Knowledge Network System Research Articles

An online-to-offline service recommendation method based on two-layer knowledge networks

This paper introduces a novel method aimed at enhancing online-to-offline (O2O) services recommendations by utilizing two-layer knowledge networks. The primary objective of this method is to assist consumers in efficiently navigating the myriad of options available when choosing O2O services. Using co-occurrence relationships, we construct a two-layer knowledge network system, comprising a service knowledge network based on service usage information as the first layer and a consumer knowledge network, built on “co-used” behaviors as the second layer. The former is established upon service use data, while the latter is founded on “co-used” behaviors among consumers. The features and information of these two knowledge networks can complement each other to produce precise and effective recommendations. Empirical findings gained from our experiments demonstrate that: (1) the proposed recommendation method outperforms widely-used and state-of-the-art recommendation methods; (2) both the service knowledge network and consumer knowledge network play an equally significant role in O2O service recommendations; (3) the location of O2O services is an essential factor in consumers’ choices for services. Notably, this research also identifies the optimal parameter settings for the proposed recommendation method.

Building a Design-Rationale-Centric Knowledge Network to Realize the Internalization of Explicit Knowledge

A large number of publicly available documents, including patent documents and journal articles, can provide designers with creative stimuli, which could facilitate product innovation and collaborative design. As an important tacit knowledge, the acquisition, sharing, and reuse of design rationale (DR) is of great value to designers, which could help designers to better understand design intentions and ideas, support design automation, and promote better collaborative design. However, due to the fragmentation of DR in documentation, this hinders designer acquisition and reuse. If the DR fragments could be automatically extracted from the technical documents to build an interconnected knowledge network system, the problem would be effectively solved, which would further promote the development and utilization of digital archives. To address this issue, this study proposes a three-dimensional design knowledge network metamodel, Design Knowledge Semantic Network (DKSN), and a DKSN-based knowledge fusion method for the construction of a Design Knowledge Network (DKN). We set up an empirical experiment to verify the feasibility and performance of the method. Patent documents and open access research articles are used as sample documents, and a product data dictionary imported from ISO/TS 23768-1 is used as the predefined artifact dictionary. The results further confirm the feasibility and good application prospects of the proposed method.

Prevalence and Associated Risk Factors of Neonatal Hypoglycemia in Iran: A Systematic Review and Meta-Analysis

Background: Neonatal hypoglycemia is the most common metabolic abnormality affecting newborns and contributes to increased morbidity and mortality. Objectives: The present systematic review and meta-analysis aim to explore the prevalence and risk factors associated with neonatal hypoglycemia in Iran. Methods: A systematic search was performed in Iranian and international databases, including SID, MagIran, Barakat Knowledge Network System, PubMed, Scopus, Web of Science, and the Google Scholar search engine searched for relevant articles using valid keywords. The search process was updated until September 28, 2021. Data were analyzed using STATA 14 software, and the significance level for all tests was considered P<0.05. Results: In 14 reviewed articles with a sample size of 18217, the prevalence of hypoglycemia in Iranian newborns was 29% [95%CI: 21%, 37%, P=0.0001] (64% in boys and 37% in girls). The hypoglycemia prevalence was 67% in infants born via cesarean section compared to 24% in vaginally delivered infants. The lowest and highest prevalence of neonatal hypoglycemia was observed in Mashhad (12%) and Arak (53%), respectively. The most common risk factors for neonatal hypoglycemia in Iran were infant prematurity (61%), septicemia (45%), respiratory distress syndrome (RDS) (26%), small for gestational age (SGA) (26%), maternal diabetes (21%), hypocalcemia (19%), intrauterine growth restriction (IUGR) (9%) and perinatal asphyxia (8%). Conclusions: Neonatal hypoglycemia is very common in Iran, affecting nearly one-third of Iranian newborns. The prevalence of hypoglycemia in boys was almost twice as high as that in girls and 2.5 times higher in infants born by cesarean section than in infants delivered vaginally. Furthermore, prematurity was reportedly the most common risk factor for neonatal hypoglycemia in Iran.

The relationship between coffee consumption and the risk of gastric cancer; a systematic review and meta-analysis

Introduction: Stomach cancer is among five common malignancies whose prevalence and incidence are considerably associated with our dietary regime. Thus, the present study aims to conduct a systematic review and meta-analysis to evaluate the relationship between coffee drinking and the risk of stomach cancer. Materials and Methods: A comprehensive literature search of the databases, including Barakat Knowledge Network System, Cochrane, IranDoc, Web of Science, PubMed, SID, Magiran, Scopus, and Google Scholar web browser was conducted using standard keywords. Data analysis of this meta-analysis was conducted using STATA 14 software and P<0.05 was considered as a significant level for tests. Results: A total of 24 studies with a sample size of 990605 were reviewed which showed drinking coffee prevents stomach cancer [OR=0.89, (95% CI: 0.82, 0.98]. However, subgroup analysis by gender found no significant statistical relationship between coffee consumption and stomach cancer risk regarding male or female gender. However, the statistically significant relationship between coffee drinking and stomach cancer risk was assessed in several countries, including Korea, Turkey, Uruguay, Venezuela, and Singapore, with the largest effect being reported in Turkey [OR=0.51 (95% CI: 0.39,0.67]. Conclusion: Coffee consumption prevents and reduces the risk of developing stomach cancer.

The Prevalence of Obesity in Iranian Children: A Systematic Review and Meta-analysis

Background: The prevalence of childhood obesity has been on an increasing trend in the world during the past decades, with studies in Iran showing different and inconsistent prevalence rates. Objectives: This study was done to determine the prevalence of obesity in children through a meta-analysis approach. Methods: This study was done to determine the prevalence of obesity in children through a meta-analysis approach from January 2000 to January 2021. Articles related to the subject were obtained by searching Scopus, ScienceDirect, SID, Magiran, Barakat Knowledge Network System, Medline (PubMed), and Google Scholar databases. The heterogeneity of the studies was evaluated using the I2 index and the data were analyzed by Comprehensive Meta-analysis software. Results: In a study on 2,637,912 individuals aged 2-15 years, the overall prevalence of obesity in Iranian children was 11.4% (95% CI: 9.4-13.7%) based on a meta-analysis. Also, in order to investigate the effects of potential factors (sample size and year of study) on the heterogeneity of obesity prevalence in Iranian children, meta-regression was used. It was reported that the prevalence of obesity in Iranian children decreased and increased with increasing sample size and increasing years of the study, respectively, and both were significantly different from each other (P<0.05). Conclusions: Considering the high prevalence of obesity in Iranian children, it is necessary for health policymakers to take effective educational measures.

Simultaneous Presentation of Autoimmune Hepatitis and Wilson's Disease: A Systematic Review Study

Background: The specialists should identify the features of Wilson disease and autoimmune hepatitis when both affect a patient to adopt appropriate treatment. Objectives: This study was conducted to determine features of the patient, disease, diagnostic studies, and therapeutic measures in cases of simultaneity of Wilson disease and autoimmune hepatitis. Methods: To find evidence related to the study objectives, we searched databases such as Barakat knowledge network system, SID, Magiran, Google Scholar, Web of Science, ProQuest, Springer, ScienceDirect, Medline via PubMed, and Scopus with specified Persian and English keywords, including “Wilson’s Disease”, “Autoimmune”, and “Hepatitis”. The inclusion criteria for the studies were 1) the study was observational and 2) the study was published in Persian or English. The exclusion criteria included low-quality studies based on the score obtained from the checklist. The obtained studies were screened in terms of titles, abstracts, and full text, and finally, the qualified studies entered the review process. The relevant data were extracted according to a designed checklist. Results: Finally, 10 studies were included in the review process. Information about 14 patients was reported. The Mean±SD age of the participants in the studies was 19±11 years. The direction of diagnosis was from autoimmune hepatitis to Wilson disease in 8 cases and from Wilson disease to autoimmune hepatitis in 3 cases. The simultaneity of autoimmune hepatitis and Wilson disease was considered in 3 patients with no primary and secondary diagnosis. Conclusions: The comorbidity of Wilson disease and autoimmune hepatitis is uncommon but is important. In the presence of relevant symptoms in these patients, the comorbidity of these two diseases should be considered. Accordingly, additional assessments such as serum ceruloplasmin, urinary 24-h copper, molecular genetic testing, MRI, serological tests, anti-nuclear antibody, anti-mitochondrial antibody, anti-smooth muscle antibody, complement level, gamma globulin, IgG, albumin, Kayser-Fleischer ring eye examination, and liver biopsy should be considered for correct diagnosis. If appropriate treatment was started for the disease with a diagnosis of Wilson disease or autoimmune hepatitis, but the response to treatment was insufficient, it is better to consider the simultaneous occurrence of two diseases or the initial misdiagnosis.

Exploring the challenges and features of implementing performance-based payment plan in hospitals: a protocol for a systematic review

BackgroundImplementing performance-based payment (PBP) plan has led to developing a number of significant potentialities such as performance improvement and effectiveness, quality improvement of provided services, and decline in health system expenditure in hospitals. Despite the fact that PBP plan has a variety of potential advantages, its implementation still may face some challenges. Hence, it seems crucial to identify these barriers and challenges in order to devise some strategies and interventions to pave the way for better implementation of PBP in hospitals. The aim of this proposed protocol is to identify, summarize, and synthesize the existing evidence by undertaking a systematic review to explore the challenges, barriers, and features of implementing PBP in hospitals.Methods and analysisAn inclusive search of the literature will be conducted in seven international and national databases including PubMed/MEDLINE, Scopus, Cochrane Library and Web of Science, Magiran, Scientific Information Database (SID), and Barakat knowledge network system (BKNS). The search will be limited to the studies published in English or Persian language. Database search will be supplemented by hand-search of citation, reference lists, and grey literature sources. Based on the pre-established criteria in all steps of the review, two researchers will independently screen all of the retrieved studies. Any discrepancies will be resolved through a discussion between two researchers. In cases where consensus is not reached, it will be referred to a third researcher. The methodological quality of all the included studies will be appraised using the Mixed Methods Appraisal Tool (MMAT). The data will be extracted by means of using a data extraction form, which will be developed and piloted by the research team. The findings will be synthesized through directed content analysis method.DiscussionWith the growth and development of payment systems all over the world, it is expected that recognizing the challenges of implementing a PBP plan in hospitals will be useful in developing and designing strategies to better implement this plan.Systematic review registrationPROSPERO registration number CRD42020152569

A Systematic Review and Meta-analysis on the Prevalence of Low Birth Weight Infants in Iran.

Background Low birth weight is a significant index for survival, intrauterine growth, and mortality in infants. Thus, this study is aimed at determining the prevalence of low birth weight in Iranian infants through a systematic review and meta-analysis. Methods This study was performed by meta-analysis from January 2000 to December 2019. The studies relevant to the topic have been obtained through search in databases of Scopus, ScienceDirect, SID, Magiran, Barakat Knowledge Network System, Medline (PubMed), and Google Scholar. Heterogeneity of the studies has been assessed by the I2 index, and data analysis was done using Comprehensive Meta-Analysis software. Results By investigating 14 articles and 93924 infants, the total prevalence of low birth weight in infants in Iran was achieved at 8.5% (95% CI: 7.3-9.9%) according to the meta-analysis; the most prevalence of low birth weight was in infants in Hamedan at 19.1% (95% CI: 21.2-17.2%) in 2007, and the lowest prevalence of low birth weight was in infants in Tonekabon at 4.2% (95% CI: 3.4-5.2%) in 2005, and also, by increasing the sample size, the prevalence of low birth weight increases, by which the difference is statistically significant (P < 0.05). Conclusion Due to the high prevalence of low birth weight in infants in Iran, health policy-makers must take effective attempts in order to reduce it in infants.

The Prevalence of Restless Legs Syndrome in Patients with Migraine: A Systematic Review and Meta-Analysis.

Background Migraine is a severe and debilitating neurologic disorder and is claimed to be the sixth disabling illness in the world. This study aimed to determine the overall prevalence of restless legs syndrome (RLS) in patients with migraine through a systematic review and meta-analysis. Methods To identify and select related studies, the Scopus, ScienceDirect, Embase, SID, IranDoc, Web of Science, Knowledge Network System Medline (PubMed), and Google Scholar databases were searched. All related cross-sectional studies, published in English or Persian language between January 2000 and December 2019 and using the keywords such as migraine, restless leg syndrome, sleep disorder, RLS, and migraine disorder, were collected. The heterogeneity of the studies was assessed using the I2 index, and the data analysis was performed using the Comprehensive Meta-Analysis software. Results Analysis was conducted on the reported results of the final 12 articles with the total sample size of 15196. The overall prevalence of RLS in patients with migraine was 16.3% (95% CI: 12.6–20.8%). The prevalence of RLS migraine patients decreased with increasing the sample size, and the prevalence of RLS migraine patients increased with increasing the research year, which was statistically significant (P < 0.05). Conclusion This study highlights that RLS is high in patients with migraine, and therefore, the clinicians should be aware of its incidence and take preventive measures.

Development of Reader Service System for Digital Library

Digital library is an extensible knowledge network system based on computer communication and sharing in the network environment. To meet the needs of digital library, a reader oriented reader service system for digital library is developed by using computer technology, communication technology and network technology. The system includes user management, book borrowing and returning, book reservation, book display, book review and other functions. Combined with the push function of mobile phone, the system realizes the purpose of carrying out book borrowing service for readers more efficiently. Through the integration of library service and digital communication, the reader service system of digital library can make readers enjoy digital information resources conveniently and quickly at any time and any place.

Health Literacy in the Population of Diabetic Patients in Iran: A Systematic Review and Meta-Analysis

The present systematic review and meta-analysis were conducted to find the degree by which the Iranian diabetic patients were informed about their disease in term of health literacy. The search was carried out in databases including the PubMed, MEDLINE (PubMed), Scopus, Embase, Cochrane Library, ProQuest, Web of Science, Science Direct and Wiley and also domestic databases including the Iranian Academic Center for Education Culture and Research (sid.ir), the Iranian Research Institute for Information Science and Technology (IranDoc.ac.ir), Barakat Knowledge Network System (barakatkns.com), the national publications database (magiran.com) and also Google Scholar and Elmnet search engines. All the original studies published by Oct 20, 2018, in Persian or English, to assess the health literacy of adults with diabetes were included in the study. Ultimately, 17 articles were included in the meta-analysis. The meta-analysis was carried out using the fixed-effects method using Stata-11.2. The pooled mean score of health literacy was 56.65 out of score of 100, and its 95% CI was estimated as 49.85 to 63.45. No significant heterogeneity could be reported for the articles included in the meta-analysis (I-squared=21.3%, P=0.177). The pooled mean scores with the CI of 95% by gender based on the study population in women and men were estimated as 47.97and 50.06 respectively. Health literacy is not high in Iranian diabetic patients and is rather inadequate in most of them in both genders. Diabetic women have somewhat lower health literacy compared to diabetic men.

The Concept of Successful Aging: A Review Article.

BackgroundWith the increasing number of elderly people in the world, usage of concepts and terminology related to this phenomenon has substantially increased. One concept in this context is successful aging. The purpose of the present study is to extract and introduce a common concept to be used in studies on measuring successful aging.MethodsThis is a review study. First, by searching the databases of Magiran, Noormags, Medlib, Irandoc, Iranmedex, Barakat Knowledge Network System, Civilica, SID, ISI Web Of Science, PubMed, Scopus, Science Direct and search engines, Google Scholar and Elmnet as well as using standard keywords such as elder, elderly, aging, and successful aging, all related published articles during the period 1995 to 2017 were retrieved. A total of 3417 documents were retrieved. By removing 3390 unrelated, duplicate and unusable documents, 27 articles were included in the study after quality control.ResultsThe findings of the study were categorized in three areas: “defining successful aging by focusing on dimensions”, “successful aging principles” and “factors influencing successful aging”. Reviewing various studies, we found that the definition of successful aging deals with cognitive action, perception, control, life satisfaction, and ethics. Successful aging is also defined as having inner feelings of happiness and satisfaction with life for the present and the past. Sometimes successful aging is also considered to be survival with health.ConclusionHealth care professionals as community health supporters can use the results from the present study for providing the grounds for successful aging. Then, they can use the designed successful aging program for preserving and promoting active and healthy aging for every elderly person in old age.

Benefits and Challenges of Policy Options in Rationing the Hospital Radiology Services: A Case Study

Objective: In many countries, limiting the financial and budgetary resources is a challenge in the health system. One of the most costly parts of the health system is undoubtedly the radiology department of hospitals. Therefore, this study aimed to determine the benefits and challenges of the policies proposed for rationing hospital radiology services. Information sources and selected methods for study: In this narrative or literature review study, Persian (SID, Magiran, Barkat Knowledge network system, Irandoc), and Latin (Google Scholar, PubMed, Scopus, ISI web of sciences) databases were searched. The applied keywords were radiology, rationing, distribution, priority setting, resource allocation, and policy brief. In the initial search, 145 articles were studied. Subsequently, after reviewing the titles and abstracts, 65 studies were selected and investigated. Finally, 44 related studies were thoroughly investigated. The inclusion criteria covered the studies in Persian or English. The exclusion criteria included the studies that did not have full texts. Our search included the studies conducted from 1/1/2000 to 1/1/ 2017. Results: The present study examined the benefits and challenges of radiology services rationing. Policy options were presented at 3 levels of provider, organizational, and system. The provider level consisted of training clinical and non-clinical personnel to use and maintain the medical equipment and requiring the physicians to use clinical guidelines. The organization level included reviewing imaging tariffs, entering insurance in controlling supply and demand for radiology services, and assessing equipment by the Institute for Health Technology Assessment. The system level contained assignment of radiological services to the private sector. Conclusion: As health care costs are rising and resources are increasingly constrained by ever-increasing demands, policy makers and officials can use the proposed solutions with regard to contextual conditions to design a rationing model. Services at the macro level of the health system and operationalization of the rationing process reduce the gap between supply and demand of the health services.

The prevalence of severe depression in Iranian older adult: a meta-analysis and meta-regression

BackgroundDepression is one of the most common psychiatric disorders in the older adult and one of the most common risk factors for suicide in the older adult. Studies show different and inconsistent prevalence rates in Iran. This study aims to determine the prevalence of severe depression in Iranian older adult through a meta-analysis approach.MethodsThe present meta-analysis was conducted between January 2000–August 2019. Articles related to the subject matter were obtained by searching Scopus, Sciencedirect, SID, magiran, Barakat Knowledge Network System, Medline (PubMed), and Google Scholar databases. The heterogeneity of the studies was evaluated using I2 index and the data were analyzed in Comprehensive Meta-Analysis software.ResultsIn a study of 3948 individuals aged 50–90 years, the overall prevalence of severe depression in Iranian older adult was 8.2% (95% CI, 4.14–6.3%) based on meta-analysis. Also, in order to investigate the effects of potential factors (sample size and year of study) on the heterogeneity of severe depression in Iranian older adult, meta-regression was used. It was reported that the prevalence of severe depression in Iranian older adult decreased with increasing sample size and increasing years of the study, which is significantly different (P < 0.05).ConclusionConsidering the high prevalence of severe depression in Iranian older adult, it is necessary for health policy makers to take effective control measures and periodic care for the older adult.

Factors Associated with Non-Suicidal Self-Injury (NSSI) in Iran: A Narrative Systematic Review

Background: Non-suicidal (NSSI) refers to the intentional damage of one’s own body without a suicidal intent, which involves common behaviors such as cutting, burning, scratching, and hitting the body. Identifying factors associated with the development and continuity of NSSI is a research priority, as prevention is crucial. The aim of the current study was to determine factors associated with NSSI in Iran. Materials and Methods: In this systematic review, Persian databases including Barakat Knowledge Network System, Magiran, SID, and international databases including Scopus, Medline, and Web of Science were searched for relevant publications in English and Persian by using the following Medical Subject Headings search terms: self-injurious OR deliberate self-harm OR deliberate self-harm OR self-destructive behavior OR non-suicidal self-injury AND Iran: from 1983 until September 2019. Two independent reviewers studied the full text of the articles and extracted the main results. The results of studies were classified and presented descriptively with a narrative approach. Results: A total of 334 articles were found of which 18 articles (n= 17343) met the inclusion criteria and were reviewed. More than half of the reviewed articles were cross-sectional (n=16). Three main themes were identified: factors associated with baseline characteristics (such as age and gender); mental disorders (such as depression); and psycho-social factors associated with mental disorders (such as self-concept disturbance). Conclusion: The meaning of identified main themes shows that the most important factor in occurrence of NSSI in Iranian patients is mental health status. Since the majority of studies were cross-sectional, the data do not yet justify risk factors. Therefore, longitudinal studies with adequate methodological qualities are recommended in future studies.

Systematic review and meta-analysis of quality of work life in Iran (2011–2017)

Background:Quality of work life (QWL) is considered as a universal concept in human resource management and organizational development, and its promotion is the key to the success of organizations’ management. Therefore, the present study aimed to evaluate the QWL in Iran through systematic review and meta-analysis.Methods:In this study, all articles related to the QWL in Iran during the years 2011–2017 were systemically reviewed by searching national and international databases such as Science Direct, PubMed, Scopus, Web of Science, Springer, SID, Magiran, Barakat Knowledge Network System, Medlib, and the Google Scholar search engine using valid keywords. The results of the studies were combined using the random effects model. The heterogeneity of studies was studied using the I2 index. Data analysis was done using STATA ver 11.Results:The mean QWL score of 15,323 samples were 60.13, 36.80, 76.19, 58.90, 68.78, 50.69, 32.24, 8.01, 70.63, 39.70, and 44.41 based on Walton, Casio, Sirgy, Mirsepasi, SF-36, Ghasem zadeh, Dehghan, Dargahi, NIOSH, Venlar, Quality of nursing work life questionnaires, respectively. Meta-regression showed that the QWL of employees had no significant relationship with the sample size and years of research.Conclusions:The mean score of QWL in Iranian employees was 56.90, with the highest and the lowest score for the questionnaire.

Barriers of Adolescents' Access to Reproductive and Sexual Health Services in Iran: A Systematic Review

Background: Adolescence is an important period in human life and the low-level access of adolescents to reproductive and sexual health services is a concern because preventive, diagnostic and therapeutic services are needed for healthy sexual and reproductive behaviors. This study was conducted with the aim of considering the barriers against adolescent access to reproductive and sexual health services in Iran. Materials and Methods: All Iranian qualitative and quantitative studies which were published without time limit were entered in this systematic review article. The investigation was performed in the international databases such as Scopus, Medline, ProQuest, and Cochrane Library and national databases such as Magiran, SID, IranDoc, and Barakat Knowledge Network System. Keywords were selected based on the Mesh and include: Youth, Teenager, Adolescent health service, and Iran, combined with the Boolean OR and AND operators. Ultimately, two researchers reviewed articles for the quality appraisal (Newcastle-Ottawa tool for observational studies and JBI-QARI tool for qualitative studies), and extracted their main findings, independently. Results: Finally, 10 articles (with 1,933 population) that comprised including criteria were selected. Articles were quantitative (n=8), and qualitative (n=2) types and their year of publication varied from 2009 to 2018. Barriers against adolescent access to reproductive and sexual health services were classified into four main categories (individual barriers, structural barriers, social barriers, and policy barriers). Conclusion: Based on the results, the barriers of adolescent access to reproductive and sexual health services include individual, structural, social, and policy barriers. Because the development of adolescents’ demands is crucial for all societies, through identification and removal of these barriers, we can promote the access of the youth to adolescent health services.

Is latent tuberculosis infection challenging in Iranian health care workers? A systematic review and meta-analysis.

The high chances of getting latent tuberculosis infection (LTBI) among health care workers (HCWs) will an enormous problem in low and upper-middle-income countries. Search strategies were done through both national and international databases include SID, Barakat knowledge network system, Irandoc, Magiran, Iranian national library, web of science, Scopus, PubMed/MEDLINE, OVID, EMBASE, the Cochrane library, and Google Scholar search engine. The Persian and the English languages were used as the filter in national and international databases, respectively. Medical Subject Headings (MeSH) terms was used to controlling comprehensive vocabulary. The search terms were conducted without time limitation till January 01, 2019. The prevalence of LTBI in Iranian's HCWs, based on the PPD test was 27.13% [CI95%: 18.64-37.7]. The highest prevalence of LTBI in Iranian's HCWs were estimated 41.4% [CI95%: 25.4-59.5] in the north, and 33.8% [CI95%: 21.1-49.3] in the west. The lowest prevalence of LTBI was evaluated 18.2% [CI95%: 3.4-58.2] in the south of Iran. The prevalence of LTBI in Iranian's HCWs who had work-experience more than 20 years old were estimated 20.49% [CI95%: 11-34.97]. In the PPD test, the prevalence of LTBI in Iranian's HCWs who had received the Bacille Calmette-Guérin (BCG) was estimated 15% [CI95%: 3.6-47.73]. While, in the QFT, the prevalence of LTBI in Iranian's HCWs in non-vaccinated was estimated 25.71% [CI95%: 13.96-42.49]. This meta-analysis shows the highest prevalence of LTBI in Iranian's HCWs in the north and the west probably due to neighboring countries like Azerbaijan and Iraq, respectively. It seems that Iranian's HCWs have not received the necessary training to prevent of TB. We also found that BCG was not able to protect Iranian's HCWs from TB infections, completely.

Mortality in Neonatal Intensive Care Units in Iran: A Systematic Review and Meta-Analysis

Background: Neonatal mortality rate is an important health index. The present study was conducted to determine the mortality rate and its causes in neonatal intensive care units (NICUS) in Iran. Methods: Online search was done without time limit until June 2018 in several databases, such as PubMed, Web of Science (ISI), Scopus, Magiran, Barakat Knowledge Network System, SID, Iranian National Library, Regional Information Center for Science and Technology (RICST), Google Scholar search engine, and Iranian journals. The articles were qualitatively assessed after evaluating the inclusion and exclusion criteria. The Cochran's Q test and I2 index were used to determine the heterogeneity between studies. Meta-analysis was done based on a random effects model using Comprehensive Meta-Analysis Software (version 2). Results: Thirty-one eligible studies were analyzed. The mortality rate in 24,995 neonates admitted to NICUs in Iran was estimated to be 11.40% (95% CI: 9.10-14.20). The lowest mortality rate reported as 7.70% (95% CI: 6.01-9.82) was related to the Center of Iran, and the highest mortality rate was reported as 19.26% (95% CI: 15.82-23.24) in the west of Iran. In this regard, the difference was statistically significant (P<0.001). The most common causes of mortality in NICUs in Iran were prematurity (44.14% [95% CI: 31.95-57.08]), respiratory distress syndrome (RDS) (31.93% [95% CI: 22.83-42.66]), congenital malformation (16.09% [95% CI: 12.85-19.95]), septicemia (12.66% [95% CI: 8.87-17.75]), and asphyxia (7.58% [95% CI: 4.63-12.19]). Conclusion: The most common causes of mortality in Iranian neonates were prematurity, RDS, and congenital anomalies. We also found the mortality rate to be acceptable (11.4%). To reduce the mortality rate, we recommend performing prenatal screening tests and genetic counseling. In addition, maternal care during pregnancy should be improved to reduce premature delivery.

The etiology and prevalence of urinary tract infection and asymptomatic bacteriuria in pregnant women in Iran: a systematic review and Meta-analysis

BackgroundUrinary tract infection (UTI) is a common clinical problem in pregnant women. Bacteriuria in pregnancy without antibiotic treatment could result in complications. This study aims to investigate the etiology and prevalence of UTI and asymptomatic bacteriuria (ASB) in pregnant women in Iran.MethodThis meta-analysis follows the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines. To avoid bias, all steps of the study were carried out independently by two researchers. We conducted a comprehensive search on all the related literature in national databases, including IranDoc, SID, Barakat Knowledge Network System, RICST, Magiran, Iranian National Library and international databases, including Scopus, Embase, Science Direct, PubMed/ Medline, Cochrane Library, Web of Sciences, EBSCO, as well as Google Scholar search engine until June 2018. After considering the inclusion/exclusion criteria and qualitative evaluation, studies were analyzed based on random effects model using Comprehensive Meta-Analysis Software Version 2.ResultsIn 31 studies with a sample size of 20,309, the prevalence of ASB in pregnant Iranian women was estimated to be 8.7% (95%CI: 7.2–10.4). The lowest and highest prevalence of ASB were observed in the third trimester (6.1% [95%CI: 2.1–16.4]) and first trimester (11.7% [95%CI: 7.9–16.9]), respectively. Subgroup analysis of the prevalence of ASB based on geographical region (P = 0.002) and province (P < 0.001) was significant but for the quality of studies (P = 0.51) was not significant. In 17 studies including 48,731 pregnant women, the prevalence of UTI was estimated to be 9.8% (95%CI: 7.6–12.5). The test for subgroup differences of prevalence of UTI for province (P < 0.001) was significant but for geographical region (P = 061) and quality of studies (P = 0.11) was not significant. Meta-regression model for the prevalence of UTI and ASB in pregnant women in Iran based on year of the studies was significant (P < 0.001). The most common microorganism involved in the etiology of UTI (61.6% [95%CI: 51.6–70.7]) and ASB (63.22% [95%CI: 51.2–73.8]) was E. coli.ConclusionUTI and ASB are prevalent in pregnant women in Iran. Therefore, UTI screening is essential in pregnant women. The most common microorganism involved in the etiology of UTI and ASB in pregnant women in Iran is E.coli.