javad faradmal

Physical fatigue is one of the major risk factors for work-related musculoskeletal disorders and has many life and financial costs. The impact of physical/biomechanical, psychosocial, environmental, and individual risk factors on muscle fatigue is undeniable. The aim of this study is to model the phenomenon of muscle fatigue (as output) in the hand in work environments based on these risk factors (as input) using soft computing methods.

In the first step, associated risk factors of fatigue for 156 subjects (in three job categories) were assessed using Copenhagen environmental, psychosocial, demographic, and Man-TRA tools. Then, the Roman-Liu equation and mean square amplitude of acceleration waves were used to measure fatigue with a dynamometer and a three-axis accelerometer, respectively. Finally, according to the nature of risk factors and the phenomenon of fatigue, six categories (24 methods) of supervised machine learning (SML) based on classification were selected. MatLab software (MatLab R2017b, The Mathworks Inc., MA, U.S.A.) was used to fit the models using SML.

The best-fitted models in the first and second half of the work shift were obtained using support vector machine methods. Physical risk factors had a significant impact on physical fatigue. After filtering low-priority risk factors, in the first half of the work shift, the most optimal model had an accuracy of 71.8%, precision of 72.5%, sensitivity of 76.9%, specificity of 70.8%, and discrimination power equal to 73%. In the second half of the work shift, the accuracy, precision, sensitivity, and specificity of the optimized model were 60.3%, 57.5%, 50%, and 46.9%, respectively, and the discrimination power was obtained at about 62%.

The fitted models for hand fatigue had acceptable performance in both sections of the shift but can still be optimized. Therefore, it is necessary for future studies to improve the quality of input and output data and include other dimensions affecting fatigue such as cognitive workload and type of work shift in future models.

Nowadays, breast cancer (BC) metastasis is a nightmare for women and one of the main challenges among researchers worldwide. Unlike traditional statistical methods that are not able to handle and take into account the complexity of effects and existence of interactions among predictor variables, the decision trees can overcome these problems. This study aimed to predict and identify the main prognostic factors of BC metastasis status (binary response) using decision tree modeling. This retrospective cohort study was conducted on 375 patients with BC who had registered with the Comprehensive Cancer Control Center from 1998 to 2013. Some demographic features related to the conditions of the Person’s disease and the type of treatment received were recorded. We applied a tree-based approach using the Gini index as the homogeneity criterion to explore the factors affecting metastasis occurrence in BC patients. The mean (SD) age of BC patients with and without metastasis was 55.7 (12.4) and 43.1 (7.2) years, respectively (P<0.001). The rate of metastasis was 33.3%. The five most important risk factors for metastasis of tumor proposed by tree diagram were age at diagnosis, grade of tumor, type of surgery, number of deliveries, and axillary surgery. The prediction accuracy of the proposed model was 84.3%, and its sensitivity and specificity were 66.4% and 93.2%, respectively. Age at diagnosis was the most important factor for predicting breast cancer metastasis, so that breast cancer patients aged over 54 were at high risk of metastasis.

 Athletes’ use of androgenic-anabolic steroids (AASs) is a significant health problem. This study aimed to determine factors associated with AAS in male bodybuilders by applying the theory of planned behavior (TPB).

 Using a multistage random sampling procedure, this descriptive-analytical cross-sectional study was performed on 429 athletes participating in gyms in Qom, Iran, in 2019. The data collection tool was a questionnaire, including demographic information and questions related to TPB constructs. Data were analyzed by descriptive statistics, Chi-square test, logistic regression, and linear regression using SPSS software, version 16.

 The results demonstrated that 188 (48.2%) athletes had a history of AAS use. The attitude (β=0.39), subjective norm (β=0.26), and perceived behavioral control (β=-0.36) predicted 38% of the variance of intention to AAS use. Further, behavioral intention was the statistically significant predictor of AAS use among the studied athletes (OR=0.83, 95% CI: 0.78-0.87). Variables such as having friends (OR=2.06, 95% CI: 1.28-3.30) or a sports coach using AAS (OR=3.1, 95% CI: 1.58-6.42) and having a history of supplementation use (OR=5.8, 95% CI: 2.65-12.8), along with age (OR=4.3, 95% CI: 0.35-53.6) had a significantly predictive role in using AAS.

 The findings revealed that nearly half of the studied athletes had a history of using AAS and supplements. TPB is applicable to identify the determinants of beliefs, intention, and behavior to use AAS among athletes. These findings can be useful in designing appropriate programs to prevent AAS use.

 There are variable results regarding lipid profile status in preterm infants with respiratory distress syndrome (RDS). We aimed to evaluate the relationship between serum lipids and RDS in preterm infants.

 This cross-sectional descriptive study was conducted on preterm infants admitted to Hamadan Fatemieh and Besat Hospitals between the years 2018-2019. Each infant was evaluated regarding RDS severity, serum lipid profile, ventilator use, and length of hospital stay. SPSS 16 was utilized to analyze the data at a 95% confidence interval.

 Out of 294 neonates, 51% were male. The mean birth weight and gestational age were 1783.51 ±551.86 grams and 32.37 ± 2.46 weeks, respectively.  Based on the severity of RDS, 9.1% were mild, 41.8% moderate and 49.1% were severe. In severe RDS, mean triglyceride, cholesterol and LDL were significantly higher and HDL lower than in mild RDS (P <0.001).

 In preterm infants with RDS, there is a significant relationship between serum lipid profile and severity of RDS, and also there is a significant correlation between serum lipid profile and birth weight and gestational age of neonates.

the Er,Cr:YSGG laser has a suitable wavelength for the ablation of both hard and soft tissues of the periodontium and can be considered as a potential tool in periodontal surgeries. The current study aimed at evaluating the application of this laser versus conventional instruments in periodontal pocket reduction flap surgery.

Eight patients (16 dental arches) requiring periodontal surgery were included (Trial registration number: IRCT201711129014N199). Using a split-mouth study design, two posterior sextants of a dental arch were randomly allocated into either a test group, open flap debridementperiodontal surgery using the Er,Cr:YSGG laser or a control group using the conventional method. Laser parameter settings of a 2780 nm wavelength, H mode (60 μs pulse duration), 25-50 Hz, 2-3.5 W output powers and Air-20%, Water-60-80% were applied and adjusted individually for each step of the flap surgery procedure. Baseline, 1 and 3-month measurements of plaque index (PI), Gingival Index (GI), gingival recession (GR), probing depth (PD) and clinical attachment level (CAL) were recorded for comparisons. Data were analyzed by a linear model for correlated data using the generalized estimating equations (GEE) method and the least significant difference (LSD).

In both treatment groups, reductions in PI and GI were observed in the 3-month follow-up period. These indices were significantly lower in the laser-treated sides compared to the conventional group (P < 0.05). The Mean PD and CAL were lower at 1 month and3 months compared to the baseline in both groups (P < 0.05). However, these parameters were not statistically different in the treatment groups during these follow-up timelines. An increase in GR was observed from the baseline to 1 month and 3 months with less recession in the laser-treated sides (P = 0.016).

Based on the results of the present study, the Er,Cr:YSGG laser assisted periodontal flap surgery resulted in similar treatment outcomes to the conventional method and may be considered as a safe and effective treatment modality.

Quercus infectoria is a species of Quercus genus (Fagaceae) whose galls are known in traditional medicine for their antibacterial, analgesic, anti-inflammatory, and astringent effects. The present study aimed to carry out quantitative and qualitative analyses of the constituents of the hydroalcoholic extract of the Q. infectoria galls from Kermanshah and to evaluate its antioxidant and antibacterial activities.

Following the extraction process using ethanol/water (70/30), phytochemical tests were done. Total phenol and flavonoid and antioxidant and antibacterial activities against specific strains of bacteria were evaluated. Some of the constituents of the extract were identified using high-performance liquid chromatography-photodiode array, and their amount was obtained.

The phytochemical tests proved that the extract contained alkaloid, flavonoid, tannin, saponin, and phenolic compounds. The amount of total phenolic and flavonoid compounds was 16.21 and 1.78 mg/g dried galls, respectively. The IC50 value of the antioxidant constituents of the extract was 47 µg/ mL. The results of the antimicrobial assay showed the high activity of the extract against Escherichia coli, Klebsiella pneumonia, Staphylococcus aureus, and S. epidermidis. The quantitative analysis of the extract confirmed the presence of gallic acid, rutin, quercetin, benzoic acid, and caffeic acid (12.30, 10.72, 5.00, 9.25, and 3.94 mg/g dried galls, respectively).

Considering the results of this study, the extract of Q. infectoria galls could be used as a primary substance in treating bacterial infections and oxidative stress-related diseases.

This study aims to identify the risk factors of disease-related death in patients with colon cancer in the presence of competing risks.

Competing risk analysis is an effective method for identifying risk factors of death from disease, and the evidence related to the prognosis of death in patients with colon cancer in the country is rare.

In this historical cohort study, the information of 196 patients with colon cancer who were referred to Imam Khomeini Clinic in Hamadan during the years 2003 to 2017 were examined. Death due to the progression of cancer was considered an interesting cause, and death related to other causes was considered a competing event. Predictors of death due to the progression of cancer were determined in the presence of competing risks. The cause-specific hazard regression model was used to determine the effects of covariates. Data was analyzed using R software vol. 3.4.3 and survival packages.

The mean (SD) age of patients was 57.1 (12.9) years, and 52.6% were male. The results of the multivariate cause-specific hazard regression model showed that the patient's age at the time of cancer diagnosis, T stage, stage of the disease and N stage had significant effects on the hazard of death due to cancer progression (p<0.05).

In the presence of various causes of death, using the cause-specific hazard model to identify the risk factors of each cause separately can better support clinical decisions compared to other models.

 Stomach cancer is the fourth most common cancer in the world and first cancer in Iran. The northern and northwestern regions of the country are areas with a high prevalence of gastrointestinal cancers, especially gastric cancer. Different factors are effective in the incidence of this cancer.

 The present study aimed to evaluate the epidemiology of gastric cancer.

 This research was a cross-sectional study. All patients referred to Tohid Hospital in Sanandaj between 2012 and 2018 were examined. Data were extracted using patients' medical records. Descriptive information was collected through SPSS software, and the results were analyzed.

 The number of patients in this study was 553. The mean age was 66.9 years, and the highest age group was 60 - 80 years. Four hundred twelve patients were male, and 141 were female. In 50% of patients, the location of the cardiac tumor was gastric. Chemotherapy was the most common treatment in more than 60% of patients.

 The results of this study show that smoking is unfortunately high in patients in this province. An educational intervention to quit smoking is recommended. Smoking is an important risk factor for gastric cancer, and this intervention may also be effective in reducing the incidence of this disease.

 Fatigue is a common and highly prevalent problem among workers. Muscle fatigue is the result of general fatigue that is caused by different risk factors. This research was conducted to assess grip fatigue between workers with manual tasks and its relationship to psychosocial risk factors.

 In this study, Jamar hydraulic dynamometer was used to investigate the decrease in the production of grip force or grip fatigue. The grip force of 157 subjects in three job levels that met inclusion criteria recorded, three times in an 8 hours shift. The psychosocial risk factors were also assessed using the Copenhagen psychosocial questionnaire and their relationship with grip force and grip fatigue was analyzed.

 sixty-one percent, 62%, and 69% of employees in light, medium, and heavy tasks, respectively, experienced grip fatigue in the second phase of the study. It seems that as the power/speed increased and the tasks became more difficult, employees experienced more grip fatigue in the right hand. The declining trend of grip force and the increase in grip fatigue was more evident in heavy task jobs. No moderate or strong correlation was observed between the psychosocial risk factors and grip fatigue.

 Because the nature of worker tasks in heavy manual tasks required more force exertion, they experienced more grip fatigue in their right hand than other workers. It is not possible to draw definitive conclusions about the impact of psychosocial risk factors on grip fatigue. Investigating the impact of cognitive loads and anthropometric dimensions on grip fatigue can be an interesting topic for future studies.

 Staphylococcus aureus is a gram-positive coccus bacterium responsible for a wide spectrum of human infections. The main colonization site for S. aureus in humans is the anterior nares. Health care workers (HCW) are commonly colonized with resistant microorganisms; however, it is not clear whether close contact with HCW is a risk factor for colonization with resistant microorganisms.

 The aim of the study was the determination of the risk of methicillin-resistant Staphylococcus aureus transmission from colonized parents to their children via daily contact.

 This was a cross-sectional study conducted in Hamadan city, the west of Iran, between October 2016 and March 2017. We defined two groups for our investigation. The first group included 1 - 6 years old children who their mother, father, or both were health care workers (HCW) in university-affiliated hospitals of Hamadan University of Medical Sciences, and the second group consisted of children whose parents were not health care workers. Both groups attended day care centers. One hundred and thirty-four children were enrolled in this study, from which 67 had HCW parents, and 67 had non-HCW parents.

 S. aureus colonization rate among children of HCWs was 17.9 % (12/67), and in children of non-HCWS was 32.8% (22/67). The colonization rate was not significantly different between these 2 groups (P = 0.052). Of all the S. aureus isolates, one methicillin-resistant isolate and one clindamycin-resistant isolate were observed. The D-test was positive in 12.1% of clindamycin sensitive isolates

 We recommend the use of anti-staphylococcal penicillin or first-generation cephalosporins in cases of non-life-threatening staphylococcal infections and clindamycin for MRSA infections. Regarding to our results, there is no difference in the choice of antibiotic between children of health care workers and other children. We also recommend avoiding switching therapy from erythromycin to clindamycin.

Defining a non-invasive marker to predict the risk of kidney damage is very helpful to manage vesicoureteral reflux (VUR) in children. This study aimed to investigate the predictive value of urinary neutrophil gelatinase-associated lipocalin (uNGAL) as a non-invasive biomarker of reflux nephropathy in pediatric with primary VUR.

This case-control study was performed on 63 children with primary VUR and 72 age- and sex-matched healthy children as controls. Urinary NGAL and creatinine levels were measured and compared between patients and control groups as well as among the subgroups of patients in terms of disease severity.

Among patients, 9 cases were diagnosed as mild, 35 as moderate, and 19 with a severe form of VUR. We observed higher but insignificant levels of uNGAL in patients versus healthy controls (P > .05), in cases with severe form compared to mild and moderate forms of VUR (P > .05) as well as in those patients with bilateral versus unilateral involvement (P > .05). The mean ratios of uNGAL/uCr were significantly higher in patients group than controls (P < .05) as well as in patients with severe form compared to moderate and mild forms of VUR (P < .05 and P < .05, respectively). Also, ROC analysis revealed the sensitivity of 61% and specificity of 53% for uNGAL/uCr ratio for prediction of VUR.

Our findings indicate a potential predictive value of uNGAL/uCr ratio as a non-invasive biomarker for the management of VUR although, its clinical application has been challenging and needs to be confirmed by further investigations.

Lighting directly and indirectly affects employeeschr('39') mental health and their performance. Good lighting is required for good visibility of the environment and should provide a luminous environment that is human-friendly and appropriate for the visual task performed. Optimal lighting is one of the most important issues in providing the physical conditions of different places, especially the workplace. Lighting can provide comfortable working conditions, especially visual comfort. Life on Earth cannot be imagined without light. Defects in the qualitative and quantitative aspects of lighting in the workplace can cause visual discomfort and reduce the productivity and efficiency of an individual. Therefore, monitoring the intensity of brightness and color temperature of light is essential to maintain and enhance the health of employees. The quantity and quality of lighting can also affect onechr('39')s mental health. For example, one of the factors associated with depression is the defect in the quantity and quality of ambient lighting. Correlated color temperatures (CCT) of light play an important role in human psychological and physiological needs. In regards of human perception, two of the most important characteristics of lights are illumination and correlated color temperature (CCT). studies have proven that different CCT provided by different lighting are important in affecting human beings psychologically and physiologically, through their visual and non-visual processes.. According to European standard EN 12665, visual comfort is defined as a personchr('39')s mental well-being in the workplace. Studies on lighting in industrial environments have been conducted more frequently and public and office environments have received less attention. CCT is found to have effects on visual and mental fatigue. The right selection of CCT in an office environment will benefit its occupants in terms of visual comfort and reduction of daytime sleepiness. Studies have shown that insufficient and uncomfortable lightning conditions in office environments increase the risk of visual and ergonomic disorders in long term. The aim of this study was to evaluate the illumination and color temperature and its relationship with visual comfort in administrative staff in Hamadan city (west of Iran).

This cross-sectional study was conducted in 50 rooms and among 70 staff of Hamadan University of Medical Sciences and random sampling. In this study, the intensity of illumination at the work surface and at the height of the individual eye The intensity of the local illumination at the work surface and at the level of the individual eye level was measured at the userchr('39')s point of view and the angles and distances were accurately observed and measured with the presence of the user in the presence of semiconductors or other factors. Also intensity of the general lighting based on the Illuminating Engineering Society of North America (IES) in terms of lux and color temperature of light source in terms of Kelvin at the work surface using new device Sekonic C-7000 SpectroMaster was measured. The device is capable of simultaneously measuring brightness intensity (Kendel / lux), color temperature, color expression index and wavelength. The device has an accuracy of over 1 nm. Visual comfort of visual display terminal users was assessed using visual fatigue questionnaire. Visual fatigue questionnaire with15 items and four components of eye stress, visual impairment, eye surface disorder and extra ocular problems was used for this purpose. This questionnaire is rated on a Likert scale ranging from 0 to 10 and none to very severe.

The results showed that the mean age of the staff was 42.18± 7.46 years with a minimum of 25 and a maximum of 62 years. In this study, the average general illumination intensity of the studied rooms was 437.57 ±116 and the average local illumination intensity was 341.16±109 and 307.13±195 respectively. Also, the intensity of illumination, general, local level at work and perpendicular were 30.6%, 33.9% and 38.4% lower than the national occupational health limits. The average color temperature during the working shift in 56% of the rooms was more than 4000 °K. The frequency of low and high visual fatigue score was 61.4% and 38.6% respectively. There was a statistically significant relationship between brightness intensity and visual fatigue of the staff during the study. The results of the study showed that people with room temperature below 4000 ° C had higher frequency of visual fatigue in these subjects. Chi-square test confirmed the relationship between the intensity of local illumination and visual fatigue of the subjects (p <0.05). The distribution of brightness intensity at most of the surfaces of the investigated environments was largely uneven (less than 0.6). Finally, the incidence of visual fatigue expressed by staff has been considerable.

local and general luminance was lower than the Iranian occupational exposure limit and it had not a suitable condition in term of quality and quantity. Light intensity distribution in office rooms was undesirable. The results of this study showed a significant relationship between artificial lighting and color temperature with visual fatigue. The results showed that in rooms which more hours of artificial lighting was used in the workplace and had less natural light, participants suffered visual fatigue. In rooms where the color temperature was close to that of the sun, people had less visual fatigue. Causes of poor quality of light are insufficient number of light sources as well as the use of cold light fluorescent lamps and inappropriate color temperature of some lights and even the color of interior surfaces and angles of the individual desk relative to the window and the use of dark curtains It indicates that in designing lighting and environmental factors related to the office environment, the quantity and quality of light sources and environmental factors influencing the proper lighting and visibility of people were less considered Defects in artificial light intensity and color temperature of the sources affect the visual acuity of the administrative staff and increase the visual fatigue of the employees. According to the Study the modification of lighting systems and training of Staff in order to prevent the visual disturbances associated with it, while improving the artificial lighting system of these places.

Influenza is an infectious and severe respiratory disease. It is one of the major problems of public health. In order to determine the spatial distribution and areas with over-expected of a disease including influenza, it can be effective in identifying environmental hazards and fair distribution of health services. In this study, the geographical distribution of the influenza and the identification of the high risk clusters of this disease were investigated.

In this study, the incidence information of influenza in a 21-month period (until October 2018) from eastern Mediterranean countries were used. The data were extracted from the world health organization's reports and used to determine the areas with over-expected incidence of influenza using flexible scan statistics.

In total, 28055 cases of influenza have been reported in the countries of the Eastern Mediterranean region during the study period. Results detected four high-risk cluster in this region. According to the results, incidence of influenza in Bahrain, Kuwait and the Qatar was significantly higher than expected. In the second place, Oman and Tunisia were also considered as a high-risk region, separately. Jordan was the next cluster, however there was no statistically significant difference between expected and observed cases of influenza in this cluster.

The results of flexible spatial exploration statistics indicated the high incidence of influenza in the countries of west of Asia and north of Africa in the Eastern Mediterranean region. Therefore, the influenza control system at the regional and national levels in high-risk countries is strongly recommended

This study is aimed to compare the results obtained from four risk assessment methods, videlicet HAL-TLV, Strain index, OCRA checklist, and ART. These musculoskeletal disorders assessment tools are generally used in the studies as well as in the field of occupational health. In this study, the data was collected via assessments of 30 tasks by 9 raters in poultry slaughter, assembly, and container production industries using four methods of upper limb musculoskeletal disorder risk assessment. In order to determine the level of agreement between the risk assessment methods, the Spearman's rank correlation coefficient and Cohen's weighted kappa were used, according to which the highest agreement and correlation were found between ART and OCRA checklist methods, while the HAL-TLV and OCRA checklist exhibited the lowest agreement and correlation. The difference between the risk classification results of the studied methods could be due to the difference of definitions of the risk variables; therefore, selecting the assessment tools for assessing the task risks in the working environment must be in accordance with the assessment objectives and complexity of the work tasks.

Pharmaceuticals, especially antibiotics, are new contaminants that because of their cumulative nature, adverse effects and drug resistance; have created a major environmental concern. The aim of this study was to evaluate UV/peroxymonosulfate (UV/PMS) process efficiency in the removal of cefexime antibiotic from aqueous solution.

This experimental laboratory study was conducted in batch mode. We assessed the effects of main operational parameters such as solution pH (3-9), reaction time (0-30 min), photocatalyst dosage (0.75-2.25 mmol/L), and initial concentration of cefexime (5-25 mg/L) on removal efficiency. Spectrophotometer (HACH DR-5000 UV–Vis) was used to measure the initial and final concentrations of cefexime.

Under optimal condition (pH=7.5, irradiation time=30 min, C0=5 mg/L, and PMS dosage=1.37 mmol/L), use of photocatalytic UV/peroxymonosulfate led to efficient removal of cefexime (93.18%).

The results of this study showed the acceptable performance of peroxymonosulfate process in the removal of cefexime.

There is always an interaction between man and his environment that can be the cause of physical, physiological and psychological stress on people and also cause discomfort, annoyance, and have direct and indirect effects on their performance and productivity, health and safety. People in their workplace are exposed to many factors related to work activities and environmental factors, which can affect their health; So workplace disruptions such as noisy environments can cause safety problems, reduce employee morale and undesirable effects on performance, working memory, and attention; For these reasons, ergonomic designers must be capable of designing the physical environment because the design of the environment not only keep people's performance high, but also provide a safe and healthy environment for improving employees' health. Noise can also negatively affect communication between people. Banks are open plan offices and the financial services provided by bank staff that requires employee's mental activity. Different sources of noise production can affect employees and negatively affect their comfortable, functional and communication aspects. Noise also effects on mental activities can cause employees to become tired early and increase their computational errors. In a bank environment where conversations between bank tellers and customers are necessary to conduct banking tasks, interfering with ambient noise, causing annoyance, human error, and ultimately failed to provide banking services. Because of high workload and the banks' competition to attract customers in order to provide better services, quiet workplace environments are essential for staff comfort and optimum performance; so right designing workplace can have a high impact on people's comfort and productivity. Speech Interference Level is a simple way to predict or evaluate speech intelligibility where the conversation occurs directly in a noisy environment. At open plan offices, employee and customer communicate face-to-face and information exchange is done in that way. In recent years, many banks in our country have established their own workstations as sited customers and face-to-face with bank tellers, but so far no study has been conducted on the changed employees' workstations and its effect on speech interference. A question now arises, is workstation redesign increase the Speech Interference Level and improve Intelligibility ratings for speech communications? Therefore, the purpose of this study was redesigned workstations and make environmental changes and its effect on SIL among bank tellers.

  This study is a descriptive-analytic and Interventional study, this was carried out for one year in three branches of one of the governmental banks of Hamadan province (N= 12). Twelve workstations were redesigned and installed after measuring the sound and calculating Speech Interference Level, and calculating the distance between customer and employee. Bank tellers are those who have a direct relationship with customers and perform banking tasks. They had to sit long during the day and they spent all their time working on computers and they were getting things done and receiving customer financial requests. They used the workstations were constructed in the present study. The tools for data collection in this study were: 1) demographic and occupational questionnaire, 2) sound measuring and frequency analyzer CEL-450، 3) A questionnaire with a question “What noise sources in your workplace do you annoy?” to determine annoying sound sources and 4) ISO 9921-2003 standard to determine speech interference level of the noise at the listener's ear (LSIL), Speech level, Speech Interference Level (SIL) and Intelligibility ratings for speech communications. SIL is a simple way to predict or evaluate speech intelligibility, Speech intelligibility also increases with increasing SIL. speech intelligibility is divided into 5 rating (bad, poor, fair, good and excellent) based on SIL, also in sensitive situations where short messages are sent include important numbers, ability to understand at least "good" is recommended by increasing speech effort; the communication will be “fair” if the difference between LSIL and the speech level (LS, A, L) that both determined at the listener’s position is greater than 10. Measuring the sound within 1 meter of the speaker's mouth, according to ISO 9921 (2003) for normal sound (60 dB) was considered. It was measured for 15 minutes at 10 a.m. to 13 p.m. every shift that they had the highest number of customers, and measuring was done twice for each workstation (total 24 times). To calculate LSIL, the sound pressure level was measured in four octave bands with the central frequencies 500 Hz, 1000 Hz, 2000 Hz and 4000 Hz at the listener position and during the normal communication period in time-weighting “slow”. the sound pressure level was measured for 15 minutes and the average of these pressure levels was calculated. After collecting the preliminary data, bank teller workstations were redesigned and built. Some actions were taken to reduce speech interference and improve communication between bank tellers and customers; For example, insert a glass between customer and bank teller and create 12 vents (diameter =2 cm) at a customer's mouth height to improve communication, changing the workstation so that the operator and customer interact face-to-face and insert chair for customers to sit in, reduce customer gathering in front of the workstations, reducing the distance between the customers and the bank tellers by creating an arc at the table, Enhancing employee privacy by placing the glass between employees in beside workstations, increasing the glass height between the bank teller and the customer to prevent customer standing communicate with the bank teller. The mean distance between bank teller and customer prior to redesigning the workstations was 123 cm which was reduced to 103 cm in redesign; the mean distance between two employees was 95 cm, which increased to 115 cm after the redesign. Environmental interventions also include the installation of perforated acoustic tiles made of plaster as a false ceiling, so that, by installing them the distance between the main and false ceilings was 25 cm and there was an empty space between them which absorbs more sound. The walls of the branches were also covered with wall plugs that made of PVC and MDF, and the floor was improved. Data were collected before and after the interventions and they were compared. Data analysis was performed using SPSS software, version 16. Data were analyzed using descriptive statistics (mean and standard deviation) and analytical statistics. The Paired t-test was used to compare the mean results of the LSIL and SIL.

In the present study, all the bank tellers were male. Everyone was married, their mean age was 38.25 (5.62) and work experience was 15.25 (6.87) years. Each bank teller were doing 30-50 customers' finances task in one shift. All participants stated that their rest time was less than 30 minutes in a shift and they are working 7-8 hours in a sitting position; none of the participants had a history of hearing loss or other hearing problems. Results from annoying sources of noise showed that the most annoying sources of noise in all three branches were the noise of customers (42.85%) and the sound of money counting machine (33.3%); Printer noise was the lowest (4.76%). Before the interventions, mean speech interference level (LSIL) was 59.50 dB (4.07) that was then reduced to 54.98 (5.52) dB and this decrease was statistically significant (p <0.05), also the results of evaluation and comparison of SIL in the workstations after and before the interventions showed that SIL increased and it was statistically significant (P <0.05), the mean of SIL before interventions was -1/00 (3.98) which reached to 5/09 (5/23) after interventions, Lots of noise in the workplace reduces SIL which in turn reduces the speech intelligibility between the bank tellers and the customers. Therefore, the interventions have improved the speech intelligibility in all three branches. So that after interventions, the "fair" speech intelligibility increased from zero to 4 cases (16.7%); and it is expected that by improving speech intelligibility, peoples' efficiency and concentration will increase; so it can be said that high levels of workplace noise reduce SIL, which in turn reduces the speech intelligibility between bank tellers and customers. 22 of the 24 measurements before the new workstations were in the “bad” speech intelligibility range, which was reduced to eight after the new workstations were installed, but after the interventions, speech intelligibility in most workstations (50%) were “poor”; Upgrading the speech intelligibility from bad to poor can be a sign of improvement; but further studies are needed to survey the sources that impair intelligibility in order to reach good or excellent level and reduce problems due to poor intelligibility such as longer speaker and listener speech and computational errors.

The overall purpose of this study was redesigned workstations and environmental interventions in the open plan office and their effects on Speech Interference Level (SIL). The findings of this study showed that the interventions were effective on SIL. According to the results of this study, redesigning work stations and environmental interventions in open plan offices can influence SIL and improve the speech intelligibility, that it can prevent errors and increase concentration and reduce fatigue by peoples' privacy and controlling annoying sound sources. Finally, it can be said that the workstation redesign and layout can improve the acoustic working environment.

There are several methods for assessing the ergonomics risk of upper-limb disorders in occupational health studies. The main objective of the present study is to determine the intra and inter-examiner reliability of three risk assessment methods of SI, OCRA Checklist and ART in repetitive tasks. Early, nine examiners used the three methods to assess the physical exposure level of the upper limb in workers 30 tasks with different levels of the profession for two assessment periods. In the results obtained using ICC for inter-examiner reliability, the risk categorizations were ρ: 0.54 to 0.77 for SI, OCRA Checklist and ART, Also the intra-examiner reliability for the final score of the three methods was κ: 0.59 to 0.67. The reliability for risk categorizations and the final score of this method using ICC obtained as moderate to good. However, the overall results showed that the reliability of the ART method was higher than the two other methods. The findings demonstrated that all three methods are appropriate for assessment in workplaces. These methods should be used based on assessment objectives, examiner skill and required duration time for assessing the tasks.

Thyroid cancer is one of the most common tumors of the endocrine system. Despite its low death rate, its prevalence is high. Different factors affect the incidence, recurrence, and mortality in patients with thyroid cancer.  This study aimed to determine the effective factors in the relapse and mortality rates of thyroid cancer. In this retrospective with a cross-sectional design, 631 cases of thyroid cancer with papillary and follicular pathology were assessed. They were referred to Imam Reza, Ghaem, and Sina hospitals. The effects of various demographic and clinical factors on the survival and relapse of patients were evaluated using parametric and semi-parametric model analysis. The obtained data were analyzed in R and SPSS. Most of the patients were female (74.8%). Their mean±SD age of the diagnosis was 39.74±15.7 years. Seventeen (2.7%) patients died, and 140(22.2%) patients had a recurrence. In multivariate analysis with the recurrence event, age of diagnosis, and tumor size were significant factors in the semi-parametric model, and the age of diagnosis, tumor size, and distant metastases were significant factors in the parametric model. In multivariate analysis with the death event, age of diagnosis, and weight were significant factors in the semi-parametric model, but the age of diagnosis and gender were significant factors in the parametric model (P<0.05). Clinical factors such as gender, age of diagnosis, tumor size, weight, and distant metastasis are effective factors in cancer recurrence and death. Therefore, it is necessary to pay attention to these factors in the treatment of patients.

4-chlorophenol (4-CP) is one of the seriously toxic chlorophenol compounds found in the effluent wastewater generated by oil refineries, pharmaceutical factories, and paper and leather producers which introduced into surface and ground water resources. This research aimed to study the feasibility of nZVI nanoparticles in activation of H2O2 and persulfate under UVA-LED irradiation based on Taguchi experimental design for 4-CP removal. This experimental study was conducted using a lab-scale batch reactor equipped with 18 ultraviolet light emitting diodes lamps with a wavelength of 390 nm. The effects of operating parameters such as pH of solution, contact time, dosage of nZVI, dosages of H2O2 and persulfate and different initial 4-CP concentration were evaluted by difiend factor of 4*4 using Taghuchi L-16 orthogonal array. Based on the results of the Taguchi method, the optimum conditions for removal of 4-CP in nZVI activated persulfate process included the initial 4-CP concentration of 25 mg/L, pH=3, reaction time of 60 min, nZVI and persulafte respective dosages of 2 and 2 mM. The highest removal efficiency and S/N values for this process were 51.83% and 34.29%, respectively. Also, optimum conditions for removal of 4-CP in nZVI activated H2O2 process were the initial 4-CP concentration of 25mg/L, pH=3, reaction time of 30 min, nZVI and H2O2 dosages of 0.75 and 1 mM. In this condition, the highest removal efficiency and S/N values were 81.76% and 38.25%, respectively. In both processes in this case, under acidic conditions, an increase in the active catalyst (Fe2+) activated more and more oxidants (radical hydroxide and radical sulfate) in both reactants, resulting in better efficiency of processes in these conditions. UVA-LED/H2O2/nZVI process could serve as a new and feasible approach for the degradation of 4-CP as well as other organic contaminants containing wastewater due to high efficiency, low contact time and need to the lowest oxidants agents. UVA-LED/H2O2/nZVI process could serve as a new and feasible approach for the degradation of 4-CP as well as other organic contaminants containing in wastewater due to high efficiency, low contact time and need to the lowest oxidants agents.

Health literacy (HL) can affect individual health, health communication anderror in taking medicine. The aim of this study was to determine the level of HL and associated factorsamong Iranian adults. In this cross-sectional study, 240 participants over 18 years of age referring to health centersin Hamadan, west of Iran in 2015 were selected by multistage random sampling. HL was assessedby the Test of Functional Health Literacy in Adults (TOFHLA). The questionnaire was completed by atrained interviewer. The independent variables were structural and intermediate social factors basedon the Commission on Social Determinants of Health (CSDH). Data were analyzed by using IBM SPSSversion 22. Average age of the participants was 30.88 ±7.38 years and 75.4% of the them were female. Thetotal score of HL was 64.58 ±16.71 (range: 23.82-98.98). Overall, 31.7% (n = 76) of the participantshad adequate HL level, 32.5% (n = 78) had borderline HL level and 35.8% (n = 86) had inadequateHL level. Additionally, participants with higher educational levels had higher HL scores than thosewith lower educational levels (P < 0.001). HL score was significantly higher in males than in females(P = 0.017). HL level seems to be inadequate among Iranian adults in the west of Iran. Moreover,enhancing social determinants such as educational level seems to increase HL. The results highlightedthe necessity for change and improvement in adults’ HL.

Guillain-Barre syndrome is an autoimmune neurological disease that is considered as the most serious type of paralysis without reflex. Different factors and therapeutic measures are effective in causes and how to control it. The aim of this study was to determine the epidemiology of Guilen Barre syndrome in Hamedan province during the years 2006-2015. In this cross-sectional descriptive study the required information from the records of 159 patients admitted to hospital Farshchian Hamadan, was investigated over a period of 8 years. The relationship between variables was analyzed by SPSS software version 16 using chi-squared test and independent T-test. Of the 159 patients, 58 (40.8%) were female and 98 (61.6%) were married. The mean age of patients was 48 ± 22.6. Lower limb weakness (95%) was the most common symptom and difficulty in swallowing and respiratory distress had the lowest incidence of symptoms. The largest age group of patients with Guillen-Baar syndrome was between the ages of 21-30. Relative healing was observed in 43 cases (27%) and death was observed in 15 cases (9.4%). There was no statistically significant relationship between gender, age, and marital status with symptoms appearing in patients with Guillen-Baar syndrome. The results revealed a different pattern of the epidemiology of Guillain-Barre syndrome in Iran from other countries. So different environmental factors are involved in GBS. According to disability and even death in such GBS patients, further research to find the etiology, treatment and prevention services will be required.

Using additives such as Balnkit, to increasing the quality color of food and for the fermentation and early preparation of bread dough, has increased in recent years. The purpose of this study was to investigate the concentration of Blankit in Hamadan breads production and risk assessment of food consumption during 2016. In this descriptive-analytical study, Balnkit, concentration in breads produced in Hamadan in 2016 was determined. A total number of 85 samples were randomly collected from all bakeries in two steps. The concentration of Blankit was determined according to ISIRI guideline using spectrophotometer in 560 nm. Then for the evaluation of risk assessment of food consumption, the value of target hazard quotients (THQ) was calculated. The Blankit was not found in 97% of samples and only 3% of samples (Lavash bread) have the Blankit. The calculation of the THQ index showed that value of THQ was 0.0041 whose value is less than 1 and the consumption of bread with this concentration will not endanger. The results of this study showed that the addition of Blankitin bread processing, with regard to the concentrations determined and eliminating it from bread due to the heat, does not pose a threat to the health of the people.

one of the major causes of child mortality is road traffic injuries. Police-assistant students are the students, who receive education on basic and simple contents of road traffic incidents. This study was conducted in order to investigate the performance of police-assistant male students comparing with the other students in Hamadan, concerning the prevention of road traffic injuries.
In this cross-sectional study two groups of boy-students in twelve schools including 184 police-assistant students in six schools and 184 non- police-assistant students in other six schools were selected randomly. In order to collect data a researcher-made questionnaire was used. Data analysis was done using SPSS 16 and chi-square test.
The mean and standard deviation of knowledge in the police-assistant group were 0.686 and 0.178 respectively and were 0.718 and 0.15 respectively in the other students group, showing there was no significant difference between the two groups regarding knowledge. There was no significant difference between the two groups in terms of the eleven behavioral items, expected from police-assistant students
There was no significant difference in the knowledge and even the behavioral items of those students who helped traffic police in comparison to those who did not help the traffic police and more proper training is necessary to improve the level of knowledge and performance of police-assistant students.

The common method for estimating survival indices is the Cox model. In the data with high volume, different order of interaction in the model is predictable. In that case, performance of the Cox model is not properly. Correspondingly, random survival forest (RSF) model is an alternative to the Cox model in this situation. The aim of this study is to determine factors that affected survival of patients with kidney transplant using RSF.
This historical cohort study carried on 459 kidney transplant recipients of living donor during of 1993- 2011 in Hamadan (Iran). Time between kidney transplant and irreversible transplant rejection was considered as a response. Modeling of determinants of survival was performed using Cox and RSF models and they were compared.
The survival rate of 5, 10 and 15 years were 91.6%, 85.3% and 74.9% respectively. Important variables selected based on various criteria in RSF were age of transplant recipient, the patient's condition at discharge, hemoglobin of receptor, the last Creatinine and the use of immunosuppressive drugs (inhibitors drug) in RSF model. Age of recipient, the patient's condition at discharge and the use of immunosuppressive drugs in the Cox model were significant.
Age of recipient, the patient's condition at discharge and the use of immunosuppressive drugs are determined as risk factors in Cox regression while the RSF method with less limited assumptions is able to determine risk factors of survival rate more precisely.

BackgroundTransient tachypnea of the newborn (TTN) is one of the most common neonatal respiratory disease and its symptoms usually begins in the first few hours after birth. The volume of fluid intake according to the neonate's conditions varies. We aimed to compare the restricted fluids volume with standard fluids volume in treatment of neonates with TTN.
This clinical trial was performed on 80 neonates with a diagnosis of TTN admitted in the Neonatal intensive care unit (NICU) of Fatemiyeh Hospital and Beasat Hospital of Hamadan Medical University in Iran. Patients were randomly divided to standard fluids volume (control = 40), and restricted fluids volume treatment groups (case = 40). The hospitalization duration, oxygen therapy duration as well as the number of days need for oxygen with hood; Nasal continuous positive airway pressure (NCPAP), and mechanical ventilation therapy was recorded. After data collection, the data were statistically analyzed via SPSS software (version 21.0).
The subjects were 30 (37.5%) females and 50 (62.5%) males (62.5%) with an average gestational age of 38.12(±1.07) weeks.The main aim from this interventional study was effect of restricted fluidtherapy on management of TTN in NICU section. The hospitalization duration, oxygen therapy duration and need for oxygen therapy with hood in the intervention group were significantly lower than the control group (P0.05).
ConclusionTTN treatment with restricted fluids volume, compared with standard volume of fluids, significantly reduces the need for respiratory supports as well as the duration of hospitalization in the NICU section.