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Abstract Hodgkin lymphoma (HL) is a rare malignancy affecting the lymphatic system. Our study examined the incidence rates of adult HL based on sex, race/ethnicity, age, and histological subgroups in the United States (US) from 2000 to 2020. Data for this study were extracted from the Surveillance, Epidemiology, and End Results 22 database. HL patients were identified utilizing the International Classification of Diseases for Oncology version 3 and categorized as classical HL, lymphocyte-rich/mixed cell/lymphocyte depleted, nodular sclerosis, classical HL, not otherwise specified, and nodular lymphocyte-predominant HL. The study reported average annual percent change (AAPC). All estimates were presented as counts and age-standardized incidence rates (ASIRs) per 100,000 individuals. Between 2000 and 2019, a total of 70,924 cases of HL were reported in the US. Classical HL was the predominant subtype (94.27%), and most incident cases were among non-Hispanic Whites (66.92%) and those aged 20–29 years (24.86%). The ASIR per 100,000 population was 3.83 for men and 2.92 for women. Both sexes showed declines in the AAPCs between 2000 and 2019 (− 0.64% [− 0.99, − 0.28] and − 0.40% [− 0.77, − 0.03] for men and women, respectively). There was a significant decrease in ASIRs after COVID-19 among both sexes (percent change: − 7.49% [− 11.58, − 3.40]). Throughout all age groups, men had a higher incidence rate compared to women, except for those aged 20–29 years. Although the overall HL incidence rate was lowered in the study period from 2000 to 2019, a dramatic decrease in ASIRs of HL patients following COVID-19 pandemic was observed.

Abstract Introduction Laryngeal cancers account for one-third of all head and neck cancers. We aimed to report the incidence trends of laryngeal cancer over 2000–2020 in the United States (US), by age, sex, race/ethnicity, and histological subtypes. Methods Data from the Surveillance, Epidemiology, and End Results 22 database were used to identify patients with laryngeal cancer based on the International Classification of Diseases for Oncology, version 3. Age-standardized incidence rates (ASIRs) for laryngeal cancer, adjusted for reporting delays, were calculated. The Joinpoint Regression Program was then utilized to determine annual percent changes (APCs) and average annual percent changes (AAPCs) in the trends. The analysis excluded data from 2020 to prevent potential bias related to the COVID-19 pandemic. Results A total of 104,991 cases of laryngeal cancer were identified in the US from 2000 to 2019. Squamous cell carcinoma was the predominant subtype, accounting for 94.53% of cases. Above 73.20% occurred among non-Hispanic whites, with the highest incidence observed among individuals aged 55–69 years (46.71%). The ASIRs were 5.98 and 1.25 per 100,000 population for men and women, respectively. Over 2000–2019, there was a significant reduction in ASIRs for laryngeal cancer in both sexes. Non-Hispanic black men exhibited the highest ASIR (9.13 per 100,000) and the largest decline in the ASIRs over 2000–2019 (AAPC: -3.26%). Conclusions Laryngeal cancer incidence rates showed a decline from 2000 to 2019, in addition to 2020, during the COVID-19 pandemic. Additional research is required to investigate risk factors and their influence on incidence rates of laryngeal cancer.

Background: Non-Hodgkin lymphoma (NHL) originates from the lymphoid tissues with a great morbidity and economic burden. It accounts for about 5 % of cancers in the United States (US) in 2024. We aimed to report the incidence trend of pediatric NHL in the US over 2000–2020, by age, sex, and subtype. Methods: We utilized data from the Surveillance, Epidemiology, and End Results (SEER) Program. Cases were categorized using the International Classification of Diseases for Oncology version 3. We reported age-standariszed incidence rates (ASIRs) and average annual percent changes (AAPC). Results: From 2000 to 2019, there were 38,098 reported cases of pediatric NHL, with B-cell NHL being the most common subtype (84.31 %). Most cases were observed in non-Hispanic Whites (46.71 %) and children aged ≤4 years (37.26 %). The ASIR per 100,000 population was 5.47 (5.40–5.54) for males and 3.95 (3.89–4.01) for females. Over the study period, both sexes showed significant increases in ASIRs (AAPCs of 0.93 % for males and 0.51 % for females). However, no significant changes were observed in the ASIRs of pediatric NHL across all races and both sexes after the COVID-19 pandemic (percent change: 1.30 % [-5.10, 7.70]). Conclusions: While overall incidence rates remained stable, significant demographic variations were evident, including increases among Hispanic males and decreases among NHB females. There is a need for targeted interventions to address demographic disparities and the complex interplay of genetic, environmental, and lifestyle factors influencing NHL ASIRs in pediatric populations.

Abstract Cancers of the kidney and renal pelvis are among the most prevalent types of urinary cancers. We aimed to outline the incidence trends of kidney and renal pelvis cancers by age, sex, race/ethnicity, and histology in the United States (US) from 2000 to 2020. The data was obtained from the Surveillance, Epidemiology, and End Results (SEER) 22 database. The identification of patients with kidney and renal pelvis cancers with morphologies of renal cell carcinoma, nephroblastoma, sarcoma, and neuroendocrine tumor was conducted utilizing the International Classification of Diseases for Oncology version 3. The average annual percent change (AAPC) were presented. All estimates were given in the form of counts and delayed age-standardized incidence rates (ASIRs) per 100,000 people. From 2000 to 2019, a total of 490,481 cases of kidney and renal pelvic cancer were recorded across all age groups in the US. The majority of them were among Non-Hispanic Whites (NHWs) (69.75%) and those aged 55–69 years (39.96%). The ASIRs per 100,000 for kidney and pelvis cancers were 22.03 for men and 11.14 for women. Non-Hispanic Black men had the highest ASIR (24.53 [24.24, 24.81]), and increase in ASIR over the 2000–2019 period (AAPC: 2.19% [1.84, 2.84]). There was a noticeable increase in incidence of kidney and renal pelvis cancers. Individuals aged 70–84 years had the highest ASIR for kidney and renal pelvis cancers. The COVID-19 era has resulted in a significant reduction in incidence rates across all demographics.

Abstract Myeloma is one of the most common types of haematological malignancies. We aimed to investigate the incidence rates of myeloma by sex, race, age, and histological subgroups in the United States (US) over 2000–2020. Data were retrieved from the the Surveillance, Epidemiology, and End Results (SEER) 22 database. The International Classification of Diseases for Oncology version 3 morphological codes 9731, 9732, and 9734 were assigned for solitary plasmacytoma of bone, plasma cell myeloma, and extraosseous plasmacytoma, respectively. Average annual percent change (AAPC) and the pairwise comparison with the parallelism and coincidence were reported. All estimates were reported as counts and age-adjusted incidence rates per 100,000 individuals. Over 2000–2019, most of myeloma cases were among those aged at least 55 years (85.51%), men (54.82%), and non-Hispanic Whites (66.67%). Among different subtypes, plasma cell myeloma with 193,530 cases had the highest frequency over the same period. Also, there was a significant decrease in the age-standardized incidence rate of myeloma across all races/ethnicities in both sexes within all age groups (AAPC: − 8.02; 95% confidence interval (CI): − 10.43 to − 5.61) and those aged

BackgroundMultiple sclerosis (MS) is characterized by inflammation and demyelination in the central nervous system. Recent studies have suggested a potential association between MS and an increased risk of atherosclerosis, a systemic vascular disease involving arterial wall thickening. Understanding this relationship is crucial, given the heightened cardiovascular risk observed in MS patients.ObjectiveTo investigate factors influencing the development of atherosclerosis in patients with multiple sclerosis (pwMS), focusing on carotid intima-media thickness (CIMT) as a marker.Methods114 pwMS (82 females and 32 males) and 127 control subjects (57 females and 70 males) were included. The mean CIMT between the two groups was compared. Additionally, the effects of annual relapse rate, EDSS (Expanded Disability Status Scale), MS duration, treatment duration, and type of Disease-modifying treatment (DMT) on CIMT were evaluated.ResultsThis study included 241 participants with a mean (SD) age of 41.13 years (10.93). CIMT was significantly higher in pwMS compared to controls (p < 0.001). Even after adjusting for age, sex, and BMI (Body Mass Index), CIMT remained significantly higher in the pwMS group (p < 0.001). Spearman's correlation analysis revealed significant associations between CIMT and age, BMI, EDSS score, and disease duration (all p < 0.05). Additionally, the SPMS (Secondary Progressive Multiple Sclerosis) disease course was significantly associated with higher CIMT (p < 0.001). Linear regression analysis identified age as the most significant predictor of increased CIMT in pwMS (p < 0.001), followed by BMI (p = 0.054).ConclusionThis study demonstrates a significant association between MS and increased CIMT. Additionally, age emerged as the most prominent predictor of high CIMT in pwMS, followed by BMI. These findings suggest a potential link between MS and increased cardiovascular risk. Further research is warranted to explore the underlying mechanisms and investigate the long-term cardiovascular outcomes in this population.

BackgroundAlthough rare, small intestine cancer is on the rise in the developed world. We aimed to investigate the incidence trends of small intestine cancer by sex, race/ethnicity, age, and histological subgroups in the United States (US) over 2000-2020. Also, we evaluated the COVID-19 impacts on the incidence trends of this cancer.MethodsData were collected from the Surveillance, Epidemiology, and End Results 22 database. Both the average annual percent change (AAPC) and age-standardized incidence rates (ASIRs) were determined. The findings were expressed as counts and incidence rates adjusted for age per 100,000 people with 95% confidence intervals (CIs).ResultsA total of 67,815 cases of small intestine cancer across all age groups were reported in the US between 2000 and 2019. Neuroendocrine carcinoma was the most often reported subtype (54.26%). The age group of 55 to 69 years (38.08%), men (53.10%), and Non-Hispanic Whites (69.07%) accounted for the majority of cases. Over 2000-2019, the ASIRs for small intestine cancer among men and women were 2.61 (95% CI: 2.59-2.64) and 1.92 (95% CI: 1.89-1.94) per 100,000, indicating a significant increase of 2.01% and 2.12%, respectively. Non-Hispanic Black men had the highest ASIR (4.25 per 100,000). Also, those aged 80-84 age group had the highest ASIR. During COVID-19, the ASIR of small intestine cancer decreased by 8.94% (5.06-12.81%).ConclusionsSmall intestine cancer incidence raised in all sexes and ethnicities. Following COVID-19, reported cases declined, possibly due to pandemic-related diagnostic challenges. The impact of underdiagnosis on patient survival needs further investigations.

Abstract Introduction Tension-type headache (TTH) is the most prevalent neurological disorder. As there is a gap in the literature regarding the disease burden attributable to TTH in the Middle East and North Africa (MENA) region, the aim of the present study was to report the epidemiological indicators of TTH in MENA, from 1990 to 2019, by sex, age and socio-demographic index (SDI). Methods Publicly available data on the point prevalence, annual incidence and years lived with disability (YLDs) were retrieved from the global burden of disease (GBD) 2019 study for the 21 countries and territories in MENA, between 1990 and 2019. The results were presented with numbers and age-standardised rates per 100000 population, along with their corresponding 95% uncertainty intervals (UIs). Results In 2019, the age-standardised point prevalence and annual incidence rates for TTH in the MENA region were 24504.5 and 8680.1 per 100000, respectively, which represents a 2.0% and a 0.9% increase over 1990-2019, respectively. The age-standardised YLD rate of TTH in this region in 2019 was estimated to be 68.1 per 100000 population, which has increased 1.0% since 1990. Iran [29640.4] had the highest age-standardised point prevalence rate for TTH, while Turkey [21726.3] had the lowest. In 2019, the regional point prevalence of TTH was highest in the 35-39 and 70-74 age groups, for males and females, respectively. Furthermore, the number of prevalent cases was estimated to be highest in those aged 35-39 and 25-29 years, in both males and females, respectively. Moreover, the burden of TTH was not observed to have a clear association with SDI. Conclusions While the prevalence of TTH in the MENA region increased from 1990 to 2019, the incidence rate did not change. In addition, the burden of TTH in MENA was higher than at the global level for both sexes and all age groups. Therefore, prevention of TTH would help alleviate the attributable burden imposed on the hundreds of millions of people suffering from TTH around the region.

Abstract Introduction: Adopting health-promoting lifestyle might be affected by a variety of factors. The existing evidence suggests that social support can improve health by fulfilling physical and mental needs. This study aimed to investigate the association between social support and health-promoting lifestyle in Pregnancy. Methods: Using multistage cluster sampling method, this cross-sectional study was conducted on 360 pregnant women. Data were collected using three questionnaires, including a self-reported demographic and obstetric, health-promoting lifestyle profile and perceived social support questionnaires. Data were analyzed using a t-test, repeated measures ANOVA, and multivariate linear regression model with SPSS software ver. 21 with. Results: The mean (SD) of health-promoting behaviors was 135.21(20.03). Amongst the different dimensions of health-promoting behaviors, the highest mean was detected in spiritual growth 26.84 (4.90) and nutrition 26.17 (4.22), respectively. Meanwhile, the lowest scores were detected in sub-domains of stress management 19.80 (3.78) and physical activity 16.71(4.14), respectively. The mean (SD) of perceived social support was 60.31 (14.75), and 51.7% of the participants had intermediate social support. Results indicated a significant difference between the mean score of Health-Promoting Lifestyle at different levels of social support. There was a direct and significant association between the scores of social support and health-promoting behavior (r=0.36; P

Abstract Aim The global obesity pandemic is a major health problem with adverse effects on physical and mental health. The aim of this study was to investigate the prevalence of obesity and the association between BMI and different aspects of lifestyle. Design A cross‐sectional study. Methods Data collected from 380 medical sciences students using demographic characteristics and Eating Behavior, Physical Activity and Perceived Stress Questionnaires were analysed using descriptive and inferential statistics, namely analysis of variance (ANOVA), t test, Pearson's test and multivariate linear regression model. Results The prevalence of obesity and overweight was 3.2% and 25.3%, respectively. There was a positive and significant statistical association between emotional eating (r = .542), extrinsic eating (r = .488) and perceived stress (r = .489) with BMI, also significant and an inverse association was obtained between emotional eating (r = −.488) and total physical activity score (r = −.394) with BMI. Factors such as sex, total physical activity score and leisure time activity, external eating behaviours, emotional eating, restricted eating and perceived stress had a significant role in explaining BMI changes. Conclusion There is a need to develop interventions to improve dietary behaviours, management stress and access to sports facilities by health‐promoting activities and the provision of online health resources.

Abstract Aim Interventions based on adopting a healthy lifestyle have been less successful. The aim of this study was to investigate the effectiveness of healthy lifestyle interventions on weight gain in overweight pregnant women. Design A cluster randomized controlled trial. Methods Health centres were selected by simple random sampling; then, 66 overweight pregnant women were enrolled by convenience sampling and divided into intervention and comparison groups. Intervention group received individual nutritional counselling and physical activity training. The data were collected in several stages with the demographic and obstetric questionnaire, maternal weight record, food frequency and international physical activity questionnaire. Results Pregnancy weight gain‐4.75(CI 95%: −4.02, −5.48) was significantly lower in the intervention group (p

Abstract Background Coronavirus disease 2019 (COVID-19) is a novel global public health emergency. Prenatal care (PNC) providing institutes should identify the needs and demands of pregnant women by optimizing the means of PNC services during the COVID-19 pandemic. The present study aims to: a) explain prenatal care experiences; b) assess the factors affecting self-care, and c) present a prenatal care guideline and Strategies to improve the PNC. Methods This mixed-methods study with a sequential explanatory design consists of three phases. The first phase is a qualitative study exploring the prenatal care experiences among pregnant women. In this phase, the subjects will be selected through purposive sampling; moreover, in-depth individual interviewing will be used for data collection. Finally, the conventional content analysis approach will be employed for data analysis. The second phase is quantitative and will be used as a cross-sectional approach for assessing the association between psychological factors of self-care. In this regard, a multistage cluster sampling method will be used to select 215 subjects who will be visited in health care centers of Tabriz, Iran. The third phase will be focusing on developing a prenatal care guideline and Strategies, using the qualitative and quantitative results of the previous phases, a review of the related literature, and the nominal group technique will be performed among experts. Discussion The present research is the first study to investigate the prenatal care experiences and factors influencing self-care among pregnant women during COVID-19 pandemic. For the purposes of the study, a mixed-methods approach will be used which aims to develop strategies for improving health care services. It is hoped that the strategy proposed in the current study could lead to improvements in this regard. Ethical code IR.TBZMED.REC.1399.003.

Abstract Background Breastfeeding has a great effect on health promotion and disease prevention in premature infants. However, various factors affect the success of breastfeeding process in mothers. The present study aims to: a) explain breastfeeding experiences; b) assess the factors affecting breastfeeding self-efficacy; and c) present a guideline for promoting breastfeeding in mothers of premature infants. Methods This mixed-methods study with a sequential explanatory design consisted of three phases. The first phase is qualitative study to explore the breastfeeding experiences in mothers of premature infants. In this phase, the subjects will be selected through purposive sampling; moreover, in-depth individual interviewing will be used for data collection. Finally, the conventional content analysis approach will be employed for data analysis. The second phase is quantitative and will be used a cross-sectional approach to assess the association of the social determinants of health with breastfeeding self-efficacy in mothers of premature infants. In this phase, the multistage cluster sampling method will be used to select 360 subjects who will be visited healthcare centers in Tabriz, Iran. The third phase focused on developing strategies to increase the ability of mothers to breastfeed their premature infants, using the qualitative and quantitative results of previous phases, a review of the related literature, and the nominal group technique will be performed among experts. Discussion The present research is the first study that investigated the experiences of breastfeeding and factors influencing breastfeeding self-efficacy in mothers of premature infants. For the purposes of the study, the mixed methods approach will be used which aimed to develop strategies for the improvement of healthcare services in this regard. It is worth noting that there is no strategic guideline in Iran’s healthcare system for the improvement of breastfeeding, especially regarding mothers of premature infants. Therefore, it is hoped that the strategy proposed in the current study can lead to improvements in this regard. Ethical code IR.TBZMED.REC.1398.100.

Abstract Background Adherence to therapy is a key predictor of the success of human immunodeficiency virus (HIV) treatment. There is limited information available from Iran about that and there is a need for more knowledge about factors influencing treatment adherence. The aim of this study is to examine adherence levels and to explore patients’ views about barriers and facilitators to HIV treatment adherence. Methods This mixed-method study with the sequential explanatory design has two phases. The first phase (quantitative phase) is a cross- sectional study to assess the in Tabriz, the sixth large city of Iran. A convenience sampling method will be used to select 150 HIV positive patients who visit health centers in Tabriz. The second phase is a qualitative study designed to explore the HIV positive patients’ views of barriers and facilitators that can affect their adherence to therapy. In this phase, purposive sampling and in-depth individual interviews will be conducted for data collection. The conventional content analysis approach will be employed for data analysis. In addition to literature review and nominal group technique, the findings of the qualitative and quantitative phases, will be used to recommend some strategies to support adherence to therapy in HIV positive patients. Discussion This is the first study looking into adherence to therapy and exploring of factors influencing in HIV positive patients which will be performed via a mixed-method approach, aiming to develop health practices improvement strategies. It is worth noting that there is no strategic guideline in Iran’s health system for improvement of treatment adherence in HIV positive patients. Health professionals and policy makers can be aware of factors influencing HIV treatment adherence. Therefore, it is hoped that the strategy proposed in the current study can lead to improvements their ability to treatment adherence.