Enrollment Phase Research Articles

MULTIMODAL BIOMETRIC ENROLMENT AND AUTHENTICATION SYSTEM (MBEAS) WITH MODIFIED SCORE-LEVEL FUSION AND TRIBLENDNN-BASED TEMPLATE MATCHING

This article proposed a multimodal biometric enrolment and authentication system (MBEAS) with modified score-level fusion and TriBlendNN-based template matching approach. It consists of four phases: (i) enrolment phase, (ii) security phase, (iii) storage phase, and (iv) authentication phase. Initially, the raw data of the iris, face, hand, speech, signature, handwriting, fingerprint, and keystroking are collected from the BiosecurID database, and then the raw images are pre-processed via resizing and cropping. Raw signal of speech is pre-processed via wavelet denoising and spectral subtraction. The raw data of key stroking is pre-processed via Z-score normalization. Then the pre-processed images of iris, face, signature, hand, handwriting, and fingerprints are segmented via optimized watershed segmentation. The pre-processed speech signal is segmented via VAD. From the segmented data, the optimal features are extracted for iris (LBP), face (IncepV3), signature and handwriting (shape features and GLCM), speech (MFCC), fingerprints (minutiae extraction), hand (palm print features), and keystroking. From the feature-extracted data, the feature fusion is then performed via modified score-level fusion. After the enrolment phase, the feature fused data is secured using watermarking. Then the watermarked data is stored in cloud storage. The final stage is the authentication stage, wherein the template matching is processed via the newly proposed TriBlendNN model. The proposed TriBlendNN model is a combination of the CNN, RNN, and Bi-LSTM. The final outcome comes from template matching. The proposed model is implemented in Python and its accuracy at learning rates of 70% and 80% are 96.89% and 97.76%, respectively.

CTN-0138: adaptation, implementation, and cluster randomized trial of a Community Pharmacy-Based Prescription Drug Monitoring Program Opioid Risk Assessment Tool—a protocol paper

BackgroundAs the opioid epidemic continues to have a major negative impact across the US, community pharmacies have come under scrutiny from legal systems attempting to hold them accountable for their role in over dispensing and lack of patient intervention. While the most available tool for monitoring patients’ opioid use is Prescription Drug Monitoring Programs (PDMP), these do not provide pharmacists with actionable information and decision support. Our study addresses this gap through three objectives: [1] incorporate validated opioid risk metric thresholds into a PDMP platform to create the Opioid Risk Reduction Clinical Decision Support (ORRCDS) tool; [2] assess ORRCDS’ ability to reduce patient opioid risk; [3] assess ORRCDS’ sustainability and viability for broader dissemination in community pharmacy.MethodsFor objective 1, our team is partnering with leadership from the largest US PDMP organization and a top-five pharmacy chain to implement ORRCDS into the pharmacy chain’s workflow following the Guideline Implementation with Decision Support (GUIDES) framework. For objective 2, our team will conduct a type-1 implementation mixed methods study using a 2-arm parallel group clustered randomized design. We anticipate enrolling ~ 6,600 patients with moderate and high opioid use risk during the 6-month enrollment phase across 80 pharmacies. This sample size will provide 96.3% power to detect a 5% or greater difference in responder rate between the intervention and control arm. Responders are patients with moderate-risk at baseline who reduce to low-risk or those with high-risk at baseline who reduce to moderate or low-risk at 180 days post last intervention. To accomplish objective 3, we will use the Consolidated Framework for Implementation Research (CFIR) to develop and execute cross-sectional qualitative interviews with pharmacists (n = 15), pharmacy leaders (n = 15), and PDMP leaders (n = 15) regarding long term adoption and sustainability of the ORRCDS tool.ConclusionsA PDMP tool that addresses moderate- and high-risk opioid use is not available in community pharmacy. This study will implement ORRCDS in a large retail pharmacy chain that will include additional screening and guidance to pharmacy staff to address risky opioid medication use. Our results will make critical advancements for protecting patient health and addressing the opioid epidemic.

Undiagnosed hypertension and diabetes mellitus in the Tabari cohort: a population-based study

BackgroundUndiagnosed hypertension (HTN) and diabetes mellitus (DM) are major public health challenges worldwide. We aimed to investigate the prevalence of undiagnosed HTN and DM, and their correlates, in a large-scale population-based cohort study.MethodsIn this cross-sectional study, data collected during the enrollment phase of the Tabari Cohort study (TCS) were utilized. Data were collected in the TCS using a standard questionnaire, blood collection, and measurement of anthropometric indices and blood pressure. Data were analyzed using the chi-squared test and univariate and multivariate logistic regression analyses. Undiagnosed HTN included those who were not aware of HTN at the time of enrollment but had systolic and diastolic blood pressures ≥ 140 mm or ≥ 90 mmHg, respectively. Undiagnosed DM included participants who were unaware of their DM at the time of enrollment and had FBS levels ≥ 126 mg/dL.ResultsThe total prevalence of undiagnosed HTN and DM were 5% (508) and 4.7% (485), respectively. The findings of multivariable logistic regression analysis showed that young age (OR: 0.40, P < 0.001), residents of urban regions (OR: 0.70, P = 0.03), lower Body Mass Index kg/m2 (BMI) (OR: 0.51, P = 0.002), waist-to-hip ratio (WHR)(OR: 0.70, P = 0.023), total cholesterol (TC) ≥ 200 mg/dL (OR: 0.1.83, P < 0.001), lack of history of DM (OR: 0.38,P < 0.001), cardiovascular diseases (CVD)(OR: 0.12, P < 0.001), and lack of a positive family history of HTN in first-(OR: 0.39, P < 0.001) and second-degree(OR: 0.56, P = 0.009) relatives were the main predictors of undiagnosed HTN. Accordingly, male sex(OR: 0.52, P = 0.004), young age(OR: 0.28, P < 0.001), residence in urban regions(OR: 0.30, P < 0.001), BMI ≥ 30 (OR: 1.51, P = 0.044), low-density lipoprotein (LDL) ≥ 130 mg/dL (OR:1.93, P < 0.001), TC ≥ 200 mg/dL (95% CI, 1.47–2.51, P < 0.001), positive history of chronic kidney disease (OR:1.39, P = 0.010 ), and lack of family history of first-(OR: 0.38, P < 0.001) and second-degree (OR: 0.62, P < 0.015) DM were the main predictors of undiagnosed DM.ConclusionOverall, younger participants, those residing in urban areas, those with TC ≥ 200 mg/dL, and those without a positive family history of HTN or DM were at a greater risk of undiagnosed HTN/DM.

Association between chronic kidney disease and cardiovascular disease risk factors in elderly: results from the first phase of Fasa and Shahedieh cohort studies

BackgroundChronic kidney disease (CKD) is associated with increased cardiovascular disease (CVD) risk factors and morbidity in the elderly population. This study aimed to examine the association between CKD and CVD risk factors in the elderly population of Fasa and Yazd (Shahdieh), Iran, using the data from the enrolment phase of Fasa and Shahedieh cohort studies.MethodsWe conducted a cross-sectional analytical study using data from Fasa and Shahedieh cohort studies, which enrolled 1487 and 1507 participants aged over 60 years, respectively. We collected data on demographic and clinical variables, kidney problems, and CVD from the two studies. We estimated the glomerular filtration rate (eGFR) using the modification of diet in renal disease (MDRD) formula and considered values less than 60 ml/min/1.73 m2 as CKD. We used independent t-tests, Spearman’s correlation coefficient, chi-square, one-way analysis of variance, and logistic regression to analyze the data. We performed the analyses using SPSS V. 22.0 software and set the significance level at 0.05.ResultsThe overall prevalence of CKD was 41.9%; 25.7% in women and 16.2% in men. The prevalence of CKD based on reported kidney problems was 1.7%, of which 54.7% were in stage 3 of CKD. Compared to participants in the early stages of CKD, participants in advanced stages had a higher prevalence of diabetes (p < 0.001), hypertension (p < 0.001), ischemic heart disease (IHD) (p < 0.001), and myocardial infarction (p < 0.001). In addition, participants in higher stages of CKD were more obese, had lower physical activity, smoked more, and consumed more opium (p < 0.001).ConclusionOur study showed that more than half of the patients were in stage three CKD, which is an advanced stage of this disease. Diabetes Melitus, hypertension, dyslipidemia, IHD, and myocardial infarction were more prevalent in patients than others. These findings demonstrate the importance of screening for CKD in patients with diabetes mellitus and hypertension. The results also suggest that lifestyle modification and prevention strategies are needed to reduce the burden of CKD and CVD in this population.

Prevalence of anemia and related factors among Tabari cohort population: a cross-sectional study

BackgroundAnemia presents a considerable public health challenge, standing as a leading contributor to elevated rates of mortality and morbidity. Therefore, this study aimed to investigate the prevalence of anemia and related factors among Tabari cohort population.MethodsThis study involved a cross-sectional investigation carried out during the enrollment phase of the Tabari cohort. The Tabari cohort is a subset of the larger nationwide cohort study known as the “Prospective Epidemiological Research Studies in IrAN” (PERSIAN) cohort. The collected data included general information, anthropometric measurements, medical history and blood samples. Anemia was defined as a hemoglobin level less than 13 mg/dL for men and less than 12 mg/dL for women. Data were analyzed using SPSS V.16.ResultsOut of the 10,073 participants included in the analysis, 1,352 individuals (13.4%) were diagnosed with anemia. In the multiple regression analysis, the odds of anemia were significantly 2.31 times in females compared to males, 3.69 times in urban residents compared to rural residents, 1.41 times in social economic categories of IV and 1.35 in social economic categories of V compared to social economic categories of I, 1.70 times in drug abuse compared to non-drug abuse, 0.71 times in body mass index (BMI) categories of 25–29.9 kg/m² and 0.70 in BMI ≥ 30 kg/m² compared to BMI < 25, 0.77 times for triglycerides(TG) > 150 compared to below 150, 0.76 times for total cholesterol(TC) > 200 compared to below 200, 0.83 times for high waist-to-hip ratio (WHR) compared to low WHR, 1.33 times in low High-density Lipoprotein (HDL) compared to high HDL, 1.18 times in diabetics (DM) compared to non-DM, and 1.37 times in individuals with coronary heart diseases (CHD) compared to healthy individuals.ConclusionAnemia was a prevalent condition among Tabari cohort population. Several conditions including female gender, urban residence, Social economic level of IV and V, drug abuse, low HDL, high WHR, DM, and CHD conditions were significantly associated with increased odds of anemia. Furthermore, BMI categories of 25–29.9 kg/m² and ≥ 30 kg/m², high TC and high TG were significantly associated with decreased odds of anemia among this population.

Elite track and field athletes’ perspective and experiences of osteopathic treatments: A descriptive phenomenological study

Background and objectivesDespite widespread osteopathic intervention, elite athletes' preferences for osteopathic care remain unclear, with limited evidence on musculoskeletal management. This study aimed to investigate elite track and field athletes’ perspectives on their experiences of osteopathic treatment to inform the development of integrated models of care. MethodsPurposive sampling was used during the enrolment phase. Semi-structured interviews were utilised to obtain data, and they were first piloted on two participants. A descriptive phenomenological method was used to undertake an inductive analysis of the interviews. Three following interviews were carried out to confirm data saturation. ResultsData saturation was reached with 13 participants (female = 6; male = 7). Participants’ ages ranged from 20 to 36 years old. The analysis showed 1 overarching theme, “Elite athletes look for a trusted specialised osteopath in their team to enhance their awareness and pursuit of specific goals,” 3 themes, and 17 categories. Themes were: “Elite athletes perceive the need to build a helping relationship with the osteopath based on trust”, “Elite athletes expect that the increase in body awareness influences the outcome of the osteopathic treatment leading to performance enhancement, injury prevention and biomechanical adjustments” and “Elite athletes are satisfied and feel more self-confident when they have consistent access to a specifically trained osteopath who works in an interdisciplinary team”. ConclusionResults from the present study can lead to quantitative experimental designs for efficacy studies and integrated models of care that take into account, not just organisational and social factors but also technical factors.

Prevalence of hysterectomy and its determinants in northern Iran: enrollment results of the Tabari cohort study

BackgroundTo the best of our knowledge, no population-based studies have provided insights into the prevalence of hysterectomy and its risk factors among northern Iranian females. Thus, the present study aimed to investigate the prevalence and sociodemographic determinants of hysterectomy in a large cohort of northern Iranian females.MethodsThis cross-sectional study included data from the enrollment phase of the Tabari cohort study (TCS). The TCS consists of 10,255 adults (4,149 males and 6,106 females) aged 35–70 years who reside in Sari, Mazandaran, Iran, of which 6103 females were included in the study. Multiple logistic regression analysis was used to search for hysterectomy determinants.ResultsOur results revealed that the prevalence of hysterectomy among northern Iranian females was 9.7% (595/6103). Additionally, 50–59 (OR: 4.63, 95% CI: 3.57–6.01) and 60–70 (OR: 5.83, 95% CI: 4.28–7.95) age groups, higher socioeconomic levels (OR: 1.66, 95% CI: 1.13–2.42), a history of tubectomy (OR: 1.27, 95% CI: 1.05–1.53), and more gravida (OR: 5.35, 95% CI: 1.62–17.63) were found to increase the odds of hysterectomy, whereas living in mountainous areas (OR: 0.57, 95% CI: 0.43–2.75) and having a job (OR: 0.62, 95% CI: 0.45–0.86) were found to decrease the odds of hysterectomy.ConclusionOlder age groups, living in urban areas, higher socioeconomic levels, not having a job, a history of tubectomy, and more gravida were found to increase the odds of hysterectomy.

Anthropometric Measures, Cardiometabolic and Hepatic Indices, and Cut-off Points for Predicting Type 2 Diabetes Mellitus in Southwest Iran: A Cross-Sectional Study from the Enrolment Phase of the Hoveyzeh Cohort Study

Background: Cut-off points for anthropometric measures associated with diabetes may vary across different ethnic groups. Objectives: This study aimed to identify the optimal cut-off values for these measures and their relationship with cardiometabolic and hepatic indices to predict type 2 diabetes mellitus (T2DM) in southwest Iran. Methods: This cross-sectional study was conducted in Hoveyzeh, Iran, and included a total of 7,300 individuals (1,607 with T2DM and 5,693 healthy participants). Anthropometric, cardiometabolic, and hepatic indices were calculated. Results: The visceral adiposity index (VAI) showed the highest correlation with cardiometabolic indices, such as the cardiometabolic index and lipid accumulation product. The conicity index (CI) had the strongest correlation with hepatic indices, including the hepatic steatosis index and the Alcoholic Liver Disease/Non-alcoholic Fatty Liver Disease (ALD/NAFLD) index. The atherogenic index of plasma was the most significant predictor of T2DM in the Hoveyzeh population for both men (OR: 3.39; CI: 2.38 - 4.81) and women (OR: 5.68; CI: 4.20 - 7.68). The optimal cut-off values for several anthropometric measures were higher in men than in women: BMI (28.0 vs. 25.48), Waist/Height ratio (0.64 vs. 0.56), Weight-adjusted waist index (11.83 vs. 10.76), CI (1.35 vs. 1.29), body roundness index (8.43 vs. 7.33), relative fat mass (44.63 vs. 28.5), and lipid accumulation product (67.23 vs. 67.04). Conversely, the cut-off values for optimal waist circumference (99.45 vs. 98.35), Waist/Hip ratio (0.99 vs. 0.96), VAI (2.22 vs. 2.19), and abdominal volume index (20 vs. 19.6) were higher in women than in men. Conclusions: The atherogenic index of plasma is a highly predictive indicator of T2DM. Our results suggest that novel anthropometric and cardiometabolic indices could serve as accessible and cost-effective strategies for assessing health outcomes related to T2DM.

The prevalence and determinants of diabetes mellitus and thyroid disorder comorbidity in Tabari cohort population

Studies have shown that the co-occurrence of diabetes mellitus (DM) and thyroid dysfunction (TD) exacerbates diabetes complications and imposes a financial burden on the healthcare system. Therefore, this study aimed to investigate the prevalence of TD-DM comorbidity and its associated risk factors. This cross-sectional study was conducted on enrollment phase data of the TABARI cohort population which consisted of 10,255 adults aged between 35 to 70 years old residing in Sari, Mazandaran, Iran from 2015 to 2017. A total of 9939 out of 10,255 individuals (96.92%) entered the study. The prevalence of TD among T2DM patients was 13.2%. The prevalence of T2DM among patients with TD was 9.2%. Furthermore, the prevalence of TD-DM comorbidity in the overall population was 2.2%. Logistic regression analysis revealed that the odds of TD-DM comorbidity was significantly higher in women (OR 2.85; 95% CI 1.58–5.11), in the age group of 60–70 years (OR 9.62; 95% CI 3.69–25.10), in smokers (OR 2.32; 95% CI 1.19–4.52), in individuals with high waist circumference (WC) (OR 2.22; 95% CI 1.32–3.75), in individuals with low high-density lipoprotein (HDL) (OR 1.60; 95% CI 1.20–2.14), in individuals with high total cholesterol (TC) (OR 1.71; 95% CI 1.21–2.41), in individuals with high triglycerides (TG) (OR 1.79; 95% CI 1.27–2.51), and significantly lower in individuals with higher physical activity (PA) (OR 0.67; 95% CI 0.49–0.93). The present study demonstrated a prevalence of 2.2% in patients with both TD and T2DM. Additionally, female gender, older age, smoking, high WC, low HDL, high TC, high TG, and low PA were predictors of TD-DM comorbidity.

Robust biometric identity authentication scheme using quantum voice encryption and quantum secure direct communications for cybersecurity

A significant problem facing cybersecurity is that most client/server identity authentication schemes depend on computational complexity which is recently challenged by the super exponential computational abilities of quantum computers. Quantum cryptography with its quantum mechanics principles solves this problem and provides mathematically un-hackable secure communication for the quantum computers epoch. Biometric authentication has a big challenge related to its protection as it has to be submitted and stored in encrypted form. Unfortunately, most existing biometric cryptosystems rely on classical cryptography, so they are insecure in quantum era. This problem is solved in this paper by introducing a novel three-factor biometric quantum identity authentication scheme combining something you know (password), something you produce (client’s voice), and something you are (client’s face image) is proposed. The scheme consists of two phases: client enrollment and client login/authentication. The methodology is to use in the enrollment phase, two layers of quantum encryption for the client’s voice signal. Each layer consists of two simple quantum circuits of SWAP and C-NOT quantum gates respectively using a different pseudorandom key obtained from a cellular automata (CA) pseudorandom generator. The proposed scheme has many merits. Firstly, it introduces a new design of muti-factors quantum biometric authentication scheme as the biometric voice data is processed, transmitted, and stored at the server database in an encrypted unconditionally secure quantum form which provides parallel processing, real-time communications, inherent level of security against attacks, tamper-proof security and exponential powerful storage capability due to the quantum properties. Secondly, the proposed scheme achieves double-layers security by combing quantum voice encryption and quantum secure direct communication in one process such that the quantum channel eavesdropper cannot obtain any valuable information in case of information leakage. Thirdly, the distribution and management of encryption key problem is solved as there is no need for key exchange prior to communication. Fourthly, it achieves high communication efficiency as although it is a three-factor biometric identity authentication, only one biometric data is sent in quantum encrypted form to the server. Fifthly, the numerical simulations showed that the proposed scheme has large key space, high key sensitivity and more robust performance against different types of attacks compared to other existing classical and quantum voice encryption schemes. Finally, as an identity authentication method, the proposed scheme achieves identification accuracy of 100% with zero False Rejection Rate (FRR) and zero False acceptance rate (FAR) which is perfect.

A population-based prospective study on obesity-related non-communicable diseases in northern Iran: rationale, study design, and baseline analysis.

Iran is facing an epidemiological transition with the increasing burden of non-communicable diseases, such as obesity-related disorders and cardiovascular diseases (CVDs). We conducted a population-based prospective study to assess the prevalence and incidence rates of CVDs and obesity-related metabolic disorders and to evaluate the predictive ability of various CVD risk assessment tools in an Iranian population. We enrolled 5,799 participants in Amol, a city in northern Iran, in 2009-2010 and carried out the first repeated measurement (RM) after seven years (2016-2017). For all participants, demographic, anthropometric, laboratory, hepatobiliary imaging, and electrocardiography data have been collected in the enrollment and the RM. After enrollment, all participants have been and will be followed up annually for 20 years, both actively and passively. We adopted a multidisciplinary approach to overcome barriers to participation and achieved a 7-year follow-up success rate of 93.0% with an active follow-up of 5,394 participants aged 18-90 years. In the RM, about 64.0% of men and 81.2% of women were obese or overweight. In 2017, about 16.2% and 5.2% of men had moderate or severe non-alcoholic fatty liver disease, while women had a significantly higher prevalence of metabolic syndrome (35.9%), and type 2 diabetes mellitus (20.9%) than men. Of 160 deceased participants, 69 cases (43.1%) died due to CVDs over seven years. The most prevalent obesity-related chronic disease in the study was metabolic syndrome. Across the enrollment and RM phases, women exhibited a higher prevalence of obesity-related metabolic disorders. Focusing on obesity-related metabolic disorders in a population not represented previously and a multidisciplinary approach for enrolling and following up were the strengths of this study. The study outcomes offer an evidence base for future research and inform policies regarding non-communicable diseases in northern Iran.

The frequency of asthma and its related factors: results of the enrolment phase of Tabari cohort study

Introduction A large portion of the world’s population has asthma. This study aimed to ascertain asthma prevalence and related factors in the Tabari cohort study (TCS). Methods The TCS included 10,255 35–70-year-olds from urban and mountainous Sari (northern Iran) between June 2015 and November 2017. Education, occupation, domicile, socioeconomic position, history of psychiatric disorders, smoking (including hookah smoking), opium usage, and daily physical activity level were determined. Results The final analysis included 9939 individuals. The asthma rate was 7.4%. Multiple factors increased asthma risk, according to statistical analysis. These factors included being female (OR, 1.337; 95% CI, 1.142–1.565), retired (OR, 1.553; 95% CI, 1.205–2.002), living in the city (OR, 1.268; 95% CI, 1.083–1.484), using opioids (OR, 1.689; 95% CI, 1.299–2.197), having lower socioeconomic status (SES) (OR, 0.723; 95% CI, 0.579–0.903), history of psychiatric disorders (OR, 2.313; 95% CI, 1.826–2.930), and aged 60–70 (OR, 2.325; 95% CI, 1.765–3.064), and BMI above 30 kg/m2 (OR, 1.499; 95% CI, 1.220–1.841). Several factors increased asthma probability in multivariate regression analysis. These factors include being female (OR = 1.389, p = 0.015), ages between 60 and 70 (OR = 2.034, p < 0.001), using opioids (OR = 1.940, p < 0.001), lower SES (OR = 0.738, p = 0.012), history of psychiatric disorders (OR = 2.035, p < 0.001), BMI above 30 kg/m2 (OR = 1.518, p < 0.001), and being a smoker (OR = 1.337, p = 0.056). Conclusion This study has identified that the prevalence of asthma in the Tabari cohort group is high. In addition, it was demonstrated that various factors are related to asthma.

Drug coated balloons in large de novo vessels; fantasy or a reality?

Key points This study by Cortese et al. has shown low rates of clinical outcomes especially target lesion revascularization (9%) in patients treated with Sirolimus coated balloon in large vessels. This is a nonrandomized single‐arm registry and hence significant impact on clinical practice is unlikely to be huge. Head‐to‐head randomized control trials comparing clinical outcomes between drug coated balloon versus drug eluting stents in large vessels is the way forward. Such studies are in the enrollment phase, and we eagerly look forward to the results from these studies.

Kharameh cohort study (KHCS) on non-communicable diseases and preliminary findings of 3-year follow-up

PurposeThe Kharameh cohort study (KHCS) is one branch of the ‘Prospective Epidemiological Research Studies in Iran’, located in the south of Iran. The enrolment phase of KHCS spanned from April...

Treatment access gap during the COVID-19 Pandemic: impact on problematic alcohol use and the moderating roles of perceived stress and resilience.

The COVID-19 pandemic may have interfered with individuals' access to alcohol use disorder (AUD) treatment, but limited research has documented the impact of treatment interference on drinking behavior. This study's purpose was to examine the associations of AUD treatment interference with problematic alcohol use, and the moderating roles of perceived stress and resilience. A cross-sectional survey design was employed. Data were drawn from the baseline assessment of the National Institute on Alcohol Abuse and Alcoholism COVID-19 Pandemic Impact on Alcohol Study. Between June 2020 and March 2021, 288 participants (48.6% female, 51.4% male) responded to key measures of interest by phone and/or through an online survey. Study hypotheses were tested using multiple linear regression models adjusted for demographic characteristics (age, sex, race, ethnicity, years of education, household income, marital status), study enrollment phase, and history of AUD. Self-reported AUD treatment interference was positively associated with problematic alcohol use as measured by the Alcohol Use Disorders Identification Test (b = 2.05, p < 0.001). Significant moderation effects indicated the association between AUD treatment interference and problematic alcohol use was stronger at a high level of perceived stress (b = 3.08, p < 0.001) and was attenuated at a high level of resilience (b = -0.13, p = 0.874). Self-reported AUD treatment interference may indicate interruption to individuals' support systems and highlight the need for continued access to treatment. Fostering positive coping strategies and resilience may help individuals mitigate risks of problematic drinking amidst a public health crisis.

Prospective incidence epidemiology study protocol: conducting active surveillance to assess the burden of Lyme disease (BOLD) in primary care practices in endemic areas of six European countries

IntroductionLyme disease (LD) is the most frequent tick-borne disease in the moderate climates of Europe. This study will inform the phase III efficacy study for Pfizer and Valneva’s investigational Lyme...

Sleep duration and Framingham´s cardiovascular risk score: results from the Hoveyzeh Cohort Study (HCS)

BackgroundCardiovascular diseases (CVDs) are the leading causes of global deaths. So, it is necessary to know the possible risk factors for each region. We aimed to assess the relationship between the risk of CVDs and sleep duration in the Iranian Arab population.MethodsIn this cross-sectional study, data from 8362 participants aged between 35 and 70 from the Hoveyzeh Cohort Study enrollment phase between 2016 and 2018 was analyzed. This study evaluated the association between ten-year CVD risk using the Framingham risk score and sleep duration. Self-reported sleep duration was categorized as short duration (equal to or less than 5 h), standard duration (6–8 h), or prolonged duration (equal to or greater than 9 h). Multivariable logistic regression to adjust for conventional CVD risks was used.ResultsAmong the assessed participants, 4892 (58.50%) were female, and the mean age was 47.93 (9.01). The average sleep duration was 7.59 (1.56) hours. The low, intermediate-to-high, and high CVD risk individuals were 6461 (77.27%), 1185 (14.17%), and 716 (8.56%), respectively. There was a significant relationship between prolonged sleep duration and lower odds of intermediate-to-high CVD risk in males (OR 0.66, 95% CI: 0.49–0.87, P-value: 0.004).ConclusionThe results of our study showed that longer sleep duration has a protective association with the intermediate to high risk of cardiovascular diseases in males. However, long and short sleep durations have no significant relationship with females’ risk of cardiovascular disease.

Blockchain-based biometric identity management

In recent years, face biometrics recognition systems are a wide space of a computer usage which is mostly employed for security purpose. The main purpose of the face biometrics recognition system is to authenticate a user from a given database. Due to the widespread expansion of the surveillance cameras and facial recognition technology, a robust face recognition system required. The recognition system needs to store a large number of training samples in any storage unit, that time hackers can access and control that data. So, Protecting and managing sensitive data is essential object. This requires a technique that preserve the privacy of individuals, maintain data integrity, and prevent information leakage. The storage of biometric templates on centralized servers has been associated with potential privacy risks. To address this issue, we have developed and implemented a proof-of-concept facial biometric identification system that uses a private Blockchain platform and smart contract technology. So, the proposed approach is presented a secure and tamper-proof from data breaches as well as hacks with data availability, by using the Blockchain platform to store face images. This paper aims to utilize Blockchain technology to identify individuals based on their biometric traits, specifically facial recognition system makes it tamper-proof (immutable) ensuring security. The system consists of enrolment and authentication phases. Blockchain technology uses peer-to-peer communication, cryptography, consensus processes, and smart contracts to ensure the security. The proposed approach was tested on two popular datasets: CelebFaces Attributes (CelebA) and large-scale face UTKFace datasets. The experimental results indicate that the system yields highly performance outcomes, as evidenced by the Equal Error Rate (EER) values of 0.05% and 0.07% obtained for the CelebA and UTKFace datasets, respectively. The system was compared to three baseline methods and scored the lowest Equal Error Rate.

Noise at school: any implications for teachers’ health? Findings from the French CONSTANCES study

Abstract Background While noise at school is a well-known issue concerning students’ well-being, data on its potential effect on teachers’ health are limited. Methods Among teachers (n = 13,843) and a sample of non-education employees (n = 34,338) participating in the French CONSTANCES cohort (enrollment phase 2012-2020), we evaluated self-reported noise exposure at inclusion with the question “do you work in an environment where you sometimes have to raise your voice to talk to people 2 or 3 meters away?”(yes/no). First, we compared proportions of teachers who reported noise exposure to different groups of non-education employees. Second, among teachers, we cross-sectionally assessed, using logistic regressions adjusted for potential confounders, how combined exposure to occupational noise and work-related stress (defined alternately as effort-reward imbalance or tension with the public) was associated with two health indicators: self-perceived health (poor vs. good) and depressive symptoms (Centre of Epidemiologic Studies Depression scale, sex-specific cut-points, high vs. low to moderate), respectively. Results Thirty-two percent of teachers declared working in a noisy environment compared to 14% among non-education employees included. Primary school teachers were particularly exposed (42.6%), in comparable proportions to manual workers (43.3%). Among teachers, noise alone was not significantly related to self-perceived health but slightly associated with higher odds of depressive symptoms. We further observed evidence of an interaction effect on depressive symptoms between noise and tension with the public. Conclusions This large study highlights that noise is a common occupational exposure among teachers in France. As it may interact with sense of physical insecurity to weight particularly on mental health, our results advocate for a better considering of such every day and long-term exposure on teachers’ health. Key messages • Noise is a common occupational exposure for French teachers. • As it may interact with work-related stress to affect mental health, noise at school should not be overlooked as an occupational hazard.

Prevalence of metabolic syndrome and its association with oral health: First results from the Kurdish cohort study.

Investigate the association between oral and dental health (ODH) and metabolic syndrome (MetS) in adults aged 35-70 years. The study utilized data from the enrollment phase of Dehgolan prospective cohort study in the west of Iran. A cross-sectional assessment was conducted on a total of 3996 participants, involving a comprehensive oral examination and the assessment of their oral hygiene behavior (ODH). MetS was defined according to the updated National Cholesterol Education Program Adult Treatment Panel III. Logistic regression used to calculate odds ratios (ORs) and 95% confidence intervals (CIs), adjusting for sociodemographic characteristics. MetS was more prevalent among those who not daily brushing and flossing. Participants with missing teeth (MT) show higher prevalent of MetS. Being female, lower age, illiteracy, family history of diabetes, low physical activity, and salt at table were independently associated with increase odds of MetS (p < 0.05). Odds of MetS were significantly decreased with use flossing (OR = 0.75; CI = 0.60-0.93), decayed (OR = 0.83; CI = 0.72-0.97), filled (OR = 0.84; CI = 0.71-0.99), and increased with MT (OR = 1.45; CI = 1.16-1.81) as long as adjusted for ODH factors. When other potential confounder such as sociodemographic, personal and nutritional habits were adjusted, daily flossing was the only factor that still statistically decreased (OR = 0.79; CI = 0.62-0.99) the odds of MetS. Daily flossing was the only factor that independently associated with MetS. Relationship of other ODH factors with Mets were confounded by sociodemographic characteristics of the participants.