sleep per week had the greatest impact on mental health.

it can be concluded that nutrition is the most important factor affecting mental health although the results showed that in some parts of the country, physical activity and sleep quality can also affect mental health, so direct impact of these parameters should not be ignored.

  The prevalence of congenital anomaly of kidney and urinary tract (CAKUT) and related chronic kidney disease (CKD) may be increased in countries with higher rate of consanguineous marriage. Therefore, we evaluated the prevalence of CKD by biochemical and kidney ultrasound measurements in the firstgrade pupils.

This cross -sectional study was carried on children aged 6 to 7 years. Urine analysis, serum creatinine, urine microalbumin to creatinine ratio and kidney ultrasound have been evaluated for participants.

653 children were recruited to the study. Stage 1 and stage 2 systolic hypertension have been found in 6.5 and 1%, respectively. The percentage of stage 1 and stage 2 diastolic hypertension were 1.3 and 0.3%, respectively. Both weight Z-score and waist Z-score had positive correlation with systolic and diastolic blood pressure. Microalbuminuria (in 2.5%) did not have any correlation with the following factors: hypertension, body mass index, microscopic hematuria, glomerular filtration rate, kidney sonographic abnormalities or kidney parenchymal thickness and family history of kidney transplantation. GFR less than 90 mL/ min /1.73 m2 has been detected in 1.8% of the students. Only 1.7% had urine RBC more than 5 in each high-power field (hpf). Approximately 1.5% had anatomical abnormality of kidney and urinary tract (hydronephrosis or hydroureter).

  Considering the higher prevalence of elevated blood pressure and microalbuminuria in Iranian children, a CKD screening program based on evaluating microalbuminuria and blood pressure measurement is needed. However, irrespective of high prevalence of consanguineous marriage in Iran, using kidney ultrasound as a screening tool has not been recommended.

The first need of any society is to have a healthy life that can be achieved through preventive education. Despite providing training in the prevention of risk factors for noncommunicable diseases in the country’s educational programs, we are witnessing an increase in the incidence of these diseases. We aimed to summarize the views of experts in the field of health and education on improving the effectiveness of these trainings.

This study was conducted with a qualitative approach and conventional content analysis method. Participants were 12 experts in the field of health and 19 employees in education who were selected by purposive and available sampling method with maximum diversity. The data collection method was semistructured interview with note‑taking.

A total of 32 subcategories and 9 main categories were extracted: “Macro health policies,” “Strategic health system,” “The role of education system in health promotion,” “Schools and Lifestyle modification,” “Informal learning,” “Preventive strategies in promoting health,” “ Lifestyle, multifactorial phenomena,” “The impact of stress on health,” and “Factors affecting preventive education.”

Providing preventive education to students is one of the ways to prevent noncommunicable diseases. If these trainings have the necessary attractiveness and support by the authorities (and especially the health system), then it will not only raise students’ awareness, but also change their attitude and improve their performance.

In 2017, the American Academy of Pediatrics (AAP) updated clinical practice guidelines for the diagnosis and management of hypertension in children. The present study aimed to assess the prevalence of hypertension in Iranian children based on the latest guidelines.

Data on 7301 student participants (3589 boys and 3712 girls) aged between 7-12 yr were assessed. The data were extracted from the fifth Childhood and Adolescence Surveillance and Prevention of Adult Non-communicable Disease (CASPIAN V) school-based study conducted in the 30 provinces of Iran in 2015. Blood pressure (BP) was classified as normal, elevated BP, and stage 1 and 2 hypertension using weighted analysis and the 2017 AAP guidelines. All analyses were performed in STATA 14.0 statistical software, with findings presented in terms of prevalence.

The overall prevalence of high BP in Iranian children was 14.7%. In addition, 15.1% of boys had high BP, with 9.4% and 1.7% of them with stage 1 and 2 hypertension, respectively. Moreover, 14.3% of girls had high BP, of which 10% had stage 1 and 1.3% with stage 2 hypertension. For elevated hypertension, it was observed in 4% of boys and 3% of girls.

Using the 2017 AAP guidelines demonstrated a higher prevalence of hypertension in children (14.7%) in Iran. The prevalence of hypertension in boys was slightly higher compared to girls.

Progressive insulin resistance is a physiological condition during pregnancy that can lead to gestational diabetes. Given the association between low blood vitamin D levels and insulin resistance, the present meta-analysis evaluated the effect of vitamin D supplementation on serum 25-hydroxyvitamin D (25[OH]D) and the homeostatic model of insulin resistance (HOMA-IR) levels in non-diabetic pregnant women.

A comprehensive literature search was conducted using electronic databases and gateways such as Cochrane Library, Medline, Google Scholar, Science Direct, Web of Sciences, Embase, and Scopus. Articles up to 2020 in both English and Persian were included in the study. The effect of vitamin D supplementation on 25(OH)D and HOMA-IR was determined based on the differences in mean changes from baseline to post-intervention. Weighted mean and 95% confidence intervals (CI) were pooled using a random-effects model. Data were analyzed using STATA software. 

Four studies, including six trials with 380 participants, reported that vitamin D supplementation increased 25(OH)D (mean change: 13.72, 95% CI: 7.28-20.17) and decreased HOMA-IR (mean change: 1.46, 95% CI: 0.56-2.37) levels compared with the placebo group. A high weekly dose of vitamin D further reduced HOMA-IR levels (adjusted R2=77.99, I2 residuals=80.49%, P=0.047). There was no significant association between the dose of vitamin D and 25(OH)D (P=0.974). Intervention duration was not associated with an increase in 25(OH)D (P=0.102), nor with a decrease in HOMA-IR (P=0.623).

Vitamin D supplementation increased 25(OH)D and decreased HOMA-IR levels in non-diabetic pregnant women. Vitamin D in high doses further reduced HOMA-IR, but did not affect 25(OH)D concentrations.

 Sedentary behavior (SB) is considered a risk factor for musculoskeletal pain. We aimed to explore the association of sedentary behavior indicators with neck pain among children and adolescents.

 A comprehensive review was performed in different databases until the end of January 2022. Odds ratios (ORs) with 95% confidence intervals were used as desired effect sizes to evaluate the association between prolonged screen time or mobile phone (MP) usage and neck pain risk.

 Among 1651 records, 15 cross-sectional studies were included in the systematic review, and 7 reports were included in the meta-analysis. Our results suggested a significant relationship between prolonged MP use and neck pain (OR=1.36, 95% CI=1.001–1.85, I2=40.8%, P value for heterogeneity test=0.119). Furthermore, a marginally insignificant association was found between prolonged screen time and neck pain (OR=1.13, 95% CI=0.98–1.30, I2=60.3%, P value=0.01); however, after sensitivity analysis and removing one study, this association became significant (OR=1.30, 95% CI=1.03–1.64). Moreover, a significant association between prolonged sitting time and neck pain was reported in two studies.

 Available good-quality evidence reveals a significant mild association between sedentary behavior and the risk of neck pain among children and adolescents. However, longitudinal studies with objective measurement tools are warranted. In particular, potential preventive educational programs are suggested for pediatrics to reduce sedentary behavior and neck pain.

According to the importance of physical activity in the child’s physical and mental development and cognitive health, developing a valid, reliable, and comprehensive assessment tool for children’s physical activity is mandated. The purpose of this study is the translation, cross‑cultural adaptation, and validation of the Persian version of the Thailand Physical Activity Children Survey questionnaire to measure the level of physical activity in children aged between 6–9 years in Iran.

This study consisted of three stages, first, the questionnaire translation into Persian language and modification of the sections according to the Iranian culture, then the evaluation of the questionnaire via a pilot study, and finally, assessing the reliability and validity of the tool. Participants of the pilot study were 250 healthy children, aged 6 to 9 years, meeting eligibility criteria, recruited through a stratified cluster sampling method from schools across Tehran.

The Persian version of the questionnaire demonstrated an acceptable content validity (Content Validity Index between 0.88‑1). The test‑retest reliability reported the Intra‑Class Correlation coefficient in the acceptable range in all sections (between 0.71‑1). Cronbach’s alpha was reported 0.993, which indicated excellent internal consistency.

According to the acceptable validity and reliability of the Persian version of the Thailand Physical Activity Children Survey for children aged 6–9 years, it is recommended in research and surveillance studies to determine the level of physical activity of children of that age group in Iran.

 Quarantine restrictions have changed the usual lifestyle habits of children and adolescents. In this review, we summarize how the COVID-19 outbreak changed lifestyle during childhood and discuss potential short- and long-term effects of NCD high-risk behaviors on health outcomes. 

 literature search was conducted in Medline database (PubMed), Scopus, Embase, Web of Science, and Google Scholar. All studies that assessed the relationship between COVID-19 outbreak and lifestyle changes were included.  

 NCD risk factors such as unhealthy diet, physical inactivity, prolonged screen time and sedentary behavior, disrupted sleep schedules and sleep quality, as well as mental disorders during COVID19 in childhood, may increase the susceptibility to NCDs in adulthood. These changes in lifestyle behaviors have short and long-term cardio-metabolic and psychological health outcomes. Since it is not clear when COVID-19 is completely controlled, assessment of the interactions between COVID-19 and lifestyle activities in the pediatric age group is critical.

 The pandemic of coronavirus disease 2019 (COVID-19) has greatly influenced all levels of health systems. During the COVID-19 pandemic, prevention and management of non-communicable diseases (NCDs) will need to be prioritized even further.

Today, the ability of the organizations to successfully knowledge management and sharing can help them in better performance. Effective knowledge sharing (KS) in the clinical context provides better clinical decisions and improves the quality of care services. This systematic review will be conducted to identify the factors related to the clinical KS (CKS). This systematic literature review will be conducted to search the published documents about the affecting factors on the (clinical) KS. To this end, PubMed, Scopus, Web of Science, ProQuest, Cochrane, Embase, SID, Magiran, IranDoc, and ISC will be thoroughly assessed with considered keywords and search strategy. No time limit will be considered and all relevant documents published will be evaluated until the start date of the search. To the best of our knowledge, no systematic review study has been conducted on the factors related to CKS and our research will try to comprehensively extract the effective factors in this topic. Identifying the factors affecting CKS will lead to transparency in the exchange and interpretation of clinical knowledge in clinical care delivery and making the best clinical decisions as well as improving the quality of clinical care. It will also provide a condition to facilitate the delivery of more effective clinical education for policymakers in the field of clinical education.

The aim of the study is to identify latent class (LC)‑derived patterns of women’s knowledge, attitude, and practice (KAP) toward coronavirus disease 2019 (COVID‑19) in Iran.

This cross‑sectional survey of 2029 women, who participated in the PERSIAN Birth Cohort, was conducted in Isfahan, Iran. KAP was assessed by shortened and validated form of a recently used questionnaire in Iran. LC analysis was used to discover underlying response patterns of KAP toward COVID‑19 using Mplus 8.0 software.

Three classes were identified: Class 1 (n = 514, 25.33%) “Low knowledge and poor practice, Class 2 (n = 423, 22.08%) “Moderate knowledge and proper practice,” and Class 3 (n = 1092, 53.82%) “Low knowledge and proper practice.” The lowest rate of positive attitude was seen in Class 3. Women living in rural areas, as well as those with lower education, were more likely to member classes with improper practice.

The findings suggest that the LCA approach can provide important information reflecting different levels of adoption of protection toward COVID‑19 infection. The results may be useful to conducting health‑care programs during the outbreaks.

 This study was conducted to shed light on the hidden relationships, trends, and patterns of the teenagers’ mental health dataset based on data mining techniques.

 The proposed method has four parts as follows: data preprocessing, data cleaning, target class selection, and extracting rules. The classes included inappropriate, moderate, and acceptable. The rules were extracted separately by implementing ID3, CHAID, and rule induction on the Caspian 5 dataset.

 It was found that the teenagers who rarely drink carbonated soda and have dinner seven days a week, have acceptable status of mental health. Besides, watching TV and playing computer games for 4 hours or more per week, drinking tea and packaged juices, eating cakes, cookies, pastries, biscuits, and chocolate weekly  could lead to inappropriate status of  mental health.

 An attempt to improve health especially in youth is one of the important concerns of every country.  The rules express the negative impact of soda on mental health. Besides, it can be concluded that there is a direct relationship between having breakfast and mental health.

Overweight obesity is now so widespread in the world. This study aims to use an artificial neural network modeling tool to develop a predictive model for the diagnosis of obesity in children and adolescents.   Participants consisted of 460 school students, aged 7-18 years, who studied in a national school-based surveillance program (CASPIAN-V). Training network with 10 input variables including: age, sex, weight, height, waist circumference, systolic blood pressure, diastolic blood pressure, body mass index, waist-to-height ratio, physical activity, and with output variable obesity with 17 and 15 hidden neurons for girls and boys was designed.   After designing the network, the value of gradient on the data was 0.0021194 for girls and 0.0031658 for boys. The sensitivity, specificity and accuracy of the neural network were 0.9444, 0.9855, 0.9822, respectively in girls, and 0.9655, 0.9757, 0.9755 in boys;  in all these cases, the designed artificial neural network performed better than waist circumference and body mass index. A review of the final weights of this network showed that the input variable body mass index in girls and the input variable waist-to-height ratio in boys had the most influence in diagnosis of obesity.   Our results show that although body mass index has a better diagnostic performance in determining excess body fat than waist circumference, in boys and girls of both groups, and also in all parameters of sensitivity, specificity and accuracy, the artificial neural network acts better than body mass index and waist circumference, so that with an accuracy of more than 96%, we can detects obesity.

Assessing the prevalence of infections, which are preventable by vaccination, is crucial to monitor the vaccination program efficacy, and it can demonstrate the gaps in population immunity. The current study attempted to assess the specific Immunoglobulin (IgG) antibody against measles, mumps, and rubella (MMR) in Iranian children and adolescents, years after their vaccination.

This cross-sectional study was conducted in Iran. Serum samples of 2100 students, aged 7-18 years, included in a national health survey, were tested for MMR antibodies by ELISA assay. Multistage random cluster sampling was used to select subjects from 30 provinces in Iran.

Overall, 1871, 1718, and 1678 serums were tested for measles, mumps, and rubella antibodies, respectively. The prevalence of positive test was 1231 (65.8%) for measles, 1327 (77.2%) for mumps and 1344 (80.1%) for rubella.

Despite high vaccination coverage in Iran, IgG antibody against measles, mumps, and rubella was not detected in a considerable proportion of children and adolescents aged 7-18 years. In case of contacts with residents of other countries, where measles or rubella have not yet been eliminated, it may create problems for Iranian children.