Babol University of Medical Sciences

To improve exclusive breastfeeding, we must resolve challenges for mothers and babies. This study aims to determine the maternal factors contributing to failure of exclusive breastfeeding. This cross-sectional study was conducted in all infants who had attended the healthcare centers for their first 6‑month vaccinations from 2019 to 2021 in Babol, Iran. Maternal factors were collected using achecklist, including demographic, social, and midwifery information. Failure of exclusive breastfeeding was defined as using anything other than breast milk, such as pacifiers, bottles, sugar water, or complementary feeding for infants during the first 6months of life. Binary logistic analysis examined the influence of predictor variables on exclusive breastfeeding. The significance level was set at P < 0.05. Out of the 1400 infants, at the end of the study, 413 (29.5%) were exclusively breastfed. Multivariate regression showed education level (odds ratio [OR]: 1.42, P = 0.003) and urban residence (OR: 1.89, P < 0.001) to be associated with increased discontinuation, while term pregnancy (OR: 0.47, P = 0.008) served as apreventive factor. Breastfeeding education (OR: 6.7, P = 0.067) and breast problems (OR: 6.4, P = 0.082) had asixfold effect on the decrease and increase of discontinuation of exclusive breastfeeding, respectively, although this relationship was not statistically significant. This study showed that preterm delivery, higher education, and living in an urban area can increase the probability of failure of exclusive breastfeeding. These findings provide valuable insights for healthcare professionals and policymakers promoting and supporting exclusive breastfeeding.

Nature exposure has been associated with mental health and cognitive benefits among older adults. However, controlled trials evaluating specific types of nature-based interventions are limited. This study aims to examine the effects of two structured outdoor activities, walking with meaningful conversation and group meditation, on mental vitality and cognitive empowerment in elderly women. This is a three-arm parallel randomized controlled trial (RCT) enrolling 111 women aged ≥ 60 from 9 urban and rural health centers in Khafr County, Iran. Participants will be randomized into the following: (1) Walking with meaningful conversation group, (2) meditation in nature group, and (3) control group with no intervention. Each intervention consists of eight 2-h sessions across 8weeks. Assessments will occur at baseline, post-intervention (week 8), and 3-month follow-up using validated questionnaires on mental vitality and cognitive empowerment. The generalized estimating equation (GEE) model will be applied to analyze changes over time. We hypothesize that both intervention groups will show significant improvements compared to the control, with walking expected to yield greater gains in mental vitality and meditation to better enhance cognitive empowerment. Findings may support the implementation of community-based, non-pharmacological programs to promote active aging. Iranian Registry of Clinical Trials IRCT20241023063481N1. Registered on 18 February 2025.

Anxiety disorders are a leading cause of disability worldwide, influenced by genetic, environmental, and infectious factors. Toxoplasma gondii (T. gondii), a neurotropic parasite, has been implicated in various psychiatric disorders, but its association with anxiety remains unclear. This study aimed to evaluate the relationship between T. gondii infection and anxiety disorders in a case-control study. We recruited 90 anxiety disorder patients and 90 healthy controls from Shahid Yahyanezhad Hospital, Babol, Iran. Anxiety severity was assessed using the Beck Anxiety Inventory. Serum samples were analyzed for anti-T. gondii IgG antibodies via ELISA. Statistical analyses included chi-square tests and logistic regression models, adjusting for potential confounders. The seroprevalence of T. gondii was lower in anxiety patients (65.55%; 95% CI 54.8–75.2%) than in controls (82.22%; 95%CI 72.7–89.5%). Univariable (OR = 0.41, 95% CI: 0.21–0.82) and multivariable (OR = 0.37, 95% CI: 0.17–0.79) analyses suggested a significant protective effect of T. gondii against anxiety. This association was particularly notable in moderate anxiety cases (OR = 0.37, 95% CI: 0.14–0.96). Higher antibody levels correlated with lower anxiety scores, reinforcing this potential protective role. T. gondii infection may reduce anxiety disorder risk, particularly in moderate cases. These findings challenge conventional views on T. gondii’s neuropsychiatric effects and warrant further research into the underlying mechanisms.

Healthcare organizations must have the ability to adapt to rapid environmental changes and respond to evidence-based needs. One of the key prerequisites for the effective implementation of these changes is organizational readiness for knowledge translation (KT). The aim of this study is to identify the dimensions and components of organizational readiness for implementing KT in medical universities in Iran. This research was conducted using a scoping review approach based on the Arksey and O'Malley framework. A comprehensive search was performed without a time limitation in international databases such as PubMed, Scopus, Web of Science, and Persian databases MagIran and SID. Out of 4540 identified documents, 14 articles were included after screening and final assessment. After extracting the dimensions and components from the reviewed studies, five dimensions and 14 components were identified, as follows: Organizational Climate (culture of readiness and innovation, intra- and inter-organizational interactions, organizational dynamics), Organizational Support (development and training opportunities, financial resources, capacity building and organizational performance improvement), Change Management (strategies and change implementation capacity, leadership support), Organizational Context (knowledge management in the organization, organizational structure and technological advancement, social capital), and Human Resources (self-efficacy and motivation, leadership, collaboration and participation). This scoping review identified five key dimensions-Organizational Climate, Organizational Support, Change Management, Organizational Context, and Human Resources-comprising 14 components that constitute organizational readiness for KT. To enhance readiness, health system managers and policymakers must understand the importance of utilizing research evidence and, through skill development and fostering participation, create the necessary environment for implementing knowledge.

Mifepristone has demonstrated favorable effects in managing uterine myomas, particularly for patients aiming to preserve fertility. This study evaluates the effect of Mifepristone on uterine parameters, including uterine volume and endometrial thickness, across different dosages. A systematic review and meta-analysis were conducted by searching PubMed, Web of Science, Scopus, Embase, Cochrane Library, and clinical trial registries up to November 30, 2024. Eligible studies were randomized controlled trials (RCTs) comparing Mifepristone with placebo, other drugs, or different Mifepristone dosages in patients with uterine myoma. The primary outcomes were changes in uterine volume and endometrial thickness. Secondary outcomes included symptom relief, such as dyspareunia. Data were pooled using a random-effects model, and effect sizes were expressed as standardized mean differences (SMD) or relative risks (RR) with 95% confidence intervals (CI). Fourteen RCTs involving a total of 1260 patients were included. Higher doses of Mifepristone (10mg daily) compared to lower doses (5mg daily) were associated with greater, albeit non-significant, reductions in uterine volume (SMD: -0.08, 95% CI: -0.25 to 0.09, p = 0.35) and a non-significant increase in endometrial thickness (SMD: 0.22, 95% CI: -0.23 to 0.66, p = 0.34). The 10mg dose was significantly more effective in resolving dyspareunia (RR: 1.87, 95% CI: 1.59 to 2.20, p < 0.01). Our analysis indicated that Mifepristone was associated with a non-significant reduction in uterine volume among patients with uterine myoma. However, higher daily doses (10mg) demonstrated greater clinical benefits in relieving dyspareunia, despite minimal changes in uterine size. These findings suggest that higher doses (10mg daily) may be a consideration for symptom relief, particularly for dyspareunia, despite minimal changes in uterine size. This suggestion is preliminary, given the non-significant primary outcomes and low certainty of evidence for key comparisons.

Cancer immunotherapy has been revolutionized through the implementation of the state-of-the-art "chimeric antigen receptor" (CAR)-mediated therapies. CAR-based technologies, which encompass CAR T cells, CAR macrophages, and CAR-NK cells, show great promise in the treatment of various cancers. Despite the success of CAR-based therapies in treating malignancies, they face numerous challenges, including dysfunction of effector innate and adaptive immune cells, immunosuppressive tumor microenvironment (TME), antigen heterogeneity, and on-target/off-tumor bio-toxicity. The CD47/SIRPα axis is recognized as a critical innate immune checkpoint and is important in regulating myeloid-derived clearance of tumor cells and the innate-adaptive cells' cross-talk in cancer immunity. This signaling axis has risen as a promising target to boost the CAR-based immunotherapies by overcoming phagocytic inhibition and modulating immune evasion. This narrative review explores the integration of CD47/SIRPα modulation as an adjunct to CAR therapies. CD47/SIRPα immune-modulation revealed its potential to boost infiltration, persistence, and phagocytic activity of the immune cells. However, its blockade also poses challenges, including hematologic toxicities, CAR T cell clearance, and compensatory escape pathways. Future work will depend on selective targeting, combinatorial checkpoint modulation, and engineered CAR designs that preserve safety while unlocking durable responses. Herein, we discuss pre-clinical and clinical advancements, safety considerations, and cutting-edge advancements.

Background:This study aimed to investigate the possible restorative effects of bone marrow-derived mesenchymalstem cells (BM-MSCs) along with royal jelly (RJ) on a rat model of polycystic ovary syndrome (PCOS). Materials and Methods:In this experimental study, 50 female Wistar rats (150-200 g) were randomly assignedto five groups: control, PCOS, PCOS+BM-MSCs, PCOS+RJ, and PCOS+BM-MSCs+RJ. PCOS was induced bysubcutaneous injection of testosterone enanthate (100 mg/kg). BM-MSCs were administered via tail vein every twoweeks. RJ was given orally (500 mg/kg/day) for 14 days. Two weeks post-treatment, blood samples were analyzed forinterleukin 6 (IL-6), tumor necrosis factor alpha (TNF-α), vascular endothelial growth factor (VEGF), and cyclooxygenase-2 (COX2), using ELISA. Ovarian tissues were examined histologically, and bone morphogenetic protein 15(BMP15) and growth differentiation factor 9 (GDF9) levels were measured by Western blot.Results:RJ and BM-MSCs improved abnormal follicle structure in PCOS rats. The mean serum levels of IL-6(P=0.016) and TNF-α (P<0.0001) were significantly reduced in the PCOS+RJ+BM-MSCs group compared to thePCOS rats. However, there was no statistically significant reduction in expression of VEGF (P=0.090) and COX-2(P=0.104). The expression levels of BMP15 and GDF9 proteins were significantly reduced in PCOS rats comparedto the control group (P<0.0001), while in the PCOS+RJ+BM-MSCs group, the expression of BMP15 (P<0.001) andGDF9 (P<0.0001) proteins increased compared to the PCOS group.Conclusion:RJ and BM-MSCs may restore ovarian function by regulating inflammation, angiogenesis, and oocytequality.