The Effect of a Supportive Educational Intervention Through Virtual Social Networks on Sleep Quality and Insomnia of Patients with Cancer.

Sleep disturbances are very common among cancer patients, and they need more support in this regard. More access to technology has provided opportunities to use virtual teaching methods to educate and support cancer patients. This study aimed to investigate the effect of supportive educational intervention (SEI) through virtual social networks (VSNs) on the sleep quality and the severity of insomnia of cancer patients. The study was conducted on 66 patients with cancer: intervention (n = 33) and control (n = 33) groups (CONSORT). Intervention group received supportive educational intervention on sleep for 2 months through virtual social networks (VSNs). All participants completed the Pittsburgh Sleep Quality Index and insomnia severity index (ISI) before and after the intervention. The mean scores of sleep quality (p = .001) and insomnia severity (p = .001) in the intervention group had a statistically significant decrease. Moreover, quality, latency, duration, efficiency, disturbances of sleep, and daytime dysfunction showed significant improvement in the intervention group, every two times after the intervention (p < .05). However, the participants' sleep quality deteriorated progressively in the control group (p = .001). Supportive educational intervention (SEI) through VSNs can be an effective method to improve sleep quality and decrease insomnia severity of patients with cancer.Trial registration number: RCT20220528055007N1Date of registration: 2022-08-31(retrospectively registered).

xsGastrointestinal symptoms are associated with a lower risk of hospitalization and mortality and Outcomes in COVID-19.

BACKGROUND: We aimed to find the association between gastrointestinal (GI) and respiratory symptoms with mortality and hospitalization among COVID-19 patients. METHODS: We analyzed the registered data of COVID-19 patients from February 20, 2020, to March 10, 2021. Depending on the patients' disease symptoms, four categories were defined: patients with only GI symptoms, patients with only respiratory symptoms, patients with both symptoms, and patients with other symptoms. Logistic regression analysis was used to assess the association of groups with outcomes. RESULTS: A total of 42,964 patients from 23 hospitals were included, of which 26.5% patients had at least one or more GI symptoms. Of total patients, 51.58% patients were hospitalized among which 22.8% had at least one or more GI symptoms. GI symptoms significantly decreased the odds of mortality (OR 0.72, 95% CI 0.56-0.92), but respiratory symptoms increased the odds for mortality (1.36: 1.24-1.50), compared with patients with other symptoms. Moreover, the odds ratio of patients who had both respiratory and GI symptoms increased (1.52: 1.31-1.78) compared with patients with other symptoms. The same results were observed for hospitalization as the outcome. CONCLUSIONS: Our study showed that the presence of GI symptoms in COVID-19 at the time of admission was associated with a lower odds of hospitalization and mortality; however, this association had higher odds for respiratory symptoms.

Effect of theory-based education on promoting a healthy lifestyle in pre-diabetic women: RCT.

BACKGROUND: Due to the fact that pre-diabetic people are at higher risk of developing diabetes, it is possible to reduce the risk by taking preventive measures. Therefore, the present study aimed to determine the effect of theory-based education on promoting a healthy lifestyle and fasting blood sugar (FBS) in pre-diabetic women. METHODS: This is a cluster-randomized controlled trial that was performed on 71 pre-diabetic women referred to Arak Comprehensive Health Service Center. Thus, using cluster sampling method, one center was randomly assigned to the intervention group and one center to the control group. The data collection tool was a questionnaire based on the theory of planned behavior (TPB) and healthy lifestyle behavior that was completed before and at least 3 months after training and FBS test was performed. The experimental group received 3 training sessions of 60 to 90 min and finally the data were analyzed using statistical software. RESULTS: After the intervention, the mean scores of knowledge (P < 0.001), attitude (P = 0.047) and perceived behavioral control related to physical activity (P = 0.046) and dietary function (P = 0.01) increased significantly in the intervention group. In addition, fasting blood sugar in the intervention group (99.70 ± 11.06) improved significantly compared to the control group (110.94 ± 17.09) (P = 0.003). CONCLUSION: Education based on the theory of planned behavior, by holding face-to-face meetings along with following up the samples after the educational intervention, can promote healthy lifestyle of pre-diabetic women. Therefore, designing and implementing similar interventions on all pre-diabetic individuals seem necessary. TRIAL REGISTRATION: The master's thesis in health education is approved by Arak University of Medical Sciences, Iran and is registered in the Iranian Registry of Clinical Trial (IRCT20190304042921N1). Prospectively registered 22/07/2019, https://en.irct.ir/trial/40596.

Trends of colorectal cancer in a central area of Iran during 2009-2014. An application of joinpoint regression.

Introduction: Colorectal cancer (CRC) has become a major public health concern. We analysed current CRC statistics in Arak, including the estimated number of new cases among males and females, age standardized rates (ASRs), and trends for cases diagnosed in the period 2009-2014. Material and methods: In this study, reported cases of CRC from 2009 through 2014 for Arak residents were obtained from the Arak cancer registry database. We used the direct method to calculate annual ASRs. Joinpoint regression was performed on the ASRs for the whole study period, and we calculated the annual percentage changes (APC). Results: 533 new CRC cases were included. The annual ASRs of CRC per 100,000 population during 2009-2014 were 13.58 (95% CI: 11.9-15.42), 16.52 (95% CI: 14.62-18.60), 15.00 (95% CI: 13.72-16.35) for females, males, and both genders, respectively. Females had an increasing trend in ASRs (APC: 10.25% and CI 95%: -0.79 to 22.53), and a slightly increasing trend was observed among males (APC = 5.03% and CI 95%: -6.14 to 17.53). Conclusions: The increasing trend was higher among females than males. These findings raise considerable concern related to a crucial growing public health problem in Arak. They were higher than the averages of ASRs in all of Iran. Furthermore, any increase in the ASRs of CRC may be due to the promotion and improvement in the quality of the cancer registry over time. It is recommended that the quality of the cancer registry is promoted more than the former.

Family clustering of SARS-CoV-2 in Qazvin, Northwest of Iran.

Background: Human infection affected by severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) has been recognized as a global health concern. We report the epidemiological and clinical characteristics of patients with a familial cluster of SARS-CoV-2 from Qazvin province (located in the northwest of Iran). Methods: In this cross-sectional study, we enrolled 332 hospitalized patients that were confirmed SARS-CoV-2 diseases with laboratory-based (PT-PCR) test in Qazvin province, Iran. Having family infection transmission and subsequently, family clustering of SARS-COV-2 disease was assessed with the Generalized Estimating Equation model in patients. Results: Crude odds ratio estimates of creating family clustering of SARS-CoV-2 infection was 0.47 times [95% CI: 0.23, 0.98, p=0.045] less for female compared to the males; 2.26 [95% CI: 1.11, 4.58, p=0.024] and 2.69 [95% CI: 1.47, 4.93, p=0.001] for SARS-CoV-2 patients that had digestive and muscle pain in comparison with those did not this mentioned symptoms, respectively. 1.52 [95% CI: 1.05, 2.23, p=0.024] for patients with a longer hospitalization compared with patients that had shorter duration of hospitalization and adjusted odds ratio estimates were 2.13 [95% CI: 1.12, 4.03, p=0.020] for patients who receive public health services in comparison those did not receive public health services. Conclusion: Our findings confirm the person-to-person transmission of this novel coronavirus in family settings and hospitals, and the reports of infected travelers in other geographical regions. Major gaps in our knowledge about the potential factors in creating family clustering of SARS-CoV-2 infection, epidemiology, duration of human transmission and etc. need fulfillment by future studies.

The effect of educational program based on theory of planned behavior on promoting retinopathy preventive behaviors in patients with type 2 diabetes: RCT.

BACKGROUND: Diabetic retinopathy is the most common microvascular complication of diabetes and it is a leading cause of visual impairment and blindness among patients with diabetes. This study aimed to investigate the effect of educational program based on Theory of Planned Behavior (TPB) on promoting retinopathy preventive behaviors in patients with type 2 diabetes. METHODS: The present study is an educational randomized controlled trial research that was conducted on 94 patients with type 2 diabetes who had gone to diabetes clinic. The samples were randomly assigned to the intervention (N = 47) and control groups (N = 47). Data collection instrument was a researcher-made questionnaire based on TPB and FBS and HbA1C tests. Then, educational program was performed for the intervention group through four educational sessions. After 3 months, data collection was repeated for the two groups and FBS, HbA1C testes were done again and data were analyzed. RESULTS: The performance of the intervention group on preventive behaviors of retinopathy increased from 2.48 ± 1.42 to 4.48 45 1.45 after the education (p < 0.001). The mean of FBS and HbA1c in the intervention group also decreased after the intervention (P < 0.05). CONCLUSION: Applying the TPB model proved is very effective in developing an educational program for patients with diabetes, to control their blood sugar and enhance preventive behaviors of retinopathy. Besides such programs, follow-up education for controlling and monitoring are highly recommended. This theory serves as a helpful theoretical framework for health-related behaviors and can be an appropriate pattern to plan for educational interventions. TRIAL REGISTRATION: This trial has been registered at Iranian Registry of Clinical Trials, IRCT20180819040834N1 . Prospectively registered 8 Apr 2019, https://en.irct.ir/trial/38401.

Quantitative and qualitative assessment of microbial aerosols in different indoor environments of a dental school clinic.

In the indoor environment of dental clinics, dental staff and patients are exposed to various types of infectious agents transported by aerosols and particles, generated during dental procedures, promoting an increased risk of cross-infection. The aim of this study was to determine the levels and diversity of microbial aerosol in relation to particle load in five different departments of a dental school clinic. The air samples were collected by an active single-stage Andersen sampler during the treatment procedure. The mean concentrations of airborne bacteria were in the range of 52-1030 and 8-844 CFU/m3 at the distances of 0.5 and 2 m, respectively. Bacterial aerosols in pediatric, endodontics, and restorative wards and fungal aerosols in all the sampling wards were significantly higher at the distances of 0.5 m. The dominant bacteria and fungi were identified as Micrococcus, Bacillus, Streptococcus, Staphylococcus, Penicillium, Cladosporium, Aspergillus, Rhizopus, and Alternaria. The positive associations were also obtained between bacteria and fungi levels and particulate matter (PM) concentrations.

Effect combined learning on oral health self-efficacy and self-care behaviors of students: a randomized controlled trial.

BACKGROUND: In order to prevent oral diseases, the use of appropriate oral health education at childhood is one of the most important strategies for improving oral health knowledge and by extension positive oral health habits. Therefore, the present study aimed to evaluate the effect of animations and games as a strategy for improving oral health self-efficacy and self-care behaviors among 6-12-aged students. METHODS: In this interventional study, 82 students were selected based on cluster random sampling including 38 for the case and 44 for the control group. The case group received four sessions of combined learning per week including animations and games while the control group received routine school education. The data were collected in six domains including demographics, self-care, knowledge, attitude, behavior and self-efficacy before and 5 months after the intervention using a questionnaire. SPSS version 20 was used for data analysis. RESULTS: Five months after the intervention, the mean score of self-care, self-efficacy, behavior increased from 3.8 to 4.8, 36.8 to 48.9, and 17.07 to 18.29, respectively indicating a significant change (p < 0.05). However, no significant change was reported in these variables in the control group (p  > 0.05). CONCLUSION: The use of animation combined with other strategies for oral health self-care education can positively influence the students' performance and self-efficacy. IRCT registration number This trial was registered at IRCT. IRCT2017042133565N1 Registration date: 2017-05-17 https://en.irct.ir/trial/25851.

The real-time reproduction number, impact of interventions and prediction of the epidemic size of COVID-19 in the center of Iran.

BACKGROUND: The monitoring of reproduction number over time provides feedback on the effectiveness of interventions and on the need to intensify control efforts. Hence, we aimed to compute basic (R0) and real-time (Rt) reproduction number and predict the trend and the size of the coronavirus disease 2019 (COVID-19) outbreak in the center of Iran. MATERIALS AND METHODS: We used the 887 confirmed cases of COVID-19 from February 20, 2020, to April 17, 2020 in the center of Iran. We considered three scenarios for serial intervals (SIs) with gamma distribution. Rt was calculated by the sequential Bayesian and time-dependent methods. Based on a branching process using the Poisson distributed number of new cases per day, the daily incidence and cumulative incidence for the next 30 days were predicted. The analysis was applied in R packages 3.6.3 and STATA 12.0. RESULTS: The model shows that the Rt of COVID-19 has been decreasing since the onset of the epidemic. According to three scenarios based on different distributions of SIs in the past 58 days from the epidemic, Rt has been 1.03 (0.94, 1.14), 1.05 (0.96, 1.15), and 1.08 (0.98, 1.18) and the cumulative incidence cases will be 360 (180, 603), 388 (238, 573), and 444 (249, 707) for the next 30 days, respectively. CONCLUSION: Based on the real-time data extracted from the center of Iran, Rt has been decreasing substantially since the beginning of the epidemic, and it is expected to remain almost constant or continue to decline slightly in the next 30 days, which is consequence of the schools and universities shutting down, reduction of working hours, mass screening, and social distancing.

The challenges and considerations of community-based preparedness at the onset of COVID-19 outbreak in Iran, 2020.

COVID-19 as an emerging disease has spread to 183 countries and territories worldwide as of 20 March 2020. The first COVID-19 case (i.e. the index case) in Iran was observed in the city of Qom on 19 February 2020. One of the cities of Markazi Province is Delijan, which shares a border with Qom. Consequently, COVID-19 has quickly spread in this city because a large population commutes daily between the two cities. This study aimed to report the challenges and considerations of community-based preparedness at the onset of COVID-19 outbreak in a city of Iran in 2020.

A randomized controlled trial of an educational intervention to promote oral and dental health of patients with type 2 diabetes mellitus.

BACKGROUND: Diabetes is the most prevalent disease resulted from metabolic disorders. This study aimed to investigate the effect of training based on health belief model (HBM) on oral hygiene-related behaviors in patients with type 2 diabetes mellitus. METHODS: This study was conducted as an educational randomized controlled trial (single blind) on 120 patients with type 2 diabetes referring to a diabetes clinic selected through systematic sampling, who were assigned to two groups of control (N = 60) and intervention (N = 60). The data collection tool was a valid and reliable questionnaire based on HBM which was completed by both groups before the intervention. Then, the intervention group received 4 sessions of educational program based on HBM in 1 month, and the same questionnaire was completed again after 3 months and the data were analyzed through SPSS version 20 software with inferential statistics, t-test, paired t-tests, Chi square, Mann-Whitney test, and Wilcoxon test analysis. RESULTS: Three months after the intervention, awareness of the patients and perceived susceptibility, benefits, self-efficacy, internal cue to action, and performance in oral and dental hygiene-related behaviors had a significant increase in the intervention group (p < 0.05). So that the performance of oral and dental hygiene in the intervention group increased from 2.16 ± 0.71 to 3.25 ± 0.49 (p = 0.001) after the education. CONCLUSION: Our results suggest that training patients with diabetes based on HBM as well as through active follow-up can enhance their skills in oral and dental hygiene-related behaviors. Controlling, monitoring and follow-up during the program are also recommended. TRIAL REGISTRATION: Iranian Registry of Clinical Trials, IRCT 2017050733847N1. Prospectively registered 14 June 2017, http://en.irct.ir/trial/26011.

The effect of educational intervention program on promoting preventive behaviors of urinary tract infection in girls: a randomized controlled trial.

BACKGROUND: Urinary tract infection is one of the most common infectious diseases in children, which can lead to serious complications for a child. The purpose of this study was to investigate the impact of Theory Planned Behavior (TPB) -based education on the promotion of preventive behaviors of urinary tract infection in mothers with a daughter under age two. METHODS: The present study is an educational randomized controlled trial that its sample consisted of 100 mothers who had a daughter under age two. They were selected through convenience sampling and then were randomly assigned to the intervention and control groups (each group included 50 participants). The data collection tool was a reliable and valid questionnaire based on TPB constructs. First, in both groups, the pre-test was administrated and then the educational intervention in the intervention group was conducted in the form of four educational sessions in 1 month (based on the pre-test need assessment) and then 3 months after the intervention (according to the ideas of Panel of Experts), post-test in both groups was administrated and then the data were analyzed through SPSS version 23 software with inferential statistics (independent t-test, paired t-test, and chi-square). The significance level was considered 0.05. RESULTS: Three months after the intervention, the mean score of the constructs of TPB in the intervention group was significantly higher than the control group. The performance of prevention of urinary tract infection in the intervention group before the education increased from 2.85 ± 0.51 to 3.74 ± 0.29 (out of 4) (p = 0.001). CONCLUSIONS: TPB-based education with active and interventional follow-up was effective in promoting the preventive behaviors of urinary tract infection. Therefore, due to the side effects of UTI, especially in vulnerable periods such as childhood, it is recommended that trainings based on this model be carried out in other health care centers in order to maintain children health. TRIAL REGISTRATION: This trial has been registered at IRCT, IRCT2017031533090N1. Registered on 9 July 2017, https://en.irct.ir/trial/25621.

Trend of gastric cancer in a province in Western Iran: A population-based study during 2001-2014.

BACKGROUND: There are no studies on the trend of gastric cancer (GC) incidence in Kurdistan, a province in the west of Iran. We aimed to estimate the trend, age-standardized incidence rate (ASR), and annual percentage change (APC) of GC in this province during 2001-2014. MATERIALS AND METHODS: The data of newly diagnosed GC patients were obtained from the regional Cancer Registering Database. The ASRs were calculated per 100,000 population during 2001-2014. Direct standardization and 95% confidence intervals (CI) were calculated by an efficient method. The temporary changes in ASRs were determined based on the APC by the joinpoint regression model. RESULTS: Overall, 2225 newly diagnosed GC patients were identified. The ASRs ranged from 13.5 (95% CI: 10.4-17.3) to 29.0 (95% CI: 24.5-34.0). The highest ASRs were related to the men and women lived in Divandareh as 32.26 and 13.66, respectively. The respective APC value of GC incidence in women demonstrated a nonsignificant increase during 2001-2008 and a nonsignificant decrease during 2008-2014 (P = 0.1). Accordingly, the incidence of GC in men increased during 2001-2004 (P = 0.1) and decreased during 2004-2014 (P = 0.001). CONCLUSION: The incidence of GC showed nonsignificant and significant decreasing trends in women and men in Kurdistan province, respectively. Despite such decreasing trends, the Kurdistan province is still considered as one of the regions with high incidence of GC in Iran. Therefore, it is necessary to implement screening programs in the province to early diagnose GC.

Effectiveness of Paromomycin on Cutaneous Leishmaniasis in Iran: A Systematic Review and Meta-Analysis.

BACKGROUND: Some treatment reported for cutaneous leishmaniasis. The studies examined the impact of the paromomycin has different characteristics and results. The aim of the present study was to conduct a systematic review and meta-analysis of all randomized clinical trials evaluating the effectiveness of paromomycin in the treatment of cutaneous leishmaniasis in Iran. METHODS: Literature search was conducted using MEDLINE, Web of Science, Scopus, Scientific Information Database, IranMedex, Magiran, Iranian Registry of Clinical Trials (from February 2000 to May 2016), and references cited in the text of selected studies. Search terms used were "paromomycin", "cutaneous leishmaniasis", "randomized"," aminosidine", "controlled trial", and "clinical trial". Random effects models were used to calculate the measure of association, with 95% confidence intervals, to analyze the efficacy of paromomycin in the treatment of cutaneous leishmaniasis. RESULTS: Initial search yielded 76 citations. Of these original results, 9 met our specific selection criteria. Four of the randomized controlled trials compared the efficacy of paromomycin in the treatment of cutaneous leishmaniasis with that of a placebo; they were included in the meta-analysis. The success rate of treatment with paromomycin was higher than that with the placebo (pooled RR=4.50, 95% CI: 2.54 to 8.02; P=0.001 and I2=26.7%), whereas the difference with the non-placebo treatments was nonsignificant (pooled RR=0.79, 95% CI: 0.58 to 1.073; P=0.131 and I2=83.3%). CONCLUSION: No significant difference was observed between paromomycin and the other treatments in their effectiveness in the treatment of cutaneous leishmaniasis. Because no single drug is effective against all the forms of leishmaniasis, we suggest multidrug therapy.

Validity and reliability of the Farsi version of the ECOS-16 questionnaire for females with osteoporosis.

The purpose of this study was to develop a Persian version of ECOS-16 Questionnaire and assess its reliability and validity. Two hundred and twenty women with postmenopausal osteoporosis were included in the study. Patients who were diagnosed as secondary osteoporosis by clinical and laboratory examinations were excluded. For reliability, an internal consistency (Cronbach's alpha coefficient) of ECOS-16 total score was calculated. The age of the study participants ranged from 50 to 75 years old (59.9 ± 7). Cronbach's alpha of the Persian version of the ECOS-16 was 0.84. Therefore, the Persian version of the ECOS-16 is a reliable and valid questionnaire to be used in the evaluation of quality of life in women with postmenopausal osteoporosis.

A risk model for occupational noise-induced hearing loss in workers.

BACKGROUND: Occupational hearing loss is one of the most common work-related diseases with various risk factors and considerable negative impacts on both physical and mental well-being of affected workers. Occupational noise-induced hearing loss (ONIHL) has a complex interaction with personal, environmental and occupational factors. OBJECTIVE: This study aimed to develop a risk model for ONIHL in workers by identifying risk factors and their interactions. METHODS: The subjects were 605 males in an industrial factory in Arak, Iran. The study took place between 2022 and 2023. The sociodemographic and occupational characteristics were collected by a health technician using questionnaires and medical records. Hearing status was assessed using audiometry by a qualified audiologist. Hearing loss was analyzed by univariate logistic analysis including age, smoking, medical history, type of occupation, and some workplace hazards. The risk model was generated by logistic regression. RESULTS: Hearing loss in the participants was 44.13% (n = 267). In univariate logistic analysis, age (OR: 2.93,95% CI: 1.848-4.656), smoking (OR: 1.80, 95% CI: 1.224-2.655), work experience (OR: 1.06, 95% CI: 1.016-1.107), previous exposure to noise (OR: 1.60, 95% CI: 1.112-2.312) or vibration (OR: 1.68, 95% CI: 1.150-2.475) and type of occupation (OR: 2.126, 95% CI: 1.055-4.285) were associated with an increased risk of ONIHL (P < 0.05). CONCLUSION: It was found that vibration exposure, work experience, previous noise exposure, type of occupation as well as age and smoking significantly affected the likelihood of developing ONIHL. This risk model could help management to prevent ONIHL and enhance application-oriented research on the condition.

Validity and Reliability of the Human Immunodeficiency Virus-Related Stigma Questionnaire in Persian.

Background: It was aimed to adapt a 12-item questionnaire into Persian among people living with human immunodeficiency virus (PLHIV) in Markazi province. Material and Methods: Content validity was evaluated based on the opinions of the relevant experts, and by calculating the scale-level content validity index (S-CVI) and the item-level content validity index (I-CVI). Reliability was assessed via test-retest, intraclass correlation coefficient (ICC), and Cronbach's alpha. Results: The obtained scores on clarity and relevancy (I-CVI) ranged from 0.9 to 1. The S-CVI also had an acceptable validity of 0.99. The Cronbach's alpha index of the whole questionnaire was 0.84 and ranged from 0.69 to 0.82 for subscales. The ICC in test-retest for all questionnaires was 0.88 and for subscales ranged from 0.77 to 0.88. Conclusion: The Persian version of the 12-item human immunodeficiency virus-related stigma questionnaire was found to be, in addition to being short and comprehensive, acceptable reliability and high validity to use in order to determine the stigma related to Persian-speaker PLHIV.

A nationwide study on the prevalence and contributing factors of obstructive sleep apnea in Iran.

Reliable obstructive sleep apnea (OSA) prevalence information in Iran is lacking due to inconsistent local study results. To estimate OSA prevalence and identify clinical phenotypes, we conducted a nationally representative study using multi-stage random cluster sampling. We recruited 3198 individuals and extrapolated the results to the entire Iranian population using complex sample survey analyses. We identified 3 clinical phenotypes as "sleepy," "insomnia," and "restless legs syndrome (RLS)." The prevalence of OSA was 28.7% (95%CI: 26.8-30.6). The prevalence of "sleepy," "insomnia," and "RLS" phenotypes were 82.3%, 77.8%, and 36.5% in women, and 64.8%, 67.5%, and 17.9% in men, respectively. "Sleepy" and "insomnia" phenotypes overlapped the most. Age (OR: 1.9), male sex (OR: 3.8), BMI (OR: 1.13), neck circumference (OR: 1.3), RLS (OR: 2.0), and insomnia (OR: 2.3) were significant OSA predictors (p-values: 0.001). In men, "sleepy" phenotype was associated with youth and unmarried status but not in women. The "insomnia" phenotype was associated with shorter sleep duration in women; cardiovascular diseases (CVD), urban residency, and shorter sleep duration in men. "RLS" phenotype was associated with shorter sleep duration and CVD in women and older age, lower educational level, CVD, and hypertension in men. The findings point to the need for funding of OSA screening in Iran, for a different assessment of men and women, and for future sleep research to consider overlapping phenotypes.

Air pollution and COVID-19 mortality and hospitalization: An ecological study in Iran.

Exposure to air pollution can exacerbate the severe COVID-19 conditions, subsequently causing an increase in the death rate. In this study, we investigated the association between long-term exposure to air pollution and risks of COVID-19 hospitalization and mortality in Arak, Iran. Air pollution data was obtained from air quality monitoring stations located in Arak, including particulate matter (PM), nitrogen dioxide (NO2), sulfur dioxide (SO2), ozone (O3) and carbon monoxide (CO). Daily numbers of Covid-19 cases including hospital admissions (hospitalization) and deaths (mortality) were obtained from a national data registry recorded by Arak University of Medical Sciences. A Poisson regression model with natural spline functions was applied to set the effects of air pollution on COVID-19 hospitalization and mortality. The percent change of COVID-19 hospitalization per 10 µg/m3 increase in PM2.5 and PM10 were 8.5% (95% CI 7.6 to 11.5) and 4.8% (95% CI 3 to 6.5), respectively. An increase of 10 µg/m3 in PM2.5 resulting in 5.6% (95% CI: 3.1-8.3%) increase in COVID-19 mortality. The percent change of hospitalization (7.7%, 95% CI 2.2 to 13.3) and mortality (4.5%, 95% CI 0.3 to 9.5) were positively significant per one ppb increment in SO2, while NO2, O3 and CO were inversely associated with hospitalization and mortality. Our findings strongly suggesting that a small increase in long-term exposure to PM2.5, PM10 and SO2 elevating risks of hospitalization and mortality related to COVID-19.

Spatial Cluster Analysis of Stomach Neoplasms in the Center of Iran Based on a Population-Based Study, 2009-2014: Application of the Poisson-Based Probability Model.

Background: A better understanding of the spatial pattern of stomach cancer can be helpful in the implementation of preventive strategies. This study is one of the first studies to establish a study unit based on the smallest possible size for cluster analysis. This study includes a novel evaluation of spatial differences in different geographical areas of Arak. The present study seeks to discover the spatial clusters of stomach cancer from 2009 to 2014 in Arak. Methods: All of the addresses of the stomach cancer cases were geocoded. After that, the number of stomach cancer cases in each census block was calculated to be entered in the SaTScan software. A discrete Poisson-based probability model was used to analyze this cluster. Results: In Arak, there are 5502 census blocks with a population of about 526,182. The number of identified and registered stomach cancer cases with an acceptable residence address was 392. Totally, 11 stomach cancer clusters were established in the area of Arak, from these; two clusters were detected statistically significant. Relative risks of the first and second clusters were 1.75 (P = 0.01) and 17.60 (P = 0.04) and those are located within the radius of 1.73 and 0.085 km, respectively. Conclusions: Our results have confirmed that two areas are at a higher risk than others. However, based on the results of this study, community-based interventions in certain geographical areas can be designed to reduce and control the incidence of stomach cancer.