Background: Although surgery in patients with cardiovascular disease usually leads to improved cardiac function and reduced physical problems, these patients often face numerous psychological problems, especially stress, because of their history of heart disease and the experience of surgery itself. The experience of stress can disrupt the recovery process and even lead to an exacerbation of cardiovascular problems. Aims: the present study aimed to predict perceived stress based on early maladaptive schemas and to investigate the mediating role of cognitive flexibility and dark personality traits in cardiovascular patients with a history of surgery. Methods: This study was a correlational research conducted using Structural Equation Modeling (SEM). The population included patients with cardiovascular disease with a history of surgery in Kermanshah in 2024. Sampling was conducted in Imam Ali Hospital. Cardiovascular. A total of 287 patients were selected using convenience sampling. Participants responded to Young Schemas Questionnaire-Short Form (YSQ-SF), Short Dark Triad Scale (SD-T), Cognitive Flexibility Inventory (CFI), and Perceived Stress Scale (PSS). The data were analyzed using SPSS-25 and R software. Results: The results of the study indicated that the conceptual model had an acceptable fit. The direct effect of early maladaptive schemas, cognitive flexibility, and dark personality traits on perceived stress was 0.23, -0.37, and 0.49, respectively, all of which were significant (P = 0.01). Moreover, the indirect effects of early maladaptive schemas through the mediating roles of dark personality traits and cognitive flexibility were estimated to be 0.22 and 0.21, respectively, and these paths were also statistically significant (P = 0.01). Fit indices for χ²/df, GFI, CFI, AGFI, IFI, and TLI were 1.44, 0.96, 0.95, 0.93, 0.97, and 0.97, respectively. Conclusions: The study suggests that in the treatment programs of cardiovascular patients with a history of surgery, attention should be paid to strengthening cognitive flexibility and modifying early maladaptive schemas as strategies to reduce dark personality traits and, consequently, reduce perceived stress.
Background: Hamstring tightness is a common musculoskeletal problem among athletes, particularly basketball players, and can negatively affect performance and increase injury risk. Various therapeutic approaches, including electrotherapy and manual therapy, are available; however, their mechanisms and comparative effectiveness are not fully understood. Objectives: This study aimed to evaluate the effects of extracorporeal shockwave therapy (ESWT), an electrotherapy intervention, on hamstring tightness and to compare its effectiveness with that of dynamic soft tissue mobilization (DSTM), a manual therapy technique, in basketball players. Methods: This randomized controlled trial was conducted from January to June 2022 at Amin Hospital, Isfahan, Iran. Forty male basketball players aged 15 - 18 years with hamstring tightness, defined as an active knee extension angle (AKEA) < 170°, were randomly assigned to the ESWT or DSTM groups. Only male participants were included to maintain sample homogeneity and reduce sex-related variability in flexibility outcomes. The ESWT protocol consisted of 4 sessions, with 1 session per week, and the DSTM protocol included 4 sessions over 4 weeks. Outcomes were assessed at baseline, immediately after the final session, and 1 month after the intervention. Outcomes included the Y-Balance Test (YBT), AKEA, passive knee extension angle (PKEA), and finger-to-floor distance. Data were analyzed using the t-test, analysis of covariance (ANCOVA), and one-way repeated-measures analysis of variance in SPSS version 26. Results: Twenty participants in the ESWT group and 20 participants in the DSTM group were evaluated. Between-group comparisons immediately after the intervention and at the 1-month follow-up showed statistically significant differences in all outcome measures (P < 0.001), with greater improvements observed in the DSTM group. Within-group analyses showed significant changes from baseline in both the ESWT (P < 0.05) and DSTM (P < 0.001) groups. Conclusions: Both ESWT and DSTM significantly improved hamstring flexibility; however, DSTM demonstrated superior effectiveness across key flexibility outcomes. These findings provide preliminary evidence supporting the distinct mechanisms of electrotherapy and manual therapy in the treatment of hamstring tightness. Further studies are needed to draw more comprehensive conclusions.
Background: The Post-Liver Transplant Quality of Life (PLTQ) instrument is a specific, disease-based questionnaire to evaluate health-related quality of life (HRQOL) among liver transplantation (LTx) recipients. Objectives: This study focused on the translation, cross-cultural adaptation, and validation of the psychometric properties of the PLTQ questionnaire to provide the Persian version of the Post-Liver Transplant Quality of Life (PV-PLTQ) instrument. Methods: This investigation is a translation and cross-cultural adaptation study followed by evaluation of validity and reliability of PV-PLTQ. Between February and June 2021, a total of 175 LTx recipients completed the PV-PLTQ and Short-Form 36 (SF-36) questionnaires at the Liver Transplantation Research Center of Tehran University of Medical Sciences. Sixty-seven randomly selected patients were asked to complete the PV-PLTQ two to three months later. Face validity, content validity, acceptability, ceiling and floor effects, internal consistency, test–retest reliability, responsiveness to change, convergent validity, and minimal detectable change (MDC) were evaluated. Internal consistency was assessed using Cronbach’s alpha (≥ 0.7); test–retest reliability using ICC; and responsiveness using effect size (ES), mean difference (MD), and standardized mean difference (SMD). Convergent validity was tested using Spearman’s correlation due to nonlinear relationships. Results: The results of face validity, content validity, and missing data proportion indicated that the PV-PLTQ questionnaire is acceptable and easy to understand. Cronbach’s alpha coefficient for the PV-PLTQ questionnaire was 0.97. The results of test-retest reliability showed a moderate to good intraclass correlation coefficient from 0.6 to 0.86 (P < 0.05). PV-PLTQ also demonstrated strong responsiveness to HRQOL changes, with a very large effect size (Cohen’s d = 3.82; 95% CI: 2.51 - 5.11), indicating substantial improvement over time among participants who reported improvement by SF-36. The correlations between PV-PLTQ domains and physical (r = 0.65) and mental (r = 0.63) components of SF-36, calculated using Spearman’s correlation, presented good convergent validity (P < 0.05). No floor effect was observed. The amount of 0.9 was calculated as the MDC of the total PV-PLTQ score. Conclusions: The PV-PLTQ questionnaire is a valid, reliable, and responsive to change instrument to evaluate HRQOL in LTx recipients.
Background: Mental health is a key aspect of overall well-being, influencing emotional stability, social relationships, and academic success. Among university students, particularly those in the health sciences, mental health knowledge and literacy are critical for personal wellness and professional preparedness. Objective: This study aimed to assess mental health knowledge, evaluate mental health literacy (MHL), and examine the relationships between these factors and the risk of depression among Thai undergraduate health science students. Methods: A cross-sectional survey was conducted among 270 Thai students using a stratified random sampling approach. Validated tools assessed mental health knowledge, MHL (MHLq-YA), and depression risk (PHQ-9). Descriptive statistics and Pearson’s correlation were used to analyze the data. Results: Most students demonstrated high mental health knowledge (90.0%) and high to very high MHL (89.3%), with generally low levels of depression risk. The most frequently reported symptoms included fatigue, sleep disturbances, and lack of interest. Although statistically significant, the correlations between mental health knowledge, MHL, and depression risk were very weak (r < 0.10), indicating minimal practical relevance. Conclusion: While students demonstrated strong mental health knowledge and literacy, these factors showed limited explanatory value for depression risk. Future interventions should focus on strengthening the practical application of MHL to enhance student well-being and prepare them for professional roles in mental health support.
Background: School avoidance during adolescence, in addition to leading to incomplete education, can have long-term negative consequences, including psychological problems such as anxiety, depression, and stress. Objectives: This study aimed to examine perceived parental support and the teacher-student relationship as predictors of school avoidance, mediated by psychological adjustment in adolescent students. Methods: This cross-sectional structural equation modeling (SEM) study was conducted in Tehran in 2025. The study included 351 high school students recruited using convenience sampling; however, 32 participants were excluded from the analysis because of incomplete responses. Therefore, the data analysis was performed on 319 participants. Participants were selected from four schools: Shahid Mofatteh Boys' School, Seyyed Razi Boys' School, Iran Girls' School, and Zohreh Bonyan Girls' School. The School Avoidance Questionnaire (SAQ), Adjustment Inventory for School Students (AISS), Parental Support Scale (PSS), and Inventory of Teacher-Student Relationships (IT-SR) were used to measure the study variables. Results: The findings indicated that the proposed research model had a good fit. The fit indices, including GFI, CFI, AGFI, RMSEA, and IFI, were 0.98, 0.98, 0.95, 0.03, and 0.98, respectively. The standardized beta coefficients for the effects of the teacher-student relationship, perceived parental support, and psychological adjustment on school avoidance were -0.28, -0.20, and 0.38, respectively. The standardized beta coefficients for the effects of the teacher-student relationship and perceived parental support on psychological adjustment were -0.49 and -0.40, respectively (P < 0.01). Analyses of indirect effects further showed that perceived parental support (-0.15) and the quality of the teacher-student relationship (-0.18), with psychological adjustment as a mediating factor, were significantly associated with school avoidance (P < 0.01). Conclusions: To reduce students’ school-related difficulties and school avoidance, counselors and psychotherapists should pay particular attention to the quality of communication between parents and students, as well as between teachers and students. These relationships may reduce psychological maladjustment. In addition, given the role of the quality of communication between students and their families in improving psychological adjustment and reducing school avoidance, educational counselors and psychotherapists should place specific emphasis on family therapy for adolescents.
Background: Population aging and the increasing number of individuals aged 60 years and older have heightened attention to the psychological challenges of later life. Death anxiety is among the most prominent concerns affecting older adults’ mental health. Objectives: This study aimed to examine the coping strategies used by older women to manage death anxiety. Methods: This qualitative study was conducted in 2025 using a grounded theory approach. Twelve women aged 65 years and older who resided in nursing homes and long-term care facilities in Tehran were recruited through purposive sampling. Data were collected through in-depth, semi-structured interviews and analyzed using the constant comparative method. Data collection continued until theoretical saturation was achieved. Results: Data analysis yielded five main categories: end-of-life tensions, including unresolved attachments and death-related fears associated with functional limitations; psychological processing of lived experience, including engagement with death-related narratives, integration of past experiences, and persistent psychological burdens; psychosocial challenges, including disrupted emotional bonds and internalized coping strategies; modes of living with death anxiety, including maintaining an active lifestyle, realistic efforts to preserve independence, and strengthening social relationships; and existential transformations, including existential satisfaction and reassurance. Conclusions: Despite age-related constraints, older women employ adaptive strategies, such as remaining active, preserving autonomy, and strengthening social ties, to cope with death anxiety. These strategies contribute to psychological calmness and improved existential well-being.
Background: Pain from dental anesthetic injections is a common cause of dental anxiety. Objectives: This study aimed to compare the efficacy of European and Iranian classical music on dental anxiety, injection-related pain, and physiological factors. Methods: In this randomized clinical trial, 90 patients undergoing mandibular molar root canal therapy (RCT) were randomly assigned to three groups (n = 30). The experimental groups listened to European or Iranian classical music during treatment, while the control group received no music. Anxiety levels were assessed using the State-Trait Anxiety Inventory (STAI), and physiological parameters (pulse and respiratory rate) were recorded. Pain from inferior alveolar nerve block (IANB) anesthesia was measured with the Visual Analogue Scale (VAS). Anxiety and physiological parameters were reassessed post-treatment. Data were analyzed using two-way repeated measures analysis of variance (ANOVA) and one-way ANOVA (α = 0.05). Results: There was no significant difference in anxiety levels or physiological parameters across the groups. However, pain from IANB injection was significantly lower in the music groups compared to the control. While the European classical music group experienced slightly lower pain levels than the Iranian classical music group, this difference was not statistically significant. Conclusions: Background music, regardless of genre, significantly reduced pain from dental anesthesia injections but had no notable effect on anxiety or physiological parameters. This approach can be a practical method for alleviating injection-induced pain in dental practice.
Background: Severe mental illnesses profoundly impair quality of life and impose substantial healthcare and socioeconomic burdens. In Iran, psychiatric disorders affect over 30% of the population, highlighting the need for effective psychosocial interventions. The clubhouse model — a community-based, member-driven approach — aims to enhance social inclusion, autonomy, and meaningful participation among individuals with chronic mental illness. Objectives: This study tested the hypothesis that participation in a clubhouse model–based program leads to greater improvements in occupational engagement compared to standard day center services among individuals with severe mental illness in Iran. Methods: Thirty-one participants diagnosed with severe psychiatric disorders were randomly assigned to an intervention group (clubhouse services; n = 15) or a control group (standard day center services; n = 16) using computer-generated block randomization (block size = 4). Allocation concealment was maintained through sequentially numbered, opaque, sealed envelopes. Both groups attended sessions twice weekly for 12 weeks. Outcomes were assessed using the Canadian Occupational Performance Measure (COPM) and the Profile of Occupational Engagement in people with Severe Mental Illness (POES) at baseline and post-intervention. Data were analyzed using paired-samples t-tests (within-group) and independent-samples t-tests (between-group), following verification of normal distribution. Results: The intervention group demonstrated significantly greater improvements in COPM performance (mean increase = 1.59, SD = 0.56, Cohen’s d = 2.84, P < 0.001) and satisfaction (mean increase = 0.92, SD = 0.65, Cohen’s d = 1.42, P < 0.001), while the control group showed no significant changes. On the POES, only the Initiating performance dimension differed significantly between groups at follow-up (P = 0.045). Conclusions: Clubhouse-based services significantly enhance self-perceived occupational performance and satisfaction among individuals with severe mental illness in Iran. The large effect sizes underscore the clinical relevance of this model. These findings support its integration into mental health rehabilitation services in similar contexts.
Background: Sexual function is an important aspect of women’s physical and psychological health, yet it is often overlooked due to cultural sensitivity. To our knowledge, no study in Iran — where sexual issues are rarely discussed — has compared the sexual function of reproductive-aged and post-menopausal women. Objectives: This cross-sectional study aimed to assess and compare sexual function status and the frequency of sexual dysfunction between these two groups. Methods: This cross-sectional study was performed in 2020 using a multi-stage sampling method on 60 women of reproductive age and 60 women in post-menopausal age. Female Sexual Function Index (FSFI) was used to assess sexual function. Data were analyzed using the Student’s t-test, partial correlation coefficient, and Mann-Whitney test. Additionally, multivariate logistic regression analysis was employed to control for potential confounding factors. Results: The frequency of low sexual function was 64.2% for women aged 21 - 27 years, 65.19% for women aged 28 - 33 years, 84.2% for women aged 34 - 39 years, and 90.5% for women aged 40 - 45 years. In menopausal women, this figure was 83.3%. The sexual function score of reproductive-aged women was significantly higher than that of post-menopausal women, with the difference observed in the total score and specifically in the "orgasm" dimension. The results for the stratified age groups showed that desire and arousal in women aged 21 - 27 were significantly better than those in post-menopausal women. Conclusions: Although the frequency of sexual dysfunction was high in both groups, post-menopausal women showed a higher frequency compared with reproductive-aged women. Thus, it is necessary for healthcare professionals to be sensitive and carefully evaluate all women, especially menopausal women who are more susceptible to sexual problems. Health providers should pay greater attention to these issues.
Context: Children with neurodevelopmental disorders (NDDs) frequently encounter difficulties in independently performing self-care activities, which can adversely affect both their development and quality of life. Video modeling (VM) is an evidence-based observational learning technique in which children acquire skills by watching and imitating video demonstrations. Although interest in this approach is increasing, a comprehensive synthesis of VM for self-care in children with NDDs is currently lacking. Objectives: This review examined VM interventions designed to improve self-care in children with NDDs, including autism spectrum disorder (ASD), intellectual disability (ID), and attention-deficit/hyperactivity disorder (ADHD), with an emphasis on intervention characteristics, implementation strategies, and outcomes. Methods: A scoping review identified 21 studies from four major databases. Two independent researchers systematically extracted and organized data to ensure accuracy. Quantitative analysis summarized study characteristics, intervention features (such as VM alone or in combination with reinforcement, prompting, chaining, or live modeling), and outcomes (including toothbrushing, toileting, and dressing) using descriptive statistics. Qualitative analysis explored recurring themes related to video devices, visual perspective, model type, integration with other techniques, intervention context (home, school, or clinical settings), and generalization across settings and tasks. Results: The VM interventions primarily employed third-person perspectives and adult models, most often within home environments. There was notable variability in video devices, implementation contexts, complementary techniques, and visual perspectives. Despite these differences, VM consistently improved self-care skills, including dressing, feeding, and personal hygiene. Approximately 95% of studies reported statistically significant improvements. Evidence suggests that tailoring interventions to developmental level, model type, visual perspective, and context enhances outcomes and promotes functional independence. Conclusions: The VM is an effective and adaptable approach for fostering independent self-care in children with NDDs. The key modifiable factors — model selection, visual perspective, and implementation context — identified as primary findings can guide clinicians, educators, and caregivers in optimizing skill acquisition. These insights inform the development of VM-based programs, supporting improved developmental outcomes and quality of life. Future research should focus on standardizing protocols and examining long-term effects to strengthen evidence-based practice.
Background: Thailand’s aging population faces a high burden of non-communicable diseases (NCDs), requiring effective self-care strategies. The Self-Rated Abilities for Health Practices (SRAHP) Scale is widely used to assess self-efficacy in health-promoting behaviors, but a validated Thai version has not been established. Objectives: To translate, culturally adapt, and evaluate the validity and reliability of the Thai version of the SRAHP Scale among older adults with NCDs. Methods: A cross-sectional study was conducted with 250 community-dwelling older adults aged ≥60 years diagnosed with at least one NCD. The SRAHP was translated using Beaton’s guidelines. Construct validity was assessed using confirmatory factor analysis (CFA), and internal consistency was measured using Cronbach’s alpha. Results: The study included 250 older adults with NCDs (mean age = 69.61 years, SD = 7.47; 63.60% female), primarily diagnosed with hypertension (65.60%) and diabetes mellitus (36.80%). Criterion validity analysis demonstrated a strong positive correlation between SRAHP scores and health-promoting behaviors (r = 0.61, P < 0.001). CFA confirmed the original four-factor structure with good model fit [χ²/df = 2.45, Comparative Fit Index (CFI) = 0.96, Tucker-Lewis Index (TLI) = 0.95, Root Mean Square Error of Approximation (RMSEA) = 0.06]. All factor loadings ranged from 0.80–0.95. Cronbach’s alpha was 0.93 overall and 0.77 - 0.91 across subscales. Conclusions: The Thai SRAHP is a valid, reliable tool for evaluating self-efficacy in health-promoting behaviors. It can support targeted interventions for older adults with NCDs and enhance chronic disease management in community and clinical settings.
Background: In the Peruvian penitentiary context, exposure to adverse conditions may contribute to the development of chronic diseases, whose association with physical disability, particularly in mobility and dexterity, has been scarcely explored. Objectives: The objective of this study is to estimate the association between chronic diseases and mobility and dexterity disabilities in the penitentiary population of Peru. Methods: A cross-sectional analytical study based on data from the 2016 National Census of the Penitentiary Population, which included 76,180 inmates in 66 penitentiary centers. Individuals over 18 years old who answered key questions about chronic diseases and disabilities were included. The final sample consisted of 75,963 inmates. A 405-item questionnaire was administered, from which only the information related to chronic diseases and disabilities was considered for analysis. Descriptive statistics, bivariate analyses, and Poisson regression models were applied to estimate adjusted associations, accounting for potential confounding variables and adhering to established ethical research principles. Results: The majority of participants were male (94%), and the predominant age group was 30 - 34 years (43.3%). About 9.7% reported mobility and dexterity disabilities, with 39.4% having mild disabilities. Regarding chronic diseases, 6.3% had lung diseases, 4.8% had hypertension, and 2.5% had diabetes. A significant association was found between chronic diseases and disability. Multimorbidity increased the risk of disability, with a prevalence ratio (PR) of 2.00 for one disease, 2.89 (2.62 - 3.20) for two diseases, and 3.91 (3.25 - 4.70) for three diseases. Conclusions: The presence of chronic diseases such as diabetes, hypertension, and respiratory disease, as well as their comorbidity, is significantly associated with a higher prevalence of mobility and dexterity disabilities among incarcerated individuals.
Background: Substance use disorder (SUD) is a major global health concern, often associated with agitation behaviours that complicate treatment and worsen outcomes. While pharmacological management is common, evidence on structured, non-pharmacological rehabilitation programs to address agitation in SUD remains limited. Methods: A quasi-experimental single-group pretest-posttest design was conducted among 50 male patients with SUD at an outpatient psychiatric clinic in Egypt (March - September 2024). Participants completed a 9-session rehabilitation program integrating anger management, cognitive restructuring, and problem-solving strategies. Agitation severity and substance misuse were measured using the validated Agitated Behavior Scale (ABS) and the Drug Abuse Screening Test (DAST-10), with steps taken to minimize self-report bias. Results: Participation in the rehabilitation program was associated with a significant reduction in agitation severity (P < 0.001, Cohen's d = 1.10) and substance misuse (P < 0.001, Cohen's d = 1.96). A subgroup analysis revealed that patients with high baseline agitation showed a large, clinically meaningful improvement, with 50% achieving a ≥ 50% reduction in symptoms [number needed to treat (NNT) ≈ 2.5]. Sociodemographic characteristics, particularly older age, were significant predictors of higher post-intervention agitation in adjusted analyses. Patients who were younger, unemployed, with lower education, and rural residence exhibited higher baseline agitation. Conclusions: This study provides preliminary evidence for the potential effectiveness of a structured rehabilitation program in reducing agitation and substance use among male patients with SUD, with analyses suggesting particularly strong effects for those with severe baseline agitation. Sociodemographic characteristics influenced outcomes, underscoring the need for tailored approaches. Future randomized controlled trials (RCTs) including control groups and more diverse populations are recommended to confirm efficacy and explore long-term effects.
Context: Diabetic foot ulcers (DFUs) represent a prevalent complication of uncontrolled diabetes. Physical modalities like electrical stimulation (ES) and photobiomodulation (PBM) demonstrate significant potential in treating DFUs. Objectives: This study aimed to systematically review the literature and perform a meta-analysis comparing PBM and ES for reducing DFU size. Data Sources: We conducted an extensive search for relevant studies by systematically exploring various international databases, including Medline (through PubMed), Web of Science, Cochrane, Scopus, and Pedro. The search was not limited by time, extending until April 29th, 2024, and was restricted to studies published in English. Study Selection: Two independent researchers participated in the search and screening of sources, and a third researcher resolved any discrepancies in case of conflicting opinions. The initial search yielded 478 articles, of which 225 remained after removing duplicates. After screening titles and abstracts, 31 full-text articles were assessed for eligibility. Ten studies were excluded due to inadequate data, lack of relevant intervention, or being non-randomized or pilot studies. Data Extraction: Twenty-one studies were included in the systematic review and meta-analysis. Results: Twenty-one studies were included. The standardized mean change for PBM was 1.79 (95% CI 0.18 - 3.39), and for ES, it was 0.36 (95% CI -0.33 - 1.06). Both PBM and ES significantly reduced DFU size compared to baseline. Although the difference between treatments was not statistically significant (P = 0.095), PBM demonstrated a clinically relevant larger effect size than ES. No adverse effects were reported for PBM, while ES was associated with minor skin irritation or burns in some cases. Conclusions: Both PBM and ES, as adjuvant treatments, significantly decrease DFU size compared to standard care alone. The PBM’s larger effect size suggests potentially greater clinical efficacy, despite non-significant statistical differences. However, further high-quality studies are needed to confirm these findings.
Context: Odontogenic keratocysts (OKCs) are aggressive jaw cysts characterized by a high recurrence rate, making accurate diagnosis critical for effective treatment. Recent advances in artificial intelligence (AI) have demonstrated potential for enhancing diagnostic accuracy in histopathology. However, the effectiveness of AI in diagnosing OKCs has not yet been systematically reviewed. Objectives: This study aims to evaluate the diagnostic and prognostic performance of AI models in detecting OKCs in histopathologic images. Methods: This systematic review was conducted in accordance with the preferred reporting items for systematic reviews and meta-analyses (PRISMA) guidelines. A comprehensive literature search was performed across PubMed, Scopus, Embase, Google Scholar, and ScienceDirect to identify studies that utilized AI models for diagnosing OKCs from histopathologic images. Studies were eligible for inclusion if they addressed the PICO (patient/population, intervention, comparison, and outcomes) framework, specifically investigating whether AI models (I) can enhance diagnostic and prognostic accuracy (O) for OKCs in histopathologic images (P). A meta-analysis was performed to pool the diagnostic performance of AI models across studies, and Egger’s test was conducted to assess publication bias. Results: A total of eight studies were included in the review. The risk of bias (ROB) across the included studies was generally low, with a few exceptions. The pooled area under the curve (AUC) for AI models in diagnosing OKCs was 0.967 (95% CI: 0.957 - 0.978). The pooled sensitivity ranged from 0.89 to 0.92, and the pooled specificity ranged from 0.88 to 0.94. The summary receiver operating characteristic (sROC) curve demonstrated an AUC of 0.93. Egger’s test for publication bias yielded a P-value of 0.522, indicating no significant evidence of publication bias. The review also highlighted several limitations, including small sample sizes, lack of external validation, and limited interpretability of the AI models. Conclusions: Artificial intelligence models, particularly deep learning architectures, demonstrate high diagnostic accuracy in detecting OKCs from histopathologic images.
Context: This review examines effective interventions for social-psychological rehabilitation in addiction recovery. Data Sources: The study was conducted in English using the PubMed, Scopus, and Web of Science databases with related MeSH terms. Study Selection: The quality assessment was performed utilizing the CONSORT statement for randomized trials of non-pharmacologic treatments. Publication bias was assessed by analyzing the Egger test. Data Extraction: The primary outcome was the review of social and psychological rehabilitation on addiction recovery, and the secondary outcome was the meta-analysis of included data from pre- to post-test assessments for psychological rehabilitation. The statistical analysis was conducted using Stata (version 14). Results: Ten studies were included in the systematic review, and six in the meta-analysis. Three main categories were identified based on the interventional studies: The role of partner/significant other, emotional support, and social network. The results of the meta-analysis reveal extremely high variability among studies (I2 = 95.8%, Tau2 = 6.4263), attributable to differences in intervention methods, sample characteristics, and measurement tools. While some evidence indicates positive effects, the overall results do not support a statistically significant benefit of psychological rehabilitation in improving addiction cessation skills. Subgroup analyses highlight inconsistent outcomes for acceptance and commitment therapy (ACT), emphasizing the need to clarify core concepts such as "acceptance" and "committed action". Variability in cognitive behavioral therapy (CBT) outcomes appears linked to differences in session content, duration, and therapist experience. Conversely, compassion-focused therapy (CFT) demonstrated no heterogeneity and a significant, strong effect, positioning it as a promising approach for future interventions. Conclusions: Given the high prevalence of psychosocial issues among addicted individuals in rehabilitation and the critical role of social support in achieving lasting recovery, a review study on the effectiveness of psychosocial interventions is clearly justified. Such a review can identify the most promising approaches for fostering social identity change, addressing diverse rehabilitation goals (like restoring socio-psychological mechanisms and building social skills), and ultimately facilitating successful societal reintegration for individuals battling addiction.
Background: The theory of planned behavior (TPB) is an effective framework for identifying behavior and related influencing factors. Objectives: The aim of this study was to develop and psychometrically test a new scale using TPB, comprising two types of measurement [direct and belief-based (indirect)], to assess treatment staff's intention to converse on sexual issues with postmenopausal women. Methods: This is a mixed exploratory-sequential study with three phases: A qualitative stage, an instrument development phase, and phase 3 (predictability of the TPB-based model). The first stage included a qualitative section performed using the content analysis method on 27 participants (13 midwives and 14 general practitioners). In the instrument development stage, questions were designed based on the findings of the qualitative stage. It was administered to a sample of 10 individuals to evaluate face and content validity. In the third stage of the study, a correlational study was used to predict sexual discussion behavior based on TPB in a sample of 208 individuals. Data analysis was performed using Amos software and SPSS. Results: From data analysis, 226 codes, 54 sub-categories, and 18 categories were obtained, which were classified under the themes of attitude, perceived behavioral control, intention, and behavior. In the instrument development stage, 121 questions and five factors were developed based on TPB. In the third stage of the study, structural analysis showed that the five-factor model (including attitude, abstract norms, perceived behavioral control, intention, and behavior) had a sufficient fit [Adjusted Goodness-of-Fit Index (AGFI) = 0.89, Root Mean Square Error of Approximation (RMSEA) = 0.07, Comparative Fit Index (CFI) = 0.9, Goodness-of-Fit Index (GFI) = 0.94], and the degree of freedom was equal to 2.87 in chi-square. Attitude had positive and significant effects, and perceived behavioral control had significant negative effects on the intention to discuss sexual issues. Behavioral intention had positive and significant effects on the studied behavior, but perceived behavioral control had negative and significant effects on the behavior. The multiple predicted coefficient value (R2) was 24% and 37% for the intention to talk about sexual issues and start talking about sexual issues, respectively. Conclusions: The questionnaire on predicting conversation on sexual issues by the medical staff demonstrated good predictive power.
Background: Oral lichen planus (OLP) is a chronic inflammatory disorder with a reported global prevalence of 0.5% to 2.6% and a 0 to 5.6% potential for malignant transformation into oral squamous cell carcinoma (OSCC), which accounts for over 90% of oral cancers and causes approximately 177,000 deaths annually worldwide. Identifying molecular markers that can distinguish high-risk OLP lesions is critical for early intervention. MicroRNA (miRNA) 146a has been implicated in inflammation-mediated carcinogenesis and may play a regulatory role in the progression from OLP to OSCC. Objectives: To evaluate and compare the expression of miRNA 146a in OLP and OSCC tissues and assess its diagnostic potential. Methods: Thirty formalin-fixed, paraffin-embedded (FFPE) tissue samples of well-differentiated OSCC and 18 samples of erosive OLP were retrospectively selected from the archives of Imam Khomeini Cancer Institute. These specific subtypes were included to minimize histopathological variability and ensure diagnostic consistency for accurate expression analysis. RNA was extracted and quantified using NanoDrop, followed by cDNA synthesis and qPCR using SYBR Green chemistry. ACTB was used as the reference gene for normalization. Expression analysis was conducted using REST 2009 software. Group differences were evaluated using the Mann-Whitney U test (P < 0.05). Results: The expression of miRNA 146a was significantly higher in OSCC (4.77 ± 4.54) compared to OLP (1.91 ± 0.96), with a P-value of 0.011, indicating its potential role as a biomarker for malignancy risk in OLP lesions. This corresponds to an approximate 2.5-fold increase in raw expression (non-log-transformed). Conclusions: The study identified a significant difference in miRNA 146a expression between OLP and OSCC samples. This suggests its potential use as a biomarker for distinguishing OLP from OSCC, though longitudinal studies are required to assess predictive value.
Background: Candidemia is a leading cause of nosocomial bloodstream infections, with conventional culture methods often requiring 48 - 72 hours for species identification and showing suboptimal sensitivity. The rapid and accurate detection of Candida spp. is crucial for timely antifungal therapy and improved patient outcomes. Objectives: The present study aimed to design and validate a laboratory-developed polymerase chain reaction (PCR) assay for the rapid detection of Candida species in culture-positive blood specimens, specifically targeting growth-positive blood culture bottles. Methods: In this cross-sectional study, conducted between November 2024 and March 2025 at Imam Reza Hospital in Mashhad, 200 growth-positive blood culture bottles flagged by BacT/ALERT or conventional systems were analyzed using an in-house PCR assay targeting the hyphal wall protein 1 (HWP1) gene. Analytical sensitivity was determined through ten-fold serial dilutions of confirmed Candidaalbicans DNA, and the assay performance was compared to conventional culture results. Results: The HWP1-PCR assay successfully detected Candida spp. DNA in 10 of 200 samples (5.0%; 95% CI: 2.7 - 9.0%), all confirmed as C. albicans by sequencing. The assay demonstrated 100% sensitivity and specificity, with no false-positive or false-negative results. The limit of detection (LOD) was 0.0174 ng/μL for genomic DNA. Conclusions: The HWP1-PCR assay shows excellent efficacy for the rapid identification of C. albicans, reducing the identification time by over 48 hours compared to traditional methods. This assay enhances the timeliness of antifungal treatment and is suitable for resource-limited settings. Future research should focus on multicenter validation and antifungal susceptibility testing to assess the impact of these findings on treatment strategies.
