Bam University of Medical Sciences

Traumatic brain injury (TBI) induces secondary neurodegeneration by interdependent inflammatory and oxidative processes. While cerium oxide nanoparticles (CeO2) exhibit antioxidant potential, regulation of Toll-like receptor 4 (TLR4)-driven neuroinflammation remains to be disclosed. The current study investigates the neuroprotective function of CeO2 in rat models of diffuse TBI focusing on the modulation of the TLR4 signaling pathway. Thirty-six male Wistar rats (n = 6/group) were randomly assigned to six groups: Sham, DMSO, TBI, and three TBI groups receiving CeO2 at 0.1, 0.5, or 1 µg/kg. Neuroinflammation (TLR4, TNF-α, IL-1β), markers of oxidative stress (MDA, NO, SOD, GPx), functional recovery through Veterinary Coma Scale (VCS), and histopathological changes were examined. CeO2 treatment demonstrated significant TLR4 suppression, corresponding with reduced pro-inflammatory cytokine release. The nanoparticles also concurrently inhibited oxidative damage by enhancing endogenous antioxidants. These molecular effects improved neural function, and treated animals were more responsive in motor and alertness tests. Histological analysis showed a reduction in edema in the CeO2 treated groups compared to the TBI group. The study establishes that CeO2 exert neuroprotection through following mechanisms: (1) TLR4-mediated anti-inflammatory action and (2) catalytic ROS scavenging. Notably, we identify TLR4 modulation as a previously unrecognized therapeutic target of CeO2 in TBI. These findings position CeO2 as a promising multitarget nanotherapeutic for TBI that can treat neuroinflammation and oxidative stress - two principal drivers of secondary injury simultaneously. This research provides groundbreaking evidence for the development of CeO2 based neuroprotective strategies and offers potential advantages over current pharmacological approaches under clinical evaluation.

ABSTRACTBackground: Physical and psychological complications and consequences of chemotherapy cause a decrease in the level of self-efficacy and self-esteem among patients. This study was conducted with the aim of evaluating the effect of training based on the family-centered empowerment model on patients’ self-efficacy and self-esteem undergoing chemotherapy.Methods: In this quasi-experimental study, 88 patients who were undergoing chemotherapy referred to Shahid Mostafa Khomeini Hospital in Ilam city, from July 2022 to July 2023, were assigned based on even and odd days of referral to the chemotherapy department in the intervention group (44 individuals) and control group (44 individuals). For the intervention group, the training program based on the family-centered empowerment model was conducted in 5 sessions of 45-60 minutes, once a week in the presence of an active family member of the patients; also,the control group did not receive any intervention and received only routine care. Data were collected using the demographic profile form, Scherer ‘s Self-Efficacy Questionnaire, and Rosenberg’s Self-Esteem Questionnaire. Data were analyzed through Stata software, version 15, using Chi-square,paired and independent t-test with a significance level of P<0.05.Results: After the intervention, the mean score of self-efficacy in the intervention group was higher than the control group (P=0.001). Moreover, the mean score of self-esteem in the intervention group was significantly higher than the control group (P=0.0005).Conclusion: Given the effect of the family-centered empowerment model training program in increasing the level of self-efficacy and self-esteem in cancer patients who were undergoing chemotherapy, the training of this intervention, along with other interventional measures, is recommended for patients undergoing chemotherapy by medical centers.

Purpose Neonatal mortality is a significant global health issue, particularly in low- and middle-income countries. This study aims to identify and understand the factors contributing to high neonatal mortality rates in the cities of Kerman and Bam, Iran, to develop effective strategies for improvement. Design/methodology/approach We employed systems dynamics to develop Causal Loop Diagrams that capture qualitative interactions among determinants of neonatal mortality. These CLDs were transformed into stock and flow diagrams for quantitative analysis. Using least squares regression techniques in MATLAB, we analyzed 60 months (2017–2021) of historical data from the Iranian Maternal and Neonatal database, the Integrated Health System (SIB), and Iran’s Statistical Yearbooks. Expert interviews and hospital informatics were also utilized to enhance the model’s robustness. Findings The developed model demonstrated a validation accuracy of approximately 94% based on Mean Absolute Percentage Error (MAPE). Key determinants were categorized into health factors (e.g. preterm birth, eclampsia), socio-demographic factors (e.g. maternal education, substance abuse), and healthcare system factors (e.g. NICU capacity, specialist staff). Simulation scenarios revealed that a 20% increase in NICU capacity could reduce neonatal mortality by 35% in Bam and 7% in Kerman. Additionally, hiring 15% more specialist staff reduced mortality by 10% in Bam and 7% in Kerman. Research limitations/implications While this study is based on data from two specific cities, which may limit its applicability to other regions with different healthcare infrastructures and socio-economic conditions, the integrated qualitative and quantitative methodology employed can be effectively applied to other areas and societies. Future research should expand to additional regions and incorporate more factors, such as genetic predispositions and environmental influences, to enhance the model’s generalizability and accuracy. The findings provide clear guidance for healthcare policymakers on effective resource allocation, such as expanding NICU capacity and training more healthcare professionals, to reduce neonatal mortality rates. Practical implications The model offers a robust framework for simulating intervention scenarios, enabling data-driven decision-making for optimizing healthcare strategies. By reducing neonatal mortality, this research contributes to the overall health and well-being of communities, fostering healthier families and populations, and leading to long-term societal benefits, including enhanced quality of life and economic productivity. Originality/value This study is among the first in Iran to utilize a comprehensive systems dynamics approach to analyze factors affecting neonatal mortality. It presents a highly accurate dynamic model that integrates qualitative and quantitative data, offering a replicable methodology adaptable to other regions facing similar health challenges. The innovative application of dynamic systems modeling in neonatal health provides significant contributions to healthcare management and public health, supporting global efforts to reduce neonatal mortality.

Abstract Aims Traumatic events of road traffic accidents (RTAs) lead mostly to post-traumatic stress disorders (PTSD). We aimed to investigate the psychometric properties of the PTSD-5 checklist at consecutive phone follow-ups and its applicability in screening for PTSD in RTA survivors. Subject and Methods The study assessed the reliability and applicability of PTSD-5 tool through phone surveys, within a national traffic cohort platform. We recruited 150 patients at one-, six-, and twelve-month follow-ups after discharge, enrolling 50 patients per phase. We measured reliability and the agreement using Kappa coefficients, percentages of agreement and Bland-Altman method. Data were analysed using STATA statistical software package version 15. Results The participants were mostly male (79.8%), with a mean age (SD) of 41 (14.7). More than 70% of participants were married or employed or educated. It had excellent internal consistency reliability at total and follow-up levels (Cronbach’s α = 0.95) and good total stability reliability (ICC=0.77,95%CI:0.68, 0.83). One month follow-up data showed poor stability reliability (ICC=0.32,95%CI:-0.10, 0.59). The agreement between test and retest data at six- and 12-month follow-ups was excellent. Total Kappa coefficient and the percentage of agreement were 0.58 and 71.3%, respectively. The Bland Altman plot on one-year follow-up data revealed more agreement at healthier state (lower scores). Conclusion The Persian PTSD checklist was highly reliable and applicable through phone interviews post discharge in road traffic injury adult patients. It was suitable to apply within the national cohort study and would decline the data collection costs.

Gastrointestinal (GI) cancers represent a major global health burden, significantly impacts the digestive system. Recent research has focused on the relationship between interleukin-6 (IL-6), interleukin-10 (IL-10), and C-reactive protein (CRP) to deepen understanding of GI cancer-including esophageal, gastric, pancreatic, hepatobiliary, and colorectal cancers-pathogenesis and to enhance diagnostic and therapeutic strategies. Elevated levels of IL-6, IL-10, and CRP have been associated with advanced disease stages and poor prognosis, underscoring their potential utility as biomarkers for disease progression and outcome prediction. Moreover, these markers appear to modulate the sensitivity of GI cancer cells to chemotherapy, suggesting that their assessment in serum and tissue samples could aid therapeutic decision-making and predict treatment responses. In addition to their diagnostic and prognostic value, IL-6, IL-10, and CRP are being investigated as targets for preventive strategies. These findings highlight the potential role of anti-inflammatory interventions in chemoprevention. Overall, studying the interplay among IL-6, IL-10, and CRP has yielded valuable insights into the molecular mechanisms driving GI cancer development and progression. Continued research is essential to fully elucidate these complex interactions and to translate these findings into effective clinical applications for the management of GI malignancies.

Addiction to narcotics, also known as opioid use disorder, brings extensive harm and challenges to the patient and society. Therefore, researchers have continually sought to find more effective protocols for treating this disorder. Pharmacological treatments have long been used for this purpose. In addition, the effectiveness of psychotherapies, specifically cognitive behavioral therapy (CBT), has always been reported in this regard. Accordingly, the present study focused on reviewing the existing findings in the mentioned field. To this end, reputable scientific databases were searched using selected keywords. The extracted findings were analyzed, categorized, and then edited in several stages. The obtained data demonstrated the efficacy of pharmacotherapy as a cornerstone of care for opioid-dependent patients. On the other hand, the findings revealed that the maintenance of treatment requires the prescription of psychotherapy, especially CBT. Therefore, the combined use of these two therapeutic approaches, in addition to the short-term effect, will also lead to long-term care for the patient. Given that controlling opioid dependence has considerable economic benefits for societies, designing and testing various combination protocols can be extremely cost-effective.