Background: We aimed to find the commonly used assessments to evaluate driver’s mental workload and its relationship with driving distraction.

Methods: Academic articles such as journals, books, reports and conference papers that are related to workload measurements methods used in identifying mental workload among drivers that are dated from Jan 2015 to Apr 2020 were used in this paper. Then, PRISMA checklist and flow diagram are being applied.

Results: The few commonly used assessments in evaluating mental workload among drivers are Karolinska Sleepiness Scale (KSS), NASA TLX, Electroencephalogram (EEG), Heart Rate (HR), eye tracking and driving performance. Moreover, different types of driving distractions show to affect the driver’s mental workload in one way or another when being evaluated using these assessments.

Conclusion: The finding of this study can be used to find the gap for future research in vehicle safety by using multimodal monitoring of different types of assessments to increase the validity and robustness in driving assessment.

Background: We aimed to examine the available evidence about the impact of the crisis on the use of healthcare services in Europe.

Methods: We developed a systematic review of scientific literature for the period 2008-2017. The researchers searched three databases Medline/PubMed, Scopus and Web of Knowledge. For manual searching, several specialized journals of related scope as well as the finalized articles' reference list were searched. Descriptive and thematic analyses were carried out. PRISMA quality criteria and the recommendations of the Centre for Reviews and Dissemination were followed.

Results: Of 3,685 studies, 35 met inclusion criteria. Regarding “Effects of the social structure” healthcare accessibility inequalities increased by socioeconomic levels, especially in unemployed, people with low educational levels and migrants. Regarding “Healthcare effect”, the impact of the recession was observed in unmet needs, pharmaceutical spending containment, reduction of hospital beds, and privatization of services.

Conclusion: Austerity policies have contributed to increasing inequalities in the use of health services during the economic downturn. In the current economic climate, new management and health planning strategies such as hospitalisation at home, new models of integrated care and pharmaceutical management are needed to help achieve greater equity and equality in health.

Background: We reviewed studies on the prevalence of Chlamydia infection as a risk factor for developing cervical cancer in a meta-analysis studies published in that subject area.

Methods: Cochrane Library and PubMed databases were systematically searched for articles (observational and randomized controlled trials) published from 2008-2018. A meta-analysis of studies was performed to analyse the association between chlamydia infection and cervical cancer.

Results: Five articles were included in the final analysis (N=5271). All five articles were case-control studies, of which three studies sampled from population-based registries. All studies involved with sexually active women with minimum 15 years old. Three studies reported the association of C. trachomatis infection cervical cancers, two other studies reported C. trachomatis-HPV co-infection in association with cervical cancer. Result showed C. trachomatis has an overall prevalence of 31.9%, pooled OR 1.96, 95% CI 1.05 to 3.67, OR 2.13, 95% CI 1.78 to 2.54 among cervical cancer. There was a mild publication bias detected at 3.0 effect estimation. Heterogeneity detected from clinical and methodological diversities particularly from C. trachomatis-HPV co-infection subgroup analysis, including sampling bias, geographical strain diversity, and different outcome endpoint measured.

Conclusion: C. trachomatis infection was significantly associated with the development of cervical cancer. Co-infection of C. trachomatis-HPV with cervical cancer is plausibly sound but temporality of C. trachomatis-HPV with the development of cervical cancer need to be proven in future prospective cohort studies.

Background: The role of parents in taking care of children with Autism Spectrum Disorder (ASD) is critical. This systematic review aimed to investigate the characteristics and results of parent training interventions for autistic children.

Methods: All relevant studies were searched using Boolean operators such as "AND" and "OR" with the keywords such as “Autism Spectrum Disorders,” “Autism,” “Autistic disorder,” “Asperger syndrome,” “Rett’s syndrome”, “Childhood disintegrative disorder”, “Non-specific pervasive disorder”, Parent*, Education*, train*, teach*, indoctrinate*, and instruct* in electronic databases such as PubMed, Scopus, Google Scholar, Cochrane Library, Science Direct, Web of knowledge, and also via manual searching in relevant journals, checking the reference list of articles, expert contact, and grey literature from 1 Jan 2000 to 30 Feb 2020. The retrieved studies were screened and reviewed then quality assessed by CONSORT checklist. The qualitative data were analyzed using content analysis method.

Results: Eventually, 53 articles were considered in which 1758 parents with autistic children participated. Overall, 49 studies were conducted in high-income countries, 19 at home, 25 in training centers, 14 carried out only in training way, 39 in training along with practices and assignments, 30 individual interventions, and 21 in groups. Moreover, the effectiveness of interventions was studied in both parents and children groups. The results for parents show direct and indirect favorable impacts of interventions on them. The results for the children indicate direct and indirect favorable effects of the parents-based interventions on the child and the symptoms of their disorder.

Conclusion: According to the included studies, parents-based training interventions significantly impact parents and their children's behavior.

Contrary to popular belief, 2019 was not the first time humans were infected by the Coronavirus. Coronavirus is one of the oldest viruses on the earth. This article discusses the history of this virus from Neanderthal time so far. We have collected a variety of articles related to coronaviruses and the extent of their interaction with humans from the first time probably appeared on earth, given that this virus is one of the ancient viruses. By examining and following the footsteps of coronaviruses in different works of literature, we found that the first homo that was infected with the coronavirus was Neanderthal. Moreover, we realized that in addition to risk factors such as age and background diseases, genetic evolution also plays an essential role in the protection of the body against coronavirus. On the other hand, this virus has evolved throughout history gradually, the same as humans. The presence of disease in humans, in any period of history, causes changes in human quality of life. Therefore, paying attention to the background of ancient diseases reveals principal information about the complexity of pathogens.

Background: To analyze the effect of multidisciplinary team (MDT) collaborative nursing model combined with mind mapping teaching method on postoperative complications and mental health of patients with advanced pancreatic cancer (APC).

Methods: The clinical data of 100 APC patients treated in Liaoning Cancer Hospital and Institute, Shenyang, China (Dec 2018 - Dec 2020) were retrospectively analyzed. They were randomly and equally split into group J and group Q. The patients of group J were nursed with mind mapping teaching method, while those of group Q were nursed with MDT collaborative nursing model combined with mind mapping teaching method to compare the incidence of complications, quality of life (QOL) and mental health between the two groups after nursing.

Results: After nursing, the SAS, SDS and NRS scores decreased in both groups, with the notably lower scores in group Q compared with group J (P < 0.05). After nursing, the QOL scores increased in both groups, with the notably higher scores in group Q compared with group J (P < 0.05). Compared with group J, the nursing satisfaction in group Q was notably higher while the incidence of complications was notably lower (P < 0.05).

Conclusion: The MDT collaborative nursing model combined with mind mapping teaching method in postoperative nursing of APC patients can improve negative emotions such as anxiety and depression, enhance the QOL, alleviate pain, reduce the incidence of postoperative complications and improve nursing satisfaction, worthy of application and promotion in clinic.

Abstract

Background: To explore the application of specialist nursing teams in patients undergoing unplanned interruptions in continuous renal replacement therapy.

Methods: Sixty-six patients admitted to the intensive care unit of Jiangsu Province Hospital, China for continuous renal replacement therapy (CRRT) and experienced unplanned interruptions from Aug 2020 to Mar 2021 were enrolled as study subjects. Twenty four patients with conventional care were taken as the control group, and 42 patients in the specialized nursing team were taken as the experimental group. The age, type of disease, and degree of illness of the two groups were statistically processed and the differences were not significant (P>0.05) and were comparable. The control group received routine CRRT care after CRRT rescue, and the experimental group received CRRT care model from a specialized nursing team.

Results: Patients in the group with specialized nursing care had 49 instances of CRRT unplanned interruptions, and the routine care group had 79 instances of CRRT unplanned interruptions. The number of unplanned interruptions in the experimental group was less than that of the control group, and the difference was statistically significant (P<0.001). The incidence of complications in the experimental group were lower than that of the control group (P<0.05). The satisfaction and quality of life of nurses in the specialist nursing group were clearly lower than those of the control group, and the difference was statistically significant (P<0.05).

Conclusion: Specialist nursing teams could reduce the occurrence of unplanned interruptions in CRRT patients in intensive care and allow patients to receive continuity of care.

Background: We aimed to investigate factors affecting ego-resilience, emotional labor, and job satisfaction and their relationship with professional self-concept among psychiatric nurses.

Methods: The study was conducted among nurses working in four psychiatric wards: Sung Eun Medical Foundation Reference Hospital (Medical Corporation) in Jeongeup City, Korea; Dasarang Hospital in Gwangju, Korea; Saemirae Hospital in Gwangju (metropolitan city), Korea; and Jangseong Hospital in Jangseong-eup City, Korea. All nurses fully understood the purpose of the study and voluntarily agreed to participate. From August 14 to September 24, 2020, direct survey data were collected by a researcher using a structured questionnaire. Of the 136 questionnaires retrieved, 129 were used for analysis, while 7 were excluded due to incomplete or missing responses.

Results: Significantly different effects on professional self-concept were noted for the following general characteristics: age (P<0.001), religion (P=0.024), duration of nursing career (P=0.041), position (P=0.021), salary (P=0.016), nursing job satisfaction (P=0.022), and psychiatric nursing job satisfaction (P=0.010). Moreover, professional self-concept was correlated with ego-resilience (r=0.62, P<0.001) and job satisfaction (r=0.41, P<0.001). In the multiple regression analysis, factors affecting professional self-concept included no religious preference (β=0.25, P<0.001), employment as a charge nurse (β=-0.20, P=0.034), and ego-resilience (β=0.58, P<0.001). The explanatory power was 42.1%.

Conclusion: Ego-resilience is the factor most strongly influencing professional self-concept. Furthermore, professional self-concept was stronger among those without religious preferences and those who held senior positions (charge nurse).

Background: We aimed to evaluate the characteristics of a stress injury in community-acquired pneumonia (CAP) patients in the respiratory intensive care unit (RICU) and analyze the risk factors, to provide evidence for clinical prevention and treatment.

Methods: This retrospective study was conducted in RICU at Qilu Hospital of Shandong University, China. We selected 85 patients with traumatic CAP who were brought in from January 2019 to December 2020 as the case group and 167 patients without traumatic CAP hospitalized in the same period as the control group. Multivariate binary Logistic regression analysis was used to explore the influencing factors.

Results: The incidence rate of a stress injury in 252 patients was 33.73%. The most affected region found in these patients was the sacrococcygeal region (24.26%). Most of the patients were presented in stage one (49.50%). Factors associated with a stress-induced injury in RICU, CAP patients were CURB-65 combined with cerebrovascular disease, fever combined with heart disease and albumin was found as an independent risk factor.

Conclusion: Attempts to improve stress injury in CAP patients through setting measurable process of care standards are to be encouraged. An approach including the patient’s clothes and bedding should be changed frequently, nutrition should be managed and the skin of the patient should be kept clean and dry. The occurrence of stress can further be reduced by the use of protective tools and the timely participation of the family members in patient management.

Background: We aimed to determine the susceptibility of Campylobacter isolates obtained from patients to various antimicrobial agents and to investigate some related antimicrobial resistance genes.

Methods: Fifty-six Campylobacter isolates obtained from fecal specimens by conventional methods at the Trakya University Health Center for Medical Research and Practice, Department of Medical Microbiology in Edirne, Turkey, from 2017-2017 were included. Antimicrobial susceptibilities were investigated by the gradient strip test method, and species determination was made by multiplex polymerase chain reaction (mPCR). The presence of the erm(B) gene and tet(O) gene was investigated in all isolates by PCR. DNA sequence analysis was performed to detect the presence of mutations in the 23S rRNA positions 2074 and 2075 in five isolates, including two erythromycin resistant isolates. The gyrA gene mutation was investigated by the mismatch amplification mutation assay (MAMA)-PCR.

Results: In 54 C. jejuni isolates, resistance to erythromycin was 3.7%; to tetracycline, 59.3%; and to ciprofloxacin, 74.1%. Phenotypically, the tet(O) gene was detected in 33 tetracycline-resistant isolates, but no erm(B) gene was found in any of the Campylobacter isolates. As a result of the DNA sequencing, it was found no mutations in the 23S rRNA gene at the 2074 and 2075 positions. The gyrA mutation was observed in all 41 ciprofloxacin resistant Campylobacter isolates.

Conclusion: Among the antimicrobial agents tested, ciprofloxacin had the highest resistance rate, and erythromycin had the lowest. Antimicrobial resistance in Campylobacter increased significantly compared with previously studies in our region as well as in the entire world. Monitoring the resistance to antimicrobial agents used to treat Campylobacter infections is important in determining empiric antimicrobial treatment.

Background: Orofacial cleft is among the most common developmental malformations in humans. This study aimed to identify the relationship between environmental factors and nonsyndromic cleft lip and/or palate (NSCL/P) in Northwest China.

Methods: This case-control study was conducted in Gansu Province, China over two years (Jan. 1, 2017–Jan. 1, 2019). Overall, 600 NSCL/P cases and 660 normal control cases were finally enrolled in the current study. Data were collected by conducting face-to-face interviews with both parents of each case.

Results: Univariate (χ²) analysis revealed 22 factors as being significantly associated with NSCL/P. Multivariate (stepwise logistic regression) analysis identified that 14 factors had statistically significant association with NSCL/P. Male gender (OR=0.789), paternal age at childbirth of 25-29 yr (OR=0.690), and folic acid supplement (OR=0.197) were found to be protective factors against NSCL/P. On the other hand, blood A-type, multiple births, positive family history of NSCLP (OR=6.660), parental consanguinity (OR=6.107), positive abortion history, high or low maternal childbearing age, and maternal passive smoking (OR=4.349), malnutrition (OR=4.431), infections, and drug use (OR=2.188) during early gestation were significant risk factors for NSCL/P.

Conclusion: Parental age at childbirth of 25–29 yr, and folic acid supplement can reduce the risk of NSCL/P. By contrast, maternal passive smoking, infections, and drug use during early gestation period, and multiple births, parental consanguinity, positive family history, and maternal abortion history can increase the risk of NSCL/P. Identification of risk factors is essential in minimizing the incidence of NSCL/P in a particular population.

Background: Precautionary allergen labels (PAL) should be used to indicate the possibility of allergen presence in the food. This study aimed to determine the prevalence and types of precautionary labeling statements on different pre-packaged food products in retail stores in Belgrade, Serbia, as well as to assess consumers’ attitudes and behavior towards PAL statements.

Methods: This was a descriptive study. The following characteristics of 1404 pre-packaged foods were analyzed: prevalence of PAL, listed food allergens on PAL, and the types of the advisory terminology. In the group of 275 participants (94 with food allergies, and 181 persons who purchasing food for a household member with food allergy) reading practice of PAL, purchasing practice based on PAL, and the opinion about PAL statements credibility were evaluated.

Results: Overall, 33.9% of products had precautionary statements for one or more allergens. “Tree nuts” were the most common allergens listed in the PAL. The most common type of PAL was “May contain traces of x [allergen]” (52.7%). The PAL was always read by half of the participants. Less than half (43.3%) of the participants incorrectly believed that PAL is regulated by national law. A quarter of participants thought that the PAL statements are trustworthy.

Conclusion: PAL statements frequently are not user-friendly and are not providing sufficient protection for food allergic patients. To gain buyers’ confidence, protect health and provide security, the necessity for the strategies that would regulate PAL by the law exists.

Background: We explored the potential mediating role of frailty in the relationship between depression and falls.

Methods: The participants were 1,408 community-dwelling older people living alone in South Korea. The potential mediating role of frailty in the relationship between depression and falls was evaluated through univariate and multivariate logistic regression. Baron and Kenny’s three-step criteria for mediation were used to examine the mediating effect.

Results: Frailty fully mediated the association between severe depression and falls in univariate (t=11.58, P<.05) and multivariate (t=10.42, P<.05) analyses.

Conclusion: Frailty is a valuable target for fall interventions in severely depressed older people living alone.

Background: Diabetes-related distress (DD) will seriously affect the therapeutic effect of diabetes and the physical and mental health of patients if an intervention treatment is not well implemented. We aimed to explore the effect of mindfulness-based cognitive therapy (MBCT) on the DD level and self-care capability of patients with diabetes.

Method: Sixty-eight patients with type 2 diabetes mellitus (T2DM) were selected from the Department of Endocrinology in Jinhua People’s Hospital, China and divided into control (CG) and intervention (IG) groups. Routine diabetes health education (RDHE) was only carried out in the CG, whereas the RDHE and MBCT were provided to the IG. Repeated ANOVA measurements were adopted to investigate the intergroup differences of these two intervention therapies on improving the DD and self-care capability of patients with diabetes.

Results: RDHE and MBCT could relieve the DD level of patients with diabetes, but the DD value in IG was lower than that in CG. In comparison with RDHE, MBCT and RDHE could significantly improve the diet and exercise dimensions of patients, and such improvement effects were significantly sustaining (P<0.05). MBCT and RDHE exerted better effects than RDHE alone on blood glucose testing, foot care, and medication intake. However, these effects were not sustaining.

Conclusion: The care and medication guide provided by MBCT consultants and medical staff can significantly relieve the patients’ DD and enhance their self-care capability. As a low-cost psychological intervention therapy with good sustaining effects, MBCT is important to strengthen the therapeutic effect on diabetes and lowering the medical cost.

Background: This study was conducted to identify the reasons for vaccine refusal of individuals/parents by analyzing the comments on the pages screened with the keyword vaccine refusal on social media.

Methods: Qualitative and quantitative methods were used in the study. Within the scope of the study, 7 pages, 216 posts and 3446 comments found with the keyword #vaccine refusal were analyzed. The comments obtained within the scope of the study were evaluated using content analysis and theme analysis methods. The study data were collected between Sep 1st and 11th, 2020.

Results: The comments on vaccine refusal were found to increase in 2018 and 2019, especially in September, October, November, and December. The reasons for vaccine refusal were grouped under 2 themes as individual reasons and vaccine-related reasons as a result of the analysis of the comments. The most commonly used word in the text analysis, consisting of 10,428 words mentioned in the posts, was found to be vaccine (3.2%).

Conclusion: Individuals/parents refuse vaccination for reasons such as distrust of vaccine content, disbelief in the need for vaccines, distrust of pharmaceutical companies, previous experiences, like-minded people/platforms, religious reasons, and preference for alternative health care approaches.

Background: Recently, the South Korean government has adopted a primary-care-based chronic disease management program as a national task. This study aimed to evaluate this program by focusing on hypertension patients and examine the effect of this program on their health.

Methods: Overall, 863 subjects who responded to a survey and 1,716 subjects in administrative data were included. Effects of the program were evaluated based on intermediate outcomes (motivation for self-management, changes in health behavior, medical service utilization, duration of consultation with physicians, and medication compliance) and outcomes (disease management, service satisfaction, and physician–patient relationship, change of blood pressure). Furthermore, we compared study participants’ baseline systolic and diastolic blood pressure with corresponding measurements obtained at examinations conducted at 3 and 6 months after baseline measurements.

Results: Patients’ motivation for self-management of hypertension, health behaviors (smoking, drinking, and exercise), regular clinic visit, and medication compliance were improved after participating in the program. Furthermore, patients’ blood pressure levels were decreased while their satisfaction with physician-patient relationships was increased.

Conclusion: Primary-care-based chronic disease management program is effective for managing hypertension. Therefore, it is essential to reinforce the role of community-based primary care to improve the health of patients with hypertension.

Background: Epigenetic alterations such as DNA methylation are known as the main cause of different types of cancers through inactivation of tumor suppressor genes, especially thyroid cancer. Identification of novel and effective markers are important in diagnosis and prevention of thyroid cancer. In the present study, the expression and methylation of Solute carrier family 5 member 8 (SLC5A8) in Papillary Thyroid Carcinoma (PTC) in comparison to multinodular goiter (MNG) have been studied.

Methods: Overall, 41 patients with PTC and 36 patients affected by MNG were recruited from four hospitals in Tehran and Qazvin, Iran in 2018. Thyroid tissues were obtained during thyroidectomy. RNA and DNA were extracted from thyroid tissues. Quantitative RT-PCR assay was performed for determining the mRNA level of SLC5A8 while Methylation-Sensitive High-Resolution Methylation was applied for assessing the methylation status.

Results: Methylation status of three regions composed of 52 CpG islands in the promoter of SLC5A8 gene was studied by HRM assay. SLC5A8 level in PTC tissues was significantly downregulated in average 0.4 fold in comparison with MNG tissues (P=0.05). The aberrant methylation of SLC5A8 (b) region was remarkably different in PTC and MNG cases. The promoter methylation of SLC5A8 (c) was significantly related to BRAF mutations and vascular invasion in PTC patients.

Conclusion: The aberrant promoter hyper methylation of SLC5A8 was related to aggressive PTC. Therefore, there is some evidence to support the hypothesis that SLC5A8 could be a paly important role in the development of PTC.

Background: We aimed to determine the age and sex standardized prevalence of corneal opacity and its determinants

Methods: The Tehran Geriatric Eye Study (TGES) is a population-based cross-sectional study conducted on 3791 subjects aged above 60 yr in Tehran, Iran (2019) selected using stratified random cluster sampling. After sampling, all subjects underwent complete ophthalmic, optometric, and eye examinations.

Results: The 3310 participated in the study, of whom the data of 3284 were analyzed. The age and sex standardized prevalence with 95% confidence interval (CI) of corneal opacity in at least one eye, both eyes, and one eye was 9.58% (95% CI: 8.50 to 10.79), 5.52% (95% CI: 4.71 to 6.45), and 4.07% (95% CI: 3.35 to 4.94), respectively. The mean uncorrected visual acuity (UCVA) and best-corrected visual acuity (BCVA) according to LogMar were worse in subjects with corneal opacity (both P<0.001). According to multiple logistic regression analysis, male sex (OR: 1.98; P: 0.003), age>80 yr (OR: 2.05; P: 0.004), and lack of insurance coverage (OR: 1.87; P: 0.004) increased the odds and high school education (OR: 0.68; P: 0.003) reduced the odds of corneal opacity. Among the study variables, sex was the most important determinant of corneal opacity (standardized beta: 0.126).

Conclusion: This study found a high prevalence of corneal opacity in the geriatric population. Considering the increasing trend of population aging in Iran, attention should be paid to prioritizing public health policies to estimate resources required for providing comprehensive corneal services and improving geriatric eye health.

Background: The effect of related factors on recovery or death rates may vary from country to country. Therefore, we aimed to investigate the relationship between demographic, clinical, laboratory factors on the survival rates of confirmed cases of COVID-19 in Shahroud, Iran.

Methods: This is an analytical study of the estimation of the survival of patients with COVID-19. Patients who had positive PCR test were considered as COVID-19 cases, and the 2-month survival of these patients was estimated. Among the diseases, heart disease and diabetes were considered as separate variables, and the patients' histories of other diseases were included in the model as comorbidities.

Results: Of 396 confirmed patients hospitalized, 109 patients (27.5%) had a history of heart disease, 100 (25.3%) were diabetic, and 80 (20.2%) had a history of other comorbidities. The number of deaths due to the disease was 59 (14.9%). The median age of those who died was 76 years. The multivariate Cox regression analysis shows that heart disease increases hazard ratio more than two times (HR=2.37, 95% CI: 1.33-4.23). The neutrophil-to-lymphocyte ratio (NLR) factor, (HR=1.15, 95% 1.08-1.22), and older age (HR=1.06, 95% CI: 1.03-1.08) increases the risk of death significantly.

Conclusion: The heart disease history, NLR factor and older age are associated with death of COVID-19 and may be helpful for the early warning and prediction of disease progression.

Background: Cancers seldom happen in childhood age and awareness of accurate cancer incidence is essential in order to preventive programs. This study aimed to estimate the childhood cancer incidence in Iran using the three-source capture -recapture method.

Methods: Total new cases of childhood cancer reported by three national data sources of MAHAK charity database, pathology reports and clinical records in Iran were enrolled in this study. The common cases among three sources were determined using data linkage method. The childhood incidence rate per 1 million populations was estimated based on three-source capture-recapture method. We used BIC, G2 and AIC statistics to select the best-fit model. Arch GIS was used to determine geographic distribution.

Results: Overall, 2567 childhood cancer was included by three sources of registries. The total estimated number of childhood cancer was 5388 (95% CI: 4742.15-6228,14). The higher estimated incidence rate was Leukemia, Lymphoma by 94.91 and 24.80 per 1 million populations and the lower incidence was liver and retinoblastoma with 2.35 and 7.01 per 1 million populations. Provinces of Ardabil and Kohgiluyeh with an incidence rate of 420.01 and 404.61 per 1 million populations had a higher incidence rate and Mazandaran and Ilam with an incidence rate of 60.87 and 66.88 per 1 million populations had the lowest incidence. The overall completeness of the childhood cancer registry based on three-source was 48%.

Conclusion: The low-quality childhood cancer registration system highlights the needs for urgent screening programs for early detection in the high prevalent area in Iran.

Background: There have been few reports on relationships between Shift Work (SW) and time to Noise-Induced Hearing Loss (NIHL). This research explores the relation between SW and time to NIHL among male workers.

Methods: Between 1990 and 2015, this historical cohort study was conducted. Two different definitions events (Low Frequency Hearing (LFH) and High Frequency Hearing (HFH)) of NIHL An average pure-tone hearing threshold was thresholds at 1, 1.5 and 2 kHz for LFH(un-normal>20) and 4, 6 and 8 kHz for HFH (un-normal>20) for Air (AC) and Bone (BC) conduction, in both ears, respectively. In this study Kaplan–Meier and Multilevel Cox Model in addition R version 3.2.1 and MLWiN software used to analysis data. P-values less than 0.05 are considered to be statistically significant

Results: There were 6632 male workers in the research survey (mean age=35(±5)). Among these subjects, 2678 (40%),278 (4%) and 3676 (56%) were Day Workers (DW), Weekly Rotating Shift workers (WRS) and Routinely Rotating Shift workers (RRS), respectively. The result of this study showed more hazard risk of ear problem in LFH (Hazard=1.55 with 95% CI= (1.06-1.39)) and HFH (Hazard=1.08 with 95% CI= (1.04-1.13)) in RRS rather than day workers. In WRS group ear problem has been seen just in LFH (Hazard=1.55 with 95% CI= (1.2-2.0)).

Conclusion: The findings of the 15-year historical cohort study generally support a relationship between SW and time to NIHL. Therefore, more actions in the field of noise control, greater use of safety devices as well as increased staff training on the use of safety devices recommended for shift worker.

Background: We aimed to investigate school-aged students' physical activity behaviors and overweight status during the COVID-19 quarantine.

Methods: In this cross-sectional study, an online questionnaire was utilized to measure participants' physical activity behavior and overweight status during the COVID-19 quarantine in Iran (May of 2021). Participants self-reported their physical activity levels, types, amounts and locations, as well as whether or not they became overweight. The chi-square test was used to determine the differences in the distribution of the participant responses. The statistical significance level was set at P<0.05.

Results: The questionnaire was completed by 43,660 school-aged students (15,532 boys and 28,128 girls). The age, weight, and height ranges were 8–17 yr, 18–144 kg, and 75–198 cm respectively. Half of the students reported changes in their body weight and became overweight during the COVID-19 pandemic (χ²=25514.4; P=0.001). Forty-one percent reported doing very little or no physical activity, 32% of students reported doing less than one hour of exercise per day (χ2=8547.7; P=0.001). The majority of students (72%) reported participating in physical activity at home (χ2=78851.2; P=0.001). Flexibility was the main kind of exercise performed, followed by walking or running, during the COVID-19 pandemic (χ2=24328.9; P=0.001).

Conclusion: During the COVID-19 pandemic, half of the students became overweight, and the majority did not engage in regular physical activity. These findings can help guide efforts to protect and promote children's health during the COVID-19 outbreak, as well as influence policies to reduce the risk of future pandemics.

Background: We aimed to compare semi-nested PCR with indirect ELISA to diagnose human fasciolosis.

Methods: Overall, 70 serum samples were collected from different areas in Iran suspected for fascioliasis. Individuals were classified based on diagnostic of fascioliasis and habitat in endemic areas. Finally, all serum samples were tested by indirect ELISA (using secretory excretory antigen) and semi-nested PCR (using ITS1 gene). The study was conducted in the School of Publish Health, Tehran University of Medical Sciences, Iran in 2021.

Results: Significant differences were found between agreement and similarity of patients' results of indirect ELISA and semi-nested PCR 94.46% and 98.4% respectively (Cohen's kappa ≥0.6; P-value≤0.05). No cross-reactions were observed with other parasitic diseases (toxocariasis, hydatidosis, strongyloidiasis, toxoplasmosis, cutaneous leishmaniasis, taeniasis and trichinosis). 69.84% of samples were positive by both techniques. In addition, the percentage of agreement and similarity between the results of the two techniques based on habitat in endemic areas was 88.9-100% and 97.7-100%, respectively (Cohen's kappa ≥0.6; P-value≤0.05).

Conclusion: Semi-nested PCR could be a suitable method for following up on patients' treatment and a confirmatory method for ELISA as for diagnosis of human fascioliasis.

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